HomeMy WebLinkAbout26-3433 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-3433 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER VFHIC;I F ❑ LOCAL AOENC WA0171300 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TRIBAL 02
TOTAL#OF OBJECT 1 1 8 28
UNITS ❑
RESERVATION I I
STRUCK z
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
c usoN 05 - 03 - 2026 1540 17 ❑.= E IN e 1070 3
S 8
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
COULON BEACH ACRD BLOCK NO. e✓ 1300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 A❑ 200 00 FMILES N EET e S ❑ E e LAKE WASHINGTON BLVD
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253653649 0 11
30
6� LAST NAME S/MS FIRSTNAME JASON MIDDLE S 1 2 31
INITIAL
STREET ❑ 3811 NE 3RD CT APT I-301 CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10� PI ATE WSU949E sTATr WAurN#' WBAHN835X8DT79200
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 A 2008 BMW 750 SD DAMAGE YES NO YES[:] NO✓
REGISTEREDOWNER WFO LAMARMADKIN12812PADILLABAYLN MOUNTVERNONWA98273 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
A INSURANCE CO 4
14 LIABILITY INSURANCE PROGRESSIVE 999298403IN EFFECT &POLICY# TOPVE—LE CHARGE <1�3
OTTOM 5 36
LECALLv YES❑NO❑ CITATION# 5
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
�U_TN� VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:3462400363
16 a
LAST NAME AHMED FIRST NAME AHMED MIDDLE M
INITIAL
17❑ STREET NEW ADDREs7 8126 HEARTBROOK FIELD LN CITY CYPRESS ST TX ZIP 77433 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19[—] DRIVER'S STATE I TX SEX M D.C.B. 07 14 2001 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ ILICENSE PLA E# XMT5416 TATL TX VIN# 2C3CCAPGXFH781017 1
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2015 MAKE CHRY MODEL UNKNOW STYLE $D _TEHICLE
TOWED✓ NOO BLIN PRIVATE TOW YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DA GEbAREA
z Cdd
LIABILITY
INSURANCE &POINSURGY#E CO GO AUTO 4605618-14IN I 9TOP
VEHICLE YES[:] N
C[:] CITATION# CHARGE i o BOTTOM
LEGALLY
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
ROSEANNE HYNES 12612 WA0171300
PAGE 01 OF
PART A
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH22612
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3433
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SIMS MYLIA A
(LAST FIRST,
ADDRESS&PHONE#
3811 NE 3RD CT APT I-301 RENTON WA 98056 SEXi F MMDDvyvv 07 - 13 - 2020
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 9 2 10 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) HOPKINS THALIA T
ADDRESS&PHONE# D O E4
3811 NE 3RD CT APT I-301 RENTON WA 98056 2069001878 SEX F MMDDvvvv 10 _ 07 _ 2000
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 3 AIRBAG 2 RESTR. 9 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) AL SAMACH HAJIR A
ADDRESS&PHONE# 1809 SW 330TH$T FEDERAL WAY WA 98023 2067782118 SEX F D.O.E. 03 _ 24 _ 2000
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 3 AIRBAG 2 RESTR. 9 EJECT 1 HELMET 2 NJURY 1 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.
ROSEANNE HYNES 05-19-26 05:15 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.EDWARDS 9070 1 712112026 1:52:35 PM
BADGE OR ID# 12612 ORI# WA0171300 TIME POLICE DISPATCHED 3:40 PM TIME POLICE ARRIVED',4:05 PM
PART I PAGE IT]OF 4�
REPORT NO. EH22612 CASE# 26-3433 OF COLLISION
05/03/26 15:40
OF CbLLI510N
NARRATIVE
26-3433
On 05/03/2026 at 1605 hours, I was in full patrol uniform, assigned as unit 1 R25 and driving a marked
Renton Police patrol vehicle when I was dispatched to 1201 Lake Washington BLVD N in the city of
Renton, County of King, State of Washington, regarding a traffic collision.
The comments in the call said in summary: In front of parking lot near round about, two motor
vehicles in parking lot request officers due to RP not having insurance.
Upon arrival, I met with the parties involved in the collision. I spoke with Driver 1 (D1) -Jason Sims,
who was the driver of Vehicle 1 (V1) -BMW. D1 said in summary that he was driving west on Coulon
Beach Park Dr into the traffic circle when he collided into Vehicle 2 (V2) -Chrysler, causing damage to
his vehicle and V2. D1 -Sims said he was in the wrong when entering the traffic circle. D1 -Sims did
not claim injury. The passengers in his vehicle were Thalia Hopkins (front right) and their child Mylia
Sims (right rear). Nobody claimed injury and I did not see visible injury upon them. I saw there was
damage to V1's front end but the vehicle appeared drivable.
I spoke with Driver 2 (D2) -Ahmed Ahmed and he said in summary that he was driving in the traffic
circle on Coulon Beach Park Dr (east side of circle) when V1 collided into his vehicle, causing severe
damage to the rear right of his vehicle. He had a front right passenger in his vehicle, Hajir Samach.
Neither D2 or passenger Samach claimed injured and 1 did not see visible injury upon her. I saw
severe damage to the rear and rear right area of V2. The vehicle was not drivable and D2 -Ahmed
called for a private tow.
I conducted a record check on D1 -Sims and found that he was unlicensed and had an ID card only
and the tabs on the vehicle were expired as of 2017. D2 -Ahmed had a valid driver license and
current tabs. Because the collision took place on an access road and not a public roadway, I did not
cite D1 for being unlicensed and expired tabs.
I saw that the traffic circle was a one-way circle in which vehicles were directed to go in a
counterclockwise direction based on the arrows on the pavement. Both D1 and D2 exchanged
insurance information. I have nothing further.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: R. Hynes #12612 Date & Place: 05/18/2026 @
1645 hrs Renton, WA
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: TRAFF CIRCL ACCESS RD AT PUBLIC PARK
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EH22612 CASE# ' 26-3433 DATE AND TIME 05/03/26 15:40
OF COLLISION
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PAGE 4 OF 4