HomeMy WebLinkAbout26-4967 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 26-4967 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
i TRIBAL UNITS 04 STRUCK' UTILITY
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CtLLISION' 06 - 1-- 2026 1157 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
PARK AVE N BLOCK NO. e✓ 200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 2ND ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:6693249112 0 11
30
6� LAST NAME KIM FIRSTNAME HYO MIDDLE J 1 2 31
INITIAL
STREET ❑ 10237 SE 3RD ST APT 4 CITY BELLEVUE ST WA ZIP 98004 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ PICENS11 ATE 14 CSG6645 STATE WA v N# 7FARW5H39HE007726
11[-j- TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# IR.. ro
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR 2017 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 5 1 34
13 2 HOND CR-V EX SV DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO MINXIN CAI 102375E 3RD ST APT 4 BELLEVUE WA 98004 D:6693249112 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 6072093564 4
IN EFFECT &POLICY# 9TOP
VEHICL' CHARGE 1 5 36
LECALLv YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN
16 a PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064998303
LAST NAME KABBA FIRST NAME ANSUMANA MIDDLE
INITIAL
17 STREET❑ NEW ADOREss❑' 5900 37TH AVE S APT L 13 CITY SEATTLE ST WA ZIP 98118 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NO
�
19 DRIVER'S STATE WA SEX M D. 01 01 1999 39
LICENSE# MMDC7YY
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HE 2 INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS HEAD AND FACE PAIN
❑21❑ PLATE# CPW7271 TATE 41
WA vIN1 4T1BE30K65U625950 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
GoI
VEH YEAR 2005 MAKE 7'Oy7' MODEL CAMRY STYLE $D —FEHICLE
TOWED NOO✓ BLIN TOWED BY v HyES NO 1/ 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO pROGRESSIVE 995297764IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
=ORAJEWSKI
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12399 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH15475
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4967
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 FIRST 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.
RAYMOND GORAJEWSK/ 06-25-26 05:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
RAYMOND GORAJEWSKI 12399 6/25/2026 5:47:34 PM
BADGE OR ID# 12399 ORI# WA0171300 TIME POLICE DISPATCHED 11:59 AM TIME POLICE ARRIVED',12:01 PM
PART I PAGE IT]OF 6�
REPORT NO. EH15475 CASE# 26-4967 OF COLLISION
06/25/26 11:57
OF CbLLI510N
NARRATIVE
ASSIGNMENT/ARRIVAL
On 06/25/2026 at approximately 1159 hours, I was dispatched to a three-vehicle collision in the
intersection of Park Avenue N and N 2nd Street in the city of Renton, King County, Washington.
I arrived at approximately 1201 hours.
UNIT 1: HONDA CR-V
Upon arrival I observed a black Honda CR-V (WA/ CSG6645, Unit 1) stopped facing northeast in the
intersection. Unit 1's front-passenger side was engaged with a power/communications pole on the
northeast corner of the intersection. Unit 1 had moderate, disabling damage to the passenger side.
DRIVER 1: KIM, HYO J.
I contacted Hyo J. Kim (DOB: 05/08/1991) standing near Unit 1. 1 positively identified Kim by his valid
Washington Driver License and established him as the uninjured driver of Unit 1.
UNIT 2: TOYOTA CAM RY
I observed a gold Toyota Camry (WA/ CPW7271) stopped facing north in the intersection just behind
Unit 1. Unit 2 had moderate, disabling front end damage.
DRIVER 2: KABBA, ANSUMANA
I contacted Ansumana Kabba (DOB: 01/01/1999) in the driver seat of Unit 2. Kabba was initially
unresponsive and seemed dazed from the collision. I positively identified Kabba by his valid
Washington Driver License and established him as the driver of Unit 2 by his admission.
Kabba was evaluated by the Renton Regional Fire Authority, complained of head and face pain, and
was transported via ambulance to Valley Medical Center.
UNIT 3: TOYOTA RAV4
I observed a black Toyota RAV4 (WA/ CTD3112, Unit 3) stopped facing west on N 2nd Street just
east of Park Avenue N. Unit 3 had minor damage to the front-driver bumper.
DRIVER 3: MAI, LONG Q.
I contacted Long Q. Mai (DOB: 04/23/1972) standing near Unit 3. 1 positively identified him by his
valid Washington Driver License and established him as the uninjured driver of Unit 3 by his
admission.
STATEMENT: KIM, HYO J.
I spoke with Kim about the collision. The following is a summary of our conversation:
Kim drove Unit 1 east on N 2nd Street toward Park Avenue N. Kim stopped at the posted stop sign
and checked for vehicles approaching on Park Avenue N. Seeing none, Kim accelerated Unit 1 into
the intersection. As Kim entered the intersection, he saw Unit 2 driving north on Park Avenue N
toward him.
Kim did not have time to stop, and Unit 2's front end collided with Unit 1's passenger side, causing a
secondary collision with Unit 3 and a tertiary collision with the power/communications pole.
This concluded my conversation with Kim.
PROPERTY DAMAGE
Unit 1 struck the power/communications pole, which was not damaged. However, Unit 1 did strike a
communication line that ran from the ground up the pole. The line was not severed but could have
been internally damaged.
I contacted Comcast call center and notified them of the damage (Pole #A1717302).
PROXIMATE CAUSE
PAGE 3 OF 6
REPORT NO. EH15475 CASE# 26-4967 OF COLLISION
06/25/26 11:57
OF CbLLI510N
NARRATIVE
I determined the proximate cause of the collision based on Kim's statement and damage observed to
Unit 1 and Unit 2.
Kim's action was the cause of the collision, namely his violation of RCW 46.61.190(2)(a).
DISPOSITION
This concluded my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Sergeant R. Gorajewski, #12399, on 06/25/2026 at 1744 hours in Renton,
Washington.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. EH15475
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 26-4967
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 tSJ CYCLE I_) PEDESTRIAN � OWNER �I YES NO
D:7026882826
0 8 29
LAST NAME MAI FIRST NAME LONG MIDDLE'.. Q
INITIAL
STREET 30
NEW AnDRFSP' 7509 140TH PL NE CITY REDMOND ST WA ZIP 98052
5 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO zERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 04 - 23 - 1972
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE CTD3112 TAr WA VIN# 4T3RWRFV4SU193958
PLATE#
9 2] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 2 5 VEH.YEAR2025 MAKE TOYT MODELRAW STYLE SV VEHICLE TOWE ET SABLIN TOWED BY anvi vEH1I' FROM TO
DAMAGE YES 'E YES NO
REGISTERED OWNER INFONA MAI 7509140TH PL NE REDMOND WA 98052 D:7026882826 J 9 33
12 SHADE IN DAMAGED AREA
7 j 4 FROM TO
LIABILITY INSURANCE INSURANCE CO STATE FARM 5480643DI347C q"i"Olx
IN EFFECT &POLICY# 1
EHICLE 34
13 ❑ LEGALLY YES NO❑ CITATION# CHARGE 0 BOTTUM
STANDING 4 MOT{7R PEDAL PROPERTY 7 e
DAMAGE THRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN1:1 OWNER YES NO D:8882662278
15 COMCAST XFINITY MIDDLE ❑ 35
LAST NAME FIRST NAME INITIAL
16 ❑ STREET ❑; 1581525THAVEW CITY, LYNNWOOD ST' WA ZIP 98087
N�n+AnnRFSS
CDL IGNITION REOUIREE7 IGNITtGN PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YES No INTERLOCK YEs N. YEs NO ❑
DRIVER'S STATE SEX U D.O.B 4 37
18 ❑ LICENSE# MMOO -
ON DUTY STATUS AIRBAG RESTR, EJECT HELMET INJURY NATURE of INJURIES ❑ 38
USE CLASS
19 ❑ LICENSE TAr VIN If 39
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ ❑ 41
TRLR TRLR
VIN# YIN#i
42
22 VEH.YEAR MAKE MODEL STYLE 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 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LECALLv
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.
RAYMOND GORAJEWSKI 06-25-26 05:46 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
25 OR RID 12399 O#I',WA0171300 GORAJEWSKI 6/25/2026 PAGE[OF 6
3000-345-013(R 11118)
REPORTNO.! EH15475 CASE# 26-4967 DATE AND TIME 06/25/2611:57
OF COLLISION
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PAGE 6 OF 6