HomeMy WebLinkAbout26-3397 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-3397 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 05 - 1-- 2026 1726 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
LOGAN AVE N BLOCK NO. e✓ 1000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e N 10TH ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254287454 0 11
30
6� LAST NAME MOSTAGHIM FIRSTNAME NIYAZ MIDDLE 1 2 31
INITIAL
STREET ❑, 844 6TH AVE NW CITY ISSAQUAH ST WA ZIP 98027 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
✓ I INTERLOCK YES[:]No NTERLOCKYEs NO✓ YES R No
8❑ LDRIVER # STATE WA SEX'M MID
-O B 10 1— 07 — 2007 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CVK5616 sTArI WAurN# JFIGPAL61CH2O4172
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR y GOVT.VEHICLE 34
13 2012 SUBA IMPREZ GA DAMAGE YES ✓ NO �MEYERS 1 $YES[:] ✓
REGISTERED OWNER INFO NIYAZ MOSTAGHIM 8446TH AVE NW ISSAQUAH WA 98027 D:4254287454 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO FARMERS 195274157 3 4
IN EFFECT &POLICY# 9TOP
15
vECEHA"LE 5 36
LLLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
❑ STAIN.D'ING 8 7 6
UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO PEDAL RTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME TZALAM COR FIRST NAME AUSTIN MIDDLE
INITIAL
17 STREET❑ NEW ADOREss❑' 4330 NE SUNSET BLVD UNIT H6 CITY RENTON ST WA ZIP 98059 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK yEs It I NOF YES
t l NOF,/
19 LDI IVERS STATE WA SEX M M D.O.B. 12 _ 15 _ 1986 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLA E# CBV5979 TArE WA vIN# 4T1C11AK7NU636720 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
%
'I
Gov HI
VEH YEAR 2022 MAKE 7'Oy7' MODEL CAMRY STYLE $D —FEHICLE
TOWED NOO✓ BLIN TOWED BY 44
fj
yES NO✓
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 868746280IN I STOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N`LJ
25 s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
E.CHANG 10065 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH07262
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3397
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS 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'
RTF
On 05-02-2026 at about 1726 hours, I was sent to a collision which occurred in the 1000 block of
Logan Ave N, within the City of Renton, King County, Washington.
Upon arrival I spoke with both drivers who were identified via their WADLs.
They both have the same account of the collision.
Unit 1 was coming out of the Landing parking garage driveway making a left turn. Unit 2 was headed
southbound on Logan Ave N in lane 2. The driver did not see unit 2 and merged into lane 2
southbound traffic. Unit 1 struck unit 2.
No injuries.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.CHANG 05-15-26 04:36 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 5/30/2026 4:36:49 PM
BADGE OR ID# 10065 OR]#' I WA0171300 TIME POLICE DISPATCHED 5:26 PM TIME POLICE ARRIVED',5:29 PM
PART I PAGE IT]OF 3�
REPORT NO. EH07262 CASE# ' 26-3397 DATE AND TIME 055/02/26 17:26
OF COLLISION
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