HomeMy WebLinkAbout26-5469 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 2s-sass 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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 N E IN CITY#
cowsloN 07 - 1-- 2026 1750 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SE CARR RD MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a 103RD AVE SE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2538677217 0 11
30
6 6❑ LAST NAME SHAMSURHMAN FIRSTNAME SHAMSURHMAN MIDDLE 1 2 31
INITIAL
STREET ❑ 2634 S 256TH ST APT N203 CITY KENT ST WA 2jp, 98032 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ DRIVERS
E#
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 I INJURY [NATURE OF
CLASS 6 CONCUSSIONRIEs z❑
3
10 9❑ P1 AT 14 CMV2035 STATE WA VIN# 5YF64MDE8RP20531 9
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR 7 1 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 2024 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 34
13 4 TOYT COROL SD DAMAGE YES NO �MEYER 3 7 TOWING YES[:] ✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2030398417 4
IN EFFECT &POLICY#
❑ LEGALLY LE CHARGE 5 ❑ 36
15 2 VEH" YEs No clTAnoN# 6A0363243 FAIL YIELD LEFT TURN MOTOR o Bo ob
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062355072
16 a
LAST NAME AL ASHOR FIRST NAME ABDULLAH MIDDLE H
INITIAL
17 STREET NEW ADOREs7 2720 SE 16TH ST CITY' RENTON ST WA ZIP 98058 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES t l NOF,/
19 LICENSE# STATE WA SEX M M .C.B. 02 _ 11 1997 39
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAUR CLSSY 6 CUTS/BRUISES TO LEFT ARM ❑OF INJURIES 40
❑21❑ PLA E# CUT1889 TATE 41
WA VIN# WBAJ61C53J6085446 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GI
VEBMWYEAR 2018 MAKE BM MODEL 530 STYLE $D DAMAGE TO TOWED II OV H 44
Yr
✓WED NOO BLIN PRIVATE TOW YES No
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY BX 14460326 STOP 5
IN EFFECT
VE""LE ❑ Nu,J CITATION# CHARGE
LEGAL to BOTTOM
LY YES
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
TIMOTHY NGUYEN 13182 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH23411
COLLISION REPORT III III III III III 111
1591972 CASE# 26-5469
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'
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.
TIMOTHY NGUYEN 07-13-26 09:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 7/24/2026 2:14:52 AM
BADGE OR ID# 13182 OR]# WA0171300 TIME POLICE DISPATCHED! 5:55 PM TIME POLICE ARRIVED 6:01 PM
PART I PAGE IT]OF 5�
REPORT NO. EH23411 CASE# 26-5469 OF COLLISION
07/13/26 17:50
OF CbLLI510N
NARRATIVE
26-5469
Unless stated otherwise, this incident occurred in the City of Renton, County of King, State of
Washington. During this incident, I was on duty as a Police Officer for the City of Renton and
assigned to Patrol District R12. I was wearing a fully marked uniform and driving a fully marked
vehicle. This incident was recorded with video and audio. It is important to note that the camera may
have captured things that I did not perceive, and I may have perceived things that were not captured
by the camera. The following is a summary of the events:
On 07/13/2026 at approximately 1805 hours, I was dispatched to an injury collision at the intersection
of SE Carr Rd and 103rd Ave SE. Dispatch advised that it was a roll over collision with two vehicles
involved. Unit 1 was identified as 2024 TOYOTA COROLLA (WA: CMV2035) and Driver 1 was
identified by WA DOL as SHAMSURHAMAN SHAMSURHAMAN (DOB: 06/03/2002). Unit 2 was
identified as 2018 BMW 530 (WA: CUT1889) and Driver 2 was identified as ABDULLAH H. AL
ASHOR (DOB: 02/11/1997).
Assisting Officers had already began investigating the circumstances and Renton Regional Fire
Authority (RRFA) had already began administering aid prior to my arrival.
Upon my arrival, I observed Unit 1 flipped over on its roof. Unit 1 was facing southbound on 103rd
Ave SE just north of the intersection. Unit 1 had severe to moderate to every side. I observed Unit 2
facing westbound in lane 1 of SE Carr Rd just west of the intersection. Unit 2 had severe damage to
its front-end.
Driver 1 was in the back of a RRFA ambulance being medically evaluated and interviewed by Officer
T. Truong. According to Officer Truong, Driver 1 was driving eastbound on SE Carr Rd in lane 2.
Driver 1 began turning northbound (left) onto 103rd Ave SE. Driver 1 claimed that Unit 2 was
speeding which caused the collision. Driver 1 ultimately declined to be medically transported. RRFA
believed that Driver 1 sustained a concussion.
Driver 2 had already been medically evaluated and cleared by RRFA. Driver 2 appeared to sustain
minor bruising and cuts to his left arm. Driver 2 advised that he would take himself to the hospital at a
later time.
I proceeded to interview Driver 2. In summary, Driver 2 was driving westbound on SE Carr Rd and
was approaching 103rd Ave SE when Unit 1 turned northbound (left) in front of him. Driver 2 was
unable to stop in time to avoid the collision. Driver 2 did not remember which lane he was traveling in.
Driver 1 and Driver 2 provided all of the necessary documents. Gene Meyer's Tow responded and
assumed custody of Unit 1. A private tow responded and assumed custody of Unit 2. Offcer Truong
took photos of the scene and uploaded them to evidence.com.
Based upon the totality of the circumstances, Driver 1 failed to yield while intending to turn left in an
intersection. I am issuing Driver 1: Infraction #6A0363243 for 46.61.185.1 - FAIL TO YIELD LEFT
TURN MOTOR VEHICLE. The Infraction will be sent to Driver 1's mailing address.
This concludes my involvement on today's date.
I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF
WASHINGTON THAT ALL STATEMENTS MADE HEREIN ARE TRUE AND ACCURATE AND THAT
I AM ENTERING MY AUTHORIZED USER ID AND PASSWORD TO AUTHENTICATE IT.
PAGE 3 OF 5
REPORT NO. EH23411 CASE# 26-5469 OF COLLISION
07/13/26 17:50
OF CbLLI510N
NARRATIVE
Signature: Officer T. Nguyen #13182
Date, Time, and Place: 07/13/2026 at approximately 2102 hours in the City of Renton, County of
King, State of Washington
PAGE 4 OF 5
REPORT NO. EH23411 CASE# ' 26-5469 DATE AND TIME 07/13/26 17:50
OF COLLISION
103RD
i' SE
1
i'
1:
PAGE 5 OF 5