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.