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20190614 mills-savage19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 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 02 Time Notified 12:20 PM Date Notified 06/14/2019 Time Arrived 12:22 PM Date Arrived 06/14/2019 Crash Time 12:19 PM Crash Date 06/14/2019 Investigating Officer/Deputy DEPUTY DARIN JENSEN Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0HWRB02Additional InformationPHOTOS Photos ByAMBER AL-MOGHRABI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS TRAVELING EAST ON HIGHWAY 77 APPROACHING FISH HATCHERY ROAD. UNIT 2 WHICH WAS PULLING A U-HAUL TRAILER WAS TRAVELING WEST ON HIGHWAY 77. UNIT 2 BEGAN FISH TAILING WITH THE U-HAUL TRAILER AND SPUN AROUND 180 DEGREES CAUSING THE REAR PORTION OF THE U-HAUL TRAILER TO STRIKE THE FRONT PORTION OF UNIT 1 PUSHING UNIT 1 INTO THE DITCH. UNIT 1 HAD DISABLING DAMAGE FROM THE COLLISION AND UNIT 2 WAS ABLE TO DRIVE AWAY. Crash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y CoordinateX Coordinate LongitudeLatitudeON CTH77 EB 0 FT E OF FISH HATCHERY ROAD 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 02--FRONT TO REAR First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO Time Scene Cleared 01:36 PM Date Scene Cleared 06/14/2019 Time All Lanes Open 01:36 PM Date All Lanes Open 06/14/2019 Time Initial Lane/Rd Closed 12:22 PM Date Initial Lane/Rd Closed 06/14/2019 Reasons for Closure LAW ENFORCEMENT Closure Type LANE CLOSURE 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 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 55 Pre CrashTire Mark Direction Of Travel EASTBOUND 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 UNITModel SENTRA Year 2006 Make NISSAN Vehicle Identification Number 9820101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , 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 ROAD RUNNER TOWING Towed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 12--FRONT Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style 4D - 4DR Color BLK - BLACK VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company STATE-FARM-GENERAL-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 HAYWARD, WI 54843 , US Race WHITE Date of Birth 07/15 Sex FEMALE Citations Issued 0 Driver ITEquipment Individual UNINDIVIDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 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 HAYWARD AREA MEM HOSP EMS Run #EMS Agency Identifier 6000954 Medical Transport EMS GROUND Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity SUSPECTED MINOR INJURY00101 Tint ComplianceEye Protection UNIT Non Motorist INDIVIDUALTruck Bus or HazMat NO Road Grade DOWNHILL Road Curvature STRAIGHT 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 55 Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 1 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 5 Operating As EndorsementsVehicle Type PASSENGER CAR02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITModel MONTERO Year 2001 Make MITSUBISHI Vehicle Identification Number 30500202 Country of Issuance UNITED STATES St MI Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address WAKEFIELD, MI 49968 , US Owner Name02Driver Distractions NOT DISTRACTED 02Driver Actions OTHER CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed By OWNER Towed 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 4D - 4DR Color BLU - BLUE VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04Individual STEFAN SAVAGE Insurance Company MIC-GENERAL-INS-CORP Policy Holder UNIT Trailer/Towed Vehicle Identification Number 7270 Address PO BOX 21508 PO BOX 21508 PHOENIX, AZ 85036 , US Organization/Company U-HAUL CO OF THE WEST COAST OF FLORIDA Unit Type EQUIPMENT TRAILER/TOWEDCountry of Issuance UNITED STATES State FL Make U-HAUL Plate Type TRL - TRAI Trailer Plate #02UNITRace BLACK Date of Birth 09/17/ Sex MALE Citations Issued 0 Driver IT Individual IDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Injury 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 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 Number STATE: MICHIGAN COUNTRY: UNITED STATES Address WAKEFIELD, MI 49968 , US UNITEquipment Non MotoristUN INDIVIDUALINDIVSeat Position 3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: MICHIGAN COUNTRY: UNITED STATES Address WAKEFIELD, MI 49968 , US Race WHITE Date of Birth 05/09/ Sex FEMALE Citations Issued 0 Passenger ITEquipment Individual UNINDIVIDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Injury Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00302Drug 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 INJURY00302 Tint ComplianceEye Protection Helmet ComplianceHelmet Use UNIT Non Motorist INDIVIDUALTint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 4--SECOND SEAT-LEFT SIDE(MOTORCYCLE/BI Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress WAKEFIELD, MI 49968 , US Race WHITE Date of Birth 08/28/ Sex MALE Citations Issued 0 Passenger ITEquipment Individual UNINDIVIDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Injury 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 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 INJURY00402 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 INJURY00502 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 6--SECOND SEAT-RIGHT SIDE Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress WAKEFIELD, MI 49968 , US Race WHITE Date of Birth 08/15/ Sex FEMALE Citations Issued 0 Passenger ITEquipment Individual UNINDIVIDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 8 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00502Drug 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 INJURY00602 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 5--SECOND SEAT-MIDDLE Safety Equipment LAP BELT ONLY On Duty Crash Driver License NumberAddress WAKEFIELD, MI 49968 , US Race BLACK Date of Birth 02/02/ Sex MALE Citations Issued 0 Passenger ITEquipment Non Motorist Individual UNINDIVIDUALCrash Time 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 9 of 10 This report does not include any CJIS data. 19061410 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB02 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00602Drug 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 12:19 PM Crash Date 06/14/2019Wisconsin Motor Vehicle Crash Form DT4000 10 of 10 This report does not include any CJIS data.