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Home My WebLink About26-4859 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 INTERSTATE ❑ CITY STREET FIRE ❑ CASE 2s-4sss 2 RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28 UNITS RESERVATION I I STRUCK z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION' 06 - 1-- 2026 1620 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 4100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 100 00 FEET e MILES S ❑ W e UNION AVE NE 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:3473109139 0 11 30 6 LAST NAME DIAZ PRIAS FIRST NAME MAYER ALFREDO MIDDLE 1 2 31 INITIAL STREET ❑, 3511 NE 11TH PL CITY RENTON ST WA Zjp, 98056 z 'NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE C$G6297 sTArI WAurN# 4$36MBC68C3027992 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. RLR 1 7 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34 13 9 2012 SUBA LEGACY SD DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2033366600 3 4 IN EFFECT &POLICY# 9TOP ❑ LEGALLY LE CHARGE 1 5 36 15 2 VE"'C NG YEs No clTAnoN# 6A0215031 FLD TO Y►ELD FROM DRIVEWAY OR o aorrob MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE (SNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YEs NO V D:2533319865 IF VEHICLE CYCLE OWNER 16 a LAST NAME SIMMONS FIRST NAME OLLINA MIDDLE C INITIAL 17 NEW STREETRE— 650 DUVALL AVE NE#S1612 CITY' RENTON ST WA ZIP 98059 37 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NoF,/ 19 DRIVER'S STATE WA ]SEX IF D.C... 04 09 _ 1996 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑LICENSE I 21❑ PLA E# CSG7618 TArE 41 WA VIN# 19XFC1F93HE213122 1 42 22❑ PLATE# STATE PLATE ILER# STATE TRLR 23❑ VIN#. N#. 43 RLR 'I GI VEH YEAR 2017 MAKE HOND MODEL CIVIC STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY OV HYES NO 1/ 44 24❑ YES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGED AREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 864441780IN STOP 5 VEHICLE YES[:] ,.I—I CITATION# CHARGE to BOTTOM LEGALLYN 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 J.CARSTENSEN 11648 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EH15508 COLLISION REPORT III III III III III 111 1591972 CASE# 26-4859 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SIMMONS SANIYYA (LAST FIRST, ADDRESS&PHONE# D O.B. ' 650 DUVALL AVE NE#S1612 RENTON WA 98059 SEXi F MMDDvyvv 03 - 20 - 2014 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑ 2 POS. 3 2 4 1 USE 2 CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) ALI KHALIL ADDRESS&PHONE# D O 8 650 DUVALL AVE NE S1612 RENTON WA 98059 SEX/ M MMDDvvvv25 _ 2025 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER Z WITNESS❑ UNIT# 2 POS 7 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) ALI KHADIJAH ADDREss&PHONE# 650 DUVALL AVE NE S1612 RENTON WA 98059 SEX M I. _ 01 _ 2024 MDDYYYY PASSENGER WITNESS UNIT# ! 2 SEAT 1 9 AIRBAG 2 RESTR. 10 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES ❑ POS. USE CLASS NARRATIVE' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.CARSTENSEN 06-21-26 05:39 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE NICOLAS SANGDER 11350 1 6/25/2026 8:50:59 PM BADGE OR ID# 11648 OR]# ': WA0171300 TIME POLICE DISPATCHED 4:29 Pry/ TIME POLICE ARRIVED',4:23 PM PART I PAGE IT]OF 5� STATE OF POLICETRAFFICN CORRECTION REPORT NO. EH15508 COLLISION REPORT III III III III III 111 1591972 CASE# 26-4859 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME(LAST FIRST,MIDDLE INITIAL) ALI AYDEN ADDRESS&PHONE# 650 DWAL!AVE NE S1612 RENTON WA 98059 SEX M MMDOYyry 04 - 08 - 2020 PASSENGER Z WITNESS❑ UNIT# 2 PQS 8 AIRBAG 2 RESTR. 4 EJECT ? 1 H U EET 2 INJURY 1 NATURE OF INJURIES NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYVYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.Q.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.CARSTENSEN 06-21-26 05:39 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE NICOLAS SANGDER 11350 1 6/25/2026 8:50:59 PM BADGE OR ID# 11648 OR]# ': WA0171300 TIME POLICE DISPATCHED 4:29 PM TIME POLICE ARRIVED',4:23 PM PART I PAGE 3�OF 5� TIME REPORT NO. EH15508 CASE# 26-4859 OF COLLISION06/21/26 16:20 NARRATIVE On 6/21/26 at about 1621 hours I was working uniformed patrol in my unmarked patrol vehicle when I was dispatched to a collision at NE 4th ST/ Union Ave NE in the City of Renton, King County, WA. I contacted the driver of Unit 1, who was identified by his WADL, and he relayed the following via Language Line for Spanish: Unit 1 was in the parking lot area near Autozone (4260 NE 4th ST) at NE 4th ST, waiting to turn onto NE 4th ST. Unit 1 said a vehicle in the far lane from him let him in. As Unit 1 pulled into NE 4th ST, he was hit from the left side from Unit 2. No injuries reported. There was damage to the left side of Unit 1. I contacted Unit 2, who was identified by her WADL, and she relayed the following: Unit 2 was driving westbound on NE 4th ST in the 4100 block, in the right lane. All of a sudden, Unit 1 pulled out in front of Unit 2. Unit 2 could not stop in time and was traveling about 35 MPH. Unit 2 collided with Unit 1. No injuries were reported to any occupants of Unit 2. There was minor damage to the front end of Unit 2. Both parties were given a business card with the case number. Infraction #6A0215031 was sent via Court Mail to Unit 1 for Failure To Yield Right of Way When Entering Roadway. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing information provided by me is true and correct. Electronically signed: J. Carstensen #11648 PAGE 4 OF 5 REPORT NO.! EH 15508 CASE# 26-4859 DATE AND TIME 06/21/26 16:20 OF COLLISION } 5 } PAGE 5 OF 5