20160319 Deyo WhiteAgency Accident Number
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Police Number
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Reportable Accident On Emergency Amended GZDVPJR
DOT Document Number Document Override Number
16031903304
16
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1
9
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16031905
16
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03/19/2016
4 - Accident Date
1556
5 - Time of Accident (Military Time)
02
6 - Total Units
01
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
027
14 - On Hwy No.
NB
14 - On Street Name 14 - Bus/Frnt/Rmp
526 FT15 - Est. Distance NORTH15 - Hwy. Dir
16 - Fr/At Hwy No.PARK RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.991831
12 - Latitude -91.49766613 - Longitude
MOTOR VEHICLE IN TRANSPORT80 - First Harmful Event REAR-END93 - 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
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
160319033479 - E M S Number
Operator/Pedestrian
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Unit Status
MOTOR VEHICLE IN TRANSPORT
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
2016
31 - Expiration Year 34 - On Duty Accident
DEYO
25 - Operator/Pedestrian Last Name
LANE
25 - First Name
SCOTT
25 - Middle Initial 25 - Suffix
07/17
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
C - POSSIBLE 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 162 - No. of Citations Issued
346.14(1)
64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
INATTENTIVE-DRIVING, FOLLOWING-TOO-CLOSE
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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Accident Report
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Wisconsin Motor Vehicle GZDVPJR 1 5
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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
KD9889
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year
1945
55 - Vehicle Identification Number
2003
50 - Year
SUBA
51 - Make
BAJA
52 - Model
UT - SPORT UTILITY
53 - Body Style
YEL
54 - Color
0100 - Skidmarks to Impact (Ft)
FRONT, FRONT DRIVER SIDE, FRONT PASSENGER SIDE
94 - Vehicle Damage
VERY-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
DEYO
46 - Vehicle Owner Last Name
BRYAN
46 - First Name
D
46 - Middle Initial 46 - Suffix
10/09/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
RURAL-MUTUAL-INS-CO-(ATTN:-CLAIMS-DEPT)63 - Liability Insurance Company Policy Holder Same As Owner60
DEYO
61 - Policy Holder Last Name
BRYAN
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
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
2018
31 - Expiration Year 34 - On Duty Accident
WHITE
25 - Operator/Pedestrian Last Name
SHANNON
25 - First Name
L
25 - Middle Initial 25 - Suffix
04/14
32 - Date Of Birth
FEMALE
33 - Sex
Accident Report
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Wisconsin Motor Vehicle
Accident Report
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Wisconsin Motor Vehicle GZDVPJR 2 525
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Insurance
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26 - Address Street & Number 26 - PO Box
WISCONSIN RAPIDS
27 - City
WI
27 - State
54494
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-LEFT-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.
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
784SMM
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
50
55 - Vehicle Identification Number
2015
50 - Year
JEEP
51 - Make
PATRIOT
52 - Model
UT - SPORT UTILITY
53 - Body Style
BLU
54 - Color
0100 - Skidmarks to Impact (Ft)
REAR, UNDERCARRIAGE
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
WHITE
46 - Vehicle Owner Last Name
SHANNON
46 - First Name
L
46 - Middle Initial 46 - Suffix
04/14/
Date Of Birth
46 - Company Name
& Number 47 - PO Box
WISCONSIN RAPIDS48 - City WI48 - State 5449448 - Zip Code .49 - Telephone Number
PROGRESSIVE-CASUALTY-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
WHITE
61 - Policy Holder Last Name
SHANNON
61 - Policy Holder First Name
61 - Policy Holder Company
02
02
02
02
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Wisconsin Motor Vehicle GZDVPJR 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
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
105 - Photos By
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Diagram and Narrative
DEPUTY SCHICK
ON MARCH 19TH, 2016 UNIT 1 AND UNIT2 WERE BOTH GOING NORTH ON STATE HWY 27. UNIT 2 WAS MAKING A LEFT HAND TURN INTO THE PRICE RITE PARKING LOT AND UNIT 1 WAS TOO CLOSE TO UNIT2. UNIT 1 WAS UNABLE TO STOP IN TIME BEFORE
STRIKING UNIT 2 IN THE REAR. THE DRIVER OF UNIT2 SAID THEY HAD THEIR TURN SIGNAL ON INDICATING THE TURN AND THE
OWNER OF PRICE RITE ALSO SAID HE SAW UNIT 2'S SIGNAL ON INDICATING THE TURN INTO PRICE RITE. THE DRIVER OF UNIT 1
SAID DUE TO THE SUN SHINING DIRECTLY AT THE TAILLIGHTS OF UNIT 2 HE COULD NOT SEE THE TAILLIGHTS ILLUMINATE AND
DIDN'T KNOW UNIT 2 WAS STOPPING TO TURN. IF UNIT 1 WOULD HAVE NOT BEEN SO CLOSE TO UNIT 2 UNIT 1 WOULD HAVE HAD
MORE TIME TO STOP PRIOR TO THE COLLISION WHICH CAUSED SEVERE DAMAGE TO BOTH VEHICLES. DEPUTY POPLIN CHECKED THE TAILLIGHTS OF UNIT 2 AND THEY WERE IN PROPER WORKING ORDER EVEN AFTER THIS CRASH.
ON MARCH 19TH, 2016 UNIT 1 AND UNIT2 WERE BOTH GOING NORTH ON STATE HWY 27. UNIT 2 WAS MAKING A LEFT HAND TURN INTO THE PRICE RITE PARKING LOT AND UNIT 1 WAS TOO CLOSE TO UNIT2. UNIT 1 WAS UNABLE TO STOP IN TIME BEFORE
STRIKING UNIT 2 IN THE REAR. THE DRIVER OF UNIT2 SAID THEY HAD THEIR TURN SIGNAL ON INDICATING THE TURN AND THE
OWNER OF PRICE RITE ALSO SAID HE SAW UNIT 2'S SIGNAL ON INDICATING THE TURN INTO PRICE RITE. THE DRIVER OF UNIT 1
SAID DUE TO THE SUN SHINING DIRECTLY AT THE TAILLIGHTS OF UNIT 2 HE COULD NOT SEE THE TAILLIGHTS ILLUMINATE AND
DIDN'T KNOW UNIT 2 WAS STOPPING TO TURN. IF UNIT 1 WOULD HAVE NOT BEEN SO CLOSE TO UNIT 2 UNIT 1 WOULD HAVE HAD
MORE TIME TO STOP PRIOR TO THE COLLISION WHICH CAUSED SEVERE DAMAGE TO BOTH VEHICLES. DEPUTY POPLIN CHECKED THE TAILLIGHTS OF UNIT 2 AND THEY WERE IN PROPER WORKING ORDER EVEN AFTER THIS CRASH.
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125 - First Name 125 - Middle Initial
Officer Information
POPLIN125 - Officer Last Name JAY 352131 - Officer ID
129 - Law Enforcement Agency No.
SAWYER COUNTY SHERIFFS DEPT
130 - Law Enforcement Agency Name
15880 EAST FIFTH STREET126 - Law Enforcement Agency Address Street & Number
HAYWARD
127 - City
WI
127 - State
54843
127 - Zip Code
(715) 634-4858 EXT.
128 - Telephone Number
03/19/2016132 - Date Notified 1556133 - Time Notified (Military Time)1602134 - Time Arrived (Military Time)03/20/2016135 - Date Of Report
16031903304 16031905 19 - Special Study
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18 - Agency Space
Accident Report
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MV4000e 01/2005
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