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Home My WebLink About25-4078 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF90803oc� RA COLLISION REPORT 1591971 CASE# 25-4078 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AOENC'Y 4200 3 COUNTY RD NVOLVED CODING PRIVATE WAY 2❑ TRIBAL TOTAL 1 UNITS#OF 02 SO BJECT TRUCK 1 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsloN' 05 - 08 - 2025 1810 17 =.= S 8 W e IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION NE 6TH PL BLOCK NO. e 2600 .� 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 30 00 FEET e✓ S 8 W e FERNDALE AVE NE 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:6163222397 1 4 30 6 LAST NAME MOHSIN FIRST NAME ASSIYA MIDDLE 1 1 2 31 INITIAL STREET Z 2705 NE 6TH PL CITY RENTON ST WA ZIP 98056 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO Z/ INTERLOCKYEs NO�/ YES D NOZ 8 LICIENSE STATE M/ SEX F MDmopyy' 05 — 29 — 1995 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 6 NATURE of INJURIES 2 USE ;CLAsg COMPL.DIZZY/SICK.IS 11 MO.PREGNANT 10 LI ENSE! DVZ6228 sTArE MI VIN# 1FMCU9G94DUC73091 3 TRAILER STATE TRAILER ,STATE 11 0 0 PLATE# PLATE# FROM To TRLR TRLR 3 7 33 12 0 0 VIN# VIN# ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT VEHICLE m 34 13 2 2013 FORD ESCAPE UT DAMAGE YES ✓ NO �M�MEYER YES NO REGISTERED OWNER INFO ASSIYA MOHSIN 2705 NE 6TH PL RENTON WA 98056 D:6163222397 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE� INSURANCE CO PROGRESSIVE 983717851 2 3 4 IN EFFECT &POLICY# 4TOP V""' CHARGE t S 36 LE,,ALLY YES❑NO❑ CITATION# 7 0 80TTOM 15❑ STM ING 7 e UN# MOTOR PEDAL ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 1 T 02 VEHICLE CYCLE. OWNER YES NO 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE' INITIAL 17❑ STREET ❑ CITY RENTON ST ZIP 4❑ 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED3 IGNTION PRESENT MEDICAL TRANSPORTED 38 INTERLOCKYEs NO JNTERLOCK YES 0-001 Es NO' 19 LICIENSE# STATE SEX U MMDDYY —� 39 HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑ 21 LICENSE I PLATE# BCJ8974 TATE I WA VIN# 4S4BSEKCOH3251209 41 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2017 MAKE $(JB,G MODEL O(iTB,QC STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO ANTHONY ROSSITER 2613 NE 6TH PL RENTONWA98056 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE❑ INSURANCE CO UNABLE TO CONTACT UNABLE TO CONTACT IN EFFECT &POLICY# 9TOP VEHICLE LEGALLY ❑ N`.,.ILJ —I CITATION CHARGE t080TTOM 25 YES a a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 RYAN KARLO RIVERA 12649 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EF90803 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4078 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. - L----------� MMDDYYYY PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j 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. RYAN KARLO RIVERA 05-08-25 08:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE CASEY PROCTER 12123 5/12/2025 10:57:08 PM BADGE OR ID# 12649 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 6:11 PM TIME POLICE ARRIVED 6:47 PM PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 57 EAN REPORT NO.` EF90803 CASE# 25-4078 O OF COLLI COLLISION TIME 05/08/25 18:10 COLLI NARRATIVE On 05/08/2025, 1 was working uniformed patrol in a marked police car as 3R23. At approximately 1811 hours, officers were dispatched to an injury collision at the intersection of NE 6th PI/Ferndale Ave NE, which is located within the city limits of Renton, County of King, Washington. Dispatch advised that a caller had reported that she had just gotten into a motor vehicle accident with a parked vehicle. The caller also advised dispatch that she had been feeling dizzy and was also 11 months pregnant and requested the fire department to evaluate her. As 1 was driving to the call, dispatch updated officers that the caller was inside of her vehicle and was unable to exit the vehicle due to the damage. She stated she had no injuries from the accident and was just feeling dizzy and nauseated. When 1 arrived at the dispatch location, 1 was able to locate the involved units as described above. Unit 1 was occupied by a sole subjects in the driver's seat as listed above. Unit 2 was unoccupied and parked on the side of the roadway near 2613 NE 6th Pl, Renton. 1 also saw that the fire department had already arrived and was speaking with the driver of Unit 1. Other officers at the scene were able to speak to the driver of Unit 1. They relayed the following to me: Unit 1 stated to officers that she had just left her house which was about a block to the east of where the incident occurred. She stated she began to head westbound on NE 6th PI from her house. Unit 1 stated that she had also been feeling dizzy and ill prior to driving her vehicle. As Unit 1 continued to drive westbound on NE 6th PI passing Ferndale Ave NE, she collided with Unit 2 that was parked unoccupied on the south side of the street facing west. took a look around Unit 1. 1 saw that her front driver's side bumper was damaged. There were large dents and scratches present. The front driver's side wheel well also appears to be slightly damage from the bumper pushing inward. I also saw that no airbags had deployed inside Unit 1. Unit 1 stated that she was still feeling dizzy and nauseous. She was also 11 months pregnant at the time of the collision. She stated she did not feel any other pain anywhere else at this time. She also stated she was wearing her seatbelt at the time of the collision. I was unable to locate any information on the registered owner for Unit 2 using law enforcement databases. 1 also attempted to knock on the door to the associated address for Unit 2 to no avail. A Renton PD business card was left at their front door for future contact. Unit 1 was driven back to her residence from the incident location by a friend. Unit 1's driver was provided with a Renton PD business card with the associated case number for her records. Unit 1 was eventually impounded by Gene Meyer tow from the location. Unit 2 was left at the location where it was originally parked. This report is for informational purpose to document the collision. This concludes my report. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. PAGE 3 OF 5 EAN REPORT NO.` EF90803 CASE# 25-4078 O OF COLLI COLLISION TIME 05/08/25 18:10 COLLI NARRATIVE Signature: Ryan Rivera (#12649) Date and Place: 05/08/2025 a@ Renton, WA PAGE 4 OF 5 REPORT NO. EF90803 CASE# 25-4078 DATE AND TIME i 05/08/25 18:10 OF COLLISION 3 wo owlell -4 ul e a ' :0 ow ;. t Y�tda {E\k �r444t �t Tf� }rCi�4�M 1 i t s � t PAGE 5 OF 5