HomeMy WebLinkAbout25-8872 POLICE TRAM 27iTFFiNc
COLLISION REP F 1591971
CASE# 25-8872 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4100 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75#OF02 STRUCK TOTAL OBJECT 11 8 2$
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
COAT sloN 10 - 13 - 2025 1902 17 a. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NONINTERSECTION ❑✓
SE PETROVITSKY RD BLOCK NO.
8 11400
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S e W B
2 0 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES No F,/ D:2063888416 0 1 30
6❑ LAST NAME THOMAS FIRST NAME BRYONTA MIDDLE J 2
INITIAL 1 31
STREET E:1' 17315 121 ST LN SE APT WW302 CITY RENTON WA
NEW ADDRESS 980585924
S7 ZIP z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALNO TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs No YES Na
8❑ LDICENS STATE WA SEX'M MMDDVY 10 - 15 - 2002 1 2 32
9 F] ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 CLASRS 1 NATURE OF INJURIES 2
PI LICENSE
699ERY STATE
OR WIN# 19UUA56943AO16543 3
10 9❑
11 0 0 PLATE# STATE PLATE# STATE ROM To
RA
TRLR TRLR. 7 3 33
12 Q 0 VIN#' VIN#
FROM TO
13 3 VEH.YEAR 2003 MAKE ACUR MODEL ATL STYLE SD VEHICLE TOWED Ft1 T02fBLIN TOWED BY GOVT.VEHIICLNO✓ 7 3 34
DAMAG❑ REGISTERED OWNER INFO IIIL—llll VEHICLE c�NO.
'II 1
SHADE 1N DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ NSURANCE CO 4
IN EFFECT &POLICY# STOP
CHARGE
vEwcLE 5 ❑ 36
15
Ecnu v YES❑NO❑ CITATION# 10 ftOTTOM
❑ nomc 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE OWNER Yes,/ No D:2064229453
16�
LAST NAME HASSAN FIRST NAME MOHAMED MIDDLE y
INITIAL
17 STREET El 5700 RAINIER AVE S APT B CITY SEATTLE ST', WA ZIP 98118 4
NEW ADDRESS ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDICAL TRANSPORTED 38
1NTERLOCKYEs NO INTERLOCK YES N- YES NOR I
19❑ DRIVER'#
❑ ON DUTY[:]II STATUS AIRBAG 2 RESTR 9 EJECT 1 H E SET CLASS 1 NATURE OF INJURIES ❑ 40
❑21❑ LICENSE gVZ4995 rATe W 41
A v1N# JTDKN3DU2E0382421 1
PLATE#
42
22 PLATE#TRAILER STATE PLATE TRAILER STATE
23 43
TRLR RLR
VIN#. 'IN#,
VEH.YEAR 2014 MAKE TQyT MODEL PR/US STYLE HB DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
O
24 YES
REGISTERED OWNER INFO OWNED BYDRIVER VEHICLE NO.2
SHADE IN DAMAGAREA
LIABILITY INSURANCE[2]
INSURANCE CO TXS INSURANCE COMPANY E 3
IN EFFECT &POLICY# t 4TOP
venu YES NU CITATION# CHARGE tOBOTTQM
LEGALLY
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
CASEY PROCTER 12123 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG40866
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8872
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) MORTON TANYA E
ADDRESS&PHONE# D�
17405 120TH LN SE APT 1203 RENTON WA 980586214 2068290245 SEXi F MMDD,O B. 09 — 14 — 1969
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGERWITNESS❑ UNIT# ; 2 POS. 19 AIRBAG 2 RESTR. 9 EJECT 1 USE CLASS ;7 HEADACHE
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET NJURY: NATURE OF INJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ ❑ POS. I 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.
CASEY PROCTER 10-14-25 12:13 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 1012312025 6:51:06 PM
BADGE OR ID# 12123 ORI# WA0171300 TIME POLICE DISPATCHED; 7:04 Pry/ TIME POLICE ARRIVED i 7:09 PM
PART B 30e0-345.160(R1Vt8) PAGE 0 OF 47
REPORT NO. EG40866 CASE# 25-8872 OF COLLI ION 10/13/25 19:02
OF COLLISION
NARRATIVE
On 10-13-2025 at approximately 1904 hours I was dispatched to 11429 SE Petrovitsky Rd in the City
of Renton, County of King, State of Washington to an unknown injury accident.
While en route the call was updated to an injury accident with one of the passengers claiming to have
a headache and neck pain. Renton Fire Authority was dispatched to the scene.
Upon my arrival the involved vehicles were stopped in the west bound lanes (lane #2). 1 contacted the
driver of unit#1, identified by his WAID as Bryonta J. Thomas (DOB 10-15-2002). Thomas advised
he was traveling from west to east on SE Petrovitsky when he went to change lanes from lane #1 to
lane #2. He said he was unable to stop in time and struck unit#2 who was stopped for traffic. He said
he was traveling at approximately 30-35ph. Thomas advised he was wearing his seatbelt and was not
injured. Thomas advised he did not have a license and did not have insurance. A DOS records check
of Thomas license showed him to be not licensed-eligible.
Sgt. Thielman spoke with the driver of unit#2, identified by his WADS as Mohamed Y. Hassan (DOB
01-01-1978). Sgt. Thielman advised Hassan was traveling from west to east on SE Petrovitsky at
approximately 15mph when he was struck by unit#1. Hassan's passenger was complaining of a
headache.
I observed damage to the front bumper of unit#1 and damage to the rear bumper of unit#2 which
was consistent with both driver's accounts.
RFA evaluated the occupants of unit#2 at the scene.
I cited Thomas for operating a motor vehicle without insurance as well as no valid operator's license
2nd degree.
I had Thomas move his vehicle to the center turn lane. Thomas was able to contact his parents who
were able to arrive and operate his motor vehicle due to him not having a valid license.
During this incident, I was equipped with a body-worn camera, which records both audio and video.
This report is merely a summary of the incident and is not intended to be an exact transcription of the
entire investigation or what may have been captured with the recording system.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by C. Procter/#12123 at 0011 hours on 10-14-2025 in Renton, WA
PAGE 3 OF 4
REPORT NO. EG40866 CASE# 25-8872 DATE AND TIME 10/13/2519:02
OF COLLISION
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PAGE 4 OF 4