HomeMy WebLinkAbout22-13645 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 22-13645 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
COLLISION.. 12 - 1-- 2022 2228 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 3RD PL BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FMILES EET e S ❑ W e SHATTUCKAVES
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:6266931101 1 4 30
6� LAST NAME ZHANG FIRSTNAME LITING MIDDLE 1 2 31
INITIAL
STREET ❑, 2454 S EL CAMINO REAL APT 6 CITy SAN MATEO ST CA Zjp, 94403 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
✓ I iNTERLOCKYEs No NTERLOCKYEs NO✓ YES R No
❑ DRIVER'S' STATE CA SEX'F MM DAY' 01 - 29 - 1971 32
8 LICENSE#
9 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 CLASS y 1 NATURE OF INJURIES 2❑
❑ 3 LICENSE 8CVS668 STATE CA VIN# 3W3B7AX6JM087060
10❑ Pr ATE 1
TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
2018 VOLK BTM CQ ❑ RO�34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
13 2 DAMAGE YES NO ✓ YES NO✓
REGISTERED OWNER INFO FENGWU AN 2454 S EL CAMINO REAL SAN MATEO CA94403 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCE CO FARMERS 189618434 4
LI EFFECT &SUR N# TOPVEHCLE CHARGE 36
LEGALLYYES NO CITATION# 2A0729752 INATTENTIVE DRIVING <1�3
orroM
15❑ STAIN,"" 6
UNIT 02 VEHICLE z CYDDALCLE ❑ PEDESTRIAN ❑ OWNER ❑ DYES✓ NO OLD MET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
17 1-1STREET CITY OLYMPIA ST ZIP 4
NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LLIICENS# STATE SEX U MMDDYY -�_ 39
WELMET 1NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
❑ILICENSE 21❑ PLA E# AUA1376 TATe 41
WA VIN# STDBK3EH3DS184825 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2013 MAKE TOYT MODEL HIGHLAN STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO ATYCAH MOHAMAD P.O.BOX 257 PMB,7489 OLYMPIA WA 98507 D:2068220687 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO I 9TOP
VE."Le ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
E.S/MS 12225 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED19644
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13645
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'
RPD CASE#: 22-13645
On 12/24/2022 at approximately 2237 hours, I was dispatched to the 200 block of S 3rd PL, in the
City of Renton, King County, Washington, for a report of a non-injury vehicle accident.
Upon arrival I identified Unit 1 as a white 2018 Volkswagen BTM, bearing CA license plate
#8CVS668. Unit 1 sustained heavy front-end damage.
I identified Unit 2 as a gray 2013 Toyota Highlander, bearing WA license plate #AUA1376. Unit 2
sustained damage to the rear of the vehicle.
I identified the driver of Unit 1 via her CADL as Liting Zhang (DOB 01/29/1971.) Zhang stated she
was not injured, and I asked her what happened. Zhang stated she was driving westbound in the 200
block of S 3rd PL, when she drove into the back of Unit 2 that was legally parked on the side of the
roadway in front of 206 S 3rd PL.
I identified the owner of Unit 2 via her WADL as Atycah Mohamad (DOB 10/10/1986.) Mohamad
stated her vehicle was legally parked on the side of the roadway facing west and she was inside of
206 S 3rd PL. Mohamad stated she heard the collision and came outside to see that Unit 1 had hit
her vehicle.
Zhang is the at fault party and she was advised she would receive a citation in the mail for Inattention.
I provided both parties with my business card with the case number on it and answered their
questions. Due to the damage to both vehicles, Bankers Towing was called and towed the vehicles
from the location. I then cleared the scene.
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 E. Sims on 12/24/2022 at 2355 hours in the City of Renton.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.SIMS 12-25-22 12:00 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
J.THIELMAN 11462 12/28/2022 6:53:10 PM
BADGE OR ID# ( 12225 ORI#' WA0171300 TIME POLICE DISPATCHED' 10:37 PM TIME POLICE ARRIVED 10:40 PM
PART I PAGE IT]OF
REPORT NO.! ED19644 CASE# 22-13645 DATE AND TIME 12/24/22 22:28
OF COLLISION
NOT TO SCALE
FNIN
UNIT 1
UNIT 2
1
z
200 block of S 3rd PL
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