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20190307 nickel-germannSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 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 04:06 PM Date Notified 03/07/2019 Time Arrived 04:09 PM Date Arrived 03/07/2019 Crash Time 04:05 PM Crash Date 03/07/2019 Investigating Officer/Deputy DEPUTY NATHAN FREY Agency Crash Number 19030707 Primary Crash Document #Document Number Override 6VL13ZQKS8Additional InformationPHOTOS Photos By397 Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS SLOWLY APPROACHING A STOPPED SCHOOL BUS, AND NEARLY STOPPED. UNIT 2 STRUCK THE REAR OF UNIT 1 BETWEEN 35-40 MILES PER HOUR. UNIT 2 WAS HEAVILY DAMAGED AND REMOVED BY JOCKS TOWING. UNIT 1, THE MODERATELY DAMAGED, WAS ABLE TO BE DRIVEN AWAY. Crash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5105057.5 X Coordinate 156148.53125 Longitude -91.441841919 Latitude 46.012695412 ON STH77 EB 431 FT E OF RED PINE LN IN THE TOWN 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) DRY 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 HILLCREST 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 55 Pre CrashTire Mark Direction Of Travel EASTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 2 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 6--REAR Initial Contact Point 6--REAR Bus Use NOT A BUS Body Style 4H - HATCHBACK 4 DOOR Color SIL - SILVER (ALUMINUM) Model UNK Year 2009 Make CHEVROLET Vehicle Identification Number 06770101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name01Driver Distractions NOT DISTRACTED 01Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing SLOW/STOPPING Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company STATE-FARM-GENERAL-INS-CO 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 10/22/ Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 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 INDIVIDUALInjury 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 INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER 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 10/27/ Sex MALE Citations Issued 0 Passenger ITEquipment Non Motorist Individual UNINDIVIDUALCrash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00201Drug 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 UNITINDIVIDUALTruck Bus or HazMat NO Road Grade HILLCREST 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 55 Pre 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 CARGO VAN (10,000 LBS OR LESS)02Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITDriver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 1--RIGHT FRONT CORNER, 11--LEFT FRONT CORNER, 12--FRONT Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style VN - VAN Color WHI - WHITE Model SAVANA Year 2012 Make GENERAL MOTORS COR Vehicle Identification Number 09240202 Country of Issuance UNITED STATES St MN Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address MT LAUREL, NJ 08054 , US Owner Name02Driver Distractions NOT DISTRACTED 02Driver Actions NO CONTRIBUTING ACTION UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event PARKED MOTOR VEHICLE02 Event 03Event 04Organization/CompanyInsurance Company PROTECTIVE-INS-CO Policy Holder UNITInjury 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 INJURY00302 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 GORDON, WI 54838 , US Race WHITE Date of Birth 07/19/ Sex MALE Citations Issued 0 Driver ITEquipment Non Motorist Individual UNINDIVIDUALCrash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS8 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 UNITINDIVIDUALCrash Time 04:05 PM Crash Date 03/07/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.