20141008 RasmussenAgency Accident Number
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Reportable Accident On Emergency Amended GZF72MH
DOT Document Number Document Override Number
14100807
14
1
0
0
8
0
7
10/08/2014
4 - Accident Date
2016
5 - Time of Accident (Military Time)
01
6 - Total Units
01
7 - Total Injured 8 - Total Killed
SAWYER - 572 - County HUNTER - 07, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
CC
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.63 MI15 - Est. Distance NORTH15 - Hwy. Dir
16 - Fr/At Hwy No.WOODLAND DR16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.931490
12 - Latitude -91.18781513 - Longitude
TRAFFIC SIGNAL80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
FULL CONTROL
112 - Access Control
STRAIGHT
113 - Road Curvature
HILL
113 - Road Terrain
BLACKTOP, BITUMINOUS, OR ASPHALT - 2
Surface Type
ONE-WAY-TRAFFIC115 - Traffic Way
OUTSIDE-SHOULDER-LEFT
117 - Relation To Roadway
DARK-NOT-LIGHTED114 - Light Condition DRY116 - Road Surface Condition CLEAR118 - Weather
Hit and Run
9
Government Property
9
Fire
9
Photos Taken
9
Trailer or Towed
9
Truck, Bus, or Hazardous Materials
9
Load Spillage
9
Construction Zone
9
Names Exchanged
9
Supplemental Reports
101
Witness Statements
102
Measurements Taken
103 79 - E M S Number
Operator/Pedestrian
OP
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Unit Status
TRAFFIC SIGNAL
81 - Most Harmful Event: Collision With
SOUTH
23 - Dir Of Travel
2524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2015
31 - Expiration Year 34 - On Duty Accident
RASMUSSEN
25 - Operator/Pedestrian Last Name
KAI
25 - First Name
J
25 - Middle Initial 25 - Suffix
11/28
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
BRUCE
27 - City
WI
27 - State
54819
27 - Zip Code
28 - Telephone Number
FRONT-SEAT-LEFT-SIDE-(MC/BIKE DRIVER, TRAIN CONDUCTOR)
39 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
40 - Safety Equipment
N - NO APPARENT INJURY
38 - Injury Severity
DEPLOYED
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
NOT-TRAPPED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
GOING-STRAIGHT
119 - What Driver Was Doing
TRAFFIC-SIGNAL-OPERATING
120 - Traffic Control 162 - No. of Citations Issued
344.62(1)
64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
FAILURE-TO-HAVE-CONTROL
122 - Driver Factors
APPEARED NORMAL88 - Driver or Pedestrian Cond UNKNOWN
89 - Substance Presence
TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
LOOSE-GRAVEL
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
5
22 - Total Occupants
247VRR
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2015
59 - Exp Year
1320
55 - Vehicle Identification Number
1994
50 - Year
NISS
51 - Make
ALTIMA
52 - Model
4D - 4DR
53 - Body Style
SIL
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT, FRONT PASSENGER SIDE, FRONT DRIVER SIDE
94 - Vehicle Damage
SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96 97 - Vehicle Removed By
BRAKE-SYSTEM
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
RASMUSSEN
46 - Vehicle Owner Last Name
KAI
46 - First Name
J
46 - Middle Initial 46 - Suffix
11/28/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
BRUCE48 - City WI48 - State 5481948 - Zip Code 49 - Telephone Number
NO INSURANCE63 - Liability Insurance Company Policy Holder Same As Owner60
RASMUSSEN
61 - Policy Holder Last Name
KAI
61 - Policy Holder First Name
61 - Policy Holder Company
01
01
01
01
BU
S
FromTo
Bus Travelling to/from School Name Body Make Seating Capacity
School District Contracted With
Occupant
Address Same As Operator
OC
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P
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01
65 - Unit No
TAFT
66 - Occupant Last Name
COLE
66 - First Name
Y
66 - Middle Initial 66 - Suffix
01
68 - Address Street & Number 68 - PO Box
CONRATH
68 - City
WI
68 - State
54731
68 - Zip Code
07/1567 - Date of Birth M69 - Sex
FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER)
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
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N - NO APPARENT INJURY
70 - Injury Severity
DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Occupant
Address Same As Operator
OC
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A
N
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01
65 - Unit No
WISTI
66 - Occupant Last Name
NICHOLAS
66 - First Name
J
66 - Middle Initial 66 - Suffix
02
68 - PO Box
BRUCE
68 - City
WI
68 - State
54819
68 - Zip Code
03/25/
67 - Date of Birth
M
69 - Sex
SECOND-SEAT-RIGHT
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
N - NO APPARENT INJURY
70 - Injury Severity
NON-DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Occupant
Address Same As Operator
OC
C
U
P
A
N
T
01
65 - Unit No
TURNER
66 - Occupant Last Name
STEVEN
66 - First Name
J
66 - Middle Initial 66 - Suffix
03
68 - Address Street & Number 68 - PO Box
LADYSMITH
68 - City
WI
68 - State
54848
68 - Zip Code
12/18
67 - Date of Birth
M
69 - Sex
SECOND-SEAT-LEFT-SIDE-(MC/BIKE PASSENGER, TRAIN BREAKMA
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
C - POSSIBLE INJURY
70 - Injury Severity
NON-DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Occupant
Address Same As Operator
OC
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P
A
N
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01
65 - Unit No
TUTTLE
66 - Occupant Last Name
AUSTIN
66 - First Name
C
66 - Middle Initial 66 - Suffix
04
68 - Address Street & Number 68 - PO Box
ISANTI
68 - City
MN
68 - State
55040
68 - Zip Code
11/05
67 - Date of Birth
M
69 - Sex
SECOND-SEAT-MIDDLE
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
N - NO APPARENT INJURY
70 - Injury Severity
NON-DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
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Trailer
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TR
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106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
Fixed Objects Struck
PR
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Property
ORGANIZATION
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
RENT-A- FLASH84 - Company Name Government Property Type
13605 SLETTIN DR
85 - Address Street & Number 85 - PO Box
MARATHON CITY86 - City WI86 - State 5444886 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
TRAFFIC-SIGNAL
82 - Object Struck 82 - Striking Unit 82 - Object Struck
82 - Striking Unit 82 - Object Struck 82 - Striking Unit 82 - Object Struck
82 - Striking Unit 82 - Object Struck 82 - Striking Unit 82 - Object Struck
105 - Photos By
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Diagram and Narrative
DEPUTY SHEPARD
ON SEPTEMBER 8TH, 2014 KAI J. RASMUSSEN WAS DRIVING SOUTH ON COUNTY HIGHWAY CC, WITH PASSENGERS COLE Y. TAFT, NICHOLAS J. WIST, STEVEN L. TURNER, AND AUSTIN C. TUTTLE. HE WAS TRAVELING THROUGH A CONSTRUCTION ZONE ON A ONE
LANE BRIDGE AND LOST CONTROL NEAR THE END. RASMUSSEN STATED THAT HE HIT A LARGE BUMP AND THE VEHICLE BEGAN
SKIDDING IN THE DIRT. WHEN THE VEHICLE REENTERED THE PAVEMENT RASMUSSEN COULD NOT REGAIN CONTROL AND HE
COLLIDED WITH A TEMPORARY TRAFFIC LIGHT THAT WAS USED FOR THE CONSTRUCTION ZONE. HIS VEHICLE ALSO HIT TWO
TRAFFIC SIGNS. WHEN IT COLLIDED THE VEHICLE TURNED 180 DEGREES. ONE OF THE TRAFFIC SIGNS WAS STILL STANDING, BUT
NO LONGER STILL COMPLETELY VERTICAL AND THE OTHER SIGN WAS WEDGED UNDER THE VEHICLE'S FRONT BUMPER. THE TRAFFIC LIGHT WAS PUSHED DOWN INTO THE DITCH NEAR A BODY OF WATER. THE VEHICLE WAS INCAPACITATED AND HAD TO
BE TOWED. RASMUSSEN DID NOT
ON SEPTEMBER 8TH, 2014 KAI J. RASMUSSEN WAS DRIVING SOUTH ON COUNTY HIGHWAY CC, WITH PASSENGERS COLE Y. TAFT, NICHOLAS J. WIST, STEVEN L. TURNER, AND AUSTIN C. TUTTLE. HE WAS TRAVELING THROUGH A CONSTRUCTION ZONE ON A ONE
LANE BRIDGE AND LOST CONTROL NEAR THE END. RASMUSSEN STATED THAT HE HIT A LARGE BUMP AND THE VEHICLE BEGAN
SKIDDING IN THE DIRT. WHEN THE VEHICLE REENTERED THE PAVEMENT RASMUSSEN COULD NOT REGAIN CONTROL AND HE
COLLIDED WITH A TEMPORARY TRAFFIC LIGHT THAT WAS USED FOR THE CONSTRUCTION ZONE. HIS VEHICLE ALSO HIT TWO
TRAFFIC SIGNS. WHEN IT COLLIDED THE VEHICLE TURNED 180 DEGREES. ONE OF THE TRAFFIC SIGNS WAS STILL STANDING, BUT
NO LONGER STILL COMPLETELY VERTICAL AND THE OTHER SIGN WAS WEDGED UNDER THE VEHICLE'S FRONT BUMPER. THE TRAFFIC LIGHT WAS PUSHED DOWN INTO THE DITCH NEAR A BODY OF WATER. THE VEHICLE WAS INCAPACITATED AND HAD TO
BE TOWED. RASMUSSEN DID NOT
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HAVE INSURANCE ON THE VEHICLE. HAVE INSURANCE ON THE VEHICLE.
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125 - First Name 125 - Middle Initial
Officer Information
SHEPARD
125 - Officer Last Name
LUCAS 316
131 - Officer ID
129 - Law Enforcement Agency No.
SAWYER COUNTY SHERIFFS DEPT
130 - Law Enforcement Agency Name
15880 EAST FIFTH STREET
126 - Law Enforcement Agency Address Street & Number
HAYWARD
127 - City
WI
127 - State
54843
127 - Zip Code
(715) 634-4858 EXT.
128 - Telephone Number
10/08/2014
132 - Date Notified 2034133 - Time Notified (Military Time)2058134 - Time Arrived (Military Time)
10/09/2014
135 - Date Of Report
14100807 19 - Special Study
18 - Agency Space
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