20190504 cunningham19050410
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8WM 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
01
Total Units
01
Time Notified
09:02 AM
Date Notified
05/04/2019
Time Arrived
09:20 AM
Date Arrived
05/04/2019
Crash Time
09:02 AM
Crash Date
05/04/2019
Investigating Officer/Deputy
DEPUTY MICHAEL SIMPSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL13MV8WMAdditional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT WAS REPORTED TO HAVE LEFT THE ROADWAY ON THE NORTH SIDE AT BREEZY POINT LN. THE VEHICLE THEN ROLLED APPROXIMATELY
THREE TIMES. THE DRIVER WAS OUT OF THE VEHICLE AT THE TIME THE DEPUTY ARRIVED. DRIVER COULD NOT OR WOULD NOT ANSWER
QUESTIONS AT THAT TIME. DRIVER WAS SIR LIFTED FOR MEDICAL TREATMENT. METHAMPHETAMINE AND PARAPHERNALIA WERE FOUND ON THE
ROADSIDE AMONGST THE DEBRIS FROM THE CRASH. DEPUTY WAS ABLE TO GET THE DRIVER TO CONSENT TO A BLOOD DRAW. THAT BLOOD HAS
BEEN SENT TO THE WISCONSIN CRIME LAB.
Crash Time 09:02 AM
Crash Date 05/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19050410
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8WM WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5087204.5
X Coordinate
155037.625
Longitude
-91.4433115
Latitude
45.851939084
INTERSECTION
ON STH27 NB
AT BREEZY POINT 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 - ON ROAD
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
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
First Harmful Event
EMBANKMENT
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
SAG(BOTTOM)
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
NORTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
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
2H - HATCHBACK 2 DOOR
Color
WHI - WHITE
Model
FORTWO
Year
2013
Make
SMART
Vehicle Identification Number
44790101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 09:02 AM
Crash Date 05/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19050410
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8WM WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
RADISSON, WI 54867 , US
Owner Name01Driver Distractions
UNKNOWN IF DISTRACTED
01Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
OWNER
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
EMBANKMENT01
Event
02Event
03Event
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
SUSPECTED SERIOUS INJUR00101 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
RADISSON, WI 54867 , US
Race
WHITE
Date of Birth
11/07/
Sex
MALE
Citations Issued
0
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 09:02 AM
Crash Date 05/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19050410
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8WM WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00101Drug Test Results
PENDING
Drug Test Type
BLOOD
Drug Test Given
TEST GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
YES
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
ST. MARY'S MEDICAL CENTER - DULUTH
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS AIR
UNIT Non Motorist
INDIVIDUALCrash Time 09:02 AM
Crash Date 05/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.