20120713 lohman20120713
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBJ 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
02:02 PM
Date Notified
12/07/2020
Time Arrived
02:15 PM
Date Arrived
12/07/2020
Crash Time
02:00 PM
Crash Date
12/07/2020
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0G5WRBJAdditional InformationPHOTOS, RECONSTRUCTION
Photos ByDEPUTY KEVIN GILLIS
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON DECEMBER 7, 2020 I, DEPUTY KEVIN GILLIS, WAS ON ROUTINE PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPARTMENT. AT APPROXIMATELY 1402 I
WAS DISPATCHED TO THE INTERSECTION OF COUNTY ROAD W AND COUNTY ROAD G IN THE TOWNSHIP OF WINTER FOR A ONE VEHICLE CRASH. DISPATCH
ADVISED THE VEHICLE HAD HIT A UTILITY POLE AND IT WAS UNKNOWN IF THERE WERE INJURIES.
UPON ARRIVAL I OBSERVED AN VAN IN THE EAST SIDE DITCH OFF OF COUNTY ROAD W. I MADE CONTACT WITH THE
DRIVER WHO I IDENTIFIED AS (DOB: 02/27/ REFUSED MEDICAL ATTENTION. STATED HE WAS TRAVELING EAST
ON COUNTY ROAD G WHEN TWO DEER CAME INTO THE ROADWAY. STATED HE SWERVED TO MISS THE DEER AND ATTEMPTED TO HIT THE
BRAKES, BUT ACCIDENTLY HIT THE ACCELERATOR WHICH SENT HIM INTO THE DITCH.
HAD HIT A UTILITY POLE, WHICH WAS BROKEN AND LAYING ON THE GROUND. THERE WERE ALSO POWER LINES ACROSS COUNTY ROAD W.
NORTH CENTRAL POWER COMPANY WAS CALLED AND ARRIVED ON SCENE TO ADDRESS THE UTILITY POLE AND POWER LINES.
Crash Time 02:00 PM
Crash Date 12/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
20120713
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBJ WISCONSIN MOTOR VEHICLE
CRASH REPORT
THERE WAS SIGNIFICANT DAMAGE TO THE FRONT END OF THE VEHICLE, WHICH CAUSED THE AIRBAGS TO DEPLOY. IT APPEARED THE VEHICLE WAS
TRAVELING AT A HIGH RATE OF SPEED WHEN IT HIT THE UTILITY POLE. I TOOK PICTURES OF THE CRASH SCENE AND THE DAMAGES TO THE VEHICLE. THE
VEHICLE WAS EVENTUALLY TOWED BY ROADRUNNER TOWING.
Structure Type
UTILITY
Y Coordinate
5085172
X Coordinate
187164.6875
Longitude
-91.029264346
Latitude
45.849023711
ON CTHW EB
11 FT S
OF CTHG EB
IN THE TOWN OF WINTER
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
Environment Factor(s)
OTHER
Roadway Factor(s)
NOT APPLICABLE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
OFF ROADWAY, LOCATION UNKNOWN
First Harmful Event
UTILITY POLE
Crash Scene
Intersection Type
T-INTERSECTION
Junction Location
INTERSECTION
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
STOP SIGN
Traffic Way
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
UTILITY POLE
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
1
Operating As EndorsementsVehicle Type
CARGO VAN (10,000 LBS OR LESS)01Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITInitial Contact Point
11 - LEFT FRONT CORNER
Bus UseBody Style
VN - VAN
Color
WHI - WHITE
Model
PROMASTER
Year
2018
Make
RAM
Vehicle Identification Number
46340101 Country of Issuance
UNITED STATES
St
WI
Plate Type
HTK - HEAVY TRUCK
License Plate Number
Vehicle
Crash Time 02:00 PM
Crash Date 12/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
20120713
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBJ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
CABLE, WI 54821 , US
Owner Name
0101Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
11 - LEFT FRONT CORNER, 12 - FRONT
VEHICLEUNITUNITVEHICLE Sequence Of Events
Event
UTILITY POLE01
Event
02Event
03Event
04Organization/CompanyInsurance Company
ACUITY,-A-MUTUAL-INSURANCE-CO
Policy Holder
UNITInjury
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 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
HUDSON, WI 54016 , US
Race
WHITE
Date of Birth
02/27/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 02:00 PM
Crash Date 12/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
20120713
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBJ 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
OTHER DISTRACTION (ANIMAL, FOOD, GROOMING)UNITNon Motorist
INDIVIDUALCrash Time 02:00 PM
Crash Date 12/07/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.