HomeMy WebLinkAbout26-4276 STATE OF II I III 1 IIIllI111IN II II I REPORT NO. EH16967 170
27
COLLISION REP FIT 1591971
SASE 26-4276 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 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#
cowsloN 06 - 1-- 2026 1526 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SW 43RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a LIND AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2532669620 0 11
30
6 LAST NAME TOOR FIRSTNAME LAKHBIR MIDDLE S 1 1 2 31
INITIAL
STREET ❑ 12805 115TH AVENUE CT E CITy PUYALLUP ST WA 2jp, 983743123 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 1 RESTR 9 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� D45614C sTArI WAvIN# 4V4NC9EH9GN937009
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR N MAKE VOLT MODEL 15 STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 DAMAGE YES NO ✓ YES[:] No
✓
REGISTERED OWNER INFO LAKHBIR TOOR 1.01115THAVENUE CTE PUYALLUP WA 983743123 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 LIABILITY INSURANCE z GREAT WEST GRT45326A
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 1060TTOM 5 35
LEGALLY YES No CITATION# 6A0254822,6A0254822 FAIL YIELD LEFT TURN MOTOR
15❑ 1ND'ING 6
UNIT VE IMOTOOR CYCLE ❑ PEDESTRIAN ❑ PROPERTY ❑ DOWNER, YES✓ NO�TFIRrIOLDMET PHONE
16 a
LAST NAME IVERSON FIRST NAME ERIN MIDDLE M
INITIAL
17❑ STREET ❑', 21370 103RD PL SE CITY' KENT ST WA ZIP 980312056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t- l NO❑
19 LDIIVEW # STATE WA ]SEX IF M .C.B. 01 10 _ 1967 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BSK6621 TAre WA VIN1i 2T3DWRFV5LW075834
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE TOYT MODEL RAV4 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO DEWAYNECAMPBELL 21370103RDPL SE KENT WA 98031 D:4253016252 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE I POLICY#E CO SAME.IN 1UQ,
5'E""LE ❑ ,J� CITATION# CHARGELEGALYYES N`L J25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH16967
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4276
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
POS. 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.
M.LEVERTON 06-02-26 05:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 71112026 11:34:51 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 3:28 Pry TIME POLICE ARRIVED 3:40 PM
PART I PAGE IT]OF 5�
REPORT NO. EH16967 CASE# 26-4276 OF COLLISION
06/02/26 15:26
OF CbLLI510N
NARRATIVE
unit 2 maroon lane 1 lind/43 unit 1 gold left turn to lind nb on yellow
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash at the intersection of SW
43rd St at Lind Ave SW. I contacted both drivers at 4130 Lind Ave SW.
I contacted the driver of unit 2 who told me she was westbound lane 1 SW 43rd St on her solid green
light when unit 1 turned left in front of her path with no escape, where he contacted her vehicle. She
did not complain of injury and damaged did require a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. He told me he was not wearing his
glasses/corrective lens as required under his restrictions for his CDL. He told me he observed his
yellow flashing light facing eastbound in the left turn lane for a northbound/left turn to Lind Ave SW.
He told me he believed unit 2 was 100 feet away when he initiated his left turn in his long 3 axle
condo/sleeper semi tractor/truck. He did not complain of injury and damages did not require a tow
truck. 100 feet at 35 mph puts unit 2 traveling 51.31 feet in one second. This is simple math putting
unit 1 reaction/perception time well behind a stopped position to movement and safely clearing an
intersection without creating an immediate hazard.
To reference RCW 46.61.185: (1) The driver of a vehicle intending to turn to the left within an
intersection or into an alley, private road, or driveway shall yield the right-of-way to any vehicle
approaching from the opposite direction which is within the intersection or so close thereto as to
constitute an immediate hazard. This may have be pronounced with his admission to not wearing his
corrective lenses as required by his CDL status. He told me he had them hanging on his shirt/collar
and did not like wearing his glasses all day while driving his commercial vehicle.
I cited Unit 1 ref RCW 46.61.185 FTYROW left run 2 vehicle crash and ref RCW 46.20.041 fail to
follow restriction requirement, no corrective lenses at the time of the crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 6/2/2026
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EH16967
r` POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 26-4276
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT# 1 USDOT 1754891 ICC# VEHICLE TYPE 3 CARGO BODY 9
TYPE
2 ❑ 1 28
CARRIER
NAME NITS SERVICES INC
.......
3 CARRIER
ADDRESS PO BOX 1226
CITY KENT ST WA ZIP'', 98035
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 03 GI80000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREETIAL
❑
16 NFln+AnnRFs.� CITY'. ST SIP
CDL IGNITION REDUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
X LEVERTON 06-02-26 05:14 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
BADGE O#I' APPROVED
/126 ORID# 2517 WA0171300 ACOBS 71/2 PAGE F41 OF F
3000-345-013(R 11118)
REPORTNO.! EH16967 CASE# 26-4276 DATE AND TIME 06/02/2615:26
OF COLLISION
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PAGE 5 OF 5