20191212 ferrer-hunt19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M 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
11:20 AM
Date Notified
12/12/2019
Time Arrived
11:20 AM
Date Arrived
12/12/2019
Crash Time
11:20 AM
Crash Date
12/12/2019
Investigating Officer/Deputy
DEPUTY NATHAN FREY
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0JB3P3MAdditional InformationOTHER DOCUMENTS
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS TRAVELING EAST ON HIGHWAY 27/77 AND BEGAN TO MAKE A LEFT TURN ONTO HIGHWAY 63 NORTH. THE OPERATOR OF UNIT 1 LOST
TRACTION DURING THE TURN AND WAS STRUCK BY UNIT 2 THAT WAS TRAVELING WEST ON HIGHWAY 77. THE OPERATOR OF UNIT 2 ADVISED
THAT HE BELIEVES UNIT 1 DID NOT YIELD RIGHT OF WAY TO HIM. THE OPERATORS OF UNITS 1 AND 2 WERE UNINJURED. UNIT 1 HAD PASSENGER
SIDE CURTAIN AIRBAG DEPLOYMENT. UNIT 2 SUSTAINED MINOR DAMAGE TO THE FRONT PASSENGER SIDE BUMPER COVER AND HEADLIGHT.
UNIT 1 SUSTAINED MODERATE DISABLING DAMAGE TO THE PASSENGER SIDE FRONT QUARTER PANEL, AND FRONT AND REAR PASSENGER
DOORS AS WELL AS POSSIBLE AXLE DAMAGE TO THE PASSENGER SIDE FRONT WHEEL. NO PICTURES WERE OBTAINED DUE TO THE WEATHER,
HEAVY TRAFFIC, AND THE FACT THAT UNIT 2 WAS IMMEDIATELY RELEASED FROM THE ACCIDENT SCENE FOR SCENE SAFETY.
Crash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5105868.5
X Coordinate
153564.21875
Longitude
-91.475711399
Latitude
46.018673134
INTERSECTION
ON USH63 NB
AT STH77 EB
IN THE CITY OF HAYWARD
IN SAWYER COUNTY
Location
Special StudyAccess Control
FULL 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, SNOW
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
NONE
Road Surface Condition(s)
SNOW, SLUSH, ICE
Light Condition
DAYLIGHT
Manner of Collision
08--FRONT TO SIDE
First Harmful Event Location
ON ROADWAY
First Harmful Event
MOTOR VEH IN TRANSPORT
Crash Scene
Intersection Type
FIVE-POINT, OR MORE
Junction Location
INTERSECTION
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
TRAFFIC SIGNAL
Traffic Way
DIVIDED HWY MEDIAN W/BARRIER
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
5
Speed Limit
35
Pre CrashTire
Mark
Direction Of Travel
NORTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
DISABLING DAMAGE
Vehicle Damage
1--RIGHT FRONT CORNER, 2--RIGHT SIDE FRONT, 3--RIGHT SIDE MIDDLE
Initial Contact Point
2--RIGHT SIDE FRONT
Bus Use
NOT A BUS
Body Style
4D - 4DR
Color
BRO - BROWN
Model
CIVIC LX
Year
2012
Make
HONDA
Vehicle Identification Number
81870101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
UNITVEHICLECrash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
FAILURE TO CONTROL
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
LEFT TURN
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
VEHICLEUNIT Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
LEFT TURN02
Event
03Event
04IndividualInsurance Company
DEIL INS GROUP
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
DEPLOYED-SIDE
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
ASIAN
Date of Birth
07/25/
Sex
FEMALE
Citations Issued
0
Driver
UN Individual
Safety EquipmentITIDUALINDIV
Crash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M 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
TRAFFIC SIGNAL
Traffic Way
DIVIDED HWY W/O TRAFFIC BARRIER
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
4
Speed Limit
35
Pre CrashTire
Mark
Direction Of Travel
WESTBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
2
Operating As EndorsementsVehicle Type
PASSENGER VAN02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITVehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
MINOR DAMAGE
Vehicle Damage
12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
VN - VAN
Color
WHI - WHITE
Model
PACIFICA
Year
2017
Make
CHRYSLER
Vehicle Identification Number
80190202 Country of Issuance
UNITED STATES
St
WI
Plate Type
DIS - DISABLED
License Plate Number
Vehicle
UNITVEHICLECrash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
FORT ATKINSON, WI 53538 , US
Owner Name
0202Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
VEHICLEUNIT Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Individual
Insurance Company
HASTINGS-MUTUAL-INS-CO
Policy Holder
UNITInjury
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 INJURY00202 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
FORT ATKINSON, WI 53538 , US
Race
WHITE
Date of Birth
08/30/
Sex
MALE
Citations Issued
0
Driver
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M 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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00302 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
FORT ATKINSON, WI 53538 , US
Race
WHITE
Date of Birth
07/01/
Sex
FEMALE
Citations Issued
0
Passenger
UN Individual
Non Motorist
Safety EquipmentITIDUALINDIV
Crash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 6 of 7
This report does not include any CJIS data.
19121207
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0JB3P3M 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
UNITINDIVIDUALCrash Time 11:20 AM
Crash Date 12/12/2019Wisconsin Motor Vehicle Crash
Form DT4000 7 of 7
This report does not include any CJIS data.