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HomeMy WebLinkAbout25-5606 )STATE TFcN 5 6 27i t Oc� RA EG04779 COLLISION REPRT 1591971 CASE# 25-5606 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4100 3 COUNTY RD ❑ NVOLVED CODING PRIVATE WAY 2❑ TRIBAL TOTAL 1 UNITS#OF 03 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 COLLISION' 06 - 28 - 2025 1135 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION SW 7TH ST BLOCK NO. e 100 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 50 00 FEET e✓ S 8 W e HARD/E AVE SW 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHiOLE ❑ CYCLE ❑ YEs Vl No D:2533475296 0 7 30 6 LAST NAME BYERS FIRST NAME ROBERT MIDDLE L 1 1 2 31 INITIAL STREET 3847 19TH AVE SW CITY SEATTLE ST WA ZIP 98126 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NOR] INTERLOCKYEs Na�/ YES R Nor,/ 8 LICIENSE#RVER' STATE WA SEX M MMOCSYY' 04 — 11 — 1962 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of N3uRIEs 2= 10 LICENSE ti� D37758G STATE WA vN# 3C7WRVTGXGE120009 3 TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# ROM TO rRLR TRLR 3 7 33 12 3 5 VIN# vI. ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE 3 9 34 13 2 2018 RAM PROMA DAMAGE YES DNO YES NO REGISTERED OWNER INFO PACIFIC SIDING&WINDOWS 4416D 40TH AVE SW SEATTLE WA 98116 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 2 3 4 14 PROGRESSIVE 03708097-9 IN EFFECT &POLICY# 4TOP VEHICLE CHARGE 5 36 Le ALLY YES❑NO❑ CITATION# 70 80TTOM 15❑ sTnNowc 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT OZ VEHICLE ❑ OVDLE' ❑ ❑ PROPSnwNF YEs�/ No D:2063964805 16� LAST NAME ADEM FIRST NAME JEMAL MIDDLE K INITIAL STREET ❑ 37 17 '❑ 3333 RA INIER AVE S APT 211 CITY SEATTLE ST, WA ZIP 981446817 NEW ADDRESS 18❑ CDL IG EQUIRED IGNITION R IGNITION PRESENT MEDICAL TRANSPORTED' 38 INTERLOCKYEs No INTERLOCK YES N.F,-/Jl YEs Nail 19 DRIVER'S STATE WA SEXM D.O.B. 01 01 1971 39 LICENSE# D.OB,Y — HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑ 21 LICENSE CKJ7641 TATE WA vIN# 4T3BK11A49UO10247 41 22❑ [TILER TRAILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2009 MAKE TOYT MODEL VENZA STYLE 5p VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO�/ YES NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2 SHADEDAMAGAREA 3 LIABILITY INSURANCE INSURANCECO STATE FARM 4100108-813.47A IN EFFECT &POLICY# 9TOP Veeiae ,J—I CITATION# CHARGE t08OTTOM LecnLLY YES N`.LJ 25 ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.STEED 8770 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG04779 COLLISION REPORT III III III III III 111 1591972 CASE# 25-5606 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL} MOHAMMED OMAR HAWA (LAST,FIRST, ADDRESS&PHONE# D(�� '. 3333 RAINIER AVE S APT 211 SEA TTLE WA 981446817 2064079840 SEX' F MMDDYYYv 04 — 12 1— 1974 SEAT : HELMET INJURY NATURE OF INJURIES El I PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS ;7 SORE CHEST FROMSEATBELT 'NAME LAsr F RST,MIDDLE INITIAL) HUEMAN GERALD T ADDRESS&PHONE# D C,B 7026 S 116TH ST SEATTLE WA 98178 2068541104 SEX U MMDDVVYv 11 _ 18 _ 1963 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ �✓ POS. USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M F L----------� MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j NARRATIVE On 06/28/25 at about 1144 hrs I arrived in the 100 block of SW 7th St for an Injury Collision, in the City of Renton, County of King, and State of Washington. All involved were identified by their WADL. Unit#3 was stopped for traffic in the WB inside lane of SW 7th St trying to make a left turn into Popeyes Chicken. Unit#2 was stopped behind Unit#3. Unit#1 was traveling WB on SW 7th St in the inside lane when the driver did not see the stopped traffic. Unit#1 collided with the back of Unit#2 which in turn was pushed into the back of Unit#3. The driver of Unit#3 complained of dizziness and the passenger of Unit #2 complained of chest pains from the seatbelt. Both were treated by Renton Fire. The witness advised he was in the EB inside lane of SW 7th St next to Unit#3 when he witnessed the collision. He said he did not think the driver of unit#1 even saw the stopped traffic when he rearended unit#2 which was pushed into the rear of Unit #3. 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. The video was uploaded to evidence.com. 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 Officer Steed on 06/28/25 1246 hrs, Renton Washington Cassidy Steed/8770 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.STEED 06-28-25 12:49 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE D.SKELTON 9139 6/28/2025 1:06:31 PM BADGE OR ID# 8770 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 11:39 AM TIME POLICE ARRIVED 11:44 AM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 47 SUPPLEMENTAL REPORT No. EG04779 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE#+ 25-5606 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # NAME IF PLACARD GWVR � NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE }j� PEDESTRIAN �/ D:2063964805 5 UNIT vT 3 VEHICLE CYCLE C) C� OWNER �' YES NO 0 7 29 LAST NAME GONZALES FIRST NAME MARNIE MIDDLE G INITIAL STREET 30 NFW ADnRFS.,p 7710 48TH AVE S CITY SEATTLE ST WA 7JP 981184104 6 ❑ 1 1 2 31 CDL IGNITION REQUIREt] IGNi71ON PRESENT MEC7ICALTANSPORTED. INTERLOCK YES NO ..INTERLOCK YES NO YES N G DRIVER'S WA SEX F D.O,Ei 07 7 LICENSE MMDDwv — O6 — 1967 HELMET I INJURY NAruRE OFINJURIEs ON DUTY STATUS: AIRBAG 2 RESTR. ¢ EJECT 1 USE 2 GLASS 7 DIZZINESS LICENSE I CRT2459 W VIN WBY83FB07RFS62861PLATE# 9 Fq] STATE TRAILER TRAILER 2 PLATE#r PLATE# STATE 10 ❑ TRLR TRLR VIN.# VIN.#. 11 3 5 VEH.YEAR2024 MAKE BMW MODEL14 I STYLE 4D VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFORONEO GONZALES 771048TH AVE S SEATTLEWA98118 3 9 33 12 � SHADE IN DAMAGED AREA 4 FROM TO INSURANCE CO LIABILITY INSURANCE SAFECO H2594340 IN EFFECT � &POLICY# �GQO 34 13 c YES NO CITATION# CHARGE iecauv sTnNoimc � � MOTOR PEDAL- ' PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YESF-1 NO 36 15 LAST NAME FIRST NAME NIDT ALE ❑ 16 ❑ STREET CITY ST ZIP NEW AODRBsa GDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES[]NO INTERLOCK YES NO :YES NO, 17 37 LLIRIVERS ICENSE# STATE SEX MMDDY Y 18 ❑ ❑ HELMET INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS 19 ❑ LICENSE TAT viN ❑ 39 PLATE# # 20 ❑ TRAILER TRAILER ❑ 40 PLATE#, STATE PLATE,# STATE 21 ❑ TRLR TRLR 41 VIN#j VIN#: 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# I.C;Q 5 44 vEHic�F ❑ ❑ CITATION# CHARGE 24 I..EG_ VES NO STIWDING 8 3 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.STEED 06-28-25 12:49 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR ID# 8770 O#RI WA0171300 APSKELTON 6122812025 PAGE OF� 3000-345-013(R 11l18) REPORT NO. EG04779 CASE# 25-5606 DATE AND TIME 06/28/25 11:35 OF COLLISION i Y.yit S{' yy2(ii' fit, i 1�1 s 4„ \Y { }a l }° 4�. 4 e UtKi. PAGE 4 OF 4