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200306 schrock20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 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 08:15 AM Date Notified 03/06/2020 Time Arrived 08:25 AM Date Arrived 03/06/2020 Crash Time 08:14 AM Crash Date 03/06/2020 Investigating Officer/Deputy DEPUTY AMANDA REED Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0GMH5K0Additional InformationPHOTOS Photos ByDEPUTY AMANDA REED Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. ON MARCH 6TH, 2020, I, DEPUTY REED RESPONDED TO A REPORT OF A VAN IN THE DITCH ON STH 77 EAST OF HATCHERY ROAD. I ARRIVED ON SCENE AND MET WITH THE DRIVER, WHO WAS TRAVELING E/B ON STH 77 WHEN HER REAR END KICKED OUT ON THE ICE COVERED ROADS AND CAUSED HER TO GO INTO THE DITCH CRASHING INTO A LARGE TRAFFIC SIGN. VEHICLE HAD A BUSTED OUT REAR WINDOW FROM THE INCIDENT. Crash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5105946 X Coordinate 159442.390625 Longitude -91.400053471 Latitude 46.022314375 ON STH77 EB 0.27 MI E OF O BRIEN HILL RD 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) CLEAR Environment Factor(s) WEATHER CONDITIONS Roadway Factor(s) NONE Road Surface Condition(s) ICE Light Condition DAYLIGHT Manner of Collision 00 - NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location ON ROADWAY First Harmful Event DITCH Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO Truck Bus or HazMat NO Road Grade UPHILL 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 DITCH 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 6 Operating As EndorsementsVehicle Type PASSENGER VAN01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage MINOR DAMAGE Vehicle Damage 06 - REAR Initial Contact Point 06 - REAR Bus UseBody Style 4D - 4DR Color WHI - WHITE Model VAN Year 2007 Make CHEVROLET Vehicle Identification Number 16230101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 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 OWNER Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event RUN OFF ROADWAY RIGHT01 Event 02Event 03Event 04Individual Insurance Company AMERICAN-FAMILY-INS-CO Policy Holder UNITDistracted By Injury 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 07 - LEFT Row 01 - FRONT ROW 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 09/17/ Sex FEMALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 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 #UNITNon Motorist INDIVIDUALDistracted By Injury 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 INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 06 -UNKNOWN ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress , , RaceDate of Birth SexCitations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00201Drug 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 UNITINDIVIDUALDistracted By Injury 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 TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00301 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 02 - SECOND ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress , , RaceDate of Birth SexCitations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00301Drug 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 UNITINDIVIDUALDistracted By Injury 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 TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00401 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 02 - SECOND ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress , , RaceDate of Birth SexCitations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00401Drug 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 UNITINDIVIDUALDistracted By Injury 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 TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00501 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 06 -UNKNOWN ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress , , RaceDate of Birth SexCitations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 7 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00501Drug 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 UNITINDIVIDUALDistracted By Injury 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 TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00601 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 06 -UNKNOWN ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress , , RaceDate of Birth SexCitations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 8 of 9 This report does not include any CJIS data. 20030609 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K0 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00601Drug 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 UNITINDIVIDUALHAYWARD, WI 54843 , US GovernmentSAWYER COUNTY (715) 634-2691 PROPOWNER01Fixed Objects Struck Property Owner Damage Tag Number 01111 Structure NumberStruck Object TRAFFIC SIGN POST Striking Unit 0101 Crash Time 08:14 AM Crash Date 03/06/2020Wisconsin Motor Vehicle Crash Form DT4000 9 of 9 This report does not include any CJIS data.