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HomeMy WebLinkAbout24-6562 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-6562 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CtLLISION' 06 - 1-- 2024 1537 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SW 7TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e HARDIEAVESW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:5407387859 0 11
30
6� LAST NAME SWINSON FIRSTNAME RONNIE MIDDLE M 1 1 2 31
INITIAL
STREET ❑, 633 CREEKWAY CIR SE CITY BOLIVIA ST INC Zjp', 284228266 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8 LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ Pi ATE 14 BZP2337 STATE WA VIN# JTEMU5JR5R6276695
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR $ 5 33
12 2 5 VIN# VIN
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2024 TOYT 4RUNNE DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO PVHOLDING CORP 15820 INTERNATIONAL BLVD TUKWILA WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO SUPER SYSTEMS EBA 0708395 3 4
IN EFFECT &POLICY# 9TOP
veHICLe CHARGE 5 36
LEGALLv Ye6❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064714850
16 a
LAST NAME MOHAMED FIRST NAME ABDIRAHMAN MIDDLE It
INITIAL
17❑ STREET ❑' 6727 MLK JR WAYS CITY SEATTLE ST WA ZIP 98118 37
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[—] DRIVER'S STATE WA SEX M D.O.B. 07 27 2001 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 I BZY6952 TATe WA VIN# 4T1B21HK3J0002278
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2018 MAKE TOYT MODEL CAMRY STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANISA MUSA 6727MLKJR WAYS SEATTLE WA 98118 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POLICY#E CO SAFECO H2452501IN 0( STOP 5
VE""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N`L J
25 ' e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE92147
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6562
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 June 21 st, 2024, at 1537 hours dispatch requested that I respond to a collision that occurred near
the intersection of SW 7th St and Hardie Ave SW, in Renton.
Upon my arrival I spoke with the driver of unit 2 and they explained they were going northbound on
Hardie Ave SW from SW 7th St when the collision occurred. As they approached the parking lot
entrance to 20 SW 7th St, unit 1 failed to see his vehicle and entered the roadway. Unit 2 was unable
to bring his vehicle to a stop because unit 1 randomly entered the roadway as he approached him.
I then spoke with the driver of unit 1. He explained something similar and stated that he planned on
making a left turn from 20 SW 7th St to go southbound on Hardie Ave SW. As he checked for
oncoming traffic, he failed to notice unit 2 going northbound on Hardie Ave SW. He pulled forward
and was subsequently struck by unit 2.
Both vehicles sustained moderate damage, and unit 1 was removed from the location by a private
tow. Unit 2 was driven away from the scene by the driver.
I provided both drivers with an exchange of information.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 06-26-24 10:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 7/2/2024 2:33:25 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 3:38 PM TIME POLICE ARRIVED',3:46 PM
PART I PAGE IT]OF
REPORT NO. EE92147 CASE# 24-6562 DATE AND TIME 06/21/2415:37
OF COLLISION
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