20191206 moore19120603
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GFB005 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
08:56 AM
Date Notified
12/06/2019
Time Arrived
09:01 AM
Date Arrived
12/06/2019
Crash Time
08:56 AM
Crash Date
12/06/2019
Investigating Officer/Deputy
DEPUTY RYAN SCHICK
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0GFB005Additional InformationPHOTOS
Photos ByDEPUTY RYAN SCHICK
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON DECEMBER 6, 2019, I, DEPUTY RYAN SCHICK OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT RESPONDED TO A SINGLE VEHICLE CAR
CRASH INTO A TREE ON STH 77 WEST OF CTH K IN THE TOWNSHIP OF HAYWARD. I ARRIVED ON SCENE AND WITNESSED A RAM 1500 THAT WENT
OFF OF THE ROADWAY AND STRUCK A TREE. THE VEHICLE WAS DISABLED DUE TO SEVERE FRONT END DAMAGE. I MET WITH THE ABOVE DRIVER,
STATED HE ISN'T SURE WHAT HAPPENED AND DOESN'T REMEMBER MUCH. HE STATED HE WAS SORE SO I CALLED EMS TO
RESPOND TO LOOK HIM OVER. REFUSED TREATMENT ON SCENE AND DID NT GO TO THE HOSPITAL. STATED HE ISN'T SURE IF HE
ZONED OUT OR NOT. HE STARTED HE DID NOT HAVE INSURANCE ON THE VEHICLE AS IT WAS JUST PURCHASED AND HE WAS IN THE PROCESS OF
GETTING IT INSURED. ROADRUNNER TOW ARRIVED AND REMOVED THE VEHICLE. NO AIRBAGS WERE DEPLOYED AND STATED HE WAS
WEARING A SHOULDER AND LAP BELT. PLEASE REFER TO SWSO CASE #:19120603 FOR MORE DETAILS.
Crash Time 08:56 AM
Crash Date 12/06/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
19120603
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GFB005 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5105926.5
X Coordinate
160163.171875
Longitude
-91.390754779
Latitude
46.022496845
ON STH77 EB
0.34 MI W
OF CTHK NB
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 - NOT ON ROAD
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
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
OUTSIDE RIGHT-OF-WAY (TRAFFICWAY)
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
TRUCK OR TRUCK COMBINATION > 10,000LBS GVWR/GCWR
Road Grade
LEVEL
Road Curvature
CURVE LEFT
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?
NO
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
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
DISABLING DAMAGE
Vehicle Damage
1--RIGHT FRONT CORNER, 11--LEFT FRONT CORNER, 12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
2D - 2DR
Color
GRN - GREEN
Model
1500
Year
2005
Make
RAM
Vehicle Identification Number
02070101 Country of Issuance
UNITED STATES
St
WI
Plate Type
TMP - TEMPORARY PLAT
License Plate Number
Vehicle
UNITVEHICLECrash Time 08:56 AM
Crash Date 12/06/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
19120603
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GFB005 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
CABLE, WI 54821 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
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
MOTOR VEH IN TRANSPORT01
Event
DITCH02
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: MINNESOTA COUNTRY: UNITED STATES
Address
CABLE, WI 54821 , US
Race
WHITE
Date of Birth
07/12/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 08:56 AM
Crash Date 12/06/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
19120603
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GFB005 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
UNITINDIVIDUALMeasured WeightMeasured WidthMeasured LengthMeasured Height
Escort Vehicle PresentEscort Vehicle Required
By Permit
Permitted Vehicle On
Permitted Route
WI Permit NumberOS/OW Load
Permitted Load
NOT APPLICABLE
Carrier Type
NOT IN COMMERCE/OTHER TRUCK
US DOT #
Cargo Body Type
NOT APPLICABLE - (MOTOR VEHICLE 10,000
Vehicle Configuration
BUS/LARGE VAN (SEATS FOR 9-15 OCCUPANTS, INC
GVWR
NOT APPLICABLE01 Address
CABLE, WI 54821 , US
Name
01Source
DRIVERUse Vehicle Owner Same as Carrier
Carrier
CKBUSUNITTRUCrash Time 08:56 AM
Crash Date 12/06/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.