HomeMy WebLinkAbout26-4873 TFFiNouCERA II I III 1 III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 26-4873 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFH1C;l F ❑ LOCAL AOENC 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION 06 - 1-- 2026 0841 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
WELLS AVE S BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 4TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255286483 0 11
30
6❑ LAST NAME KNOEDLER FIRSTNAME SHERRIE MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 3151 NE 16TH ST 220 CITY RENTON ST WA ZIP' 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'F MID
.O B 01 1— 02 — 1947 2 32
INJURY —, [NATURE OF
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 H U EETCLASS 7 SCRAPEDINJURIES LEFTARM z❑
3
10 2❑ PI ATE14 AEL1785 sTAr WA uN#' 1G8Al54F142198929
- TRAILER STATE PL TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 5 1 34
13 A 2004 SATU ION SD vES 0NO agW�MEYERS TOWING ves❑ No
DAMAGE
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14[Al
LIABILITY INSURANCE INSURANCE CO STATE FARM 127-3059-001.47B 4
LI EFFECT &POLICY# TOPVEHicLE CHARGE 36
LEGALLvYes❑NO CITATION# <1�3
OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2062284083
16 a
LAST NAME DIRIE FIRST NAME SUNDUS MIDDLE A
INITIAL
17 NEW ADDRES�' 14814 2STREET 6TH LN S CITY SEATAC ST WA ZIP 98104 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK vEs❑NOF YEs❑NOF,/
19 D IVEW #
INJURY 7 NATURE OF INJURIES 40
20 F1 ON DUTY[:I]
STATUS AIRBAG,2 RESTR 4 EJECT 1 USE CLASS LEFT KNEEAREA
❑ 41
21❑ PLATE# BOH2464 TATE WA VIN1i 5YFBURHE4FP354099 1
42
22❑ PIR ILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2015 MAKE 7'Dy7- MODEL CORO!! STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED By vHyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 512-0783-DO4-47AIN 1 9TOP 5
VE"LE ❑ N`L J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
SlTIVEN/TAMAIVENA 12812 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH15577
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4873
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.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.
SITIVENI TAMAIVENA 06-24-26 01:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 6/26/2026 4:01:02 AM
BADGE OR ID# 12812 OR]# ! WA0171300 TIME POLICE DISPATCHED; 8:56 AM TIME POLICE ARRIVED:9:00 AM
PART I PAGE IT]OF 4�
REPORT NO. EH15577 CASE# 26-4873 OF COLLISION
06/22/26 08:41
OF CbLLI510N
NARRATIVE
During this incident, I was equipped with a body-worn camera. It is important to note that the camera
may have captured things I did not perceive, and I may have perceived things not captured by the
camera. This report is intended as a summary of events to the best of my recollection and perception
of what occurred. I have paraphrased conversation(s) and may not include an exact sequencing of
events. Any inaccuracies, omissions, or mistakes are inadvertent.
26-4873
On 06-22-2026, at 0841 hours, I was dispatched to an unknown injury accident located at Wells Ave
S and S 4th St, within the City of Renton, King County, State of Washington.
Unit 1 is Knoedler, Sherrie L (DOB 01-02-1947), confirmed by her WA Doi photo. Sherrie is the
driver/register owner for the 2004 Saturn Ion bearing license plate WA/AEL1785.
Unit 2 is Dirie, Sundus A (DOB 10-06-1999), confirmed by his WA Doi photo. Dirie is the registered
owner and driver of the Green Toyota Corolla bearing license plate WA/BQH2464.
Unit 1 stated that she was on S 4th St approaching Wells Ave S, which is a 4-way stop sign. She
stated that she stopped at the stop sign and proceeded to cross Wells Ave S when all of a sudden
she was struck by Unit 2. Unit 1 stated that she did not see her vehicle.
Unit 2 stated that she was traveling northbound on Wells Ave S, approaching a stop sign on S 4th St.
She stopped at the stop sign and observed Unit 1 approaching the stop sign on S 4th St. She stated
that she noticed that Unit 1 was driving "recklessly". As Unit 1 approached her stop sign, she
observed her stop several times at the stop sign, but did not proceed across Wells Ave S. The unit
she started was halfway past S 4th St. Unit 2 stated that that was when she was struck by Unit 1.
The collision details: Unit 1's front bumper struck the middle driver's side of Unit 2's vehicle.
Injury: Unit 1 had a scrape on her left forearm. Unit 2 had a complaint of pain in her left knee. They
did not want to be seen by Fire.
I completed a sector collision report. I gave Unit 1 and Unit 2 their information exchange.
This concludes my report.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer Si. Tamaivena #12812,
June 22, 2026, at 1651 hours, Renton, WA.
PAGE 3 OF 4
REPORT NO.! EH15577 CASE# 26-4873 DATE AND TIME 06/22/26 08:41
OF COLLISION
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