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HomeMy WebLinkAbout24-6470 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-6470 2
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 2$
TRIBAL UNITS 01 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# ❑
Ct ELISION' 06 - 19 - 2024 2202 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
128TH AVE SE BLOCK NO. e✓ 17200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e SE 172 ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2062318222 30
6� LAST NAME HAMDARD FIRSTNAME RESHAD MIDDLE 1 2 31
INITIAL
STREET 01 12210 SE PETROVITSKY RD APT J CITy RENTON ST WA 2jp, 98058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10� Pi aT�S� CL V7992 sTATe WAvIN# 5NPEB4AC76H032398
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TPILR. 1 5 33
12❑ VIN#' VIN#
RomM TO
34
13❑ VEH.YEARN MAKE HYUN MODEL SONATA STYLE 4D VEHICLE TOWED 0 TOO ffBLIN TQVWkkRS yOS❑ENO
DAMAGE ILJI tSA1Vi�c
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE INSURANCE CO THE GENERAL INSURANCE WA7093727 3 4
IN EFFECT &POLICY# 9TOP
15❑ vECEHA"LE 5 36
LLLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 8 7 6
UNIT MOTORVEHIC
❑ CYCLE PEDAL- ❑ PEDESTRIAN ❑ PROPERTY ❑ DYES H OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
KEITH PETTY 12809 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE92588
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6470
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.
KEITH PETTY 06-20-24 01:34 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 7/3/2024 11:51:35 PM
BADGE OR ID# 12809 OR]# WA0171300 TIME POLICE DISPATCHED 10:17 PM TIME POLICE ARRIVED 10:21 PM
PART I PAGE IT]OF 5�
REPORT NO. EE92588 CASE# 24-6470 OF COLLISION
06/19/24 22:02
OF CbLLI510N
NARRATIVE
24-6470
1 was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #227, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 3r13.
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
On 06/19/2024 at approximately 2217 hours I was dispatched to the intersection of SE 172nd ST and
128th Ave SE in the of Renton, County of King, State of Washington for a hangup.
Upon arrival I contacted RESHAD HAMDARD (DOB 06/28/1993) identified by his WADL photo.
Reshad had called 911 and hung-up multiple times. As I was enroute another caller called and stated
that there was an accident at the above location. As I arrived, I talked to Reshad through Language
Line as he only spoke Bali. Reshad was still sitting in his black 2011 Hyundai Sonata (CLV7992/WA).
Reshad stated that as he was driving south bound on 128th Ave SE something got in his eyes, and
he couldn't see. When he opened his eyes, he hit a tree just south of 17251 128th Ave SE.
The accident caused significant front-end damage with airbag deployment to his Hyundai. Rendering
it undrivable.
I had RRFA respond as Reshad's airbag had deployed. He was coughing and seamed shook up.
RRFA cleared Reshad at the scene, and he denied any other medical treatment.
Reshad provided me with al the info I asked without appearing to be intoxicated. His speech was
clear, and he did not fumble while finding the right documents. RRFA stated his eyes were a little
watery but did not see any HGN indicators.
Banker's towing was dispatched and towed the vehicle to their yard after having Reshad sign for the
tow.
This report is to document the circumstance of the collision and damage to the vehicle.
"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: K.Petty, Date: 06/20/24at 0125 hours, Place: Renton, King County, WA
PAGE 3 OF 5
REPORT NO. EE92588 CASE# 24-6470 OF COLLISION
06/19/24 22:02
OF CbLLI510N
NARRATIVE
PAGE 4 OF 5
REPORT NO. EE92588 CASE# 24-6470 DATE AND TIME 06/19/24 22:02
OF COLLISION
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