HomeMy WebLinkAbout25-5437 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG08226oc� RA
COLLISION REPORT 1591971
CASE# 25-5437 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL A`CENC'Y 4150 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL UNITS TOTAL#OF 02 TRUCK OBJECT 11 0 28
RESERVATION
3 4 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# 2 2 0
DATE OF'. N E
GOUISION' 06 - 22 - 2025 0147 17 S W IN 1070 a 5 1
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
BENSON DR S BLOCK NO. e 1600 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES N�. FEET S 8 W e S 16TH ST
0 1 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE CYCLE' YES NO �/ D:2064746597 0 5 30
5 LAST NAME NUR FIRST NAME JAMA MIDDLE A 1 1 2 31
INITIAL
STREET E1 921 S 34TH PL CITY RENTON ST WA ZIP 98055 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NOR] INTERLOCKYES N �/ YES F Nor,/
g DRIVER' STATE WA SEX M MMOS. 01 — 05 — 1974 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT, 1 HELMET 2 INJURY 7 NATURE OF INJURIES 2
USE ,CLASS LEFT HIP AND LEG PAIN
10 9 LI ENSE! AJU5382 STATE WA VIN# 5TDKK4CC1AS315646 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 1 5 33
12 3 5 VIN# VIN#
FROM TO
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BUN TOWED BY GO
VEHICLE
13 4 2010 TOYT S/ENNA VN DAMAGE YES NO ✓ YES NO 1 1 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 GEICO 6159-01-49-65
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE t 5 36
Lemur yes❑NO❑ CITATION# 7 o BOTTOM
15❑ sTANowc 7 e
UNIT OZ MOTOR PEDAL ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE CYCLE. nWNFR YES NO
16�
LAST NAME UNKNOWN FIRST NAME 25-5437 MIDDLE'
17 F1 INITIAL
STREET ❑
'� UNKOWN CITY I RENTON ST ZIP 4 37
NEW ADDRESS
1$ CDL IGNITION REQUIREfl IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYE No INTERLOCK YES N0 YEs NO'
19 LICIENSE# STATE SEX U MMDOYY' -� � 39
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑
LICENSE I
21 PLATE# rare VIN# 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR MAKE TOYT MODEL COROLL STYLE 4D VEHICLE TOWED TO ---
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO 25.5411 UNKNOWN RENTON VEHICLE NO,2
SHADE IN DAMAGE$AREA
2 3 �4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT &POLICY# t 9TOP
vewae ❑ ,.I—I CITATION
CHARGE
AI to BOTTOM
�EE �Y YES N`LJ
25 a a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW MOLLENBERG 13031 WA0171300
PART A PAGE 01 OF
3000-345-159(R 11/181
POLIICFETRAFFICN CORRECTION REPORT NO. EG08226
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5437
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.
MATTHEW MOLLENBERG 06-22-25 10:24 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
7/9/2025 4:19:15 PM
P.SUMMERS 8887
BADGE OR ID# 13031 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 1:52 AM TIME POLICE ARRIVED 1:59 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT No.` EG08226 CASE# 25-5437 O COLLI COLLISION TIME
OF 06/22/25 01:47
COLLI
NARRATIVE
Renton Case #25-5437
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 06-22-2025 at approximately 0154 hours I was dispatched to a non-injury motor vehicle collision
located at Talbot Rd S/Benson Dr S. Dispatch was working through a language barrier and slow in
receiving information. Officers were advised while enroute that the accident is a possible hit and run
collision.
I arrived on scene and contacted the reporting party who identified himself as Jama A. Nur (DOB 01-
05-1974) in the 1600 block of Benson Dr S, he was the operator of Unit 2 which was a Toyota Sienna
bearing WA/AJU5382. He stated he was traveling southbound on Benson Rd S in the number 1 lane
closest to the yellow line. Unit 1 was identified by Jama as a white possible Toyota Corolla. Unit 1
sped past him in the number 2 lane also traveling southbound and switched lanes into the number 1
lane in front of Jama. Unit 1 then attempted to make a U-Turn into the northbound traffic. Jama stated
there was oncoming traffic, so Unit 1 braked aggressively in front of Jama, causing Jama to quickly
change lanes. He was unable to change lanes quickly enough and struck the back of Unit 1.
The front bumper on the driver's side of Unit 2 was damaged. The damages to Unit 1 are unknown.
Based on information provided by Jama the proximate cause of the collision was Unit 1 attempting to
do an illegal U-Turn while traveling southbound on Benson Dr S, causing Jama to strike their vehicle.
On 06-22-2025 at 1950 hours I contacted Jama by phone to further discuss information regarding the
collision that happened. While speaking with him he advised me that he woke up today feeling pain in
his left leg from the collision. He advised he is thinking about going in to the doctor, I advised him to
call back if injuries are found due to the collision if he decides to go to the doctor.
I provided Jama with the Renton Case #25-5437.
If a suspect is identified there is probable cause for violation of RCW 46.52.020 (hit and run -
attended), due to them leaving the scene of the accident and failing to provide their information.
This concludes my involvement in Renton case #25-5437.
1 declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by M. Mollenberg on 06-22-2025 at 2220 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. EG08226 CASE# 25-5437 DATE AND TIME i 06/22/25 01:47
OF COLLISION
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