20161002 Dunbar RA Pinno and SonsAgency Accident Number
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Reportable Accident On Emergency Amended GZDNRQZ
DOT Document Number Document Override Number
16100202
16
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0
2
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10/02/2016
4 - Accident Date
1000
5 - Time of Accident (Military Time)
02
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County WINTER - 17, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
HAYSTACK RD
14 - On Street Name 14 - Bus/Frnt/Rmp
0.53 MI15 - Est. Distance SOUTH15 - Hwy. Dir
16 - Fr/At Hwy No.THORNAPPLE GRADE16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.688064
12 - Latitude -90.89254013 - Longitude
MOTOR VEHICLE IN TRANSPORT80 - First Harmful Event SIDESWIPE. OPPOSITE DIRECTION93 - Manner of Collision
NO CONTROL
112 - Access Control
CURVE
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 79 - E M S Number
Operator/Pedestrian
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Unit Status
MOTOR VEHICLE IN TRANSPORT
81 - Most Harmful Event: Collision With
SOUTH
23 - Dir Of Travel
5524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
WI
30 - State
2023
31 - Expiration Year 34 - On Duty Accident
DUNBAR
25 - Operator/Pedestrian Last Name
JACK
25 - First Name
A
25 - Middle Initial 25 - Suffix
11/03/1
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
LAKE TOMAHAWK
27 - City
WI
27 - State
54539
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
UNKNOWN
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
NOT-TRAPPED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
NEGOTIATING-CURVE
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.
NOT-APPLICABLE
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
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
TRUCK
21 - Unit Type
PICKUP/UTILITY-TRUCK
Vehicle Type
1
22 - Total Occupants
ML6725
56 - License Plate Number
LTK57 - Plate Type WI
58 - State
2017
59 - Exp Year
293
55 - Vehicle Identification Number
2012
50 - Year
DODG
51 - Make
RAM 1500
52 - Model
TK - TRUCK
53 - Body Style
WHI
54 - Color 100 - Skidmarks to Impact (Ft)
MIDDLE DRIVER SIDE
94 - Vehicle Damage
MINOR
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
46 - Vehicle Owner Last Name 46 - First Name 46 - Middle Initial 46 - Suffix Date Of Birth
RA PINNO AND SONS CONSTRUCTION INC46 - Company Name
47- Address Street & Number 47 - PO Box
ROSENDALE48 - City WI48 - State 5497448 - Zip Code 49 - Telephone Number
WEST-BEND-MUTUAL-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 61 - Policy Holder First Name
RA PINNO AND SONS CONSTRUCTION INC61 - 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
5524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
Last Name
MORGAN
25 - First Name
R
25 - Middle Initial 25 - Suffix
12/02/
32 - Date Of Birth
FEMALE
33 - Sex
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Wisconsin Motor Vehicle GZDNRQZ 2 424
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Vehicle
Vehicle Owner
Insurance
OP
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IN
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26 - Address Street & Number 26 - PO Box
RIO
27 - City
WI
27 - State
53960
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
UNKNOWN
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
NOT-TRAPPED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
NEGOTIATING-CURVE
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
NOT OBSERVED88 - 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
TRUCK
21 - Unit Type
PICKUP/UTILITY-TRUCK
Vehicle Type
1
22 - Total Occupants
LL3720
56 - License Plate Number
LTK57 - Plate Type WI
58 - State
2017
59 - Exp Year
3369
55 - Vehicle Identification Number
1995
50 - Year
FORD
51 - Make
RANGER
52 - Model
TK - TRUCK
53 - Body Style
BLK
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT DRIVER SIDE
94 - Vehicle Damage
MINOR
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
FRANCIS
46 - Vehicle Owner Last Name
MORGAN
46 - First Name
R
46 - Middle Initial 46 - Suffix
12/02/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
RIO48 - City WI48 - State 5396048 - Zip Code .49 - Telephone Number
WISCONSIN-COUNTY-MUTUAL-INS-CORP63 - Liability Insurance Company Policy Holder Same As Owner60
FRANCIS
61 - Policy Holder Last Name
MORGAN
61 - Policy Holder First Name
61 - Policy Holder Company
02
02
02
02
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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 WAS ONLY ABLE TO MAKE CONTACT WITH THE DRIVER OF UNIT 1. COMPLAINANT STATED THAT HE WAS TRAVELING SOUTH ON HAYSTACK RD BETWEEN THORNAPPLE GRADE AND WEST LN. COMPLAINANT NOTICED UNIT 2 TRAVELING NORTH AND
AT A FASTER RATE OF SPEED THAN THE CURVE WOULD ALLOW. UNIT 1 TRIED TO GET OUT OF THE WAY AS UNIT 2 WAS COMING
ACROSS INTO UNIT 1 LANE OF TRAVEL. UNIT 2 HIT UNIT 1 IN THE DRIVER'S SIDE DOOR, DAMAGING THE DOOR. UNIT 2 WAS
DAMAGED IN THE FRONT DRIVER'S SIDE OF THE VEHICLE. DEPUTY WAS UNABLE TO GET INTO CONTACT WITH UNIT 2 OPERATOR.
ALL INFORMATION REGARDING CRASH IS FROM UNIT 1 OPERATOR.
DEPUTY WAS ONLY ABLE TO MAKE CONTACT WITH THE DRIVER OF UNIT 1. COMPLAINANT STATED THAT HE WAS TRAVELING SOUTH ON HAYSTACK RD BETWEEN THORNAPPLE GRADE AND WEST LN. COMPLAINANT NOTICED UNIT 2 TRAVELING NORTH AND
AT A FASTER RATE OF SPEED THAN THE CURVE WOULD ALLOW. UNIT 1 TRIED TO GET OUT OF THE WAY AS UNIT 2 WAS COMING
ACROSS INTO UNIT 1 LANE OF TRAVEL. UNIT 2 HIT UNIT 1 IN THE DRIVER'S SIDE DOOR, DAMAGING THE DOOR. UNIT 2 WAS
DAMAGED IN THE FRONT DRIVER'S SIDE OF THE VEHICLE. DEPUTY WAS UNABLE TO GET INTO CONTACT WITH UNIT 2 OPERATOR.
ALL INFORMATION REGARDING CRASH IS FROM UNIT 1 OPERATOR.
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125 - First Name 125 - Middle Initial
Officer Information
SIMPSON
125 - Officer Last Name
MICHAEL 357
131 - Officer ID
129 - Law Enforcement Agency No.SAWYER COUNTY SHERIFFS DEPT130 - Law Enforcement Agency Name
15880 EAST FIFTH STREET
126 - Law Enforcement Agency Address Street & Number
HAYWARD127 - City WI127 - State 54843127 - Zip Code (715) 634-4858 EXT.128 - Telephone Number
10/02/2016
132 - Date Notified 1044133 - Time Notified (Military Time)1044134 - Time Arrived (Military Time)
10/02/2016
135 - Date Of Report
16100202 19 - Special Study
18 - Agency Space
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