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20072501 quaderer20072501 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FL 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 02 Total Units 01 Time Notified 12:18 AM Date Notified 07/25/2020 Time Arrived 12:33 AM Date Arrived 07/25/2020 Crash Time 12:18 AM Crash Date 07/25/2020 Investigating Officer/Deputy DEPUTY DENNIS NELSON Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0HPL4FLAdditional InformationNONE, PHOTOS Photos ByDEPUTY NELSON Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. ON 7-25-20 AT 0018 DEPUTY NELSON WAS DISPATCHED TO A ONE VEHICLE ACCIDENT AT THE INTERSECTION OF SAND LAKE RD AND CTH F. CALLER ADVISED THAT TWO PEOPLE WERE INJURED. DEPUTY NELSON ARRIVED ONSCENE AND OBSERVED DEPUTY SIMPSON AND EMS PERSONAL WERE TENDING TO THE SUBJECTS. DEPUTY NELSON OBSERVED A BLACK IMPALA HAD GONE THROUGH THE INTERSECTION IMPACTING INTO THE DITCH. DEPUTY NELSON LOOKED AT THE INTERSECTION AND DID NOT OBSERVE ANY BRAKE MARKS PRIOR TO CRASHING INTO THE DITCH. THE FRONT PASSENGER WAS OUT OF THE VEHICLE LAYING IN THE DITCH. THE DRIVER WAS STUCK IN THE DRIVER SEAT. DEPUTY NELSON SPOKE WITH AND HE ADVISED THAT THEY WERE COMING FROM A BAR AND WERE HEADED HOME WHEN THE CRASHED. EMS STAFF REMOVED FORM THE VEHICLE. A BLOOD DRAW WAS DONE ON THE WHILE WAITING FOR THE HELICOPTER TO LAND. BOTH SUBJECTS WERE FLOWN TO A UNKNOWN HOSPITAL. Crash Time 12:18 AM Crash Date 07/25/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 5 This report does not include any CJIS data. 20072501 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FL WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5086216.5 X Coordinate 152639.21875 Longitude -91.473397578 Latitude 45.84187118 ON SAND LAKE RD 9 FT W OF CTHF EB IN THE TOWN OF SAND LAKE 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 DARK/UNLIT Manner of Collision 00 - NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location SHOULDER RIGHT First Harmful Event EMBANKMENT Crash Scene Intersection Type T-INTERSECTION Junction Location INTERSECTION 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 EMBANKMENT Total Lanes 1 Speed Limit 45 Pre CrashTire Mark Direction Of Travel EASTBOUND Insurance? UNKNOWN Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 2 Operating As EndorsementsVehicle Type PASSENGER CAR01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage DISABLING DAMAGE Vehicle Damage 12 - FRONT Initial Contact Point 12 - FRONT Bus UseBody Style 4D - 4DR Color BLK - BLACK Model IMPALA Year 2011 Make CHEVROLET Vehicle Identification Number 35350101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 12:18 AM Crash Date 07/25/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 5 This report does not include any CJIS data. 20072501 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FL WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address STONE LAKE, WI 54876 , US Owner Name 0101Driver Actions DISREGARDED STOP SIGN 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 UNITVEHICLE Sequence Of Events Event EMBANKMENT01 Event 02Event 03Event 04Distracted By Injury LocationStriking Unit # Distracted By Action UNKNOWN Distracted By Source NOT APPLICABLE (NOT DISTRACTED) Time of DeathDate of DeathHospital OTHER WISCONSIN FACILITY EMS Run #EMS Agency Identifier 6000954 Medical Transport EMS AIR Trapped/Extricated TRAPPED/NOT EXTRICATED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity SUSPECTED SERIOUS INJUR00101 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 INDIAN Date of Birth 09/14/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 12:18 AM Crash Date 07/25/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 5 This report does not include any CJIS data. 20072501 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FL WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL Drug Type 00101Drug Test Results CANCELLED PER POSITIVE ALCOHOL RESULT Drug Test Type BLOOD Drug Test Given TEST GIVEN Alcohol Test Results PENDING Alcohol Test Type BLOOD Alcohol Test Given TEST GIVEN Suspected Drug Use YES Suspected Alcohol Use YES To/From SchoolAction Other Action Prior Action UNITINDIVIDUALDistracted By Injury Prior Action LocationStriking Unit # Distracted By Action Distracted By Source Time of DeathDate of DeathHospital OTHER MINNESOTA FACILITY EMS Run #EMS Agency Identifier 6000954 Medical Transport EMS AIR Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity SUSPECTED SERIOUS INJUR00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 09 - RIGHT Row 01 - FRONT ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address STONE LAKE, WI 54876 , US Race INDIAN Date of Birth 10/27/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 12:18 AM Crash Date 07/25/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 5 This report does not include any CJIS data. 20072501 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FL WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL, UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL Drug Type 00201Drug 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 UNITINDIVIDUALCrash Time 12:18 AM Crash Date 07/25/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 5 This report does not include any CJIS data.