HomeMy WebLinkAbout26-3853 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-3853 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 CITY# ❑
COLLISION'. 05 - 19 - 2026 1315 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S CARR RD BLOCK NO. e✓ 900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 100 00 FEET e S ❑ W e 103RD AVE SE❑
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ,/NO D:2066009522 0 6 30
6� LAST NAME BA FIRSTNAME SOULEYMANE MIDDLE 0 3 31
INITIAL
STREET ❑, 3508 S 180TH ST APT B5 CITY SEATAC ST WA 2jp, 981884305 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z YEs No�/
8❑ LRIIVER #
� ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CLX3272 sTArI WAvIN# 1NXBR12E22Z564107
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR 2002 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 4 TOYT COROL SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFOSOULEYMANEBA3508S 180THSTAPTBS SEATAC WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO BRISTOL WEST G01 7642455 00 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 6AO092347 FOLLOW VEHICLE TOO CLOSELY <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066659663
16 a
LAST NAME SINGH FIRST NAME SAHIB MIDDLE
INITIAL
17❑ STREET ❑', 4222 SW 323RD ST CITY FEDERAL WAY ST WA ZIP 980232495 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYEs❑No� INTERLOCK ves No� YES
NDF
19 LICENSE# STATE WA SEX M I D.MMDDYY 04 12 _ 1957 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS ❑
21❑ LICENSE I CLS7633 TAre WA VIN# JTLKE50E091080785
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2009 MAKE TOYT MODEL SCION STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YESfj
NO,/ YES NO
REGISTERED OWNER INFO SAHIB SINGH 4222 SW 323RD ST FEDERAL WAY WA 98023 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#ECO STATE FARM 5270555 D2447DIN I STOP
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EHO5318
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3853
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SINGH INDERJIT
(LAST FIRST,
ADDRESS&PHONE# D.0
.B.
FEDERAL WAY 7036256562 SEX M MMDOYyry 01 - 10 - 1959
PASSENGER Z WITNESS UNIT# 2 SEA 3 AIRBAG 2 RESTR. q 1 EJECT ? J POS. H USEET 2 1 CLASS ,1 NATURE OF INJURIES
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYY
PASSENGER [:]WITNESSO UNIT# SEAT 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.
D.NELSON 05-22-26 01:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 5/22/2026 11:14:06 PM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 4:99 Pm TIME POLICE ARRIVED',1:29 Pm
PART I PAGE IT]OF 4]
REPORT NO. EH05318 CASE# 26-3853 OF COLLISION
05/19/26 13:15
OF CbLLI510N
NARRATIVE
26-3853 ACC
On 5/19/2026 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 two-vehicle collision with unknown details near the
9000 block of S Carr Rd Renton/King/WA. An involved party's family member was calling to report the
collision.
Officer Onishi arrived on scene before me and advised it was non-injury.
I arrived on scene and was able to get all vehicles moved out of the roadway.
The driver of the 2002 Toyota Corolla WA/CLX3272 (Unit 1) was identified by his WADL as
Souleymane Ba DOB: 10/15/1999. Souleymane said that he was driving west on S Carr Rd in the #1
lane. He said that an ambulance with lights and sirens activated was driving in the opposite direction
and Unit 2 suddenly stopped in front of him. He said that he collided with the rear bumper of Unit 2.
There was heavy damage to the front bumper and hood of the Corolla, it was not drivable.
Souleymane did not request a tow.
The driver of the 2009 Toyota Scion WA/CLS7633 (Unit 2) was identified by his WADL as Sahib
Singh DOB: 4/12/1957. Sahib said that he was driving west in the #1 lane of S Carr Rd when he saw
an ambulance with lights and sirens activated driving in the opposite direction. He said that he began
to slow down when Unit 1 struck his rear bumper. There was moderate damage to the rear bumper of
the Scion, it was drivable. Sahib did not request a tow.
I cited Souleymane for RCW 46.61.145.1 Following Vehicle Too Closely under Sector citation
#6A0092374. This citation should be mailed to his DOL address.
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 5/19/2026 Renton WA
PAGE 3 OF 4
REPORT NO. EH05318 CASE# ' 26-3853 DATE AND TIME 05/19/26 13:15
OF COLLISION
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