20102924 hamilton-bishop20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL 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
09:50 PM
Date Notified
10/29/2020
Time Arrived
10:00 PM
Date Arrived
10/29/2020
Crash Time
09:49 PM
Crash Date
10/29/2020
Investigating Officer/Deputy
SERGEANT NICK ALMOGHRABI
Agency Crash Number
20102924
Primary Crash Document #Document Number Override
6VL0J3XHKLAdditional InformationPHOTOS
Photos BySGT ALMOGHRABI
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
R/O WAS DISPATCHED TO A TWO VEHICLE PROPERTY DAMAGE CRASH WITH NO ROAD BLOCKAGE ON 11/29/20 LOCATED ON STH 27/70 EAST OF RIVER ROAD
IN THE TOWNSHIP OF COUDERAY. UPON ARRIVAL, R/O MET WITH BOTH DRIVER'S AND ONE PASSENGER AND ASSURED NO ONE WAS INJURED. R/O LEARNED
THAT THE OPERATOR OF THE CHEVY PICKUP TRAVELING SOUTH WAS SLOWING AND PREPARING TO TURN LEFT ONTO A TRAIL/PATH. THE OPERATOR
ADVISED HE DID HAVE HIS TURN SIGNAL ON. THE CHEVY SUSTAINED DAMAGE TO THE FRONT DRIVER'S CORNER AND WAS REMOVED BY THE OPERATOR.
THE OPERATOR OF A SOUTHBOUND TOYOTA COROLLA ADVISED SHE SAW THE SLOW MOVING PICKUP WITH LIGHTS SHINING OUT BOTH THE DRIVER AND
PASSENGER WINDOWS AS THEY WERE SHINING FOR DEER. THE TOYOTA OPERATOR STATED SHE SAW BRAKE LIGHTS BUT THAT THERE WAS NOT A TURN
SIGNAL ACTIVATED. THE TOYOTA OPERATOR BEGAN TO PASS, IN A PASSING ZONE, ON THE LEFT WHEN THE PICKUP BEGAN TO MAKE IT'S LEFT TURN AT
WHICH POINT THE VEHICLES COLLIDED. THE PICKUP WAS ABLE TO PULL OFF ONTO THE TRAIL WHILE THE TOYOTA ENTERED THE EAST DITCH COMING TO A
REST. R/O OBSERVED THE DRIVER'S AIRBAG ON THE TOYOTA HAD DEPLOYED AND THE VEHICLE SUSTAINED DISABLING DAMAGE TO THE FRONT
PASSENGER SIDE AND WAS REMOVED BY A TOW COMPANY.
Crash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5081103
X Coordinate
159527.65625
Longitude
-91.381343527
Latitude
45.799415352
ON STH27 SB
1064 FT E
OF RIVER RD
IN THE TOWN OF COUDERAY
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
DARK/UNLIT
Manner of Collision
07 - SIDESWIPE/SAME DIRECTION
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
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
2
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01 Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
11 - LEFT FRONT CORNER
Initial Contact Point
11 - LEFT FRONT CORNER
Bus UseBody Style
T - DIRT
Color
GRN - GREEN
Model
Z71
Year
1993
Make
CHEVROLET
Vehicle Identification Number
20770101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LCO - LAC COURTE OREI
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
0101Driver Actions
OTHER CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
LEFT TURN
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
UNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Individual
Insurance Company
STATE-FARM-GENERAL-INS-CO
Policy Holder
UNITDistracted By
Injury
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 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
STONE LAKE, WI 54876 , US
Race
INDIAN
Date of Birth
12/27/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL 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
NOT APPLICABLE
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 Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
STONE LAKE, WI 54876 , US
Race
INDIAN
Date of Birth
01/31/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL 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
SOUTHBOUND
Insurance?
YES
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
UNITWhat Driver Was Doing
OVERTAKE LEFT
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER, 02 - RIGHT SIDE FRONT
Initial Contact Point
01 - RIGHT FRONT CORNER
Bus UseBody Style
4D - 4DR
Color
GRY - GRAY
Model
COROLLA CE
Year
2007
Make
TOYOTA
Vehicle Identification Number
1 5130202 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
WINTER, WI 54896 , US
Owner Name
0202Driver Actions
IMPROPER OVERTAKING / PASSING LEFT
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
UNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04Individual
Insurance Company
GEICO-CASUALTY-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
DEPLOYED-FRONT
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
WINTER, WI 54896 , US
Race
WHITE
Date of Birth
02/08/
Sex
FEMALE
Citations Issued
0
Driver
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 6 of 7
This report does not include any CJIS data.
20102924
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0J3XHKL 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 09:49 PM
Crash Date 10/29/2020Wisconsin Motor Vehicle Crash
Form DT4000 7 of 7
This report does not include any CJIS data.