HomeMy WebLinkAbout26-5413 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 26-5413 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F E: LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 01 STRUCK' TREE OR STUMP
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
Ct ELISION' 07 - 11 - 2025 2247 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SOUTHWEST 43 ST BLOCK NO. e✓ 1200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElDESA✓NHORESHOLDMET PHONE 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8 DRIVERS. STATE SEX.U D.Q.B. 1 32
❑ :LICENSE# MMDDYY -=
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10❑ P1 ATNES# C78725Y sTAT WAv N# 5TFDY5F18HX654086
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. TRLR 3 7 33
12❑ VIN#j VIN#
Rom 34
13❑ VEH.YEAR 20 17 MAKE TOYT MODEL TUNDR STYLE PK VEHICLE TOWED NOO pLSABLIN TSIYYEp9vMEYER vOVT.V
DAMAGE IILLJJII (��IV6
REGISTERED OWNER INFO WILLIAM COUGHLIN 1131387TH AVE E PUYALLUP WA 98375 D:2534599398 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VENICLE CHARGE 5 36
LEGALLv YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STAIN.D'ING 6
UNIT 02 VE IOOR ❑ CYCLE ❑ PEDESTRIAN ❑ PROPE OWNFRRTY ❑ DYES NO THR OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' Sr ZIP 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PR-E- tSENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YES It1 I NOF YES l NO❑
19 LLIICENS # STATE I SEX MMDDYY -=_ 39
-----WELMET NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE 41
VIN# `1
PLATE#
42
22 [TRAILER T
❑ PLATE# STATE pLATE#ILER STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VE."Le ES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY Y
25 s � e
7BRYAN
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26GROZAV 12489 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH2O988
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5413
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CORREA MONIQUE N
(LAST FIRST,
ADDRESS&PHONE#
2532595813 SEXi F MMDDYYYY 12 - O6 - 1991
---------------------------
PASSENGER❑WITNESS❑1 UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
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.
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.
BRYAN GROZAV 07-12-26 05:16 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.BRAUN 2194 1 7/15/2026 10:32:51 PM
BADGE OR ID# ` 12489 OR]#' WA0171300 TIME POLICE DISPATCHED 10:47 PM TIME POLICE ARRIVED',10:48 PM
PART I PAGE IT]OF 4�
DATE AND
REPORT NO. EH2O988 CASE# 26-5413 OFCOLISION 07/11/2622:47
OF COLLISION
NARRATIVE
CASE 26-5413
This incident was captured on my body worn video camera and/or in-car dash camera due to the
sensitive circumstances. This report is a summary of events that occurred and is not an exact
sequencing of events.
On Saturday July 11th, 2026, at approximately 22:52, 1 responded to a 911 call regarding a crash
notification from a cell phone in the area of Asian Ginger Teriyaki located at 1250 Southwest 43rd St
within the City of Renton, King County, Washington.
***CALL REMARKS: ACN, OPEN LINE, BEEPING NOISES/ROAD NOISE, WPH2, UNC 45 NEG
TTY,MAP SHOWING ON 43RD IFO LOC,NO ANS ON CB. BLK PU TRUCK INTO TREE.. DRIVER
HAS NOT EXITED VEH BELIEVES DRIVER IS INJURED .. ADDING FD. NEW RP FOR
SAME.......UNK INJS....STATES VEH VS TREE OR POLE.....SAW BM OR BF 10-12,NVY TOP EXIT
DRIVER SEAT AND RAN BEHIND SUBWAY.
Several other officers arrived on scene before me and located the vehicle in question, a black 2017
Toyota Tundra pickup truck with Washington license plate C78725Y. The vehicle struck a tree which
was undisturbed, but the vehicle had heavy front-end damage. There was no driver on scene and per
a witness on scene, Monique N. Correa (DOB: 12.06.1991) the driver fled on foot after the crash.
I located a phone number for the registered owner, William O. Caughlin (DOB: 5.01.1975) and
noticed the phone number was the same phone number the crash notification was received from. The
cell phone was still inside the vehicle. The vehicle was registered in Puyallup, Pierce County Sheriff's
Office attempted to contact William but could not reach him. Per the deputies that attempted to
contact William, they were familiar with him and noted he has a history of hit and run collisions.
I also noticed William's DOL status was suspended 2nd, and he was required to have an ignition
interlock device which I did not see when I looked inside the vehicle.
The vehicle was later towed from the scene.
This concludes my involvement in this case.
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 B. Grozav #12489 on 7.12.2026 at 17:15 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. EH2O988 CASE# 26-5413 DATE AND TIME 07/11/26 22:47
OF COLLISION
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