200715 tamm-decoraSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G 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
01
Total Units
02
Time Notified
04:29 PM
Date Notified
07/15/2020
Time Arrived
04:29 PM
Date Arrived
07/15/2020
Crash Time
04:28 PM
Crash Date
07/15/2020
Investigating Officer/Deputy
DEPUTY DARIN JENSEN
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0HWRB0GAdditional InformationNONE, PHOTOS
Photos ByTROOPER KRAETKE
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON WEDNESDAY JULY 15, 2020, UNIT 1 WAS TRAVELING WEST ON MAIN STREET, CROSSING USH 63. UNIT 2 ACCELERATED RAPIDLY ON USH 63
NORTHBOUND. UNIT 2 STRUCK UNIT 1 ON THE DRIVER SIDE IN THE REAR PORTION OF THE CAR. ALL OCCUPANTS FROM UNIT 2 RAN FROM THE SCENE. THE
OPERATOR FROM UNIT 1 WAS TRANSPORTED TO THE HOSPITAL BY A PRIVATE PARTY.
Crash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5105350.5
X Coordinate
152936.640625
Longitude
-91.483417704
Latitude
46.013707167
ON USH63 NB
20 FT E
OF MAIN ST
IN THE CITY 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
01 - ANGLE
First Harmful Event Location
ON ROADWAY
First Harmful Event
MOTOR VEH IN TRANSPORT
Crash Scene
Intersection Type
FOUR-WAY INTERSECTION
Junction Location
INTERSECTION
Within Interchange Area
NO
Time Scene Cleared
05:48 PM
Date Scene Cleared
07/15/2020
Time All Lanes Open
05:48 PM
Date All Lanes Open
07/15/2020
Time Initial Lane/Rd Closed
04:32 PM
Date Initial Lane/Rd Closed
07/15/2020
Reasons for Closure
LAW ENFORCEMENT, FIRE/EMS
Closure Type
CLOSURE-ONE DIRECTION
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
STOP SIGN
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
15
Pre CrashTire
Mark
Direction Of Travel
WESTBOUND
Insurance?
UNKNOWN
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
UNITModel
CAMRY
Year
2010
Make
TOYOTA
Vehicle Identification Number
42080101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
GORDON, WI 54838 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
08 - LEFT SIDE REAR, 09 - LEFT SIDE MIDDLE
Initial Contact Point
08 - LEFT SIDE REAR
Bus UseBody Style
4D - 4DR
Color
BLK - BLACK
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Injury
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
UNKNOWN
Injury Severity
SUSPECTED MINOR INJURY00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
01 - FRONT ROW
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
GORDON, WI 54838 , US
Race
WHITE
Date of Birth
12/15/
Sex
FEMALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G 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)UNITNon Motorist
INDIVIDUALTruck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
CONCRETE
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
4
Speed Limit
25
Pre CrashTire
Mark
Direction Of Travel
NORTHBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
3
Operating As EndorsementsVehicle Type
PASSENGER CAR02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITInitial Contact Point
12 - FRONT
Bus UseBody Style
4D - 4DR
Color
SIL - SILVER (ALUMINUM)
Model
GRAND PRIX
Year
2008
Make
PONTIAC
Vehicle Identification Number
10620202 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0202Driver Actions
EXCEED SPEED LIMIT, FAILURE TO CONTROL, OPERATED MOTOR VEHICLE IN AGGRESSIVE/RECKLESS MANNER
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
08 - LEFT SIDE REAR, 09 - LEFT SIDE MIDDLE, 10 - LEFT SIDE FRONT, 11 -
LEFT FRONT CORNER, 12 - FRONT
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Distracted By
Injury
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 INJURY00202 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
01 - FRONT ROW
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
INDIAN
Date of Birth
03/12/
Sex
FEMALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00202Drug Test ResultsDrug Test TypeDrug Test Given
TEST REFUSED
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
YES
Suspected Alcohol Use
NO
To/From SchoolAction Other
Action
Prior Action
LocationStriking Unit #
Distracted By Action
NOT DISTRACTED
UNITNon Motorist
INDIVIDUALDistracted By
Injury
Distracted By Action
Distracted By Source
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 INJURY00302 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
09 - RIGHT
Row
01 - FRONT ROW
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
INDIAN
Date of Birth
02/11/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 6 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00302Drug 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
INDIVIDUALDistracted By
Injury
LocationStriking Unit #
Distracted By Action
Distracted By Source
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 INJURY00402 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
09 - RIGHT
Row
06 -UNKNOWN ROW
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
INDIAN
Date of Birth
07/02/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 7 of 8
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB0G WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00402Drug 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
UNITINDIVIDUALCrash Time 04:28 PM
Crash Date 07/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 8 of 8
This report does not include any CJIS data.