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200430 king-olson20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 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 09:50 AM Date Notified 04/30/2020 Time Arrived 10:00 AM Date Arrived 04/30/2020 Crash Time 09:49 AM Crash Date 04/30/2020 Investigating Officer/Deputy DEPUTY AMANDA REED Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0GMH5K1Additional 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 APRIL 30TH, 2020, I, DEPUTY REED RESPONDED TO A TWO VEHICLE ACCIDENT ON STH 77 NEAR O'BRIEN HILL ROAD. A TRUCK BEING OPERATED BY WAS BEING OPERATED WESTBOUND ON STH 77 AND FOLLOWED BY A TRUCK BEING OPERATED BY AND A VAN BEING OPERATED BY WAS FOLLOWING HER. - TRUCK DIED ON HIM, HE ATTEMPTED TO TURN LEFT ONTO O'BRIEN HILL ROAD TO GET OFF OF STATE HIGHWAY 77, HAD HER FLASHERS ON BEHIND HIM DUE TO HIS LIGHTS NOT BEING OPERATIONAL. THOUGHT - WAS GOING TO PULL OVER SO SHE WAVED AROUND THEM. THEN BEGAN TO PASS THEM AND ENDED UP COLLIDING WITH - WHEN HE TURNED LEFT INSTEAD OF PULLING OVER. - WAS SUBSEQUENTLY CITED FOR OPERATING WHILE SUSPENDED, NON-REGISTRATION OF AUTOMOBILE AND OPEARTING A MOTOR VEHICLE WITH NO INSURANCE. I WAS UNABLE TO DECIDE WHO WAS SPECIFICALLY AT FAULT FOR THE ACCIDENT. Crash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5105664 X Coordinate 159102.1875 Longitude -91.404234437 Latitude 46.019614669 ON O BRIEN HILL RD 116 FT S OF STH77 WB 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) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 07 - SIDESWIPE/SAME DIRECTION First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO 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 TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? NO Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 3 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 UNITExtent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 11 - LEFT FRONT CORNER Initial Contact Point 11 - LEFT FRONT CORNER Bus UseBody Style 2D - 2DR Color SIL - SILVER (ALUMINUM) Model BEETLE Year 2001 Make VOLKSWAGEN Vehicle Identification Number 57720101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address STATE HIGHWAY 27 HAYWARD, WI 54843 , US Owner Name BOBBY G KING-BUSS (224) 303-72630101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors OTHER DISABLED What Driver Was Doing LEFT TURN Vehicle Removed ByTowed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04Distracted By Injury LocationStriking Unit # 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 NumberAddress HAYWARD, WI 54843 , US Race BLACK Date of Birth 11/25/ Sex MALE Citations Issued 3 Driver ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 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 UNITINDIVIDUAL Violations DescriptionNON-REGISTRATION OF AUTO, ETCStatute Number341.04(1)Issue To? 001 UTC Number BE64943901 DescriptionOPERATE MOTOR VEHICLE W/O INSURANCEStatute Number344.62(1)Issue To? 001 UTC Number BE64943802 DescriptionOPERATING WHILE SUSPENDEDStatute Number343.44(1)(a)Issue To? 001 UTC Number BE64943703 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 TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type PASSENGER VAN02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITBus UseBody Style 2D - 2DR Color WHI - WHITE Model ECONOLINE Year 2008 Make FORD Vehicle Identification Number 40280202 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 0202Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing OVERTAKE LEFT Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 01 - RIGHT FRONT CORNER, 02 - RIGHT SIDE FRONT, 04 - RIGHT SIDE REAR Initial Contact Point 02 - RIGHT SIDE FRONT VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04IndividualInsurance Company ACUITY,-A-MUTUAL-INSURANCE-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 NON DEPLOYED Injury Severity NO APPARENT INJURY00202 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat PositionRow 99 - UNKNOWN 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 01/21/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 20043005 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K1 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 NOT DISTRACTED Distracted By Source NOT APPLICABLE (NOT DISTRACTED)UNITNon Motorist INDIVIDUALCrash Time 09:49 AM Crash Date 04/30/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.