20160216 Pichieti SchererAgency Accident Number
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Reportable Accident On Emergency Amended GZDWFR7
DOT Document Number Document Override Number
16021602
16
0
2
1
6
0
2
02/16/2016
4 - Accident Date
1441
5 - Time of Accident (Military Time)
02
6 - Total Units
01
7 - Total Injured 8 - Total Killed
SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
B
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
765 FT15 - Est. Distance WEST15 - Hwy. Dir
16 - Fr/At Hwy No.BENDER RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.998391
12 - Latitude -91.43568813 - Longitude
MOTOR VEHICLE IN TRANSPORT80 - First Harmful Event ANGLE93 - Manner of Collision
NO CONTROL
112 - Access Control
STRAIGHT
113 - Road Curvature
HILL
113 - Road Terrain
BLACKTOP, BITUMINOUS, OR ASPHALT - 2
Surface Type
NOT-PHYSICALLY-DIVIDED-(2-WAY TRAFFIC)115 - Traffic Way
ON-ROADWAY
117 - Relation To Roadway
DAYLIGHT114 - 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
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Unit Status
MOTOR VEHICLE IN TRANSPORT
81 - Most Harmful Event: Collision With
WEST
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
2019
31 - Expiration Year 34 - On Duty Accident
PICCHIETTI
25 - Operator/Pedestrian Last Name
JUSTIN
25 - First Name
ALEX
25 - Middle Initial 25 - Suffix
10/19/1
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
HAYWARD
27 - City
WI
27 - State
54843
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
OVERTAKING-ON-LEFT
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 362 - No. of Citations Issued
343.44(1)(A)
64 - 1st Statute No.
341.04(1)
64 - 2nd Statute No.
344.62(1)
64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
EXCEEDING-SPEED-LIMIT, INATTENTIVE-DRIVING
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
01
Accident Report
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Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
TRUCK
21 - Unit Type
PICKUP/UTILITY-TRUCK
Vehicle Type
2
22 - Total Occupants
JZ1813
56 - License Plate Number
LTK57 - Plate Type WI
58 - State
2015
59 - Exp Year
17858
55 - Vehicle Identification Number
2012
50 - Year
FORD
51 - Make
F350 SUPER
52 - Model
PK - PICKUP
53 - Body Style
BLK
54 - Color
12100 - Skidmarks to Impact (Ft)
FRONT
94 - Vehicle Damage
MODERATE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
ROADRUNNER TOWING
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
PICCHIETTI
46 - Vehicle Owner Last Name
JUSTIN
46 - First Name
ALEX
46 - Middle Initial 46 - Suffix
10/19/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code .49 - Telephone Number
NONE63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 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
Operator/Pedestrian
Unit Status
MOTOR VEHICLE IN TRANSPORT
81 - Most Harmful Event: Collision With
WEST
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
2021
31 - Expiration Year 34 - On Duty Accident
SCHERER
25 - Operator/Pedestrian Last Name
CURTIS
25 - First Name
R
25 - Middle Initial 25 - Suffix
11/13
32 - Date Of Birth
MALE
33 - Sex
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Wisconsin Motor Vehicle
Accident Report
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Wisconsin Motor Vehicle GZDWFR7 2 525
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Vehicle Owner
Insurance
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IN
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26 - Address Street & Number 26 - PO Box
HAYWARD
27 - City
WI
27 - State
54843
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
B - NON-INCAPACITATING INJURY
38 - Injury Severity
DEPLOYED
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
TRAPPED/EXTRICATED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
MAKING-LEFT-TURN
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 62 - No. of Citations Issued
64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
NOT-APPLICABLE
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
91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
392TTN
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year
6332
55 - Vehicle Identification Number
2004
50 - Year
HOND
51 - Make
ODYSSEY
52 - Model
VN - VAN
53 - Body Style
SIL
54 - Color 100 - Skidmarks to Impact (Ft)
REAR DRIVER SIDE, MIDDLE DRIVER SIDE, FRONT DRIVER SIDE
94 - Vehicle Damage
VERY-SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
A-1 TOWING
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
SCHERER
46 - Vehicle Owner Last Name
CURTIS
46 - First Name
R
46 - Middle Initial 46 - Suffix
11/13
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code .49 - Telephone Number
WEST-BEND-MUTUAL-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
SCHERER
61 - Policy Holder Last Name
CURTIS
61 - Policy Holder First Name
61 - Policy Holder Company
02
02
02
02
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Wisconsin Motor Vehicle GZDWFR7 3 5
School Bus
02
BU
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FromTo
Bus Travelling to/from School Name Body Make Seating Capacity
School District Contracted With
Occupant
Address Same As Operator
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65 - Unit No
WADE
66 - Occupant Last Name
MARISSA
66 - First Name
REATTA
66 - Middle Initial 66 - Suffix
01
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
12/30/
67 - Date of Birth
F
69 - Sex
FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER)
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
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
Trailer
01
TR
L
106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
105 - Photos By
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Diagram and Narrative
DEPUTY JEFF CAIN
UNIT TWO DROVE ONTO HWY B FROM A PRIVATE DRIVEWAY AND BEGAN WESTBOUND THEN IMMEDIATELY TURNED LEFT INTO
ANOTHER PRIVATE DRIVEWAY AS UNIT ONE WAS APPROACHING FROM THE WEST. UNIT ONE CHANGED LANES TO ATTEMPT TO
PASS AS UNIT ONE TURNED IN FRONT OF UNIT ONE.
UNIT TWO DROVE ONTO HWY B FROM A PRIVATE DRIVEWAY AND BEGAN WESTBOUND THEN IMMEDIATELY TURNED LEFT INTO
ANOTHER PRIVATE DRIVEWAY AS UNIT ONE WAS APPROACHING FROM THE WEST. UNIT ONE CHANGED LANES TO ATTEMPT TO
PASS AS UNIT ONE TURNED IN FRONT OF UNIT ONE.
Officer Information
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OF
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125 - First Name 125 - Middle Initial
CAIN
125 - Officer Last Name
JEFF 314
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
02/16/2016
132 - Date Notified 1441133 - Time Notified (Military Time)1446134 - Time Arrived (Military Time)
02/23/2016
135 - Date Of Report
16021602 19 - Special Study
18 - Agency Space
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