HomeMy WebLinkAbout23-3932 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED51837 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-3932 2 0 5
INTERSTATE CITY STREET RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION: 04 - 1-- 2023 0913 17 ❑.❑ S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
TALBOT RD S BLOCK NO. e✓ 4300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 300 00 FEET e S B W e S 43RD ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065409962 0 11
30
6� LAST NAME HUSSEIN FIRSTNAME ZA/NAB MIDDLE S 1 2 31
INITIAL
STREET ❑ 11020 SE KENT KANGLEY RD APT D201 CITY KENT ST WA ZIP 98030 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEXI F MM DAY' 03 1- 24 - 1990 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES 2❑
3
,OF
P1 ATNES# BWP6054 sTAr WAV N# 2T18U4EE4CC863516
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 5 33
12 3 5 VIN#' VIN#
ROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 5 1 34
13 8 2012 TOYT COROL SD DAMAGE YES No � �MEYER'S TOWING YES[:] No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILI VINSURANCE INSURANCE CO AMERICAN FAMILY INSURANCE 41075-02169.71 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068234764
16 a
LAST NAME ABRHA FIRST NAME NATNAEL MIDDLE M
INITIAL
17❑ STREET ❑', 12404 SE 202ND PL CITY KENT ST WA ZIP 98031 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LICENSE# STATE WA SEX M M D.C.B. 10 _ 10 _ 1984 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 6 RESTR 9 EJECT ''1 USE CLASS ❑
21❑ LICENSE I BMA1854 TAre WA vIN# KNAGM4AD7E5065933
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
TOWED BV Gov HI 44
VEH YEAR 2014 MAKE /(//� MODEL QP'I'/fllJ/� STYLE $D —FEHICLE
TO WED✓ NOO BLIN GENE MEYER'S TOWING YES NO�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE� &POINSURGY#E CO STATE FARM 4407833-C27-47IN 9TOP 5
VE""LE ❑ N,J� CITATION# CHARGE to BOTTOM
LEGALLY YES 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
NATHANIEL BROWN 12765 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED51837
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3932
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'
On 04/07/2023, at approximately 0917 hours, I was dispatched to a collision at the 4300 block of
Talbot Rd. S. Dispatch advised one driver had reported a swollen hand. Medical was dispatched.
At approximately 0922 hours, I arrived on scene. Sergeant Johnson was able to obtain both drivers'
information as well as their accounts of the incident. Sergeant Johnson conveyed that driver 1
(identified by WADL as Zainab S. Hussein, DOB 03/24/1990) was in a parking lot facing West
attempting to turn South onto Talbot Rd. S when the vehicles in lanes 1 and 2 of the northbound
traffic stopped and motioned for vehicle 1 to turn left. However, the driver of vehicle 2 (identified by
WADL as Natnael M. Abrha, DOB 10/10/1984) was driving north on Talbot Rd S in the center left turn
lane. This caused the front end of vehicle 2 to strike the front left corner of vehicle 1, with both
vehicles sustaining significant damage to the front bumpers and hood areas. Sergeant Johnson
established that there were no injuries and medical was canceled.
Based on the above information, Hussein (vehicle 1) has been deemed to have caused this collision
because vehicle 1 failed to yield to vehicle 2, which had the right of way as vehicle 2 was traveling
straight on the primary roadway, Talbot Rd S.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
NATHANIEL BROWN 04-07-23 03:16 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 411712023 4:26:26 AM
BADGE OR ID# 12765 ORI# WA0171300 TIME POLICE DISPATCHED 9:97 AM TIME POLICE ARRIVED 9:22 AM
PART I PAGE IT]OF 3�
REPORT NO. ED51837 CASE# 23-3932 DATE AND TIME 04/07/23 09:13
OF COLLISION
I
Not to scale
O
-2
cu F-
Parking lot exit
Vehicle 1
Vehicle
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