HomeMy WebLinkAbout23-11569 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE09139 170
27
COLLISION REP FIT 1591971
CASE 23-11569 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 CITY# ❑
COLLISION.. 10 — 09 — 2023 1733 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
DUVALL AVE NE BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066706765 0 11
30
6� LAST NAME MUHUMED FIRSTNAME ABD/ MIDDLE A F 2 31
INITIAL
STREET ❑ 6306 30TH AVE SW CITY SEATTLE ST WA 2jp, 98126 z=
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CHP5694 sTArI WAVIN# JTDKB200067512570
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR 2006 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34
13 4 TOYT PRlUS HB DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14� LIABILITY INSURANCE INSURANCECOAMERICAN FAMILY INSURANCE 41093-14376.78
IN EFFECT &POLICY# 9TOP
CH
VEwcLE ARGE 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:3605106769
16 a
LAST NAME RA Z FIRST NAME ALEXANDR MIDDLE
INITIAL
17❑ STREET ❑', 300 VUEMONT PL NE#L301 CITY' RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK yEs I I NOF YEs t l NOF,/
19 D IVEW #
❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# CER5187 TArE 41
WA VIN# WDBUF87XX96421788 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH D
YEAR 2009 MAKE MERZ MODEL E350 STYLE $D AMAGE TOWED NOO✓ BLIN TOWED BY v HyES NO 1/ 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO GEICO 6122640854IN STOP 5
VE""LE LEGAL ❑ N`LJ,J� CITATION# CHARGE to BOTTOM
LY YES 6
25 7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE09139
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11569
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MILES MADISON
(LAST FIRST,
ADDRESS&PHONE#
UNKNOWN RENTON WA 4256810426 SEXi F MMDDvyry
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) BOX LAUREL
ADDRESS&PHONE# DOB -
UNKNOWN RENTON WA 8137663010 SEX' F MMDpvvvv
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
23-11569
On October 9, 2023, at 1733 hours dispatch requested that I respond to a collision that occurred near
the intersection of NE 4th St and Duvall Ave NE, in the City of Renton, County of King, and state of
Washington.
Upon my arrival I noticed that the collision occurred just north of the intersection. I found a vehicle
facing southbound in the northbound lane, and another vehicle had gone down into an embankment
on the southbound lane.
I spoke with the driver of unit 2, a 2009 Mercedes Benz E350 bearing Washington plates CER5187.
The driver was identified as Alexandr Raz (03/23/1992). He explained he was driving southbound on
Duvall Ave NE in the right turn lane when the collision took place. Unit 1 pulled in front of him,
causing the collision.
Two witnesses, verbally identified as Madison Miles and Laurel Box, said they witness the collision
take place. Madison noticed unit 1 wanting to make a U-turn, so she stopped and left a gap open so
he could pass. Unit proceeded through but failed to notice unit 2 driving down the right turn lane. He
pulled in front of unit 2, not giving him a chance to come to a complete stop. Laurel mentioned as
similar story, and said unit 2 made an illegal U-turn, causing the collision.
I then spoke with the driver of unit 1, a 2006 Toyota Prius bearing Washington plates CHP5694. The
driver identified as Abdi A. Muhumed (01/05/2002) explained he made a U-turn but failed to see unit 2
driving down the lane. He thought unit 2 would notice him.
I provided them with an exchange of information.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 10-10-23 03:02 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 1011412023 6:25:50 PM
BADGE OR ID# ! 12007 OR]# WA0171300 TIME POLICE DISPATCHED! 5:36 PM TIME POLICE ARRIVED',5:42 PM
PART I PAGE IT]OF 3�
REPORT NO. EE09139 CASE# ' 23-11569 DATE AND TIME 10/09/23 17:33
OF COLLISION
i
11
i
Ave NE
E
NE 4th St
138th Ave SE
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