HomeMy WebLinkAbout25-9193 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-9193 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 1 8 28
TRIBAL 1 02 STRUCK NONE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 10 - 23 - 2025 1654 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 43RD ST BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4253369711 0 3 30
6❑ LAST NAME ALI FIRSTNAME ABDINUR MIDDLE A 1 2 31
INITIAL
STREET ❑ 5627 S 150TH PL CITY TUKWILA WA
NEW ADDRESS ST ZIP 981882420 z
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ DRIVER'S STATE SEX'M D.o.6. 01 - 01 - 1985 1 2 32
LICENSE# MMD)3YY
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U S 2 CLASRuY INJUF NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CTY6866 sTArI WA urN# WAUTPBF28MN039521
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 3 2021 AUDI A6 SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ABDINUR AL13100 S 208TH STAPT B104 SEATAC WA 98198 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO GEICO 6181646883 3 4
IN EFFECT &POLICY# 9TOP
VE—LE
15❑ 5 36
LECALLv YES❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a : OWNER ❑ YES 1/ NO D:2069131312
LAST NAME PERRY FIRST NAME JOHN MIDDLE I P
INITIAL
17 NEW STREETR 7' 12602 SE 299TH PL CITY'AUBURN ST WA ZIP 980922190 37
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 DRIVER'S STATE WA SEX M I D.O.B. O6 _ 25 _ 2007 0 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
❑ILICENSE 21❑ PLA E# BHX4437 TAre 41
WA VIN# JTJBT20X150091468 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2005 MAKE LEXS MODEL GX STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO NORA PERRY 12602 SE 299TH PL AUBURN WA 98092 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&POLICY#E CO GEICO 6130-61-43-05IN IUQ,
5VEHICLE ❑ C[:] CITATION# CHARGELEGALLY YES N25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
CASEY PROCTER 12123 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG44967
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9193
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CASTANEDA ALICIA A
(LAST FIRST,
ADDRESS&PHONE# D O.B.
10609 202ND AVE E BONNEY LAKE WA 98391 2065186532 SEXi F MMDOYyry 11 - 24 - 1987
PASSENGER WITNESS[:] UNIT# 2 SEA 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE OF INJURIES
POS. USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMD YYe, -
PASSENGER ❑WITNESS UNIT# SEAT I 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'
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 10-23-25 07:50 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 111412025 4:37:53 PM
BADGE OR ID# 12123 OR]#' WA0171300 TIME POLICE DISPATCHED; 5:07 Pry] TIME POLICE ARRIVED',5:12 PM
PART I PAGE IT]OF 4]
REPORT NO. EG44967 CASE# 25-9193 OF COLLISION
10/23/25 16:54
OF CbLLI510N
NARRATIVE
On 10-23-2025 at approximately 1707 hours I was dispatched to E Valley Rd and S 180th St in the
City of Renton, County of King, State of Washington to a non-injury collision. The involved vehicles
had pulled into the Chevron Gas Station just west of the above location.
The involved vehicles were described as a gray Audi and a white Lexus.
Upon my arrival I contacted all parties and confirmed no one was injured. I spoke with the driver of
unit#1, identified by his WADL as Abdinur A. Ali (DOB 01-01-1985). Ali said he was traveling east to
west on SW 43rd ST. He said he was attempting to turn left (south bound) into the Chevron parking
lot. He said he was slowly moving forward as traffic had made space for him to turn into the parking
lot. He said unit#2 was traveling from west to east in lane #1. He said unit#2 was traveling fast at
approximately 40 mph and struck unit#1.
I spoke with the driver of unit#2, identified by his WADL as John P. Perry (DOB 06-25-2007). He said
he was traveling from west to east on SW 43rd St. He was going to make a righthand turn (south
bound) into the Chevron parking lot as well. He said unit#1 was turning into the parking lot and struck
unit#2.
1 observed damage to the passenger side front bumper of unit#1 and damage to the driver side front
bumper of unit#2. The damage appeared to match what both drivers told me.
I provided both drivers an exchange of information.
A Sector collision report was completed.
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 1949 hours on 10-23-2025 in Renton, WA
PAGE 3 OF 4
REPORT NO. EG44967 CASE# ' 25-9193 DATE AND TIME 10/23/25 16:54
OF COLLISION
5
{i4
P,
1 ?4
s
Y y�
u4
5
y t
1
}
ti
sr.
PAGE 4 OF 4