HomeMy WebLinkAbout25-1343 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF65429 170
27
COLLISION REP FIT 1591971
CASE 25-1343 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 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# ❑
COLLISION' 02 - 11 - 2025 1049 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 7TH ST BLOCK e✓ 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 00 FMILES EET e S ❑ W e RAINIER AVE SE
2 0 29
R PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:8585680700 0 11
30
6� LAST NAME ISMAIL FIRSTNAME IDIL MIDDLE J 1 2 31
INITIAL
STREET ❑ 600 SW 5TH CT APT J408 CITY RENTON ST WA ZIP 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYES NO INTERLOCK YES NO YES No
8❑ DRIVERS
# STATE WA SEX'U MM DlY' 10 - 10 - 1972 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS
ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9� P1 ATE 14 CDV7721 STATE WA V N# JTDEAMDE9NJ037016
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 0 VIN#' UIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 2 2022 TOYT COROL DAMAGE YES�NO YES❑ NO✓
REGISTERED OWNER INFO ALI ABDI 600 SW 5TH CT APT J408 RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14� LIABILITY INSURANCE� INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
35
VEHICLe CHARGE 5
LECALLv res❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062505696
LAST NAME LEWIS FIRST NAME D'VONNE MIDDLE M
INITIAL
17❑ STREET ❑', 7757 SEWARD PARK AVE S CITY SEATTLE ST WA ZIP 981184248 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOF INTERLOCK YYEEsI I I NOF YES t l NO❑
19� DRIVER # STATE WA SEX M MMDDW 10 _ 14 1983 El 39
20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 40
USE CLASS NECK
21❑ LICENSE I CPM9747 TATE WA VIN1t KNDC3DLC2R5620821
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2024 MAKE KIA MODEL EV6 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO D'VONNELEWIS7757SEWARDPARKAVES SEATTLE WA 98118 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE� &POINSULICY#E CO SAME. I STOP 5
VE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF65429
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1343
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'
blu/1 In chng lane 2 into blk/2
RTF
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash near the 100 block of S 7th
St.
I contacted the driver of unit 2 who told me he was in lane 1 eastbound when unit 1 made a lane
change into the side of his car. He complained of neck pain. He was checked and released on scene
by Renton Fire. Damages did not require a tow truck.
I contacted the driver of unit 1. She said she was eastbound in lane 2 and was attempting a lane
change. She said it was clear when she was moving from lane 2 into lane 1 as unit 1 sped by where
she made contact with him. She did not complain of injury and damages did not require a tow truck.
Information/Insurance only
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 2/11/2025
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 02-11-25 11:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 2/13/2025 4:20:50 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 10:49 AM TIME POLICE ARRIVED 10:50 AM
PART I PAGE IT]OF 3�
REPORT NO. EF65429 CASE# ' 25-1343 DATE AND TIME 02/11/25 10:49
OF COLLISION
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