HomeMy WebLinkAbout20151019 NortonAgency 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 GZDLK2Z
DOT Document Number Document Override Number
15101909
15
1
0
1
9
0
9
15101909
15
1
0
1
9
0
9
10/19/2015
4 - Accident Date
1515
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County ROUND LAKE - 13, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
MORGAN RD
14 - On Street Name 14 - Bus/Frnt/Rmp
721 FT15 - Est. Distance NORTH15 - Hwy. Dir
07716 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
46.067423
12 - Latitude -91.16542813 - 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
OUTSIDE-SHOULDER-RIGHT
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
DITCH
81 - Most Harmful Event: Collision With
NORTH
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
MN
30 - State
2018
31 - Expiration Year 34 - On Duty Accident
NORTON
25 - Operator/Pedestrian Last Name
GREGORY
25 - First Name
BRIAN
25 - Middle Initial 25 - Suffix
05/20/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number 26 - PO Box
DULUTH
27 - City
MN
27 - State
55808
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
NOT APPLICABLE
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 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.
FAILURE-TO-HAVE-CONTROL
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 GZDLK2Z 1 4
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
1
22 - Total Occupants
YBJ7849
56 - License Plate Number
LTK57 - Plate Type MN
58 - State
2016
59 - Exp Year
3508
55 - Vehicle Identification Number
1999
50 - Year
FRHT
51 - Make
ICCHA
52 - Model
VN - VAN
53 - Body Style
WHI
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT, FRONT PASSENGER SIDE, MIDDLE PASSENGER SIDE, REAR PASSENGER SIDE, REAR, FRONT DRIVER
SIDE, UNDERCARRIAGE
94 - Vehicle Damage
SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
ROY'S ENTERPRISES
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
SPEE DEE DELIVERY SERVICE INC46 - Company Name
47- Address Street & Number 47 - PO Box
DULUTH48 - City MN48 - State 5580848 - Zip Code 49 - Telephone Number
APOLLO63 - Liability Insurance Company Policy Holder Same As Owner60
61 - Policy Holder Last Name 61 - Policy Holder First Name
SPEE DEE DELIVERY SERVICE INC61 - Policy Holder Company
01
01
01
01
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
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDLK2Z 2 424
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
TOWN OF SPIDER LAKE
84 - Company Name
COUNTY/MUNICIPAL
Government Property Type
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
Fixed Objects Struck
PR
O
P
E
R
T
Y
O
W
N
E
R
Property
ORGANIZATION
Organization Type 84 - Property Owner Last Name 84 - First Name 84 - Middle Initial 84 - Suffix
02
JUMP RIVER ELECTRIC CO-OP84 - Company Name Government Property Type
13895W CTH B
85 - Address Street & Number 85 - PO Box
HAYWARD86 - City WI86 - State 5484386 - Zip Code (715) 634-4575 EXT.87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
UTILITY-POLE
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
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDLK2Z 3 4
105 - Photos By
DI
A
G
R
A
M
A
N
D
N
A
R
R
A
T
I
V
E
Diagram and Narrative
SGT NICK ALMOGHRABI
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO A ONE VEHICLE PROPERTY DAMAGE ROLLOVER ON MORGAN ROAD IN THE
TOWNSHIP OF SPIDER LAKE ON 10/19/15 AT 15:31. UPON MY ARRIVAL 2/10 MILE NORTH OF STH 77 ON MORGAN ROAD, I OBSERVED
A SPEE-DEE DELIVERY TRUCK ROLLED OVER ON THE PASSENGER SIDE IN THE EAST DITCH DOWN AN EMBANKMENT. UPON
CHECKING THE CAB BY CRAWLING ONTO THE DRIVER'S SIDE OF THE VAN, I DID NOT LOCATE ANYONE. I WAS ADVISED SOON AFTER THAT THE OPERATOR HAD GOTTEN A RIDE AND A TOW SERVICE WAS BRINGING HIM TO THE SCENE. WHILE WAITING FOR
THE OPERATOR TO ARRIVE, I OBSERVED WHERE THE VEHICLE TRACKS ENTERED THE EAST SHOULDER LEADING TO THE DITCH.
THERE WAS A THIN TIRE MARK ON THE ROADWAY FROM THE DRIVER'S SIDE FRONT TIRE LEADING ME TO BELIEVE THE
OPERATOR HAD TAKEN THE CORNER TOO FAST. I ALSO OBSERVED WHERE THE PASSENGER SIDE OF THE TRUCK STRUCK A
JUMP RIVER ELECTRIC POLE CAUSING MINOR DAMAGE TO IT. UPON THE ARRIVAL OF THE OPERATOR, IDENTIFIED AS GREGORY
NORTON OF DULUTH, HE ADVISED HE THE TRUCK WAS NEAR EMPTY AND WAS NOT HAULING ANY HAZARDOUS MATERIALS. WHEN
ASKED, I WAS TOLD THERE WAS 1/2 TANK OF FUEL IN A 22 GALLON TANK. I DID NOT OBSERVE ANY FUEL LEAKAGE. NORTON TOLD
ME THAT HE HAS BRONCHITIS AND HAD A COUGHING ATTACK WHILE NEGOTIATING THE CORNER AT WHAT HE ESTIMATED WAS 30
MPH. NORTON STATED ONCE HE LEFT THE ROADWAY HE TRIED TO CORRECT THE TRUCK BUT KEPT GETTING PULLED FURTHER
OFF THE ROAD DOWN INTO THE DITCH. I HAD OBSERVED A LARGE BOULDER THE VEHICLE STRUCK IN THE EMBANKMENT WHICH
WAS BELIEVED TO BE THE CAUSE OF ROLLING ONTO THE PASSENGER SIDE. NORTON ADDED THAT THE TRUCK HAS A MANUAL
TRANSMISSION AND THAT HE DOESN'T USUALLY DRIVE A CLUTCH. DUE TO THE TRUCK BEING APPROXIMATELY 15 FEET OFF THE
ROADWAY AND 15 FEET DOWN AN EMBANKMENT, A MEDIUM DUTY WRECKER WAS CALLED TO REMOVE IT. FROM THE TIME NORTON EXITED THE ROADWAY, HE TRAVELED 145 FEET BEFORE COMING TO A REST. NO INJURIES WERE SUSTAINED.
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO A ONE VEHICLE PROPERTY DAMAGE ROLLOVER ON MORGAN ROAD IN THE
TOWNSHIP OF SPIDER LAKE ON 10/19/15 AT 15:31. UPON MY ARRIVAL 2/10 MILE NORTH OF STH 77 ON MORGAN ROAD, I OBSERVED
A SPEE-DEE DELIVERY TRUCK ROLLED OVER ON THE PASSENGER SIDE IN THE EAST DITCH DOWN AN EMBANKMENT. UPON
CHECKING THE CAB BY CRAWLING ONTO THE DRIVER'S SIDE OF THE VAN, I DID NOT LOCATE ANYONE. I WAS ADVISED SOON AFTER THAT THE OPERATOR HAD GOTTEN A RIDE AND A TOW SERVICE WAS BRINGING HIM TO THE SCENE. WHILE WAITING FOR
THE OPERATOR TO ARRIVE, I OBSERVED WHERE THE VEHICLE TRACKS ENTERED THE EAST SHOULDER LEADING TO THE DITCH.
THERE WAS A THIN TIRE MARK ON THE ROADWAY FROM THE DRIVER'S SIDE FRONT TIRE LEADING ME TO BELIEVE THE
OPERATOR HAD TAKEN THE CORNER TOO FAST. I ALSO OBSERVED WHERE THE PASSENGER SIDE OF THE TRUCK STRUCK A
JUMP RIVER ELECTRIC POLE CAUSING MINOR DAMAGE TO IT. UPON THE ARRIVAL OF THE OPERATOR, IDENTIFIED AS GREGORY
NORTON OF DULUTH, HE ADVISED HE THE TRUCK WAS NEAR EMPTY AND WAS NOT HAULING ANY HAZARDOUS MATERIALS. WHEN
ASKED, I WAS TOLD THERE WAS 1/2 TANK OF FUEL IN A 22 GALLON TANK. I DID NOT OBSERVE ANY FUEL LEAKAGE. NORTON TOLD
ME THAT HE HAS BRONCHITIS AND HAD A COUGHING ATTACK WHILE NEGOTIATING THE CORNER AT WHAT HE ESTIMATED WAS 30
MPH. NORTON STATED ONCE HE LEFT THE ROADWAY HE TRIED TO CORRECT THE TRUCK BUT KEPT GETTING PULLED FURTHER
OFF THE ROAD DOWN INTO THE DITCH. I HAD OBSERVED A LARGE BOULDER THE VEHICLE STRUCK IN THE EMBANKMENT WHICH
WAS BELIEVED TO BE THE CAUSE OF ROLLING ONTO THE PASSENGER SIDE. NORTON ADDED THAT THE TRUCK HAS A MANUAL
TRANSMISSION AND THAT HE DOESN'T USUALLY DRIVE A CLUTCH. DUE TO THE TRUCK BEING APPROXIMATELY 15 FEET OFF THE
ROADWAY AND 15 FEET DOWN AN EMBANKMENT, A MEDIUM DUTY WRECKER WAS CALLED TO REMOVE IT. FROM THE TIME NORTON EXITED THE ROADWAY, HE TRAVELED 145 FEET BEFORE COMING TO A REST. NO INJURIES WERE SUSTAINED.
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
ALMOGHRABI125 - Officer Last Name NICK 392131 - 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
10/19/2015132 - Date Notified 1531133 - Time Notified (Military Time)1544134 - Time Arrived (Military Time)10/19/2015135 - Date Of Report
15101909 15101909 19 - Special Study
18 - Agency Space
Accident Report
of
MV4000e 01/2005
Page
PK2012
Wisconsin Motor Vehicle GZDLK2Z 4 4