20190604 flowersSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F1BQ6P 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
01
Time Notified
10:30 PM
Date Notified
06/04/2019
Time Arrived
10:40 PM
Date Arrived
06/04/2019
Crash Time
10:30 PM
Crash Date
06/04/2019
Investigating Officer/Deputy
DEPUTY CALEB JORSTAD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F1BQ6PAdditional InformationPHOTOS
Photos ByDEPUTY CALEB JORSTAD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON JUNE 4 2019, I DEPUTY JORSTAD WITH THE SAWYER COUNTY SHERIFF'S OFFICE RESPONDED TO A VEHICLE IN THE DITCH ON HIGHWAY 27/70
AND PIERCE LANE IN THE TOWNSHIP OF SAND LAKE. WHEN I ARRIVED ON SCENE, I SAW A VEHICLE OVERTURNED DOWN AN EMBANKMENT. THE
INDIVIDUALS THAT CALLED IT IN WERE STILL ON SCENE, AS WELL AS A FIRST RESPONDER. THERE WAS NO ONE IN THE VEHICLE. THE STONE LAKE
FIRE DEPARTMENT SEARCHED THE SURROUNDING AREA BOTH PHYSICALLY AND WITH A FLIR THERMAL DEVICE. I ALSO SEARCHED THE AREA
THOROUGHLY, FINDING NO SUBJECTS IN THE AREA. I PHOTOGRAPHED THE VEHICLE. THE VEHICLE WAS THEN REMOVED FROM THE
EMBANKMENT.
Crash Time 10:30 PM
Crash Date 06/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F1BQ6P WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5086921
X Coordinate
154320.046875
Longitude
-91.452322739
Latitude
45.849035592
ON STH27 SB
450 FT E
OF PIERCE LN
IN THE TOWN OF SAND 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
TRAFFICWAY - NOT ON ROAD
Animal Type
Weather Condition(s)
CLEAR
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
WET
Light Condition
DARK/UNLIT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
UPHILL
Road Curvature
CURVE LEFT
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
EMBANKMENT
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
1
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
ALL AREAS
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
4D - 4DR
Color
ONG - ORANGE
Model
NEON
Year
2005
Make
DODGE
Vehicle Identification Number
508030101 Country of Issuance
UNITED STATES
St
FL
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 10:30 PM
Crash Date 06/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F1BQ6P WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
MARCO ISLAND, FL 34145 , US
Owner Name01Driver DistractionsUNKNOWN IF DISTRACTED
01Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
UNKNOWN
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
DITCH01
Event
EMBANKMENT02
Event
TREE03
Event
04IndividualInsurance Company
ALLSTATE-INS-CO
Policy Holder
UNITInjury
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
DEPLOYED-FRONT
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: FLORIDA COUNTRY: UNITED STATES
Address
MARCO ISLAND, FL 34145 , US
Race
WHITE
Date of Birth
02/10/
Sex
MALE
Citations Issued
1
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 10:30 PM
Crash Date 06/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F1BQ6P WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
NOT OBSERVED
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug UseSuspected Alcohol Use
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
UNIT Non Motorist
INDIVIDUAL Violations
DescriptionFAILURE OF OPERATOR TO NOTIFY POLICE OF ACCIDENTSeq Num006Statute Number346.70(1)Issue To?
001
UTC Number
BE60920101
Crash Time 10:30 PM
Crash Date 06/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.