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20190814 culhaneSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z7RB06 WISCONSIN MOTOR VEHICLE CRASH REPORT Secondary CrashAmendedCrash Type NON-DOMESTICATED ANIMAL W/ NO INJURYReportable 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 09:05 PM Date Notified 08/14/2019 Time ArrivedDate ArrivedCrash Time 09:03 PM Crash Date 08/14/2019 Investigating Officer/Deputy DEPUTY CALEB JORSTAD Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0Z7RB06I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. Structure Type NO STRUCTURE Y Coordinate 5103004.5 X Coordinate 162083.640625 Longitude -91.363948278 Latitude 45.997223666 ON CTHB WB 241 FT W OF ROUND LAKE SCHOOL RD IN THE TOWN OF HAYWARD IN SAWYER COUNTY Location Special StudyAccess ControlTribal Land Crash Classification - Jurisdiction NO SPECIAL JURISDICTION Crash Classification - Location PUBLIC PROPERTY Relation To Trafficway TRAFFICWAY - ON ROAD Animal Type DEER Weather Condition(s) Environment Factor(s) Roadway Factor(s)Road Surface Condition(s) Light ConditionManner of Collision NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location ON ROADWAY First Harmful Event NON DOMESTICATED ANIMAL (ALIVE) Crash Scene Road GradeRoad CurvatureSurface Type Traffic Control Inoperative/MissingTraffic ControlTraffic Way Emergency Motor Vehicle Use NON-EMERGENCY, NON-TRANSPORT Special Function POLICE Most Harmful Event: Collision With NON DOMESTICATED ANIMAL (ALIVE) Total LanesSpeed LimitPre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITCrash Time 09:03 PM Crash Date 08/14/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 3 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z7RB06 WISCONSIN MOTOR VEHICLE CRASH REPORT Truck Bus or HazMat NO Owner AddressOwner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle FactorsWhat Driver Was Doing Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 12--FRONT Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style UT - SPORT UTILITY VEHICLE Color BLK - BLACK Model EXPLORER Year 2018 Make FORD Vehicle Identification Number B68810101 Country of Issuance UNITED STATES St WI Plate Type OFF - MUNICIPAL OFFICI License Plate Number VEHICLEUNIT Vehicle UNITVEHICLEGovernmentInsurance Company COUNTRY-MUTUAL-INSURANCE-CO Policy Holder UNITInjury Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/ExtricatedEjection PathEjected AirbagInjury Severity NO APPARENT INJURY00101 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position Safety Equipment SHOULDER & LAP BELT On Duty Crash POLICE Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address MINONG, WI 54859 , US Race WHITE Date of Birth 05/20/ Sex MALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 09:03 PM Crash Date 08/14/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 3 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z7RB06 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 Distracted By Source Non Motorist UNITINDIVIDUALCrash Time 09:03 PM Crash Date 08/14/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 3 This report does not include any CJIS data.