HomeMy WebLinkAbout23-7634 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-7634 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ HIT F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK' BUILDING
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 07 - 1-- 2023 2344 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
16924 116TH AVE S ST e✓
MILEPOST 16924
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253369518 30
6❑ LAST NAME HASAN FIRSTNAME ABDULLAH MIDDLE K 1 1 2 31
INITIAL
STREET 01 15650 42ND AVE S CITY TUKWILA ST WA 21p 98188 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 12 — 13 — 2002 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CFY6041 sTArr WAVIN# 1 HGCY2F74PA014186
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR. O 0 33
12❑ VIN#' VIN#'
FROM
34
13A VEH.YEARN MAKE HOND MODEL ACCOR STYLE 4C VEHICLE TOWED NOOpLSABLIN TSIYYEp9vMEYERS v�s❑ENo�
DAMAGE IILLJJII (��IV6
REGISTERED OWNER INFO PVHOLDING CORP 15820 INTERNATIONAL BLVD TUKWILA WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ UABILI INSURANCE❑ INSURANCE CO 2 3
IN EFFECT &POLICY# 9TOP
veH'Cl.e CHARGE 36
LEGALLY YFS❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2069798702
16❑
LAST NAME ANDERSON FIRST NAME TODD MIDDLE
INITIAL
STREET
CITY' ST ZIP 37
17� NEW ADDRES7
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
N AAH GIRELLO 12607 WA0171300
PAGE 01 OF
PART A
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED80074
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7634
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PANTEL JOSHUA D
(/AST FIRST,
ADDRESS&PHONE# D O.B. '
17228 139TH PL SE RENTON WA 98055 4257653266 SEX M MMDOYyry 05 - 08 - 1978
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
NOAH GIRELLO 07-05-23 05:02 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 711612023 2:33:22 PM
BADGE OR ID# 12607 ORI# WA0171300 TIME POLICE DISPATCHED 11:46 PM TIME POLICE ARRIVED',11:52 PM
PART Ei PAGE IT]OF 4]
REPORT NO. ED80074 CASE# 23-7634 OF COLLISION
07/04/23 23:44
OF CbLLI510N
NARRATIVE
23-7634
At about 2346 hours on 07/04/2023 1 was dispatched to an accident at, 16924 116th Ave SE, in the
city of Renton, King County, Washington. Dispatch advised me that there was one vehicle into a
building and injuries were unknown.
Vehicle information: 2023 Silver Honda Accord (WALIC/CFY6041) (VIN/1 HGCY2F74PA014186)
Driver: Abdullah K Hasan (DOB 12/13/2002)
Witness: Joshua D Pantel (DOB 05/08/1978)
Upon my arrival I observed several subjects and vehicles in the parking lot to the west of the building.
There was no vehicle in the building and everyone on scene advised they were ok, and no one
required medical assistance. The driver of the vehicle was then contacted. The vehicle had extensive
damage to the rear of the vehicle, specificity the rear driver's side. The driver of the vehicle advised
that he was the sole occupant of the vehicle at the time of the accident and there was no airbag
deployment.
The following as a summary of what the driver said happened. The driver of the vehicle said that he
was in the parking lot with friend, and they were lighting off fireworks because it was the 4th of July.
The driver had his vehicle facing west bound in the parking lot, with the back of the vehicle facing the
building. The driver stated that someone in the group that was lighting off fireworks threw a lit firework
underneath the driver's car while he was inside the car. Because of this the driver reversed too
quickly and ran through the pillars and into the building. The pillars holding the awning had severe
damage while the building had little to no damage. I do not believe there was substantial structural
damage.
The following is a summary of what the witness said happened. I contacted Joshua and he explained
that he owns the neighboring business, and his alarm went off due to the fireworks. Joshua said when
he arrived in the parking lot, he observed the large group lighting fireworks. Joshua said he also saw
someone throw the firework underneath the vehicle which caused the driver to reverse quickly into
the building.
The vehicle was inoperable an required a tow. I called for a owner requested tow and the vehicle was
towed by Gene Meyers. I was unable to reach the building owner likely due to the time of night and
because it was a holiday. Joshua said he knows the building owner well and would fill him in on what
happened in the morning, so I provided Joshua a case number to give to the building owner.
Pictures of the vehicle and building were taken and uploaded via Axon capture. The driver did not
have access to his insurance at this time.
This concludes my involvement with 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 N. GIRELLO #12607 on 07/04/2023 at 0000 Renton, WA
PAGE 3 OF 4
REPORT NO. ED80074 CASE# 23-7634 DATE AND TIME 07/04/23 23:44
OF COLLISION
16924 116th ave se
e
vehicle 1
PAGE 4 OF 4