20112207 kruschke-heutmaker318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 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
04
Total Units
02
Time Notified
12:01 PM
Date Notified
11/22/2020
Time Arrived
12:08 PM
Date Arrived
11/22/2020
Crash Time
12:01 PM
Crash Date
11/22/2020
Investigating Officer/Deputy
DEPUTY MATHIAS HALBUR
Agency Crash Number
20112207
Primary Crash Document #Document Number Override
6VL0Z6J8W0Additional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON NOVEMBER 22ND, 2020, I DEPUTY MATHIAS HALBUR WAS ON DUTY FOR THE SAWYER COUNTY SHERIFF'S OFFICE. I WAS REQUESTED BY DISPATCH TO
RESPOND TO THE AREA OF US HIGHWAY 63 SLIGHTLY NORTH OF THE LENROOT TOWN HALL REFERENCE A TWO-VEHICLE HEAD ON COLLISION. I BEGAN EN
ROUTE AT 12:03 PM. DEPUTY SHEPARD WAS EN ROUTE AS WELL. I ARRIVED ON SCENE AT 12:08 PM. WHEN I EXITED MY SQUAD, I OBSERVED TWO
JUVENILES WHO WERE SITTING ON THE SHOULDER OF THE NORTHBOUND LANE. A MALE JUVENILE, WHO WAS LATER IDENTIFIED AS DOB: 5/5/ WAS
LAYING ON HIS BACK AND APPEARED TO BE IN PAIN. A FEMALE JUVENILE, WHO WAS LATER IDENTIFIED AS DOB: 06/13/ HAD BLOOD ON HER
FACE, BUT WAS SITTING UP AND SPEAKING. BOTH JUVENILES WERE ALERT AND CONSCIOUS. MULTIPLE CIVILIANS WERE ATTENDING TO THE JUVENILES.
AFTER TALKING WITH CIVILIANS ON SCENE, I LEARNED THAT THE DRIVERS OF BOTH OF THE VEHICLES WERE STILL INSIDE THEIR RESPECTIVE VEHICLES.
THE VEHICLES INVOLVED WERE A BLUE 2005 CHEVROLET SILVERADO WITH WI PLATE OF AND A BLUE 2013 FORD FLEX WITH WI PLATES OF
THE FORD FLEX WAS RESTING AGAINST THE GUARDRAIL ON THE NORTHBOUND LANE SHOULDER, AND THE SILVERADO WAS CONTACTING THE FRONT END
OF THE FLEX WITH ITS TAILGATE. BOTH VEHICLES HAD SIGNIFICANT FRONT END DAMAGE, AND THE SILVERADO ALSO HAD SIGNIFICANT REAR END DAMAGE.
I APPROACHED THE DRIVER OF THE SILVERADO, WHO WAS LATER IDENTIFIED AS DOB:11/25/ HAD BLEEDING OUT OF
HIS LEFT EAR, WAS COMPLAINING OF LEG PAIN, BUT WAS ABLE TO SPEAK AND THINK CLEARLY AND APPEARED OTHERWISE STABLE. I THEN WENT TO THE
Crash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 WISCONSIN MOTOR VEHICLE
CRASH REPORT
FORD FLEX WHERE A CIVILIAN WAS ATTEMPTING TO EXTRICATE THE DRIVER, DOB: 1/4/ I ASKED HOW HE WAS DOING.
COMPLAINED ABOUT SEVERE LEG AND WRIST PAIN, BUT APPEARED OTHERWISE STABLE. DEPUTY SHEPARD AND SAWYER COUNTY AMBULANCE
PERSONNEL ARRIVED ON SCENE. DEPUTY SHEPARD SHUT DOWN TRAFFIC IN THE SOUTHBOUND LANE AND I INFORMED THE AMBULANCE PER
Structure Type
NO STRUCTURE
Y Coordinate
5111765.5
X Coordinate
158528.4375
Longitude
-91.41599439
Latitude
46.074082575
ON USH63 NB
507 FT E
OF OLD 63
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 - ON ROAD
Animal Type
Weather Condition(s)
CLOUDY, SNOW, FREEZING RAIN OR FREEZING DRIZZLE
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
ICE
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
NO
Time Scene Cleared
01:34 PM
Date Scene Cleared
11/22/2020
Time All Lanes Open
01:34 PM
Date All Lanes Open
11/22/2020
Time Initial Lane/Rd Closed
12:15 PM
Date Initial Lane/Rd Closed
11/22/2020
Reasons for Closure
LAW ENFORCEMENT, TOW TRUCK, FIRE/EMS, WEATHER CONDITIONS
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
OVERTURN/ROLLOVER
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
UTILITY TRUCK/PICKUP TRUCK01 Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITCountry of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
OSCEOLA, WI 54020 , US
Owner Name
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, 02 - RIGHT SIDE FRONT, 05 - RIGHT REAR
CORNER, 06 - REAR, 07 - LEFT REAR CORNER, 10 - LEFT SIDE FRONT, 11 -
LEFT FRONT CORNER, 12 - FRONT
Initial Contact Point
12 - FRONT
Bus UseBody Style
PK - PICKUP
Color
BLU - BLUE
Model
SILVERADO
Year
2005
Make
CHEVROLET
Vehicle Identification Number
51020101
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
CROSS CENTERLINE02
Event
RUN OFF ROADWAY LEFT03
Event
04Individual
Insurance Company
STATE-FARM-GENERAL-INS-CO
Policy Holder
UNITInjury
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
.
OSCEOLA, WI 54020 , US
Race
WHITE
Date of Birth
11/25/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 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
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #
2018503
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
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
NORTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
3
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITModel
FLEX
Year
2013
Make
FORD
Vehicle Identification Number
53170202 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
BALDWIN, WI 54002 , US
Owner Name
0202Driver 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, 02 - RIGHT SIDE FRONT, 03 - RIGHT SIDE
MIDDLE, 04 - RIGHT SIDE REAR, 10 - LEFT SIDE FRONT, 11 - LEFT FRONT
CORNER, 12 - FRONT
Initial Contact Point
12 - FRONT
Bus UseBody Style
UT - SPORT UTILITY VEHICLE
Color
BLU - BLUE
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
RUN OFF ROADWAY RIGHT02
Event
GUARDRAIL FACE03
Event
04IndividualInsurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UNITInjury
EMS Run #
2018503
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 INJUR00202 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
BALDWIN, WI 54002 , US
Race
WHITE
Date of Birth
01/04/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Distracted By
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00202Drug 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
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
UNITNon Motorist
INDIVIDUALInjury
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #
2018503
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-COMBINATION
Injury Severity
SUSPECTED MINOR INJURY00302 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat PositionRow
99 - UNKNOWN
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License NumberAddress
BALDWIN, WI 54002 , US
Race
ASIAN
Date of Birth
05/05/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 6 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Distracted By
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
LocationStriking Unit #
Distracted By Action
Distracted By Source
UNITNon Motorist
INDIVIDUALDistracted By
Injury
Distracted By Source
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
EMS Run #
2018503
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABLE
Ejected
NOT EJECTED
Airbag
DEPLOYED-COMBINATION
Injury Severity
SUSPECTED MINOR INJURY00402 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat PositionRow
99 - UNKNOWN
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License NumberAddress
BALDWIN, WI 54002 , US
Race
ASIAN
Date of Birth
06/13/
Sex
FEMALE
Citations Issued
0
Passenger
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 7 of 8
This report does not include any CJIS data.
318
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0Z6J8W0 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
Prior Action
LocationStriking Unit #
Distracted By Action
UNITNon Motorist
INDIVIDUALLENROOT, WI 54843 , US
PROPOWNER01Fixed Objects Struck
Property Owner
Damage Tag Number
208241
Structure NumberStruck Object
GUARDRAIL FACE
Striking Unit
0201
Crash Time 12:01 PM
Crash Date 11/22/2020Wisconsin Motor Vehicle Crash
Form DT4000 8 of 8
This report does not include any CJIS data.