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20190809 beaudin-schulerON AUGUST 9, 2019, I, DEPUTY AMBER AL-MOGHRABI, WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT. AT APPROXIMATELY 14:58, I WAS ADVISED BY DISPATCH TO RESPOND TO KWIK TRIP IN HAYWARD FOR A REPORT OF A 2 VEHICLE ACCIDENT. UPON ARRIVAL AT 15:01, I WAS MET BY WHO STATED HER DAUGHTER WAS IN A CAR ACCIDENT WHILE TRYING TO LEAVE THE PARKING LOT. I ADVISED DISPATCH THAT I HAD A WI REGISTRATION FOR HIM TO RUN. THEY ADVISED THAT THEY HAD ALREADY RUN BOTH VEHICLES WHICH CAME BACK CURRENT AND CLEAR. DISPATCH ADVISED THAT HE ALSO RAN BOTH DRIVERS WHO AGAIN CAME BACK CLEAR AND VALID. I ASKED IF I COULD TALK TO HER DAUGHTER, , WHO WAS THE DRIVER OF THE SEDAN. STATED THAT HER AND HER BROTHER WERE IN THE VEHICLE PARKED AT THE ENTRANCE ON STATE HWY 27. SHE SAID THEY WERE STOPPED WHILE WAITING FOR TRAFFIC TO SLOW DOWN SO THEY COULD TURN ON TO STATE HWY 27. SHE SAID AT THAT TIME A WHITE TRUCK STARTED TO BACK OUT OF THEIR PARKING SPOT AND HIT HER VEHICLE. I ASKED WHERE THAT VEHICLE WENT. SHE SAID THAT THE MALE DRIVER GOT OUT OF HIS TRUCK AND CAME UP TO TALK TO HER. SHE SAID THAT HE GAVE HER HIS INSURANCE CARD TO TAKE A PICTURE OF AND PROVIDED HIS TELEPHONE NUMBER AND SAID THERE WAS NO DAMAGE TO HIS VEHICLE AND LEFT. SHE STATED THAT HE SAID HE DID NOT SEE HER 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL 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 02 Time Notified 02:58 PM Date Notified 08/09/2019 Time Arrived 03:01 PM Date Arrived 08/09/2019 Crash Time 02:55 PM Crash Date 08/09/2019 Investigating Officer/Deputy DEPUTY AMBER ALMOGHRABI Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0FZQKRLAdditional InformationPHOTOS Photos ByDEPUTY AMBER AL-MOGHRABI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. Crash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. VEHICLE PARKED THERE. SAID THAT SHE CALLED HER MOTHER THEN BECAUSE SHE WASN'T SURE WHAT SHE SHOULD DO. I LOOKED AT THE DAMAGE TO R CAR AND NOTICED A CRACK TO THE PASSENGER SIDE REAR BUMPER ALONG WITH DENTS AND SCRATCHES. I TOOK PICTURES OF THE DAMAGE AND ATTACHED THEM TO MY REPORT IN SPILLMAN. I ASKED IF HER OR HER BROTHER WERE INJURED. SHE STATED THEY WERE NOT AND WERE BOTH WEARING THEIR SEAT BELTS. I THEN GOT HER BROTHER'S INFORMATION, WHO HAD LEFT THE SCENE WITH HIS FATHER, AS HE WAS THE PASSENGER IN THAT VEHICLE. SEE REPORT FOR MORE DETAILS. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5105265.5 X Coordinate 152849.78125 Longitude -91.48447457 Latitude 46.012901144 ON STH27 NB 59 FT S OF USH63 NB IN THE CITY OF HAYWARD IN SAWYER COUNTY Location Special StudyAccess Control NO CONTROL Tribal Land Crash Classification - Jurisdiction PRIVATE PROPERTY Crash Classification - Location PRIVATE PROPERTY Relation To Trafficway NON TRAFFICWAY - PARKING LOT Animal Type Weather Condition(s) CLEAR Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 07--REAR TO SIDE First Harmful Event Location OFF ROADWAY, LOCATION UNKNOWN First Harmful Event MOTOR VEH IN TRANSPORT 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 0 Speed Limit 05 Pre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 2 Operating As EndorsementsVehicle Type PASSENGER CAR01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITBus Use NOT A BUS Body Style SD - SEDAN Color GRY - GRAY Model ION Year 2004 Make SATURN Vehicle Identification Number 8520101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other STOPPED IN PARKING LOT WAITING TO LEAV Vehicle Factors NOT APPLICABLE What Driver Was Doing OTHER Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 3--RIGHT SIDE MIDDLE, 4--RIGHT SIDE REAR, 5--RIGHT REAR CORNER Initial Contact Point 4--RIGHT SIDE REAR VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company INTEGRITY-MUTUAL-INS-CO Policy Holder UNITInjury 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 NON DEPLOYED 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 Race INDIAN Date of Birth 09/11/ Sex FEMALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL 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 NOT DISTRACTED Distracted By Source NOT APPLICABLE (NOT DISTRACTED) Non Motorist UNITINDIVIDUALInjury Distracted By 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 NON DEPLOYED Injury Severity NO APPARENT INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address BLK RIVER FALLS, WI 54615 , US Race INDIAN Date of Birth 09/08/ Sex MALE Citations Issued 0 Passenger UN Individual Safety EquipmentITIDUALINDIV Crash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00201Drug 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 Non Motorist UNITINDIVIDUALTruck 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 0 Speed Limit 05 Pre 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 UTILITY TRUCK/PICKUP TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage NO DAMAGE Vehicle Damage NO DAMAGE Initial Contact Point 6--REAR Bus Use NOT A BUS Body Style PK - PICKUP Color WHI - WHITE Model F150 XLT Year 2013 Make FORD Vehicle Identification Number 51380202 Country of Issuance UNITED STATES St MN Plate Type LTK - LIGHT TRUCK License Plate Number Vehicle UNITVEHICLECrash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address CHISAGO CITY, MN 55013 , US Owner Name 0202Driver Actions UNSAFE BACKING Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing BACKING Vehicle Removed By OWNER Towed Due To Damage NOT TOWED VEHICLEUNIT Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company SAFECO-INS-CO-OF-AMERICA Policy Holder UNITInjury Distracted By Distracted By Action UNKNOWN Distracted By Source UNKNOWN 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 NON DEPLOYED Injury Severity NO APPARENT INJURY00302 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: MINNESOTA COUNTRY: UNITED STATES Address CHISAGO CITY, MN 55013 , US Race WHITE Date of Birth 02/12/ Sex MALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 19080931 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0FZQKRL WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition NOT OBSERVED 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 To/From SchoolAction Other Action Prior Action LocationStriking Unit #Non Motorist UNITINDIVIDUALCrash Time 02:55 PM Crash Date 08/09/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.