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20190527 thyssen-brueggeman19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL 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 06:37 AM Date Notified 05/27/2019 Time Arrived 06:37 AM Date Arrived 05/27/2019 Crash Time 06:37 AM Crash Date 05/27/2019 Investigating Officer/Deputy DEPUTY DEREK BECKSTRAND Agency Crash NumberPrimary Crash Document #Document Number Override 6VL133SSFLAdditional InformationPHOTOS Photos ByDEPUTY SIMPSON Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. ON MAY 15TH 2019 DISPATCH ADVISED ME OF A TRAFFIC CRASH ON C HWY B AT THE ROUND LAKE MARINA. WHEN I ARRIVED THERE WERE TWO PARTIES OUTSIDE THEIR VEHICLES IN THE MARINA PARKING LOT. I ASKED THEM WHAT HAPPENED AND TOLD ME THAT SHE WAS TRYING TO TURN LEFT OUT OF THE PARKING LOT AND DID NOT SEE FROM THE LEFT. I COLLECTED EACH OF THEIR INFORMATION, DID NOT HAVE HER INSURANCE CARD ON HER BUT VERBALLY TOLD ME SHE HAS PROGRESSIVE INSURANCE. NEITHER PARTY SAID THEY HAD ANY INJURIES. I GAVE EACH PARTY THE CASE NUMBER AND ADVISED THEM TO GIVE THEIR INSURANCE COMPANIES THE NUMBER. I CLEARED FROM THE SCENE AND APPROXIMATELY AN HOUR LATER I SAW DODGE CARAVAN STOPPED AT A STOP SIGN IN HAYWARD, OFF OF HWY 77. VAN HAD SHUT OFF AT THE STOP SIGN AND SHE WAS UNABLE TO GET IT STARTED. EVENTUALLY WE GOT THE VAN STARTED AND DROVE AWAY FROM THE SCENE. Crash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5101947 X Coordinate 165872.828125 Longitude -91.31441615 Latitude 45.98959081 ON CTHB WB 673 FT W OF RICHARDSON BAY RD IN THE TOWN OF HAYWARD 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) CLOUDY Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 08--FRONT TO SIDE First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location OTHER LOCATION NOT LISTED AB Within Interchange Area NO Truck Bus or HazMat NO Road Grade LEVEL Road Curvature CURVE - UNKNOWN DIRECTION 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 35 Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type PASSENGER VAN01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 2--RIGHT SIDE FRONT, 3--RIGHT SIDE MIDDLE, 4--RIGHT SIDE REAR Initial Contact Point 3--RIGHT SIDE MIDDLE Bus Use NOT A BUS Body Style VN - VAN Color SIL - SILVER (ALUMINUM) Model CARVAN Year 2000 Make DODGE Vehicle Identification Number 01680101 Country of Issuance UNITED STATES St WI Plate Type LCO - LAC COURTE OREI License Plate Number VEHICLEUNIT Vehicle Crash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address COUDERAY, WI 54828 , 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 By OPERATOR Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company PROGRESSIVE-DIRECT-INSURANCE-CO Policy Holder UNITInjury 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 SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address COUDERAY, WI 54828 , US Race INDIAN Date of Birth 11/16/ Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL 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 EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 0 Speed Limit N/A 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 PASSENGER CAR02 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, 12--FRONT Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style 4H - HATCHBACK 4 DOOR Color WHI - WHITE Model EXPLORER Year 2013 Make FORD Vehicle Identification Number 28400202 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL WISCONSIN MOTOR VEHICLE CRASH REPORT Owner AddressOwner Name02Driver Distractions NOT DISTRACTED 02Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company PROGRESSIVE-DIRECT-INSURANCE-CO Policy Holder UNITInjury Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00202 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 NumberAddress HAYWARD, WI 54843 , US Race WHITE Date of Birth 05/15/1 Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 19051809 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL133SSFL 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 EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UNIT Non Motorist INDIVIDUALCrash Time 06:37 AM Crash Date 05/27/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.