HomeMy WebLinkAbout26-4908 TFFiNouCERA II I III 1 III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STIR FIRE CASE
EET ❑
2s-4so8 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 �2$
TRIBAL UNITS 01 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CtLLISION' 06 - 1-- 2026 1252 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 8TH ST BLOCK NO. e✓ 4105
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:4259850602 30
6� LAST NAME WILLIAMS FIRSTNAME COLLEEN MIDDLE S 1 1 2 31
INITIAL
STREET ❑ 4102 NE 7TH ST CITY RENTON ST WA ZIP 980594745 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES 1/ NO
8❑ DRIVERS
E#
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U SE CLASS 6 WRIST PAINJURIES z❑
3
10❑ P1 ATNES# CWF7454 sTAr WAv N# 3GNAXPEG6TL333302
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12❑ vIN#' VIN#
FROM
34
13� VEH.YEAR2O26 MAKE CHEV MODEL EQU/NO STYLE VEHICLE TOWEDNOOpLSABLIN TQyED.BLRS YES[:] No
HICLE
DAMAGE IILLJJII ttSSAA1IVV/it�66
REGISTERED OWNER INFO LARRYBROWN4f02 NE 7TH ST RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE INSURANCE CO STATE FARM
IN EFFECT &POLICY# 9TOP
vEcnLLv Hla.e 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ LE STANDING 8 6
UNIT 02 MOTO
R ❑ CYCLE PEDAL- ❑ PEDESTRIAN ❑ PROPERTY ❑ DYES H OLD METVEHIC PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
17❑ NEW ADDRESS❑' CITY ST ZIP ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX MMDDYY -�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE VIN# 41
PLATE#
42
22❑ PIR I I TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH16973
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4908
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) DUIMOV/C ANGELIE
(LAST FIRST,
ADDRESS&PHONE# D O.B.
RENTON 4252044808 SEX' U MMDDYYYY - -
PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓S UNIT# ! POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
C.ARNOLD 06-23-26 02:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 71112026 6:33:51 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 12:53 PM TIME POLICE ARRIVED',12:58 PM
PART I PAGE IT]OF 4�
REPORT NO. EH16973 CASE# 26-4908 OF COLLISION
06/23/26 12:52
OF CbLLI510N
NARRATIVE
RTF 26-4908
On 6/23/2026 at 1252 hours I was dispatched to a single motor vehicle collision at 4105 ne 8TH St in
the City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that she was traveling West on NE 8th St at around the 4100 block.
Collision
Driver 1 stated she blacked out and when she came to, Unit 1 was resting on it's passenger side on
the South side of the roadway.
Per a video from a nearby school, it showed Unit 1 slowly drift from it's lane and into the oncoming
lane of travel. It then showed Unit 1 collide with the rocks on the South side of NE 8th St. This caused
Unit 1 to partially roll and come to rest on it's passenger side doors.
Injuries
Driver 1 complained of right hand pain, and was transported to valley medical center. Driver 1 later
displayed syncope while in the ambulance following the collision. Based upon this and the fact that
Driver 1 stated that she blacked out, it appears that this collision was related to a medical issue.
Vehicle Disposition
Unit 1 was impounded by Bankers
Final Disposition
This report is to document the collision and for insurance purposes.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 14:18 on 6/23/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORTNO.! EH16973 CASE# 26-4908 DATE AND TIME 06/23/2612:52
OF COLLISION
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PAGE 4 OF 4