HomeMy WebLinkAbout25-8404 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 25-8404 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28
UNITS
RESERVATION I
STRUCK
z
3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 09 - 1-- 2025 1829 17 ❑.= S IN 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e SHATTUCKAVES
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2063268656 0 1 30
6 LAST NAME AYELE FIRSTNAME NARDOS MIDDLE I K 1 1 2 31
INITIAL
STREET ❑ 25203 22ND AVE S CITY DES MOINES ST WA ZIP 981989049 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED1/ I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO NTERLOCKYEs NO Z YE. No�/
8❑ LDRIVER # STATE WA SEX'F MID
.O B 06 - 09 - 1996 1 2 32
9❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 1 INJURYCLASS 7 1 UPER LEFT THIGH PAIN z❑
3
10[1P1 ATNFS# CKE1710 sTAT WAv N# 4S36WAN6XN3015010
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 1 7 33
12 3 5 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13FAl 2022 SUBA LEGACY SD DAMAGE YES NO YES[:] NO✓
REGISTEREDOWNER WFO NARDOS AYELE 25203 22ND AVE S DES MOINES WA 981989049 D:2063268656 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ ABILI INSURANCE U INSURANCE CO PROGRESSIVE 987731754 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE36
LEGALLv YES❑NO CITATION# <1�3
OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNFR ❑ YES NO ,/ D:2062632250
16 a
LAST NAME ABDULLAHI FIRST NAME ALI MIDDLE A
INITIAL
17 STREET❑ NEW ADORE57 27104 133RD PL SE CITY KENT ST WA ZIP 98042 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDI IVER # STATE WA SEX M M MD D.O.B.B. 01 01 1982 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLATE# A1008C TATE 41
WA VIN1 1VHHH3V22C6708022 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2012 MAKE ONTR MODEL BUS STYLE BU VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO ALI ABDULLAHI 27104133RD PL SE KENT WA 98042 D:2062632250 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO KING COUNTY SELF INSURANCE STOP 5
IN EFFECT
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# FENCY
26
KEV/N PETERSON 12808 A0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EG32785
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8404
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
I was dispatched to a motor vehicle collision on 09/28/25 at the intersection of S 3rd St and Shattuck
Ave S, in city Renton, King County WA.
Unit 1 CKE1710 Driver: Nardos K. Ayele (DOB 06/09/1996)
Unit 2 A1008C Driver: Abdullahi A. Ali (DOB 01/01/1982)
Spoke to unit 1 who told me that she was driving south on Shattuck Ave S when she approached S
3rd St. She did not realize S 3rd St was a one way and attempted to make a right hand tun and go
West on S 3rd St. She then ran into the front of Unit 2 which was traveling East on S 3rd St.
Unit 2 told me that he was traveling East on S 3rd St when approaching Shattuck Ave S, he saw Unit
1 turn towards him and crashed into Unit 1. He said that Unit 1 turned into his lane and drove towards
him just as the collision happen.
Unit 1 complained of upper left thigh pain and had a bump on her upper thigh. She denied seeing
medics on scene and stated would take herself to the hospital shortly. Unit 2 stated no injuries. I
spoke to the Metro bus supervisor who got a photocopy of the information exchange that both drivers
were given.
Photos of Unit 1's leg and her car were taken and loaded to evidence.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: Officer Kevin L. Peterson Date and Place: 09/29/2025, 0006 hours at Renton,
WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
KEVIN PETERSON 09-29-25 12:07 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 9/29/2025 8:47:25 PM
BADGE OR ID# 1Y808 OR]#' ' WA0171300 TIME POLICE DISPATCHED 6:31 PM TIME POLICE ARRIVED]6:41 PM
PART PAGE IT]OF
REPORT NO. EG32785 CASE# 25-8404 DATE AND TIME 09/28/2518:29
OF COLLISION
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