200307 sharlow20030706
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N8 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
01
Total Units
01
Time Notified
02:20 AM
Date Notified
03/07/2020
Time Arrived
02:35 AM
Date Arrived
03/07/2020
Crash Time
02:20 AM
Crash Date
03/07/2020
Investigating Officer/Deputy
DEPUTY MICHAEL SIMPSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0GNQ6N8Additional InformationNONE
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 CALLED IN BY A THIRD PARTY. DRIVER OF UNIT ONE MISSED DRIVEWAY AND ENDED UP ON EMBANKMENT OF SNOW AND ICE. DRIVER OF UNIT 1
WAS ARRESTED FOR OWI 5TH OFFENSE. VEHICLE HAD COSMETIC DAMAGE TO FRONT END.
Crash Time 02:20 AM
Crash Date 03/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20030706
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5095727.5
X Coordinate
160319.34375
Longitude
-91.381504388
Latitude
45.931049042
ON CTHK SB
0.68 MI S
OF KINNAMON RD
IN THE TOWN OF BASS LAKE
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
DARK/UNLIT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
First Harmful Event
EMBANKMENT
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
HILLCREST
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
EMBANKMENT
Total Lanes
2
Speed Limit
45
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
2
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
MINOR DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER, 12 - FRONT
Initial Contact Point
12 - FRONT
Bus UseBody Style
LL - CARRYALL
Color
SIL - SILVER (ALUMINUM)
Model
JOURNEY SE
Year
2012
Make
DODGE
Vehicle Identification Number
511360101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 02:20 AM
Crash Date 03/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20030706
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
RIGHT TURN
Vehicle Removed ByTowed Due To Damage
NOT TOWED
UNITVEHICLE Sequence Of Events
Event
EMBANKMENT01
Event
02Event
03Event
04Distracted By
Injury
LocationStriking Unit #
Distracted By Action
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #EMS Agency IdentifierMedical Transport
LAW ENFORCEMENT
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
POSSIBLE 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
INDIAN
Date of Birth
02/28/
Sex
MALE
Citations Issued
2
Driver
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 02:20 AM
Crash Date 03/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20030706
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0GNQ6N8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test Results
PENDING
Alcohol Test Type
BLOOD
Alcohol Test Given
TEST GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
YES
To/From SchoolAction Other
Action
Prior Action
UNITINDIVIDUAL Violations
DescriptionOPERATING WHILE REVOKED (REV ALC/CONT SUBST/REFUSAL 4th+)Statute Number343.44(1)(B)Issue To?
001
UTC Number
BE64984201
DescriptionOWI (5th or 6th)Statute Number346.63(1)(a)Issue To?
001
UTC Number
BE64984102
Crash Time 02:20 AM
Crash Date 03/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.