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20091936 serini-lueloff20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 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 00 Total Units 02 Time Notified 06:56 PM Date Notified 09/19/2020 Time Arrived 06:59 PM Date Arrived 09/19/2020 Crash Time 06:56 PM Crash Date 09/19/2020 Investigating Officer/Deputy DEPUTY IAN HALL Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0DT5JN4Additional InformationPHOTOS, RECONSTRUCTION Photos BySGT HALL Reconstruction BySAWYER COUNTY SHERIFFDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 WAS TRAVELING WEST ON COUNTY HWY B LOOKING FOR A LOCATION THEY PASSED TO BUY FIREWOOD. UNIT 2 WAS WEST BOUND ON COUNTY HWY B AND APPROACHING UNIT 1. UNIT 1 WAS DRIVING SLOWER THATN THE SPEED LIMIT TO FIND THE DRIVEWAY. UNIT 2 BEGAN TO PASS UNIT 1 AND AS UNIT 2 PULLED INTO THE LEFT LANE TO PASS UNIT 1 BEGAN TO TURN AND ACTIVATED ITS TURN SIGNAL AND DID NOT SEE UNIT 2 PASSING. UNIT 2 STRUCK UNIT 1. Crash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5102986.5 X Coordinate 162382.125 Longitude -91.360091977 Latitude 45.997207897 ON CTHB WB 737 FT E OF ROUND LAKE SCHOOL RD IN THE TOWN OF HAYWARD 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 DUSK Manner of Collision 01 - ANGLE First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION 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 2 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 FUNCTIONAL DAMAGE Vehicle Damage 09 - LEFT SIDE MIDDLE Initial Contact Point 09 - LEFT SIDE MIDDLE Bus UseBody Style UT - SPORT UTILITY VEHICLE Color MAR - MAROON (BURGUNDY) Model TERRAIN Year 2010 Make GM Vehicle Identification Number 18460101 Country of Issuance UNITED STATES St IL Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address STREAMWOOD, IL 60107 , US Owner Name 0101Driver Actions Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN Vehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event LEFT TURN02 Event 03Event 04Individual Insurance Company ALLSTATE-INDEMNITY-CO Policy Holder UNITDistracted By Injury Distracted By Action UNKNOWN Distracted By Source NOT APPLICABLE (NOT DISTRACTED) 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 DEPLOYED-SIDE Injury Severity NO APPARENT 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: ILLINOIS COUNTRY: UNITED STATES Address STREAMWOOD, IL 60107 , US Race WHITE Date of Birth 04/25/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 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 INDIVIDUALDistracted By Injury 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 DEPLOYED-CURTAIN Injury Severity NO APPARENT INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 09 - RIGHT Row 01 - FRONT ROW Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License NumberAddress BUFFALO GROVE, IL , US Race WHITE Date of Birth 08/23/ Sex FEMALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 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 Prior Action UNITINDIVIDUALTruck 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 UTILITY TRUCK/PICKUP TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITWhat Driver Was Doing OVERTAKE LEFT Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED Extent Of Damage MINOR DAMAGE Vehicle Damage 03 - RIGHT SIDE MIDDLE Initial Contact Point 02 - RIGHT SIDE FRONT Bus UseBody Style TK - TRUCK Color SIL - SILVER (ALUMINUM) Model SILVERADO Year 2004 Make CHEVROLET Vehicle Identification Number 50620202 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VEHICLEUNIT Vehicle Crash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address WAUSAU, WI 54401 , US Owner Name 0202Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event 02Event 03Event 04Individual Insurance Company USAA-CASUALTY-INS-CO Policy Holder UNITDistracted By Injury LocationStriking Unit # Distracted By Action NOT DISTRACTED Distracted By Source NOT APPLICABLE (NOT DISTRACTED) 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 NON DEPLOYED Injury Severity NO APPARENT INJURY00302 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 WAUSAU, WI 54401 , US Race WHITE Date of Birth 12/16/ Sex MALE Citations Issued 0 Driver ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 20091936 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0DT5JN4 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00302Drug 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 UNITINDIVIDUALCrash Time 06:56 PM Crash Date 09/19/2020Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.