20160223 LanghamAgency Accident Number
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Reportable Accident On Emergency Amended GZDR0DT
DOT Document Number Document Override Number
16022301
16
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2
2
3
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1
02/23/2016
4 - Accident Date
0100
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County SAND LAKE - 14, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
F
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.41 MI15 - Est. Distance SOUTH15 - Hwy. Dir
16 - Fr/At Hwy No.MARSH LAKE RD S16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.775200
12 - Latitude -91.45854513 - Longitude
DITCH80 - 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
OUTSIDE-SHOULDER-RIGHT
117 - Relation To Roadway
DARK-NOT-LIGHTED114 - Light Condition DRY116 - Road Surface Condition CLOUDY118 - 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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DITCH
81 - Most Harmful Event: Collision With
NORTH
23 - Dir Of Travel
4524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2024
31 - Expiration Year 34 - On Duty Accident
LANGHAM
25 - Operator/Pedestrian Last Name
ROBERT
25 - First Name
JOHN
25 - Middle Initial 25 - Suffix
04/16/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
STONE LAKE
27 - City
WI
27 - State
54876
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
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.
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
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
268AWG
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year
125
55 - Vehicle Identification Number
2006
50 - Year
FORD
51 - Make
TAURUS
52 - Model
4D - 4DR
53 - Body Style
MAR
54 - Color
0100 - Skidmarks to Impact (Ft)
TOTAL (DAMAGE TO ALL AREAS)
94 - Vehicle Damage
SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96 97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
LANGHAM
46 - Vehicle Owner Last Name
ROBERT
46 - First Name
JOHN
46 - Middle Initial 46 - Suffix
04/16
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
STONE LAKE48 - City WI48 - State 5487648 - Zip Code 49 - Telephone Number
PEKIN-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
LANGHAM
61 - Policy Holder Last Name
ROBERT
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
Trailer
01
TR
L
106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
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Wisconsin Motor Vehicle GZDR0DT 2 424
Fixed Objects Struck
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Property
UNKNOWN
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
86 - City 86 - State 86 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
DITCH
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
ON FEBRUARY 23RD, 2016, I, DEPUTY SHEPARD OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT WAS DISPATCHED TO A
REPORT OF AN INDIVIDUAL WALKING ON COUNTY HWY F NEAR HAUER RD. I LOCATED THE SUBJECT AT 4:57AM AND IDENTIFIED
HIM AS ROBERT J. LANGHAM. LANGHAM ADVISED THAT HE ROLLED HIS VEHICLE SEVERAL MILES SOUTH ON HWY F. HE STATED
THAT HE DID SO AT APPROXIMATELY 1:00AM AND HAD BEEN WALKING HOME SINCE. I HAD LANGHAM SIT IN MY VEHICLE AND I
TRANSPORTED HIM BACK TO HIS VEHICLE. I LOCATED THE VEHICLE ON THE EAST SIDE OF COUNTY HWY F APPROXIMATELY ONE
QUARTER MILE SOUTH OF MARSH LAKE RD. THE VEHICLE WAS OVERTURNED AND FACING SOUTH. HE ADVISED THAT HE HIT THE DITCH AND THE VEHICLE HAD GOTTEN PULLED IN. THE VEHICLE FLIPPED AND CHANGED DIRECTIONS. THERE WAS EXTENSIVE
DAMAGE TO ALL AREAS OF THE VEHICLE. THE AIR BAGS WERE DEPLOYED. LANGHAM STATED THAT HE WAS WEARING HIS SEAT
BELT AND WAS ABLE TO UNHOOK HIMSELF WHEN THE VEHICLE STOPPED ROLLING. HE STATED THAT HE WAS UNINJURED AND
DID NOT NEED MEDICAL ATTENTION. ROADRUNNER TOWING ARRIVED ON SCENE AND TOWED THE VEHICLE. THEY TOWED IT TO
HAYWARD AUTO SALVAGE. I GAVE LANGHAM A RIDE HOME. HE WAS NOT ISSUED ANY CITATIONS. HE HAD ADVISED THAT HE SLID
ON ICE, HOWEVER I DID NOT SEE ANY ICE ON THE PORTION OF THE ROAD WHERE HE HAD GONE INTO THE DITCH. AN INCIDENT REPORT WILL BE FILED ON THIS CASE AS WELL.
ON FEBRUARY 23RD, 2016, I, DEPUTY SHEPARD OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT WAS DISPATCHED TO A
REPORT OF AN INDIVIDUAL WALKING ON COUNTY HWY F NEAR HAUER RD. I LOCATED THE SUBJECT AT 4:57AM AND IDENTIFIED
HIM AS ROBERT J. LANGHAM. LANGHAM ADVISED THAT HE ROLLED HIS VEHICLE SEVERAL MILES SOUTH ON HWY F. HE STATED
THAT HE DID SO AT APPROXIMATELY 1:00AM AND HAD BEEN WALKING HOME SINCE. I HAD LANGHAM SIT IN MY VEHICLE AND I
TRANSPORTED HIM BACK TO HIS VEHICLE. I LOCATED THE VEHICLE ON THE EAST SIDE OF COUNTY HWY F APPROXIMATELY ONE
QUARTER MILE SOUTH OF MARSH LAKE RD. THE VEHICLE WAS OVERTURNED AND FACING SOUTH. HE ADVISED THAT HE HIT THE DITCH AND THE VEHICLE HAD GOTTEN PULLED IN. THE VEHICLE FLIPPED AND CHANGED DIRECTIONS. THERE WAS EXTENSIVE
DAMAGE TO ALL AREAS OF THE VEHICLE. THE AIR BAGS WERE DEPLOYED. LANGHAM STATED THAT HE WAS WEARING HIS SEAT
BELT AND WAS ABLE TO UNHOOK HIMSELF WHEN THE VEHICLE STOPPED ROLLING. HE STATED THAT HE WAS UNINJURED AND
DID NOT NEED MEDICAL ATTENTION. ROADRUNNER TOWING ARRIVED ON SCENE AND TOWED THE VEHICLE. THEY TOWED IT TO
HAYWARD AUTO SALVAGE. I GAVE LANGHAM A RIDE HOME. HE WAS NOT ISSUED ANY CITATIONS. HE HAD ADVISED THAT HE SLID
ON ICE, HOWEVER I DID NOT SEE ANY ICE ON THE PORTION OF THE ROAD WHERE HE HAD GONE INTO THE DITCH. AN INCIDENT REPORT WILL BE FILED ON THIS CASE AS WELL.
Officer Information
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125 - First Name 125 - Middle Initial
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
02/23/2016
132 - Date Notified 0432133 - Time Notified (Military Time)0457134 - Time Arrived (Military Time)
02/23/2016
135 - Date Of Report
16022301 19 - Special Study
18 - Agency Space
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZDR0DT 4 4