HomeMy WebLinkAbout26-1911 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG91270OLCERA
COLLISION REPORT 1591971
CASE# 26-1911 2
INTERSTATE CITY STREET❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL AGENCY 4250 3
HIT&RUN COUNTY RD PRIVATE WAY ❑✓ NVOLVED ✓F CODING
2❑ TOTAL 1
TRIBAL UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
OOLLISION' 03 - 10 - 2026 1330 17 =.�� S WE IN
OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
LIND AVE SW BLOCK NO. e 720 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 1❑ 250 00 FEET e✓ S 8✓ W e SW 7TH ST
IF51
29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES NO ✓ 1 a 30
6 LAST NAME UNKNOWN FIRST NAME UNKNOWN MIDDLE 1 1 2 31
INITIAL
STREET F-1 CITY ST ZIP' 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs Nb YEs NO
LCEENSE# STATE SEX U MMDDYY'. —=— t 32
8❑
9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 9 HELM
USEET 9 CLASS 0 NATURE OF INJURIES 2
LICENSE, 3
1 O PI ATF# STATE V(N
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR TRLR 0 0 33
12 0 0 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BUN TOWED By GOVT VEHICLE m
13 9 UNKN DUNE DAMAGE YES No ✓ Yes No 34
REGISTERED OWNER INFO UNKNOWNUNKNOWN VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE El
CO 2 3 4
IN EFFECT &POLICY# __4_TO_P_
v e `Le CHARGE t S ❑ 36
c LY YES❑NO❑ CITATION# HARE 7 o BOTTOM
15❑ STM ING B 7 e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT vEHICLE cvDLE' ❑ ❑ rwNFR YEs�/ No D:2069534290
16❑
LAST NAME KAMALI FIRST NAME MAHDI MIDDLE'
INITIAL
STREET ❑
17 ' 3429 E GRANDVIEW AVE CITY TACOMA ST, WA ZIP 98404 37
NEW AbbRESS
18 F� CDL IGNITION RI UIRED fGNfTION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCKYEs No INTERLO'KYES NO vEs No'
19 DRIVER' # STATE SEk M MMDDYY 12 31 1965 39
INJURY NATURE OF INJURIES 40
20❑ ON DUTY� STATUS' AIRBAG g RESTR g EJECT 9 USE 9 CLASS 0 ❑
21 LICENSE CSY0241 rare WA vIN# USE
41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2025 MAKE CHEV MODEL EQUINOX STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO MAHD/KAMALI3429 EGRANDVIEWAVE TACOMA WA 98404 D:2069534290 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO STATE FARM 578 6708 C21 47A
IN EFFECT &POLICY# t 9TOP
veeiae ❑ ,J—I CITATION# CHARGE tO BOTTOM
LecnLLY YES N`[
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG91270
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1911
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS El UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : 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 �____ ----j
NARRATIVE
26-1911 HR
RTF
On 3/10/2026 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a hit and run collision that had occurred in the parking
lot of the DK Market at 720 Lind Ave SW Renton/King/WA.
I arrived on scene and located the owner of the 2025 Chevrolet Equinox WA/CSY0241, he was
identified by his WADL as Mandi Karnali DOB: 12/31/19675. Mandi said that he parked and went
inside the store for approximately 1 hour (1330-1430). He said when he came out, he noticed there
was a large dent and paint transfer to the driver side doors and rear quarter panel of his vehicle.
He said that the spot next to his vehicle was empty when he parked and when he came outside. He
said that he checked with store management, and they advised they did not have any cameras in the
parking lot. No witnesses called to report the collision.
The paint transfer was to Mandi's vehicle was yellow but no other identifiers were located.
I provided Mandi with a case number.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 3/10/2026 Renton WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 03-10-26 04:40 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
4/2/2026 1:20:41 PM
C.JACOBS 1953
BADGE OR ID# 12421 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 2:30 Pry TIME POLICE ARRIVED 2:30 PM
PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37
REPORT NO. EG91270 CASE# 26-1911 DATE AND TIME 03/10/26 13:30
OF COLLISION
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