HomeMy WebLinkAbout23-7161 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-7161 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.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 06 - 1-- 2023 1344 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW GRADY WAY BLOCK NO. e✓ 00
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 15 00 FEET MILES e S ❑ W e RAINIER AVE S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2533291133 0 81
30
6� LAST NAME KHOSHAKHTAR FIRSTNAME MAJID MIDDLE 1 2 31
INITIAL
STREET ❑, 2529 NE 1ST ST CITY RENTON ST WA ZIP 980568877 z
NEW ADDRESS
7❑ COL ,/ I IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO NTERLOCKYEs NO,/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10[1 PI P1 ATE 14 AGT0775 sTAr WAu N#' JN8AF5MV86T028639
5 TRAILER STATE TRAILER STATE
11
3-LATE# PLATE# FROM ro
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2011 NISS JUKE UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO JANETH OBURA 2529 NE 1STST RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO STATE FARM 185 5702-B24.47E 3 4
IN EFFECT &POLICY# 9TOP
VErIICLE CHARGE 5 36
LEGALLY res❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ PHONE
2068221789
16 a
LAST NAME HELMS FIRST NAME KATHLEEN MIDDLE I L
INITIAL
17❑ NEW ADDRE— 232 BUR STREET NETT AVE S APT 8206 CITY RENTON ST WA Zip 98057 37
18❑ CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE LA SEX IF I D.Q.B. 127_ 17 _ 1993 2 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CCS9816 TArE WA VIN 1 41
5NPD84LFSJH304043 1
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2018 MAKE HYUN MODEL ELANTRA STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO KATHLEEN HELMS 232 BURNETT AVE S APT B206 RENTONWA98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&POLICY#E CO GEICO 6099638204IN I 9TOP
VE
25 i o BOTTOM
LEGALLY YES Nu
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
GREGORY BILLS 1
12495 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED73793
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7161
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SCHREINER MORGEN J
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
225 LOGAN AVE S#308 RENTON WA 98057 2065966569 SEXi F MMDOYyry 10 - 19 - 1989
PASSENGER Z WITNESS❑ UNIT# 2 PAS j 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE 2 CLASS '1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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 06-24-23 03:47 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 6/26/2023 9:57:13 AM
BADGE OR ID# 12495 ORI# WA0171300 TIME POLICE DISPATCHED 1:46 PM TIME POLICE ARRIVED:1:53 PM
PART Ei PAGE IT]OF 4�
REPORT NO. ED73793 CASE# 23-7161 OF COLLISION
06/24/23 13:44
OF CbLLI510N
NARRATIVE
On 06/24/2023 at 1346 hours I was dispatched to the intersection of Rainier Ave S / SW Grady Way,
in the City of Renton, King County, Washington. I was responding to a call of a blocking collision.
While en route, dispatch advised the following: two vehicle, non-injury accident blocking the
intersection at Rainier/ Grady.
In this report, Unit 1 refers to a white 2011 Nissan Juke (WA/AGT0775), driven by Majid Khoshakhtar
(DOB 11/15/1978, WA DL). Unit 2 refers to a black 2018 Hyundai Elantra (WA/CCS9816), driven by
Kathleen L. Helms (DOB 12/17/1993, LA DL), with Morgen J. Schreiner (DOB 10/19/1989, WA DL) in
the front passenger seat.
At approximately 1353 hours, I arrived and observed Units 1 and 2 in lane 2 of 4 on eastbound SW
Grady Way. Unit 2 was first in line at the light, Unit 1 was directly behind. Unit 2 had minor damage to
the rear bumper, Unit 1 had minor damage to the front license plate. Both vehicles were drivable so I
instructed the drivers to meet me in the Red Lion parking lot to clear the road.
Once parked in the Red Lion, I interviewed all three occupants. My investigation determined the
following:
Unit 2 was stopped first in line at the red light. Unit 1 was directly behind them. Lane 1 is a left turn
only lane, and lanes 2 and 3 are straight only. Helms and Schreiner said when the left turn arrow for
lane 1 turned green, the lights controlling 2 and 3 stayed red. When the left arrow turned green, Unit 1
started rolling forward and struck the bumper of Unit 2.
Majid told me he never took his foot off the brake the whole time. I examined the damage to each car
and observed the "Younker" text on the license plate holder on the front of Unit 1 was partially
stamped onto the rear bumper of Unit 2. When I asked Majid about this, he said that he never said
the collision didn't occur, just that he never took his foot off the brake.
Based on my investigation, it appears Unit1 rolled into the back of Unit 2 when the light in the
adjacent lane turned green.
I provided both drivers a SECTOR exchange of information form. I did not issue any infractions.
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, 06/24/2023 at 1533 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. ED73793 CASE# ' 23-7161 DATE AND TIME 06/24/23 13:44
OF COLLISION
R-ainierAve S
N
Not to scare
Unit 1 —
f
Unit
PAGE 4 OF 4