HomeMy WebLinkAbout26-4473 TFFiNouCERA II I III 1 III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 26-4473 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4150 3
HIT 8 RUN ✓ CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 6 0 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#
cawsloN 06 - 09 - 2026 1126 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
PARK AVE N BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 4TH ST
0 1 29
MOTU '�01 VEHtOR Z CLE CYCCLE. El �ESAGE NHORE✓LD MET PHONE O 1 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITIt)N PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10[1-1P1 ATE 14 CTF2428 STATE WA VIN# 2G1WG5E35D1154602
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# IR.. ro
TRLR. YRLR. 5 1 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 2013 CHEV IMPALA DAMAGE YES NO ✓ YES❑ NO✓
REGISTERED OWNER INFO MICHAEL HAYDEN 16140128TH AVE SE RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STAIN,DIING 8 7 6
UNIT 02 VEHIMOTOCLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME OTHMAN FIRST NAME ZAIRINA MIDDLE N
INITIAL
17 STREET❑ NEW ADDRESS❑' 250 VASHON AVE SE CITY RENTON ST WA ZIP 980595106 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT tSENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YES It1 I NOF YES l NO❑
19 D IVEW #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIEs ❑ 40
USE CLASS LEG
❑21❑ PLATE# AYM0390 TATE 41
WA VIN# 2TIBURHE2FC308982 4
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWED eY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO ZAIRINA OTHMAN 250 VASHON AVE SE RENTON WA 980595106 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU8 PORKY#E CO ALLSTATE TBDIN 1 5vewILe ❑ ,.I— CITATION# CHARGE
25 UQ,
LEGALLY YES N
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH18718
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4473
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MULLER IRENE P
(LAST FIRST,
ADDRESS&PHONE#
2063886054 SEX i U MMDDYYYY 10 - 20 - 1992
---------------------------
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY : NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) LlZ
ADDRESS&PHONE# D O B
2067796361 SEX U MMDDYYYY
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS 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.
M.LEVERTON 06-17-26 09:55 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 7/7/2026 4:08:01 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED ?1:Y8 AM TIME POLICE ARRIVED',11:34 AM
PART I PAGE IT]OF 4]
REPORT NO. EH18718 CASE# 26-4473 OF COLLISION
06/09/26 11:26
OF CbLLI510N
NARRATIVE
WHT NB BLUE LN2/3 NO LIGHTS
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash at the intersection of Park
Ave N and N 4th St. Witnesses reported one of the vehicles fled the scene after impact.
I contacted the driver of unit 2 who was seated in a witness vehicle out of the roadway. She could not
provide many details to the crash, which direction she was going for sure or which lane she was in.
She said she was unable to move her vehicle and left it block both westbound and northbound. She
complained of leg pain. Renton Fire arrived on scene and checked her and later transported her to
VMC for further treatment. I was able to move her vehicle into a nearby parking lot, where Bankers
towed it for damages.
Two witnesses on scene said it was a white sedan going northbound lane 1. They said since the
heavy winds and power being out the intersection should have been treated like a 3 way stop,
however, both drivers failed to slow or stop and crashed into each other. Wit/Liz was empathic that
neither driver stopped and both caused the collision ref RCW 46.61.183.
6/17/2026: Several attempts to locate unit one has been with negative results.
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 6/17/2026
PAGE 3 OF 4
REPORTNO.! EH18718 CASE# 26-4473 DATE AND TIME 06/09/2611:26
OF COLLISION
47
d � n i
" sv
t �
l
" lid 5 i
4
t�U"
t
}R,
r t
} .
i Y
gp.
V1 9
Y
Shi'' 9
fib
t #
t 1
� v t4f�6
i
i
i t
PAGE 4 OF 4