The URL can be used to link to this page

Home My WebLink About26-4881 TFFiNouCERA II I III 1 III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 SASE 26-4881 2 INTERSTATE ❑ CITY STREET ❑ FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ HIT 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# ❑ COLLISION'. 06 - 1-- 2026 1300 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE S BLOCK NO. e✓ 743 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 5 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:2064454992 1 3 30 6� LAST NAME SEYDUZOV FIRSTNAME ANTON MIDDLE 1 2 31 INITIAL STREET ❑, 16012 SE RENTON/SSAQUAH RD CITy RENTON ST WA ZIP' 980596216 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 Fl PI ATE 14 52866D STATE WA V N#' 2NP3HN8XOBM118052 TRAILER 73100D STATE WA TRAILER STATE 11 0 0 PLATE# PLATE# Rom ro TRLR TRLR 7 7 33 12 0 0 VIN# VIN#' 2011 PTRB 348 CC plsA ❑ RO�34 ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE 13 A DAMAGE YES NO YES NO✓ REGISTEREDOWNERINFO CITYSEATTLEFFDPOBOX94689 SEATTLEWA98124 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ UABILI INSURANCE NSURANCE CO CITYOFSEATTLE SELFINSURED 3 IN EFFECT &POLICY# 9TOP VEHICLe CHARGE 5 36 LEGALLv YeS❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066977645 16❑ LAST NAME HARRIS FIRST NAME WILLIAM MIDDLE L INITIAL 17 STREET ❑ 325 WASHINGTON AVE S#397 CITY KENT ST WA ZIP 980325767 37 NEW ADDRESS I I I I I ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICALt—T�RANSFORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs I I No� YEs t l No❑ 11 19[ LICENSE# STATE WA SEX M M D.O.B. 08 _ 11 1962 39 WELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 9 CLASS 1 ❑ 21❑ LICENSE I CR66039 TATe WA VINE 3N1CN7APXCL940562 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. TOWED BY Gov HI 44 VEH YEAR 2012 MAKE jyl$$ MODEL VERSA STYLE DAMAGE TOWED NOO✓ BLIN YES NO 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO IGD VE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PART A PAGE 01 OF C7 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EH16971 COLLISION REPORT III III III III III 111 1591972 CASE# 26-4881 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. C.ARNOLD 06-22-26 04:46 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 7/1/2026 6:34:52 AM BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 4:04 Pry TIME POLICE ARRIVED',1:06 PM PART I PAGE IT]OF 5� REPORT NO. EH16971 CASE# 26-4881 OF COLLISION 06/22/26 13:00 OF CbLLI510N NARRATIVE CC 26-4881 On 6/22/2026 at 1304 hours I was dispatched to a motor vehicle collision at Walmart located at 743 Rainier Ave S in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that he was parked and stopped within a parking stall facing North in the Walmart parking lot. Driver 1 stated that he was in the Walmart parking lot attempting to perform a u-turn to exit the lot onto SW 7th St. Collision Driver 2 stated that while parked, Unit 1 drove behind him and the trailer from Unit 1 dragged and collided with the rear passenger side bumper of Unit 2. Driver 1 stated that he thought he had clearance and the trailer from Unit 1 dragged and collided with the rear passenger side bumper of Unit 2. Injuries None reported. Vehicle Disposition Unit 1 was operational and Unit 2 appeared operational, however Driver 2 remained on scene to call a private tow later possibly. Final Disposition This collision occurred on private property and I am unable to determine proximate cause. This report is for insurance and documentation purposes only. 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 13:41 on 6/22/2026 in the City of Renton, King County, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EH16971 r` POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 26-4881 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT# 1 USL70T ICC# VEHICLE TYPE 9 CARGO BODY 5 TYPE 2 ❑ 1 28 CARRIER CITY OF SEATTLE FFD NAME 3 CARRIER ADDRESS PO 80X 94689 CITY SEATTLE ST WA ZIP'', 98124 4 ❑ NAME # PLACARD: :❑ NAME IF NO NUMBER SOURCE 3 AXLES 02 GI35050 + 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 INTERLOCK 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. C.ARNOLD 06-22-26 04:46 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 12509 O#I',WA0171300 JACOBS 7/1/2026 PAGE F OF 3000-345-013(R 11118) REPORTNO.! EH16971 CASE# 26-4881 DATE AND TIME 06/22/2613:00 OF COLLISION n� t } i a 4 x 1 � { �i f1 i t }} f t{ 5 p � SfY v 3a off , } to PAGE 5 OF 5