20161121 NoyceAgency Accident Number
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Reportable Accident On Emergency Amended GZHJPJ2
DOT Document Number Document Override Number
16112107
16
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1
2
1
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7
11/21/2016
4 - Accident Date
0655
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County SPIDER LAKE - 15, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
PEDERSON RD
14 - On Street Name 14 - Bus/Frnt/Rmp
0.39 MI15 - Est. Distance NORTH15 - Hwy. Dir
07716 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
46.078930
12 - Latitude -91.28854413 - Longitude
DITCH80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
NO CONTROL
112 - Access Control
CURVE
113 - Road Curvature
HILL
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
DARK-NOT-LIGHTED114 - Light Condition ICE116 - 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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DITCH
81 - Most Harmful Event: Collision With
NORTH
23 - Dir Of Travel
2524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2023
31 - Expiration Year 34 - On Duty Accident
NOYCE
25 - Operator/Pedestrian Last Name
MATTHEW
25 - First Name
JOHN
25 - Middle Initial 25 - Suffix
08/23/
& 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
NONE-USED-VEHICLE-DRIVER/OCCUPANT
40 - Safety Equipment
N - NO APPARENT 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
SLOWING-OR-STOPPING
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 NEITHER-ALCOHOL-NOR-DRUGS-PRESENT
89 - Substance Presence
TEST NOT 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
SNOW,-ICE,-OR-WET
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
32602
55 - Vehicle Identification Number
2009
50 - Year
FORD
51 - Make 52 - Model
PK - PICKUP
53 - Body Style
WHI
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT, FRONT PASSENGER SIDE, MIDDLE PASSENGER SIDE, FRONT DRIVER SIDE, REAR PASSENGER SIDE
94 - Vehicle Damage
MODERATE
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
NOYCE
46 - Vehicle Owner Last Name
MATTHEW
46 - First Name
JOHN
46 - Middle Initial 46 - Suffix
08/23
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
USAA-CASUALTY-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
NOYCE
61 - Policy Holder Last Name
MATTHEW
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
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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
DITCH
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
N. RASCHKA
ON NOVEMBER 21, 2016 I, DEPUTY RASCHKA RESPONDED TO A ONE VEHICLE ROLLOVER ON PEDERSON RD JUST SOUTH ON
STATE HWY 77. I ARRIVED ON-SCENE AND MET WITH OPERATOR/OWNER MATTHEW NOYCE WHO ADVISED HE WAS TRAVELING
NORTH ON PEDERSON RD AND WAS SLOWING DOWN AROUND THE S-CURVES TRAVELLING ABOUT 25 MPH WHEN HIS TRUCK
SLIPPED ON THE ICE ON THE CURVE AND VEERED OFF THE ROADWAY. HE STATED IT WAS ALONG THE EDGE AND THEN TIPPED
OVER. HE STATED HE WAS ABLE TO GET OUT OF THE DRIVERS SIDE AFTER A FEW MINUTES BECAUSE A TREE BRANCH WAS
HOLDING IT SHUT. HE STATED HE WAS NOT INJURED BUT WAS NOT WEARING A SEATBELT. STATED THE AIRBAGS DID DEPLOY. THERE IS MODERATE DAMAGE TO THE PASSENGER SIDE OF THE VEHICLE AND SOME DAMAGE TO THE DRIVERS SIDE. THE ROAD
CONDITIONS ON PEDERSON ROAD ARE ICEY AND SLIPPERY. END OF REPORT.
ON NOVEMBER 21, 2016 I, DEPUTY RASCHKA RESPONDED TO A ONE VEHICLE ROLLOVER ON PEDERSON RD JUST SOUTH ON
STATE HWY 77. I ARRIVED ON-SCENE AND MET WITH OPERATOR/OWNER MATTHEW NOYCE WHO ADVISED HE WAS TRAVELING
NORTH ON PEDERSON RD AND WAS SLOWING DOWN AROUND THE S-CURVES TRAVELLING ABOUT 25 MPH WHEN HIS TRUCK
SLIPPED ON THE ICE ON THE CURVE AND VEERED OFF THE ROADWAY. HE STATED IT WAS ALONG THE EDGE AND THEN TIPPED
OVER. HE STATED HE WAS ABLE TO GET OUT OF THE DRIVERS SIDE AFTER A FEW MINUTES BECAUSE A TREE BRANCH WAS
HOLDING IT SHUT. HE STATED HE WAS NOT INJURED BUT WAS NOT WEARING A SEATBELT. STATED THE AIRBAGS DID DEPLOY. THERE IS MODERATE DAMAGE TO THE PASSENGER SIDE OF THE VEHICLE AND SOME DAMAGE TO THE DRIVERS SIDE. THE ROAD
CONDITIONS ON PEDERSON ROAD ARE ICEY AND SLIPPERY. END OF REPORT.
Officer Information
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125 - First Name 125 - Middle Initial
RASCHKA
125 - Officer Last Name
NICOLE 388
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
11/21/2016
132 - Date Notified 1855133 - Time Notified (Military Time)1910134 - Time Arrived (Military Time)
11/21/2016
135 - Date Of Report
16112107 19 - Special Study
18 - Agency Space
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