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Home My WebLink About25-8677 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 25-8677 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 1 8 28 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 90 - 1-- 2025 1907 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ AIRPORT WAY BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e SHATTUCKAVE S 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2066999362 0 11 30 6� LAST NAME WILLIAMS FIRSTNAME JAYSHAWN MIDDLE B 1 1 2 31 INITIAL STREET ❑ 22207 46TH AVE S CITY KENT ST WA 2jp, 980328449 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� A8751055 sTArI WAvIN# 1 C4SDHCT8MC758965 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34 13 2021 DODO DURAN UT DAMAGE YES No �LII� RS ves❑ No✓ REGISTERED OWNER INFO JAYSHAWN WILLIAMS 2220746TH AVE S KENT WA 980328449 D:2066999362 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 863397853 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069006035 16 a LAST NAME JARVIS FIRST NAME NICHOLAS MIDDLE I S INITIAL 17 STREET❑ NEW ADDREss❑' 10424 RAINIER AVE S CITY SEATTLE ST WA ZIP 981782735 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX M D.Q.B. 07 12 _ 2009 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑ 41 21❑ PLA E# CTA9185 TArE WA VIN# 2T1 CF22P02C560627 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2002 MAKE TOYT MODEL CAMRY STYLE SO VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ D YES NO BANKERS YES NO REGISTERED OWNER INFO MARK JARVIS 10424 RAINIER AVE S SEATTLEWA98178 AMA VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE &POINSURGY#E CO SAFECO H2524533IN STOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM LEGALLY YES N J 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# [ZoNCY 26 KEV/N PETERSON 12808 171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG35370 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8677 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) JENKINS KHALEAL R (LAST FIRST, ADDRESS&PHONE# 10908 36TH AVE CT E TACOMA WA 98446 SEX M MMDOYyry 03 - 11 - 2009 {� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESS� UNIT# POS 3 AIRBAG 6 RESTR. q EJECT USE 2 CLASS 7 NECK PA/N AND LEFTL--- NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# Id DOB E MMDDYVYV PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. 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. KEVIN PETERSON 10-07-25 01:32 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE HANSEN HSU 12651 1 10/7/2025 5:57:10 PM BADGE OR ID# 9Y808 CRI#' WA0171300 TIME POLICE DISPATCHED! 7:09 PSI TIME POLICE ARRIVED]7:13 PM PART I PAGE IT]OF 5� REPORT NO. EG35370 CASE# 25-8677 OF COLLISION 10/06/25 19:07 OF CbLLI510N NARRATIVE I was dispatched to a motor vehicle collision on 10/07/25 at the intersection of Airport Way and Shattuck Ave S, in city Renton, King County WA. Unit 1 A8751055 Driver: Jayshawn B. Williams (DOB 09/18/2007) Unit 2 CTA9185 Driver: Nicholas S. Jarvis (DOB 07/12/2009) Unit 3 CTA6083 Driver: Nuura M. Abdalah (DOB 11/09/2006) Unit 4 CJH5734 Driver: Mark J. Harman (DOB 01/08/1991) 1 spoke to Unit 1 who told me that he was traveling East on Airport Way when approaching Shattuck Ave S his light was yellow as he was approaching the and entering the intersection. He then stated that Unit 2 pulled into the intersection of Airport Way where he then hit them. He then slid into Unit 3 who was in lane 2 of Airport Way facing West. I spoke to Unti 2 who told me he was at the intersection of Shattuck Ave S and Airport Way facing North to cross the intersection into the airport. He stated his light was green and as he drove into the intersection, he was struck by Unit 1. I spoke to Unit 3 who told me she was sitting at a red light at Airport Way and Shattuck Ave S facing west when she was suddenly struck by Unit 1. I spoke to Unit 4 who was sitting in lane 1 on Airport Way and Shattuck Ave S at a redlight when Unti 3 was hit and then hit his vehicle on the driver side. I spoke to the passenger of Unti 1 who had complaints of neck pain and left leg pain. Fire was dispatched to the scene and evaluated him. All drivers were given an information exchange for insurance. 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: 10/07/2025, 0130 hours at Renton, WA PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EG355370 r`I POLICE TRAFFIC 1 1 s 27 COLLISION REPORT CASE# 25-8677 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 1 8 28 CARRIER NAME 3 CARRIER L ADDRESS `❑ CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 �✓ � PEDESTRIAN YES NO 5 VEHICLE CYCLE OWNER ✓ D:2069020681 0 8 29 LAST NAME ABOALAH FIRST NAME NUURA MIDDLE'.. M INITIAL 0 8 STREET 30 NFW AnnsgRF + 413 STEVENS AVE NW CITY RENTON ST WA ZIP 98057 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YEs N ✓ DRIVER'S LICENSE STATE I WA SEX F MMDDYYv', 11 - 09 - 2006 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE CTA6083 TAr Wq VIN# 4T1C11AKXLU381686 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2020 MAKE TOYT MODEL CAMRY I STYLE SD I VEHICLE TOWE E T SABLI �d�i' anvi vFHIG P FROM TO DAMAGE YES✓NO YES NO ✓ REGISTERED OWNER INFONASREENALTAMIM1413 STEVENS AVE NW RENTON WA 98057 J 9 33 12 SHADE IN DAMAGED AREA 7 j4 FROM TO LIABILITY INSURANCE INSURANCE CO GEICO 6199.26.05.03 C�Q' IN EFFECT &POLICY# 934 13VEHICL ❑ CITATION# CHARGE LEGALLY YES NO STANDING 8 7 6 DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:2037255296 15 � HARMAN MARK MIDDLE ❑ 36 LAST NAME FIRST NAME INITIAL I 2 16 ❑ STREET ❑L. 23322 145TH PL SW CITY VASHON ST WA ZIP 98070 NFln+AnnRFss CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICAL TANSPORTED 17 ❑ INTERLOCK YE. NO✓ INTERLOCK YES NO✓ YEs No;./ ❑ DRIVER'S D.O.B 4 37 LICENSE# STATE WA SEX M MMDDyYY' 01 - 08 - 1991 18 ❑ ON DUTY❑ STATUS AIRBAG 2 RESTR, 4 EJECT 1 1 HELMET 2 INJURY I 1 NATURE OF INJURIES 38 USE CLASS 19 ❑ ❑ PLATE# CJH5734 TAr WA v!N# JTJHK31 U782854514 3 39 20 ❑ TRAILER STATE TRAILER ST 40 PLATE#< PLATE# ATE 21 ❑ ❑ 41 TRLR TRLR ViN# YIN#i 42 22 VEH.YEAR2008 MAKE LEXS MODEL RX STYLE U1. VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1 DAMAGE YES NO ✓ YES NO ✓ 23 ❑ REGISTERED OWNERINFORIARKHARMAN932839THAVESSEATTLEWA98118 SHADE IN DAMAGED AREA 43 z s 4 LIABILITY INSURANCE INSURANCE CO STATE FARM 4790015-E28-47A 9'1'OP ❑ VEHICLE EFFECT &POLICY# i _'.'-_"'_ 4 44 24 LE E ALE YES[Z NO❑ CITATION# CHARGE iq 60TiOM LEGALLY y� E:l STANDING G 6`J O I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 10-07-25 01:32 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 12808 O#IL WA0171300 HSU 10/7/2025 PAGE F41 OF❑ 3000-345-013(R 11118) REPORT NO. EG35370 CASE# 25-8677 DATE AND TIME 10/06/2519:07 OF COLLISION � R j5 T.' } t a w' a o nT Y r e � 4 �t { F � Y . i .T 1 t PAGE 5 OF 5