20160304 MetropulosAgency Accident Number
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Reportable Accident On Emergency Amended GZDVPJQ
DOT Document Number Document Override Number
16030402608
16
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6
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16030410
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03/04/2016
4 - Accident Date
1525
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality INTERSECTION11 - Accident Location
14 - On Hwy No.
ROUND LAKE SCHOOL RD
14 - On Street Name 14 - Bus/Frnt/Rmp 15 - Est. Distance 15 - Hwy. Dir
07716 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
46.029422
12 - Latitude -91.36328513 - Longitude
OTHER OBJECT-- NOT FIXED80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
PARTIAL 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
ON-ROADWAY
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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Unit Status
OTHER OBJECT-- NOT FIXED
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
2017
31 - Expiration Year 34 - On Duty Accident
METROPULOS
25 - Operator/Pedestrian Last Name
CASSIDY
25 - First Name
JOY
25 - Middle Initial 25 - Suffix
05/03
32 - Date Of Birth
FEMALE
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
NON-DEPLOYED
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
NOT-TRAPPED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
MAKING-RIGHT-TURN
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, 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
01
Accident Report
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Wisconsin Motor Vehicle GZDVPJQ 1 4
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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
698WTC
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
1784
55 - Vehicle Identification Number
2008
50 - Year
HOND
51 - Make
CIVIC
52 - Model
4D - 4DR
53 - Body Style
SIL
54 - Color
40100 - Skidmarks to Impact (Ft)
FRONT, FRONT DRIVER SIDE
94 - Vehicle Damage
SEVERE
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
DALE
46 - Vehicle Owner Last Name
KIMBERLEY
46 - First Name
JOY
46 - Middle Initial 46 - Suffix
07/04
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
AMERICAN-FAMILY63 - Liability Insurance Company Policy Holder Same As Owner60
DALE
61 - Policy Holder Last Name
KIMBERLEY
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
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
OTHER-OBJECT-NOT-FIXED
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
ON MARCH 4TH, 2016 I DEPUTY POPLIN WAS ON PATROL AND CAME ACROSS A SINGLE VEHICLE ACCIDENT WHICH JUST
HAPPENED. IT WAS ACTIVELY SNOWING AND THE ROAD CONDITIONS WERE SNOW COVERED AND SLIPPERY. UNIT 1 WAS GOING
EAST ON STATE HWY 77 AND ATTEMPTED TO MAKE A RIGHT HAND TURN ONTO ROUND LAKE SCHOOL ROAD. UNIT 1 WAS GOING
TOO FAST FOR THE SNOWY CONDITIONS AND LOST CONTROL GOING ACROSS ALL OF ROUND LAKE SCHOOL RD STRIKING THE
SNOWBANK ON THE EAST SIDE OF ROUND LAKE SCHOOL RD CAUSING DAMAGE TO UNIT 1.
ON MARCH 4TH, 2016 I DEPUTY POPLIN WAS ON PATROL AND CAME ACROSS A SINGLE VEHICLE ACCIDENT WHICH JUST
HAPPENED. IT WAS ACTIVELY SNOWING AND THE ROAD CONDITIONS WERE SNOW COVERED AND SLIPPERY. UNIT 1 WAS GOING
EAST ON STATE HWY 77 AND ATTEMPTED TO MAKE A RIGHT HAND TURN ONTO ROUND LAKE SCHOOL ROAD. UNIT 1 WAS GOING
TOO FAST FOR THE SNOWY CONDITIONS AND LOST CONTROL GOING ACROSS ALL OF ROUND LAKE SCHOOL RD STRIKING THE
SNOWBANK ON THE EAST SIDE OF ROUND LAKE SCHOOL RD CAUSING DAMAGE TO UNIT 1.
Officer Information
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Wisconsin Motor Vehicle GZDVPJQ 3 4
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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
03/04/2016
132 - Date Notified 1525133 - Time Notified (Military Time)1525134 - Time Arrived (Military Time)
03/07/2016
135 - Date Of Report
16030402608 16030410 19 - Special Study
18 - Agency Space
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