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200613 nelson-mooreSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F 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 03:19 PM Date Notified 06/13/2020 Time Arrived 03:21 PM Date Arrived 06/13/2020 Crash Time 03:18 PM Crash Date 06/13/2020 Investigating Officer/Deputy DEPUTY DARIN JENSEN Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0HWRB0FAdditional InformationPHOTOS Photos ByD. JENSEN Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. THE OPERATOR OF UNIT 1 WAS STOPPED WAITING TO TURN INTO A TRAFFIC LANE LEAVING A PARKING LOT THAT HAD AN ENTRANCE AND EXIT WITH A CONCRETE MEDIAN BETWEEN THE EXIT AND ENTRANCE LANES. THE OPERATOR OF UNIT 2 PULLED INTO THE EAST SIDE LANE OF THE PARKING LOT WHERE UNIT 1 WAS STOPPED. UNIT 2 WAS A PICK UP TRUCK PULLING A PONTOON BOAT ON A TRAILER. THE PONTOON BOAT ON THE TRAILER STRUCK THE FRONT OF UNIT 2. THE BUMPER OF UNIT 1 WAS RIPPED OFF AND STUCK ON THE WHEEL OF THE PONTOON TRAILER WHICH WAS ATTACHED TO UNIT 2. Crash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5103076 X Coordinate 160694.140625 Longitude -91.381890426 Latitude 45.997179981 ON CTHB 493 FT E OF CTHK EB 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 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 06 - SIDESWIPE/OPPOSITE DIRECTION First Harmful Event Location SEPARATOR 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTION Most Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed LimitPre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 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 FUNCTIONAL DAMAGE Vehicle Damage 01 - RIGHT FRONT CORNER, 02 - RIGHT SIDE FRONT, 03 - RIGHT SIDE MIDDLE Initial Contact Point 01 - RIGHT FRONT CORNER Bus UseBody Style 4D - 4DR Color WHI - WHITE Model CHARGER Year 2006 Make DODGE Vehicle Identification Number 21880101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEAVING A PARKED POSITION Vehicle Removed By OWNER Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company ALLSTATE-INS-CO 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 12/14/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F 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 INDIVIDUALTruck Bus or HazMat NO Road Grade LEVEL Road CurvatureSurface 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 MOTOR VEH IN TRANSPORT Total Lanes 2 Speed LimitPre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 1 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type UTILITY TRUCK/PICKUP TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITVehicle Removed By OWNER Towed Due To Damage NOT TOWED Extent Of Damage DISABLING DAMAGE Vehicle Damage 08 - LEFT SIDE REAR Initial Contact Point 00 - NON-COLLISION Bus UseBody Style PK - PICKUP Color MAR - MAROON (BURGUNDY) Model SILVERADO Year 2006 Make CHEVROLET Vehicle Identification Number 09260202 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VEHICLEUNIT Vehicle Crash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address FREMONT, WI 54940 , US Owner Name 0202Driver Actions IMPROPER TURN Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN UNITVEHICLE Sequence Of Events Event LEFT TURN01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04IndividualInsurance Company ACUITY,-A-MUTUAL-INSURANCE-CO Policy Holder UNIT Trailer/Towed Vehicle Identification Number Address FREMONT, WI 54940 , US IndividualUnit Type RECREATIONAL TRAILER/Country of IssuanceStateMake KARA Plate TypeTrailer Plate #02UNITInjury 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 Position 07 - LEFT Row 01 - FRONT ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address FREMONT, WI 54940 , US Race WHITE Date of Birth 12/03/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HWRB0F 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) Time of DeathDate of DeathHospital UNITNon Motorist INDIVIDUALCrash Time 03:18 PM Crash Date 06/13/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.