HomeMy WebLinkAbout20150325 LanghamAgency Accident Number
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Reportable Accident On Emergency Amended GZDR0DQ
DOT Document Number Document Override Number
15032502
15
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3
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5
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03/25/2015
4 - Accident Date
0503
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County METEOR - 10, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
048
14 - On Hwy No.
WB
14 - On Street Name 14 - Bus/Frnt/Rmp
1095 FT15 - Est. Distance WEST15 - Hwy. Dir
16 - Fr/At Hwy No.VALLEY VIEW RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.689441
12 - Latitude -91.31118913 - Longitude
DITCH80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
NO CONTROL
112 - Access Control
STRAIGHT
113 - Road Curvature
HILL
113 - Road Terrain
BLACKTOP, BITUMINOUS, OR ASPHALT - 2
Surface Type
NOT-PHYSICALLY-DIVIDED-(2-WAY TRAFFIC)115 - Traffic Way
OUTSIDE-SHOULDER-LEFT
117 - Relation To Roadway
DAWN114 - Light Condition SNOW/SLUSH116 - Road Surface Condition CLOUDY118 - 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
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Unit Status
DITCH
81 - Most Harmful Event: Collision With
WEST
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
LANGHAM
25 - Operator/Pedestrian Last Name
NICOLE
25 - First Name
M
25 - Middle Initial 25 - Suffix
09/23
32 - Date Of Birth
FEMALE
33 - Sex
26 - Address Street & Number 26 - PO Box
EXELAND
27 - City
WI
27 - State
54835-2165
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 UNKNOWN
89 - Substance Presence
TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
Accident Report
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MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDR0DQ 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
KP7012
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2015
59 - Exp Year
7795
55 - Vehicle Identification Number
50 - Year
CHEV
51 - Make
K1500
52 - Model
2D - 2DR
53 - Body Style
RED
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT DRIVER SIDE, MIDDLE DRIVER SIDE, REAR DRIVER SIDE
94 - Vehicle Damage
MODERATE
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
LANGHAM
46 - Vehicle Owner Last Name
NICOLE
46 - First Name
M
46 - Middle Initial 46 - Suffix
09/23/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
EXELAND48 - City WI48 - State 54835-216548 - Zip Code 49 - Telephone Number
GEICO-ADVANTAGE-INSURANCE-CO63 - Liability Insurance Company Policy Holder Same As Owner60
LANGHAM
61 - Policy Holder Last Name
NICOLE
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
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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 GZDR0DQ 2 424
Fixed Objects Struck
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Property
UNKNOWN
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
86 - City 86 - State 86 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
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 82 - Striking Unit 82 - Object Struck
105 - Photos By
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Diagram and Narrative
ON MARCH 25TH, 2015, AT APPROXIMATELY 5:03AM, NICOLE M. LANGHAM WAS DRIVING WEST ON STATE HIGHWAY 48. THE
ROADWAY WAS MOSTLY COVERED WITH ICE AND SLUSH, HOWEVER IN THE AREA LANGHAM WAS DRIVING THE ICE WAS
DIFFICULT TO SEE. AS SHE DROVE OVER A HILL IN THE ROADWAY THE REAR END OF HER VEHICLE BEGAN TO LOSE TRACTION
AND LANGHAM LOST CONTROL OF THE VEHICLE. THE TRUCK SLID ACROSS THE ONCOMING LANE OF TRAFFIC AND INTO THE
SOUTH DITCH. WHEN THE VEHICLE ENTERED THE DITCH, IT TIPPED ONTO THE DRIVERS SIDE. THIS CAUSE DENTING AND
SCRATCHES ACROSS THE ENTIRETY OF THE DRIVER'S SIDE. THE SIDE MIRROR WAS ALSO BROKEN OFF ON IMPACT. THE LUMBER THAT SHE HAD IN THE FLATBED OF THE TRUCK SPILLED OUT. LANGHAM WAS ABLE TO CLIMB OUT OF THE PASSENGER SIDE
DOOR AND WAS UNINJURED.
ON MARCH 25TH, 2015, AT APPROXIMATELY 5:03AM, NICOLE M. LANGHAM WAS DRIVING WEST ON STATE HIGHWAY 48. THE
ROADWAY WAS MOSTLY COVERED WITH ICE AND SLUSH, HOWEVER IN THE AREA LANGHAM WAS DRIVING THE ICE WAS
DIFFICULT TO SEE. AS SHE DROVE OVER A HILL IN THE ROADWAY THE REAR END OF HER VEHICLE BEGAN TO LOSE TRACTION
AND LANGHAM LOST CONTROL OF THE VEHICLE. THE TRUCK SLID ACROSS THE ONCOMING LANE OF TRAFFIC AND INTO THE
SOUTH DITCH. WHEN THE VEHICLE ENTERED THE DITCH, IT TIPPED ONTO THE DRIVERS SIDE. THIS CAUSE DENTING AND
SCRATCHES ACROSS THE ENTIRETY OF THE DRIVER'S SIDE. THE SIDE MIRROR WAS ALSO BROKEN OFF ON IMPACT. THE LUMBER THAT SHE HAD IN THE FLATBED OF THE TRUCK SPILLED OUT. LANGHAM WAS ABLE TO CLIMB OUT OF THE PASSENGER SIDE
DOOR AND WAS UNINJURED.
Officer Information
Accident Report
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PK2012
Wisconsin Motor Vehicle GZDR0DQ 3 4
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125 - First Name 125 - Middle Initial
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
03/25/2015
132 - Date Notified 0514133 - Time Notified (Military Time)0543134 - Time Arrived (Military Time)
03/30/2015
135 - Date Of Report
15032502 19 - Special Study
18 - Agency Space
Accident Report
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MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDR0DQ 4 4