20161212 IshamAgency Accident Number
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Police Number
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Reportable Accident On Emergency Amended GZH0DMR
DOT Document Number Document Override Number
16121209
16
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9
16121209
16
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9
12/12/2016
4 - Accident Date
1820
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
K
14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp
0.35 MI15 - Est. Distance SOUTH15 - Hwy. Dir
16 - Fr/At Hwy No.MOSQUITO BROOK RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
46.019188
12 - Latitude -91.38398913 - 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-RIGHT
117 - Relation To Roadway
DARK-NOT-LIGHTED114 - 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
NORTH
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
2020
31 - Expiration Year 34 - On Duty Accident
ISHAM
25 - Operator/Pedestrian Last Name
LAURIE
25 - First Name
A
25 - Middle Initial 25 - Suffix
10/23/
32 - Date Of Birth
FEMALE
33 - Sex
26 - Address Street & 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
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
01
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZH0DMR 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
901WPT
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2017
59 - Exp Year
02
55 - Vehicle Identification Number
2009
50 - Year
MITS
51 - Make
GALANT
52 - Model
4D - 4DR
53 - Body Style
WHI
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT PASSENGER SIDE, FRONT
94 - Vehicle Damage
MODERATE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
A1 TOWING
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
ISHAM
46 - Vehicle Owner Last Name
LAURIE
46 - First Name
A
46 - Middle Initial 46 - Suffix
10/23/1
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
NONE63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 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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MV4000e 01/2005
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Wisconsin Motor Vehicle
Accident Report
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZH0DMR 2 424
Fixed Objects Struck
PR
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Property
INDIVIDUAL
Organization Type
BUTTERFIELD
84 - Property Owner Last Name
DONALD
84 - First Name
L
84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
HAYWARD
86 - City
WI
86 - State
54843
86 - Zip Code
.
87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
OTHER-POST
82 - Object Struck
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
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 ON 12/12/16 AT 18:23 LOCATED ON CTH K SOUTH OF
STH 77 IN THE TOWNSHIP OF HAYWARD. UPON ARRIVAL, I OBSERVED A MALE PARTY TRYING TO DIG OUT A WHITE MITSUBISHI
GALANT THAT WAS IN THE EAST DITCH. UPON CONTACT WITH THE PARTY WHO WAS IDENTIFIED AS JOSEPH ISHAM SR, HE
ADVISED HIS WIFE HAD BEEN DRIVING AND WAS IN HIS TRUCK PARKED IN THE DRIVEWAY ADJACENT TO THE CRASH. WHILE
SPEAKING WITH HIM, I OBSERVED MODERATE FRONT END DAMAGE AND FOUND THE VEHICLE HAD STRUCK A MAIL BOX THAT
WAS CONNECTED TO A FOUR INCH PIPE. UPON SPEAKING WITH THE OPERATOR, LAURIE ISHAM, SHE ADVISED SHE CAUGHT THE SIDE OF THE SNOW COVERED ROAD AND IT PULLED HER INTO THE DITCH AND THAT SHE HAD STRUCK THE MAILBOX. NO
CITATIONS WERE ISSUED HOWEVER JOSEPH ISHAM WAS TAKEN INTO PHYSICAL CUSTODY FOR AN INJUNCTION VIOLATION AND
LAURIE ISHAM TAKEN INTO CUSTODY FOR OBSTRUCTION AND RESISTING. A1 TOWING WAS DISPATCHED TO REMOVE THE
VEHICLE FROM THE DITCH AND TOW IT AWAY.
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO A VEHICLE IN THE DITCH ON 12/12/16 AT 18:23 LOCATED ON CTH K SOUTH OF
STH 77 IN THE TOWNSHIP OF HAYWARD. UPON ARRIVAL, I OBSERVED A MALE PARTY TRYING TO DIG OUT A WHITE MITSUBISHI
GALANT THAT WAS IN THE EAST DITCH. UPON CONTACT WITH THE PARTY WHO WAS IDENTIFIED AS JOSEPH ISHAM SR, HE
ADVISED HIS WIFE HAD BEEN DRIVING AND WAS IN HIS TRUCK PARKED IN THE DRIVEWAY ADJACENT TO THE CRASH. WHILE
SPEAKING WITH HIM, I OBSERVED MODERATE FRONT END DAMAGE AND FOUND THE VEHICLE HAD STRUCK A MAIL BOX THAT
WAS CONNECTED TO A FOUR INCH PIPE. UPON SPEAKING WITH THE OPERATOR, LAURIE ISHAM, SHE ADVISED SHE CAUGHT THE SIDE OF THE SNOW COVERED ROAD AND IT PULLED HER INTO THE DITCH AND THAT SHE HAD STRUCK THE MAILBOX. NO
CITATIONS WERE ISSUED HOWEVER JOSEPH ISHAM WAS TAKEN INTO PHYSICAL CUSTODY FOR AN INJUNCTION VIOLATION AND
LAURIE ISHAM TAKEN INTO CUSTODY FOR OBSTRUCTION AND RESISTING. A1 TOWING WAS DISPATCHED TO REMOVE THE
VEHICLE FROM THE DITCH AND TOW IT AWAY.
Officer Information
Accident Report
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZH0DMR 3 4
OF
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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
12/12/2016
132 - Date Notified 1823133 - Time Notified (Military Time)1835134 - Time Arrived (Military Time)
12/12/2016
135 - Date Of Report
16121209 16121209 19 - Special Study
18 - Agency Space
Accident Report
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZH0DMR 4 4