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.