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Home My WebLink About24-162 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 ❑ ❑ RESULTED ❑ CASE z4-162 2 INTERSTATE CITY STREET FIRE 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION 01 — 1—— 2024 1728 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW 43RD ST BLOCK NO. e✓ 100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 2❑ 50 00 FMILES EET e S ❑ E e SR 167 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO F,/ I D:2065040206 0 11 30 6� INITIAL LAST NAME YUSUF FIRSTNAME MOHAMED MIDDLE F 1 1 2 31 STREET ❑, 13445 MARTIN LUTHER KING JR W UNIT C301 CITY SEATTLE ST WA ZIP 981785221 2 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 9 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ PI ATE 14 BON2175 STATE WA VIN#' KMHDH4AEXDU798822 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM ro TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 2 2013 HYUN ELANTR DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO MOHAMED YUSUF313 FERNDALEAVE SEAPT313 RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE❑ INSURANCE CO NONE NONE 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LE—Lft Yes❑NO❑ CITATION# 10 BOTTOM 15❑ NDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO 1/ D:4255451701 16 a LAST NAME NELSON FIRST NAME TRINITY MIDDLE I R INITIAL 17 STREET IS❑' 16856 121 ST AVE SE CITY' RENTON ST WA ZIP 980586063 37 NEW ADDRES 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38 INERLOCKYES❑No� INTERLOCK Y�EsI❑NOF YES ❑NO� 19 DRIVER # STATE WA ]SEX IF M D.C.B. 04 26 _ 2001 39 F—NATURE OF INJURIES 20� ON DUTY[:I] STATUS AIRBAG 2 RESTR 9 EJECT 1 WEB MEET LASSY 7 COMPLAINT OF NECK PAIN ❑ 40 LICENSE I ❑21❑ PLA E# CER1131 TATE 41 WA VIN# 1HGCP36828A030020 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2008 MAKE HOND MODEL ACCORD STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO TRINITY NELSON 16856121STAVE SE RENTON WA 98058 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE &POINSURGY#E CO FARMERS 189312020IN STOP VE"LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N`L J 25 s � a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7AGENCY 26 ROBERT SLINKMAN 11618 WA0171300 1 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE39848 COLLISION REPORT III III III III III 111 1591972 CASE# 24-162 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' All three units were traveling eastbound on SW 43rd St in lane 2. Unit 3 stopped behind other vehicles that were stopped at a red light. Unit 3 was stopped for roughly 15 seconds. The driver of unit 3 observed unit 2 in his rearview mirror. He advised that unit 2 was slowing down and came to a brief stop before rear-ending his vehicle. Unit 2 was slowing down and coming to a compelte stop before unit 1 rear-ended unit 2. After unit 1 rear ended unit 2, both vehicles slid into vehicle 3. Damage was minor to all vehicles. No vehicle needed a tow. The pasenger of unit 2 advised of neck pain. No visable injuries observed for any occupants. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SL/NKMAN 01-07-24 12:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1 111212024 5:55:57 PM BADGE OR ID# 11618 OR]# WA0171300 TIME POLICE DISPATCHED 5:29 Pry] TIME POLICE ARRIVED 5:31 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. EE39848 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-162 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:8088689189 0 1 29 LAST NAME : TORRES FIRST NAME RYAN MIDDLE'.. B INITIAL STREET 30 NEW AnDRFrtP 14600 SE 176TH ST UNIT M3 CITY RENTON ST WA ZIP 980588922 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YES N L DRIVER'S STATE I SEX M M�DDYBYv 04 - 04 - 1995 LICENSE 7 F-I ON DUTY STATUS AIRBAG 2 RESTR. 9 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BNS0175 TAr WA VIN# 5N1AT2MVXHC821206 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2017 MAKE NISS MODELROGUE I STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1I' P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFORYAN BONETE 14600 SE 176TH ST UNIT M3 RENTON WA 98058 ] 3 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 946523406 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES❑ NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiR rD IGNITION PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SLINKMAN 01-07-24 12:35 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 11618 O#II,WA0171300 APPROVED BY 1/112/2024 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EE39848 CASE# ' 24-162 DATE AND TIME 01/055/24 17:28 OF COLLISION 7p V .............................. ............................ PAGE 4 OF 4