20161119 NienasAgency Accident Number
AC
C
I
D
E
N
T
#
PO
L
I
C
E
#
Police Number
GE
N
E
R
A
L
I
N
F
O
R
M
A
T
I
O
N
Reportable Accident On Emergency Amended GZJ2863
DOT Document Number Document Override Number
16111915426
16
1
1
1
9
1
5
4
2
6
16111902
16
1
1
1
9
0
2
11/19/2016
4 - Accident Date
0728
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HUNTER - 07, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
B
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.76 MI15 - Est. Distance NORTH15 - Hwy. Dir
16 - Fr/At Hwy No.FOREST ROAD 30416 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.939987
12 - Latitude -91.08653313 - Longitude
TREE80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - 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
OUTSIDE-SHOULDER-RIGHT
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
OP
E
R
A
T
O
R
/
P
E
D
E
S
T
R
I
A
N
Unit Status
TREE
81 - Most Harmful Event: Collision With
WEST
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
2024
31 - Expiration Year 34 - On Duty Accident
NIENAS
25 - Operator/Pedestrian Last Name
GREGORY
25 - First Name
R
25 - Middle Initial 25 - Suffix
05/19
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
WINTER
27 - City
WI
27 - State
54896
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
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
APPEARED NORMAL88 - Driver or Pedestrian Cond NEITHER-ALCOHOL-NOR-DRUGS-PRESENT
89 - Substance Presence
TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZJ2863 1 4
VE
H
I
C
L
E
VE
H
O
W
N
E
R
Vehicle
Vehicle Owner
Insurance
School Bus
IN
S
91 - Drugs Reported
SNOW,-ICE,-OR-WET
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PICKUP/UTILITY-TRUCK
Vehicle Type
1
22 - Total Occupants
LE4229
56 - License Plate Number
LTK57 - Plate Type WI
58 - State
2017
59 - Exp Year
810
55 - Vehicle Identification Number
2000
50 - Year
DODG
51 - Make
DAKOTA
52 - Model
PK - PICKUP
53 - Body Style
GRN
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT
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
BUTTERFIELD INC46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
RURAL-COMMUNITY-INSURANCE-COMPANY63 - Liability Insurance Company Policy Holder Same As Owner60
NIENAS
61 - Policy Holder Last Name
GREGORY
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
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZJ2863 2 424
Fixed Objects Struck
PR
O
P
E
R
T
Y
O
W
N
E
R
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
A
G
R
A
M
A
N
D
N
A
R
R
A
T
I
V
E
Diagram and Narrative
DEPUTY AMBER AL-MOGHRABI
ON NOVEMBER 19, 2016, I, DEPUTY AL-MOGHRABI WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT.
AT APPROXIMATELY 7:28 AM I WAS DISPATCHED TO COUNTY ROAD B JUST EAST OF VENISON CREEK ROAD FOR A ONE VEHICLE
ACCIDENT WITH NO INJURIES. UPON ARRIVAL I NOTICED A LIGHT GREEN TRUCK ON THE NORTH SIDE OF COUNTY ROAD B IN THE
DITCH. I NOTICED THE TRUCK HAD HIT A TREE. I GOT OUT OF MY VEHICLE AND SPOKE WITH GREGORY NIENAS WHO WAS THE
DRIVER. HE STATED THAT HE WAS TRAVELING WEST AT APPROXIMATELY 45 MILES PER HOUR. HE STATED HE WAS GOING
AROUND THE CURVE AND HIT THE GRAVEL WHICH IS WHEN HIS CAR SLID INTO THE DITCH. GREGORY STATED HE HAS NOT BEEN DRINKING AND WAS NOT ON ANY DRUGS AND THAT HE WAS WEARING HIS SEATBELT. DISPATCH ADVISED ME THAT A-1 TOWING
WAS ENROUTE TO THE SCENE. WHILE WAITING FOR THE TOW TRUCK I TOOK PICTURES OF THE TRUCK. THE FRONT HOOD AND
BUMPER HIT THE TREE WHICH LEFT A LARGE DENT IN THE MIDDLE. I ENTERED THOSE PICTURES INTO EVIDENCE AS ITEM
NUMBER 1600773-0001. GREGORY STATED HE ONLY HAD LIABILITY INSURANCE WITH RURAL INSURANCE. AT APPROXIMATELY
8:10, A-1 ARRIVED ON SCENE AND REMOVED THE VEHICLE FROM THE DITCH. THE VEHICLE WAS STILL DRIVEABLE. I CLEARED
THE CALL AT 8:29. THIS IS ALL THE INFORMATION I HAVE AT THIS TIME.
ON NOVEMBER 19, 2016, I, DEPUTY AL-MOGHRABI WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT.
AT APPROXIMATELY 7:28 AM I WAS DISPATCHED TO COUNTY ROAD B JUST EAST OF VENISON CREEK ROAD FOR A ONE VEHICLE
ACCIDENT WITH NO INJURIES. UPON ARRIVAL I NOTICED A LIGHT GREEN TRUCK ON THE NORTH SIDE OF COUNTY ROAD B IN THE
DITCH. I NOTICED THE TRUCK HAD HIT A TREE. I GOT OUT OF MY VEHICLE AND SPOKE WITH GREGORY NIENAS WHO WAS THE
DRIVER. HE STATED THAT HE WAS TRAVELING WEST AT APPROXIMATELY 45 MILES PER HOUR. HE STATED HE WAS GOING
AROUND THE CURVE AND HIT THE GRAVEL WHICH IS WHEN HIS CAR SLID INTO THE DITCH. GREGORY STATED HE HAS NOT BEEN DRINKING AND WAS NOT ON ANY DRUGS AND THAT HE WAS WEARING HIS SEATBELT. DISPATCH ADVISED ME THAT A-1 TOWING
WAS ENROUTE TO THE SCENE. WHILE WAITING FOR THE TOW TRUCK I TOOK PICTURES OF THE TRUCK. THE FRONT HOOD AND
BUMPER HIT THE TREE WHICH LEFT A LARGE DENT IN THE MIDDLE. I ENTERED THOSE PICTURES INTO EVIDENCE AS ITEM
NUMBER 1600773-0001. GREGORY STATED HE ONLY HAD LIABILITY INSURANCE WITH RURAL INSURANCE. AT APPROXIMATELY
8:10, A-1 ARRIVED ON SCENE AND REMOVED THE VEHICLE FROM THE DITCH. THE VEHICLE WAS STILL DRIVEABLE. I CLEARED
THE CALL AT 8:29. THIS IS ALL THE INFORMATION I HAVE AT THIS TIME.
Officer Information
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZJ2863 3 4
OF
F
I
C
E
R
I
N
F
O
R
M
A
T
I
O
N
125 - First Name 125 - Middle Initial
ALMOGHRABI
125 - Officer Last Name
AMBER 340
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
11/19/2016
132 - Date Notified 0728133 - Time Notified (Military Time)0759134 - Time Arrived (Military Time)
11/19/2016
135 - Date Of Report
16111915426 16111902 19 - Special Study
18 - Agency Space
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZJ2863 4 4