20160405 HernandezAgency Accident Number
AC
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N
T
#
PO
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#
Police Number
GE
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F
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Reportable Accident On Emergency Amended GZDVPJS
DOT Document Number Document Override Number
16040601
16
0
4
0
6
0
1
16040601
16
0
4
0
6
0
1
04/05/2016
4 - Accident Date
1900
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County RADISSON - 12, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
H
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.62 MI15 - Est. Distance SOUTH15 - Hwy. Dir
16 - Fr/At Hwy No.ASHEGON FIRE LN16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.841477
12 - Latitude -91.22480613 - Longitude
TREE80 - 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
DUSK114 - Light Condition UNKNOWN116 - Road Surface Condition UNKNOWN118 - 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
OP
E
R
A
T
O
R
/
P
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D
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S
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Unit Status
TREE
81 - Most Harmful Event: Collision With
NORTH
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
IL
30 - State
2018
31 - Expiration Year 34 - On Duty Accident
HERNANDEZ
25 - Operator/Pedestrian Last Name
SALVADOR
25 - First Name 25 - Middle Initial 25 - Suffix
03/29/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
BERWYN
27 - City
IL
27 - State
60402
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
GOING-STRAIGHT
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 162 - No. of Citations Issued
346.70(1)
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
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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Wisconsin Motor Vehicle GZDVPJS 1 4
VE
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H
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N
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
S
91 - Drugs Reported
SNOW,-ICE,-OR-WET
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
V515576
56 - License Plate Number
AUT57 - Plate Type IL
58 - State
2016
59 - Exp Year
6375
55 - Vehicle Identification Number
2000
50 - Year
TOYT
51 - Make 52 - Model
UT - SPORT UTILITY
53 - Body Style
SIL
54 - Color
0100 - Skidmarks to Impact (Ft)
REAR, REAR PASSENGER SIDE, MIDDLE PASSENGER SIDE
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
HERNANDEZ
46 - Vehicle Owner Last Name
SALVADOR
46 - First Name 46 - Middle Initial 46 - Suffix
03/29/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
BERWYN48 - City IL48 - State 6040248 - Zip Code T.49 - Telephone Number
AMERICAN-FAMILY63 - Liability Insurance Company Policy Holder Same As Owner60
HERNANDEZ
61 - Policy Holder Last Name
SALVADOR
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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Fixed Objects Struck
PR
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N
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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
TREE
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
DI
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Diagram and Narrative
POPLIN
UNIT 1 WAS GOING NORTH ON COUNTY HWY H. THE DRIVER OF UNIT 1 ADVISED IT WAS ACTIVELY SNOWING AND THIS CREATED
HAZARDOUS ROAD CONDITIONS. THE DRIVER SAID THE ROAD CONDITIONS CAUSED HIM TO LOSE CONTROL AND LEAVE THE
ROADWAY STRIKING A TREE CAUSING SEVERE DAMAGE TO THE VEHICLE. THE DRIVER NEVER CALLED THE SHERIFF'S
DEPARTMENT TO REPORT THIS CRASH HOWEVER HE CALLED TWO DIFFERENT TOW TRUCKS AND ALSO CALLED FOR A RIDE
HOME AFTER THE CRASH. I ISSUED HIM A CITATION FOR FAILURE TO REPORT AN ACCIDENT.
UNIT 1 WAS GOING NORTH ON COUNTY HWY H. THE DRIVER OF UNIT 1 ADVISED IT WAS ACTIVELY SNOWING AND THIS CREATED
HAZARDOUS ROAD CONDITIONS. THE DRIVER SAID THE ROAD CONDITIONS CAUSED HIM TO LOSE CONTROL AND LEAVE THE
ROADWAY STRIKING A TREE CAUSING SEVERE DAMAGE TO THE VEHICLE. THE DRIVER NEVER CALLED THE SHERIFF'S
DEPARTMENT TO REPORT THIS CRASH HOWEVER HE CALLED TWO DIFFERENT TOW TRUCKS AND ALSO CALLED FOR A RIDE
HOME AFTER THE CRASH. I ISSUED HIM A CITATION FOR FAILURE TO REPORT AN ACCIDENT.
Officer Information
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Wisconsin Motor Vehicle GZDVPJS 3 4
OF
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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
04/06/2016
132 - Date Notified 1211133 - Time Notified (Military Time)1236134 - Time Arrived (Military Time)
04/06/2016
135 - Date Of Report
16040601 16040601 19 - Special Study
18 - Agency Space
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