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20091027 balko20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Secondary CrashAmendedCrash Type DT4000 (STANDARD CRASH)Reportable TagsSchool Bus Related YES, SCHOOL BUS DIRECActive School ZoneGovernment Property Reporting ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 01 Total Injured 03 Total Units 02 Time Notified 06:34 PM Date Notified 09/10/2020 Time Arrived 06:45 PM Date Arrived 09/10/2020 Crash Time 06:34 PM Crash Date 09/10/2020 Investigating Officer/Deputy DEPUTY DENNIS NELSON Agency Crash Number 20091027 Primary Crash Document #Document Number Override 6VL0HPL4FMAdditional InformationCMV INSPECTION, FATAL CRASH SUPPLEMENT, PHOTOS, RECONSTRUCTION, WITNESS STATEMENTS Photos ByDEPUTY NELSON 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. DRIVER OF UNIT 1 WAS TRAVELING NORTHBOUND ON STH 40, IN THE PROCESS OF TURNING LEFT ONTO STH 48. DRIVER OF UNIT 2 WAS TRAVELING SOUTHBOUND ON STH 40. THE DRIVER OF UNIT 1 FAILED TO YIELD THE RIGHT OF WAY TO UNIT 2. BOTH UNITS COLLIDED IN AN OFFSET HEAD-ON COLLISION. . Crash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5065809.5 X Coordinate 171674.890625 Longitude -91.215105023 Latitude 45.668017385 ON STH40 SB 12 FT S OF CTHD WB IN THE TOWN OF WEIRGOR 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) GLARE 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 FOUR-WAY INTERSECTION Junction Location INTERSECTION-RELATED Within Interchange Area NO Truck Bus or HazMat VEHICLE DESIGNED TO CARRY 9 OR MORE PPL, INCLUDING DRIVER Road Grade SAG(BOTTOM) 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 NORTHBOUND Insurance? UNKNOWN Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # Recorded 5 Total Occs 5 Operating As Endorsements S - SCHOOL BUS Vehicle Type SCHOOL BUS01 Unit Type BUS Vehicle Operating As Classification C CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage DISABLING DAMAGE Vehicle Damage 12 - FRONT Initial Contact Point 12 - FRONT Bus Use SCHOOL Body Style BU - BUS Color YEL - YELLOW Model SCHOOL BUS Year 2015 Make ICBU Vehicle Identification Number 57190101 Country of Issuance UNITED STATES St WI Plate Type BUS - BUS License Plate Number VEHICLEUNIT Vehicle Crash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address BRUCE, WI 54819 , US Owner Name 0101Driver Actions FAILED TO YIELD RIGHT-OF-WAY Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN Vehicle Removed By S&R TOWING Towed Due To Damage TOWED DUE TO DISABLING DAMAGE UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04Distracted By Injury LocationStriking Unit # Distracted By Action NOT DISTRACTED Distracted By Source NOT APPLICABLE (NOT DISTRACTED) Time of DeathDate of DeathHospital LAKEVIEW MEDICAL CENTER EMS Run # 5318 EMS Agency Identifier 6000954 Medical Transport EMS GROUND Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity POSSIBLE 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 EXELAND, WI 54835 , US Race WHITE Date of Birth 05/06/ Sex FEMALE Citations Issued 0 Driver ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT 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 UNITINDIVIDUALDistracted By Injury Prior Action LocationStriking Unit # Distracted By Action Distracted By Source 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 NOT APPLICABLE Injury Severity SUSPECTED MINOR INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 08 - MIDDLE Row 06 -UNKNOWN ROW Safety Equipment NOT APPLICABLE On Duty Crash Driver License NumberAddress EXELAND, WI 54835 , US Race WHITE Date of Birth 04/20/ Sex FEMALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL 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 UNITINDIVIDUALDistracted By Injury Prior Action LocationStriking Unit # Distracted By Action Distracted By Source 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 NOT APPLICABLE Injury Severity SUSPECTED MINOR INJURY00301 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 09 - RIGHT Row 06 -UNKNOWN ROW Safety Equipment OTHER On Duty Crash Driver License NumberAddress , , Race HISPANIC Date of Birth 06/23/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL 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 UNITINDIVIDUALDistracted By Injury Prior Action LocationStriking Unit # Distracted By Action Distracted By Source 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 NOT APPLICABLE Injury Severity NO APPARENT INJURY00501 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 06 -UNKNOWN ROW Safety Equipment NOT APPLICABLE On Duty Crash Driver License NumberAddress , , Race WHITE Date of Birth 06/17/ Sex FEMALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00501Drug 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 UNITINDIVIDUALDistracted By Injury Prior Action LocationStriking Unit # Distracted By Action Distracted By Source 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 NOT APPLICABLE Injury Severity NO APPARENT INJURY00601 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat PositionRow 99 - UNKNOWN Safety Equipment NOT APPLICABLE On Duty Crash Driver License NumberAddress , AL , US Race WHITE Date of Birth 04/19/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 7 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00601Drug 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 UNITINDIVIDUALMeasured 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 NOT IN COMMERCE/OTHER TRUCK US DOT # Cargo Body Type BUS (SEATS FOR MORE THAN 15 OCCUPAN Vehicle Configuration BUS(SEATS FOR MORE THAN 15 OCCUPANTS, INCL GVWR 10,001-26,000 LBS01 Address 104 W WASHINGTON AVE BRUCE, WI 54819 , US Name BRUCE SCHOOL01 Source DRIVERUse Vehicle Owner Same as Carrier Carrier CKBUSUNITTRUTruck Bus or HazMat NO Road Grade DOWNHILL 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 SOUTHBOUND Insurance? UNKNOWN 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 UNIT Vehicle Crash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 8 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address BRUCE, WI 54819 , US Owner Name 0202Driver Actions UNKNOWN Driver Prior Action Other Vehicle Factors UNKNOWN What Driver Was Doing GOING STRAIGHT Vehicle Removed By ROADRUNNER TOWING Towed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 12 - FRONT Initial Contact Point 12 - FRONT Bus UseBody Style 4D - 4DR Color ONG - ORANGE Model NITRO Year 2007 Make DODGE Vehicle Identification Number 0202Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNITUNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04Injury Trapped/Extricated TRAPPED/EXTRICATED Ejection Path NOT EJECTED/NOT APPLICABLE Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity FATAL INJURY00402 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 07 - LEFT Row 01 - FRONT ROW Safety Equipment NONE USED - VEHICLE OCCUPANT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address BRUCE, WI 54819 , US Race WHITE Date of Birth 09/16/ Sex FEMALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 9 of 10 This report does not include any CJIS data. 20091027 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0HPL4FM WISCONSIN MOTOR VEHICLE CRASH REPORT Distracted By Drug & Alcohol Individual Condition NOT OBSERVED Drug Type 00402Drug 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 Time of Death 18:55 Date of Death 09/10/2020 Hospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UNITNon Motorist INDIVIDUALDate of Birth 12/04/1953EXELAND, WI 54835 , US01Witness WITNESSCrash Time 06:34 PM Crash Date 09/10/2020Wisconsin Motor Vehicle Crash Form DT4000 10 of 10 This report does not include any CJIS data.