HomeMy WebLinkAbout25-80050 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-80050 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 11 - 1-- 2025 1903 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RENTON AVE S
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e S 132ND ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:3158783339 0 11
30
6� LAST NAME ABDI FIRSTNAME MAHAMED MIDDLE S 1 2 31
INITIAL
STREET ❑ 6312 29TH AVE SW CITY SEATTLE ST WA ZIP 981262974 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO,/ INTERLOCKYEs NO�/ YEs No�/
8❑ DRIVERS
# STATE WA SEXI M I ELMIDI Y' 09 - 28 - 1992 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑
3
LICENSE CCX0344 sTArI WAurN If JTDZN3EU7C3060902
10[ PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR. TRLR 3 5 33
12 3 5 VIN#' VIN#
;. FROM TO
VEH.YEAR 2012 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 TOYT PRIUS V DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO MAHAMED ABD1131229THAVE SW SEATTLE WA 98126 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO NATIONAL GENERAL 2031864719 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a OWNER ❑ YES,/ NO D:2069725754
LAST NAME TORRES FIRST NAME LORENA MIDDLE
INITIAL
17❑ NEW ADDRE— 128E MASTREET IN ST APT 709 CITY AUBURN ST WA ZIP 98002 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE CA ]SEX IF I D.C.B. 08 _ 02 _ 1979 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 9 EJECT 1 H EET 2 NJAU EY
E NECK PAIN AND MOUTH AREA ❑ 40
❑ 41
21❑ PLATE# 9EC(a443 TArE CA vIN1 2HGES16542H567045 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2002 MAKE HOND MODEL CIVIC STYLE SO VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES,� NO BANKERS YES NO
REGISTERED OWNER INFO LORENA TORRES 128 E MAIN ST APT 709 AUBURN WA 98002 D:2069725754 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO PACIFIC PREFERRED 25129304931 STOP 5
IN EFFECT
VEHICLE ❑ ,.I—I CITATION# CHARGE to BOTTOM
LEGALLY YES N
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KEV/N PETERSON 12808 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EG51203
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80050
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) TORRES BELANNA M
(LAST FIRST,
ADDRESS&PHONE# D O.B.
128 E MAIN ST APT 709 AUBURN WA 98002 SEXi F MMDDYYYY 06 - 20 - 2014
SEAT HELMET N NATURE OF INJU NECK PA/N ANOIRES
PASSENGER WITNESS[] UNIT# 2 POS. 3 AIRBAG'2 RESTR. 9 EJECT 1 USE 2 CLASS
!6 HEAD AS WELL AS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX 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.
MMDDYYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
I was dispatched to a vehicle collision on 11/21/25 at Renton Ave S and S 132nd St, in city Renton,
King County WA.
Unit 1 CCX0344 Driver: MAHAMED S. ABDI (DOB 09/28/1992)
Unit 1 9ECG443 Driver: Lorena Torres (DOB 08/02/1979)
Upon arriving I spoke to the driver of Unit 1 who told me that he was traveling West on Renton Ave S
when he was going to make a left turn on S 132nd St. Upon him trying to turn to head South on S
132nd St as he was turning, he was hit by Unit 2.
1 then spoke to the driver of Unit 2 who told me they were traveling East on Renton Ave S when
approaching the intersection of Renton Ave S and S 132nd St Unit 1 pulled out in front of them.
Renton Fire arrived on scene to evaluate all personal. Unit 1 stated he had no injuries, and his car
was still drivable. Unit 2 driver stated they had tongue pain and neck pain, and the passenger had leg
pain and neck and head pain from hitting their head on the front window. Unit 2 passenger and the
mother were transported to Valley Medical Center.
Information Exchange was given to both parties.
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: 11/21/2025, 2347 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 11-22-25 12:35 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.BRAUN 2194 1 1112212025 1:12:18 AM
BADGE OR ID# ` 12808 OR]# WA0171300 TIME POLICE DISPATCHED', 7:03 PM TIME POLICE ARRIVED 7:07 PM
PART I PAGE IT]OF 3�
REPORT NO. EG51203 CASE# 25-80050 DATE AND TIME 11/21/2519:03
OF COLLISION
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