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.