HomeMy WebLinkAbout20150630 DahlAgency Accident Number
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Reportable Accident On Emergency Amended GZDHL64
DOT Document Number Document Override Number
15063010
15
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6
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06/30/2015
4 - Accident Date
1811
5 - Time of Accident (Military Time)
01
6 - Total Units
01
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
CHIPPEWA TRL
14 - On Street Name 14 - Bus/Frnt/Rmp
1008 FT15 - Est. Distance EAST15 - Hwy. Dir
16 - Fr/At Hwy No.WHEELER RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
46.004478
12 - Latitude -91.44265313 - Longitude
DITCH80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - Manner of Collision
NO CONTROL
112 - Access Control
CURVE
113 - Road Curvature
LEVEL/FLAT
113 - Road Terrain
BLACKTOP, BITUMINOUS, OR ASPHALT - 2
Surface Type
NOT-PHYSICALLY-DIVIDED-(2-WAY TRAFFIC)115 - Traffic Way
OFF-ROADWAY-LOCATION-UNKNOWN
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 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
3524 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State 31 - Expiration Year 34 - On Duty Accident
DAHL
25 - Operator/Pedestrian Last Name
JESSE
25 - First Name
D
25 - Middle Initial
JR
25 - Suffix
12/02/
32 - Date Of Birth
MALE
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
NON-DEPLOYED
41 - Airbag
NOT-EJECTED
42 - Ejected 44
Medical Transport
NOT-TRAPPED
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
NEGOTIATING-CURVE
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 262 - No. of Citations Issued
346.57(3)
64 - 1st Statute No.
343.05(3)(A)
64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
EXCEEDING-SPEED-LIMIT, SPEED-TOO-FAST-FOR-CONDITIONS, FAILURE-TO-HAVE-CONTROL
122 - Driver Factors
NOT OBSERVED88 - 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
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PK2012
Wisconsin Motor Vehicle GZDHL64 1 5
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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
3
22 - Total Occupants
369DXU
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year 55 - Vehicle Identification Number
1999
50 - Year
MERC
51 - Make
SABLE
52 - Model
4D - 4DR
53 - Body Style
SIL
54 - Color
84100 - Skidmarks to Impact (Ft)
TOTAL (DAMAGE TO ALL AREAS)
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
DAHL
46 - Vehicle Owner Last Name
DONNA
46 - First Name
D
46 - Middle Initial 46 - Suffix
01/01
Date Of Birth
46 - Company Name
47 - PO Box
HAYWARD48 - City WI48 - State 5484348 - Zip Code 49 - Telephone Number
WEST-BEND-MUTUAL-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60
DAHL
61 - Policy Holder Last Name
DONNA
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
DAHL
66 - Occupant Last Name
JESSE
66 - First Name
L
66 - Middle Initial
SR
66 - Suffix
01
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
02/19/67 - Date of Birth M69 - Sex
FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER)
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
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MV4000e 01/2005
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Wisconsin Motor Vehicle
Accident Report
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Wisconsin Motor Vehicle GZDHL64 2 525
C - POSSIBLE INJURY
70 - Injury Severity
NON-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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P
A
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01
65 - Unit No
BARBER
66 - Occupant Last Name
JACK
66 - First Name
S
66 - Middle Initial 66 - Suffix
02
68 - Address Street & Number 68 - PO Box
HAYWARD
68 - City
WI
68 - State
54843
68 - Zip Code
08/07
67 - Date of Birth
M
69 - Sex
SECOND-SEAT-LEFT-SIDE-(MC/BIKE PASSENGER, TRAIN BREAKMA
71 - Seat Position
SHOULDER-BELT-AND-LAP-BELT-USED
72 - Safety Equipment
N - NO APPARENT INJURY
70 - Injury Severity
NON-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
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Property
GOVERNMENT
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
TOWN OF HAYWARD
84 - Company Name
COUNTY/MUNICIPAL
Government Property Type
15460 STATE HWY 77
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
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
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105 - Photos By
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Diagram and Narrative
N. RASCHKA
ON JUNE 30, 2015 I, DEPUTY RASCHKA RESPONDED TO A ONE VEHICLE ROLLOVER ON CHIPPEWA TRAIL IN THE TOWN OF
HAYWARD JUST EAST OF WHEELER RD. I ARRIVED ON-SCENE AN OBSERVED A SILVER VEHICLE ROLLED OVER ON ITS TOP
LAYING IN THE SOUTH DITCH OF CHIPPEWA TRAIL, WEST OF 14979W CHIPPEWA TRAIL. I OBSERVED ON MALE SUBJECT SITTING
ON THE SIDE OF THE ROADWAY, LOOKING AT THE VEHICLE DRESSED IN ONLY BLUE HAWAIIAN SWIMWEAR. IT APPEARED THAT HE HAD LACERATIONS TO BOTH HIS HANDS AND FEET. I COULD DETECT A STRONG ODOR OF INTOXICANTS COMING FROM HIM. HE
VERBALLY IDENTIFIED HIMSELF AS JESSE L DAHL 02191980. I ASKED HIM IF THERE WAS ANYONE ELSE IN THE VEHICLE, HE DID
NOT RESPOND AT FIRST. I ASKED IF HE WAS OK, HE CONTINUED TO LOOK AT THE VEHICLE AS HE WAS IN SHOCK. HE THEN
STATED THAT A JACK BARBER WAS IN THE VEHICLE. MR. DAHL STATED MR. BARBER FLED THE SCENE. I ASKED MR DAHL IF HE
WAS THE OPERATOR OF THE VEHICLE, HE STATED "I WAS BUT I WASN'T" I ASKED HIM WHAT THAT MEANT, HE STATED THAT HE
WAS THE DRIVER. I ASKED HIM THEN IF HE HAD BEEN DRINKING HE STATED THAT HE HAD AND HE WAS GOING BACK TO PRISON.
SHERIFF KELSEY ARRIVED AT THAT TIME AND BEGAN SPEAKING WITH MR. DAHL. MR. DAHL TOLD SHERIFF KELSEY THAT HE DID
NOT WANT TO GET HIS SON IN TROUBLE AND WAS NOT GOING TO LET SOMETHING HAPPEN TO HIM. I ASKED MR. DAHL IF HE
COULD TELL US IF HIS SON WAS STILL IN THE VEHICLE,, HE STATED "NO I GOT HIM THE HELL OUT OF HERE" I ASKED HOW HIS SON
LEFT, HE STATED HE PUT HIM IN ANOTHER CAR AND GOT HIM OUT, HE THEN STATED HE LEFT ON FOOT WEARING A BLACK SHIRT
AND SHORTS. MR. BARBER WAS THEN LOCATED BY DEPUTY AL-MOGHRABI. MR BARBER ADVISED THAT MR. DAHL'S SON JD JR
WAS THE DRIVER OF THE VEHICLE, THAT THEY ALL HAD BEEN DRINKING AND THAT MR. DAHL ALLOWED HIS SON TO DRIVE AND
MR. DAHL SR WAS TOO INTOXICATED TO DRIVE. MR BARBER STATED THAT JD JR WAS "TRYING TO BE COOL" AND WAS GOING WAY TO FAST AROUND THE CORNER, LOST CONTROL AND CAUSED THE VEHICLE TO ROLL. SEE REPORT 15063010.
ON JUNE 30, 2015 I, DEPUTY RASCHKA RESPONDED TO A ONE VEHICLE ROLLOVER ON CHIPPEWA TRAIL IN THE TOWN OF
HAYWARD JUST EAST OF WHEELER RD. I ARRIVED ON-SCENE AN OBSERVED A SILVER VEHICLE ROLLED OVER ON ITS TOP
LAYING IN THE SOUTH DITCH OF CHIPPEWA TRAIL, WEST OF 14979W CHIPPEWA TRAIL. I OBSERVED ON MALE SUBJECT SITTING
ON THE SIDE OF THE ROADWAY, LOOKING AT THE VEHICLE DRESSED IN ONLY BLUE HAWAIIAN SWIMWEAR. IT APPEARED THAT HE HAD LACERATIONS TO BOTH HIS HANDS AND FEET. I COULD DETECT A STRONG ODOR OF INTOXICANTS COMING FROM HIM. HE
VERBALLY IDENTIFIED HIMSELF AS JESSE L DAHL 02191980. I ASKED HIM IF THERE WAS ANYONE ELSE IN THE VEHICLE, HE DID
NOT RESPOND AT FIRST. I ASKED IF HE WAS OK, HE CONTINUED TO LOOK AT THE VEHICLE AS HE WAS IN SHOCK. HE THEN
STATED THAT A JACK BARBER WAS IN THE VEHICLE. MR. DAHL STATED MR. BARBER FLED THE SCENE. I ASKED MR DAHL IF HE
WAS THE OPERATOR OF THE VEHICLE, HE STATED "I WAS BUT I WASN'T" I ASKED HIM WHAT THAT MEANT, HE STATED THAT HE
WAS THE DRIVER. I ASKED HIM THEN IF HE HAD BEEN DRINKING HE STATED THAT HE HAD AND HE WAS GOING BACK TO PRISON.
SHERIFF KELSEY ARRIVED AT THAT TIME AND BEGAN SPEAKING WITH MR. DAHL. MR. DAHL TOLD SHERIFF KELSEY THAT HE DID
NOT WANT TO GET HIS SON IN TROUBLE AND WAS NOT GOING TO LET SOMETHING HAPPEN TO HIM. I ASKED MR. DAHL IF HE
COULD TELL US IF HIS SON WAS STILL IN THE VEHICLE,, HE STATED "NO I GOT HIM THE HELL OUT OF HERE" I ASKED HOW HIS SON
LEFT, HE STATED HE PUT HIM IN ANOTHER CAR AND GOT HIM OUT, HE THEN STATED HE LEFT ON FOOT WEARING A BLACK SHIRT
AND SHORTS. MR. BARBER WAS THEN LOCATED BY DEPUTY AL-MOGHRABI. MR BARBER ADVISED THAT MR. DAHL'S SON JD JR
WAS THE DRIVER OF THE VEHICLE, THAT THEY ALL HAD BEEN DRINKING AND THAT MR. DAHL ALLOWED HIS SON TO DRIVE AND
MR. DAHL SR WAS TOO INTOXICATED TO DRIVE. MR BARBER STATED THAT JD JR WAS "TRYING TO BE COOL" AND WAS GOING WAY TO FAST AROUND THE CORNER, LOST CONTROL AND CAUSED THE VEHICLE TO ROLL. SEE REPORT 15063010.
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Witness
ROTHGEB107 - Witness Last Name ETHAN107 - First Name D107 - Middle Initial
01
108 - Address Streeet & Number 108 - PO Box
11/18/
109 - Date of Birth
HAYWARD110 - City WIState 54843110 - Zip Code (111 - Telephone Number
Officer Information
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125 - First Name 125 - Middle Initial
RASCHKA
125 - Officer Last Name
NICOLE 388
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
06/30/2015
132 - Date Notified 1811133 - Time Notified (Military Time)1815134 - Time Arrived (Military Time)
06/30/2015
135 - Date Of Report
15063010 19 - Special Study
18 - Agency Space
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZDHL64 5 5