HomeMy WebLinkAbout20181110 TOMCZIK.pdfON NOVEMBER 10. 2018, I, DEPUTY AMBER AL-MOGHRABI WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPT. AT
APPROXIMATELY 13:53 I WAS ADVISED BY DISPATCH TO RESPOND TO POLISH ROAD NEAR THE CREEK FOR A ONE VEHICLE ROLLOVER. DISPATCH
STATED THAT THE EXACT LOCATION WAS UNKNOWN AND THAT EMS AND FIRE WERE EN ROUTE. DISPATCH ALSO ADVISED THAT THERE WAS NO INJURIES, BUT THAT ONE SUBJECT MAY BE TRAPPED IN THE VEHICLE. I ACTIVATED MY EMERGENCY LIGHTS AND SIREN AND WENT EN ROUTE
FROM WINTER, WI. AS I GOT TO WEIRGOR ROAD I HEARD AN EMT STATE THAT THEY DROVE POLISH ROAD FROM ST HWY 40 TO WEIRGOR ROAD
AND DID NOT SEE THE ACCIDENT. I ADVISED DISPATCH THAT I HAD JUST TURNED ONTO WEIRGOR AND WOULD BE IN THE AREA. AT THAT TIME
DISPATCH ADVISED ME THAT EXELAND FIRE DEPT WAS ON SCENE AND THAT IT WAS NEAR THE S CURVES CLOSER TO ST HWY 48. THEY ALSO
ADVISED EVERYONE WAS OUT OF THE VEHICLE AND THAT I COULD SLOW DOWN. I ARRIVED ON SCENE AT APPROXIMATELY 14:10. I SPOKE TO
THE FEMALE SUBJECT WHO WAS THE DRIVER OF THE VEHICLE. SHE STATED HER NAME WAS AND WAS THE OWNER OF THE VEHICLE. I RAN THE LICENSE PLATE WHICH CAME BACK TO HER. I GOT HER INFORMATION AND ASKED HER ABOUT WHAT HAD HAPPENED. SHE
STATED THAT SHE WAS HEADED SOUTH ON POLISH ROAD AND WHEN SHE SAW THE CURVE COMING UP SHE STARTED TO SLOW DOWN. SHE
18111016081
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
DT4000 (STANDARD CRASH)Reportable
TagsSchool Bus Related
NOActive School ZoneGovernment
Property
Reporting
ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
01
Time Notified
01:51 PM
Date Notified
11/10/2018
Time Arrived
02:10 PM
Date Arrived
11/10/2018
Crash Time
01:45 PM
Crash Date
11/10/2018
Investigating Officer/Deputy
DEPUTY AMBER ALMOGHRABI
Agency Crash Number
18111005
Primary Crash Document #Document Number Override
6V
L
1
3
W
8
H
L
5
Additional InformationPHOTOS
Photos ByDEPUTY AMBER AL-MOGHRABI
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
Crash Time 01:45 PM
Crash Date 11/10/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
STATED AT THAT TIME SHE STARTED TO SLIDE AND LOST CONTROL OF THE VEHICLE. STATED SHE WAS TRAVELING APPROXIMATELY 20-
25 MPH AND WAS WEARING HER SEATBELT. I ADVISED THAT THE SPEED LIMIT ON POLISH ROAD IS 55 MPH, BUT THAT THERE WAS A
CAUTIONARY 15 MPH SPEED LIMIT SIGN JUST BEFORE THE CURVES. I STATED THAT WITH THE CONDITIONS AT THIS TIME AND THE ROAD BEING SNOW COVERED AND SLIPPERY SHE WAS GOING TOO FAST. ADVISED ME THAT HER FRIEND WAS ALSO IN THE CAR WITH
HER ALONG WITH HIS DOG. I GOT INFORMATION AND PROVIDED THAT TO DISPATCH. SEE REPORT FOR MORE.
18111016081
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5070852
X Coordinate
168103.5625
Longitude
-91.26427129
Latitude
45.711577622
ON POLISH RD
1.05 MI S
OF MAJKA LN
IN THE TOWN OF WEIRGOR
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
Crash Classification - Jurisdiction
NO SPECIAL JURISDICTION
Crash Classification - Location
PUBLIC PROPERTY
Relation To Trafficway
TRAFFICWAY - ON ROAD
Animal Type
Weather Condition(s)
CLOUDY
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
SNOW
Light Condition
DAYLIGHT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
OVERTURN/ROLLOVER
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
DOWNHILL
Road Curvature
CURVE RIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
OTHER
Traffic Way
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTIONMost Harmful Event: Collision With
OVERTURN/ROLLOVER
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
2
Operating As EndorsementsVehicle Type
PASSENGER VAN01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Model
GRAND CARA
Year
2002
Make
DODGE
Vehicle Identification Number
46570101
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 01:45 PM
Crash Date 11/10/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
18111016081
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
PARK FALLS, WI 54552 , US
Owner Name
01
Driver DistractionsUNKNOWN IF DISTRACTED
01
Driver Actions
SPEED TOO FAST/COND
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
DAVE'S TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
ALL AREAS
Initial Contact Point
NON-COLLISION
Bus UseNOT A BUSBody Style
VN - VAN
Color
BLU - BLUE
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventOVERTURN/ROLLOVER01
Event
02
Event
03
Event
04
IndividualInsurance Company
HARTFORD-ACCIDENT-&-INDEMNITY-CO
Policy Holder
UN
I
T
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
PARK FALLS, WI 54552 , US
Race
WHITEDate of Birth
12/21/
Sex
FEMALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 01:45 PM
Crash Date 11/10/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
18111016081
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
1
01
Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00
1
01
Tint ComplianceEye Protection
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Injury
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00
2
01
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
SURING, WI 54174 , US
Race
WHITEDate of Birth
01/27/
Sex
MALE
Citations Issued
0
Passenger
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 01:45 PM
Crash Date 11/10/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
18111016081
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
2
01
Drug Test ResultsDrug Test TypeDrug Test GivenTEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 01:45 PM
Crash Date 11/10/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.