20190313 phinn-ammann19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W 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
03
Total Units
02
Time Notified
08:14 AM
Date Notified
03/13/2019
Time Arrived
08:16 AM
Date Arrived
03/13/2019
Crash Time
08:14 AM
Crash Date
03/13/2019
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL12XVN0WAdditional InformationNONE, PHOTOS,
RECONSTRUCTION
Photos ByDEPUTY BECKSTRAND
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON MARCH 13TH I DEPUTY BECKSTRAND WAS DISPATCHED TO PHIPPS RD ABOUT A MILE EAST OF HWY 63 IN RESPONSE TO A 2 VEHICLE CRASH.
DISPATCH TOLD ME THERE WERE NO APPARENT INJURIES AND THE ROAD WAS NOT BLOCKED. PHINN WAS TRAVELING SOUTH BOUND ON PHIPPS
RD AND WAS TRAVELING NORTH BOUND ON PHIPPS RD. I GOT TO THE SCENE AND SAW A TAN DODGE STRATUS WITH FRONT
DRIVERSIDE DAMAGE AND A BLUE HONDA VAN WITH SIDE DAMAGE DONE FROM THE DRIVERSIDE REAR DOOR BACK TO THE REAR TIRE. WHEN I
GOT THERE TOLD ME THE OTHER DRIVER WAS TELLING HER THAT HER NECK AND BACK HURT. DEPUTY GILLIS CALLED FOR EMS FOR
. AFTER WAS IN THE AMBULANCE, TOLD ME THAT HER BACK HURTS AND SHE WANTED TO GET IT LOOKED AT. I ASKED A
EMT TO CHECK HER OVER AND TOLD ME HER DAD WOULD BE TAKING HER TO HOSPITAL TO GET IT LOOKED AT.
Crash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5109349.5
X Coordinate
157603.578125
Longitude
-91.426182386
Latitude
46.051939986
ON PHIPPS RD
176 FT E
OF PORKIES RD
IN THE TOWN OF LENROOT
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)
RAIN
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
ICE
Light Condition
DAWN
Manner of Collision
OTHER
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
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 FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
45
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
DISABLING DAMAGE
Vehicle Damage
11--LEFT FRONT CORNER, 12--FRONT
Initial Contact Point
11--LEFT FRONT CORNER
Bus Use
NOT A BUS
Body Style
4D - 4DR
Color
TAN - TAN
Model
STRATUS
Year
2004
Make
DODGE
Vehicle Identification Number
512920101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W 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
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
CROSS CENTERLINE01
Event
MOTOR VEH IN TRANSPORT02
Event
03Event
04IndividualInsurance Company
PROGRESSIVE-UNIVERSAL-INSURANCE-COMP
Policy Holder
UNITInjury
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
POSSIBLE 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
03/02/
Sex
FEMALE
Citations Issued
0
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W 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
HAYWARD AREA MEM HOSP
EMS Run #EMS Agency IdentifierMedical Transport
OTHER
UNIT Non Motorist
INDIVIDUALTruck 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
45
Pre CrashTire
Mark
Direction Of Travel
NORTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
3
Operating As EndorsementsVehicle Type
PASSENGER CAR02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
DISABLING DAMAGE
Vehicle Damage
8--LEFT SIDE REAR, 9--LEFT SIDE MIDDLE
Initial Contact Point
9--LEFT SIDE MIDDLE
Bus Use
NOT A BUS
Body Style
MV - MINI VAN
Color
BLU - BLUE
Model
ODYSSEY
Year
2011
Make
HONDA
Vehicle Identification Number
03780202 Country of Issuance
UNITED STATES
St
WI
Plate Type
PAK - PACKER
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
(02Driver Distractions
NOT DISTRACTED
02Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04IndividualInsurance Company
STATE-FARM-MUTUAL-AUTOMOBILE-INS-CO
Policy Holder
UNITInjury
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED SERIOUS INJUR00202 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
RaceDate of Birth
07/01/
Sex
FEMALE
Citations Issued
0
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W WISCONSIN MOTOR VEHICLE
CRASH REPORT
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
HAYWARD AREA MEM HOSP
EMS Run #
19031303251
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
UNIT Non Motorist
INDIVIDUALInjury
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #
19031303251
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED MINOR INJURY00302 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
9--THIRD SEAT-RIGHT SIDE
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License NumberAddress
HAYWARD, WI 54843 , US
RaceDate of Birth
Sex
MALE
Citations Issued
0
Passenger
ITEquipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 6 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W 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
UNITINDIVIDUALInjury
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 INJURY00402 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
6--SECOND SEAT-RIGHT SIDE
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License NumberAddress
HAYWARD, WI 54843 , US
RaceDate of Birth
Sex
MALE
Citations Issued
0
Passenger
ITEquipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 7 of 8
This report does not include any CJIS data.
19031304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0W WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00402Drug 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 08:14 AM
Crash Date 03/13/2019Wisconsin Motor Vehicle Crash
Form DT4000 8 of 8
This report does not include any CJIS data.