200318 register-metcalf20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 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
01:11 PM
Date Notified
03/18/2020
Time Arrived
01:11 PM
Date Arrived
03/18/2020
Crash Time
01:10 PM
Crash Date
03/18/2020
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0G5WRB9Additional InformationPHOTOS
Photos ByDEPUTY KEVIN GILLIS
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS ATTEMPTING TO TURN ONTO 1ST STREET SOUTH FROM STH 70 WHEN UNIT 2 CRASHED IN THE REAR OF UNIT 1.
Crash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 6
This report does not include any CJIS data.
20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5086852
X Coordinate
147402.90625
Longitude
-91.541084171
Latitude
45.844912675
ON STH70 WB
75 FT N
OF 4TH ST S
IN THE TOWN OF SAND 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 - ON ROAD
Animal Type
Weather Condition(s)
CLOUDY
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
03 - FRONT TO REAR
First Harmful Event Location
ON ROADWAY
First Harmful Event
MOTOR VEH IN TRANSPORT
Crash Scene
Intersection Type
T-INTERSECTION
Junction Location
INTERSECTION-RELATED
Within Interchange Area
NO
Time Scene Cleared
02:00 PM
Date Scene Cleared
03/18/2020
Time All Lanes Open
02:00 PM
Date All Lanes Open
03/18/2020
Time Initial Lane/Rd Closed
01:11 PM
Date Initial Lane/Rd Closed
03/18/2020
Reasons for Closure
LAW ENFORCEMENT
Closure Type
LANE CLOSURE
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
DIVIDED HWY W/O TRAFFIC BARRIER
Emergency Motor Vehicle Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
35
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01 Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITModel
F150
Year
2016
Make
FORD
Vehicle Identification Number
87880101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 6
This report does not include any CJIS data.
20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
LEFT TURN
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
06 - REAR, 07 - LEFT REAR CORNER
Initial Contact Point
06 - REAR
Bus UseBody Style
PK - PICKUP
Color
GRY - GRAY
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
LEFT TURN01
Event
02Event
03Event
04IndividualInsurance Company
ERIE-INSURANCE-EXCHANGE
Policy Holder
UNITInjury
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
STONE LAKE, WI 54876 , US
RaceDate of Birth
12/26/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 6
This report does not include any CJIS data.
20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Distracted By
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 #
Distracted By Action
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
Time of DeathDate of DeathHospital
UNITNon Motorist
INDIVIDUALTruck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
DIVIDED HWY W/O TRAFFIC BARRIER
Emergency Motor Vehicle Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
35
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITBus UseBody Style
SD - SEDAN
Color
RED - RED
Model
TAURUS
Year
2008
Make
FORD
Vehicle Identification Number
4450202 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 6
This report does not include any CJIS data.
20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
0202Driver Actions
OTHER CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
A-1 TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER, 02 - RIGHT SIDE FRONT, 11 - LEFT FRONT
CORNER, 12 - FRONT
Initial Contact Point
12 - FRONT
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04IndividualInsurance Company
AMERICAN-FAMILY-INS-CO
Policy Holder
UNITInjury
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
NOT APPLICABLE
Injury Severity
NO APPARENT INJURY00202 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
03/22/
Sex
MALE
Citations Issued
1
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 6
This report does not include any CJIS data.
20031805
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRB9 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Distracted By
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
LocationStriking Unit #
Distracted By Action
OTHER ACTION (LOOKING AWAY FROM TASK ETC)
Distracted By Source
OTHER DISTRACTION (ANIMAL, FOOD, GROOMING)UNITNon Motorist
INDIVIDUAL Violations
DescriptionINATTENTIVE DRIVINGStatute Number346.89(1)Issue To?
002
UTC Number
BE65081301
Crash Time 01:10 PM
Crash Date 03/18/2020Wisconsin Motor Vehicle Crash
Form DT4000 6 of 6
This report does not include any CJIS data.