HomeMy WebLinkAbout23-4246 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-4246 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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# ❑
cowsloN 04 - 1-- 2023 1631 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON DR S BLOCK NO. e✓ 3500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 1. 00 FEET MILES e S B W e S 172ND ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4255590346 0 7 30
6� LAST NAME KIM FIRSTNAME JOSHUA MIDDLE S 1 1 2 31
INITIAL
STREET ❑✓ 10701 MAIN ST#610 CITY BELLEVUE ST WA ZIP 98008 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aTES� BWP7615 sTArI WAurN# 1N46t11E75C323781
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 5 1 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE J 9 34
13 2005 NISS ALTIMA SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO JOSHUA KIM 10701 MAIN ST#610 BELLEVUE WA 98008 D:4255590346 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 817559118 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ cvcLE ❑ ❑ OWNER [:]EA.
YEs No ,/ D:4252130395
16 a
LAST NAME ASHRAF FIRST NAME MUHAMMAD MIDDLE /
INITIAL
17❑ STREET NEW ADDREss❑' 16629 NE 30TH ST CITY BELLEVUE ST WA ZIP 980082124 4❑ 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[-] D IVEW #
❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# BIG3437 TArE 41
WA VIN# JTDKN3DU7F1985490 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2015 MAKE 7'Oy7- MODEL pRIUS STYLE HB DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE 8 POINSURGY#E CO GEIC04016-98-83-07IN 1 9TOP
"'LE CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES NEI
❑ TAGENCY
s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
GREGORY BILLS 12495 WA0171300
1
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED51930
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4246
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.
GREGORY BILLS O4-15-23 05:26 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 411712023 10:57:48 AM
BADGE OR ID# 12495 OR]# WA0171300 TIME POLICE DISPATCHED 4:35 PM TIME POLICE ARRIVED',4:36 PM
PART I PAGE IT]OF 4�
REPORT NO. ED51930 CASE# 23-4246 OF COLLISION
04/15/23 16:31
OF CbLLI510N
NARRATIVE
On 04/15/2023 at 1635 hours I was dispatched to the intersection of Benson Dr S / SE 172nd St, in
the City of Renton, King County, Washington. I was responding to a call of a motor vehicle collision.
At approximately 1636 hours, I arrived on scene.
In this report, Unit 1 describes a silver 2005 Nissan Altima (WA/BWP7615), driven by Joshua S. Kim
(DOB 12/02/1987, WA DQ. Unit 2 describes a black 2015 Toyota Prius (WA/BIG3437), driven by
Muhammad I. Ashraf(DOB 04/29/1950, WA DI_). There were no passengers in either vehicle.
I interviewed both drivers, who gave the same version of events:
They were driving in the left lane, going northbound on Benson Dr S. As they were approaching SE
172nd St, a vehicle a few cars ahead of them slowed then stopped to turn left. Unit 2 stopped for
traffic. Unit 1 was unable to stop in time, and struck the rear of Unit 2. The steering wheel airbag
deployed in Unit 1, but no airbags deployed in Unit 2. Both drivers declined injury. I requested Renton
Fire respond to evaluate Kim, which they did.
At the time of collision, it was raining, the road was wet, and that section of Benson Dr S is on a curve
with a downhill grade.
Unit 1 was not drivable, so I requested a tow truck respond to the scene.
I provided both drivers an exchange of information form, and waited on scene blocking traffic until the
tow truck arrived for Unit 1.
This concludes my involvement in this case.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. Gregory Bills #12495, 04/15/2023 at 1718 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. ED51930 CASE# ' 23-4246 DATE AND TIME 04/15/23 16:31
OF COLLISION
Mat.Ca Scale
B—a D,S
. \ ._ 1/eh�eCss staPPed�farfrafie.
Uiii12
Unit I
SE 172id St
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