HomeMy WebLinkAbout24-973 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z4-s73 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ 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 2311 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e S 3RD ST
1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2532576370 0 11
30
6� LAST NAME CARTER FIRSTNAME MICHAYLLA MIDDLE S 1 2 31
INITIAL
STREET ❑ 16206 36TH AVE WEST APT 120 CITY LYNNWOOD ST WA ZIP 980870000 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ Pi aT�S� CEC8550 sTArI WAurN# KNDEUCA26M7093275
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 4 8 33
12 3 5 VIN# VIN#
i:.... FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 6 2 34
13 3 2021 KIA SElTOS 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO MICHELLE WALKER-GOMEZ 1620636TH AVE WAPT 120 LYNNWOOD WA 98087 D:2533440109 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
<53
4
14 3 LIABILITY INSURANCE INSURANCE CO SAFECO H2548689IN EFFECTPOLICY# TOPVEHCLE CHARGE TTOM 5 36
LEGALLY YES❑NO CITATION# 4A0001158 INT LICENSE-PASSENGER UNDER 20,
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:3608888002
16 a
LAST NAME AHMED FIRST NAME KATHRA MIDDLE I D
INITIAL
17❑ STREET ❑', 300 VUEMONT PL NE APT B103 CITY' RENTON ST WA ZIP 980564506 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. 11 27 1989 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE BYH5398 TAre WA vIN# SALYJ2EX5MA307495
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE LNDR MODEL RANGE STYLE UT VEHICLETOWED TO BLIN TOWED BY GOV HI �44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KATHRA AHMED 300 VUEMONTPL NE APT B103 RENTONWA98056 D:3608887002 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU8 PORGY#E CO PROGRESSIVE 950826983IN IULI�iKOTTlf0�-
F'E""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25 OFFICR'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.PAGE 8660 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE47398
COLLISION REPORT III III III III III 111
1591972 CASE# 1 24-973
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WAFER QUINCYJ
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
16206 36TH AVE W APT 120 LYNNWOOD WA 98087 2066816235 SEX M MMDouyvv 12 - 21 - 2007
PASSENGER Z WITNESS UNIT# F1 SEA 9 AIRBAG 2 RESTR. 4 EJECT ? 1 H U SE 2 `CLASS 1 NATURE OF INJURIES
POSNAME
(LAST,FIRST,MIDDLE INITIAL) RIOS ANDREA M
ADDRESS&PHONE#
6107 PARKWAY LYNNWOOD WA 98037 4252180119 SEX U MMaDYvvv 08 _ 18 _ 2009
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.
C.PAGET 01-27-24 01:38 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 21512024 6:53:13 AM
BADGE OR ID# 8660 OR]# WA0171300 TIME POLICE DISPATCHED; 11:16 PM TIME POLICE ARRIVED',11:20 PM
PART Ei PAGE IT]OF 4]
REPORT NO. EE47398 CASE# 24-973 OF COLLISION
01/26/24 23:11
OF CbLLI510N
NARRATIVE
24-973 Non-injury collision
Axon:
Axon body cam available
Documents:
Sector Infraction #4A0001158 for (2) counts Violation intermediate license provisions and fail to yield
right of way-entering highway from private road or driveway.
Narrative:
On 01.27.2024 at 2320 hours, I arrived at a non-injury, non-blocking collision which occurred in the
300 block of Rainier AVE S at 2320 hours. This address is within the city limits of Renton, County of
King, WA. The collision occurred on Rainier AVE S, but both vehicles pulled into the Shell/7-11
located at 300 Rainier AVE S. Rainier AVE S at this point in the road travels SE to NW.
The occupants of both cars were advised that they were being recorded. I verified that there were no
injuries in both cars.
I spoke with Michaylla S Carter DOB/08.07.2007 who was driving a red 2021 Kia Seltos
WA/CEC8550. This vehicle is registered to Michelle Walker-Gomez. Carter provided her photo
WADL which is an intermediate driver's license issued 10.10.2023 that has the following provisions.
DRIVER RESTRICTION: No Driving 1:00 AM to 5:00 AM DRIVER RESTRICTION: No Passengers
Under 20 DRIVER RESTRICTION: No Wireless Communication Devices. Carter provided the
registration and called the owner of the car (her grandmother) for proof of insurance. Carter had two
passengers in her car. In the front passenger seat was her cousin, Andrea M Rios 08.18.2009 (age
14) and her friend Quincy J Wafer DOB/12.21.2007 (age 16). Neither is an immediate family member
to Carter.
Carter told me that she was pulling out of the 7-11 onto Rainier AVE S, which is in the northwest
direction. Carter didn't see the silver Range Rover driven by Kathra D Ahmed and hit her car.
I spoke with Kathra D Ahmed DOB/11.27.1989. Ahmed provided her photo WADL, proof of insurance
and registration. Ahmed was driving a silver 2021 Landrover Range Rover WA/BYH5398. Ahmed is
the legal owner of her vehicle. There were no passengers. Amhed said she was headed north
(actually northwest) on Rainier AVE S in the 2nd lane from the curb which a red Kia driven by Carter
pulled out of the 7-11 and struck her vehicle.
Michelle Walker-Gomez responded to the scene. As soon as she exited the car she came in, she
started yelling at her granddaughter that she wasn't supposed to have passengers.
I told Carter and Walker-Gomez that the infractions would come in the mail. I issued Sector Infraction
#4A0001158 for (2) counts Violation intermediate license provisions and fail to yield right of way-
entering highway from private road or driveway. Infractions to be mailed by the court.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Paget/8660 1/27/2024 1:33 AM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE47398 CASE# 24-973 DATE AND TIME 01/26/24 23:11
OF COLLISION
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PAGE 4 OF 4