HomeMy WebLinkAbout25-7739 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-7739 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 1 8 2$
TRIBAL UNITS 04 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 09 - 05 - 2025 1026 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
EAST VALLEY HIGHWAY BLOCK NO. e✓ 4300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a SW 43RD ST
0 1 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 0 4 30
6� LAST NAME ANDERSON FIRSTNAME FRANK MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 405 S 7TH ST,APT 304 CITY RENTON ST WA 21p 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO�/ I INTERLOCK YES NO YES �/ NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 INJURY 5 HELMET 2 NATURE OF INJURIES 2❑
USE CLASS UNKNOWN AMOUNT OF INJ AT THIS TIME
3
10❑ Pl ATE 14 D45342F STATE WA ,r,#' 4TAVL52N6WZ058245
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. YRLR. 5 1 33
12 3 5 VIN#j VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 3 $ 34
13 4 1998 TOYT TACOM YES NO � �MEYERS TOWING YES[:] No✓
DAMAGE
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO UNK UNK <�3
4
IN EFFECT &POLICY#'E"CL' CHARGE36
LEGALLY YES❑NO❑ CITATION# TTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES�/ NO D:2067537798
16 a
LAST NAME SHARIF FIRST NAME FOAD MIDDLE I J
INITIAL
17❑ STREET ❑', 4225 NE 9TH CIR CITY' RENTON ST WA ZIP 980594570 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/
19 LDI IVEW # STATE WA SEX M M D.O.B. 04 20 _ 1999 El 39
HELMET {NJURY 6 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 USE 2 CLASS ABRASIONS TO FACE
21❑ LICENSE I BXU7224 TATe I WA VIN# JTMRFREVXFD124907
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2015 MAKE TOYT MODEL RAV4 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO FOADSHARIF4225NE9THCIR RENTON WA 980594570 D:2067537798 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO GEICO 4119 18 36 57IN 1 STOP 5
'E""LE ❑ N`L J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG36328
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7739
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SAHOTA SANDEEP S
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
5213 SKYLER CT CONCORD CA 94521 5106854986 SEX M MMDOYyvv 01 - 16 - 1976
PASSENGER WITNESS❑'UNIT# q POS 3 AIRBAG 2 RESTR. q EJECT ? H USEET 2 `CLASS ,1 NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL) GRASNAN MICHAEL A
ADDRESS&PHONE# D O B
2539063223 MM6DYvvv 05 _ 09 _ 1995 SEX M
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) PARATA RODOLFO
AooREss&PHONE# 2537091291 M M 12 01 _ 1997
SEX.
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ POS. USE CLASS
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.
D.NELSON 09-05-25 04:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1 1011012025 1:30:49 PM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED! 40:27 AM TIME POLICE ARRIVED',10:29 AM
PART I PAGE IT]OF 5�
REPORT NO. EG36328 CASE# 25-7739 OF COLLISION
09/05/25 10:26
OF CbLLI510N
NARRATIVE
25-7739 ACCINJ
On 9/5/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a multiple vehicle collision with injury in the intersection
of Easy Valley Highway and SW 43rd St Renton/King/WA. Multiple callers were reporting a blocking
collision with injury in the intersection. RRFA was dispatched as well for possible extrication from
vehicle.
I arrived on scene and located RRFA personnel rendering aid to a male on the ground. He was
slightly combative with firefighters and had to be restrained for treatment.
The driver of the 1998 Toyota Tacoma WA/D45342F (Unit 1), was identified by his WADL as Frank A
Anderson DOB: 10/18/1966. Frank was being tended to by RRFA personnel. The Toyota had
extensive front-end damage and was resting against both Units 3 and 4. As fire personnel treated
Frank, they advised that it appeared her was suffering from an unknown medical event, they advised
there was no sign of impairment. Frank was transported to Harborview Medical Center for further
treatment. There was no airbag deployment in the Toyota and there was extensive damage to the
front and driver side of the Toyota. I completed a Sector Impound Form and Gene Meyers Towing
removed the vehicle from the scene.
I was not able to locate any form of insurance for the Toyota. Since Frank was transported to
Harborview for treatment, I was not able to return his license, this was placed in RPD Inmate Property
Storage.
Officer Fajarillio advised me that he had spoken to the driver of the 2015 Toyota Rav4 WA/BXU7224
(Unit 2), identified by his WADL as Foad J Sharif DOB: 4/20/1999. Foad explained that he was
turning left onto southbound East Valley Highway from westbound SW 43rd St. He said that as he
entered the intersection, he was struck on the driver side by Unit 1 as it ran a red light going north on
East Valley Highway in the #1 lane. There was extensive damage to the driver side doors and front
and rear quarter panels of the Toyota. There was a combination of airbags deployed in the Toyota
and Foad had minor abrasions to his face, he was evaluated by RRFA personnel and cleared at the
scene. The Toyota was removed from the scene by Gene Meyers Towing.
I spoke with the driver of the 2008 Honda Element WA/CHP9160 (Unit 3), identified by her WADL as
Vicki L Malloy DOB: 8/15/1954. Vicki said that she was turning north onto East Valley Highway from
eastbound SW 43rd St. She said that she was making her turn through the intersection when she was
struck on the passenger side by the black Toyota Tacoma. She said that this impact pushed her into
Unit 4 where her vehicle came to a rest. There was a combination of airbags deployed inside the
Element. Vicki was evaluated by RRFA for pain in her left knee and cleared at the scene. The
Element was removed from the scene by Gene Meyers Towing.
The driver of the 2025 Volkswagen Tiguan FL/DQ78FJ (Unit 4), was identified by his CADL as
Mandeep S Thiara DOB: 3/4/1962. Mandeep was facing south on East Valley Hwy in the #2 lane
stopped for the light. He said that he saw the Tacoma driving northbound in the #1 lane and fail to
stop at the red light, after it collided with Unit 2 it collided with Unit 3 and pushed Unit 3 and itself into
the Volkswagen. No airbags were deployed in the Volkswagen and neither Mandeep nor his
passenger, Sandeep S Sahola DOB: 1/16/1976, were injured. The Volkswagen was able to leave the
scene.
I attempted to view traffic cameras but was not able to get the cameras to work.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 9/5/2025 Renton WA
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG36328
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 25-7739
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 28
CARRIER
NAME
3 CARRIER
ADDRESS `❑
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE ISJ CYCLE I_) PEDESTRIAN � OWNER �I YES✓ NO
D:2537099778
0 4 Zg
LAST NAME MALLOY FIRST NAME VICKI MIDDLE'.. L
INITIAL
STREET
NFW AnDRFSP' 19418 SE 170TH ST CITY RENTON ST WA ZIP 980580823
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO✓ zERLOCK YES❑NO❑✓ YEs N ✓
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv 08 - 15 - 1954
7 ❑ HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 3 RESTR. 4 EJECT 1 USE 2 CLASS 6 COMPLAINT OF PAIN LEFT KNEE
8 ❑ 1 1 2 32
LICENSE CHP9160 TAT INA VIN# 5J6YH28738L008168
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2008 MAKE HOND MODELELEMENT STYLE VEHICLE TOWS E T SABLI T ';tALB�'ERS TOWING f�f1VT VFHII' P FROM TO
DAMAGE YES✓NO YES NO ✓
REGISTERED OWNER INFORICHARD MALLOY 19418 SE 170TH ST RENTON WA 98058 ] 1 33
12 3 5 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE INSURANCE CO GEIC0414594 70 91
IN EFFECT &POLICY#
VEHICLE �M, 9 9 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE pp@@
STANDING gyg 7 b
DAMAGE THRESHOLD MET PHONE ❑ 35
14 UNIT# 4 MOTOR ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO
VEHICLE : CYCLE OWNER ✓ D:5106854986
THIARA MANDEEP MIDDLE S
❑ 36
15
LAST NAME FIRST NAME INITIAL '
2 STREET
16 ❑ ❑; 2672 AMATCHI CT CITY', TRACY ST CA ZIP 94304
NFn+AnnRFSS
CDL IGNITION REdUiREE7 IGNITtGN PRESENT MEDICAL TANSPORTEII
17 ❑ INTERLOCK YES NO✓ INTERLOCK YEs NC7✓ YEs ND./ ❑
DRIVER'S STATE CA SEX M D.O.B 37
LICENSE# MMDDYYY` 03 - 04 - 1962
18 ❑ INJURY 1 ❑ON DUTY� STATUS AIRBAG 2 RESTR, 4 EJECT 1 HELMET 2 ' NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑
PLATE#
DQ78FJ TAr WA vIN# 1V2WR2CA5SC533980 39
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ TRLR TRLR 41❑
ViN# YIN#i
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE
2025 VOLK TIGUAN DAMAGE YES NO ✓ YES NO ✓
23 ❑ REGISTERED OWNER INFO SIXTRENTAL CAR 1501 NW49TH ST UNIT f00 FORT LAUDERDALEFL 33309 SHADE IN DAMAGED AREA F 43
LIABILITY INSURANCE INSURANCE CO EMPIRE FIRE AND MARINE RSF5185385 05 09180
❑ IN VEHICLE
&POLICY# 4��,
E:l
44
24 LE LE ALE LLY YESZ NO❑ CITATION# CHARGE
.STANDING a 7 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 09-05-25 04:29 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 12421 O#I',WA0171300 APJACOBS 10/10/202 PAGE F41 OF❑
3000-345-013(R 11118)
REPORT NO. EG36328 CASE# ' 25-7739 DATE AND TIME 09/05/25 10:26
OF COLLISION
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PAGE 5 OF 5