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20191222 gunnufsonSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0JB3P3P WISCONSIN MOTOR VEHICLE CRASH REPORT Secondary CrashAmendedCrash Type NON-DOMESTICATED ANIMAL W/ NO INJURYReportable 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 05:37 PM Date Notified 12/22/2019 Time ArrivedDate ArrivedCrash Time 05:37 PM Crash Date 12/22/2019 Investigating Officer/Deputy DEPUTY NATHAN FREY Agency Crash Number 19122219 Primary Crash Document #Document Number Override 6VL0JB3P3PI, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. Structure Type Y Coordinate 5101450.5 X Coordinate 168863.25 Longitude -91.275567709 Latitude 45.986581813 ON CTHB EB 0.29 MI S OF HOPP RD IN THE TOWN OF ROUND LAKE IN SAWYER COUNTY Location Special StudyAccess ControlTribal Land Crash Classification - Jurisdiction NO SPECIAL JURISDICTION Crash Classification - Location PUBLIC PROPERTY Relation To Trafficway TRAFFICWAY - ON ROAD Animal Type DEER Weather Condition(s) Environment Factor(s) Roadway Factor(s)Road Surface Condition(s) Light ConditionManner of Collision NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location ON ROADWAY First Harmful Event NON DOMESTICATED ANIMAL (ALIVE) Crash Scene Road GradeRoad CurvatureSurface Type Traffic Control Inoperative/MissingTraffic ControlTraffic Way Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With NON DOMESTICATED ANIMAL (ALIVE) Total LanesSpeed LimitPre 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 CARGO VAN (10,000 LBS OR LESS)01Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITCrash Time 05:37 PM Crash Date 12/22/2019Wisconsin Motor Vehicle Crash Form DT4000 1 of 3 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0JB3P3P WISCONSIN MOTOR VEHICLE CRASH REPORT Truck Bus or HazMat NO Owner AddressOwner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle FactorsWhat Driver Was Doing Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 8--LEFT SIDE REAR, 9--LEFT SIDE MIDDLE, 10--LEFT SIDE FRONT Initial Contact Point 10--LEFT SIDE FRONT Bus Use NOT A BUS Body Style PK - PICKUP Color BLU - BLUE Model F150 Year 1992 Make FORD Vehicle Identification Number 94740101 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VEHICLEUNIT Vehicle UNITVEHICLEIndividual Insurance Company WISCONSIN-MUTUAL-INS-CO Policy Holder UNITInjury Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/ExtricatedEjection PathEjected AirbagInjury Severity NO APPARENT INJURY00101 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address COLFAX, WI 54730 , US Race WHITE Date of Birth 04/26/ Sex MALE Citations Issued 0 Driver UN Individual Safety EquipmentITIDUALINDIV Crash Time 05:37 PM Crash Date 12/22/2019Wisconsin Motor Vehicle Crash Form DT4000 2 of 3 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0JB3P3P WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Distracted By 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 # Distracted By Action Distracted By Source Non Motorist UNITINDIVIDUALCrash Time 05:37 PM Crash Date 12/22/2019Wisconsin Motor Vehicle Crash Form DT4000 3 of 3 This report does not include any CJIS data.