HomeMy WebLinkAbout25-8207 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG31034oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-8207 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL i UNITS TRUCK
#OF 01 SO"" TRAFFIC SIGNAL POLE 1 28
i RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 09 - 21 - 2025 1822 17 =.= S 8 W e OF IN 8 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAIN AVE S BLOCK NO. e 300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e S 3RD ST
0 3 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:9256339266 30
5❑ LAST NAME MOHAMMADI FIRST NAME MASIMA MIDDLE t 1 2 31
INITIAL
STREET ] 16255 NE 87TH ST APT A310 CITY; REDMOND ST WA ZIP; 98052 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPt)RTED 3
INTERLOCK YES NO✓ INTERLOCKYEs NO✓ YES NO✓
g❑ DRIVER # STATE WA SEXI F MMDDYY' 10 - 07 - 2001 t 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CMR8398 STATE WA VIN#; 4T1BF1FK8DU300028 3
10 F1 as ATP tt
TRAILER
11 0 0 STATE TRAILER STATE PLATE# PLATE# 3 ROM
TRLR zRLR 5 3 33
12 VIN#' VIN#
FROM TO
HICLE
13 2 VEH.YEAR 2013 MAKE TOYT MODEL CAMRY STYLE SD VEHICLE TO YED NOIyS46LIN diW9YMEYER GESr`-IVT ENp m 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO QUERBAN MOHAMMADI 16255 NE 87TH STAPTA310 REDMOND WA 98052 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE / INSURANCE CO PROGRESS/VE 9853 52879 < 34IN
EFFECT &POLICY#VEn" CHARGE 36
LEc , YES❑NO❑ CITATION# t15 STM ING
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
UNIT�' PEDESTRIAN
VEHICLE CYCLE' DOWNER YES NO
16❑
LAST NAME FIRST NAME MIDDLE'
INITIAL
17❑ STREET ❑ CITY ST ZIP 4❑ 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED: 38
INTERLOCKYEs NO INTERLOCK YES R No vEs NQ
19 LICENS# STATE SEX MMDUYY —= 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASS ❑
21 PLATE# rare vIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
1-1— ❑ ,.I—I CITATION# CHARGE to BOTTOM
LEGnLLY YES NC
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HUNTER DEIGHAN 13030 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG31034
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8207
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 NJURY NATURE OF INJURIES
POS. ' USE CLASS 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 CLASS ----�
: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
25-8207
Unless otherwise noted, the following happened within the City Limits of Renton, County of King,
State of Washington.
On 09/21/25 at approximately 1846 hours 1 arrived on scene of a single car collision at Main Ave S
and S 3rd St. Unit#1 had crashed head on into the traffic signal controlling northbound traffic on Main
Ave S. The occupants of Unit#1 were not injured.
The driver of Unit#1 was traveling north on Main Ave S in lane 1. Unit#1 attempted to turn right onto
S 3rd St. The driver of Unit#1 said that she thought the train tracks were the far right turn lane. Unit
#1 turned from lane 1 onto the train tracks. They realized that it was not actually a lane and panicked.
They meant to brake but accidentally hit the gas pedal and accelerated into the traffic signal pole. The
pole was not damaged but Unit#1 had significant front end damage and needed to be towed away
from the scene. The driver of Unit#1 did not appear impaired in any way.
The driver of Unit#1 is the proximate cause of this accident. The driver of Unit#1 turned into
an area not meant for cars and accidentally accelerated into a signal pole.
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 H. Deighan 13030 on 09/21/2025 hours in Renton WA.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HUNTER DE/GHAN 09-22-25 12:18 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 9/23/2025 8:11:36 PM
BADGE OR ID# j 13030 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:28 PM TIME POLICE ARRIVED i 6:31 PM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3
REPORT NO. EG31034 CASE# 25-8207 DATE AND TIME 09/21/25 18:22
OF COLLISION
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