20161204 RappleyAgency Accident Number
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Reportable Accident On Emergency Amended GZH0DMQ
DOT Document Number Document Override Number
16120406
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16120406
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12/04/2016
4 - Accident Date
1625
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County DRAPER - 03, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
070
14 - On Hwy No.
EB
14 - On Street Name 14 - Bus/Frnt/Rmp
0.27 MI15 - Est. Distance WEST15 - Hwy. Dir
EE16 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.883507
12 - Latitude -90.74580913 - Longitude
DITCH80 - 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-LEFT
117 - Relation To Roadway
DUSK114 - 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
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Unit Status
DITCH
81 - Most Harmful Event: Collision With
EAST
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
2025
31 - Expiration Year 34 - On Duty Accident
RAPPLEY
25 - Operator/Pedestrian Last Name
JAMIE
25 - First Name
M
25 - Middle Initial 25 - Suffix
01/03
32 - Date Of Birth
FEMALE
33 - Sex
26 - Address Street & Number 26 - PO Box
TOMAHAWK
27 - City
WI
27 - State
54487
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 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.
SPEED-TOO-FAST-FOR-CONDITIONS
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
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Accident Report
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZH0DMQ 1 4
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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
518PNE
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
02
55 - Vehicle Identification Number
2013
50 - Year
FORD
51 - Make
FUSION
52 - Model
4D - 4DR
53 - Body Style
GRY
54 - Color 100 - Skidmarks to Impact (Ft)
REAR, REAR DRIVER SIDE
94 - Vehicle Damage
MINOR
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
PULLED OUT BY TOW COMPANY
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
RAPPLEY
46 - Vehicle Owner Last Name
JAMIE
46 - First Name
M
46 - Middle Initial 46 - Suffix
01/03/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
TOMAHAWK48 - City WI48 - State 5448748 - Zip Code 49 - Telephone Number
WEA-PROPERTY-&-CASUALTY-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
RAPPLEY
61 - Policy Holder Last Name
JAMIE
61 - Policy Holder First Name
61 - Policy Holder Company
01
01
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BU
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FromTo
Bus Travelling to/from School Name Body Make Seating Capacity
School District Contracted With
Trailer
01
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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 GZH0DMQ 2 424
Fixed Objects Struck
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Property
GOVERNMENT
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
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SAWYER COUNTY HIGHWAY DEPARTMENT
84 - Company Name
COUNTY/MUNICIPAL
Government Property Type
14688W CTH B
85 - Address Street & Number 85 - PO Box
HAYWARD
86 - City
WI
86 - State
54843
86 - Zip Code
(715) 634-2692 EXT.
87 - Telephone Number
208232
83 - Government Damage Tag Number
01
82 - Striking Unit
DITCH
82 - Object Struck
01
82 - Striking Unit
TRAFFIC-SIGN-POST
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
SGT NICK ALMOGHRABI
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO A VEHICLE IN THE DITCH OFF STH 70 NEAR CTH EE IN THE TOWNSHIP OF
DRAPER ON 12/04/16. UPON MY ARRIVAL, I OBSERVED A FORD FUSION IN THE NORTH DITCH WEST OF CTH EE. UPON MAKING
CONTACT WITH THE OPERATOR, SHE WAS NOT INJURED. THE OPERATOR STATED SHE WAS TRAVELING EAST ON STH 70 AT
APPROXIMATELY 50 MPH WHEN SHE BEGAN TO LOSE CONTROL OF HER VEHICLE BELIEVING SHE WAS HYDRO PLANING. THE
OPERATOR STATED SHE CROSSED OVER THE WEST BOUND LANE OF TRAFFIC AND ENTERED THE DITCH BACKWARDS IN WHICH
THE TRACKS INDICATE THE SAME. THE REAR OF THE VEHICLE STRUCK A NO PASSING SIGN BREAKING THE POST OFF AND CAUSING MINOR DAMAGE TO THE REAR OF THE VEHICLE. THE ROAD CONDITIONS AT THE TIME OF THE CRASH WERE
SNOW/SLUSH COVERED AND SLIPPERY IN SPOTS. NO CITATIONS WERE ISSUED IN THIS INCIDENT. A TOW COMPANY FROM
PHILLIPS WAS DISPATCHED TO PULL THE VEHICLE FROM THE DITCH.
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO A VEHICLE IN THE DITCH OFF STH 70 NEAR CTH EE IN THE TOWNSHIP OF
DRAPER ON 12/04/16. UPON MY ARRIVAL, I OBSERVED A FORD FUSION IN THE NORTH DITCH WEST OF CTH EE. UPON MAKING
CONTACT WITH THE OPERATOR, SHE WAS NOT INJURED. THE OPERATOR STATED SHE WAS TRAVELING EAST ON STH 70 AT
APPROXIMATELY 50 MPH WHEN SHE BEGAN TO LOSE CONTROL OF HER VEHICLE BELIEVING SHE WAS HYDRO PLANING. THE
OPERATOR STATED SHE CROSSED OVER THE WEST BOUND LANE OF TRAFFIC AND ENTERED THE DITCH BACKWARDS IN WHICH
THE TRACKS INDICATE THE SAME. THE REAR OF THE VEHICLE STRUCK A NO PASSING SIGN BREAKING THE POST OFF AND CAUSING MINOR DAMAGE TO THE REAR OF THE VEHICLE. THE ROAD CONDITIONS AT THE TIME OF THE CRASH WERE
SNOW/SLUSH COVERED AND SLIPPERY IN SPOTS. NO CITATIONS WERE ISSUED IN THIS INCIDENT. A TOW COMPANY FROM
PHILLIPS WAS DISPATCHED TO PULL THE VEHICLE FROM THE DITCH.
Officer Information
Accident Report
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Wisconsin Motor Vehicle GZH0DMQ 3 4
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125 - First Name 125 - Middle Initial
ALMOGHRABI
125 - Officer Last Name
NICK 392
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
12/04/2016
132 - Date Notified 1628133 - Time Notified (Military Time)1723134 - Time Arrived (Military Time)
12/04/2016
135 - Date Of Report
16120406 16120406 19 - Special Study
18 - Agency Space
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MV4000e 01/2005
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