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20112804 lessila20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 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 01 Total Units 01 Time Notified 02:25 AM Date Notified 11/28/2020 Time Arrived 02:45 AM Date Arrived 11/28/2020 Crash Time 02:10 AM Crash Date 11/28/2020 Investigating Officer/Deputy DEPUTY AMBER OSHEA DORN Agency Crash NumberPrimary Crash Document #Document Number Override 6VL0Z6J8W1Additional InformationPHOTOS Photos ByDEPUTY O'SHEA DORN Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. D.O.B. 11/03/ WAS TRAVELING EASBOUND ON CTH B WITH THREE PASSENGERS, - D.O.B. 09/21/ AND D.O.B. 10/29/ LEFT THE ROADWAY, INTO THE EASTBOUND DITCH RESULTING IN AN OVER TURN/ROLLOVER OF THE VEHICLE. THE VEHICLE'S FINAL RESTING SPOT WAS OVER THE GUARD RAIL OF THE BRIDGE NEAR THE RIVER. ATTACHED TO SAWYER COUNTY SHERIFF'S DEPARTMENT CASE NUMBER 20112804. Crash Time 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5098483.5 X Coordinate 180386.8125 Longitude -91.125194117 Latitude 45.965414629 ON CTHB EB 702 FT S OF RIVER RD IN THE TOWN OF HUNTER 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 00 - NO COLLISION W/VEHICLE IN TRANSPORT First Harmful Event Location SHOULDER RIGHT First Harmful Event DITCH 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 CURVE LEFT 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 DITCH Total Lanes 2 Speed Limit 55 Pre CrashTire Mark Direction Of Travel EASTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # RecordedTotal Occs 3 Operating As EndorsementsVehicle Type PASSENGER CAR01 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UNITExtent Of Damage DISABLING DAMAGE Vehicle Damage 15 - ALL AREAS Initial Contact Point 13 - TOP Bus UseBody Style 4D - 4DR Color BLK - BLACK Model ECOSPORT Year 2019 Make FORD Vehicle Identification Number 82690101 Country of Issuance UNITED STATES St WI Plate Type AUT - AUTOMOBILE License Plate Number VEHICLEUNIT Vehicle Crash Time 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address OAK CREEK, WI 53154 , US Owner Name 0101Driver Actions UNKNOWN Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing UNKNOWN Vehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE UNITVEHICLE Sequence Of Events Event MOTOR VEH IN TRANSPORT01 Event DITCH02 Event OVERTURN/ROLLOVER03 Event 04Individual Insurance Company AMERICAN-FAMILY-INS-CO Policy Holder UNITDistracted By Injury Distracted By Action UNKNOWN Distracted By Source UNKNOWN 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 POSSIBLE INJURY00101 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 07 - LEFT Row 01 - FRONT ROW Safety Equipment RESTRAINT USE UNKNOWN On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address OAK CREEK, WI 53154 , US Race WHITE Date of Birth 11/03/ Sex FEMALE Citations Issued 0 Driver ITSafety Equipment Individual UNINDIVIDUALCrash Time 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 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 DEPLOYED-COMBINATION Injury Severity NO APPARENT INJURY00201 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 09 - RIGHT Row 01 - FRONT ROW Safety Equipment RESTRAINT USE UNKNOWN On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address PHILLIPS, WI 54555 , US Race WHITE Date of Birth 09/21/ Sex FEMALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL 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 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 DEPLOYED-COMBINATION Injury Severity NO APPARENT INJURY00301 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 10 - UNKNOWN SE Row 02 - SECOND ROW Safety Equipment RESTRAINT USE UNKNOWN On Duty Crash Driver License Number STATE: WASHINGTON COUNTRY: UNITED STATES Address WINTER, WI 54896 , US Race WHITE Date of Birth 10/29/ Sex MALE Citations Issued 0 Passenger ITSafety Equipment Non Motorist Individual UNINDIVIDUALCrash Time 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 20112804 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL0Z6J8W1 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL Drug Type 00301Drug 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 02:10 AM Crash Date 11/28/2020Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.