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20082823 kinderman-sutherland20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 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 01 Total Units 02 Time Notified 03:30 PM Date Notified 08/28/2020 Time Arrived 03:35 PM Date Arrived 08/28/2020 Crash Time 03:29 PM Crash Date 08/28/2020 Investigating Officer/Deputy DEPUTY AMANDA REED Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0GMH5K9Additional InformationPHOTOS Photos ByDEPUTY MARSHAL SAVITSKI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. ON AUGUST 28TH, 2020, I, DEPUTY REED WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S OFFICE, AT 1530 I WAS DISPATCHED TO STH 77 AT O'BRIEN HILL ROAD FOR A TWO VEHICLE ACCIDENT. A JEEP BEING DRIVEN BY WAS TRAVELING W/B ON STH 77 AND A ECOSPORT DRIVEN BY WAS STOPPED AT THE STOP SIGN ON O'BRIEN HILL ROAD FACING N/B. MR. ACCELERATED ONTO STH 77 BUT DID NOT YIELD RIGHT OF WAY TO MR. MR. VEHICLE STRUCK THE REAR OF MR. VEHICLE CAUSING MR. TO GO INTO THE DITCH AND ROLL SEVERAL TIMES. MR. WAS TRANSPORTED TO HAMH FOR MINOR INJURIES, AND MR. WAS ARRESTED FOR OPERATING A MOTOR VEHICLE WHILE INTOXICATED CAUSING INJURY. Crash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5105701 X Coordinate 159095.359375 Longitude -91.404348718 Latitude 46.019941336 ON STH77 WB 16 FT N OF O BRIEN HILL RD IN THE TOWN OF HAYWARD IN SAWYER COUNTY Location Special StudyAccess Control PARTIAL 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 OTHER First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type FOUR-WAY INTERSECTION Junction Location INTERSECTION-RELATED 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 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 (SPORT) UTILITY VEHICLE01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage DISABLING DAMAGE Vehicle Damage 15 - ALL AREAS Initial Contact Point 08 - LEFT SIDE REAR Bus UseBody Style 4D - 4DR Color BLK - BLACK Model CHEROKEE Year 2020 Make JEEP Vehicle Identification Number 31290101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address EAU CLAIRE, WI 54703 , US Owner Name 0101Driver 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 UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04Individual Insurance Company PROGRESSIVE-ADVANCED-INSURANCE-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 # 1 EMS Agency Identifier 1 Medical Transport EMS GROUND Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-COMBINATION Injury Severity SUSPECTED MINOR 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 EAU CLAIRE, WI 54703 , US Race WHITE Date of Birth 07/18/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 WISCONSIN MOTOR VEHICLE CRASH REPORT 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 #UNITNon Motorist INDIVIDUALTruck Bus or HazMat NO Road Grade LEVEL Road Curvature STRAIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control STOP SIGN 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 NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 1 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 UNITVehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 10 - LEFT SIDE FRONT, 11 - LEFT FRONT CORNER, 12 - FRONT Initial Contact Point 11 - LEFT FRONT CORNER Bus UseBody Style 4D - 4DR Color RED - RED Model ECOSPORT Year 2018 Make FORD Vehicle Identification Number 65170202 Country of Issuance UNITED STATES St WI Plate Type TMP - TEMPORARY PLAT License Plate Number VEHICLEUNIT Vehicle Crash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 0202Driver Actions FAILED TO YIELD RIGHT-OF-WAY Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event MOTOR VEH IN TRANSPORT02 Event 03Event 04Individual Insurance Company STATE-FARM-GENERAL-INS-CO Policy Holder UNITDistracted By Injury LocationStriking Unit # Distracted By Action UNKNOWN Distracted By Source UNKNOWN Time of DeathDate of DeathHospital HAYWARD AREA MEM HOSP EMS Run #EMS Agency IdentifierMedical Transport LAW ENFORCEMENT Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity NO APPARENT INJURY00202 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 07 - LEFT Row 01 - FRONT ROW Safety Equipment LAP BELT ONLY On Duty Crash Driver License Number STATE: MINNESOTA COUNTRY: UNITED STATES Address HAYWARD, WI 54843 , US Race INDIAN Date of Birth 11/29/ Sex MALE Citations Issued 1 Driver ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 20082823 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0GMH5K9 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL Drug Type 00202Drug Test ResultsDrug Test TypeDrug Test Given TEST NOT GIVEN Alcohol Test Results 26 Alcohol Test Type PRELIMINARY BREATH TEST (PBT) Alcohol Test Given TEST GIVEN Suspected Drug Use NO Suspected Alcohol Use YES To/From SchoolAction Other Action Prior Action UNITINDIVIDUAL Violations DescriptionCAUSE INJURY/OPERATE WHILE UND INFLUENCEStatute Number346.63(2)Issue To? 002 UTC Number BE60923201 Crash Time 03:29 PM Crash Date 08/28/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.