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20190219 lang- snow19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC 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 12:13 PM Date Notified 02/19/2019 Time Arrived 12:19 PM Date Arrived 02/19/2019 Crash Time 12:10 PM Crash Date 02/19/2019 Investigating Officer/Deputy SERGEANT GREG RIPCZINSKI Agency Crash Number 19021902 Primary Crash Document #Document Number Override 6VL15CPTKCAdditional InformationNONE, PHOTOS Photos BySGT GREG RIPCZINSKI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT #1 WAS IN THE SOUTHBOUND LANE OF GUARD STREET, OPERATOR PERFORMED A BACKING MANEUVER COLLIDING WITH UNIT #2 WHILE IT WAS ATTEMPTING TO MAKE A RIGHT HAND TURN INTO A PARKING LOT. Crash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type FIRE Y Coordinate 5106421.5 X Coordinate 152690.28125 Longitude -91.487369314 Latitude 46.023193782 ON 15880 W GUARD ST 221 FT E OF NYMAN AVE (FIRE 15880) IN THE CITY OF HAYWARD 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) CLEAR Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) SNOW Light Condition DAYLIGHT Manner of Collision 02--FRONT TO REAR 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 LEVEL Road Curvature STRAIGHT 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 FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 25 Pre CrashTire Mark Direction Of Travel SOUTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 1 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 UNITExtent Of Damage NO DAMAGE Vehicle Damage NO DAMAGE Initial Contact Point 6--REAR Bus Use NOT A BUS Body Style TK - TRUCK Color RED - RED Model RAM Year 2018 Make DODGE Vehicle Identification Number 32870101 Country of Issuance UNITED STATES St WI Plate Type MUN - MUNICIPAL License Plate Number VEHICLEUNIT Vehicle Crash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name01Driver Distractions UNKNOWN IF DISTRACTED 01Driver Actions UNSAFE BACKING Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing BACKING Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04GovernmentInsurance Company LEAGUE-OF-WISCONSIN-MUNICIPALITIES-MUTU Policy Holder UNITInjury Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00101 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 HAYWARD, WI 54843 , US Race WHITE Date of Birth 11/11/ Sex MALE Citations Issued 1 Driver ITEquipment Individual UNINDIVIDUALCrash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00101Drug Test ResultsDrug Test TypeDrug Test Given TEST 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 UNIT Non Motorist INDIVIDUAL Violations DescriptionUNSAFE BACKING OF VEHICLESeq Num001Statute Number346.87Issue To? 001 UTC Number AB82095601 Truck Bus or HazMat NO Road Grade LEVEL Road Curvature STRAIGHT 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 FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 25 Pre CrashTire Mark Direction Of Travel SOUTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 2 Operating As EndorsementsVehicle Type PASSENGER CAR02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITBus Use NOT A BUS Body Style 4D - 4DR Color WHI - WHITE Model MILAN Year 2010 Make MERCURY Vehicle Identification Number 83200202 Country of Issuance UNITED STATES St WI Plate Type LCO - LAC COURTE OREI License Plate Number Vehicle Crash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address COUDERAY, WI 54828 , US Owner Name02Driver Distractions NOT DISTRACTED 02Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 12--FRONT Initial Contact Point 12--FRONT VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company STATE-FARM-MUTUAL-AUTOMOBILE-INS-CO Policy Holder UNITTint 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 COUDERAY, WI 54828 , US Race INDIAN Date of Birth 06/30 Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Injury Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00202Drug Test ResultsDrug Test TypeDrug Test Given TEST 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 Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00202 UNIT Non Motorist INDIVIDUALInjury EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00302 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 2--FRONT SEAT-MIDDLE Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress COUDERAY, WI 54828 , US Race INDIAN Date of Birth 03/17/1 Sex FEMALE Citations Issued 0 Passenger ITEquipment Individual UNINDIVIDUALCrash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 19021902 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15CPTKC WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00302Drug Test ResultsDrug Test TypeDrug Test Given TEST 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 UNIT Non Motorist INDIVIDUALCrash Time 12:10 PM Crash Date 02/19/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.