HomeMy WebLinkAbout20150902 WinklerAgency Accident Number
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Reportable Accident On Emergency Amended GZDWFQX
DOT Document Number Document Override Number
15090203
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9
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09/02/2015
4 - Accident Date
0951
5 - Time of Accident (Military Time)
01
6 - Total Units 7 - Total Injured
01
8 - Total Killed
SAWYER - 572 - County HUNTER - 07, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
RIVER RD
14 - On Street Name 14 - Bus/Frnt/Rmp
361 FT15 - Est. Distance SOUTH15 - Hwy. Dir
16 - Fr/At Hwy No.FIORELLI RD16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.955583
12 - Latitude -91.14753313 - Longitude
TREE80 - 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
OUTSIDE-SHOULDER-RIGHT
117 - Relation To Roadway
UNKNOWN114 - Light Condition WET116 - Road Surface Condition RAIN118 - 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
SOUTH
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
IL
30 - State
2019
31 - Expiration Year 34 - On Duty Accident
WINKLER
25 - Operator/Pedestrian Last Name
DARTH
25 - First Name
MICHAEL
25 - Middle Initial 25 - Suffix
04/04/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
LEWISTOWN
27 - City
IL
27 - State
61542
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
K - FATAL 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 62 - No. of Citations Issued
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
NOT OBSERVED88 - Driver or Pedestrian Cond UNKNOWN
89 - Substance Presence
TEST GIVEN, ALCOHOL UNKNOWN90 - Alcohol Test 90 - Alcohol Content TEST GIVEN DRUGS UNKNOWN91 - Drug Test
01
Accident Report
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MV4000e 01/2005
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PK2012
Wisconsin Motor Vehicle GZDWFQX 1 4
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
SNOW,-ICE,-OR-WET
124 - Highway Factors
TRUCK
21 - Unit Type
PICKUP/UTILITY-TRUCK
Vehicle Type
1
22 - Total Occupants
92484TB
56 - License Plate Number
LTK57 - Plate Type IL
58 - State
2015
59 - Exp Year
4476
55 - Vehicle Identification Number
2001
50 - Year
CHEV
51 - Make
S10
52 - Model
PK - PICKUP
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
WINKLER
46 - Vehicle Owner Last Name
DARREN
46 - First Name
MICHAEL
46 - Middle Initial 46 - Suffix Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
LEWISTOWN48 - City IL48 - State 6154248 - Zip Code 49 - Telephone Number
COUNTRY-CASUALTY-INSURANCE-CO63 - Liability Insurance Company Policy Holder Same As Owner60
WINKLER
61 - Policy Holder Last Name
DARREN
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
Trailer
01
TR
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106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
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Wisconsin Motor Vehicle
Accident Report
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Wisconsin Motor Vehicle GZDWFQX 2 424
Fixed Objects Struck
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Property
UNKNOWN
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
86 - City 86 - State 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 JAY POPLIN
UNIT ONE WAS SOUTHBOUND ON RIVER ROAD AND NEGOTIATING A LEFT HAND CURVE. IT LEFT THE ROAD ON THE RIGHT AND
TRAVELED ON THE SHOULDER BEFORE COMING BACK ONTO THE ROADWAY WHERE IT SPUN AROUND AND AGAIN LEFT THE
ROADWAY TO THE RIGHT, SLIDING SIDEWAYS WITH IT'S LEFT SIDE STRIKING AND BREAKING OFF TREES AND ROLLING ONTO IT'S
LEFT SIDE AND STRIKING MORE TREES BEFORE COMING TO A STOP.
UNIT ONE WAS SOUTHBOUND ON RIVER ROAD AND NEGOTIATING A LEFT HAND CURVE. IT LEFT THE ROAD ON THE RIGHT AND
TRAVELED ON THE SHOULDER BEFORE COMING BACK ONTO THE ROADWAY WHERE IT SPUN AROUND AND AGAIN LEFT THE
ROADWAY TO THE RIGHT, SLIDING SIDEWAYS WITH IT'S LEFT SIDE STRIKING AND BREAKING OFF TREES AND ROLLING ONTO IT'S
LEFT SIDE AND STRIKING MORE TREES BEFORE COMING TO A STOP.
Officer Information
Accident Report
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Wisconsin Motor Vehicle GZDWFQX 3 4
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125 - First Name 125 - Middle Initial
CAIN
125 - Officer Last Name
JEFF 314
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
09/02/2015
132 - Date Notified 0951133 - Time Notified (Military Time)1017134 - Time Arrived (Military Time)
09/07/2015
135 - Date Of Report
15090203 19 - Special Study
18 - Agency Space
Accident Report
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Wisconsin Motor Vehicle GZDWFQX 4 4