HomeMy WebLinkAbout26-4882 TFFiNouCERA II I III 1 III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 26-4882 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I 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 1409 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 7TH ST
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES
NO ,/ D:2062409548 0 11
30
6❑ LAST NAME ASHFORD FIRSTNAME ALAN MIDDLE C 1 2 31
INITIAL
STREET ❑, 13420 REINDEER LN SIN CITY PORT ORCHARD ST WA 2jp, 98367 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'M MID
-O B 10 1— 11 — 1979 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� D17949H sTAT� WAVIN# 1D7RV1CT5AS136575
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR 1 5 33
12 0 0 VIN#' VIN#
ROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34
13 A 2010 DODG RAM PK DAMAGE YES NO YES[:] No✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# OP MOT VEH W/OUT INSURANCE, )o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:7783182951
16 a
LAST NAME ATIENZA FIRST NAME ELMER MIDDLE
INITIAL
17 STREET NEW ADOREs�' 757 29TH AVE E CITY VANCOUVER BC ST BC ZIP 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER'S STATE BC SEX M I D.C.B. 05 _ 18 _ 1968 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 2 EJECT 1 USE CLASS ❑
21❑ LICENSE I VG157L TATe BC V IN# 5N1AT2MV7LC744268
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2020 MAKE jyl$$ MODEL ROGUE STYLE UT DAMAGE TOWED NOO✓ BLIN TOWED BY vHyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU&PORGY#E CO INSURANCE COMPANY OF BC 9KYYJ I STOP
IN EFFECT
VE"LE ❑ Nu,J CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
SlTIVEN/TAMAIVENA 12812 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH15578
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4882
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SAL/M JIMMY S
(LAST FIRST,
ADDRESS&PHONE# D.0.B.
6719 TYNE ST VANCOUVER BC BC 6047247431 SEX M MMDDYYYY 02
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS, 3 2 4 1 USE CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) MAALA-SALIM PATRICIA A
ADDRESS&PHONE# DOB
6719 TYNE ST VANCOUVER BC BC 7788617183 SEX IF MMDDYvvv 03 - 13 - 1965
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER �WITNESS❑ UNIT# 2 POS. 9 AIRBAG'2 RESTR. 4 EJECT 1 USE CLASS MINOR NECKINJURY
NAME
(LAST FIRST,MIDDLE INITIAL) ATIENZAA LILIBETH
ADDRESS&PHONE# 757 29TH AVE E VANCOUVER BC BC 7783182956 SEX F D.o.B. 12 _ 18 _ 1969
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 7 AIRBAG 2 RESTR. 4 EJECT 1 HELMET NJURY 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.
S/TIVENI TAMAIVENA 06-24-26 01:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
D.SKELTON 9139 6/26/2026 4:01:47 AM
BADGE OR ID# 12812 OR]# ! WA0171300 TIME POLICE DISPATCHED; 2:11 PM TIME POLICE ARRIVED:2:21 PM
PART I PAGE IT]OF 4]
REPORT NO. EH15578 CASE# 26-4882 OF COLLISION
06/22/26 14:09
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.
26-4882
On 06-22-2026, at 1409 hours, I was dispatched to an accident located at S 7th St and Rainier Ave S,
within the City of Renton, King County, State of Washington.
Unit 1 is Ashford, Alan C (DOB 10-11-1979), confirmed by his WA Doi photo. Alan is the
driver/register owner for the 2010 Dodge Ram 1500 Jeep bearing license plate WA/D17949H.
Unit 2 is Atienza, Elmer (DOB 05-18-1968), confirmed by her British Columbia, Canada, Doi photo.
Elmer is the registered owner and driver of the 2020 Nissan Rogue bearing license plate British
Columbia/VG15L.
Unit 2 was occupied by 3 more Canadian passengers. All subjects were identified by their British
Columbia IDs and where they sat in the vehicle:
Drive side passenger- Salim, Jimmy S (DOB 02-04-1964), no injury.
Left passenger- Atienza, Lilibeth (DOB 12-18-1969), no injury.
Right passenger- Maala-Salim, Patrica A (DOB 03-13-1965), complaint of pain in her neck from the
collision.
Unit 1 stated that he was in lane 2 on Rainier Ave S, headed southbound, approaching S 7th St. He
stated that he had a busy day with family matters. Unit said that he was on his phone and looked up
and did not see Unit 2 stop, which caused him to strike Unit 2. Unit 1 admitted that he had caused the
Collison due to being distracted by his phone.
Unit 2 stated that he was in lane 2 traveling southbound on Rainier Ave S approaching S 7th St when
he was struck by Unit 1.
The collision details: Unit 1's front bumper struck Unit 2's rear bumper damages are minimum.
I completed a sector collision report. I gave Unit 1 and Unit 2 their information exchange.
Unit 1 will be cited for RCW 46.61.672 (using a phone while operating a vehicle) and 46.30.020 (no
insurance), which he understood.
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 24, 2026, at 1200 hours, Renton, WA.
PAGE 3 OF 4
REPORTNO.! EH15578 CASE# 26-4882 DATE AND TIME 06/22/2614:09
OF COLLISION
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