20101709 weberg20101709
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3V 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
01
Time Notified
08:44 AM
Date Notified
10/17/2020
Time Arrived
09:20 AM
Date Arrived
10/17/2020
Crash Time
08:43 AM
Crash Date
10/17/2020
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3VAdditional InformationPHOTOS
Photos ByDEPUTY L. SHEPARD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON OCTOBER 17TH, 2020, AT APPROXIMATELY 8:44AM, REPORTED TO SAWYER COUNTY DISPATCH THAT HE HAD SLID OFF THE ROAD AND
CRASHED INTO A TREE. HE ADVISED HE WAS UNINJURED, BUT COULDN'T GET THE DOOR OF THE VEHICLE OPEN. DEPUTY SHEPARD OF THE SHERIFF'S
DEPARTMENT AND MEMBERS OF THE ROUND LAKE FIRE DEPARTMENT RESPONDED TO THE SCENE. THE FIRE DEPARTMENT PERSONNEL OPENED THE
VEHICLE AND GOT OUT PRIOR TO DEPUTY SHEPARD ARRIVING. WHEN DEPUTY SHEPARD ARRIVED HE PHOTOGRAPHED THE SCENE AND
INTERVIEWED HAD BEEN TRAVELING WEST ON MOOSE LAKE RD. HE REACHED A DOWN HILL RIGHT CURVE. HIS VEHICLE LOST TRACTION
AND BEGAN TO SLID DOWN THE HILL OUT OF CONTROL. IT HAD BEEN SNOWING AND THE ROAD SURFACE WAS SLUSHY AND SLIPPERY. HIS VEHICLE SLID
OFF THE SOUTH SIDE OF THE ROAD. THE DRIVERS SIDE SCRAPED ALONG THE TREE LINE UNTIL THE FRONT END OF THE VEHICLE HIT A LARGER TREE,
SWINGING THE REAR END OF THE VEHICLE BACK TOWARDS THE ROAD AND THEN COMING TO A STOP. THE DRIVERS SIDE OF THE VEHICLE AS WELL AS THE
FRONT END WERE SEVERELY DAMAGED AND SIDE/FRONT AIRBAGS WERE DEPLOYED. THE VEHICLE WAS A 2015 JEEP GRAND CHEROKEE.
PROVIDED DEPUTY SHEPARD WITH INSURANCE INFORMATION AND WAS THEN GIVEN A RIDE HOME BY THE FIRE DEPT. CHIEF. THE VEHICLE WAS REMOVED
AND TOWED BY ROADRUNNER TOWING OUT OF HAYWARD, WI.
Crash Time 08:43 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20101709
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3V WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5105346.5
X Coordinate
176590.921875
Longitude
-91.17869836
Latitude
46.025240975
ON MOOSE LAKE RD
0.65 MI W
OF FULLINGTON RD
IN THE TOWN OF ROUND LAKE
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 - NOT ON ROAD
Animal Type
Weather Condition(s)
SNOW
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
SLUSH
Light Condition
DAYLIGHT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
TREE
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
UNKNOWN
Time Scene Cleared
10:26 AM
Date Scene Cleared
10/17/2020
Time All Lanes Open
10:25 AM
Date All Lanes Open
10/17/2020
Time Initial Lane/Rd Closed
09:15 AM
Date Initial Lane/Rd Closed
10/17/2020
Reasons for Closure
LAW ENFORCEMENT, TOW TRUCK, FIRE/EMS
Closure Type
LANE CLOSURE
Truck Bus or HazMat
NO
Road Grade
DOWNHILL
Road Curvature
CURVE RIGHT
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
TREE
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
UNITModel
GRAND CHER
Year
2015
Make
JEEP
Vehicle Identification Number
48860101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 08:43 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20101709
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3V WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
UNKNOWN
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER, 07 - LEFT REAR CORNER, 08 - LEFT SIDE REAR,
09 - LEFT SIDE MIDDLE, 10 - LEFT SIDE FRONT, 11 - LEFT FRONT CORNER, 12
- FRONT
Initial Contact Point
11 - LEFT FRONT CORNER
Bus UseBody Style
4H - HATCHBACK 4 DOOR
Color
RED - RED
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
CROSS CENTERLINE01
Event
RUN OFF ROADWAY LEFT02
Event
DITCH03
Event
TREE04
IndividualInsurance Company
SECURA-SUPREME-INS-CO
Policy Holder
UNITInjury
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
TRAPPED/EXTRICATED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-COMBINATION
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: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
08/27/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 08:43 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20101709
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3V WISCONSIN MOTOR VEHICLE
CRASH REPORT
Distracted By
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 #
Distracted By Action
UNKNOWN
Distracted By Source
UNKNOWN
Time of DeathDate of DeathHospital
UNITNon Motorist
INDIVIDUALCrash Time 08:43 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.