20191109 galowitz19110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3D 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
07:39 PM
Date Notified
11/09/2019
Time Arrived
07:55 PM
Date Arrived
11/09/2019
Crash Time
07:39 PM
Crash Date
11/09/2019
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3DAdditional InformationPHOTOS
Photos ByDEPUTY L. SHEPARD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON NOVEMBER 9TH, 2019, AT APPROXIMATELY 1939 DEPUTY SHEPARD RESPONDED TO A REPORT OF A VEHICLE IN THE DITCH ON COUNTY HWY K
APPROXIMATELY ONE QUARTER MILE EAST OF STATE HWY 27. THE VEHICLE HAD BEEN TRAVELING EAST WHEN IT LOST TRACTION AND BEGAN TO
SLIDE DUE TO ICY AND WET ROAD CONDITIONS. THE VEHICLE LEFT THE ROADWAY TO THE NORTH TRAVELING APPROXIMATELY 15 FEET DOWN AN
EMBANKMENT AND STRIKING A TREE ON THE DRIVER'S SIDE OF THE VEHICLE. THE TREE SLID ALONG THE ENTIRE DRIVER'S SIDE CAUSING
SIGNIFICANT SCRATCHING AND DENTING. THE DRIVER AND ONLY OCCUPANT WAS AND HE APPEARED TO BE UNINJURED. DUE
TO STAFFING ISSUES COMBINED WITH DIMINISHED ROAD CONDITIONS THE VEHICLE WAS NOT TOWED UNTIL THE FOLLOWING DAY.
Crash Time 07:39 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3D WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5094367
X Coordinate
152456.8125
Longitude
-91.481626782
Latitude
45.914912615
ON CTHK EB
0.55 MI W
OF THUNDER POINT 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
TRAFFICWAY - NOT ON ROAD
Animal Type
Weather Condition(s)
FREEZING RAIN OR FREEZING DRIZZLE
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
WET, ICE
Light Condition
DARK/UNLIT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
EMBANKMENT
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
UNKNOWN
Truck Bus or HazMat
NO
Road Grade
UPHILL
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?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01 Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
DISABLING DAMAGE
Vehicle Damage
7--LEFT REAR CORNER, 8--LEFT SIDE REAR, 9--LEFT SIDE MIDDLE, 10--LEFT
SIDE FRONT, 11--LEFT FRONT CORNER
Initial Contact Point
11--LEFT FRONT CORNER
Bus Use
NOT A BUS
Body Style
4H - HATCHBACK 4 DOOR
Color
RED - RED
Model
CHEROKEE
Year
2017
Make
JEEP
Vehicle Identification Number
38930101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
UNITVEHICLECrash Time 07:39 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3D WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
FAILURE TO CONTROL, RAN OFF ROADWAY
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
RUN OFF ROADWAY LEFT01
Event
EMBANKMENT02
Event
TREE03
Event
04Injury
Distracted By
LocationStriking Unit #
Distracted By Action
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
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
WHITE
Date of Birth
04/08/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 07:39 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3D 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
UNITINDIVIDUALCrash Time 07:39 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.