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Home My WebLink About20150107 FischerAgency Accident Number AC C I D E N T # PO L I C E # Police Number GE N E R A L I N F O R M A T I O N Reportable Accident On Emergency Amended GZDR0DP DOT Document Number Document Override Number 2014010705 20 1 4 0 1 0 7 0 5 01/07/2015 4 - Accident Date 1805 5 - Time of Accident (Military Time) 02 6 - Total Units 00 7 - Total Injured 00 8 - Total Killed SAWYER - 572 - County SAND LAKE - 14, TOWN3 - Municipality PARKING LOT11 - Accident Location 14 - On Hwy No. PARKING LOT 14 - On Street Name 14 - Bus/Frnt/Rmp 15 - Est. Distance 15 - Hwy. Dir 16 - Fr/At Hwy No.1ST ST S16 - From/At Street Name 16 - Business/Frontage/Ramp OTHER # 17 - Structure Type 5796N 17 - Structure Number 45.844712 12 - Latitude -91.54113113 - Longitude PARKED MOTOR VEHICLE80 - First Harmful Event HEAD ON93 - Manner of Collision NO CONTROL 112 - Access Control 113 - Road Curvature LEVEL/FLAT 113 - Road Terrain BLACKTOP, BITUMINOUS, OR ASPHALT - 2 Surface Type PARKING-LOT-OR-PRIVATE-PROPERTY115 - Traffic Way PARKING-LOT-OR-PRIVATE-PROPERTY 117 - Relation To Roadway DARK-LIGHTED114 - Light Condition ICE116 - Road Surface Condition CLEAR118 - 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 E R A T O R / P E D E S T R I A N H - HIT AND RUN Unit Status PARKED MOTOR VEHICLE 81 - Most Harmful Event: Collision With 23 - Dir Of Travel 1024 - 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 26 - Address Street & Number 26 - PO Box 27 - City 27 - State 27 - Zip Code 28 - Telephone Number 39 - Seat Position RESTRAINT-USE-UNKNOWN 40 - Safety Equipment 38 - Injury Severity UNKNOWN 41 - Airbag UNKNOWN 42 - Ejected 44 Medical Transport UNKNOWN 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 NOT OBSERVED88 - Driver or Pedestrian Cond UNKNOWN 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 GZDR0DP 1 4 VE H I C L E VE H O W N E R Vehicle Vehicle Owner Insurance School Bus IN S 91 - Drugs Reported SNOW,-ICE,-OR-WET 124 - Highway Factors AUTOMOBILE 21 - Unit Type PASSENGER-CAR Vehicle Type 1 22 - Total Occupants 56 - License Plate Number 57 - Plate Type 58 - State 59 - Exp Year 55 - Vehicle Identification Number 50 - Year 51 - Make 52 - Model 53 - Body Style 54 - Color 100 - Skidmarks to Impact (Ft) UNKNOWN 94 - Vehicle Damage UNKNOWN 95 - Extent Of Damage Vehicle Towed Due To Damage 96 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 46 - Company Name 47- Address Street & Number 47 - PO Box 48 - City 48 - State 48 - Zip Code 49 - Telephone Number UNKNOWN63 - 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 Operator/Pedestrian L - LEGALLY PARKED Unit Status MOTOR VEHICLE IN TRANSPORT 81 - Most Harmful Event: Collision With 23 - Dir Of Travel 1024 - 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDR0DP 2 424 VE H I C L E VE H O W N E R Vehicle Vehicle Owner Insurance OP E R A T O R / P E D E S T R I A N IN S 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 NOT-APPLICABLE 124 - Highway Factors AUTOMOBILE 21 - Unit Type PASSENGER-CAR Vehicle Type 0 22 - Total Occupants 124TRV 56 - License Plate Number AUT57 - Plate Type WI 58 - State 2015 59 - Exp Year 9962 55 - Vehicle Identification Number 2007 50 - Year FORD 51 - Make FOCUS 52 - Model 4D - 4DR 53 - Body Style MAR 54 - Color 100 - Skidmarks to Impact (Ft) FRONT 94 - Vehicle Damage MINOR 95 - Extent Of Damage Vehicle Towed Due To Damage 96 97 - Vehicle Removed By NOT-APPLICABLE 123 - Vehicle Factors 45 Vehicle Owner Same As Operator FISCHER 46 - Vehicle Owner Last Name ERIC 46 - First Name J 46 - Middle Initial 46 - Suffix 07/26/ Date Of Birth 46 - Company Name 47- Address Street & Number 47 - PO Box STONE LAKE48 - City WI48 - State 54876-402848 - 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 02 02 02 02 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDR0DP 3 4 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 DI A G R A M A N D N A R R A T I V E Diagram and Narrative ERIC J FISCHER PARKED HIS VEHICLE IN THE STONE LAKE PUB PARKING LOT. THERE WAS NO DAMAGE TO HIS VEHICLE WHEN IT WAS PARKED. FISCHER AND HIS WIFE ENTERED THE BUSINESS. WHEN FISCHER EXITED TO SMOKE HE NOTICED THAT THERE WAS A DENT ON THE FRONT BUMPER OF HIS VEHICLE. THERE WAS SOME BLACK PLASTIC FROM A DIFFERENT VEHICLE NEAR THE DAMAGES. FISCHER SUSPECTED ANOTHER PATRON WHO HAD BEEN KICKED OUT OF THE BAR WAS RESPONSIBLE. AN INVESTIGATION INTO THE MATTER IS BEING CONDUCTED ERIC J FISCHER PARKED HIS VEHICLE IN THE STONE LAKE PUB PARKING LOT. THERE WAS NO DAMAGE TO HIS VEHICLE WHEN IT WAS PARKED. FISCHER AND HIS WIFE ENTERED THE BUSINESS. WHEN FISCHER EXITED TO SMOKE HE NOTICED THAT THERE WAS A DENT ON THE FRONT BUMPER OF HIS VEHICLE. THERE WAS SOME BLACK PLASTIC FROM A DIFFERENT VEHICLE NEAR THE DAMAGES. FISCHER SUSPECTED ANOTHER PATRON WHO HAD BEEN KICKED OUT OF THE BAR WAS RESPONSIBLE. AN INVESTIGATION INTO THE MATTER IS BEING CONDUCTED OF F I C E R I N F O R M A T I O N 125 - First Name 125 - Middle Initial Officer Information SHEPARD 125 - Officer Last Name LUCAS 316 131 - 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 01/07/2015 132 - Date Notified 1809133 - Time Notified (Military Time)1817134 - Time Arrived (Military Time) 01/07/2015 135 - Date Of Report 2014010705 19 - Special Study 18 - Agency Space Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDR0DP 4 4