HomeMy WebLinkAbout25-4576 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF95788OLCERA
COLLISION REPORT 1591971
CASE# 25-4576 2
INTERSTATE CITY STREET FIRE
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-A`NG 4150 3
HIT&RUN ✓ CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eOCL s o v' 05 - 25 - 2025 1756 17 =.= S 8 W e OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S BLOCK NO. e 400 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e S 4TH PL
0 1 29
MOTOR PEDAL- DAM AG TSHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES NHREO ✓ Q 8 30
5 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31
INITIAL
STREET F�
NEW ADDRESS CITY', RENTON ST: ZIP: 2
7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYEs No INTERLOCKYEs NO YES NO
8❑ LCEENSE# SRVERISTTATE SEX U MMDDYY' —=— 1 2 32
9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM
USEET 9 CLASSY O NATURE OF INJURIES 2
LICENSE, 3
10� PI ATP# STATE V(N
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 5 1 33
12 3 5 VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE SV VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34
13� DAMAGE YES�NO ✓� YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN RENTON VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE El
NSURANCE CO 3 4
IN EFFECT &POLICY# __4_TO_P_
LEwcLE CHARGE t S ❑ 36
""' yES❑NO❑ CITATION# 10 BOTTOM
15❑ STM ING s 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES NO �/ D:2066641271
16�
LAST NAME HABTEMARIAM FIRST NAME NEFTALEM MIDDLE T
INITIAL
STREET ❑
17 ❑ 19019 129TH PL SE CITY RENTON ST, WA ZIP 98058 g 37
NEW ADORE SS
1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38
CDL INTERLOCKYEs NO✓ INTERLOCI£YEs xz ✓ yEs No
19 DRIVER'S
MMDDYY I -
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 40
USE CLASS COMPLAINT OF BACK PAIN
21[ LICENSLATE E BJC7806 rare WA vIN# 5UXKR0050FOP03241 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2015 MAKE BMW MODEL XS STYLE $V VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ NO✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO STATE FARM 510 2526-COB-47A
IN EFFECT &POLICY# t STOP
VEHICLE
LE—Y N.I—I, CITATION# CHARGE to BOTTOM
E— YES
25 s s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JEREMY ENGEL 13006 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF95788
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4576
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE 0,SS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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.
JEREMY ENGEL 05-25-25 10:27 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 512912025 1:59:43 AM
BADGE OR ID# j 13006 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:58 PM TIME POLICE ARRIVED i 6:01 PM
PAST B a Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF95788 CASE# 25-4576 OF DATE AND r�N + 05/25/25 17:56
O�COLLISION
NARRATIVE
25-4576
RTF
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 05/25/2024 at approximately 1758 1 was dispatched to a blocking accident at the intersection of S
4th PI and Rainier Ave S, City of Renton, County of King, Washington. While enroute dispatch
advised one of the involved complained of a back injury.
I arrived on scene and located one of the involved vehicles which was a BMW X5 bearing
WA/BJC7806. 1 contacted the driver who was identified via his WADL as Neftalem T. Habtemariam
(05/23/1979). Habtemariam stated he had slight back pain from the collision.
I asked Habtemariam where the other vehicle involved was and he stated he did not see it and
believes it drove off. He could only describe it as a black SUV which was being driven by a dark skin
male.
Renton Regional Fire Authority arrived on scene to evaluate Habtemariam but he declined the need
for medical attention. 1 gathered Habtemariam's recollection of the incident.
Habtemariam was the driver of Unit#2 which was on Rainier Ave S stopped at a red light at the
intersection of S 4th PI. Unit#2 was facing northbound in lane 2 of 4. Unit#1 was driving behind Unit
#2 and did not stop causing the front end of Unit#1 to collide with the rear end of Unit#2. Unit#1 and
Unit#2 then turned eastbound onto S 4th P1, where Unit#2 stopped, and Unit#1 drove away.
There was a small scratch on the back on Unit#2 where Unit#1 collided with it. 1 photographed the
damage and uploaded it to AXON.
I determined Unit#1 to be the proximate cause due to Inattentive Driving (RMC 10-12-25). Unit#1
was unable to be located and there is no suspect information at this time.
Unit#2 was able to be driven away from the scene without further incident.
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 by Officer J. Engel #13006 5/25/2025 10:21 PM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. E F95788 CASE# 25-4576 DATE AND TIME 05/25/25 17:56
OF COLLISION
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