Loading...
20190604 hollen - headleyON JUNE 4, 2019, I, DEPUTY AMBER AL-MOGHRABI, WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT. AT APPROXIMATELY 15:21 DISPATCHED ADVISED DEPUTY JENSEN TO RESPOND TO THE LCO COUNTRY STORE AT 8575 COUNTY ROAD K, FOR A TWO VEHICLE ACCIDENT WITH NO INJURIES. I ADVISED DISPATCH THAT I WAS JUST DOWN THE ROAD AND WOULD RESPOND TO THE ACCIDENT. UPON ARRIVAL AT 15:24 I NOTICED A WHITE DODGE RAM, WHO I HAD KNOWN BELONGED TO AND A KIA SORENTO WITH A MINNESOTA PLATE SITTING NEXT TO EACH OTHER IN THE PARKING LOT. I GOT OUT OF MY PATROL VEHICLE AND WENT TO TALK TO AND THE FEMALE THAT WAS DRIVING THE KIA. STATED THAT HE WAS SITTING IN HIS TRUCK PARKED IN HIS PARKING SPOT WHEN HE NOTICED A VEHICLE BACKING OUT OF THE PARKING STALL IN FRONT OF HIM. HE STATED THAT HE NOTICED HER TURNING TO WIDE AND SAW THAT SHE WAS ABOUT TO HIT HIS TRUCK SO HE STARTED HONKING THE HORN TO GET HER ATTENTION. STATED THAT THE FEMALE DRIVER MUST NOT HAVE HEARD HIM AND HER REAR END HIT THE PASSENGER SIDE OF THE FRONT END OF HIS TRUCK. I ASKED THE FEMALE IF THAT IS WHAT HAD HAPPENED AND SHE STATED IT WAS AND THAT SHE DID NOT SEE HIM WHEN SHE WAS BACKING UP. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF 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 03:22 PM Date Notified 06/04/2019 Time Arrived 03:24 PM Date Arrived 06/04/2019 Crash Time 03:15 PM Crash Date 06/04/2019 Investigating Officer/Deputy DEPUTY AMBER ALMOGHRABI Agency Crash Number 19060413 Primary Crash Document #Document Number Override 6VL0FZQKRFAdditional InformationPHOTOS Photos ByDEPUTY AMBER AL-MOGHRABI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. Crash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 8 This report does not include any CJIS data. I RAN THE MINNESOTA PLATE - THROUGH DISPATCH WHICH CAME BACK TO I ASKED THE FEMALE IF SHE WAS AND SHE STATED SHE WAS. I THEN ADVISED DISPATCH TO RUN ROBIN AS SHE WAS THE DRIVER OF THE KIA. I THEN RAN THE WI LICENSE PLATE ON THE DODGE RAM WHICH CAME BACK TO I ASKED DISPATCH TO ALSO RUN HIM AS HE WAS THE DRIVER OF THE OTHER VEHICLE. I ASKED IF HE HAD BEEN WEARING HIS SEATBELT AND HE STATED HE WAS AND THAT HE WAS THE ONLY PERSON IN HIS VEHICLE. ALSO STATED THAT HE HAD STATE FARM FOR INSURANCE. I THEN ASKED IF SHE WAS WEARING HER SEATBELT. SHE STATED SHE WAS AND THAT WAS IN THE PASSENGER SEAT AND WAS ALSO WEARING HIS SEATBELT. SEE REPORT FOR MORE. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y CoordinateX Coordinate LongitudeLatitudePARKING LOT COUNTY ROAD K LOT IN THE TOWN OF BASS LAKE 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 NON TRAFFICWAY - PARKING LOT 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 IN PARKING LANE OR ZONE First Harmful Event PARKED MOTOR VEHICLE 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With PARKED MOTOR VEHICLE Total Lanes 0 Speed Limit 05 Pre CrashTire Mark Direction Of Travel NOT ON ROADWAY Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 3 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITModel SORENTO Year 2019 Make KIA MOTORS CORPORA Vehicle Identification Number 041480101 Country of Issuance UNITED STATES St MN Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF WISCONSIN MOTOR VEHICLE CRASH REPORT Owner AddressOwner Name01Driver Distractions UNKNOWN IF DISTRACTED 01Driver Actions UNSAFE BACKING Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing BACKING Vehicle Removed ByTowed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 6--REAR Initial Contact Point 6--REAR Bus Use NOT A BUS Body Style UT - SPORT UTILITY VEHICLE Color WHI - WHITE VEHICLEUNITUNITVEHICLE Sequence Of Events Event PARKED MOTOR VEHICLE01 Event 02Event 03Event 04Individual ROBIN TAINTER Insurance Company ALLSTATE-INS-CO Policy Holder UNITHelmet 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 09/27/ Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF WISCONSIN MOTOR VEHICLE CRASH REPORT Injury 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 Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00101 Tint ComplianceEye Protection 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 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 INDIAN Date of Birth 04/25/1 Sex MALE Citations Issued 0 Passenger ITEquipment Individual UNINDIVIDUALCrash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF 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 To/From SchoolLocationPrior ActionStriking Unit # Time of DeathDate of DeathHospital 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 INJURY00301 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 6--SECOND SEAT-RIGHT SIDE Safety Equipment CHILD RESTRAINT - TYPE UNKNOWN On Duty Crash Driver License NumberAddress HAYWARD, WI 54843 , US Race INDIAN Date of Birth 03/06/ Sex FEMALE Citations Issued 0 Passenger ITEquipment Non Motorist Individual UNINDIVIDUALCrash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00301Drug 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 LEVEL Road Curvature STRAIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control NO CONTROL Traffic Way PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With PARKED MOTOR VEHICLE Total Lanes 0 Speed Limit 05 Pre CrashTire Mark Direction Of Travel NOT ON ROADWAY Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type UTILITY TRUCK/PICKUP TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status LEGALLY PARKED Unit Summary UNITDriver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEGALLY PARKED Vehicle Removed By OWNER Towed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 1--RIGHT FRONT CORNER Initial Contact Point 1--RIGHT FRONT CORNER Bus Use NOT A BUS Body Style PK - PICKUP Color WHI - WHITE Model RAM 2500 Year 2009 Make DODGE Vehicle Identification Number 607670202 Country of Issuance UNITED STATES St WI Plate Type FFO - FIRE FIGHTER RED License Plate Number VEHICLEUNIT Vehicle Crash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name02Driver Distractions NOT DISTRACTED 02Driver Actions NO CONTRIBUTING ACTION UNITVEHICLE Sequence Of Events Event PARKED MOTOR VEHICLE01 Event 02Event 03Event 04IndividualInsurance Company STATE-FARM-GENERAL-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 UNKNOWN Ejection Path UNKNOWN Ejected UNKNOWN Airbag UNKNOWN Injury Severity NO APPARENT INJURY00402 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Safety Equipment NONE USED - VEHICLE OCCUPANT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address HAYWARD, WI 54843 , US Race WHITE Date of Birth 12/24/ Sex MALE Citations Issued 0 Unknown ITEquipment Non Motorist Individual UNINDIVIDUALCrash Time 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 8 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRF 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 03:15 PM Crash Date 06/04/2019Wisconsin Motor Vehicle Crash Form DT4000 8 of 8 This report does not include any CJIS data.