HomeMy WebLinkAbout20151108 JohnsonAgency Accident Number
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Reportable Accident On Emergency Amended GZDR0DS
DOT Document Number Document Override Number
15110805
15
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8
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11/08/2015
4 - Accident Date
2213
5 - Time of Accident (Military Time)
01
6 - Total Units
00
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County SAND LAKE - 14, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location
14 - On Hwy No.
PIERCE LN
14 - On Street Name 14 - Bus/Frnt/Rmp
9 FT15 - Est. Distance NORTH15 - Hwy. Dir
02716 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
17 - Structure Type 17 - Structure Number
45.848827
12 - Latitude -91.45401413 - Longitude
DITCH80 - First Harmful Event NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT93 - 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
OUTSIDE-SHOULDER-LEFT
117 - Relation To Roadway
DARK-LIGHTED114 - 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
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Unit Status
DITCH
81 - Most Harmful Event: Collision With
WEST
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
2021
31 - Expiration Year 34 - On Duty Accident
JOHNSON
25 - Operator/Pedestrian Last Name
JASON
25 - First Name
A
25 - Middle Initial 25 - Suffix
11/27
32 - Date Of Birth
MALE
33 - Sex
26 - PO Box
COLUMBUS
27 - City
MN
27 - State
55025
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-RIGHT-TURN
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 262 - No. of Citations Issued
346.63(1)(A)
64 - 1st Statute No.
344.62(1)
64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
DRIVER-CONDITION, FAILURE-TO-HAVE-CONTROL
122 - Driver Factors
ABILITY IMPAIRED88 - Driver or Pedestrian Cond ALCOHOL-PRESENT
89 - Substance Presence
TEST GIVEN90 - Alcohol Test 0690 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
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Vehicle
Vehicle Owner
Insurance
School Bus
IN
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91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
1
22 - Total Occupants
HB4995
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year
24970
55 - Vehicle Identification Number
1997
50 - Year
FORD
51 - Make
F-150
52 - Model
PK - PICKUP
53 - Body Style
BLK
54 - Color 100 - Skidmarks to Impact (Ft)
FRONT DRIVER SIDE, MIDDLE DRIVER SIDE, REAR DRIVER SIDE
94 - Vehicle Damage
MODERATE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96 97 - Vehicle Removed By
TIRES
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
JOHNSON
46 - Vehicle Owner Last Name
JASON
46 - First Name
A
46 - Middle Initial 46 - Suffix
11/27/
Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
COLUMBUS48 - City MN48 - State 5502548 - Zip Code 49 - Telephone Number
VEHICLE NOT INSURED63 - Liability Insurance Company Policy Holder Same As Owner60
JOHNSON
61 - Policy Holder Last Name
JASON
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
Trailer
01
TR
L
106 - Power Unit Number License Plate Number Plate Type State Expiration Year
Trailer Make Unit Type Vehicle Identification Number
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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
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
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Diagram and Narrative
ON NOVEMBER 8TH, 2015, DEPUTY SHEPARD OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT RESPONDED TO A VEHICLE ROLL
OVER WITH NO INJURIES. THE INCIDENT OCCURRED ON PIERCE ROAD. THE DRIVER WAS THE ONLY OCCUPANT OF THE VEHICLE
AND WAS IDENTIFIED AS JASON A JOHNSON. JOHNSON ADVISED THAT HE WAS TRAVELING WEST ON STATE HWY 2770 WHEN HIS
VEHICLE BEGAN TO SHAKE. JOHNSON STATED THAT IT FELT AS THOUGH THE LUG NUTS ON ONE OF HIS FRONT TIRES WERE LOSE
AND THE TIRE WAS NEAR FALLING OFF. HE ATTEMPTED TO CONTROL THE VEHICLE AND MAKE A RIGHT HAND TURN ONTO PIERCE
RD. WHEN HE TURNED HE CROSSED OVER THE CENTER OF PIERCE RD, HIS FRONT DRIVER'S SIDE TIRE CONTACTED THE WEST SHOULDER OF THE ROADWAY. THE VEHICLE CONTINUED INTO THE WEST DITCH OF PIERCE RD JUST OFF OF STATE HWY 2770.
THE INCLINE OF THE DITCH WAS VERY STEEP AND WHEN HIS REAR TIRES ALSO LEFT THE ROADWAY THE VEHICLE TIPPED ONTO
THE DRIVER'S SIDE. IT WAS DISCOVERED BY DEPUTY SHEPARD THAT THE VEHICLE WAS NOT INSURED AND NOT REGISTERED TO
JOHNSON YET. JOHNSON HAD PURCHASED THE VEHICLE APPROXIMATELY ONE WEEK PRIOR TO THE CRASH AND HAD NOT YET
BROUGHT THE TITLE INTO THE DMV. THE VEHICLE HAD LICENSE PLATES ATTACHED FROM A DIFFERENT VEHICLE THAT JOHNSON
OWNED. AN OPEN BEER CAN WAS ALSO DISCOVERED INSIDE THE PASSENGER COMPARTMENT OF THE VEHICLE. JOHNSON ADMITTED TO DRINKING AND DRIVING AND WAS SUBSEQUENTLY RAN THROUGH STANDARDIZED FIELD SOBRIETY TESTS.
JOHNSON FAILED ALL THREE OF THE TESTS THAT HE WAS GIVEN AND ALSO PROVIDED A PRELIMINARY BREATH SAMPLE
SHOWING A BREATH ALCOHOL CONCENTRATION OF .095. JOHNSON WAS PLACED INTO CUSTODY FOR OWI 1ST OFFENSE. HE WAS
ISSUED A CITATION FOR BOTH THE OWI AND OPERATING WITHOUT
ON NOVEMBER 8TH, 2015, DEPUTY SHEPARD OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT RESPONDED TO A VEHICLE ROLL
OVER WITH NO INJURIES. THE INCIDENT OCCURRED ON PIERCE ROAD. THE DRIVER WAS THE ONLY OCCUPANT OF THE VEHICLE
AND WAS IDENTIFIED AS JASON A JOHNSON. JOHNSON ADVISED THAT HE WAS TRAVELING WEST ON STATE HWY 2770 WHEN HIS
VEHICLE BEGAN TO SHAKE. JOHNSON STATED THAT IT FELT AS THOUGH THE LUG NUTS ON ONE OF HIS FRONT TIRES WERE LOSE
AND THE TIRE WAS NEAR FALLING OFF. HE ATTEMPTED TO CONTROL THE VEHICLE AND MAKE A RIGHT HAND TURN ONTO PIERCE
RD. WHEN HE TURNED HE CROSSED OVER THE CENTER OF PIERCE RD, HIS FRONT DRIVER'S SIDE TIRE CONTACTED THE WEST SHOULDER OF THE ROADWAY. THE VEHICLE CONTINUED INTO THE WEST DITCH OF PIERCE RD JUST OFF OF STATE HWY 2770.
THE INCLINE OF THE DITCH WAS VERY STEEP AND WHEN HIS REAR TIRES ALSO LEFT THE ROADWAY THE VEHICLE TIPPED ONTO
THE DRIVER'S SIDE. IT WAS DISCOVERED BY DEPUTY SHEPARD THAT THE VEHICLE WAS NOT INSURED AND NOT REGISTERED TO
JOHNSON YET. JOHNSON HAD PURCHASED THE VEHICLE APPROXIMATELY ONE WEEK PRIOR TO THE CRASH AND HAD NOT YET
BROUGHT THE TITLE INTO THE DMV. THE VEHICLE HAD LICENSE PLATES ATTACHED FROM A DIFFERENT VEHICLE THAT JOHNSON
OWNED. AN OPEN BEER CAN WAS ALSO DISCOVERED INSIDE THE PASSENGER COMPARTMENT OF THE VEHICLE. JOHNSON ADMITTED TO DRINKING AND DRIVING AND WAS SUBSEQUENTLY RAN THROUGH STANDARDIZED FIELD SOBRIETY TESTS.
JOHNSON FAILED ALL THREE OF THE TESTS THAT HE WAS GIVEN AND ALSO PROVIDED A PRELIMINARY BREATH SAMPLE
SHOWING A BREATH ALCOHOL CONCENTRATION OF .095. JOHNSON WAS PLACED INTO CUSTODY FOR OWI 1ST OFFENSE. HE WAS
ISSUED A CITATION FOR BOTH THE OWI AND OPERATING WITHOUT
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INSURANCE. INSURANCE.
OF
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125 - First Name 125 - Middle Initial
Officer Information
SHEPARD
125 - Officer Last Name
LUCAS 316
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
11/08/2015
132 - Date Notified 2213133 - Time Notified (Military Time)2240134 - Time Arrived (Military Time)
11/08/2015
135 - Date Of Report
15110805 19 - Special Study
18 - Agency Space
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Wisconsin Motor Vehicle GZDR0DS 4 4