HomeMy WebLinkAbout25-5330 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG06262OLCERA
COLLISION REPORT 1591971
CASE# 25-5330 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AOENC'Y 4100 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' 06 - 18 - 2025 1700 17 =.= S 8 W e IN OF M 1070 a
4� ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
RAINIER AVE N
4a� MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET S 8 W e NW 3RD PL
0 3 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:7089667535 0 1 30
5 LAST NAME GHUNAIM FIRST NAME HISHAM MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 354 LIND AVE NW UPPR UNIT CITY RENTON ST WA ZIP 980575134 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs N YES F NOFJ
8❑ LICIENS# STATE WA SEX M MMor YY' 11 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of NJURIEs 2=
LICENSE, CPC0001 srArE WA 1111N], JMIBPBDL4M1314786 3
10� P1 ATP rt
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 7 5 33
12 3 5 VIN# vI.
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 2 2021 MAZD 3 DAMAGE YES�NO� YES❑ 1 5 34
REGISTERED OWNER INFO HISHAM GHUNAIM 354 LIND AVE NWUPPR UNIT RENTON WA 980575134 0:7089667535 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE NSURANCE CO PROGRESSIVE 9675885321
IN EFFECT &POLICY# 4TOP _
sVEHICLE rgNOLNG ❑ ❑ 5A0607974 CHARGE PROHAMPROPER TURN o ooTro6 36
Yes NO CITATION#
15
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES 1/ NO D:2069405216
16�
LAST NAME REID FIRST NAME CLAYTON MIDDLE R
INITIAL
STREET ❑ 37
17 ❑ 1203 N 10TH PL APT 1528 CITY RENTON ST, WA ZIP 980575469
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38
INTERLOCKYES No INTERLOCK YES - YEs NOI
19 DRIVER' # STATE WA SEx M MMDtiYY 02 19 2002 39
20❑ ON DUTY STATUS AIRBAG'2 RESTR 4 EJECT 1 HELMET INJURY' 7 NATURE OF INJURIES ❑ 40
USE CLASS NECK
21 LICENSE CNH2960 TATE WA vIN# 1 FMSK8DH4LGB64909 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
TOWED BY GOV HI 44
VEH.YEAR 2Q2Q MAKE FORD MODEL EXPLORE STYLE DAMIAGETOWED No BLIN BANKERS YES NI �/
24
REGISTERED OWNER INFO CLAYTON REID 1203 N 10TH PL APT 1528 RENTON WA 980575469 D:2069405216 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCE CO ALLSTATE 820 267 691
IN EFFECT &POLICY# 9TOP
veeiae ❑ ,J—I CITATION# CHARGE t080TTOM
LecnLLY YES N`[
25 s 7 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG06262
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5330
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.
M.LEVERTON 06-24-25 10:45 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 71312025 9:00:01 AM
BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:04 pry TIME POLICE ARRIVED 5:04 PM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT NO.` EG06262 CASE# 25-5330 O COLLI COLLISION TIME
OF 06/18/25 17:00
COLLI
NARRATIVE
wht/1 rt slv/2 lane 2 sb
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at the NW 3rd PI at
Rainier Ave N.
I located unit 2 southbound lane 2 still blocking. Unit 2 was concerned because his tire was flat and
partially separated from the rim. Unit 2 told me he was southbound in lane 2 when unit 1 made a right
turn from NW 3rd PI into the side of his vehicle. He did complain of injury and was checked/released
by Renton Fire on scene. His vehicle was towed for damages.
I contacted the driver of unit 1 ID'd by picture WADL who told me he was making a right turn from NW
3rd PI onto Rainer Ave S. He said that he purposely makes his turn into lane 2 because he wants to
be in that lane right away. He told me he didnt see unit 2 as he made his turn. Damages did not
require a tow truck and he did not complain of injury.
I cited unit 1 Ref RCW 46.61.290 improper turn two vehicle injury crash via complaint. Unit 1 did turn
right to the most immediately lane which is required.
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 6/24/2025
PAGE 3 OF 4
REPORT NO. EG06262 CASE# 25-5330 DATE AND TIME i 06/18/25 17:00
OF COLLISION
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