20190530 karow19053006
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0Z 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
07:11 AM
Date Notified
05/30/2019
Time Arrived
07:18 AM
Date Arrived
05/30/2019
Crash Time
07:00 AM
Crash Date
05/30/2019
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL12XVN0ZAdditional InformationPHOTOS
Photos ByDEPUTY KEVIN GILLIS
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
VEHICLE WAS TRAVELING SOUTH ON STH 27. DRIVER OF THE VEHICLE CLAIMED HE SWERVED TO MISS A DEER AND LOST CONTROL OF THE
VEHICLE. THE VEHICLE CROSSED INTO THE NORTHBOUND LANE AND BACK ACROSS THE SOUTHBOUND LANE, COMING TO A REST IN A CULVERT
IN THE WEST SIDE DITCH.
Crash Time 07:00 AM
Crash Date 05/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
19053006
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5119324.5
X Coordinate
151180.296875
Longitude
-91.516273193
Latitude
46.138195389
ON STH27 SB
0.63 MI S
OF DUCK POND 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
DEER
Weather Condition(s)
CLOUDY
Environment Factor(s)
ANIMAL (S) IN ROADWAY
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
CULVERT
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
DIVIDED HWY W/O TRAFFIC BARRIER
Emergency Motor Vehicle Use
EMERGENCY OPERATION, EMERGEN
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
CULVERT
Total Lanes
2
Speed Limit
55
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # InjuredTotal Occs
2
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
MINOR DAMAGE
Vehicle Damage
1--RIGHT FRONT CORNER, 11--LEFT FRONT CORNER, 12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
UT - SPORT UTILITY VEHICLE
Color
GRN - GREEN
Model
LIBERTY
Year
2004
Make
JEEP
Vehicle Identification Number
2490101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 07:00 AM
Crash Date 05/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
19053006
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
GRAND VIEW, WI 54839 , US
Owner Name01Driver DistractionsUNKNOWN IF DISTRACTED
01Driver Actions
SWERVED OR AVOIDED DUE TO WIND, SLIPPERY SURFACE, MOTOR VEHICLE, OBJECT, NON-MOTORIST IN ROADWAY, ETC.
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
OWNER
Towed Due To Damage
NOT TOWED
UNITVEHICLE Sequence Of Events
Event
CULVERT01
Event
02Event
03Event
04Injury
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
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
NOT APPLICABLE
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
CABLE, WI 54821 , US
Race
WHITE
Date of Birth
06/10/
Sex
MALE
Citations Issued
1
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 07:00 AM
Crash Date 05/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
19053006
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0Z 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
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 INJURY00201 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
UNKNOWN
Safety Equipment
NOT APPLICABLE
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
MINONG, WI 54859 , US
Race
WHITE
Date of Birth
06/12/
Sex
FEMALE
Citations Issued
0
Passenger
ITEquipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 07:00 AM
Crash Date 05/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
19053006
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0Z 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
UNITINDIVIDUAL Violations
DescriptionOPERATING AFTER SUSPENSIONSeq Num001Statute Number343.44(1)(a)Issue To?
001
UTC Number
BD19101501
Crash Time 07:00 AM
Crash Date 05/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.