20161214 Duffy SperosGZJ3QMH 51Wisconsin Motor Vehicle
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79 - E M S Number103
Measurements Taken
102
Witness Statements
101
Supplemental Reports
9
Names Exchanged
9
Construction Zone
9
Load Spillage
9
Truck, Bus, or Hazardous Materials
9
Trailer or Towed
9
Photos Taken
9
Fire
9
Government Property
9
Hit and Run
118 - Weather
Clear
116 - Road Surface Condition
Snow/Slush
114 - Light Condition
Dark-Not-Lighted
117 - Relation To Roadway
On-Roadway
115 - Traffic Way
Not-Physically-Divided-(2-Way Traffic)
Surface Type
Blacktop, Bituminous, or Asphalt - 2
113 - Road Terrain
Level/Flat
113 - Road Curvature
Straight
112 - Access Control
No Control
93 - Manner of Collision
Angle
80 - First Harmful Event
Motor Vehicle In Transport
13 - Longitude-91.44671112 - Latitude
46.011253
17 - Structure Number17 - Structure Type
16 - Business/Frontage/Ramp16 - From/At Street Name
WHEELER RD
16 - Fr/At Hwy No.
15 - Hwy. Dir15 - Est. Distance14 - Bus/Frnt/Rmp14 - On Street Name
WB
14 - On Hwy No.
077
11 - Accident LocationIntersection3 - Municipality
HAYWARD - 06, Town
2 - County
SAWYER - 57
8 - Total Killed
00
7 - Total Injured
00
6 - Total Units
02
5 - Time of Accident (Military Time)
1725
4 - Accident Date
12/14/2016
16
1
2
1
4
0
4
16121404
Document Override NumberDOT Document Number
GZJ3QMHAmendedOn EmergencyReportable Accident
GE
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Police Number
PO
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AC
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Agency Accident Number
01
91 - Drugs Reported
91 - Drug Test
Test Not Given
90 - Alcohol Content90 - Alcohol TestTest Not Given
89 - Substance Presence
Neither-Alcohol-Nor-Drugs-Present88 - Driver or Pedestrian CondAppeared Normal
122 - Driver Factors
Not-Applicable
64 - 5th Statute No.64 - 4th Statute No.64 - 3rd Statute No.64 - 2nd Statute No.64 - 1st Statute No.
62 - No. of Citations Issued0120 - Traffic Control
No-Control
119 - What Driver Was Doing
GOING STRAIGHT
92 - Pedestrian Action92 - Pedestrian Location43 - Trapped/ExtricatedNot-Trapped
Medical Transport
4442 - Ejected
Not-Ejected
41 - Airbag
Deployed
38 - Injury Severity
N - No Apparent Injury
40 - Safety EquipmentShoulder-Belt-And-Lap-Belt-Used39 - Seat PositionFront-Seat-Left-Side-(MC/Bike Driver, Train Conductor)
28 - Telephone Number27 - Zip Code
54843
27 - State
WI
27 - City
HAYWARD
26 - PO Box47126 - Address Street & Number
33 - Sex
Male
32 - Date Of Birth
07/14/
25 - Suffix25 - Middle InitialO25 - First NameJAMES25 - Operator/Pedestrian Last NameDUFFY
34 - On Duty Accident31 - Expiration Year
2017
30 - State
WI
29 - Driver's License Number
Operating Commercial Motor Vehicle3537 - Endorsements36 - Operating as ClassifiedD CLASS
24 - Speed Limit55
23 - Dir Of Travel
WEST
81 - Most Harmful Event: Collision With
Motor Vehicle In Transport
Unit Status
OP
E
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T
O
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P
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D
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S
T
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I
A
N
Operator/Pedestrian
GZJ3QMH 52Wisconsin Motor Vehicle
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MV4000e 01/2005
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School District Contracted With
Seating CapacityBody MakeSchool NameBus Travelling to/from
To From
BU
S
01
01
01
01
61 - Policy Holder Company
61 - Policy Holder First Name
JAMES
61 - Policy Holder Last Name
DUFFY
60
Policy Holder Same As Owner
63 - Liability Insurance Company
GENERAL-CASUALTY
49 - Telephone Number48 - Zip Code
5484348 - StateWI
48 - City
HAYWARD
47 - PO Box
471
47- Address Street & Number
46 - Company Name
Date Of Birth
07/14/
46 - Suffix46 - Middle Initial
O
46 - First Name
JAMES
46 - Vehicle Owner Last Name
DUFFY
Vehicle Owner Same As Operator
45
123 - Vehicle Factors
Not-Applicable
97 - Vehicle Removed By
A-1 TOWING
96
Vehicle Towed Due To Damage
95 - Extent Of Damage
Severe
94 - Vehicle Damage
Front, Front Driver Side, Rear Driver Side, Front Passenger Side
100 - Skidmarks to Impact (Ft)54 - Color
GRY
53 - Body Style
PK - PICKUP
52 - Model
F150
51 - Make
FORD
50 - Year
2015
55 - Vehicle Identification Number086559 - Exp Year201758 - StateWI57 - Plate TypeLTK56 - License Plate NumberGV3322
22 - Total Occupants
1
Vehicle Type
Pickup/Utility-Truck
21 - Unit Type
Automobile
124 - Highway Factors
Not-Applicable
IN
S
School Bus
Insurance
Vehicle Owner
Vehicle
VE
H
O
W
N
E
R
VE
H
I
C
L
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02
28 - Telephone Number27 - Zip Code
54843
27 - State
WI
27 - City
HAYWARD
26 - PO Box26 - Address Street & Number
33 - Sex
Male
32 - Date Of Birth
02/06/
25 - Suffix25 - Middle InitialP25 - First NameJORDAN25 - Operator/Pedestrian Last NameSPEROS
34 - On Duty Accident31 - Expiration Year
2024
30 - State
WI
29 - Driver's License Number
Operating Commercial Motor Vehicle3537 - Endorsements36 - Operating as ClassifiedD CLASS
24 - Speed Limit45
23 - Dir Of Travel
NORTH
81 - Most Harmful Event: Collision With
Motor Vehicle In Transport
Unit Status
Operator/Pedestrian
GZJ3QMH 53Wisconsin Motor Vehicle
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02
02
02
61 - Policy Holder Company
61 - Policy Holder First Name
RICHARD
61 - Policy Holder Last Name
SPEROS
60 Policy Holder Same As Owner63 - Liability Insurance CompanyWILSON-MUTUAL-INS-CO
49 - Telephone Number48 - Zip Code5482848 - StateWI48 - CityCOUDERAY
47 - PO Box47- Address Street & Number
46 - Company Name
Date Of Birth
10/16/1
46 - Suffix46 - Middle Initial
L
46 - First Name
RICHARD
46 - Vehicle Owner Last Name
SPEROS
Vehicle Owner Same As Operator
45
123 - Vehicle Factors
Not-Applicable
97 - Vehicle Removed By96
Vehicle Towed Due To Damage
95 - Extent Of Damage
Severe
94 - Vehicle Damage
Front, Front Passenger Side, Rear Passenger Side
100 - Skidmarks to Impact (Ft)54 - Color
RED
53 - Body Style
PK - PICKUP
52 - Model
SILVERADO
51 - Make
CHEV
50 - Year
2011
55 - Vehicle Identification Number
34716
59 - Exp Year
2017
58 - State
WI57 - Plate TypeLTK
56 - License Plate Number
TMM00SE
22 - Total Occupants
1
Vehicle Type
Pickup/Utility-Truck
21 - Unit Type
Automobile
124 - Highway Factors
Snow,-Ice,-or-Wet
91 - Drugs Reported
91 - Drug TestTest Not Given90 - Alcohol Content1590 - Alcohol TestTest Given
89 - Substance Presence
Alcohol-Present88 - Driver or Pedestrian CondAbility Impaired
122 - Driver Factors
Speed-Too-Fast-for-Conditions
64 - 5th Statute No.64 - 4th Statute No.64 - 3rd Statute No.
346.57(3)
64 - 2nd Statute No.
346.63(1)(A)
64 - 1st Statute No.
346.63(1)(A)
62 - No. of Citations Issued3120 - Traffic Control
Stop-Sign
119 - What Driver Was Doing
SLOW/STOPPING
92 - Pedestrian Action92 - Pedestrian Location43 - Trapped/Extricated
Not-Trapped
Medical Transport
4442 - Ejected
Not-Ejected
41 - Airbag
Deployed
38 - Injury Severity
N - No Apparent Injury
40 - Safety Equipment
Shoulder-Belt-And-Lap-Belt-Used
39 - Seat Position
Front-Seat-Left-Side-(MC/Bike Driver, Train Conductor)
OP
E
R
A
T
O
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P
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D
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S
T
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N
Insurance
Vehicle Owner
Vehicle
VE
H
O
W
N
E
R
VE
H
I
C
L
E
GZJ3QMH 54Wisconsin Motor Vehicle
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MV4000e 01/2005
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Accident Report
School District Contracted With
Seating CapacityBody MakeSchool NameBus Travelling to/from
To From
BU
S
02
IN
S
School Bus
Vehicle Identification NumberUnit TypeTrailer Make
Expiration YearStatePlate TypeLicense Plate Number106 - Power Unit Number
TR
L
01
Trailer
FREY 397
Diagram and Narrative
DI
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105 - Photos By
UNIT 1 WAS TRAVELING WEST ON STATE HIGHWAY 77 AT 55 MILES PER HOUR. UNIT 2 FAILED TO STOP AT THE INTERSECTION OF HIGHWAY 77 ON WHEELER. UNIT 1 STRUCK THE FRONT DRIVERS SIDE PANEL OF UNIT 2. UNIT 2 WAS THEN SPUN AROUND
SEVERAL TIMES. BOTH VEHICLES CAME TO REST IN THE DITCH/ SWAMP AREA DIRECTLY ACROSS FROM WHEELER IN THE
HIGHWAY 77 WESTBOUND DITCH.
126 - Law Enforcement Agency Address Street & Number
15880 EAST FIFTH STREET
130 - Law Enforcement Agency Name
SAWYER COUNTY SHERIFFS DEPT
129 - Law Enforcement Agency No.
131 - Officer ID
397NATHAN
125 - Officer Last Name
FREY
Officer Information
125 - Middle Initial125 - First Name
GZJ3QMH 55Wisconsin Motor Vehicle
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Accident Report
18 - Agency Space
19 - Special Study16121404
135 - Date Of Report
12/14/2016
134 - Time Arrived (Military Time)1735133 - Time Notified (Military Time)1725132 - Date Notified
12/14/2016
128 - Telephone Number
(715) 634-4858 Ext.
127 - Zip Code
54843
127 - State
WI
127 - City
HAYWARD
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