HomeMy WebLinkAbout23-12371 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-12371 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER � VFHIC;I F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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.. 10 - 1-- 2023 1541 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE 172ND ST BLOCK NO. e✓ 10405
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 9 29
UNIT MOTOR
Z PEDAL-
CYCLE El DAYESMAGE NHORESHOLD MET PHONE 01 1 4 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY RENTON ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES No YES No
DRIVERS
STATE SEX D - 328 LICENSE MDYY❑ M
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTAT1 urN#'
10❑ PI ATE 14
TRAILER TRAILER
STATE STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR m 33
12 0 0 VIN# VIN#'
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R 1 34
13 A UNKN UNKNO DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ ABILI INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY#VEwcLE CHARGE 36
LECALLvYes❑NO❑ CITATION# EQ,
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ No D:2533154394
16❑
LAST NAME HASSEN FIRST NAME HUSSEN MIDDLE /
INITIAL
17 ST EETR 10405 S
7 E 172ND ST APT 4 CITY RENTON ST WA ZIP 98055 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t—T�RANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YES It1 I NoF t l YES NO
19 DRIVE # STATE SEX U MMDDYY 12 _ 12 _ 1979 39
INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 1 EJECT 1 USE 9 CLASS 1 ❑
❑ILICENSE 21❑ PLA E# BTF1527 TATe WA VIN# 5(BZER13707J156410 41
4
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2007 MAKE SATU MODEL OUTLOO STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV!TN
44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO HUSSEN HASSEN 10405 SE 172ND ST APT 4 RENTON WA 98055 D:2533154394 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO GE/CO 6122499624IN 1 9TOP 5
VE—LE ❑ ,J� CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N`L J
$ '
7SHA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE14816
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12371
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'
On 10/28/2023 at about 1548 hours I was working uniform marked patrol as 1 R15 when I got
dispatched to take a report by phone of a hit and run collision that occurred in the parking lot of the
Glenview Heights Apartments located at 10405 SE 172nd St within the city limits of Renton, King
County, Washington. I called and spoke to Hussen Hassen who was the registered owner of Unit 2-
black colored 2007 Saturn Outlook with Washington license plate BTF1527.
Hussen parked Unit 2 in the private parking lot of the Glenview Heights Apartments near building #7 a
couple of nights prior to the collision; however, he last saw his vehicle undamaged at about 0430
hours on 10/28/2023. Hussen returned to his vehicle at about 1430 hours this afternoon and saw that
it had damage to the rear driver side fender area of the car. The unoccupied Unit 2 was driveable
and there were no reported injuries. There were no cameras found posted in the area, and no
witnesses have come forward.
The identity of the hit and run vehicle and driver are unknown at this time. I did not see the scene
where the collision occurred.
I gave Hussen the Renton PD case number over the phone.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Weather: UNKNOWN
Motor Vehicle Unit 1
Action Code: UNKNOWN
**** END OF AUTO-POPULATED SECTION ****
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
SHAWN CROW 10-29-23 05:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
DESIREE SCOTT 10272 1013112023 7:14:00 AM
BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED! 3:48 PM TIME POLICE ARRIVED',3:48 PM
PART Ei PAGE IT]OF
REPORT NO.! EE14816 CASE# ' 23-12371 DATE AND TIME 10/28/23 15:41
OF COLLISION
*The scene of the collision was not viewers. The report was taken Over the phone.
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