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Home My WebLink About24-11112 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 CASE 24-11112 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 04 STRUCK' TREE OR STUMP RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION'. 10 - 1-- 2024 1903 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NO. e✓ --- ----� N 3RD ST MILEPOST 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 50 00 FEET MILES e S ❑ W e PARKAVEN 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4255459169 0 11 30 6� LAST NAME ABUBAKAR FIRSTNAME SUMAYA MIDDLE M 1 1 2 31 INITIAL STREET ❑, 2223 SMITHERS AVE S CITy RENTON ST WA 2jp, 980554208 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs No Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES 2❑ 3 LICENSE CLT1000 sTArI WAurN# KNDJN2A25G7836793 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. TRLk2 1 3 33 12 3 0 VIN#' VIN#' >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE IVEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 7 3 34 13 1 2016 KIA SOUL SD DAMAGE vesNo � �MEYERS ves❑ No REGISTERED OWNER INFO ABDULKADIRABUBAKAR 2223 SMITHERS AVE S RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE NSURANCE CO NATIONAL GENERAL 2024939826 4 IN EFFECT &POLICY#VEHICL CHARGE36 LEGALLv Yes❑NO CITATION# <,IQ 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ OYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2062933683 16 a LAST NAME DION FIRST NAME DAVID MIDDLE A INITIAL 17 NEW AET 1:1' 433 BREMERTON AVE NE APT C102 CITY RENTON ST WA ZIP 980594729 37 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 RRS LDI IVE STATE WA SEX M M .C... 11 18 _ 1950 39 20 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 WEB SET 2 NJAURSY 6 BACK PAIN NECK PAIN RIGHT WRIST PAIN F—NATURE OF INJURIES 40 ❑ILICENSE 21❑ PLA E# AJH3083 TArE 41 WA VIN# 1N4A641D4VC750150 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 1997 MAKE NISS MODEL SENTRA STYLE SD VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44 24 DAMAGE YES�/ NO (,ENE MEYERS YES No�/ REGISTERED OWNER INFO DAVID DION 433 BREMERTON AVE NEAPT C102 RENTONWA98059 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU PORGY#E CO GEIC04390-34-76-25IN 9TOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE io BOTTOM LEGALLY YES N J 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# [ZoNCY 26 KEV/N PETERSON 1P808 171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF31332 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11112 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' 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. KEVIN PETERSON 10-26-24 12:07 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 111212024 4:11:00 PM BADGE OR ID# ! 1Y808 ORI#' WA0171300 TIME POLICE DISPATCHED 7:04 PM TIME POLICE ARRIVED]7:04 PM PART I PAGE IT]OF 5� REPORT NO. EF31332 CASE# 24-11112 OF COLLISION 10/25/24 19:03 OF CbLLI510N NARRATIVE I was dispatched to a collision on 10/25/24 at 1904 hours at N 3rd St and Park Ave N, in city Renton, King County WA. Unit 1 CLT1000 Driver: Sumaya M. Abubakar (DOB 06/24/2005) Unit 2 AJH3083 Driver: David A. Dion (DOB 11/18/1950) Unit 3 CLX5807 Owner: Dung V. Tran (DOB 05/07/1975) Unit 4 CAZ3043 Owner: Ky N. LE (DOB 07/21/1983) Unit 2 was driving East on N 3rd St in lane 1 when approaching the intersection of N 3rd St and Park Ave N he was T boned on the side by Unit 1. Unit 2 then hit Unit 3's vehicle which was parked in the parking lot of Crawfish restaurant. Unit 3's driver side door was open which then hit the passenger side door of Unit 4. Unit 1 after hitting Unit 2 drove up on the curb and ran into the tree. Unit 1 told me she was pulling out of the parking lot on the North of N 3rd St, and someone waved her into traffic, so she took off and that's when she ran into Unit 2 causing him to hit Unit 3 and Unit 4. Unit 3 and Unit 4 were not in their vehicles at the time of the accident. Driver of Unit 2 was seen by fire on scene for pain in the back, neck, and left wrist. He was transported to the hospital. Unit 1 stated no injuries. All drivers and vehicle owners were given a information exchange with the case number. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 10/25/2024, 2143 hours at Renton, WA **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 3 Action Code: PARKED IN PARKING LOT Motor Vehicle Unit 4 Action Code: PARKING LOT PARKED **** END OF AUTO-POPULATED SECTION **** PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EF31332 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-11112 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 1 8 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:2066881685 9 29 LAST NAME : TRAN FIRST NAME DUNG MIDDLE 1 V INITIAL 1 g 30 STREET NEW AnDRFSP' 8403 S 119TH ST CITY SEATTLE ST WA ZIP 981784036 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO✓ zERLOCK YES❑NO❑✓ YEs N ✓ DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 05 TOE] - 1975 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. 1 EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE BWE7115 TAr INA VIN# 5FNRL38845B106440 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR 91 VIN.#. VIN.#. 11 0 0 VEH.YEAR200Jr MAKE HOND MODELODYSSEY STYLE VN I VEHICLE TOME ET SABLIN TOWED BY anvi vFHICP FROM TO DAMAGE YES NO ✓ YES NO ✓ REGISTERED OWNER INFO SHADE IN DAMAGED AREA.TUAN NGUYEN 812816TH AVE SW SEATTLE WA 98106 rj 5 33 12 z 3 FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM 165 2554-F30.478 q"i"Olx IN EFFECT &POLICY# 1 ------- 5 5 34 13 ❑ EL L ❑ ❑ CHARGE 0 BQTTUM LEGAGALLY YES NO CITATION# STANDING 8 7 DAM AGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES IN VEHICLE CYCLE OWNER ✓ D:2069818223 15 ❑ LAST NAME LE KY FIRST NAME MIDDLE N ❑ 36 INITIAL 2 STREET 16 ❑ ❑ 202 FIELD AVE NE CITY RENTON ST WA ZIP 98059 NEn+AnnRFSS CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICAL TANSPORTED 17 ❑ INTERLOCK YES No✓ INTERLOCK YE NO✓ YEs No.1 ❑ DRIVER'S D.O.B 4 37 LICENSE# STATE WA SEX M MMDDyYY' 07 - 21 - 1983 18 ❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR, 1 EJECT 1 1 HELMET 2 INJURY 1 NATURE OF INJURIES 38 USE CLASS 19 ❑ ❑ 39PLATE# CAZ3043 AW v+N# SYJYGDEE1MF276690 20 ❑ TRAILER' STATE TRAILER ST 40 PLATE#< PLATE# ATE 21 ❑ ❑ 41 TRLR TRLR ViN# YIN#i 42 22 VEH.YEAR2021 MAKE TESL MODEL MODEL STYLE SD VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1 DAMAGE YES NO ✓ YES NO ✓ 23 ❑ REGISTEREDOWNER INFO KYLE 202 FIELD AVE NE RENTON WA 98059 D:2069818223 SHADE IN DAMAGED AREA 43 z 4 LIABILITY INSURANCE INSURANCE CO FIRST NATIONAL H2564204 F TOP i _. --` ❑ ❑ IN EFFECT &POLICY# 1 44 24 VEHICLE YES[:] NO CITATION L CHARGE iG BOi"TpM LEGALLY STANDING I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 10-26-24 12:07 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26F7 ORID# 12808 O#IL WA0171300 SUMMERS 111212024 PAGE F41 OF❑ 3000-345-013(R 11118) REPORT NO. EF31332 CASE# ' 24-11112 DATE AND TIME 10/25/24 19:03 OF COLLISION x m I 9 1 4�1 > �l t �4X s �r �7!•� P�� I f e� S r ti Ave S*� PAGE 5 OF 5