HomeMy WebLinkAbout20150328 OlsonAgency Accident Number
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Reportable Accident On Emergency Amended GZDSGV3
DOT Document Number Document Override Number
15032804
15
0
3
2
8
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4
380
38
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03/28/2015
4 - Accident Date
0701
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County BASS LAKE - 01, TOWN3 - Municipality PRIVATE PROPERTY11 - Accident Location
14 - On Hwy No.
PRIVATE PROPERTY
14 - On Street Name 14 - Bus/Frnt/Rmp 15 - Est. Distance 15 - Hwy. Dir
16 - Fr/At Hwy No.BROWNS RD16 - From/At Street Name 16 - Business/Frontage/Ramp
FIRE #
17 - Structure Type
8709 N
17 - Structure Number
45.954943
12 - Latitude -91.48380013 - Longitude
TREE80 - 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
PARKING-LOT-OR-PRIVATE-PROPERTY115 - Traffic Way
PARKING-LOT-OR-PRIVATE-PROPERTY
117 - Relation To Roadway
DARK-NOT-LIGHTED114 - Light Condition DRY116 - 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
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Unit Status
TREE
81 - Most Harmful Event: Collision With
EAST
23 - Dir Of Travel
4524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2018
31 - Expiration Year 34 - On Duty Accident
OLSON
25 - Operator/Pedestrian Last Name
DEBORAH
25 - First Name
J
25 - Middle Initial 25 - Suffix
11/18
32 - Date Of Birth
FEMALE
33 - Sex
26 - Address Street & Number 26 - PO Box
HAYWARD
27 - City
WI
27 - State
54843
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
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 0162 - No. of Citations Issued
346.70(1)
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
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Wisconsin Motor Vehicle GZDSGV3 1 4
VE
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
S
91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
02
22 - Total Occupants
HA7603
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2015
59 - Exp Year
9632
55 - Vehicle Identification Number
2014
50 - Year
FORD
51 - Make
F150
52 - Model
PK - PICKUP
53 - Body Style
BLK
54 - Color 100 - Skidmarks to Impact (Ft)
UNDERCARRIAGE, FRONT DRIVER SIDE, MIDDLE DRIVER SIDE, REAR DRIVER SIDE, REAR
94 - Vehicle Damage
SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
A-1 TOWING
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
OLSON
46 - Vehicle Owner Last Name
CRAIG
46 - First Name
A
46 - Middle Initial 46 - Suffix
08/20
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
AMERICAN-FAMILY-MUTUAL-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
OLSON
61 - Policy Holder Last Name
CRAIG
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
Occupant
Address Same As Operator
OC
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01
65 - Unit No
OLSON
66 - Occupant Last Name
CRAIG
66 - First Name
A
66 - Middle Initial 66 - Suffix
01
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
08/2067 - Date of Birth M69 - Sex
FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER)
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
Accident Report
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MV4000e 01/2005
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PK2012
Wisconsin Motor Vehicle
Accident Report
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MV4000e 01/2005
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PK2012
Wisconsin Motor Vehicle GZDSGV3 2 424
N - NO APPARENT INJURY
70 - Injury Severity
DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Trailer
01
TR
L
106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
Fixed Objects Struck
PR
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Property
INDIVIDUAL
Organization Type
HESSEL
84 - Property Owner Last Name
GARY
84 - First Name
A
84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
HAYWARD
86 - City
WI
86 - State
54843
86 - Zip Code
87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
TREE
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
DEPUTY MALCOLM HAAG #380
ON MARCH 28TH, 2015 AT APPROXIMATELY 0701 AM I, DEPUTY MALCOLM HAAG, WAS CONTACTED BY SAWYER COUNTY DISPATCH
FOR A CRASH THAT OCCURRED ON WILLIAMS RD. THE TOW COMPANY HAD BEEN CONTACTED BY THE DRIVER TO REMOVE THE
VEHICLE FROM THE SIDE OF THE ROADWAY. THE TOW DRIVER ALERTED DISPATCH TO THE CRASH. I ARRIVED ON SCENE AT APPROXIMATELY 0724 AM AND OBSERVED AN UNOCCUPIED ABANDONED VEHICLE. I
ON MARCH 28TH, 2015 AT APPROXIMATELY 0701 AM I, DEPUTY MALCOLM HAAG, WAS CONTACTED BY SAWYER COUNTY DISPATCH
FOR A CRASH THAT OCCURRED ON WILLIAMS RD. THE TOW COMPANY HAD BEEN CONTACTED BY THE DRIVER TO REMOVE THE
VEHICLE FROM THE SIDE OF THE ROADWAY. THE TOW DRIVER ALERTED DISPATCH TO THE CRASH. I ARRIVED ON SCENE AT APPROXIMATELY 0724 AM AND OBSERVED AN UNOCCUPIED ABANDONED VEHICLE. I
Accident Report
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZDSGV3 3 4
CONTACTED DISPATCH WITH THAT VEHICLE'S WI LTK REGISTRATION. I SPOKE TO A NEARBY OBSERVER, HE STATED THAT HE LIVED ACROSS THE ROAD FROM THE CRASH SCENE. HE STATED THAT HE HAD WOKEN UP SOMETIME BETWEEN 3 AM AND 5 AM
THAT MORNING TO THE SOUND OF A VEHICLE REVVING AND TIRES SPINNING. I OBSERVED TWO INDIVIDUALS WALKING TOWARD
THE CRASHED VEHICLE. THEY WERE IDENTIFIED AS DEBORAH AND CRAIG OLSON. DEBORAH STATED THAT SHE WAS THE
DRIVER OF THE VEHICLE AND CRAIG WAS THE PASSENGER. DEBORAH STATED THAT THEY WERE EN ROUTE BACK TO THEIR
RESIDENCE FROM A FRIENDS HOUSE AT APPROXIMATELY 0545 AM. SHE SAID THAT SHE OBSERVED TWO DEER ENTER THE
ROADWAY AND THAT SHE SWERVED TO AVOID THEM. SHE SAID THAT SHE LOST CONTROL OF THE VEHICLE AND STRUCK A TREE. SHE STATED THAT SHE WAS NOT FAMILIAR WITH THE VEHICLE AND WAS TRAVELING AT APPROXIMATELY 35 MPH. BOTH VEHICLE
OCCUPANTS SAID THAT THEY WERE WEARING THEIR SEATBELTS. THEY SAID THAT AFTER THE CRASH THEY RETURNED TO THEIR
RESIDENCE ON FOOT AND CONTACTED THE TOW COMPANY. THEY STATED THAT THEY HAD FORGOTTEN TO CONTACT LAW
ENFORCEMENT ABOUT THE CRASH. I INFORMED THEM THEY WOULD BOTH BE MAILED CITATIONS FOR FAILING TO REPORT THE
CRASH. THE TOW COMPANY REMOVED THE VEHICLE AND I CLEARED FROM THE SCENE. I CONTACTED THE LANDOWNER WHERE
THE CRASH HAD OCCURRED AND ALERTED HIM TO CRAIG AND DEBORAH OLSON'S INSURANCE.
CONTACTED DISPATCH WITH THAT VEHICLE'S WI LTK REGISTRATION. I SPOKE TO A NEARBY OBSERVER, HE STATED THAT HE LIVED ACROSS THE ROAD FROM THE CRASH SCENE. HE STATED THAT HE HAD WOKEN UP SOMETIME BETWEEN 3 AM AND 5 AM
THAT MORNING TO THE SOUND OF A VEHICLE REVVING AND TIRES SPINNING. I OBSERVED TWO INDIVIDUALS WALKING TOWARD
THE CRASHED VEHICLE. THEY WERE IDENTIFIED AS DEBORAH AND CRAIG OLSON. DEBORAH STATED THAT SHE WAS THE
DRIVER OF THE VEHICLE AND CRAIG WAS THE PASSENGER. DEBORAH STATED THAT THEY WERE EN ROUTE BACK TO THEIR
RESIDENCE FROM A FRIENDS HOUSE AT APPROXIMATELY 0545 AM. SHE SAID THAT SHE OBSERVED TWO DEER ENTER THE
ROADWAY AND THAT SHE SWERVED TO AVOID THEM. SHE SAID THAT SHE LOST CONTROL OF THE VEHICLE AND STRUCK A TREE. SHE STATED THAT SHE WAS NOT FAMILIAR WITH THE VEHICLE AND WAS TRAVELING AT APPROXIMATELY 35 MPH. BOTH VEHICLE
OCCUPANTS SAID THAT THEY WERE WEARING THEIR SEATBELTS. THEY SAID THAT AFTER THE CRASH THEY RETURNED TO THEIR
RESIDENCE ON FOOT AND CONTACTED THE TOW COMPANY. THEY STATED THAT THEY HAD FORGOTTEN TO CONTACT LAW
ENFORCEMENT ABOUT THE CRASH. I INFORMED THEM THEY WOULD BOTH BE MAILED CITATIONS FOR FAILING TO REPORT THE
CRASH. THE TOW COMPANY REMOVED THE VEHICLE AND I CLEARED FROM THE SCENE. I CONTACTED THE LANDOWNER WHERE
THE CRASH HAD OCCURRED AND ALERTED HIM TO CRAIG AND DEBORAH OLSON'S INSURANCE.
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125 - First Name 125 - Middle Initial
Officer Information
HAAG
125 - Officer Last Name
MALCOLM 380
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
03/28/2015
132 - Date Notified 0701133 - Time Notified (Military Time)0724134 - Time Arrived (Military Time)
03/30/2015
135 - Date Of Report
15032804 380 19 - Special Study
18 - Agency Space
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDSGV3 4 4