20111509 denzer20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X 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
03
Total Units
02
Time Notified
12:03 PM
Date Notified
11/15/2020
Time Arrived
12:13 PM
Date Arrived
11/15/2020
Crash Time
12:02 PM
Crash Date
11/15/2020
Investigating Officer/Deputy
DEPUTY LUCAS SHEPARD
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0F03P3XAdditional InformationPHOTOS
Photos ByL. SHEPARD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON NOVEMBER 15TH, 2020, DEPUTY SHEPARD ALONG WITH MULTIPLE OTHER LAW ENFORCEMENT OFFICERS FROM MULTIPLE AGENCIES, WAS DISPATCHED
TO A TWO VEHICLE HEAD ON COLLISION ON STATE HWY 77 APPROXIMATELY AN EIGHTH MILE EAST OF THE INTERSECTION WITH COUNTY HWY K. FIRE AND
EMS WERE BOTH DISPATCHED AS WELL. BASED ON OFFICER OBSERVATION AND INTERVIEWS WITH PASSENGERS DEPUTY SHEPARD DETERMINED THAT A
BLACK 2014 JEEP GRAND CHEROKEE WAS BEING DRIVEN BY AND CRASHED HEAD ON WITH A BLUE 2011 FORD F150 DRIVEN BY
WAS A PASSENGER IN THE F150. AND WERE PASSENGERS IN THE
JEEP. AND WERE BOTH INJURED IN THE CRASH AND THE EXTENT OF THEIR INJURIES IS UNKNOWN. WAS
TRAPPED IN THE TRUCK AND NEEDED TO EXTRICATED BY FIRE PERSONNEL. VORLICKY AND WANDA DENZER WERE BOTH TRANSPORTED TO THE HOSPITAL
BY AMBULANCE. DEPUTIES SPOKE WITH ALL OF THE PASSENGERS IN BOTH VEHICLES AND THEY ALL STATED THAT VEHICLE CROSSED THE
CENTER LINE WHEN IT HIS A SLIPPERY PATCH AND COLLIDED HEAD ON WITH THE VEHICLE. IT WAS SNOWING AND THE ROADS WERE VERY SNOW
COVERED AND SLIPPERY. BOTH VEHICLES WERE PRESUMED TOTALED AND TOWED.
Crash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5106184
X Coordinate
160977.59375
Longitude
-91.380446164
Latitude
46.025210016
ON STH77 EB
964 FT E
OF CTHK EB
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)
SNOW
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
SNOW, SLUSH
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
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
UNKNOWN
Time Scene Cleared
02:06 PM
Date Scene Cleared
11/15/2020
Time All Lanes Open
02:06 PM
Date All Lanes Open
11/15/2020
Time Initial Lane/Rd Closed
12:13 PM
Date Initial Lane/Rd Closed
11/15/2020
Reasons for Closure
LAW ENFORCEMENT, TOW TRUCK, FIRE/EMS
Closure Type
FULL CLOSURE
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
EASTBOUND
Insurance?
UNKNOWN
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
UNITModel
F150
Year
2011
Make
FORD
Vehicle Identification Number
49140101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
12044 N PETERS RD
HAYWARD, WI 54843 , US
Owner Name
WANDA E DENZER
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
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
PK - PICKUP
Color
BLU - BLUE
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
RUN OFF ROADWAY RIGHT02
Event
03Event
04Injury
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
TRAPPED/EXTRICATED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-COMBINATION
Injury Severity
SUSPECTED SERIOUS INJUR00101 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
06/08/
Sex
FEMALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X 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
UNITNon Motorist
INDIVIDUALDistracted By
Injury
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-COMBINATION
Injury Severity
SUSPECTED MINOR 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
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
01/10/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X 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
LocationStriking Unit #
Distracted By Action
UNITNon Motorist
INDIVIDUALTruck 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?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
4
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent 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
BLK - BLACK
Model
GRAND CHER
Year
2014
Make
JEEP
Vehicle Identification Number
957920202 Country of Issuance
UNITED STATES
St
MN
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
EDINA, MN 55424 1154, US
Owner Name
0202Driver Actions
FAILURE TO CONTROL
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
CROSS CENTERLINE01
Event
MOTOR VEH IN TRANSPORT02
Event
03Event
04Distracted By
Injury
LocationStriking Unit #
Distracted By Action
UNKNOWN
Distracted By Source
UNKNOWN
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #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
SUSPECTED MINOR 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: MINNESOTA COUNTRY: UNITED STATES
Address
EDINA, MN 55424 1154, US
Race
WHITE
Date of Birth
11/13/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 6 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
NOT OBSERVED
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
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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00402 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: MINNESOTA COUNTRY: UNITED STATES
Address
EDINA, MN 55436 1947, US
Race
WHITE
Date of Birth
08/07/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 7 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00402Drug 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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00502 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
09 - RIGHT
Row
02 - SECOND ROW
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: MINNESOTA COUNTRY: UNITED STATES
Address
EDINA, MN 55424 1705, US
Race
WHITE
Date of Birth
09/10/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 8 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00502Drug 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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00602 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
02 - SECOND ROW
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: MINNESOTA COUNTRY: UNITED STATES
Address
EDINA, MN 55424 1324, US
Race
WHITE
Date of Birth
02/26/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 9 of 10
This report does not include any CJIS data.
20111509
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0F03P3X WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00602Drug 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
UNITINDIVIDUALCrash Time 12:02 PM
Crash Date 11/15/2020Wisconsin Motor Vehicle Crash
Form DT4000 10 of 10
This report does not include any CJIS data.