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20070212 nelson20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 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 03 Time Notified 09:53 AM Date Notified 07/02/2020 Time Arrived 10:20 AM Date Arrived 07/02/2020 Crash Time 09:53 AM Crash Date 07/02/2020 Investigating Officer/Deputy DEPUTY CHARLES LOGAN Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0GD2XW6Additional InformationPHOTOS Photos ByC.LOGAN Reconstruction BySAWYER COUNTY SHERIFFDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS TRAVELING NORTH ON HWY 63 WHEN TWO WHEELS AND BRAKE DRUMS FELL OFF THE TRAILER. THE DRIVER OF UNIT 1 SAID HE SAW THE WHEELS COME OFF AND ONE OF THEM CONTINUED TO ROLL DOWN THE ROAD SO HE TRIED TO BLOCK IT WITH HIS TRUCK TO MAKE SURE NO ONE HIT IT, THE OTHER ONE WAS STILL IN THE ROADWAY. TWO VEHICLES STRUCK THAT PIECE OF WHEEL/TIRE/BRAKE PARTS CAUSING DAMAGE TO BOTH. UNIT 3 WAS TOWED DUE TO THE DAMAGE CAUSED. UNIT 3 DROVE TO THE MECHANIC BUT LEARNED THERE WAS SEVERE DAMAGE UNDERNEATH ALSO. THE DRIVER OF UNIT 1 STATED THE TRUCK HAD BEEN INSPECTED A SHORT TIME BEFORE BY THE COMPANY MECHANIC AND FOUND NO ISSUES WITH THE WHEELS OR TIRES. THE DRIVER OF UNIT 1 WAS NOT THE OWNER OF THE TRUCK, BOTH UNIT 2 AND UNIT 3 STRUCK AND RAN OVER A LARGE CHUNK OF METAL DEBRIS. Crash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5119988.5 X Coordinate 165589.6875 Longitude -91.330730468 Latitude 46.151364361 ON USH63 NB 0.73 MI N OF MOODY'S RD IN THE TOWN OF LENROOT 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 00 - NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location ON ROADWAY First Harmful Event THROWN OR FALLING OBJECT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO Truck Bus or HazMat TRUCK OR TRUCK COMBINATION > 10,000LBS GVWR/GCWR 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 OTHER NON-COLLISION Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 1 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type TRUCK TRACTOR (SEMI ATTACHED)01Unit Type TRUCK Vehicle Operating As Classification A CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage MINOR DAMAGE Vehicle Damage 14 - UNDERCARRIAGE Initial Contact Point 00 - NON-COLLISION Bus UseBody Style DS - TRACTOR-TRUCK DIESEL Color WHI - WHITE Model SEMI Year 2005 Make VOLVO Vehicle Identification Number 15010101 Country of Issuance UNITED STATES St WI Plate Type TOR - TRACTOR License Plate Number VEHICLEUNIT Vehicle Crash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address CUSHING, WI 54006 , US Owner Name 0101Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors OTHER What Driver Was Doing GOING STRAIGHT Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UNITVEHICLE Sequence Of Events Event EQUIPMENT FAILURE (BLOWN TIRE, BRAKE FAILURE, ETC)01Event 02Event 03Event 04Organization/Company LAURITSEN FIREWOOD & RENTAL INC Insurance Company PROGRESSIVE-CLASSIC-INS-CO Policy Holder UNIT Trailer/Towed Vehicle Identification Number D15B Address 2606 250TH AVE CUSHING, WI 54006 , US Organization/CompanyUnit Type FULL TRAILER TRAILER/Country of Issuance UNITED STATES State WI Make SAVG Plate Type STL - SEMI Trailer Plate #01UNITInjury 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 FREDERIC, WI 54837 , US Race WHITE Date of Birth 12/11 Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 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) Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UNITNon Motorist INDIVIDUALMeasured WeightMeasured WidthMeasured LengthMeasured Height Escort Vehicle PresentEscort Vehicle Required By Permit Permitted Vehicle On Permitted Route WI Permit NumberOS/OW Load Permitted Load NOT APPLICABLE Carrier Type INTRASTATE CARRIER US DOT # 1004033 Cargo Body Type LOG TRUCK Vehicle Configuration TRUCK TRACTOR/SEMI-TRAILER GVWR MORE THAN 26,000 LB01 Address CUSHING, WI 54006 , US Name 01Source DRIVERUse Vehicle Owner Same as Carrier Carrier CKBUSUNITTRUTotal HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary Crash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT 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 STRUCK BY FALLING, SHIFTING CARGO OR ANYT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES UNITOwner Address HAYWARD, WI 54843 , US Owner Name 0202Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed By OWNER Towed Due To Damage NOT TOWED Extent Of Damage DISABLING DAMAGE Vehicle Damage 14 - UNDERCARRIAGE Initial Contact Point 14 - UNDERCARRIAGE Bus UseBody Style UT - SPORT UTILITY VEHICLE Color BLK - BLACK Model X5 Year 2016 Make BMW Vehicle Identification Number 65690202 Country of Issuance UNITED STATES St WI Plate Type TMP - TEMPORARY PLAT License Plate Number VEHICLEUNIT Vehicle UNITVEHICLE Sequence Of Events Event STRUCK BY FALLING, SHIFTING CARGO OR ANYTHING SET IN MOTION BY MOTOR VEHICLE01 Event 02Event 03Event 04IndividualInsurance Company PROGRESSIVE-CLASSIC-INS-CO Policy Holder UNITRaceDate of Birth 09/16/ Sex FEMALE Citations Issued 0 Driver IT Individual IDUALCrash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT Distracted By Injury 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 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 HAYWARD, WI 54843 , US UNITSafety Equipment Non MotoristUN INDIVIDUALINDIVTotal HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type PASSENGER CAR03 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary Crash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT 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 STRUCK BY FALLING, SHIFTING CARGO OR ANYT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES UNITOwner Address STILLWATER, MN 55082 , US Owner Name 0303Driver 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 12 - FRONT, 14 - UNDERCARRIAGE Initial Contact Point 12 - FRONT Bus UseBody Style UT - SPORT UTILITY VEHICLE Color WHI - WHITE Model ACADIA Year 2013 Make GENERAL MOTORS COR Vehicle Identification Number 38330303 Country of Issuance UNITED STATES St MN Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle UNITVEHICLE Sequence Of Events Event STRUCK BY FALLING, SHIFTING CARGO OR ANYTHING SET IN MOTION BY MOTOR VEHICLE01 Event 02Event 03Event 04IndividualInsurance Company WEST-BEND-MUTUAL-INS-CO Policy Holder UNITRaceDate of Birth 12/17/ Sex FEMALE Citations Issued 0 Driver (IT Individual IDUALCrash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 7 of 8 This report does not include any CJIS data. 20070212 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GD2XW6 WISCONSIN MOTOR VEHICLE CRASH REPORT Distracted By Injury Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00303Drug 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 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 INJURY00303 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: MINNESOTA COUNTRY: UNITED STATES Address STILLWATER, MN 55082 , US UNITSafety Equipment Non MotoristUN INDIVIDUALINDIVCrash Time 09:53 AM Crash Date 07/02/2020Wisconsin Motor Vehicle Crash Form DT4000 8 of 8 This report does not include any CJIS data.