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HomeMy WebLinkAbout20150503 AbeitaAgency 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 GZDKSV5 DOT Document Number Document Override Number 15050306 15 0 5 0 3 0 6 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 OP E R A T O R / P E D E S T R I A N 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDKSV5 1 5 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 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 S FromTo Bus Travelling to/from School Name Body Make Seating Capacity School District Contracted With Occupant Address Same As Operator OC C U P A N T 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDKSV5 2 525 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 C U P A N T 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 C U P A N T 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 C U P A N T 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDKSV5 3 5 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 O P E R T Y O W N E R 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 DI A G R A M A N D N A R R A T I V E 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. Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDKSV5 4 5 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 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDKSV5 5 5