20191109 schilling19110909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB0008 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
02
Total Units
01
Time Notified
08:01 PM
Date Notified
11/09/2019
Time Arrived
08:36 PM
Date Arrived
11/09/2019
Crash Time
08:01 PM
Crash Date
11/09/2019
Investigating Officer/Deputy
DEPUTY MATTHEW JEFSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0FB0008Additional InformationPHOTOS
Photos ByDEPUTY JEFSON
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I, DEPUTY MATTHEW JEFSON OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT WAS DISPATCHED TO A ONE VEHICLE ROLL OVER ON WEST LANE
IN THE WINTER TOWNSHIP. DISPATCH ADVISED THAT ONE OF THE OCCUPANTS WAS EJECTED. WINTER FIRE, STATE TROOPER ANDERSON AND
THE AMBULANCE WERE ON SCENE PRIOR TO MY ARRIVAL. AFTER WE GOT THE DRIVER WHO WAS THE ONE EJECTED OUT OF THE DITCH AND INTO
THE AMBULANCE. TROOPER ANDERSON ADVISED THAT HE COULD SMELL THE ODOR OF INTOXICANT AND THAT THE DRIVER ADMITTED TO
DRINKING. I ADVISED HIM THAT I WOULD HANDLE THE CRASH PORTION. THE PASSENGER WAS CHECKED OUT AND BOTH OCCUPANTS WERE
TRANSPORTED BY AMBULANCE TO FLAMBEAU HOSPITAL. I THEN TOOK PHOTOGRAPHS OF THE CRASH AND ASSISTED SGT. NICK AL-MOGHRABI
WITH MEASURING. THE VEHICLE WAS THEN REMOVED FROM DITCH BY ROAD RUNNER. I THEN CLEARED.
Crash Time 08:01 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
19110909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB0008 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5072204
X Coordinate
204868.3125
Longitude
-90.793843419
Latitude
45.740364207
ON WEST LN
2.75 MI N
OF O' CONNEL RD
IN THE TOWN OF WINTER
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)
CLEAR
Environment Factor(s)
NONE
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
SNOW, ICE
Light Condition
DARK/UNLIT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
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
DOWNHILL
Road Curvature
CURVE LEFT
Surface Type
DIRT
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
35
Pre CrashTire
Mark
Direction Of Travel
EASTBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
2
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
ALL AREAS
Initial Contact Point
2--RIGHT SIDE FRONT
Bus Use
NOT A BUS
Body Style
PK - PICKUP
Color
BLK - BLACK
Model
F150
Year
2006
Make
FORD
Vehicle Identification Number
55230101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
UNITVEHICLECrash Time 08:01 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
19110909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB0008 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
276N LAKE AVE
PHILLIPS, WI 54555 , US
Owner Name
GLEN A SCHILLING
0101Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
VEHICLEUNIT Sequence Of Events
Event
RUN OFF ROADWAY RIGHT01
Event
CULVERT02
Event
OVERTURN/ROLLOVER03
Event
TREE04
Injury
Distracted By
LocationStriking Unit #
Distracted By Action
UNKNOWN
Distracted By Source
UNKNOWN
Time of DeathDate of DeathHospital
FLAMBEAU HOSP
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
THROUGH SIDE WINDOW
Ejected
TOTALLY EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED SERIOUS INJUR00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
PHILLIPS, WI 54555 , US
Race
WHITE
Date of Birth
09/24/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 08:01 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
19110909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB0008 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test Results
PENDING
Alcohol Test Type
BLOOD
Alcohol Test Given
TEST GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
YES
To/From SchoolAction Other
Action
Prior Action
UNITINDIVIDUALInjury
Distracted By
LocationStriking Unit #
Distracted By Action
Distracted By Source
Time of DeathDate of DeathHospital
FLAMBEAU HOSP
EMS Run #EMS Agency Identifier
6000989
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED MINOR INJURY00201 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
PHILLIPS, WI 54555 , US
Race
WHITE
Date of Birth
06/15/
Sex
MALE
Citations Issued
0
Passenger
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 08:01 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
19110909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB0008 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
UNITINDIVIDUALCrash Time 08:01 PM
Crash Date 11/09/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.