HomeMy WebLinkAbout26-5525 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-5525 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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#
cowsloN 07 - 1-- 2026 1519 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
OAKESDALE AVE SW
e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e SW GRADYWAY
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066507838 0 11
30
6 LAST NAME SANCHEZ VILLERO FIRST NAME JOSE MIDDLE M 1 2 31
INITIAL
STREET ❑ 4941 SW GREENSBORO WAY APT 23 CITY BEAVERTON ST OR ZIP, 970782588 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ D.
01 LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM
USEET I ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10 1❑ P1 ATE 14 CPA3298 STATE WA VIN# 3N1CN7AP3EL824509
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 r 2014 NISS VERSA DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO JADRIANY MARRUFO ALVARADO 4308 NE SUNSET BLVD UNIT 03 RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO <53 4
IN EFFECT &POLICY# TOPvEHICLE CHARGE 36
LEGALLvYEs No clTAnoN# 6A0254837 FOLLOW VEHICLE TOO CLOSELY orrom
15❑ STANDING 7 6
N VE ICCLE CYCLE OWNERPPROPERTY DES� NO OLD MET PHONE
UI�IIT ❑ PEDESTRIAN ❑ ❑
16 a •,
LAST NAME HUMPHRIES FIRST NAME SCOTT MIDDLE I E
INITIAL
17❑ STREET ❑', 7205 LOWER RIDGE RD APT B CITY EVERETT ST WA ZIP 982034997 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t- l No❑
19[—] LDI IVER # STATE WA SEX M M D.C.B. 09 _ 12 _ 1978 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CJP9004 TATe WA KL79MRSL8P6214804
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE CHEV MODEL TRAILBL STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CASCADIA METALS INTERNATIONAL WAY LONGVIEW WA 98632 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO AMERICAN CAS 20427IN 1 9TOP
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH24210
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5525
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
PM 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 02:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 7/27/2026 10:21:01 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 3:20 PM TIME POLICE ARRIVED',3:29 PM
PART I PAGE IT]OF 4�
REPORT NO. EH24210 CASE# 26-5525 OF COLLISION
07/15/26 15:19
OF CbLLI510N
NARRATIVE
wht slow slv rear
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash near the
intersection of Oakesdale Ave SW at SW Grady Way.
When I arrived both vehicles were blocking northbound lane 1 just south of the intersection.
I contacted the driver of unit 2 who told me he was just barely moving to when he was hit from behind
by unit 1. He did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 ID'd by his picture OrDL. He told me that he was proceeding north
when he hit unit 2. He did not provide a reason why he hit unit 2. He merely just drove into the back
of unit 2. He did not complain of injury and damages did require a tow truck.
I cited unit 1 ref RCW 46.61.145 Following too close, 2 vehicle crash via complaint.
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.! EH24210 CASE# ' 26-5525 DATE AND TIME 07/15/26 15:19
OF COLLISION
va
t
4�0 4v5.
4
V�
u.
x
SY L
g Ct t:
$d}
t
\y "
tip 's
t
PAGE 4 OF 4