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HomeMy WebLinkAbout25-9110 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG44858OLCERA COLLISION REPORT 1591971 CASE# 25-9110 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4250 3 COUNTY RD NVOLVED CODING PRIVATE WAY 2❑ TRIBAL UNITS#OF 02 SO TRUCK 5 1 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsfoN' 10 - 21 - 2025 1358 17 =.= S 8 w E IN OF M 1070 a 4� ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. RAINIER AVE S 4a� MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET e S 8 w e S 3RD ST 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2065513261 30 5 LAST NAME AHMED FIRST NAME MAHDI MIDDLE Y 1 1 2 31 INITIAL STREET ❑ 24218 185TH LOOP SE NEW CITY, COVINGTON ST WA ZIP 980427237 2 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO INTERLOCK YES N YES D NO 8 LICIENSE#RVER' STATE WA SEx M MMDO DrYY' 01 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY CLASS 1 NAruRE of INJURIES 2 10 1❑ LI ENSrtEI BJY6348 STATE WA VN# 4T1BE46K99U842492 3 TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# ROM TO TRLR TRLR 5 1 33 12 VIN# VIN PP:... FROM TO VERYEAR MAKE MODEL STYLE VEHICLE TOWED TO 7 3 34 BLIN �tpy {"(g GOVT VEHICLE 13 2 2009 TOYT CAMRY DAMAGE YES ✓ No� �"-�"-�RS YES❑ NO� REGISTERED OWNER INFO MAHDI AHMED 24218185TH LOOP SE COVINGTON WA 980427237 0:2065513261 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 2 3 4 14 ST FARM 582 5674-E21-47 IN EFFECT &POLICY# <DQ, VEHICLE CHARGE 36 LecnLLY YES❑NO❑ CITATION# 15❑ sTANowc B 7 e �y MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT©2 PEDESTRIAN ❑✓ VEHICLE CYCLE' OWNER YES�/ NO 16� LAST NAME UNK FIRST NAME UNK MIDDLE' INITIAL 17 F1 STREET ❑ '❑ LKA 12 3 ABC CITY I RENTON ST, WA ZIP 98057 37 NEW ADDRESS 18❑ CDL IGNITION REQUIREC3 IGNITION PRESENT NEDICALTRANSPORTED' ❑ 38 INTERLOCKYES NO INTERLOCK YES 11-Ohl YEs NO 19[ LICIENSE#RVER' SEXI F MMDDYY 01 01 1990 39 20 ON DUTY STATUS 3 AIRBAG RESTR EJECT R U EET _LA SY 0 NATURE OF INJURIES ❑ 40 LICENSE 21 PLATE# TATE VIN# 41 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR r RLR 43 UIN#. 'IN#. VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24[--;---2] DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,.I—I CITATION# CHARGE tO BOTTOM LEEAILY YES N`LJ 25 a a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF 3000-345-159(R 11/181 POLIICFETRAFFICN CORRECTION REPORT NO. EG44858 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9110 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME FUNK LISA M (LAST,FIRST,MIDDLE INITIAL} ADDRESS&PHONE# DOB 2064651197 SEX U MMDDYYYY 08 — 09 — 1990 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS ---� 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# S ' D.O EX .B.MMDD —F L----------� YYYY EAT HELMETNJURY URE OF PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q 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. M.LEVERTON 10-21-25 04:09 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 111412025 12:03:42 PM BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 1:59 PM TIME POLICE ARRIVED 2:00 PM PART B 3 Do-3mx-,aR(Burls) PAGE 27 OF 47 REPORT NO.` EG44858 CASE# 25-9110 OLI?TIME OF 10/21/25 13:58 COLLISION NARRATIVE gold/1 In 3 nb green ped dry fender lof RTF Within the city limits of Renton/King/Wa I responded to a car vs ped at the intersection of Rainier Ave S at S 3rd St. While enroute Dispatch advised that the pedestrian after being struck, jumped to her feet and fled on foot towards the east. The Ped was described as a mid 30's 5'5 black female dressed in black pants and carrying a large duffle bag. The driver of unit 1 did not provide very much information and remained pretty quiet during my contact. He did not complain of injury and damages to the windshield required a tow truck. A witness remained on scene and explained the following. She and unit 1 were northbound Rainer Ave S with a green light. Wit was in lane 2 unit 1 was in lane 3 and lane 1 was closed for construction, within a construction zone. Wit said the ped crossed from the west to the east against the ped light. She said she was close to or at one point next to unit 1. She thought unit 1 was able to see the ped as she was slowing. She said she saw the ped contact unit 1 near the driver fender and land on her feet after rolling across the car and smashing in the windshield. She attempted to contact the Ped. The ped wanted nothing to do with anyone left the scene on foot. An area check was negative in location the Ped. information/insurance only I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 10/21/2025 PAGE 3 OF 4 REPORT NO. EG44858 CASE# 25-9110 DATE AND TIME i 10/21/25 13:58 OF COLLISION Y tt; t �Y i o w S �Y 1 1; Ypi, 0 4} r � t k " e � 41 4 L Y i S ?ax Y' ) k �t l 4 i PAGE 4 OF 4