HomeMy WebLinkAbout25-00153 STATE OF I !�� I III I III I IIII III II I . 5 27c REPORT NO EF55741
COLLISION REP FIT
1591971
❑ ❑ FIRE ❑ CASE$# 25-00153 2 576
INTERSTATE CITY STREET ✓ RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
cawsloN 01 - 1-- 2025 1917 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON DR S BLOCK NO. e✓ 2600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 175 00 FEET MILES e S B W e S 27TH PL
2 0 29
MOTUNIT O1 VEHICR Z PEDAL-CLE CYCLE ElYYESA✓NO THRESHOLD MET PHONE Q 11
30
6❑ LAST NAME LEI FIRSTNAME ZILIN MIDDLE 1 2 31
INITIAL
STREET ❑, 10925 SE 172ND ST CITY RENTON ST WA Zlp' 98055 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs No✓ INTERLOCKYEs NO✓ YES R No
8❑ LDRIVER # STATE WA SEX'M MID
LOB 09 1— 27 — 1956 1 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES 2❑
3
10 7� 1 Pi ATES# CBL3018 sTATe WA uN# 4T18F3EKXBU618355
TRAILER STATE TRAILED STATE
11 4 0 PLATE# PLATE# FROM To
TRLR. TRLR 1 5 33
12 4 VIN#' VIN#
>;. FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TAW/g[ GOVT.VEHICLE 34
13 4 2011 TOYT CAMRY SD DAMAG 1 5 E YES NO YES❑ No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14� LIABILITY INSURANCE INSURANCECOAMERICAN FAMILY INSURANCE 41076-75974.06 4
IN EFFECTPOLICY# TOPVEHICLE CHARGE 36
LECALL'Yres NO CITATION# <1�3
OTTOM
15❑ STAIN,DIING 7 6
UNIT O2 VEHIMOTCCLE CYCLE ❑ PEDESTRIAN ❑ OWNER PEDAL- YES
❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME KHUJAZADA FIRST NAME SA MIDDLE M
INITIAL
17❑ STREET NEW ADOREs7 24016 62ND WAYS APT 20-303 CITY KENT ST WA ZIP 98032 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCKYEB❑No� INTERLOCK ves NO YES NOF
19 DRIVER'S STATE WA SEX M D.O.B. 07 26 _ 1982 39
LICENSE# MMDC7YY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 7 COMPLAINED OF PAIN.TRIMED TRANSPORT VMC ❑F—NATURE OF INJURIES 40
❑21❑ PLATE# CMP5333 TATE WA vIN# 41
JTDKN3DUOA0113232 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2010 MAKE 7'Dy7- MODEL pRIUS STYLE HB —TEHICLE
TOWED✓ NOO BLIN BANKERS YES No✓
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU8 PORGY#E CO pROGRESSIVE 984998036IN 1U
9TOP
VE""LE ❑ ,J� CITATION# CHARGE o BOTTOMLEGALYYES N`L J25 '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
JEREMY ENGEL 13006 WA0171300
1
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF55741
COLLISION REPORT III III III III III 111
1591972 CASE# 25-00153
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.
JEREMY ENGEL 01-06-25 03:18 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 111312025 11:07:35 PM
BADGE OR ID# ( 13006 ORI# WA0171300 TIME POLICE DISPATCHED 7:97 Pry TIME POLICE ARRIVED',7:17 PM
FART I PAGE IT]OF 4�
REPORT NO. EF55741 CASE# 25-00153 OF COLLISION
01/05/25 19:17
OF CbLLI510N
NARRATIVE
26-00153
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.
On 01/05/2025 at approximately 1917 hours I was patrolling in the 2200 block of Benson Dr S, City of
Renton, County of King, Washington.
I observed a grey Toyota Camry (Unit#1) driving southbound in the 2200 block of Benson Dr S in
lane 2 of 2. 1 was traveling behind Unit#1, and it did not have its vehicle lights activated. I informed
dispatch I would be initiating a traffic stop on Unit#1. 1 activated the emergency lights on my fully
marked patrol vehicle to signal Unit#1 to pull over. Unit#1 merged into lane 1 of 2 to stop. Unit#2
had stopped multiple car lengths ahead in lane 1 of 2 in response to my emergency lights. Unit#1 did
not appear to slow down and collided with the rear end of Unit#2 in the 2600 block of Benson Dr S.
The collision was captured on my AXON Fleet Camera.
I started Renton Regional Fire Department after seeing airbag deployment on Unit#1. 1 contacted the
driver, Zilin Lei (09/27/1956), who I identified via his WADL photo. Lei stated he did not have any
injuries.
I contacted the driver of Unit#2, Sayed M. Khujazada (07/26/1982). Khujazada initially stated he had
no injuries but later complained of pain. He was later transported to Valley Medical Center via TriMed.
Based on my observation of the collision I determined the driver of Unit#1 (Lei) was the proximate
cause for collision due to inattentiveness. Lei should have been paying closer attention to the
movement of traffic in front of him.
Both vehicles were towed by Bankers Towing due to extensive damage. I photographed the damage
to both vehicles and uploaded it to AXON. I provided both parties with an exchange of information.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer J. Engel #13006 1/6/2025 3:07 AM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF55741 CASE# 25-00153 DATE AND TIME 01/05/2519:17
OF COLLISION
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