20191130 owens19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G 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
08:36 PM
Date Notified
11/30/2019
Time Arrived
08:42 PM
Date Arrived
11/30/2019
Crash Time
08:36 PM
Crash Date
11/30/2019
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3GAdditional 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 30TH, 2019, DEPUTY SHEPARD WAS SENT TO A REPORTED HIT AND RUN CRASH LOCATED ON STATE HWY 77 APPROXIMATELY 300
YARDS WEST OF THE INTERSECTION WITH COUNTY HWY K IN THE HAYWARD TOWNSHIP IN SAWYER COUNTY. DEPUTY SHEPARD MADE CONTACT
WITH THE COMPLAINANT AND DRIVER OF UNIT ONE. SHE WAS IDENTIFIED AS SHE ADVISED THAT SHE HAD BEEN TRAVELING
WEST ON HWY 77 AND A VEHICLE HAD REPORTEDLY HIT HER TRAVELING EAST. THE ROADS WERE SNOW COVERED AND VERY SLIPPERY. SHE
STATED THAT SHE OBSERVED THE EASTBOUND TRAVELING VEHICLE, WHICH SHE BELIEVED TO BE EITHER A PICKUP TRUCK OR AN SUV. THE
VEHICLE WAS IN AND OUT OF IT'S LANE AND BEGAN SLIDING SIDEWAYS AND OUT OF CONTROL AS SHE WAS PASSING IT. THE VEHICLE SIDE
SWIPED HER VEHICLE AND CONTINUED DRIVING EAST WITHOUT STOPPING. THE SIDE MIRROR OF HER VEHICLE WAS SHATTERED AND THERE
WAS A SINGLE SCRATCH ON THE SIDE OF HER CAR. PHOTOS WERE TAKEN AND OWENS WAS THEN RELEASED FROM THE SCENE. ANOTHER
OFFICER CHECKED EAST ON 77 FOR THE POTENTIAL SUSPECT VEHICLE, BUT WAS UNABLE TO LOCATE IT.
Crash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 6
This report does not include any CJIS data.
19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5105944
X Coordinate
160250.1875
Longitude
-91.389646398
Latitude
46.022698966
ON STH77 WB
0.29 MI W
OF CTHK WB
IN THE TOWN OF HAYWARD
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)
SNOW
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
NONE
Road Surface Condition(s)
WET, SNOW, ICE
Light Condition
DARK/UNLIT
Manner of Collision
06--SIDESWIPE/OPPOSITE 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
UNKNOWN
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
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NOT APPLICABLE
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
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
UNITExtent Of Damage
MINOR DAMAGE
Vehicle Damage
9--LEFT SIDE MIDDLE, 11--LEFT FRONT CORNER
Initial Contact Point
11--LEFT FRONT CORNER
Bus Use
NOT A BUS
Body Style
4H - HATCHBACK 4 DOOR
Color
SIL - SILVER (ALUMINUM)
Model
XL7 LIMITE
Year
2007
Make
SUZUKI
Vehicle Identification Number
24610101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
UNITVEHICLECrash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 6
This report does not include any CJIS data.
19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
VEHICLEUNIT Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Individual
Insurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
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
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
12/04/
Sex
FEMALE
Citations Issued
0
Driver
UN Individual
Safety EquipmentITIDUALINDIV
Crash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 6
This report does not include any CJIS data.
19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G 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
UNKNOWN
Road Curvature
UNKNOWN
Surface Type
UNKNOWN
Traffic Control Inoperative/Missing
UNKNOWN
Traffic Control
UNKNOWN
Traffic Way
UNKNOWN
Emergency Motor Vehicle Use
UNKNOWN
Special Function
UNKNOWN
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed LimitPre CrashTire
Mark
Direction Of Travel
UNKNOWN
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
HIT AND RUN
Unit Summary
UNITVehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
VEHICLE NOT AT SCENE
Vehicle Damage
VEHICLE NOT AT SCENE
Initial Contact Point
VEHICLE NOT AT SCENE
Bus Use
NOT A BUS
Body StyleColor
ModelYearMakeVehicle Identification Number
0202Country of IssuanceStPlate TypeLicense Plate Number
Vehicle
UNITVEHICLECrash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 6
This report does not include any CJIS data.
19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
, ,
Owner Name
0202Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
UNKNOWN
What Driver Was Doing
UNKNOWN
VEHICLEUNIT Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Injury
Distracted By
Prior Action
LocationStriking Unit #
Distracted By Action
Distracted By Source
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT APPLICABLE
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT APPLICABLE
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
NONE USED - VEHICLE OCCUPANT
On Duty Crash
Driver License NumberAddress
, ,
RaceDate of Birth
SexCitations Issued
0
Driver
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 6
This report does not include any CJIS data.
19113018
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
NOT OBSERVED
Drug Type
00202Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug UseSuspected Alcohol Use
To/From SchoolAction Other
Action
UNITINDIVIDUALCrash Time 08:36 PM
Crash Date 11/30/2019Wisconsin Motor Vehicle Crash
Form DT4000 6 of 6
This report does not include any CJIS data.