HomeMy WebLinkAbout25-8945 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EG38083 170
27
COLLISION REP FIT 1591971
CASE 25-8945 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� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 02 STRUCK' FIRE HYDRANT
RESERVATION
z
3❑ DArE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 10 - 1-- 2025 1938 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❑ 1.❑ FEET e S ❑ W e LAKEAVES
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2066063648 0 11
30
LAST NAME GHEBREKIDAN FIRSTNAME KIBREAB MIDDLE K
6 INITIAL 1 2 31
STREET ❑ 8027 S 117TH ST TTLE WA
NEW ADDRESS STjP', 96178 2
CITY SEA
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER # STATE WA SEXI M MM D Y' 10 1- 09 - 1984 2 32
CENS [NATURE OF INJURIES
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 H USE 2 7 CLASS RIGHT KNEE PAIN 2❑
3
10 9❑ P1 ATE 14 BPP1116 STATE WA v N# 5TDBK3EH7BS071439
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 5 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 7 3 34
13 4 2011 TOYT CAMRY SD DAMAGE YES NOBS YYES[:] No✓
REGISTERED OWNER INFO KIBREAB GHEBREKIDAN 8021 S 117TH ST SEATTLE WA 98178 D:2066063648 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO BRISTOL WEST G01700257600
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064320464
16 a
LAST NAME HASSAN FIRST NAME DUNIYE MIDDLE E
INITIAL
17 STREET❑ NEW ADDRESS❑' 124 GLENNWOOD PL NE CITY l RENTON ST WA ZIP 98056 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 IF D.C... 01 01 1978 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAU EY 7 PAIN IN CHEST LEFT ARM AND LEFT LEG ❑F—NATURE OF INJURIES 40
❑21❑ PLATE# CTZ3635 TATE 41
WA VIN# SNMJBCAEONH111164 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2022 MAKE HYUN MODEL TUCSON STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES�/ NO BANKERS YES NO
REGISTERED OWNER INFO DUNIYE HASSAN 124 GLENNWOOD PL NE RENTON WA 98056 D:2064320464 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO LIBERTY MUTUAL AOS2685759234054 STOP 5
IN EFFECT
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. EG38083
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8945
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ABDULLAHI FATHI A
(I.P.ST FIRST,
ADDRESS&PHONE#
124 GLENWOOD PL NE RENTON WA 98056 SEX i U MMDDYyry 03 - 23 - 2005
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ �, 2 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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 10/15/25 at the intersection of Airport Way and Lake
Ave S, in city Renton, King County WA.
Unit 1 BPP1116 Driver: Kibreab K. Ghebrekidan (DOB 10/09/1984)
Unit 2 CTZ3635 Driver: Duniye E. Hassan (DOB 01/01/1978)
1 spoke to Unit 1 who told me that he was traveling East on Airport Way when approaching Lake Ave
S where he was attempting to turn South on when he suddenly got into an accident. He told me that
was all he remembered and told me he believes he was in lane 1. Unit 1 stated he had left knee pain.
Unit 2 stated that they were traveling East on Airport Way in lane 1 when approaching Lake Ave S.
She then said that Unit 1 was traveling in lane 2 when he suddenly turned in front of them as if he
was turning onto Lake Ave S and Unit 2 hit him. Driver of Unit 2 stated chest pain left arm pain and
left leg pain.
Unit 1 knocked over the light pole and hit the fire hydrant during the collision.
Renton Fire came to location and evaluated all personal on scene. Both drivers on scene were given
information exchange. City streets were notified and brought out to location for the downed light pole.
Per the damage on Unit 1 and Unit 2 the damage is consistent with Unit 2's statement.
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: 10/16/2025, 0053 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 10-16-25 01:18 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 1011612025 1:41:56 AM
BADGE OR ID# 1Y808 OR]#' ' WA0171300 TIME POLICE DISPATCHED 7:40 PM TIME POLICE ARRIVED',7:43 PM
PART I PAGE IT]OF
REPORT NO. EG38083 CASE# ' 25-8945 DATE AND TIME 10/15/25 19:38
OF COLLISION
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