20101711 bergman20101711
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3W 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
11:53 AM
Date Notified
10/17/2020
Time Arrived
11:53 AM
Date Arrived
10/17/2020
Crash Time
11:52 AM
Crash Date
10/17/2020
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3WAdditional 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 11:53AM, DEPUTY SHEPARD WAS DRIVING WEST ON TAGALDER RD. APPROXIMATELY 1/4 MILE EAST OF THE
INTERSECTION WITH SMALL RD, DEPUTY SHEPARD OBSERVED A VEHICLE THAT HAD ROLLED OVER AND WAS AT REST ON THE VEHICLE ROOF OFF THE
ROADWAY ON THE NORTH SIDE OF THE ROAD. DEPUTY SHEPARD HAD OBSERVED VEHICLE TRACKS FROM THE CRASHED VEHICLE THAT APPEARED IT WAS
INTENTIONALLY DRIFTING ON THE DIRT ROAD FOR APPROXIMATELY A MILE. IT APPEARED THE DRIVER MUST HAVE LOST CONTROL AND WENT OFF THE
ROADWAY AND THE VEHICLE DUG IN AND ROLLED. DEPUTY SHEPARD CONFIRMED THAT THE VEHICLE WAS UNOCCUPIED. IT WAS A GRAY 2005 TOYOTA
COROLLA REGISTERED TO AFTER APPROXIMATELY A HALF HOUR OF WAITING FOR A TOW TRUCK, THE DRIVER ARRIVED BACK ON
SCENE IN A DIFFERENT VEHICLE. DEPUTY SHEPARD IDENTIFIED HER AS - SHE ADVISED SHE LOST HER PHONE IN THE CRASH SO
COULDN'T CALL 911. SHE WALKED TO HER BOYFRIENDS HOUSE ON SMALL RD AFTER THE CRASH AND WAS GIVEN A RIDE BACK TO SCENE. SHE WAS
UNINJURED AND CONFIRMED HOW THE CRASH OCCURRED. THE VEHICLE WAS TOWED AND THE SCENE WAS CLEARED.
Crash Time 11:52 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20101711
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3W WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5114584
X Coordinate
158190.078125
Longitude
-91.42238121
Latitude
46.099201441
ON TAG ALDER RD
0.44 MI E
OF SMALL RD
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 - NOT ON ROAD
Animal Type
Weather Condition(s)
CLOUDY
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
UNKNOWN
Time Scene Cleared
01:10 PM
Date Scene Cleared
10/17/2020
Time All Lanes Open
01:00 PM
Date All Lanes Open
10/17/2020
Time Initial Lane/Rd Closed
12:30 PM
Date Initial Lane/Rd Closed
10/17/2020
Reasons for Closure
TOW TRUCK
Closure Type
FULL CLOSURE
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
DIRT
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
OVERTURN/ROLLOVER
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 CAR01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITModel
COROLLA
Year
2005
Make
TOYOTA
Vehicle Identification Number
14580101 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 11:52 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20101711
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3W WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
FAILURE TO CONTROL, OPERATED MOTOR VEHICLE IN AGGRESSIVE/RECKLESS MANNER
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
ACCELERATING IN ROAD
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
15 - ALL AREAS
Initial Contact Point
00 - NON-COLLISION
Bus UseBody Style
4D - 4DR
Color
GRY - GRAY
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
RUN OFF ROADWAY RIGHT01
Event
OVERTURN/ROLLOVER02
Event
03Event
04IndividualInsurance Company
STATE-FARM-GENERAL-INS-CO
Policy Holder
UNITInjury
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 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
05/26/
Sex
FEMALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 11:52 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20101711
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3W 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 11:52 AM
Crash Date 10/17/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.