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20190204 LANGHAM-HAGENY.pdfSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Secondary CrashAmendedCrash Type DT4000 (STANDARD CRASH)Reportable TagsSchool Bus Related NOActive School ZoneGovernment Property Reporting ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 00 Total Injured 00 Total Units 02 Time Notified 02:02 PM Date Notified 02/04/2019 Time Arrived 02:29 PM Date Arrived 02/04/2019 Crash Time 02:00 PM Crash Date 02/04/2019 Investigating Officer/Deputy DEPUTY CALEB JORSTAD Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 4 V W D 7 5 Additional InformationPHOTOS Photos ByDEPUTY CALEB JORSTAD Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS TRAVELING EASTBOUND ON PANK ROAD AND BEGAN TO NEGOTIATE A TURN, WHEN UNIT 2, WHICH WAS TRAVELING WESTBOUND, WAS ALSO NEGOTIATING THE TURN. WHEN UNIT 2 TRIED MOVING MORE TO THE RIGHT, UNIT 2 TRACKED TO THE LEFT AND COLLIDED HEAD-ON WITH UNIT 1. Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5084863.5 X Coordinate 149567.34375 Longitude -91.511851263 Latitude 45.828176886 ON PANK RD 0.56 MI W OF ROLLINGWOOD RD IN THE TOWN OF SAND LAKE IN SAWYER COUNTY Location Special StudyAccess Control NO CONTROL Tribal Land Crash Classification - Jurisdiction NO SPECIAL JURISDICTION Crash Classification - Location PUBLIC PROPERTY Relation To Trafficway TRAFFICWAY - ON ROAD Animal Type Weather Condition(s) CLOUDY Environment Factor(s) WEATHER CONDITIONS Roadway Factor(s) NONE Road Surface Condition(s) SLUSH, ICE Light Condition DAYLIGHT Manner of Collision 03--FRONT TO FRONT First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO Truck Bus or HazMat NO Road Grade UPHILL Road Curvature CURVE LEFT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control NO CONTROL Traffic Way TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 35Pre CrashTire Mark Direction Of Travel EASTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type UTILITY TRUCK/PICKUP TRUCK01 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage DISABLING DAMAGE Vehicle Damage 1--RIGHT FRONT CORNER, 2--RIGHT SIDE FRONT, 10--LEFT SIDE FRONT, 11-- LEFT FRONT CORNER, 12--FRONT Initial Contact Point 12--FRONT Bus UseNOT A BUSBody Style PK - PICKUP Color SIL - SILVER (ALUMINUM) Model 1500 Year 2013 Make RAM Vehicle Identification Number 76410101 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VE H I C L E UN I T Vehicle Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address STONE LAKE, WI 54876 , US Owner Name 01 Driver DistractionsUNKNOWN IF DISTRACTED 01 Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing NEGOTIATING CURVE Vehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE UN I T VE H I C L E Sequence Of Events EventMOTOR VEH IN TRANSPORT01 EventMOTOR VEH IN TRANSPORT02 Event 03 Event 04 IndividualInsurance Company SECURA-INS-A-MUTUAL-CO Policy Holder UN I T Injury Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00 1 01 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address STONE LAKE, WI 54876 , US Race WHITE Date of Birth 04/11/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00 1 01 Drug Test ResultsDrug Test TypeDrug Test GivenTEST NOT GIVEN Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given TEST NOT GIVEN Suspected Drug Use NO Suspected Alcohol Use NO Action Other Action To/From SchoolLocationPrior ActionStriking Unit # Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UN I T Non Motorist IN D I V I D U A L Truck Bus or HazMat NO Road Grade DOWNHILL Road Curvature CURVE RIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control NO CONTROL Traffic Way TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 35Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? NO Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 2 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type UTILITY TRUCK/PICKUP TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 12--FRONT Initial Contact Point 12--FRONT Bus UseNOT A BUSBody Style TK - TRUCK Color WHI - WHITE Model F350 SUPER Year 2005 Make FORD Vehicle Identification Number 61460202 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VE H I C L E UN I T Vehicle Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address STONE LAKE, WI 54876 , US Owner Name 02 Driver DistractionsUNKNOWN IF DISTRACTED 02 Driver Actions SPEED TOO FAST/COND, FAILURE TO CONTROL Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing NEGOTIATING CURVE Vehicle Removed ByTowed Due To Damage NOT TOWED UN I T VE H I C L E Sequence Of Events EventMOTOR VEH IN TRANSPORT01 EventMOTOR VEH IN TRANSPORT02 Event 03 Event 04 Injury EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity NO APPARENT INJURY00 2 02 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address STONE LAKE, WI 54876 , US Race WHITEDate of Birth 02/10/ Sex MALE Citations Issued 2 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL14VWD75 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00 2 02 Drug Test ResultsDrug Test TypeDrug Test GivenTEST NOT GIVEN Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given TEST NOT GIVEN Suspected Drug Use NO Suspected Alcohol Use NO Action Other Action To/From SchoolLocationPrior ActionStriking Unit # Time of DeathDate of DeathHospital UN I T Non Motorist IN D I V I D U A L Violations DescriptionOPERATE MOTOR VEHICLE W/O INSURANCESeq Num001Statute Number344.62(1)Issue To? 002 UTC Number AE53841501 DescriptionOPERATING AFTER SUSPENSIONSeq Num001Statute Number343.44(1)(A)Issue To? 002 UTC Number AE53841602 Crash Time 02:00 PM Crash Date 02/04/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.