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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.