20190923 kerner19092331
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3C 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
11:50 PM
Date Notified
09/23/2019
Time Arrived
12:05 AM
Date Arrived
09/24/2019
Crash Time
11:45 PM
Crash Date
09/23/2019
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3CAdditional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON 9/23/2019, AT APPROXIMATELY 11:50PM, DEPUTY SHEPARD WAS REQUESTED TO RESPOND TO A ONE VEHICLE CRASH ON STATE HWY 27/70
NEAR THE FIRE NUMBER 15388 IN THE SAND LAKE TOWNSHIP. WHEN DEPUTY SHEPARD ARRIVED ON SCENE HE IDENTIFIED THE DRIVER OF THE
VEHICLE INVOLVED IN THE CRASH AS . VEHICLE WAS IN THE NORTH DITCH AND SEVERELY DAMAGED. IT APPEARED
HE HAD ENTERED THE DITCH APPROXIMATELY 50 YARDS WEST OF WHERE THE VEHICLE CAME TO REST AND AFTER TRAVELING STRAIGHT IN THE
DITCH FOR APPROXIMATELY 25 YARDS THE VEHICLE ROLLED MULTIPLE TIMES. HAD WHAT APPEARED TO BE MINOR INJURY TO HIS
FOREHEAD AND ARM. ADVISED THAT THE ACCIDENT OCCURRED WHEN HE SWERVED TO MISS A BEAR IN THE ROADWAY. HE HAD BEEN
TRAVELING EAST AND SWERVED INTO THE NORTH DITCH. WAS TRANSPORTED FROM THE SCENE TO THE HOSPITAL BY AMBULANCE AS A
PRECAUTION AND THE VEHICLE WAS TOWED.
Crash Time 11:45 PM
Crash Date 09/23/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19092331
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3C WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5086968.5
X Coordinate
153317.359375
Longitude
-91.465232012
Latitude
45.848960717
ON STH27 SB
108 FT W
OF TURKEY TROT 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 - NOT ON ROAD
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
ROADSIDE
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Time Scene Cleared
01:10 AM
Date Scene Cleared
09/24/2019
Time All Lanes Open
12:55 AM
Date All Lanes Open
09/24/2019
Time Initial Lane/Rd Closed
12:45 AM
Date Initial Lane/Rd Closed
09/24/2019
Reasons for Closure
TOW TRUCK
Closure Type
FULL CLOSURE
Truck Bus or HazMat
NO
Road Grade
LEVEL
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
OVERTURN/ROLLOVER
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
UNITModel
AVEO/LS
Year
2007
Make
CHEVROLET
Vehicle Identification Number
34760101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 11:45 PM
Crash Date 09/23/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19092331
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3C WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
.
RADISSON, WI 54867 , US
Owner Name
0101Driver Actions
RAN OFF ROADWAY, SWERVED OR AVOIDED DUE TO WIND, SLIPPERY SURFACE, MOTOR VEHICLE, OBJECT, NON-
MOTORIST IN ROADWAY, ETC.
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
ALL AREAS
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
SD - SEDAN
Color
RED - RED
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
CROSS CENTERLINE01
Event
DITCH02
Event
OVERTURN/ROLLOVER03
Event
04IndividualInsurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UNITInjury
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-FRONT
Injury Severity
SUSPECTED MINOR 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
.
RADISSON, WI 54867 , US
Race
WHITE
Date of Birth
03/23/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Safety EquipmentITIDUALINDIV
Crash Time 11:45 PM
Crash Date 09/23/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19092331
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3C 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
NO
Suspected Alcohol Use
NO
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #
Distracted By Action
UNKNOWN
Distracted By Source
UNKNOWN
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
Non Motorist
UNITINDIVIDUALCrash Time 11:45 PM
Crash Date 09/23/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.