HomeMy WebLinkAbout26-5035 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 26-5035 2 0 7
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 0 4 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION' 06 - 1-- 2026 2019 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
N 3RD ST BLOCK NO. e✓ 1100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S ❑ W e PARKAVEN
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2064123917 0 11
30
6� LAST NAME BOSCH FIRSTNAME NIKKIA MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 614 VALLEY ST APT A CITY SEATTLE ST WA ZIP 98109 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs 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 2❑
3
10 9❑ Pi aT�S� CWG3590 sTArI WAVIN# WDDGF54X38F058622
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 1 2008 MERZ C300 SD DAMAGE YES NO YES❑ NO✓
REGISTEREDOWNERINFO MAKOTOWATANABE775216TH AVE NW SEATTLE INA 98117 D:2067432285 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NPOLICY E CO BRISTOL WEST GOI-7652541.00 4
LI EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO CITATION# 6A0002942 FOLLOW VEHICLE TOO CLOSELY <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE i ❑ ❑ OWNER ❑ YES 1/ NO D:2533590718
16 a
LAST NAME GREEN FIRST NAME STANLEY MIDDLE 1p
INITIAL
17 STREET❑ NEW ADORE57 5001 YEW LN SW CITY LAKEWOOD ST WA ZIP 98499 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19[—] LDI IVER # STATE WA SEX DDY
M M D.O.B.
O6 1_ 17 _ 2002 39
20 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HE 2 INJURY 6 NATURE of INJURIEs 40
USE CLASS HEADACHE
❑LICENSE I 21❑ PLA E# CWT6344 TArE WA VIN 1t WBAGV8C08LBP48625 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2020 MAKE BMW MODEL M85OX1 STYLE SO DAMAGE TOWED TOO✓
24❑ fj
YES BLIN YE NO 1/
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE I PORGY#E CO PATRIOT GENERAL 11410920075 1 970E
IN EFFECT
vEwCLe ❑ ,J� CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N J
$ '
7JUS
NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KAUPPILA 12883 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH16069
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5035
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WATANABE MAKOTO D
(LAST FIRST,
ADDRESS&PHONE# D O.B.
7752 16TH AVE NW SEATTLE WA 98117 2067432285 SEX M MMDDYyry 11 - 24 - 2005
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O 13
SEXI MMDDVYYV
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YVYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
26-05035
On 06/27/2026, 1 was working as a uniformed police officer for the city of Renton. At approximately
2019 hours, I was dispatched to an injury motor vehicle collision at N 3rd St and Park Ave N. Portions
of my involvement in the incident were captured on my department-issued bodycam. Any statements
referred to have been paraphrased and summarized.
I contacted the involved parties in the parking lot at Crawfish House, 247 Park Ave N. The driver of
unit 2 told me that he was going east on N 3rd St, driving straight ahead. He had to brake for the
vehicle in front of him when unit 1 suddenly struck him from behind. This driver was evaluated by
Renton Regional Fire Authority for what he described to me as a headache.
The driver of unit 1 told me that the collision occurred because she was unable to stop in time before
colliding with unit 2, which braked suddenly.
I observed that the rear of unit 2 suffered noticeable damage as a result of the collision. Unit 1
sustained similar damage to the front.
I was sent a video of the collision by Officer Mello, which was taken by a witness. Upon watching it,
saw that the collision played out under circumstances similar to how it was described to me by
involved parties.
The driver of unit 1 is the proximate cause of this collision. This is due to following unit 2 too closely,
leaving them with not enough time to stop before a collision occurred. I cited the driver for violation of
RCW 46.61.145-following too closely (cite #6A0002942).
Nothing further.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JUSTIN KAUPPILA 06-27-26 11:45 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
GLENN LATRONICO 13151 1 6/28/2026 4:37:43 AM
BADGE OR ID# 12883 ORI# WA0171300 TIME POLICE DISPATCHED 8:99 Pry] TIME POLICE ARRIVED i 8:22 PN1
PART B PAGE IT]OF 3�
REPORT NO.! EH16069 CASE# 26-5035 DATE AND TIME 06/27/26 20:19
OF COLLISION
t �
4 l �5 ht
mm ra
t �r
Rows z
._
v
4.
v
t
i
k
3
ily�Xd� ij: t
t �
a�
gg
ti
tl
i Ar
PAGE 3 OF 3