HomeMy WebLinkAbout24-4232 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-4232 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 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# ❑
CtLLISION' 04 - 18 - 2024 1125 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
68TH AVE S BLOCK NO. e✓ 13500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 2001. 00 FMILES EET e S B W e BEACON COAL MINE RD
0 2 29
p PEDAL-UNIT U1 VEHIOCLE CYCLE ❑ YES AGE NTHRESHOLDO MET PHONE O 1 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑
NEW ADDRESS CITY SEATTLE ST ZIP z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ DRIVERS STATE STAfE SEX u MMDDYY - 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 9 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE UNKNOWN sTATI VrN#
10[ PI ATE#
11[—jTRAILER STAI E TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
rRLR. TRLR. 1 5 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE TOYT MODEL COROL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO UNKNOWN SEATTLE VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY#verIIC CHARGE 36
LECALLv Yes❑NO CITATION# CQ
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066370535
LAST NAME MOHAMMAD NAZIR FIRST NAME MOHAMMAD MIDDLE H
INITIAL
17❑ STREET ❑', 13445 MARTIN LUTHER KING JR W UNIT A206 CITY' SEATTLE ST WA ZIP 981785208 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL—T�RANSPORTED 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 01 03 _ 1983 39
LICENSE# MMDDYY
HELMET INJURY 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS COMPLAINT OF LEG PAIN ❑
21❑ LICENSE I CLR4610 TATE WA VIN# JM1CR293360130780
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2006 MAKE MAZp MODEL 5 STYLE VN VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO
REGISTERED OWNER INFO MOHAMMAD MOHAMMAD NAZIR 13445 MARTIN LUTHER KING JR W SEATTLE WA 98178 VEHICLE NO.2
SHADE DA GEbAREA
LIABILITY INSURANCE &PORGY#INSURANCE CO AMERICAN FAMILY 41101-23996-72 Cdd
IN EFFECT CTOP
VEHICLE ❑ ,J�J CITATION# CHARGE I�BOTTOM
LEGALLY YES N
25 7.FF1CJEO-S NAME(PRINT) OFFICER PHONE BADGE OR ID# ��A
NCY
26
HNSON 0505 0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE69656
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4232
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 04-19-2024 at about 1235 hours, I was dispatched to a Hit and Run Collision in the vicinity of 68th
Ave S and Beacon Coal Mine Rd in the City of Renton, County of King, Washington State. I arrived in
the area at about 1252 hours. Approximately 200 feet north of the intersection I observed a vehicle
off the roadway and in a ditch to the east of the roadway. The vehicle was pointed in a generally
north direction.
The driver of Unit 02 was identified by WADS. The driver did not speak English but had a friend at the
location who provided assistance with translation. The friend was not involved with the collision and
came to the location after. The driver of Unit 02 was wearing a seatbelt and complained of leg pain
as a result of the collision.
Unit 02 was northbound on 68th Ave S when a black Toyota Corolla (Unit 01) in the southbound
lanes attempted to pass other vehicles going southbound. Unit 01 entered the northbound lanes and
drove directly towards Unit 02. The driver of Unit 02 veered to the right to avoid Unit 01 and drove
into the ditch.
68th Ave S is a narrow two-lane roadway with no shoulders nor pedestrian sidewalks. To the west of
the southbound lanes is a metal barrier to prevent vehicles from leaving the roadway and going down
a steep embankment. To the east of the northbound lanes is a large drainage ditch and a steep
embankment up. The grade of the roadway inclines to the north. The lanes are divided by a solid
double yellow line indicating a no passing zone. Although the vehicles did not collide, the actions of
the driver of Unit 01 forced Unit 02 off the roadway to avoid a head on collision.
There is no additional information about Unit 01 and no description of the driver.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
CO.JOHNSON 04-18-24 02:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 4/19/2024 6:22:18 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 12:35 PM TIME POLICE ARRIVED 12:52 PM
PART I PAGE IT]OF
REPORT NO. EE69656 CASE# ' 24-4232 DATE AND TIME 04/18/24 11:25
OF COLLISION
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Not,i
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