HomeMy WebLinkAbout26-5682 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
SASE 26-5682 z
INTERSTATE ❑ CITY STREET FIRE ❑
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 07 - 1-- 2026 0143 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE PETROVITSKY RD BLOCK NO. e✓ 11600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 116THAVE SE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ✓NO D:4252874099 0 11
30
6� LAST NAME PARCHER FIRSTNAME ELIZABETH MIDDLE R 1 2 31
INITIAL
STREET ❑ 11422 SE 164TH ST CITY RENTON ST WA ZIP 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES z❑
USE CLASS HIP PAIN;LEG WAS TRAPPED IN VEHICLE
3
10[1Pl ATNFS# CER9134 STATE WA VIN If 5NMSH73E97HO15107
5 TRAILER STATE TRAILER STATE
11
3-LATE# PLATE# ROM TO
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 $ 34
13 8 2007 HYUN SANTA SV DAMAGE vE8 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA �
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE UNKNOWN 35
IN EFFECT &POLICV# �1'OP
VEwcLE ❑ 36
LEGALLY YES No CITATION# 6A0002952 CHARGE FAIL TO OBEY TRAFFIC CONTROL BO OM $
15❑ STANDING
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT a2 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:4255915643
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME HOLMES FIRST NAME JAMES MIDDLE M
INITIAL
17 STREET❑ NEW ADDREss❑' 16729 125TH AVE SE CITY RENTON ST WA ZIP 98058 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK vEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 07 30 _ 1985 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY O NATURE OF INJURIES ❑ 40
❑21❑ PLA E# CTV3733 TATE 41
WA VIN# 1C4RJFBM8FC716157 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GI
VEH YEAR 2015 MAKE JEEPMODEL GRAND STYLE $V DAMAGE TO ✓WED NO BANKERS YES NoO BLIN TOWED By OV 44
H
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSURANCE
#E CO USAA 0531593577101IN STOP 5
--E ❑ ,J� CITATION# CHARGE
25 to BOTTOM
LEGALLY YES N`L J
' a
7JUS
NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26KAUPPILA 12883 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH23101
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5682
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) DUARTE VELETA SAMUEL E
(LAST FIRST,
ADDRESS&PHONE# D O.B.
31108 3RD AVE BLACK DIAMOND WA 98010 2532025730 SEX M MMDOYyry 04 - 04 - 2001
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE of INJURIES
❑✓ POS, ' USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# Id DOB
E MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
JUSTIN KAUPPILA 07-21-26 03:19 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 7/23/2026 1:18:46 AM
BADGE OR ID# 12883 OR]# WA0171300 TIME POLICE DISPATCHED! 1:45 AM TIME POLICE ARRIVED:1:46 AM
FART I PAGE IT]OF 4�
DATE AND
TIME
REPORT NO. EH23101 CASE# 26-5682 OF COLLISION07/21/2601:43
NARRATIVE
On 07/21/2026, 1 was working as a uniformed police officer for the city of Renton. At approximately
0145 hours, I was dispatched to a motor vehicle collision at 116th Ave SE and SE Petrovitsky Rd.
Portions of my involvement in the incident were captured on my department-issued bodycam. Any
statements referred to have been paraphrased and summarized.
When I arrived on scene, I observed unit 2 stationary in the middle of the intersection with heavy front
-end damage. I spoke to the driver, who advised he was going straight ahead through the intersection
when he was struck by unit 1, which was headed east on SE Petrovitsky Rd. He reported that the
stoplight for his direction of travel was green, as it had been since he was at the very bottom of the hill
on 116th Ave SE.
I found unit 1 on its driver's side facing eastbound on SE Petrovitsky Rd. Renton Regional Fire
Authority personnel had to extricate the driver from the vehicle, and later transported her to Valley
Medical Center (VMC), 400 S 43rd St. I later went to VMC and spoke to her. She reported that she
was headed east on SE Petrovitsky Rd. She had a lot of trouble recalling what exactly happened due
to it having played out so fast. When I asked her what color the stoplight was at the intersection, she
stated she could not definitively remember, but that it might have been red.
Back at the intersection, I captured photos of the scene. Those photos were uploaded to the case file
via AXON Capture. Further, I completed a tow/impound form for unit 1, since the driver was medically
transported. I provided an emailed copy of the form to Bankers Towing, who removed the vehicle
from the scene. Unit 2 was also towed by Bankers, though that was signed by the driver, who is also
the registered owner.
I called a witness. He advised that he was on the south side of the intersection, facing north, in the
moments leading up to the collision. He was perplexed that the stoplight was taking so long, so he
looked around at the lights controlling the other directions of travel. He noticed the only one that was
green was the one monitoring southbound traffic. At about that time, he saw unit 2 coming up the hill.
It entered the intersection, making it about halfway through, when unit 1 came "speeding" eastbound
on SE Petrovitsky Rd, striking it. He reported that unit 1 flipped at least once before landing on its
side just east of the intersection. After jumping out of his own vehicle to check on the driver of unit 1,
he called 911.
Based on the accounts provided to me and my observations at the scene, I cited the driver of unit 1
for violation of RCW 46.61.055-FAIL TO OBEY TRAFFIC CONTROL LEGEND. I routed the citation
through the Renton Prosecuting Attorney's queue.
Nothing further.
PAGE 3 OF 4
REPORT NO.! EH23101 CASE# 26-5682 DATE AND TIME 07/21/26 01:43
OF COLLISION
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PAGE 4 OF 4