200402 burchfield20040212
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3N 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
02:39 PM
Date Notified
04/02/2020
Time Arrived
02:55 PM
Date Arrived
04/02/2020
Crash Time
02:39 PM
Crash Date
04/02/2020
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3NAdditional InformationPHOTOS
Photos ByDEPUTY L. SHEPARD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON APRIL 2ND, 2020, AT APPROXIMATELY 2:39PM, DEPUTY SHEPARD, WAS DISPATCHED TO A MINOR ONE VEHICLE CRASH BEHIND THE LCO CASINO. THE
DRIVER OF THE VEHICLE CALLED IN THE INCIDENT HIMSELF. WHEN DEPUTY SHEPARD ARRIVED HE IDENTIFIED THE DRIVER AS THE
VEHICLE BELONGED TO AND HIS WIFE AND WAS A 2012 KIA SPORTAGE WITH WI REGISTRATION - WAS ATTEMPTING TO
BACK UP TO A OVERHEAD GARAGE TYPE DOOR AND HE BACKED INTO THE CORNER OF A METAL DUMPSTER. THE REAR PASSENGER SIDE CORNER OF THE
VEHICLE STRUCK THE OUTSIDE CORNER OF THE DUMPSTER. THERE WERE MINOR DAMAGES AND DENTING TO THE BODY OF THE VEHICLE AND NO
DAMAGES TO THE DUMPSTER. DEPUTY SHEPARD PHOTOGRAPHED THE SCENE AND THE DAMAGE.
Crash Time 02:39 PM
Crash Date 04/02/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20040212
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3N WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5103054.5
X Coordinate
161133.3125
Longitude
-91.376220251
Latitude
45.997202303
ON CTHB WB
0.37 MI E
OF CTHK WB
IN THE TOWN OF HAYWARD
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
LAC COURTE OREILLES BAND
Crash Classification - Jurisdiction
INDIAN RESERVATION/TRUST
Crash Classification - Location
TRIBAL LAND
Relation To Trafficway
NON TRAFFICWAY - PARKING LOT
Animal Type
Weather Condition(s)
CLEAR
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
OFF ROADWAY, LOCATION UNKNOWN
First Harmful Event
OTHER OBJECT - NOT FIXED
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
UNKNOWN
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
UNKNOWN
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
PARKING LOT OR PRIVATE PROPERTY
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
OTHER OBJECT - NOT FIXED
Total Lanes
0
Speed Limit
N/A
Pre CrashTire
Mark
Direction Of Travel
NOT ON ROADWAY
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
MINOR DAMAGE
Vehicle Damage
05 - RIGHT REAR CORNER
Initial Contact Point
05 - RIGHT REAR CORNER
Bus UseBody Style
4H - HATCHBACK 4 DOOR
Color
SIL - SILVER (ALUMINUM)
Model
SPORTAGE
Year
2012
Make
KIA MOTORS CORPORA
Vehicle Identification Number
36470101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 02:39 PM
Crash Date 04/02/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20040212
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3N WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
UNSAFE BACKING
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
BACKING
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
UNITVEHICLE Sequence Of Events
Event
OTHER OBJECT - NOT FIXED01
Event
02Event
03Event
04Individual
Insurance Company
FARMERS-INS-CO-INC
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
11/11/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 02:39 PM
Crash Date 04/02/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20040212
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3N 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
INDIVIDUALCrash Time 02:39 PM
Crash Date 04/02/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.