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Home My WebLink About20160109 HolmAgency 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 GZDHL6C DOT Document Number Document Override Number 16010906 16 0 1 0 9 0 6 01/09/2016 4 - Accident Date 1734 5 - Time of Accident (Military Time) 01 6 - Total Units 00 7 - Total Injured 00 8 - Total Killed SAWYER - 572 - County HUNTER - 07, TOWN3 - Municipality NON-INTERSECTION11 - Accident Location B 14 - On Hwy No.14 - On Street Name 14 - Bus/Frnt/Rmp 0.60 MI15 - Est. Distance SOUTH15 - Hwy. Dir 16 - Fr/At Hwy No.FOREST ROAD 30416 - From/At Street Name 16 - Business/Frontage/Ramp 17 - Structure Type 17 - Structure Number 45.923505 12 - Latitude -91.07149413 - Longitude EMBANKMENT80 - 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 SHOULDER-(OTHER THAN SHOULDER WITHIN MEDIAN OR GORE) 117 - Relation To Roadway DARK-NOT-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 E R A T O R / P E D E S T R I A N Unit Status TREE 81 - Most Harmful Event: Collision With EAST 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 2022 31 - Expiration Year 34 - On Duty Accident HOLM 25 - Operator/Pedestrian Last Name JOHN 25 - First Name D 25 - Middle Initial JR 25 - Suffix 03/09/ 32 - Date Of Birth MALE 33 - Sex 26 - Address Street & Number 26 - PO Box WINTER 27 - City WI 27 - State 54896 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 GOING-STRAIGHT 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. DRIVER-CONDITION 122 - Driver Factors REDUCED ALERTNESS88 - 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 GZDHL6C 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 AUTOMOBILE 21 - Unit Type PICKUP/UTILITY-TRUCK Vehicle Type 1 22 - Total Occupants LX3100 56 - License Plate Number LTK57 - Plate Type WI 58 - State 2016 59 - Exp Year 8920 55 - Vehicle Identification Number 1998 50 - Year FORD 51 - Make RANGER 52 - Model PK - PICKUP 53 - Body Style LBL 54 - Color 100 - Skidmarks to Impact (Ft) FRONT DRIVER SIDE, FRONT, FRONT PASSENGER SIDE, MIDDLE PASSENGER SIDE, UNDERCARRIAGE 94 - Vehicle Damage MODERATE 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 HOLM 46 - Vehicle Owner Last Name JOHN 46 - First Name D 46 - Middle Initial JR 46 - Suffix 03/09/ Date Of Birth 46 - Company Name 47- Address Street & Number 47 - PO Box WINTER48 - City WI48 - State 5489648 - Zip Code 49 - Telephone Number PROGRESSIVE-CASUALTY-INS-CO63 - Liability Insurance Company Policy Holder Same As Owner60 HOLM 61 - Policy Holder Last Name JOHN 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 Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL6C 2 424 Fixed Objects Struck PR O P E R T Y O W N E R 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 DI A G R A M A N D N A R R A T I V E Diagram and Narrative ON JANUARY 9, 2016 AT APPROXIMATELY 5:34 PM I, DEPUTY RASCHKA WAS ADVISED THAT A JOHN HOLM HAD PUT HIS VEHICLE IN THE DITCH ON CTH B NEAR VENISON CREEK. I WAS IN THE AREA ON A UNRELATED CALL AND ONCE CLEARED, WENT TO MR. HOLM'S VEHICLE. I OBSERVED THAT IT WAS SEVERAL FEET DOWN THE SOUTH EMBANKMENT OF COUNTY HWY B, FACING SOUTEAST IN THE BRUSH AND THE TREES. IT APPEARED THE VEHICLE HAD LEFT THE ROADWAY FROM THE EASTBOUND LANE, THERE WERE NO SKIDMARKS TO INDICATE BRAKING. PHOTOS OF THE VEHICLE IN THE WOODS WERE TAKEN. THE OPERATOR, JOHN HOLM, ARRIVED ON-SCENE WITH DENENNY'S TOWING OUT OF WINTER, WI TO REMOVE THE VEHICLE. IN SPEAKING WITH MR. HOLM HE ADVISED THAT HE HAD JUST FINISHED WORKING 36 HRS AS A PARAMEDIC FOR SAWYER COUNTY AND HAD SLEPT ONLY A FEW HOURS BEFORE SPENDING ALL DAY IN HAYWARD AT HIS SONS BASKETBALL TOURNAMENT. HE STATED HE FELL ASLEEP AND WOKE UP AS THE VEHICLE WAS TRAVELING DOWN THE EMBANKMENT. HE STATED THE VEHICLE CAME TO AN ABRUPT STOP WHEN HE BELIEVED IT HIS A LARGE TREE TRUCK LAYING HALFWAY ON ITS SIDE. HE SAID THE TREE SPLIT IN TWO AND MISSED LANDING ON HIS TRUCK. HE WAS ABLE TO GET OUT, WAS NOT INJURED, THE AIRBAGS DID NOT DEPLOY AND WAS UTILIZING HIS SAFETY BELT. THE VEHICLE WAS THEN PULLED OUT BY DENENNY'S AND PHOTOS OF THE VEHICLE WERE TAKEN ONCE COMPLETELY OUT. DAMAGE WAS MODERATE, WITH THE DRIVER FRONT TIRE OFF THE RIM AND FLAT, MISSING PASSENGER MIRROR AND DENTS ALONG SIDE THE PASSENGER SIDE. POSSIBLE DAMAGE TO THE UNDERCARRIAGE DUE TO LANDING ON A LARGE TREE TRUNK. MR. HOLM SHOWED ME HIS PROGRESSIVE INSURANCE CARD AND STATED HE WAS NOT INJURED. THE VEHICLE WAS REMOVED AND I WAS CLEAR. END OF NARRATIVE. ON JANUARY 9, 2016 AT APPROXIMATELY 5:34 PM I, DEPUTY RASCHKA WAS ADVISED THAT A JOHN HOLM HAD PUT HIS VEHICLE IN THE DITCH ON CTH B NEAR VENISON CREEK. I WAS IN THE AREA ON A UNRELATED CALL AND ONCE CLEARED, WENT TO MR. HOLM'S VEHICLE. I OBSERVED THAT IT WAS SEVERAL FEET DOWN THE SOUTH EMBANKMENT OF COUNTY HWY B, FACING SOUTEAST IN THE BRUSH AND THE TREES. IT APPEARED THE VEHICLE HAD LEFT THE ROADWAY FROM THE EASTBOUND LANE, THERE WERE NO SKIDMARKS TO INDICATE BRAKING. PHOTOS OF THE VEHICLE IN THE WOODS WERE TAKEN. THE OPERATOR, JOHN HOLM, ARRIVED ON-SCENE WITH DENENNY'S TOWING OUT OF WINTER, WI TO REMOVE THE VEHICLE. IN SPEAKING WITH MR. HOLM HE ADVISED THAT HE HAD JUST FINISHED WORKING 36 HRS AS A PARAMEDIC FOR SAWYER COUNTY AND HAD SLEPT ONLY A FEW HOURS BEFORE SPENDING ALL DAY IN HAYWARD AT HIS SONS BASKETBALL TOURNAMENT. HE STATED HE FELL ASLEEP AND WOKE UP AS THE VEHICLE WAS TRAVELING DOWN THE EMBANKMENT. HE STATED THE VEHICLE CAME TO AN ABRUPT STOP WHEN HE BELIEVED IT HIS A LARGE TREE TRUCK LAYING HALFWAY ON ITS SIDE. HE SAID THE TREE SPLIT IN TWO AND MISSED LANDING ON HIS TRUCK. HE WAS ABLE TO GET OUT, WAS NOT INJURED, THE AIRBAGS DID NOT DEPLOY AND WAS UTILIZING HIS SAFETY BELT. THE VEHICLE WAS THEN PULLED OUT BY DENENNY'S AND PHOTOS OF THE VEHICLE WERE TAKEN ONCE COMPLETELY OUT. DAMAGE WAS MODERATE, WITH THE DRIVER FRONT TIRE OFF THE RIM AND FLAT, MISSING PASSENGER MIRROR AND DENTS ALONG SIDE THE PASSENGER SIDE. POSSIBLE DAMAGE TO THE UNDERCARRIAGE DUE TO LANDING ON A LARGE TREE TRUNK. MR. HOLM SHOWED ME HIS PROGRESSIVE INSURANCE CARD AND STATED HE WAS NOT INJURED. THE VEHICLE WAS REMOVED AND I WAS CLEAR. END OF NARRATIVE. Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL6C 3 4 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 01/09/2016 132 - Date Notified 1734133 - Time Notified (Military Time)1742134 - Time Arrived (Military Time) 01/09/2016 135 - Date Of Report 16010906 19 - Special Study 18 - Agency Space Accident Report of MV4000e 01/2005 Page PK2012 Wisconsin Motor Vehicle GZDHL6C 4 4