HomeMy WebLinkAbout26-4914 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 2s-491a 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 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 1458 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY BLOCK NO. e✓ 200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e SHATTUCKAVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:9452686291 0 11
30
6 LAST NAME WAITHIRA FIRSTNAME MONICAH MIDDLE 1 2 31
INITIAL
STREET ❑ 6801 S 133RD ST APT F351 CITY SEATTLE ST WA 2jp, 981785173 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ DRIVERS
E# STATE WA SEX'F MM DAY' 04 1— 20 — 1971 2 32
LICEN [NATURE OF INJURIES
9 ON DUTY❑ STATUS' AIRBAG 4 RESTR 4 . EJECT 1 H USE 2 CLASS ,7 COMPLAINT OF CHEST PAW z❑
3
10❑ Pi ATNES14 CWW0607 STATE WA ,I,# JF2GPAGC5EH341789
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. TRLR. 3 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE M DAMAGE ODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 34
13 4 2014 SUBA �/ YES NO �MEYERS 7 3 TOWING YEYES[:] ✓No
REGISTERED OWNER INFO MONICAHWAITHIRA 6801 S 133RD STAPT F351 SEATTLE WA 98178 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO ALLIANCE 872519404 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vEGALLv HICLe 1 36
YES�No D CITATION# 6A0092355 CHARGE FAIL YIELD LEFT TURN MOTOR Io eorroM
STANDING 8 7 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
YE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ S 1/ NO D:2067951725
16 a
LAST NAME SEGURA-ORTIZ FIRST NAME ANGELA MIDDLE R
INITIAL
17❑ STREET ❑', 3714 S 152ND ST TRLR 30 CITY' TUKWILA ST WA ZIP 981882259 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/
19 LDIIVEW # STATE WA ]SEX IF M .C.B. 09 _ 27 2004 39
HELMET {NJURy 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 USE 2 CLASS COMPLAINT OF LEG PAIN
21❑ LICENSE I C38229Y TATe I WA VIN# 1C6RR7KT7DS558765
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2013 MAKE RAM MODEL 1500 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANGELA SEGURA-ORTIZ 3714 S 152ND ST TRLR 30 TUKWILA WA 98188 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 536 9655 D15 47DIN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
7NELSON
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12421 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH16974
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4914
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WHEATON CHRISTOPHER
(LAST FIRST,
ADDRESS&PHONE# D.O.B.
2066041595 SEX' M MMDDYYYY -❑
---------------------------
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O 8
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.
D.NELSON 06-26-26 12:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1 71112026 6:29:51 AM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 3:00 PM TIME POLICE ARRIVED',3:10 PM
PART I PAGE IT]OF 4�
REPORT NO. EH16974 CASE# 26-4914 OF COLLISION
06/23/26 14:58
OF CbLLI510N
NARRATIVE
26-4914 ACCINJ
On 6/23/2026 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a two-vehicle, blocking collision in the intersection of
Airport Way and Shattuck Ave S Renton/King/WA. The caller was reporting two vehicles blocking the
middle of the intersection.
I arrived on scene and located both vehicles which had pulled out of the intersection into a side street.
I spoke with both drivers who had minor complaints of pain, I started RRFA to evaluate both drivers.
The driver of the 2014 Subaru Crosstrek WA/CWW0607 was identified by her WADL as Monicah
Waithra DOB: 4/20/1971. Monicah said that she was in the turn lane from westbound Airport Way to
turn south onto Shattuck Ave S. She said that she had the green light when she entered the
intersection and was struck by Unit 2. There was heavy damage to the passenger side doors, and the
side airbags had deployed. The vehicle was not drivable and was removed from the scene by Gene
Meyers Towing. Monicah was evaluated for complaint of chest pain by RRFA and cleared at the
scene.
The driver of the 2013 Ram 1500 WA/C38229Y was identified by her WADL as Angela R Segura-
Ortiz DOB: 9/27/2004. Angela said that she was driving east in the #3 lane of Airport Way with a
green light when Monicah suddenly turned in front of her. There was damage to the front bumper/grill
of the Ram. The Ram was moved off the roadway and Angela advised she would get her own tow.
Angela was evaluated by RRFA for a complaint of leg pain and cleared at the scene.
A witness, Chritopher Wheatin advised he was behind Monicah in the turn lane, he said that she had
a green yield light and suddenly turn into front of the Ram.
I cited Monicah for RCW 46.61.185.1 Failure to Yield Left Turn Motor Vehicle under Sector citation
#6A0092355. This citation should be mailed to her DOL address.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 6/24/2026 Renton WA
PAGE 3 OF 4
REPORTNO.! EH16974 CASE# 26-4914 DATE AND TIME 06/23/2614:58
OF COLLISION
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