20191015 loeffler19101510
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GD2XVV 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
01
Time Notified
02:33 PM
Date Notified
10/15/2019
Time Arrived
02:33 PM
Date Arrived
10/15/2019
Crash Time
02:33 PM
Crash Date
10/15/2019
Investigating Officer/Deputy
DEPUTY CHARLES LOGAN
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0GD2XVVAdditional InformationPHOTOS
Photos ByC.LOGAN
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
DEPUTY LOGAN WAS ON PATROL AND FOUND A CRASH ON MOOSE LAKE ROAD ABOUT ONE AND A HALF MILES EAST OF FOREST ROAD 320.
DEPUTY LOGAN WAS ADVISED THAT THE DRIVER JUST CALLED IT IN AS WELL AND WOULD BE AT THE SCENE SOON. A SHORT TIME LATER THE
DRIVER ARRIVED BACK AT THE SCENE. THE DRIVER ALREADY CONTACTED ROAD RUNNER TOWING TO REMOVE THE VEHICLE. THE VEHICLE HAD
SEVER FRONT END DAMAGE AS IT STRUCK SOME TREES WHEN IT WENT OFF THE ROADWAY. A WHILE LATER ROAD RUNNER TOWING ARRIVED TO
REMOVE THE VEHICLE. THE DRIVER ( ) STATED THAT HE DID NOT KNOW WHAT HAPPENED AND THAT HE WAS DRIVING AND HE JUST
WENT OFF THE ROAD FOR AN UNKNOWN REASON. DEPUTY LOGAN DID NOT NOTICE ANY SIGNS OF IMPAIRMENT WITH . THE VEHICLE
WAS NOT DRIVEABLE AND WAS TOWED TO THE IMPOUND FOR ROAD RUNNER TOWING.
Crash Time 02:33 PM
Crash Date 10/15/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19101510
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GD2XVV WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5105176
X Coordinate
180170.125
Longitude
-91.132460572
Latitude
46.025390107
ON MOOSE LAKE RD
0.51 MI E
OF FEDERAL FOREST RD 320
IN THE TOWN OF ROUND 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)
CLOUDY
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 LEFT
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
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
TREE
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 # RecordedTotal 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
1--RIGHT FRONT CORNER, 11--LEFT FRONT CORNER, 12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
4D - 4DR
Color
MAR - MAROON (BURGUNDY)
Model
CONTINENTA
Year
2002
Make
LINCOLN
Vehicle Identification Number
07180101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
UNITVEHICLECrash Time 02:33 PM
Crash Date 10/15/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19101510
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GD2XVV WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
FAILURE TO CONTROL
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
VEHICLEUNIT Sequence Of Events
Event
DITCH01
Event
TREE02
Event
03Event
04IndividualInsurance Company
AMERICAN-FAMILY-INS-CO
Policy Holder
UNITInjury
Distracted By
Distracted By Action
UNKNOWN
Distracted By Source
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-FRONT
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
HAYWARD, WI 54843 , US
RaceDate of Birth
08/15/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Safety EquipmentITIDUALINDIV
Crash Time 02:33 PM
Crash Date 10/15/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19101510
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GD2XVV 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
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #Non Motorist
UNITINDIVIDUALCrash Time 02:33 PM
Crash Date 10/15/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.