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Home My WebLink About20150918 Martin ThompsonAgency 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 GZDFCJ1 DOT Document Number Document Override Number 15091813432 15 0 9 1 8 1 3 4 3 2 15091805 15 0 9 1 8 0 5 09/18/2015 4 - Accident Date 1244 5 - Time of Accident (Military Time) 02 6 - Total Units 02 7 - Total Injured 00 8 - Total Killed SAWYER - 572 - County HAYWARD - 06, TOWN3 - Municipality INTERSECTION11 - Accident Location B 14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp 15 - Est. Distance 15 - Hwy. Dir K16 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp 17 - Structure Type 17 - Structure Number 45.997169 12 - Latitude -91.38383613 - Longitude MOTOR VEHICLE IN TRANSPORT80 - First Harmful Event HEAD ON93 - 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 ON-ROADWAY 117 - Relation To Roadway DAYLIGHT114 - Light Condition DRY116 - Road Surface Condition CLOUDY118 - 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 EAST 23 - Dir Of Travel 4524 - Speed Limit D CLASS 36 - Operating as Classified 37 - Endorsements 35 Operating Commercial Motor Vehicle 29 - Driver's License Number WI 30 - State 2018 31 - Expiration Year 34 - On Duty Accident MARTIN 25 - Operator/Pedestrian Last Name BRADLEY 25 - First Name S 25 - Middle Initial 25 - Suffix 05/08/ 32 - Date Of Birth MALE 33 - Sex 26 - Address Street & Number 26 - PO Box TOMAH 27 - City WI 27 - State 54660 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 C - POSSIBLE 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 TRAFFIC-SIGNAL-OPERATING 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 01 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDFCJ1 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 TRUCK 21 - Unit Type PICKUP/UTILITY-TRUCK Vehicle Type 2 22 - Total Occupants HS7153 56 - License Plate Number LTK57 - Plate Type WI 58 - State 2015 59 - Exp Year 9217 55 - Vehicle Identification Number 2011 50 - Year FORD 51 - Make F250 52 - Model PK - PICKUP 53 - Body Style DGR 54 - Color 0100 - Skidmarks to Impact (Ft) FRONT, FRONT DRIVER SIDE, FRONT PASSENGER SIDE 94 - Vehicle Damage VERY-SEVERE 95 - Extent Of Damage Vehicle Towed Due To Damage 96 A-1 TOWING 97 - Vehicle Removed By NOT-APPLICABLE 123 - Vehicle Factors 45 Vehicle Owner Same As Operator MARTIN 46 - Vehicle Owner Last Name BRADLEY 46 - First Name S 46 - Middle Initial 46 - Suffix 05/08 Date Of Birth 46 - Company Name 47 - PO Box TOMAH48 - City WI48 - State 5466048 - 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 Operator/Pedestrian Unit Status MOTOR VEHICLE IN TRANSPORT 81 - Most Harmful Event: Collision With WEST 23 - Dir Of Travel 4524 - Speed Limit C CLASS 36 - Operating as Classified 37 - Endorsements 35 Operating Commercial Motor Vehicle 29 - Driver's License Number WI 30 - State 2021 31 - Expiration Year 34 - On Duty Accident THOMPSON 25 - Operator/Pedestrian Last Name TREVOR 25 - First Name DEAN 25 - Middle Initial 25 - Suffix 11/21/ 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 GZDFCJ1 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 TREGO 27 - City WI 27 - State 54888 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 MAKING-LEFT-TURN 119 - What Driver Was Doing TRAFFIC-SIGNAL-OPERATING 120 - Traffic Control 162 - No. of Citations Issued 346.18(3) 64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No. FAIL-TO-YIELD-RIGHT-OF-WAY 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 TRUCK 21 - Unit Type PICKUP/UTILITY-TRUCK Vehicle Type 1 22 - Total Occupants RB19327 56 - License Plate Number HTK57 - Plate Type WI 58 - State 2015 59 - Exp Year 0043 55 - Vehicle Identification Number 1995 50 - Year FORD 51 - Make C-9000 52 - Model CB - CAB CHASSIS 53 - Body Style YEL 54 - Color 0100 - Skidmarks to Impact (Ft) FRONT PASSENGER SIDE, UNKNOWN 94 - Vehicle Damage MODERATE 95 - Extent Of Damage Vehicle Towed Due To Damage 96 WATTS ENTERPRISE 97 - Vehicle Removed By NOT-APPLICABLE 123 - Vehicle Factors 45 Vehicle Owner Same As Operator 46 - Vehicle Owner Last Name 46 - First Name 46 - Middle Initial 46 - Suffix Date Of Birth STATEWIDE SURFACING46 - Company Name 47- Address Street & Number 47 - PO Box 48 - City 48 - State 48 - 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 02 02 02 02 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDFCJ1 3 5 School Bus 02 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 MARTIN 66 - Occupant Last Name GEORGETTE 66 - First Name C 66 - Middle Initial 66 - Suffix 01 68 - Address Street & Number 68 - PO Box TOMAH 68 - City WI 68 - State 54660 68 - Zip Code 03/06 67 - Date of Birth F 69 - Sex FRONT-SEAT-RIGHT-SIDE-(TRAIN ENGINEER) 71 - Seat Position SHOULDER-BELT-AND-LAP-BELT-USED 72 - Safety Equipment C - POSSIBLE INJURY 70 - Injury Severity 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 105 - Photos By DI A G R A M A N D N A R R A T I V E Diagram and Narrative CRAIG DEPEW ON SEPTEMBER 18, 2015, I, DEPUTY RYAN SCHICK WAS DISPATCHED TO RESPOND TO COUNTY ROAD K AND COUNTY ROAD B FOR A 2 VEHICLE HEAD ON COLLISION. UPON ARRIVAL, I WITNESS A YELLOW DUMP TRUCK FACING SOUTH IN THE INTERSECTION AND ALSO A PICKUP TRUCK FACING SOUTH IN THE INTERSECTION WITH SEVERE DAMAGED. AFTER ON SEPTEMBER 18, 2015, I, DEPUTY RYAN SCHICK WAS DISPATCHED TO RESPOND TO COUNTY ROAD K AND COUNTY ROAD B FOR A 2 VEHICLE HEAD ON COLLISION. UPON ARRIVAL, I WITNESS A YELLOW DUMP TRUCK FACING SOUTH IN THE INTERSECTION AND ALSO A PICKUP TRUCK FACING SOUTH IN THE INTERSECTION WITH SEVERE DAMAGED. AFTER Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDFCJ1 4 5 TALKING TO THE DRIVER OF THE DUMP TRUCK, TREVOR THOMPSON, HE STATED THAT HE HAD A GREEN LIGHT AND DIDNT THINK ANY VEHICLES WERE APPROACHING HIM EAST ON COUNTY ROAD B, SO HE TURN SOUTH ONTO COUNTY ROAD K AFTER TRAVELING WEST ON COUNTY ROAD B, FAILING TO YIELD THE RIGHT OF WAY, WHERE A PICKUP TRUCK THEN HIT MR. THOMPSON HEAD ON IN THE MIDDLE OF THE INTERSECTION OF COUNTY ROAD K AND COUNTY ROAD B. TALKING TO THE DRIVER OF THE DUMP TRUCK, TREVOR THOMPSON, HE STATED THAT HE HAD A GREEN LIGHT AND DIDNT THINK ANY VEHICLES WERE APPROACHING HIM EAST ON COUNTY ROAD B, SO HE TURN SOUTH ONTO COUNTY ROAD K AFTER TRAVELING WEST ON COUNTY ROAD B, FAILING TO YIELD THE RIGHT OF WAY, WHERE A PICKUP TRUCK THEN HIT MR. THOMPSON HEAD ON IN THE MIDDLE OF THE INTERSECTION OF COUNTY ROAD K AND COUNTY ROAD B. 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 SCHICK125 - Officer Last Name RYAN 351131 - Officer ID 129 - Law Enforcement Agency No. SAWYER COUNTY SHERIFFS DEPT 130 - Law Enforcement Agency Name 15880 EAST FIFTH STREET126 - Law Enforcement Agency Address Street & Number HAYWARD 127 - City WI 127 - State 54843 127 - Zip Code (715) 634-4858 EXT. 128 - Telephone Number 09/18/2015132 - Date Notified 1244133 - Time Notified (Military Time)1248134 - Time Arrived (Military Time)09/20/2015135 - Date Of Report 15091813432 15091805 19 - Special Study 18 - Agency Space 136 136 136 136 136 Truck and Bus A truck or truck combination > 10,000 lbs GVWR/GCWR Any vehicle displaying a hazardous materials placard 02 TR U C K / B U S A vehicle designed to carry 9 or more people, including the driver 136 Fatal Injury Medical Transport One or more vehicles towed from the scene due to disabling damage 02 Unit Number 137 - Hazardous Materials Class Numbers 137 - Hazardous Materials "UN" Nos. HazMat Placard Displayed Hazardous Cargo Was Released 137 - Name Of Hazardous Materials in this Load 137 - Name Of Hazardous Materials Released Interstate Carrier 138 1484710 140 - US DOT No.140 - ICC MC No.LC No.IC No. VEHICLE-SIDE 141 - Source STATEWIDE SURFACING AND CONSTRUCTION 139 - Carrier Name W2478 HIGHWAY 63 142 - Carrier Address SPRINGBROOK City WI State 54875 Zip Code 143 - GVWR (Lbs) 4 144 - Total No. of Axles SINGLE-UNIT-TRUCK-3-OR-MORE-AXLES 145 - Vehicle Configuration DUMP 147 - Cargo Body Type COLLISION-INVOLVING-MOTOR-VEHICLE-IN-TRANSPOR 146 - First Event BLANK 146 - Second Event BLANK 146 - Third Event BLANK 146 - Fourth Event Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDFCJ1 5 5