20160618 GreerAgency Accident Number
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Reportable Accident On Emergency Amended GZDJBDX
DOT Document Number Document Override Number
16061807771
16
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06/18/2016
4 - Accident Date
1854
5 - Time of Accident (Military Time)
01
6 - Total Units
01
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County ROUND LAKE - 13, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
TWIN LAKE ROAD
14 - On Street Name 14 - Bus/Frnt/Rmp
200 FT15 - Est. Distance EAST15 - Hwy. Dir
16 - Fr/At Hwy No.SUN N SNO ROAD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number 12 - Latitude 13 - Longitude
UTILITY POLE80 - 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
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
UTILITY POLE
81 - Most Harmful Event: Collision With
WEST
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
2020
31 - Expiration Year 34 - On Duty Accident
GREER
25 - Operator/Pedestrian Last Name
LYNN
25 - First Name
M
25 - Middle Initial 25 - Suffix
06/04/
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
B - NON-INCAPACITATING 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 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.
DRIVER-CONDITION
122 - Driver Factors
ABILITY IMPAIRED88 - Driver or Pedestrian Cond ALCOHOL-PRESENT
89 - Substance Presence
TEST GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
Accident Report
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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
763LZL
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
2G1WG5EK8B1
55 - Vehicle Identification Number
2011
50 - Year
CHEV
51 - Make
IMPALA LT
52 - Model
4D - 4DR
53 - Body Style
WHI
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT, TOP OF VEHICLE
94 - Vehicle Damage
MODERATE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
OWNER
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
GREER
46 - Vehicle Owner Last Name
LYNN
46 - First Name
M
46 - Middle Initial 46 - Suffix
06/04
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
UNKNOWN63 - 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
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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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Wisconsin Motor Vehicle GZDJBDX 2 424
Fixed Objects Struck
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ORGANIZATION
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
JUMP RIVER ELECTRIC
84 - Company Name Government Property Type
13895 W COUNTY HIGHWAY B
85 - Address Street & Number 85 - PO Box
HAYWARD
86 - City
WI
86 - State
54843
86 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
UTILITY-POLE
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
UNIT ONE, OPERATED BY MS. GREER, LEFT THE ROADWAY AND CONTINUED WEST THROUGH THE DITCH LINE. MS. GREER DROVE
OVER A DRIVEWAY THEN STRUCK A ELECTRICAL POLE OWNED BY JUMP RIVER ELECTRIC. MS. GREER PULLED THE VEHICLE BACK
ONTO THE ROADWAY AND THEN CONTINUED TO HER RESIDENCE ON SCHELLER ROAD.
UNIT ONE, OPERATED BY MS. GREER, LEFT THE ROADWAY AND CONTINUED WEST THROUGH THE DITCH LINE. MS. GREER DROVE
OVER A DRIVEWAY THEN STRUCK A ELECTRICAL POLE OWNED BY JUMP RIVER ELECTRIC. MS. GREER PULLED THE VEHICLE BACK
ONTO THE ROADWAY AND THEN CONTINUED TO HER RESIDENCE ON SCHELLER ROAD.
Officer Information
Accident Report
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Wisconsin Motor Vehicle GZDJBDX 3 4
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125 - First Name 125 - Middle Initial
JENSEN
125 - Officer Last Name
DARIN 387
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
06/18/2016
132 - Date Notified 1856133 - Time Notified (Military Time)1859134 - Time Arrived (Military Time)
06/18/2016
135 - Date Of Report
16061807771 19 - Special Study
18 - Agency Space
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Wisconsin Motor Vehicle GZDJBDX 4 4