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HomeMy WebLinkAbout26-3637 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 26-3637 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 5 1 28 TOTAL#OF OBJECT TRIBAL UNITS 03 STRUCK' FENCE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ CowsloN 05 - 11 - 2026 1645 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 5325 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El No ,/ I D:4258665557 0 11 30 6❑ LAST NAME KHURRAM FIRSTNAME SHAHBAZ MIDDLE 1 2 31 INITIAL STREET ❑, 961 10TH PL NE UNIT 206 CITY ISSAQUAH ST WA ZIP, 98029 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ,/ I INTERLOCK YES[:]NO NTERLOCKYEs NO,/ YES ,/ NO 8❑ LDRIVER # STATE WA SEX'M MID LOB 12 1— 18 — 1988 2 32 9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 I [NATURE OF H U EET 2 1 INJURY CLASS 6 KNEE PAIN JURIES z❑ 3 LICENSE CVS9067 STATE WA VIN# 2HGES25762H581991 10 9❑ Pr ATE� TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 7 34 13 4 2002 HOND CIVIC SD DAMAGE YES NO �MEYERS YES❑ No✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO ROOT INSURANCE 9MC3XV 4 IN EFFECT &POLICY# 9TOP VIC CHARGE 1 36 LECALLEHLEv res�NO D CITATION# 1 o BOTTOM 15❑ STAIN,DIING 8 7 6 UNIT 02 vEHIMOTOCLE CYCLE ❑ PEDESTRIAN ❑ oWNFR PEDAL RTY ❑ DYES NO OLD MET PHONE 16 a LAST NAME UNKNOWN FIRST NAME UNKNOWN MIDDLE INITIAL STREET CITY RENTON ST ZIP 4 17❑ NEW ADDRESS❑ ❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YEs❑NOF,/ 19 LLIICENS # STATE SEX U MMDDYY —�_ ❑ 39 20❑ ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 H U EET 9 LASS O NATURE OF INJURIES 40 ❑21❑ TATE 41 IN#LICENSE V 1 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR MAKE IbIITS MODEL UNKNOW STYLE SD VEHICLE TOWED TO BLIN TOWED BY Gov HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO (NEWJ VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5 VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM LEGALLY YES N 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 SLAKE BOWIE 12105 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EHO5118 COLLISION REPORT III III III III III 111 1591972 CASE# 26-3637 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) UNKNOWN KIRK (LAST FIRST, ADDRESS&PHONE# UNKNOWN RENTON WA 98056 2067950145 SEX M MMDDYyry -�- PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY 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' On 05-11-2026 at 1657 hours I was dispatched to 5325 NE Sunset Blvd, in the City of Renton, County of King, State of Washington, for a reported one vehicle collision into a fence. Upon arrival, I saw unit 1's vehicle off the road and through apart of the fence of 5325 NE Sunset Blvd. The driver had knee/leg pain and was being evaluated by the Renton Fire Department. He was unable to give his side of the story as he was in to much pain and needed to be transported. I spoke to the owner of the residence, Mirley, and she was able to show me video of the incident. Her video shows Unit 1 driving eastbound and a silver Mitsubishi sedan driving westbound came across the center line towards Unit 1. Unit 1 swerved out of the way to prevent a head on collision and went off the road ultimately crashing into the fence. The Mitsubishi continued to drive westbound and never came back to the scene. 1 sent Mirley an Axon evidence link to upload the videos to and she agreed to upload them. See video for further information. A witness, Kirk, was in his truck driving eastbound behind Unit 1 when the other vehicle came across the center line and caused Unit 1 to swerve. I provided all parties involved with my business card which contained the case number for their records. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electrically signed by Officer B. Bowie / 12105 on 05-11-2026 at 1757 hours in the City of Renton. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. SLAKE BOWIE 05-11-26 06:14 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE PHILIP DAVIS 12018 1 5/22/2026 10:25:27 AM BADGE OR ID# 12105 ORI# WA0171300 TIME POLICE DISPATCHED! 4:51 PM TIME POLICE ARRIVED',4:53 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EH051 1 8 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 26-3637 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE I_J CYCLE u PEDESTRIAN � OWNER � YEs� NO D:4259193933 MIDDLE.. 29 LAST NAME BASTO FIRST NAME MIRLEY INITIAL M STREET 30 ❑ NEW AnnRFSP 5325 NE SUNSET BLVD CITY RENTON ST WA ZIP 98056 6 CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YEs No zERLOCK YES❑N0� vES N L DRIVER'S STATE SEX F M�DDYBYv 08 - 01 - 1998 LICENSE 7 F-I ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE GLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9F-I TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EHILLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36 STREET 16 NEW AnntxFs.� CITY'. ST ZIP CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. BLAKE BOWIE 05-11-26 06:14 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OBADGE R ID# 12105 O#I',WA0171300 APPROVED PDAVISBY 5%2E2/2026 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EH05118 CASE# ' 26-3637 DATE AND TIME 05/11/26 16:45 OF COLLISION Al Y k, \h t45 1 1 rp l � 1 t, R Yc cs� I . ' PAGE 4 OF 4