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20191126 mickelson19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 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 02:33 PM Date Notified 11/26/2019 Time Arrived 08:16 AM Date Arrived 12/04/2019 Crash Time 02:30 PM Crash Date 11/26/2019 Investigating Officer/Deputy DEPUTY KEVIN GILLIS Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0G5WRB4Additional InformationPHOTOS Photos ByDEPUTY KEVIN GILLIS Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 AND UNIT 2 WERE TRAVELING EAST ON STH 70. UNIT 2 PULLED OVER TO THE SIDE OF THE ROAD AND UNIT 1 ATTEMPTED TO LEGALLY PASS. UNIT 2 THEN ATTEMPTED TO TURN LEFT INTO A DRIVEWAY WHEN IT STRUCK UNIT ONE IN THE REAR PASSENGER SIDE. UNIT TWO WAS DRIVEN BY AN UNKNOWN UNDERAGE CHILD. UNIT 2 DID NOT HAVE ANY FUNCTIONING LIGHTS ON THE TRACTOR AND AFTER INVESTIGATION IT WAS DETERMINED THAT UNIT 2 WAS AT FAULT FOR THE CRASH. Crash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5083154 X Coordinate 190620.59375 Longitude -90.983566933 Latitude 45.832463686 ON STH70 EB 974 FT E OF OLSON 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 - ON ROAD Animal Type Weather Condition(s) CLOUDY Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 05--SIDESWIPE/SAME DIRECTION First Harmful Event Location ON ROADWAY 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 DIVIDED HWY W/O TRAFFIC BARRIER Emergency Motor Vehicle Use NON-EMERGENCY, NON-TRANSPORT Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT 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 UTILITY TRUCK/PICKUP TRUCK01 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 4--RIGHT SIDE REAR, 5--RIGHT REAR CORNER Initial Contact Point 4--RIGHT SIDE REAR Bus Use NOT A BUS Body Style TK - TRUCK Color GRN - GREEN Model SIERRA Year 2013 Make GENERAL MOTORS COR Vehicle Identification Number 64360101 Country of Issuance CANADA St ON Plate Type LTK - LIGHT TRUCK License Plate Number Vehicle UNITVEHICLECrash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address WINTER, WI 54896 , US Owner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing OVERTAKE LEFT Vehicle Removed By OWNER Towed Due To Damage NOT TOWED VEHICLEUNIT Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company NORTHBRIDGE GENERAL INSURANCE Policy Holder UNITInjury Distracted By 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 WINTER, WI 54896 , US Race WHITE Date of Birth 04/23/ Sex FEMALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 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 LocationStriking Unit #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 DIVIDED HWY W/O TRAFFIC BARRIER Emergency Motor Vehicle Use NON-EMERGENCY, NON-TRANSPORT Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT 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 1 Train/Bus # RecordedTotal Occs 2 Operating As EndorsementsVehicle Type FARM TRACTOR/SELF PROPELLED02 Unit Type EQUIPMENT Vehicle Operating As Classification O CLASS Unit Status IN TRANSIT Unit Summary UNITVehicle Removed By OWNER Towed Due To Damage NOT TOWED Extent Of Damage NO DAMAGE Vehicle Damage NO DAMAGE Initial Contact Point 12--FRONT Bus Use NOT A BUS Body Style TC - TRACTOR Color Model FARMALL YearMake MCCK Vehicle Identification Number 0202Country of Issuance UNITED STATES St WI Plate TypeLicense Plate Number Vehicle UNITVEHICLECrash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address NEW RICHMOND, WI 54017 , US Owner Name 0202Driver Actions OTHER CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN VEHICLEUNIT Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event LEFT TURN02 Event 03Event 04IndividualInsurance Company RURAL-MUTUAL-INS-CO-(ATTN:-CLAIMS-DEPT) Policy Holder UNITInjury Distracted By LocationStriking Unit # 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 NOT APPLICABLE Injury Severity NO APPARENT INJURY00202 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Safety Equipment NOT APPLICABLE On Duty Crash Driver License NumberAddress NEW RICHMOND, WI 54017 , US RaceDate of Birth Sex MALE Citations Issued 0 Driver UNKNOWN UNKNOWN UN Individual Non Motorist Safety EquipmentITIDUALINDIV Crash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00202Drug 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 UNITINDIVIDUALInjury Distracted By LocationStriking Unit # Distracted By Action 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 NOT APPLICABLE Injury Severity NO APPARENT INJURY00302 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER Safety Equipment NOT APPLICABLE On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address NEW RICHMOND, WI 54017 , US Race WHITE Date of Birth 05/26/ Sex MALE Citations Issued 1 Passenger UN Individual Non Motorist Safety EquipmentITIDUALINDIV Crash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 19112613 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRB4 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL 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 UNITINDIVIDUAL Violations DescriptionPERMIT CHILD TO OPERATE FARM MACHINERYStatute Number346.925(1)Issue To? 003 UTC Number BE65080601 Crash Time 02:30 PM Crash Date 11/26/2019Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.