20191103 fogal19110304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N5 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
01:26 AM
Date Notified
11/03/2019
Time Arrived
01:26 AM
Date Arrived
11/03/2019
Crash Time
01:26 AM
Crash Date
11/03/2019
Investigating Officer/Deputy
DEPUTY MICHAEL SIMPSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0GNQ6N5Additional InformationPHOTOS
Photos ByDEPUTY MICHAEL SIMPSON
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
DEPUTY SIMPSON FOUND UNIT 1 CRASHED HEAD-ON INTO A TREE. DRIVER SAID THAT THEY DID NOT RECALL WHAT HAD HAPPENED BUT
BELIEVED THAT THEY MAY HAVE FALLEN ASLEEP WHILE DRIVING. DRIVER SAID THAT SHE WAS TRAVELING EASTBOUND ON CTY RD K. VEHICLE
ENDED UP ON THE NORTH SIDE OF CTY RD K AGAINST A TREE. VEHICLE WAS TOWED DUE TO DAMAGE BY ROAD RUNNER TOWING. OPERATOR OF
THE VEHICLE WAS TAKING TO A LOCAL HOSPITAL BY AMBULANCE AND THEN TRANSPORTED TO DULUTH, MN FOR FURTHER TREATMENT.
Crash Time 01:26 AM
Crash Date 11/03/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19110304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5094369.5
X Coordinate
156471.546875
Longitude
-91.430015483
Latitude
45.916952717
ON CTHK EB
0.40 MI W
OF HIGHLAND RD
IN THE TOWN OF BASS 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
NON TRAFFICWAY - OTHER
Animal Type
Weather Condition(s)
CLOUDY
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DARK/UNLIT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER LEFT
First Harmful Event
EMBANKMENT
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Time Scene Cleared
03:59 AM
Date Scene Cleared
11/03/2019
Time All Lanes Open
03:59 AM
Date All Lanes Open
11/03/2019
Time Initial Lane/Rd Closed
03:33 AM
Date Initial Lane/Rd Closed
11/03/2019
Reasons for Closure
TOW TRUCK
Closure Type
LANE CLOSURE
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
CURVE RIGHT
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
TREE
Total Lanes
2
Speed Limit
45
Pre CrashTire
Mark
Direction Of Travel
EASTBOUND
Insurance?
NO
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITModel
AZTEK
Year
2003
Make
PONTIAC
Vehicle Identification Number
23450101 Country of Issuance
UNITED STATES
St
WI
Plate TypeLicense Plate Number
Vehicle
Crash Time 01:26 AM
Crash Date 11/03/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19110304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
0101Driver Actions
FAILED TO KEEP IN DESIGNATED LANE
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
10--LEFT SIDE FRONT, 11--LEFT FRONT CORNER, 12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
LL - CARRYALL
Color
SIL - SILVER (ALUMINUM)VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
EMBANKMENT01
Event
TREE02
Event
03Event
04Injury
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 APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-SIDE
Injury Severity
SUSPECTED SERIOUS INJUR00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
NONE USED - VEHICLE OCCUPANT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
STONE LAKE, WI 54876 , US
Race
WHITE
Date of Birth
06/21/
Sex
FEMALE
Citations Issued
1
Driver
UN Individual
Safety EquipmentITIDUALINDIV
Crash Time 01:26 AM
Crash Date 11/03/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19110304
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N5 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Distracted By
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
YES
Suspected Alcohol Use
NO
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #
Distracted By Action
UNKNOWN
Distracted By Source
UNKNOWN
Non Motorist
UNITINDIVIDUAL Violations
DescriptionOPERATING WHILE SUSPENSIONStatute Number343.44(1)(a)Issue To?
001
UTC Number
BE64982701
Crash Time 01:26 AM
Crash Date 11/03/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.