HomeMy WebLinkAbout26-4659 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 26-4659 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 1310 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW GRADY WAY BLOCK NO. e✓ 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 35 00 FEET MILES e S ❑ W e RAINIER AVE S
1 0 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:2064584385 0 7 30
6� LAST NAME HILL FIRSTNAME DONTE MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 19202 54TH ST E CITY LAKE TAPPS ST WA ZIP 98391 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 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� C93635Y sTAr� WAurN# 1GC4WSEY4NF116462
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 7 3 33
12 3 5 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2022 CHEV SILVER TR DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO NATIONAL GENERAL 2064584385 3 4
IN EFFECT &POLICY# 9TOP
vECALLv HICLE 5 36
YES❑NO❑ CITATION# CHARGE 10 BOTTOM
15 LE❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2535615034
16 a
LAST NAME CUNNINGHAM FIRST NAME BRANDON MIDDLE R
INITIAL
17❑ STREET ❑', 334 WELLS AVE S APT 329 CITY' RENTON ST WA ZIP 98057 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 01 17 1997 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CSZ2520 TAre WA VIN# 1B3JZ65Z74V100580
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2004 MAKE DODG MODEL VIPER STYLE CP VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YESfj
NO,/ YES NO
REGISTERED OWNER INFO JOHN SAMPLES 6905120TH STE PUYALLUP WA 98373 D:2535615034 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO GEIC04342753276IN 1 GD
LEGAL25
LY YES Nu
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
D.MYERS 10433 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH17508
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4659
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 FIRST 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'
On 06-15-2026 at approximately 1329 hours, I responded to a traffic collision in the 200 block of S 7th
St in the City of Renton, County of King, State of Washington.
I contacted the driver of Unit#2 who told me he was stopped for the traffic light in the 100 block of
SW Grady Way. He was waiting to make a left turn onto Rainier Ave S in the far left lane which is a
left turn only lane. While he was stopped, Unit#1 hit the rear of his vehicle. He does not believe he
moved his vehicle and then all sudden he felt a second impact from Unit#1 hit the rear of his vehicle
a second time. To avoid blocking traffic he gestured to the driver of Unit#1 to follow him where
contacted in in the 200 block of SW 7th St.
I contacted the driver of Unit#1 who told me was stopped for the traffic light in the 100 block of SW
Grady Way. He was waiting to make a left turn onto Rainier Ave S in the far left lane which is a left
turn only lane. According to him, Unit#2 was not stopped in front of him and moved into the left lane
when the traffic light turned green. This caused him to hit the rear of his vehicle with the front of his
truck.
Based off the statements made by both drivers I am unable to determine how the collision happened.
The impact or damage to Unit#1 appears to be consistent with Unit#2 being stopped in the left lane
at point of impact versue merging into a lane of travel.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.MYERS 06-21-26 12:42 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
RAYMOND GORAJEWSKI 12399 7/3/2026 8:19:03 AM
BADGE OR ID# 10433 OR]# WA0171300 TIME POLICE DISPATCHED 1:29 Pry TIME POLICE ARRIVED 1:31 PM
PART I PAGE IT]OF 3�
REPORTNO.! EH17508 CASE# 26-4659 DATE AND TIME 06/15/2613:10
OF COLLISION
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