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HomeMy WebLinkAbout25-4366 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF93370OLCERA COLLISION REPORT 1591971 CASE# 25-4366 2 INTERSTATE CITY STREET FIRE I RESULTEDLVED STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 3 COUNTY RD ❑ NT&RUN ©DING PRIVATE WAY 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eDCL s on' 05 - 18 - 2025 0758 17 =.= S 8 W e OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a PUGET DR SE MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------ 1.1 FEET e S 8 W e ? ONES PL SE 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2068224354 0 1 30 6 LAST NAME NGUYEN FIRST NAME QUYEN MIDDLE T 1 1 2 31 INITIAL STREET ] 1611 FERNDALE AVE SE CITY; RENTON I ST; WA ZIP; 98058 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NO�/ INTERLOCKYES NO�/ YES NOF,/ 8❑ DCIENSE# STATE WA SEXI M MMDDYY' 12 — 03 — 1999 1 2 32 9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USE ET 9 CLASSY 1 [NATURE of INJURIES 2 10 LI ENSE BMG6921 STATE WA VIN# 5J8YD4H54KL003159 3 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR rRLR. 7 1 3 33 12 3 5 VIN# vIN# FROM TO 13 2 VEH.YEAR2019 MAKE ACUR MODEL MDX STYLE 4H VEHICLE TOYED NO�iS46LIN Tv4 EBYMEYERS GOS❑VT EHICLE Np 7 3 34 DAMAGE IIII._IIII REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 LIABILITY INSURANCE INSURANCE CO 4 14 AMERICAN FAMILY 41053-31859-91 IN EFFECT &POLICY# 9TOP CHARGE 5 36 Lemur yes[:]NO[:] CITATION# 80TFOM 15❑ STANDING s 7 6 PROPERTY MOTOR PEDAL- PEDESTRIAN Y DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ nWNFR vEs�/ No D:4255664354 16� LAST NAME RABBANY FIRST NAME HAMEEDA MIDDLE' INITIAL 17 F1 STREET ❑ ❑ 3000 SE ROYAL HILLS DR APT 27F CITY RENTON ST, WA ZIP 98058 37 NEW ADDRESS 18❑ IGNITION RE(]UIRED IGNITION PRESENT MEDICALTRANSPORTED 38 CDL INTERLOCKYEs NO INTERLOCK YES No YES NO 19 DRIVER'S STATE WA SEX F D.O.a. 08 10 1992 39 LICENSE# MMDDYY - HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR g EJECT 1 USE 9 CLASS 1 ❑ 21 1 LICENSE CAY3999 TATE WA VIN# 4T3B6RFV8MU054520 41 11 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# VEH.YEAR 2Q21 MAKE TOYT MODEL RAV4 STYLE 4(-/ VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES �/ No GENE MEYERS REGISTERED OWNER INFO HAMEEDA RABBANY 3000 SE ROYAL HILLS DR APT 27F RENTON WA 98058 D:4255664354 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 992644144 IN EFFECT &POLICY# t STOP veG— ❑ ,J—I CITATION# CHARGE to BOTTOM LEGn��Y YES N`.LJ 25 $ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 DAMES ELFERING 13002 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF93370 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4366 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) RABBANY YUSUF ADDRESS&PHONE# D� 3000 SE ROYAL HILLS DR APT 27F RENTON WA 98058 SEXi M MM DDYVYY 08 — 17 — 2010 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES 2 POS. 3 2 9 1 USE 9 CLASS 11 ----� :NAME (LAST FIFST MIDDLE INITIAL) ADDRESS R PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE OF INJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.O.B. YY PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. I USE CLASS NARRATIVE CASE NO. 25-4366 Narrative Unless otherwise noted the following events occurred within the City of Renton, County of King, State of Washington while I was working uniformed patrol. This report is not an exact sequencing of events and statements have been paraphrased and summarized. On 05/18/2025 at approximately 0801 hours I was dispatched to a report of a non-blocking non-injury collision that occurred on Puget Dr SE near the intersection of Jones PL SE. Upon my arrival I confirmed that none of the involved parties had injuries and facilitated an exchange of information. Both parties requested that I call a tow for their vehicles. Unit 1 was leaking gasoline and oil and had marks on the passenger's side front fender. Unit 2's rear driver's side wheel was bent in and damaged. Both vehicles were towed privately. The driver of unit 1 informed me that he did not know how the crash occurred. The driver and passenger of unit 2 stated that they were travelling eastbound on Puget Dr SE when Unit 1 struck their vehicle from behind. They were unable to tell me where their vehicle was positioned on the roadway at the time of the collision. I provided both parties with an exchange of information and the case number. Both parties arranged a ride home. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. ELECTRONICALLY SIGNED BY J. ELFERING R1 3002 05/1 8/2025, 0904 HOURS, RENTON WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JAMES ELFERING 05-18-25 09:14 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.SKELTON 9139 512112025 3:45:35 AM BADGE OR ID# j 13002 ORI# WA0171300 TIME POLICE DISPATCHED 8:01 AM TIME POLICE ARRIVED i 8:04 AM PAST B 3 Da-3mx—attar gt 1Mffp PAGE 2�OF F3 REPORT NO. EF93370 CASE# 25-4366 DATE AND TIME 05/18/2507:58 OF COLLISION j g}, IpX, tr a � h 4 f} s a�tt5`h t ✓{ Y, 3 y v is �l ohs z Fes£5,5 4 4 L? Y �r sn l �r v� PAGE 3 OF 3