20051716 dennis20051716
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB000B 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
06:14 PM
Date Notified
05/17/2020
Time Arrived
06:25 PM
Date Arrived
05/17/2020
Crash Time
06:14 PM
Crash Date
05/17/2020
Investigating Officer/Deputy
DEPUTY MATTHEW JEFSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0FB000BAdditional InformationPHOTOS
Photos ByM JEFSON
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I, DEPUTY MATTHEW JEFSON OF THE SAWYER COUNTY SHERIFF'S DEPARTMENT WAS DISPATCHED TO A ONE VEHICLE PROPERTY DAMAGE ACCIDENT
WITHOUT INJURY ON STH 48 NEAR COPLY RD IN THE METEOR TOWNSHIP. DISPATCH ADVISED THE DRIVER HAD CALLED AND STATED THAT HE FELL ASLEEP,
WENT INTO THE DITCH AND HIT A TREE. I ARRIVED ON SCENE AND MET WITH THE DRIVER AND LONE OCCUPANT. HE ADVISED THAT HE WAS DRIVING FROM
SOMERSET, WI AND THE STRAIGHT ROAD MADE HIM TIRED AND HE DOZED OFF. I MADE SURE THAT HE DIDN'T NEED ANY MEDICAL TREATMENT AND THEN
HAD DISPATCH SEND THE NEAREST TOW WHICH WAS JERRY'S AMOCO OUT OF BRUCE, WI. I THEN TOOK PHOTOGRAPHS OF THE CRASH AND DAMAGE. I
GATHERED HIS INSURANCE INFORMATION. WE THEN WAITED TILL JERRY'S ARRIVED. THE SUBJECT FATHER DID COME AND PICKED UP THE DRIVER. SGT. AL
MOGHRABI ARRIVED TO ASSIST SHORTLY BEFORE JERRY'S DID. WE BLOCKED OFF THE EASTBOUND LANE OF STH 48 UNTIL THE VEHICLE WAS REMOVED. I
THEN CLEARED FROM THE SCENE.
Crash Time 06:14 PM
Crash Date 05/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20051716
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB000B WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5068520
X Coordinate
165744.90625
Longitude
-91.292885285
Latitude
45.689514802
ON STH48 EB
971 FT E
OF COPLEY RD
IN THE TOWN OF WEIRGOR
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 - NOT 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
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Time Scene Cleared
08:04 PM
Date Scene Cleared
05/17/2020
Time All Lanes Open
08:04 PM
Date All Lanes Open
05/17/2020
Time Initial Lane/Rd Closed
07:25 PM
Date Initial Lane/Rd Closed
05/17/2020
Reasons for Closure
TOW TRUCK
Closure Type
CLOSURE-ONE DIRECTION
Truck Bus or HazMat
NO
Road Grade
DOWNHILL
Road Curvature
STRAIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
DIVIDED HWY W/O TRAFFIC BARRIER
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
TREE
Total Lanes
2
Speed Limit
55
Pre CrashTire
Mark
Direction Of Travel
EASTBOUND
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
UNITModel
TAHOE
Year
2006
Make
CHEVROLET
Vehicle Identification Number
83300101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 06:14 PM
Crash Date 05/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20051716
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB000B WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
9050W RIDGE WAY
OJIBWA, WI 54862 , US
Owner Name
SHAWN O DENNIS
0101Driver Actions
OTHER CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
JERRYS AMOCO
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER, 02 - RIGHT SIDE FRONT, 10 - LEFT SIDE FRONT,
11 - LEFT FRONT CORNER, 12 - FRONT
Initial Contact Point
12 - FRONT
Bus UseBody Style
UT - SPORT UTILITY VEHICLE
Color
BLU - BLUE
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
DITCH02
Event
TREE03
Event
04IndividualInsurance Company
PROGRESSIVE-CLASSIC-INS-CO
Policy Holder
UNITInjury
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-FRONT
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
OJIBWA, WI 54862 , US
Race
WHITE
Date of Birth
01/25/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 06:14 PM
Crash Date 05/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20051716
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0FB000B 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
UNKNOWN
Distracted By Source
Time of DeathDate of DeathHospital
UNITNon Motorist
INDIVIDUALCrash Time 06:14 PM
Crash Date 05/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.