20161211 Brown WalczakAgency Accident Number
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Reportable Accident On Emergency Amended GZJ286C
DOT Document Number Document Override Number
16121116424
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16121105
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12/11/2016
4 - Accident Date
1240
5 - Time of Accident (Military Time)
02
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County EXELAND - 52, VILLAGE3 - Municipality NON-INTERSECTION11 - Accident Location
048
14 - On Hwy No.
WB
14 - On Street Name 14 - Bus/Frnt/Rmp
447 FT15 - Est. Distance EAST15 - Hwy. Dir
16 - Fr/At Hwy No.GRANT AVE16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.668077
12 - Latitude -91.24076213 - Longitude
PARKED MOTOR VEHICLE80 - First Harmful Event REAR-END93 - 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
ON-ROADWAY
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
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Unit Status
PARKED MOTOR VEHICLE
81 - Most Harmful Event: Collision With
WEST
23 - Dir Of Travel
3524 - Speed Limit
B CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2017
31 - Expiration Year
WINTER-HWY-MAINTENANCE
34 - On Duty Accident
BROWN
25 - Operator/Pedestrian Last Name
RODNEY
25 - First Name
R
25 - Middle Initial 25 - Suffix
10/02/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
EXELAND
27 - City
WI
27 - State
54835
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 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
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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
TRUCK
21 - Unit Type
SNOW-PLOW
Vehicle Type
1
22 - Total Occupants
82633
56 - License Plate Number
GOV57 - Plate Type WI
58 - State
2050
59 - Exp Year
01166
55 - Vehicle Identification Number
2012
50 - Year
INTL
51 - Make
NONE
52 - Model
CB - CAB CHASSIS
53 - Body Style
RED
54 - Color 100 - Skidmarks to Impact (Ft)
NONE
94 - Vehicle Damage
NONE
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
HIGHWAY DEPARTMENT46 - Company Name
47- Address Street & Number 47 - PO Box
WINTER48 - City WI48 - State 5489648 - Zip Code .49 - Telephone Number
GOVERNMENT63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 61 - Policy Holder First Name
SAWYER COUNTY HIGHWAY DEPT61 - 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
L - LEGALLY PARKED
Unit Status
MOTOR VEHICLE IN TRANSPORT
81 - Most Harmful Event: Collision With 23 - Dir Of Travel
3524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number 30 - State 31 - Expiration Year 34 - On Duty Accident
25 - Operator/Pedestrian Last Name 25 - First Name 25 - Middle Initial 25 - Suffix
32 - Date Of Birth 33 - Sex
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Wisconsin Motor Vehicle GZJ286C 2 525
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Vehicle
Vehicle Owner
Insurance
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IN
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26 - Address Street & Number 26 - PO Box
27 - City 27 - State 27 - Zip Code 28 - Telephone Number
39 - Seat Position
NOT-APPLICABLE-NONMOTORIST
40 - Safety Equipment
38 - Injury Severity
NOT APPLICABLE
41 - Airbag
NOT-APPLICABLE
42 - Ejected 44
Medical Transport
NOT-APPLICABLE
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
LEGALLY-PARKED
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
88 - Driver or Pedestrian Cond 89 - Substance Presence
90 - Alcohol Test 90 - Alcohol Content 91 - Drug Test
91 - Drugs Reported
SNOW,-ICE,-OR-WET
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
0
22 - Total Occupants
285XLF
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
1F 429
55 - Vehicle Identification Number
2000
50 - Year
FORD
51 - Make
EXPLORER
52 - Model
UT - SPORT UTILITY
53 - Body Style
MAR
54 - Color 100 - Skidmarks to Impact (Ft)
REAR PASSENGER SIDE, MIDDLE PASSENGER SIDE
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
WALCZAK
46 - Vehicle Owner Last Name
JONI
46 - First Name
M
46 - Middle Initial 46 - Suffix
12/27
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
EXELAND48 - City WI48 - State 5483548 - Zip Code 49 - Telephone Number
NOT-REQUIRED63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 61 - Policy Holder First Name
61 - Policy Holder Company
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02
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School Bus
02
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
105 - Photos By
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Diagram and Narrative
DEPUTY AMBER AL-MOGHRABI
ON DECEMBER 11, 2016, I WAS ADVISED TO CALL RODNEY BROWN WITH THE SAWYER COUNTY HIGHWAY DEPT REFERENCE HIM HITTING A PARKED VEHICLE WITH THE SNOW PLOW ON STATE HWY 48. UPON CALLING RODNEY, HE STATED HE WAS TRAVELING
WESTBOUND ON STATE HWY 48 AT APPROXIMATELY 10-15 MILES PER HOUR. HE STATED THERE WAS A VEHICLE PARKED IN THE
NORTH LANE IN FRONT OF THE HOUSE JUST EAST OF SUE'S SALON. RODNEY STATED THE RIGHT WING OF HIS PLOW HIT THE
LEFT REAR OF THE PARKED VEHICLE AND CAUSED DAMAGE. RODNEY STATED HE WAS WEARING HIS SEATBELT AND THAT HE
HAD ALREADY CONTACTED HIS BOSS AT THE HIGHWAY DEPT. HE ALSO ADVISED THAT THERE WAS NO DAMAGE TO THE PLOW
TRUCK. I ADVISED HIM THAT I WOULD BE GOING TO THE OWNER OF THE OTHER VEHICLES ADDRESS TO SPEAK WITH THEM AND TAKE PICTURES OF THE DAMAGED VEHICLE. AT 13:58 I ARRIVED AT 937 N LINCOLN AVE IN EXELAND WHERE JONI WALCZAK LIVES.
SHE STATED SHE WAS INSIDE A HOUSE WHEN HER 15 YEAR OLD SON CAME RUNNING IN STATING THAT A PLOW TRUCK HAD HIT
THEIR PARKED VEHICLE. JONI SAID HER 4 CHILDREN WERE SITTING IN THE VEHICLE WHEN IT HAPPENED, BUT NONE OF THEM
WERE HURT. I NOTICED THERE WAS DAMAGE TO THE PASSENGER SIDE TAILLIGHT AND REAR BUMPER AND ALSO THE REAR
WINDOW WAS SHATTERED AND MISSING. I TOOK PICTURES OF THE VEHICLE AND ENTERED THEM INTO EVIDENCE. I TOLD BOTH
PARTIES TO CONTACT THEIR INSURANCE COMPANIES AND TOLD JONI TO GET AN ESTIMATE ON HER VEHICLE. I CLEARED THE
CALL AT 14:04.
ON DECEMBER 11, 2016, I WAS ADVISED TO CALL RODNEY BROWN WITH THE SAWYER COUNTY HIGHWAY DEPT REFERENCE HIM HITTING A PARKED VEHICLE WITH THE SNOW PLOW ON STATE HWY 48. UPON CALLING RODNEY, HE STATED HE WAS TRAVELING
WESTBOUND ON STATE HWY 48 AT APPROXIMATELY 10-15 MILES PER HOUR. HE STATED THERE WAS A VEHICLE PARKED IN THE
NORTH LANE IN FRONT OF THE HOUSE JUST EAST OF SUE'S SALON. RODNEY STATED THE RIGHT WING OF HIS PLOW HIT THE
LEFT REAR OF THE PARKED VEHICLE AND CAUSED DAMAGE. RODNEY STATED HE WAS WEARING HIS SEATBELT AND THAT HE
HAD ALREADY CONTACTED HIS BOSS AT THE HIGHWAY DEPT. HE ALSO ADVISED THAT THERE WAS NO DAMAGE TO THE PLOW
TRUCK. I ADVISED HIM THAT I WOULD BE GOING TO THE OWNER OF THE OTHER VEHICLES ADDRESS TO SPEAK WITH THEM AND TAKE PICTURES OF THE DAMAGED VEHICLE. AT 13:58 I ARRIVED AT 937 N LINCOLN AVE IN EXELAND WHERE JONI WALCZAK LIVES.
SHE STATED SHE WAS INSIDE A HOUSE WHEN HER 15 YEAR OLD SON CAME RUNNING IN STATING THAT A PLOW TRUCK HAD HIT
THEIR PARKED VEHICLE. JONI SAID HER 4 CHILDREN WERE SITTING IN THE VEHICLE WHEN IT HAPPENED, BUT NONE OF THEM
WERE HURT. I NOTICED THERE WAS DAMAGE TO THE PASSENGER SIDE TAILLIGHT AND REAR BUMPER AND ALSO THE REAR
WINDOW WAS SHATTERED AND MISSING. I TOOK PICTURES OF THE VEHICLE AND ENTERED THEM INTO EVIDENCE. I TOLD BOTH
PARTIES TO CONTACT THEIR INSURANCE COMPANIES AND TOLD JONI TO GET AN ESTIMATE ON HER VEHICLE. I CLEARED THE
CALL AT 14:04.
Officer Information
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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
12/11/2016
132 - Date Notified 1243133 - Time Notified (Military Time)1311134 - Time Arrived (Military Time)
12/11/2016
135 - Date Of Report
16121116424 16121105 19 - Special Study
18 - Agency Space
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