HomeMy WebLinkAbout26-5490 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 26-5490 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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#
cawsloN 07 - 1-- 2026 1511 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SW 7TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e POWELL AVE SW
0 4 29
UNIT 01 MOTOOR Z PED
AL ❑ YESAGE NHORE✓LDMET PHONE O 1 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ LICIENSE#
STA fE I
SEX u MMDOBYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10[ PI ATE#
C7
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM ro
TRLR 7 1. TRLR 33
12 3 0 vIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 2 DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO [NEW] VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ NSURANCE CO 3 4
LI EFFECT &POLICY#VEwcLE CHARGE 36
LECALLvYEs❑NO CITATION# EQ,
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2063918693
16 a
LAST NAME OOSTERHOF FIRST NAME NATALIE MIDDLE I S
INITIAL
17 STREET NEW ADDRESS❑' 28524 235TH CT SE CITY' MAPLE VALLEY ST WA ZIP 980383308 37
18� CDL IGNITION REQUIRED IGNITION PRESENT tS1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YES It I NOF YES l NO❑
19[-] D IVEW #
I {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
LICENSE I ❑21❑ PLA E# BRJ8427 TATe 41
WA vIN# KM8K2CAA8LU400084 4
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
YEAR 2020 MAKE HYUN MODEL KONA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
VEH
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO NATALIE OOSTERHOF28524235TH CT SE MAPLE VALLEY WA 980383308 D:2063918693 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ST FARM 2574893 DOS-47CIN IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH24205
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5490
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.
M.LEVERTON 07-16-26 11:21 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 7/27/2026 10:23:35 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 3:13 PM TIME POLICE ARRIVED',3:23 PM
PART I PAGE IT]OF 4�
REPORT NO. EH24205 CASE# 26-5490 OF COLLISION
07/14/26 15:11
OF CbLLI510N
NARRATIVE
gry/2 eb In 1 blk/1 wb to nb It
RTF
Within the city limits of Renton/King/Wa I responded to a 2 vehicle hit and run crash at the
intersection of SW 7th St at Powell Ave SW.
I contacted the driver of unit 2 who explained the following: She was eastbound SW 7th St in lane 1
when unit 1 described as a smaller black 4 dr sedan made a left turn in front of her vehicle without
enough room to avoid being hit by unit 1. Unit 2 told me that a young possible indian/asain female
said she was sorry and had only been driving for 2 days, drove off, turned around and then fled the
scene east on SW 7th St. Unit 2 did not complain of injury and damages did not require a tow truck.
Unit 2 was unable to provide a plate on unit 1. She did get a picture of a small black sedan but upon
magnification only made the picture blurry without being able to obtain additional information.
Information/insurance only
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 7/16/2026
PAGE 3 OF 4
REPORT NO. EH24205 CASE# ' 26-5490 DATE AND TIME 07/14/26 15:11
OF COLLISION
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PAGE 4 OF 4