HomeMy WebLinkAbout26-4692 STATE OF II I III 1 IIIllI111IN II II I REPORT NO. EH18027 170
27
COLLISION REP FIT 1591971
SASE 26-4692 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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 1351 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 8TH ST
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067994025 0 11
30
6� LAST NAME BLAYLOCK FIRSTNAME FRANCES MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 3500 NE 9TH ST CITY RENTON ST WA 21p 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10❑ P1 aT�S� CKF5147 sTArI WAVIN# JTEEP21A040061919
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
rRLR. TRLR 1 5 33
12 3 5 VIN#' uIN
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 4 2004 TOYT HIGHLA DAMAGE vesNo ves❑ NO
REGISTERED OWNER INFO STEVEN BLAYLOCK 3500 NE 9TH ST RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO USAA 05269 52 04C 3 4
IN EFFECT &POLICY# 9TOP
VEwcte CHARGE 1 5 36
YES No CITATION# 6A0254451 IMPROPER LANE USAGE o eorrom
15❑ NDING 8 6
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2537093779
16 2
LAST NAME PARK FIRST NAME LISA MIDDLE $
INITIAL
17❑ STREET ❑', 4923 SW 330TH ST CITY' FEDERAL WAY ST WA ZIP 98023 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 F] LDI IVEW # STATE WA ]SEX IF M .C... 01 05 _ 1982 El 39
HELMET I INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I CTD1111 TAre WA VIN1t 7SAYGDEE6TF355399
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2026 MAKE TESL MODEL MODEL Y STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANNA PARK 4923 SW 330TH ST FEDERAL WAY WA 98023 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 990030891IN 1 9TOP 5
VE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH18027
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4692
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.
C.ARNOLD 06-17-26 11:32 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 71512026 5:39:48 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED; 2:29 Pry] TIME POLICE ARRIVED',2:38 PM
PART I PAGE IT]OF 4�
REPORT NO. EH18027 CASE# 26-4692 OF COLLISION
06/16/26 13:51
OF CbLLI510N
NARRATIVE
CC 26-4692
On 6/16/2026 at 1429 hours I was dispatched to a motor vehicle collision at N 8th St and Logan Ave
N in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was traveling South on Logan Ave N approaching N 8th St in the #1 lane.
Driver 1 stated that she was facing South on Logan Ave N in the #2 lane preparing to merge right into
the #1 lane.
Collision
Driver 2 stated that as she passed Unit 1, Unit 1 merged into her causing the front passenger side
bumper to collide with the rear drivers side door on Unit 2.
Driver 1 stated that she thought that Unit 2 was yielding to her. Driver 1 stated that she began her
merge and the front passenger side bumper of Unit 1 collided with the rear drivers side door of Unit 2.
Injuries
None reported.
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because a vehicle shall be driven as
nearly as practicable entirely within a single lane and shall not be moved from such lane until the
driver has first ascertained that such movement can be made with safety. Had Driver 1 waited until it
was safe to move her vehicle, this collision would not have happened.
Driver 1 was cited reference RCW 46.61.140.
1 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 11:27 on 6/17/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO.! EH18027 CASE# ' 26-4692 DATE AND TIME 06/16/26 13:51
OF COLLISION
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PAGE 4 OF 4