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Home My WebLink About20150213 RodriguezAgency 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 GZDC4V1 DOT Document Number Document Override Number 15021303 15 0 2 1 3 0 3 02/13/2015 4 - Accident Date 1902 5 - Time of Accident (Military Time) 01 6 - Total Units 00 7 - Total Injured 00 8 - Total Killed SAWYER - 572 - County RADISSON - 12, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location 040 14 - On Hwy No. NB 14 - On Street Name 14 - Bus/Frnt/Rmp 507 FT15 - Est. Distance SOUTH15 - Hwy. Dir 16 - Fr/At Hwy No.CEMETARY RD16 - From/At Street Name 16 - Business/Frontage/Ramp 17 - Structure Type 17 - Structure Number 45.753283 12 - Latitude -91.22546113 - Longitude UTILITY POLE80 - 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 E R A T O R / P E D E S T R I A N Unit Status UTILITY POLE 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 30 - State 31 - Expiration Year 34 - On Duty Accident RODRIGUEZ 25 - Operator/Pedestrian Last Name ANTELMO 25 - First Name C 25 - Middle Initial 25 - Suffix 02/11 32 - Date Of Birth MALE 33 - Sex 26 - Address Street & Number 86 26 - PO Box RADISSON 27 - City WI 27 - State 54867 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. FAILURE-TO-HAVE-CONTROL 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 GZDC4V1 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 NOT-APPLICABLE 124 - Highway Factors AUTOMOBILE 21 - Unit Type PASSENGER-CAR Vehicle Type 1 22 - Total Occupants 396WWB 56 - License Plate Number AUT57 - Plate Type WI 58 - State 2015 59 - Exp Year 7146 55 - Vehicle Identification Number 2000 50 - Year STRN 51 - Make LS1 52 - Model 4D - 4DR 53 - Body Style GRN 54 - Color 100 - Skidmarks to Impact (Ft) FRONT 94 - Vehicle Damage SEVERE 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 DANCHEZ 46 - Vehicle Owner Last Name DANIEL 46 - First Name S 46 - Middle Initial 46 - Suffix 02/16 Date Of Birth 46 - Company Name 47- Address Street & Number 47 - PO Box RADISSON48 - City WI48 - State 5486748 - 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 Trailer 01 TR L 106 - Power Unit Number License Plate Number Plate Type State Expiration Year Trailer Make Unit Type Vehicle Identification Number Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDC4V1 2 424 Fixed Objects Struck PR O P E R T Y O W N E R Property ORGANIZATION Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix 01 NORTH CENTRAL POWER 84 - Company Name Government Property Type 85 - Address Street & Number 68 85 - PO Box RADISSON 86 - City WI 86 - State 54867 86 - Zip Code 87 - Telephone Number 83 - Government Damage Tag Number 01 82 - Striking Unit UTILITY-POLE 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 82 - Striking Unit 82 - Object Struck 105 - Photos By DI A G R A M A N D N A R R A T I V E Diagram and Narrative ON 02-13-15 AT 19:02 DEPUTY NELSON WAS DISPATCHED TO ONE VEHICLE ACCIDENT ON STH 40 SOUTH OF RADISSON. DEPUTY NELSON ARRIVED ON SCENE AND MADE CONTACT WITH EMS WHO WAS ALREADY ON SCENE. EMS ADVISED DEPUTY NELSON THAT THERE WAS ONE SUBJECT IN THE VEHICLE AT THE TIME OF THE ACCIDENT AND THAT HE WAS NOT INJURED. DEPUTY NELSON OBSERVED THAT THE VEHICLE WAS TRAVELING NORTH ON STH 40 WHEN IT WENT OFF THE ROAD. THE VEHICLE TRAVELED THROUGH THE DITCH BEFORE HITTING A POWER POLE. THE POWER POLE HAD BEEN BROKEN OFF CAUSING SERVER DAMAGE TO THE FRONT END OF THE VEHICLE. DEPUTY NELSON MADE CONTACT WITH THE MALE DRIVER LATTER ID AS ANTELMO C. RODRIGUEZ. RODRIGUEZ DID NOT SPEAK MUCH ENGLISH BUT ADVISED THAT HE WAS OK. DEPUTY NELSON DID NOT SEE ANY SIGNS OF INTOXICATION WHILE SPEAKING WITH RODRIGUEZ. DEPUTY NELSON HAD VEHICLE REMOVED BY ROADRUNNER TOWING AND TRANSPORTED THE DRIVER TO HIS RESIDENCE. ON 02-13-15 AT 19:02 DEPUTY NELSON WAS DISPATCHED TO ONE VEHICLE ACCIDENT ON STH 40 SOUTH OF RADISSON. DEPUTY NELSON ARRIVED ON SCENE AND MADE CONTACT WITH EMS WHO WAS ALREADY ON SCENE. EMS ADVISED DEPUTY NELSON THAT THERE WAS ONE SUBJECT IN THE VEHICLE AT THE TIME OF THE ACCIDENT AND THAT HE WAS NOT INJURED. DEPUTY NELSON OBSERVED THAT THE VEHICLE WAS TRAVELING NORTH ON STH 40 WHEN IT WENT OFF THE ROAD. THE VEHICLE TRAVELED THROUGH THE DITCH BEFORE HITTING A POWER POLE. THE POWER POLE HAD BEEN BROKEN OFF CAUSING SERVER DAMAGE TO THE FRONT END OF THE VEHICLE. DEPUTY NELSON MADE CONTACT WITH THE MALE DRIVER LATTER ID AS ANTELMO C. RODRIGUEZ. RODRIGUEZ DID NOT SPEAK MUCH ENGLISH BUT ADVISED THAT HE WAS OK. DEPUTY NELSON DID NOT SEE ANY SIGNS OF INTOXICATION WHILE SPEAKING WITH RODRIGUEZ. DEPUTY NELSON HAD VEHICLE REMOVED BY ROADRUNNER TOWING AND TRANSPORTED THE DRIVER TO HIS RESIDENCE. Officer Information Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDC4V1 3 4 OF F I C E R I N F O R M A T I O N 125 - First Name 125 - Middle Initial NELSON 125 - Officer Last Name DENNIS 382 131 - 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 02/13/2015 132 - Date Notified 1902133 - Time Notified (Military Time)1935134 - Time Arrived (Military Time) 02/23/2015 135 - Date Of Report 15021303 19 - Special Study 382 SQUAD C SHIFT 18 - Agency Space Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDC4V1 4 4