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20190610 skowronski19061019 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GNQ6N1 WISCONSIN MOTOR VEHICLE CRASH REPORT Secondary CrashAmendedCrash Type NON-DOMESTICATED ANIMAL W/ NO INJURYReportable TagsSchool Bus Related NOActive School ZoneGovernment Property Reporting ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 00 Total Injured 00 Total Units 01 Time Notified 02:09 PM Date Notified 06/10/2019 Time ArrivedDate ArrivedCrash Time 01:27 PM Crash Date 06/10/2019 Investigating Officer/Deputy DEPUTY MICHAEL SIMPSON Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0GNQ6N1I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. Structure Type NO STRUCTURE Y Coordinate 5086802.5 X Coordinate 187171.671875 Longitude -91.030233617 Latitude 45.863663785 ON CTHW NB 77 FT N OF FADNESS RD IN THE TOWN OF WINTER IN SAWYER COUNTY Location Special StudyAccess ControlTribal Land Crash Classification - Jurisdiction NO SPECIAL JURISDICTION Crash Classification - Location PUBLIC PROPERTY Relation To Trafficway TRAFFICWAY - ON ROAD Animal Type DEER Weather Condition(s) Environment Factor(s) Roadway Factor(s)Road Surface Condition(s) Light ConditionManner of Collision NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location ON ROADWAY First Harmful Event NON DOMESTICATED ANIMAL (ALIVE) Crash Scene Road GradeRoad CurvatureSurface Type Traffic Control Inoperative/MissingTraffic ControlTraffic Way Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With NON DOMESTICATED ANIMAL (ALIVE) Total LanesSpeed LimitPre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 2 Operating As EndorsementsVehicle Type MOTOR HOME01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITCrash Time 01:27 PM Crash Date 06/10/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 3 This report does not include any CJIS data. 19061019 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GNQ6N1 WISCONSIN MOTOR VEHICLE CRASH REPORT Truck Bus or HazMat NO Owner AddressOwner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle FactorsWhat Driver Was Doing Vehicle Removed By OPERATOR Towed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 11--LEFT FRONT CORNER, 12--FRONT Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style 3D - THREE DOOR Color BGE - BEIGE Model CHATEAU Year 2019 Make CHEVROLET Vehicle Identification Number 14130101 Country of Issuance UNITED STATES St MI Plate TypeLicense Plate Number VEHICLEUNIT Vehicle UNITVEHICLEIndividualInsurance Company ALLSTATE-INS-CO Policy Holder UNITInjury Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/ExtricatedEjection PathEjected AirbagInjury Severity NO APPARENT INJURY00101 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: MICHIGAN COUNTRY: UNITED STATES Address BENTON HARBOR, MI 49033 , US Race WHITE Date of Birth 08/31/ Sex MALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 01:27 PM Crash Date 06/10/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 3 This report does not include any CJIS data. 19061019 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GNQ6N1 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Distracted By 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 To/From SchoolAction Other Action Prior Action LocationStriking Unit # Distracted By Action Distracted By Source Non Motorist UNITINDIVIDUALCrash Time 01:27 PM Crash Date 06/10/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 3 This report does not include any CJIS data.