HomeMy WebLinkAbout20160120 Hill JohnsonAgency Accident Number
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Reportable Accident On Emergency Amended GZDVPJL
DOT Document Number Document Override Number
16012000746
16
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16012005
16
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5
01/20/2016
4 - Accident Date
0600
5 - Time of Accident (Military Time)
02
6 - Total Units
01
7 - Total Injured
00
8 - Total Killed
SAWYER - 572 - County WEIRGOR - 16, TOWN3 - Municipality PARKING LOT11 - Accident Location
14 - On Hwy No.
PARKING LOT
14 - On Street Name 14 - Bus/Frnt/Rmp 15 - Est. Distance 15 - Hwy. Dir
C16 - Fr/At Hwy No.16 - From/At Street Name 16 - Business/Frontage/Ramp
FIRE #
17 - Structure Type
11069W
17 - Structure Number 12 - Latitude 13 - Longitude
OTHER FIXED OBJECT80 - First Harmful Event SIDESWIPE. SAME DIRECTION93 - Manner of Collision
NO CONTROL
112 - Access Control
CURVE
113 - Road Curvature
LEVEL/FLAT
113 - Road Terrain
BRICK OR BLOCK - 3
Surface Type
PARKING-LOT-OR-PRIVATE-PROPERTY115 - Traffic Way
PARKING-LOT-OR-PRIVATE-PROPERTY
117 - Relation To Roadway
DAYLIGHT114 - Light Condition WET116 - 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
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H - HIT AND RUN
Unit Status
OTHER FIXED OBJECT
81 - Most Harmful Event: Collision With
EAST
23 - Dir Of Travel
3024 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number
WI
30 - State
2007
31 - Expiration Year 34 - On Duty Accident
HILL
25 - Operator/Pedestrian Last Name
JUSTIN
25 - First Name
A
25 - Middle Initial 25 - Suffix
11/06/
32 - Date Of Birth
MALE
33 - Sex
26 - Address Street & Number
25
26 - PO Box
RADISSON
27 - City
WI
27 - State
54867
27 - Zip Code 28 - Telephone Number
FRONT-SEAT-LEFT-SIDE-(MC/BIKE DRIVER, TRAIN CONDUCTOR)
39 - Seat Position
RESTRAINT-USE-UNKNOWN
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
NEGOTIATING-CURVE
119 - What Driver Was Doing
NO-CONTROL
120 - Traffic Control 162 - No. of Citations Issued
343.44(1)(B)
64 - 1st Statute No.64 - 2nd Statute No.64 - 3rd Statute No.64 - 4th Statute No.64 - 5th Statute No.
INATTENTIVE-DRIVING, FAILURE-TO-HAVE-CONTROL, DRIVER-CONDITION
122 - Driver Factors
REDUCED ALERTNESS88 - Driver or Pedestrian Cond ALCOHOL-PRESENT
89 - Substance Presence
TEST GIVEN90 - Alcohol Test 0690 - Alcohol Content TEST NOT GIVEN91 - Drug Test
01
Accident Report
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Wisconsin Motor Vehicle GZDVPJL 1 5
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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
855LWV
56 - License Plate Number
AUT57 - Plate Type WI
58 - State
2016
59 - Exp Year
8982
55 - Vehicle Identification Number
2009
50 - Year
DODG
51 - Make
CALIBER
52 - Model
4D - 4DR
53 - Body Style
WHI
54 - Color
00100 - Skidmarks to Impact (Ft)
TOTAL (DAMAGE TO ALL AREAS)
94 - Vehicle Damage
VERY-SEVERE
95 - Extent Of Damage
Vehicle Towed Due To Damage
96
OPERATOR
97 - Vehicle Removed By
NOT-APPLICABLE
123 - Vehicle Factors
45
Vehicle Owner Same As Operator
HILL
46 - Vehicle Owner Last Name
ROBERT
46 - First Name
M
46 - Middle Initial 46 - Suffix
07/24/1
Date Of Birth
46 - Company Name
47- Address Street & Number
25
47 - PO Box
RADISSON48 - City WI48 - State 5486748 - 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
L - LEGALLY PARKED
Unit Status
MOTOR VEHICLE IN TRANSPORT
81 - Most Harmful Event: Collision With 23 - Dir Of Travel
1024 - Speed Limit
D CLASS
36 - Operating as Classified 37 - Endorsements 35
Operating Commercial Motor Vehicle
29 - Driver's License Number 30 - State 31 - Expiration Year 34 - On Duty Accident
25 - Operator/Pedestrian Last Name 25 - First Name 25 - Middle Initial 25 - Suffix
32 - Date Of Birth 33 - Sex
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MV4000e 01/2005
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Wisconsin Motor Vehicle GZDVPJL 2 525
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Vehicle
Vehicle Owner
Insurance
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IN
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26 - Address Street & Number 26 - PO Box
27 - City 27 - State 27 - Zip Code 28 - Telephone Number
39 - Seat Position
NOT-APPLICABLE-NONMOTORIST
40 - Safety Equipment
38 - Injury Severity
NOT APPLICABLE
41 - Airbag
NOT-APPLICABLE
42 - Ejected 44
Medical Transport
NOT-APPLICABLE
43 - Trapped/Extricated 92 - Pedestrian Location 92 - Pedestrian Action
LEGALLY-PARKED
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.
NOT-APPLICABLE
122 - Driver Factors
88 - Driver or Pedestrian Cond 89 - Substance Presence
90 - Alcohol Test 90 - Alcohol Content 91 - Drug Test
91 - Drugs Reported
NOT-APPLICABLE
124 - Highway Factors
AUTOMOBILE
21 - Unit Type
PASSENGER-CAR
Vehicle Type
0
22 - Total Occupants
56 - License Plate Number 57 - Plate Type 58 - State 59 - Exp Year
3843
55 - Vehicle Identification Number
2005
50 - Year
JEEP
51 - Make
LIBERTY
52 - Model
UT - SPORT UTILITY
53 - Body Style
SIL
54 - Color 100 - Skidmarks to Impact (Ft)
MIDDLE PASSENGER SIDE, FRONT PASSENGER SIDE, FRONT
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
JOHNSON
46 - Vehicle Owner Last Name
JOEL
46 - First Name
K
46 - Middle Initial 46 - Suffix Date Of Birth
46 - Company Name
47- Address Street & Number 47 - PO Box
CORNELL48 - City WI48 - State 5473248 - Zip Code 49 - Telephone Number
NOT-REQUIRED63 - 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
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School Bus
02
BU
S
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
Fixed Objects Struck
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Property
INDIVIDUAL
Organization Type
JOHNSON
84 - Property Owner Last Name
JOEL
84 - First Name
K
84 - Middle Initial 84 - Suffix
01
84 - Company Name Government Property Type
85 - Address Street & Number 85 - PO Box
CORNELL
86 - City
WI
86 - State
54732
86 - Zip Code 87 - Telephone Number
83 - Government Damage Tag Number
01
82 - Striking Unit
OTHER-FIXED-OBJECT
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
POPLIN 352
ON JANUARY 20TH, 2016 AT APPROXIMATELY 0600 I WAS DISPATCHED TO THE SCENE OF A CRASH WHERE THE SUSPECT VEHICLE
LEFT. UPON ARRIVAL I OBSERVED TRACKS IN THE SNOW WHERE THE SUSPECT VEHICLE UNIT 1 WAS GOING SOUTH ON STATE
HWY 48. UNIT 1 ATTEMPTED TO NEGOTIATE A CORNER AND LEFT THE ROADWAY STRIKING A
ON JANUARY 20TH, 2016 AT APPROXIMATELY 0600 I WAS DISPATCHED TO THE SCENE OF A CRASH WHERE THE SUSPECT VEHICLE
LEFT. UPON ARRIVAL I OBSERVED TRACKS IN THE SNOW WHERE THE SUSPECT VEHICLE UNIT 1 WAS GOING SOUTH ON STATE
HWY 48. UNIT 1 ATTEMPTED TO NEGOTIATE A CORNER AND LEFT THE ROADWAY STRIKING A
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Wisconsin Motor Vehicle GZDVPJL 4 5
SNOWBANK GOING THROUGH A PARKING LOT WHERE IT STRUCK A BUILDING CASING SEVERE DAMAGE TO THE VEHICLE AND MODERATE DAMAGE TO THE BUILDING. UNIT 1 BOUNCED OFF THE BUILDING AND CONTINUED WHERE IT STRUCK UNIT 2 WHICH
WAS LEGALLY PARKED AND UNOCCUPIED IN THE PARKING LOT. UNIT 1 CAUSED SEVERE DAMAGE TO UNIT 2. UNIT 1 FLED THE
SCENE AND WAS LOCATED LATER WHERE THE DRIVER ADMITTED TO WHAT HAD HAPPENED AND WAS ARRESTED FOR MULTIPLE
CHARGES.
SNOWBANK GOING THROUGH A PARKING LOT WHERE IT STRUCK A BUILDING CASING SEVERE DAMAGE TO THE VEHICLE AND MODERATE DAMAGE TO THE BUILDING. UNIT 1 BOUNCED OFF THE BUILDING AND CONTINUED WHERE IT STRUCK UNIT 2 WHICH
WAS LEGALLY PARKED AND UNOCCUPIED IN THE PARKING LOT. UNIT 1 CAUSED SEVERE DAMAGE TO UNIT 2. UNIT 1 FLED THE
SCENE AND WAS LOCATED LATER WHERE THE DRIVER ADMITTED TO WHAT HAD HAPPENED AND WAS ARRESTED FOR MULTIPLE
CHARGES.
OF
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125 - First Name 125 - Middle Initial
Officer Information
POPLIN
125 - Officer Last Name
JAY 352
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
01/20/2016
132 - Date Notified 0921133 - Time Notified (Military Time)1000134 - Time Arrived (Military Time)
01/20/2016
135 - Date Of Report
16012000746 16012005 19 - Special Study
18 - Agency Space
Accident Report
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MV4000e 01/2005
Page
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Wisconsin Motor Vehicle GZDVPJL 5 5