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Home My WebLink About20150813 Goss CodyAgency 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 GZDHL67 DOT Document Number Document Override Number 15081303 15 0 8 1 3 0 3 08/13/2015 4 - Accident Date 1453 5 - Time of Accident (Military Time) 02 6 - Total Units 00 7 - Total Injured 00 8 - Total Killed SAWYER - 572 - County COUDERAY - 51, VILLAGE3 - Municipality NON-INTERSECTION11 - Accident Location 027 14 - On Hwy No. SB 14 - On Street Name 14 - Bus/Frnt/Rmp 500 FT15 - Est. Distance NORTH15 - Hwy. Dir 16 - Fr/At Hwy No.SHEPTIC RD16 - From/At Street Name 16 - Business/Frontage/Ramp 17 - Structure Type 17 - Structure Number 45.796231 12 - Latitude -91.29133913 - Longitude DITCH80 - First Harmful Event SIDESWIPE. OPPOSITE DIRECTION93 - 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 ON-ROADWAY 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 OP E R A T O R / P E D E S T R I A N Unit Status MOTOR VEHICLE IN TRANSPORT 81 - Most Harmful Event: Collision With SOUTH 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 2023 31 - Expiration Year 34 - On Duty Accident GOSS 25 - Operator/Pedestrian Last Name TIFFANY 25 - First Name JEAN 25 - Middle Initial 25 - Suffix 07/15/ 32 - Date Of Birth FEMALE 33 - Sex 26 - Address Street & Number 26 - PO Box RICE LAKE 27 - City WI 27 - State 54868 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 OVERTAKING-ON-LEFT 119 - What Driver Was Doing NO-CONTROL 120 - Traffic Control 362 - No. of Citations Issued 341.04(1) 64 - 1st Statute No. 346.05(1) 64 - 2nd Statute No. 346.57(2) 64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No. EXCEEDING-SPEED-LIMIT, INATTENTIVE-DRIVING, LEFT-OF-CENTER, FAILURE-TO-HAVE-CONTROL, DRIVER- CONDITION 122 - Driver Factors REDUCED ALERTNESS88 - Driver or Pedestrian Cond UNKNOWN 89 - Substance Presence TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST REFUSED91 - Drug Test 01 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL67 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 1 22 - Total Occupants 586WMP 56 - License Plate Number AUT57 - Plate Type WI 58 - State 2015 59 - Exp Year 8613 55 - Vehicle Identification Number 1999 50 - Year MERC 51 - Make COUGAR 52 - Model 2H - HATCHBACK 2 53 - Body Style RED 54 - Color 100 - Skidmarks to Impact (Ft) TOTAL (DAMAGE TO ALL AREAS) 94 - Vehicle Damage VERY-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 GOSS 46 - Vehicle Owner Last Name TIFFANY 46 - First Name JEAN 46 - Middle Initial 46 - Suffix 07/15/ Date Of Birth 46 - Company Name 47- Address Street & Number 47 - PO Box RICE LAKE48 - City WI48 - State 5486848 - Zip Code .49 - Telephone Number PROGRESSIVE-CLASSIC-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60 GOSS 61 - Policy Holder Last Name TIFFANY 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 Operator/Pedestrian Unit Status MOTOR VEHICLE IN TRANSPORT 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 9512 29 - Driver's License Number WI 30 - State 2020 31 - Expiration Year 34 - On Duty Accident CODY 25 - Operator/Pedestrian Last Name BRUCE 25 - First Name ALLEN 25 - Middle Initial 25 - Suffix 03/15 32 - Date Of Birth MALE 33 - Sex Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL67 2 525 VE H I C L E VE H O W N E R Vehicle Vehicle Owner Insurance OP E R A T O R / P E D E S T R I A N IN S 26 - Address Street & Number 26 - PO Box COUDERAY 27 - City WI 27 - State 54828 27 - Zip Code 28 - Telephone Number FRONT-SEAT-LEFT-SIDE-(MC/BIKE DRIVER, TRAIN CONDUCTOR) 39 - Seat Position NONE-USED-VEHICLE-DRIVER/OCCUPANT 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 062 - No. of Citations Issued 64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No. NOT-APPLICABLE 122 - Driver Factors APPEARED NORMAL88 - Driver or Pedestrian Cond NEITHER-ALCOHOL-NOR-DRUGS-PRESENT 89 - Substance Presence TEST NOT GIVEN90 - Alcohol Test 90 - Alcohol Content TEST NOT GIVEN91 - Drug Test 91 - Drugs Reported NOT-APPLICABLE 124 - Highway Factors AUTOMOBILE 21 - Unit Type PASSENGER-CAR Vehicle Type 1 22 - Total Occupants 377TXM 56 - License Plate Number AUT57 - Plate Type WI 58 - State 2016 59 - Exp Year 9954 55 - Vehicle Identification Number 2003 50 - Year CHEV 51 - Make IMPALA 52 - Model 4D - 4DR 53 - Body Style SIL 54 - Color 100 - Skidmarks to Impact (Ft) TOTAL (DAMAGE TO ALL AREAS) 94 - Vehicle Damage VERY-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 CODY 46 - Vehicle Owner Last Name BRUCE 46 - First Name ALLEN 46 - Middle Initial 46 - Suffix 03/15/ Date Of Birth 46 - Company Name 47- Address Street & Number 47 - PO Box COUDERAY48 - City WI48 - State 5482848 - Zip Code (715) 945-2983 EXT.49 - Telephone Number PEKIN-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60 CODY 61 - Policy Holder Last Name BRUCE 61 - Policy Holder First Name 61 - Policy Holder Company 02 02 02 02 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL67 3 5 School Bus 02 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 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 TOWNSHIP OF COUDERAY 84 - Company Name COUNTY/MUNICIPAL Government Property Type 85 - Address Street & Number 85 - PO Box COUDERAY 86 - City WI 86 - State 54828 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 DI A G R A M A N D N A R R A T I V E Diagram and Narrative ON AUGUST 13, 2015 AT APPROXIMATE 2:56 PM I, DEPUTY RASCHKA WAS CHECKING ON-DUTY FOR THE SAWYER COUNTY SHERIFF DEPARTMENT WHEN I HEARD OF A CRASH ON STH 27 JUST OUTSIDE OF COUDERAY. I WENT EN-ROUTE AT THAT TIME ARRIVING A FEW MINUTES LATER. I ARRIVED ON-SCENE AND OBSERVED SEVERAL VEHICLES ON AUGUST 13, 2015 AT APPROXIMATE 2:56 PM I, DEPUTY RASCHKA WAS CHECKING ON-DUTY FOR THE SAWYER COUNTY SHERIFF DEPARTMENT WHEN I HEARD OF A CRASH ON STH 27 JUST OUTSIDE OF COUDERAY. I WENT EN-ROUTE AT THAT TIME ARRIVING A FEW MINUTES LATER. I ARRIVED ON-SCENE AND OBSERVED SEVERAL VEHICLES Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL67 4 5 PARKED IN THE ROADWAY, ALONG WITH A SILVER CHEVY IMPALA WHICH WAS IN THE SOUTH DITCH FACING NORT AND A RED SMALLER VEHICLE WHICH WAS FACING EASTBOUND, ALSO IN THE SOUTH DITCH. I OBSERVED THAT THERE APPEARED TO BE PIECES OF THE RED VEHICLE IN THE NORTH DITCH, NEAR THE ENTRANCE TO THE HISTORICAL MARKER PARK, JUST WEST OF THE BRIDGE ON STH 27. THERE WAS ALSO ONE TIRE, AND WHAT APPEARED TO BE THE HOOD OF THE RED VEHICLE ON THAT SIDE AS WELL. THERE WAS A MALE SUBJECT NEAR THE SILVER IMPALA, LATER IDENTIFIED AS BRUCE A. CODY HE STATED HE WAS WB FROM RADISSON WHEN HE OBSERVED THE RED VEHICLE IN HIS LANE OF TRAVEL, TRAVELING FOR A BIT ON THE SHOULDER AND THEN IN HIS DIRECT LANE. HE STATED HE SWERVED TO AVOID THE RED VEHICLE, WHICH WAS TRAVELING AT A HIGH RATE OF SPEED, WHEN THE RED VEHICLE SWERVED BACK INTO THE EASTBOUND LANE, HITTING THE PASSENGER SIDE OF HIS VEHICLE, CAUSING HIM TO ROLL TWICE AND COME TO A STOP. HE ADVISED HE WAS DRIVING AT APPROXIMATE 50-55 MPH, AS HE WAS ABOUT TO ENTER THE 45 MPH ZONE, IN COUDERAY. I THEN MET WITH A FEMALE WHO WAS STANDING NEAR THE RED CAR, WITH SEVERAL INDIVIDUALS AROUND HER, ASSISTING HER. SHE STATED SHE WAS THE DRIVER OF THE RED VEHICLE, AND THAT SHE WAS NOT INJURED, HOWEVER HER HEAD HURT. I RADIOED FOR AN AMUBLANCE AT THAT TIME, TO GET HER CHECKED OUT. SHE STATED THAT THE LAST THING SHE REMEMBERS IS THAT SHE WAS EASTBOUND ON STH 27, SHE STATED SHE TRAVELS THE ROAD FREQUENTLY. SHE STATED SHE MAY HAVE FALLEN ASLEEP AND REMEMBERS SWERVING AND CRASHING INTO MR. CODY. SHE STATED SHE DID NOT BELIEVE SHE WAS GOING VERY FAST. FULL REPORT #15081303 PARKED IN THE ROADWAY, ALONG WITH A SILVER CHEVY IMPALA WHICH WAS IN THE SOUTH DITCH FACING NORT AND A RED SMALLER VEHICLE WHICH WAS FACING EASTBOUND, ALSO IN THE SOUTH DITCH. I OBSERVED THAT THERE APPEARED TO BE PIECES OF THE RED VEHICLE IN THE NORTH DITCH, NEAR THE ENTRANCE TO THE HISTORICAL MARKER PARK, JUST WEST OF THE BRIDGE ON STH 27. THERE WAS ALSO ONE TIRE, AND WHAT APPEARED TO BE THE HOOD OF THE RED VEHICLE ON THAT SIDE AS WELL. THERE WAS A MALE SUBJECT NEAR THE SILVER IMPALA, LATER IDENTIFIED AS BRUCE A. CODY HE STATED HE WAS WB FROM RADISSON WHEN HE OBSERVED THE RED VEHICLE IN HIS LANE OF TRAVEL, TRAVELING FOR A BIT ON THE SHOULDER AND THEN IN HIS DIRECT LANE. HE STATED HE SWERVED TO AVOID THE RED VEHICLE, WHICH WAS TRAVELING AT A HIGH RATE OF SPEED, WHEN THE RED VEHICLE SWERVED BACK INTO THE EASTBOUND LANE, HITTING THE PASSENGER SIDE OF HIS VEHICLE, CAUSING HIM TO ROLL TWICE AND COME TO A STOP. HE ADVISED HE WAS DRIVING AT APPROXIMATE 50-55 MPH, AS HE WAS ABOUT TO ENTER THE 45 MPH ZONE, IN COUDERAY. I THEN MET WITH A FEMALE WHO WAS STANDING NEAR THE RED CAR, WITH SEVERAL INDIVIDUALS AROUND HER, ASSISTING HER. SHE STATED SHE WAS THE DRIVER OF THE RED VEHICLE, AND THAT SHE WAS NOT INJURED, HOWEVER HER HEAD HURT. I RADIOED FOR AN AMUBLANCE AT THAT TIME, TO GET HER CHECKED OUT. SHE STATED THAT THE LAST THING SHE REMEMBERS IS THAT SHE WAS EASTBOUND ON STH 27, SHE STATED SHE TRAVELS THE ROAD FREQUENTLY. SHE STATED SHE MAY HAVE FALLEN ASLEEP AND REMEMBERS SWERVING AND CRASHING INTO MR. CODY. SHE STATED SHE DID NOT BELIEVE SHE WAS GOING VERY FAST. FULL REPORT #15081303 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 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 08/13/2015 132 - Date Notified 1453133 - Time Notified (Military Time)1458134 - Time Arrived (Military Time) 08/13/2015 135 - Date Of Report 15081303 19 - Special Study 18 - Agency Space Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL67 5 5