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HomeMy WebLinkAbout23-9224 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-9224 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 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# ❑ COLLISION: 08 — 1—— 2023 1723 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BENSON RD S BLOCK NO. e✓ 800 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 300 00 FEET e S B W e GRADYWAYS 0 2 29 R PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ,/No D:2067863608 N:2069736205 0 11 30 6❑ LAST NAME NUR FIRSTNAME IKRAM MIDDLE M 1 1 2 31 INITIAL STREET ❑, 3602 S 180TH CITY SEATAC ST WA 2jp, 98188 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'F MID .O B 11 1- 15 - 2001 2 32 9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 . EJECT 1 HELMETU E 2 CLASS INJURY5 [NATURE OF INJURIES BACKAND LEG PAIN z❑ 3 10 9❑ P1 ATE BWB7634 STATE WA VIN# 4T1M11BKfl0004120 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. A'RLR. 1 5 33 12 0 0 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 5 1 34 13 2 2020 TOYT CAMRY SD DAMAGE vES 0NO agW�MEYERS vEs❑ No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 912P VEHICLE CHARGE 5 36 LEGALLY YEs❑NO❑ CITATION# 10 BOTTOM 15❑ NDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:4259194437 N:4255163282 16 a LAST NAME FELICIDAD FIRST NAME MARYANN MIDDLE N INITIAL 17 STREET I❑ 1815 LAKE YOUNGS WAY CITY' RENTON ST WA ZIP 98058 37 NEW ADDREss❑' 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YES ❑NOF,/ 19 F] DRIVER'S STATE WA ]SEX IF D.C... 07 26 _ 1968 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑21❑ PLATE# 343YN0 TATE WA VIN# 41 JTDBL40E199070151 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. TOWED BV Gov HI 44 VEH YEAR 2009 MAKE 7'Dy7' MODEL CORO!! STYLE $D —FEHICLE TOWED✓ NOO BLIN GENE MEYERS YES NO�/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&POLICY#E CO PEMCO CA0693267IN 9TOP 5 VE""LE ❑ Nu J,J� CITATION# CHARGE LEGAL io BOTTOM LY YES 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 E.EDMUNDS 12576 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED88764 COLLISION REPORT III III III III III 111 1591972 CASE# 23-9224 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY) NAME MIDDLE INITIAL) OMAR MOHAMED A (LAST FIRST, ADDRESS&PHONE# D O.B. 11431 SE 162ND ST RENTON WA 98055 SEX M MMDOYyry 02 - 22 - 2000 PASSENGER Z WITNESS❑!UNIT# 1 PEA 3 AIRBAG'6 RESTR. 4 EJECT ? 1 HEL MET 2 INJURY CLAS 1 NATURE OF INJURIES NAME (LAST,FIRST,MIDDLE INITIAL) SANTOS RENTAO ADDRESS&PHONE# D O B SEATAC SEX' M MMoovvYv 04 f 7 _ 1943 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESSO UNIT# 2 PGS 3 AIRBAG'6 RESTR. 4 EJECT 1 USE 2 CLASS TRANSPORTEDDUE TO ELDERY NAME (LAST FIRST,MIDDLE INITIAL) BANDA ALFREDO R AooREss PHONE# 2712 SE 16TH ST RENTON WA 98058 4256522223 SEX M D.C•B. 10 I. _ 05 _ 1971 MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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. E.EDMUNDS 08-12-23 02:42 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIREE SCOTT 10272 1 8/13/2023 12:44:54 PM BADGE OR ID# 12576 ORI#' WA0171300 TIME POLICE DISPATCHED 5:24 PM TIME POLICE ARRIVED',5:24 PM PART Ei PAGE IT]OF 4� TIME REPORT NO. ED88764 CASE# 23-9224 OF COLLISION08/11/23 17:23 NARRATIVE On 08/02/2023 1 was working a marked patrol unit in the City of Renton, County of King, State of Washington. I was assigned to District 15. At approximately 1724 hours, I was dispatched to an unknown injury collision in the 800 block of Benson RD S (Renton WA, King County). Call notes stated: "NOW... 2 VEH MVA... UNK INJS...BLOCKING... GRY HISS VS. GRY MAID... POSSIBLE MALE OR FEMALE LAYING ON GROUND NEARBY.. ONE VEH SPUN AROUND... RP NO LONGER IN AREA.. 2 MVA, SIL TOYT CAMRY VS SIL TOYT COROLLA, BLKIND ON BENSON, PT ON GROUND, CONS, CO PAIN IN LEGS, CRYING HYSTERICALLY..." I responded to the location and observed two vehicles- Vehicle #2 (WA/343YNO) and Vehicle #1 (WA/BWB7634) blocking both lanes of travel. Both vehicles had significant front-end damage. Vehicle #1 had come to rest in the oncoming lane of traffic. Vehicle #2 was stopped in the center of its lane. The damage to both vehicles appeared to exceed $1000. The driver of Vehicle #1 (later identified as Ikram M Nur-11/15/2001) was laying down in the street, complaining of pain in her legs and back. Her passenger (Mohammed A Omar-02/22/2000) was standing with her, attempting to provide comfort. I advised incoming medical personnel of Nur's location as they arrived. I contacted the driver of Vehicle #2, Maryann N Felicidad -07/26/1968 at her vehicle. Felicidad was standing on the passenger side of her vehicle, requesting aid for her passenger, Renato Santos - 04/17/1943. Santos did not have any visible injury but was slow to respond and appeared dazed. I advised incoming medical personnel of Santos location as they arrived. A witness to the collision, Alfredo R Banda -10/05/1971, flagged me down. Banda stated he was driving south bound on Benson RD S near the police station when Vehicle #1 attempted to pass him at a high rate of speed by changing lanes into oncoming traffic. Banda stated Vehicle #1 could not complete the pass due to oncoming traffic and returned to the southbound lane, behind him. A short distance later, Vehicle #1 attempted to pass Banda again by moving into oncoming traffic. This, second, time Vehicle #1 struck Vehicle #2 head on. I spoke with Felicidad, who described the accident in a similar manner. Felicidad stated she was driving straight in her lane, when Vehicle #1 moved suddenly into her lane. Felicidad stated she did not have time to swerve and avoid the collision. Nur was unable to provide an account of the collision due to treatment of her injuries. Her passenger, Omar, stated they were arguing in the vehicle, and he may have struck the gearshift inadvertently. This caused Nur to lose control of the vehicle, moving into oncoming traffic. An NCIC/WACIC check was conducted with both driver's information. Both returned clear. Felicidad provided vehicle registration and proof of insurance. Omar was able to locate Nur's vehicle registration, but not proof of insurance. Nur and Santos were both transported to Valley Medical Center for evaluation and treatment. Gene Meyer's towed both vehicles from the scene to their impound yard. I provided an exchange of information to both parties. This concluded my involvement with the case. 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. Edmunds/12576 at 0241 hours on 08/12/2023 in the City of Renton, WA. PAGE 3 OF 4 REPORT NO. ED88764 CASE# ' 23-9224 DATE AND TIME 08/11/23 17:23 OF COLLISION ���yyyf t�h 1� j i l� tt t PAGE 4 OF 4