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20072908 ibarra-cox20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF 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 02 Total Injured 03 Total Units 02 Time Notified 09:38 AM Date Notified 07/29/2020 Time Arrived 09:45 AM Date Arrived 07/29/2020 Crash Time 09:36 AM Crash Date 07/29/2020 Investigating Officer/Deputy DEPUTY KEVIN GILLIS Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0G5WRBFAdditional InformationFATAL CRASH SUPPLEMENT, PHOTOS, RECONSTRUCTION, WITNESS STATEMENTS Photos ByDEPUTY KEVIN GILLIS, DETECTIVE BRYAN DEYO Reconstruction ByWISCONSIN STATE PATROL NWR/SPO Diagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS TRAVELING EASTBOUND ON STATE HWY 27/77 AND UNIT 2 WAS TRAVELING WESTBOUND ON STATE HWY 27/77. UNIT 1 CROSSED INTO THE WESTBOUND LANE AND HIT UNIT 2 HEAD ON AT THE INTERSECTION OF COUNTY HWY T. Crash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5109263.5 X Coordinate 152762.03125 Longitude -91.488513442 Latitude 46.048728676 INTERSECTION ON STH27 NB AT CTHT WB 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 02 - FRONT TO FRONT First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type T-INTERSECTION Junction Location INTERSECTION Within Interchange Area NO Time Scene Cleared 02:06 PM Date Scene Cleared 07/29/2020 Time All Lanes Open 02:00 PM Date All Lanes Open 07/29/2020 Time Initial Lane/Rd Closed 09:51 AM Date Initial Lane/Rd Closed 07/29/2020 Reasons for Closure LAW ENFORCEMENT, FIRE/EMS Closure Type FULL CLOSURE 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 MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel EASTBOUND Insurance? UNKNOWN Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 1 Train/Bus # RecordedTotal Occs 4 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITModel CR-V Year 2016 Make HONDA Vehicle Identification Number 99560101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number Vehicle Crash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address MILWAUKEE, WI 53215 , US Owner Name 0101Driver Actions WRONG SIDE OR WRONG WAY, FAILED TO KEEP IN DESIGNATED LANE Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed By A-1 TOWING Towed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 01 - RIGHT FRONT CORNER, 11 - LEFT FRONT CORNER, 12 - FRONT Initial Contact Point 12 - FRONT Bus UseBody Style UT - SPORT UTILITY VEHICLE Color BLK - BLACK VEHICLEUNITUNITVEHICLE Sequence Of Events Event CROSS CENTERLINE01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04Injury Time of DeathDate of DeathHospital ST MARYS HOSP EMS Run #EMS Agency Identifier 6001349 Medical Transport EMS AIR Trapped/Extricated NOT TRAPPED 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 MILWAUKEE, WI 53215 , US Race HISPANIC Date of Birth 08/28/ Sex FEMALE Citations Issued 1 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Distracted By Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00101Drug Test Results PENDING 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 NO Suspected Alcohol Use NO To/From SchoolAction Other Action Prior Action LocationStriking Unit # Distracted By Action UNKNOWN Distracted By Source UNKNOWN UNITNon Motorist INDIVIDUALDistracted By Injury Distracted By Source Time of DeathDate of DeathHospital ST MARYS HOSP EMS Run #EMS Agency Identifier 6001349 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 MILWAUKEE, WI 53215 , US Race HISPANIC Date of Birth 05/22 Sex FEMALE Citations Issued 0 Passenger ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition ASLEEP OR FATIGUED 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 Prior Action LocationStriking Unit # Distracted By Action UNITNon Motorist INDIVIDUALDistracted By Injury Distracted By Action Distracted By Source Time of Death 09:45 Date of Death 07/29/2020 Hospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-SIDE Injury Severity FATAL INJURY00301 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 07 - LEFT Row 02 - SECOND ROW Safety Equipment LAP BELT ONLY On Duty Crash Driver License NumberAddress MILWAUKEE, WI 53215 , US Race HISPANIC Date of Birth 12/02/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition OTHER Drug Type 00301Drug 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 Death 09:45 Date of Death 07/29/2020 Hospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-SIDE Injury Severity FATAL INJURY00401 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 09 - RIGHT Row 02 - SECOND ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address MILWAUKEE, WI 53208 , US Race HISPANIC Date of Birth 10/05/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition OTHER Drug Type 00401Drug 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 UNITINDIVIDUAL Violations DescriptionOPERATING LEFT OF CENTER (DEATH)Statute Number346.05(1)Issue To? 001 UTC Number BE65082201 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 MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 1 Operating As EndorsementsVehicle Type PASSENGER CAR02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage DISABLING DAMAGE Vehicle Damage 01 - RIGHT FRONT CORNER, 11 - LEFT FRONT CORNER, 12 - FRONT Initial Contact Point 12 - FRONT Bus UseBody Style 4D - 4DR Color GRN - GREEN Model CAMRY Year 2004 Make TOYOTA Vehicle Identification Number 22770202 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 7 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Owner 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 A-1 TOWING Towed Due To Damage TOWED DUE TO DISABLING DAMAGE UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04IndividualInsurance Company AMERICAN-FAMILY-INS-CO Policy Holder UNITDistracted By Injury Distracted By Action NOT DISTRACTED Distracted By Source NOT APPLICABLE (NOT DISTRACTED) Time of DeathDate of DeathHospital HAYWARD AREA MEM HOSP EMS Run # 4767 EMS Agency Identifier 6000954 Medical Transport EMS GROUND Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity SUSPECTED MINOR INJURY00502 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 04/24 Sex FEMALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 8 of 9 This report does not include any CJIS data. 20072908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0G5WRBF WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00502Drug Test Results PENDING 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 NO Suspected Alcohol Use NO To/From SchoolAction Other Action Prior Action LocationStriking Unit #UNITNon Motorist INDIVIDUALCrash Time 09:36 AM Crash Date 07/29/2020Wisconsin Motor Vehicle Crash Form DT4000 9 of 9 This report does not include any CJIS data.