HomeMy WebLinkAbout20150503 AbeitaAgency Accident Number
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Reportable Accident On Emergency Amended GZDKSV5
DOT Document Number Document Override Number
15050306
15
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05/03/2015
4 - Accident Date
1559
5 - Time of Accident (Military Time)
01
6 - Total Units
01
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County RADISSON - 12, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
027
14 - On Hwy No.
NB
14 - On Street Name 14 - Bus/Frnt/Rmp
0.63 MI15 - Est. Distance WEST15 - Hwy. Dir
16 - Fr/At Hwy No.CRAWFORD AVE N16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.770160
12 - Latitude -91.23711913 - Longitude
GUARDRAIL END80 - 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
SHOULDER-(OTHER THAN SHOULDER WITHIN MEDIAN OR GORE)
117 - Relation To Roadway
DAYLIGHT114 - 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
1505030552379 - E M S Number
Operator/Pedestrian
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Unit Status
GUARDRAIL END
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
WI
30 - State
2015
31 - Expiration Year 34 - On Duty Accident
ABEITA
25 - Operator/Pedestrian Last Name
REBECCA
25 - First Name
A
25 - Middle Initial 25 - Suffix
11/01/
32 - Date Of Bi th
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 362 - No. of Citations Issued
343.44(1)(B)
64 - 1st Statute No.
343.18(1)
64 - 2nd Statute No.
344.62(2)
64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
NOT-APPLICABLE
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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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
5
22 - Total Occupants
488UTR
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2015
59 - Exp Year
2200
55 - Vehicle Identification Number
2006
50 - Year
PONT
51 - Make
MONTANA
52 - Model
VN - VAN
53 - Body Style
GRN
54 - Color
0100 - Skidmarks to Impact (Ft)
FRONT, FRONT PASSENGER SIDE, FRONT DRIVER SIDE
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
ABEITA
46 - Vehicle Owner Last Name
REBECCA
46 - First Name
A
46 - Middle Initial 46 - Suffix
11/01/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - 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
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FromTo
Bus Travelling to/from School Name Body Make Seating Capacity
School District Contracted With
Occupant
Address Same As Operator
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01
65 - Unit No
ABEITA
66 - Occupant Last Name 66 - First Name 66 - Middle Initial 66 - Suffix
01
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
04/04/67 - Date of Birth F69 - Sex
FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER)
71 - Seat Position
RESTRAINT-USE-UNKNOWN
72 - Safety Equipment
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B - NON-INCAPACITATING INJURY
70 - Injury Severity
DEPLOYED
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Occupant
Address Same As Operator
OC
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01
65 - Unit No
ABEITA
66 - Occupant Last Name 66 - First Name 66 - Middle Initial 66 - Suffix
02
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
07/01/
67 - Date of Birth
F
69 - Sex
SECOND-SEAT-RIGHT
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
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
Occupant
Address Same As Operator
OC
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A
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01
65 - Unit No
ABEITA
66 - Occupant Last Name 66 - First Name 66 - Middle Initial 66 - Suffix
03
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
01/06/
67 - Date of Birth
M
69 - Sex
THIRD-ROW-LEFT-SIDE-(SIDECAR: MOTORCYCLE PASSENGER)
71 - Seat Position
CHILD-SAFETY-SEAT-USED
72 - Safety Equipment
N - NO APPARENT INJURY
70 - Injury Severity
NOT APPLICABLE
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
Occupant
Address Same As Operator
OC
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01
65 - Unit No
BEAULIEU
66 - Occupant Last Name 66 - First Name
E
66 - Middle Initial 66 - Suffix
04
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
12/24/
67 - Date of Birth
M
69 - Sex
THIRD-ROW-LEFT-SIDE-(SIDECAR: MOTORCYCLE PASSENGER)
71 - Seat Position
CHILD-SAFETY-SEAT-USED
72 - Safety Equipment
N - NO APPARENT INJURY
70 - Injury Severity
NOT APPLICABLE
73 - Airbag
NOT-EJECTED
75 - Ejected
Medical Transport
77
NOT-TRAPPED
76 - Trapped/Extricated 78 - Agency Space
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Trailer
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106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
Fixed Objects Struck
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Property
GOVERNMENT
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
SAWYER COUNTY HIGHWAY DEPARTMENT84 - Company Name COUNTY/MUNICIPALGovernment Property Type
14688W COUNTY ROAD B
85 - Address Street & Number 85 - PO Box
HAYWARD86 - City WI86 - State 5484386 - Zip Code (715) 634-2691 EXT.87 - Telephone Number
0
83 - Government Damage Tag Number
01
82 - Striking Unit
GUARDRAIL-END
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 HALL #312
ON MAY 3, 2015, I, DEPUTY HALL WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT. I RESPONDED TO A ONE VEHICLE CRASH ONE MILE WEST OF RADISSON AT APPROXIMATELY 4:30 PM. AFTER ARRIVING ON SCENE I SPOKE WITH THE
OPERATOR OF THE VAN THAT STRUCK A GUARD RAIL. THE FEMALE OPERATOR SAID HER NAME WAS EMILY QUADERER. AFTER
RELEASING HER AND THE PASSENGERS FROM THE SCENE I DISCOVERED THAT THE DRIVER OF THE VAN WAS ACTUALLY
REBECCA A. ABEITA DOB-110182. I LOOKED AT A BOOKING PHOTO AND IDENTIFIED HER AS THE ACTUAL OPERATOR OF THE VAN. I
WILL BE ISSUEING REBECCA THREE CITATIONS AND FORWARDING CHARGES TO THE DISTRICT ATTORNEY FOR OBSTRUCTING.
THE CAUSE OF THE CRASH IS UNKNOWN. A PASSERBY BELIEVED IT APPEARED TO BE A VEHICLE MALFUNCTION.
ON MAY 3, 2015, I, DEPUTY HALL WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT. I RESPONDED TO A ONE VEHICLE CRASH ONE MILE WEST OF RADISSON AT APPROXIMATELY 4:30 PM. AFTER ARRIVING ON SCENE I SPOKE WITH THE
OPERATOR OF THE VAN THAT STRUCK A GUARD RAIL. THE FEMALE OPERATOR SAID HER NAME WAS EMILY QUADERER. AFTER
RELEASING HER AND THE PASSENGERS FROM THE SCENE I DISCOVERED THAT THE DRIVER OF THE VAN WAS ACTUALLY
REBECCA A. ABEITA DOB-110182. I LOOKED AT A BOOKING PHOTO AND IDENTIFIED HER AS THE ACTUAL OPERATOR OF THE VAN. I
WILL BE ISSUEING REBECCA THREE CITATIONS AND FORWARDING CHARGES TO THE DISTRICT ATTORNEY FOR OBSTRUCTING.
THE CAUSE OF THE CRASH IS UNKNOWN. A PASSERBY BELIEVED IT APPEARED TO BE A VEHICLE MALFUNCTION.
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125 - First Name 125 - Middle Initial
Officer Information
HALL
125 - Officer Last Name
IAN 312
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
05/03/2015
132 - Date Notified 1600133 - Time Notified (Military Time)1634134 - Time Arrived (Military Time)
05/13/2015
135 - Date Of Report
15050306 19 - Special Study
18 - Agency Space
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MV4000e 01/2005
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