20141124 HaackAgency Accident Number
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Reportable Accident On Emergency Amended GZFBRQW
DOT Document Number Document Override Number
14112514400
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14112502
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11/24/2014
4 - Accident Date
1500
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HUNTER - 07, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
B
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.69 MI15 - Est. Distance WEST15 - Hwy. Dir
16 - Fr/At Hwy No.CALLAHAN LAKE RD16 - From/At Street Name 16 - Business/Frontage/Ramp
FIRE #
17 - Structure Type
9899N
17 - Structure Number
45.982185
12 - Latitude -91.25339613 - Longitude
MAILBOX80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
NO CONTROL
112 - Access Control
STRAIGHT
113 - Road Curvature
LEVEL/FLAT
113 - Road Terrain
BLACKTOP, BITUMINOUS, OR ASPHALT - 2
Surface Type
NOT-PHYSICALLY-DIVIDED-(2-WAY TRAFFIC)115 - Traffic Way
SHOULDER-(OTHER THAN SHOULDER WITHIN MEDIAN OR GORE)
117 - Relation To Roadway
DAYLIGHT114 - Light Condition SNOW/SLUSH116 - Road Surface Condition SNOW118 - 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
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H - HIT AND RUN
Unit Status
MAILBOX
81 - Most Harmful Event: Collision With
EAST
23 - Dir Of Travel
5524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2022
31 - Expiration Year 34 - On Duty Accident
HAACK
25 - Operator/Pedestrian Last Name
GARY
25 - First Name
A
25 - Middle Initial 25 - Suffix
11/22
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
COUDERAY
27 - City
WI
27 - State
54828
27 - Zip Code 28 - Telephone Number
FRONT-SEAT-LEFT-SIDE-(MC/BIKE DRIVER, TRAIN CONDUCTOR)
39 - Seat Position
SHOULDER-BELT-ONLY-USED
40 - Safety Equipment
N - NO APPARENT INJURY
38 - Injury Severity
NON-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
NO-CONTROL
120 - Traffic Control 062 - No. of Citations Issued
64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
SPEED-TOO-FAST-FOR-CONDITIONS, LEFT-OF-CENTER, FAILURE-TO-HAVE-CONTROL
122 - Driver Factors
NOT OBSERVED88 - Driver or Pedestrian Cond UNKNOWN
89 - Substance Presence
TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
Accident Report
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
SNOW,-ICE,-OR-WET
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
984MGT
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2015
59 - Exp Year
0962
55 - Vehicle Identification Number
2008
50 - Year
MAZD
51 - Make
MAZDA3I
52 - Model
4D - 4DR
53 - Body Style
GRY
54 - Color 100 - Skidmarks to Impact (Ft)
REAR PASSENGER SIDE, REAR
94 - Vehicle Damage
MODERATE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
OPERATOR
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
HAACK
46 - Vehicle Owner Last Name
GARY
46 - First Name
A
46 - Middle Initial 46 - Suffix
11/22
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
COUDERAY48 - City WI48 - State 5482848 - Zip Code 49 - Telephone Number
ESURANCE-INSURANCE-COMPANY63 - Liability Insurance Company Policy Holder Same As Owner60
HAACK
61 - Policy Holder Last Name
GARY
61 - Policy Holder First Name
61 - Policy Holder Company
01
01
01
01
BU
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FromTo
Bus Travelling to/from School Name Body Make Seating Capacity
School District Contracted With
Trailer
01
TR
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106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
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Fixed Objects Struck
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Property
INDIVIDUAL
Organization Type
FITCH
84 - Property Owner Last Name
GERI
84 - First Name
L
84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
HAYWARD
86 - City
WI
86 - State
54843
86 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
MAILBOX
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
POPLIN AND CAIN
UNIT 1 WAS GOING EAST ON COUNTY HWY B AT ABOUT 40 MPH. UNIT 1 HIT A PILE OF SLUSH AND SNOW ON THE SNOW COVERED
ROADWAY AND LOST CONTROL OPERATING ACROSS THE ENTIRE ROADWAY AND SPINNING COMPLETELY AROUND FACING BACK
WEST STRIKING A GROUP OF MAILBOXES AT THE END OF KINGFISHER LN. 4 MAILBOXES WERE HIT OWN BY GERI FITCH AT 9899N,
JANICE KINGFISHER AT 9885N, VICTOR OLKER AT 9891N, AND DUGLECM FITCH AT 9901N. ALL FIRE NUMBERS ARE FOR
KINGFISHER LANE. UNIT 1 LEFT THE SCENE AND THE INCIDENT WAS REPORTED THE NEXT DAY BY THE DRIVER. UNIT 1 SUSTAINED
MODERATE DAMAGE TO THE PASSENGER SIDE REAR AND REAR OF THE VEHICLE.
UNIT 1 WAS GOING EAST ON COUNTY HWY B AT ABOUT 40 MPH. UNIT 1 HIT A PILE OF SLUSH AND SNOW ON THE SNOW COVERED
ROADWAY AND LOST CONTROL OPERATING ACROSS THE ENTIRE ROADWAY AND SPINNING COMPLETELY AROUND FACING BACK
WEST STRIKING A GROUP OF MAILBOXES AT THE END OF KINGFISHER LN. 4 MAILBOXES WERE HIT OWN BY GERI FITCH AT 9899N,
JANICE KINGFISHER AT 9885N, VICTOR OLKER AT 9891N, AND DUGLECM FITCH AT 9901N. ALL FIRE NUMBERS ARE FOR
KINGFISHER LANE. UNIT 1 LEFT THE SCENE AND THE INCIDENT WAS REPORTED THE NEXT DAY BY THE DRIVER. UNIT 1 SUSTAINED
MODERATE DAMAGE TO THE PASSENGER SIDE REAR AND REAR OF THE VEHICLE.
Officer Information
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125 - First Name 125 - Middle Initial
POPLIN
125 - Officer Last Name
JAY 352
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
11/25/2014
132 - Date Notified 1025133 - Time Notified (Military Time)1044134 - Time Arrived (Military Time)
11/25/2014
135 - Date Of Report
14112514400 14112502 19 - Special Study
18 - Agency Space
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