20120813 garnett20120813
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBK WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
PRIVATE PROPERTY/PARKING LOTReportable
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
02:31 PM
Date Notified
12/08/2020
Time Arrived
02:52 PM
Date Arrived
12/08/2020
Crash Time
02:30 PM
Crash Date
12/08/2020
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0G5WRBKAdditional InformationPHOTOS
Photos ByDEPUTY KEVIN GILLIS
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS PULLING INTO A PARKING SPOT IN THE ESSENTIA HEALTH PARKING LOT AND SCRAPED UNIT 2, WHICH WAS LEGALLY PARKED. UNIT 1 HAD VERY
MINOR DAMAGE TO THE FRONT PASSENGER SIDE BUMPER AND UNIT 2 HAD VERY MINOR DAMAGE TO THE REAR DRIVER SIDE BUMPER.
Crash Time 02:30 PM
Crash Date 12/08/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
20120813
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBK WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5107625.5
X Coordinate
152841.640625
Longitude
-91.486295363
Latitude
46.034073171
PARKING LOT
STH27 SB LOT
IN THE TOWN OF HAYWARD
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
Crash Classification - Jurisdiction
PRIVATE PROPERTY
Crash Classification - Location
PRIVATE PROPERTY
Relation To Trafficway
NON TRAFFICWAY - PARKING LOT
Animal Type
Weather Condition(s)
CLEAR
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
01 - ANGLE
First Harmful Event Location
UNKNOWN
First Harmful Event
PARKED MOTOR VEHICLE
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
PARKING LOT OR PRIVATE PROPERTY
Emergency Motor Vehicle Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
PARKED MOTOR VEHICLE
Total Lanes
0
Speed Limit
N/A
Pre CrashTire
Mark
Direction Of Travel
NOT ON ROADWAY
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER VAN01 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
MINOR DAMAGE
Vehicle Damage
01 - RIGHT FRONT CORNER
Initial Contact Point
01 - RIGHT FRONT CORNER
Bus UseBody Style
VN - VAN
Color
SIL - SILVER (ALUMINUM)
Model
TOWN & COU
Year
2008
Make
CHRYSLER
Vehicle Identification Number
25290101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 02:30 PM
Crash Date 12/08/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
20120813
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBK WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
0101Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
PARK MANEUVER
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
UNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
PARKED MOTOR VEHICLE02
Event
03Event
04Individual
Insurance Company
AMERICAN-AUTOMOBILE-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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
01 - FRONT ROW
Safety Equipment
OTHER
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
STONE LAKE, WI 54876 , US
Race
WHITE
Date of Birth
02/19/
Sex
MALE
Citations Issued
0
Driver
ITSafety Equipment
Individual
UNINDIVIDUALCrash Time 02:30 PM
Crash Date 12/08/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
20120813
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBK 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
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
PARKING LOT OR PRIVATE PROPERTY
Emergency Motor Vehicle Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
0
Speed Limit
N/A
Pre CrashTire
Mark
Direction Of Travel
NOT ON ROADWAY
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # RecordedTotal Occs
0
Operating As EndorsementsVehicle Type
PASSENGER CAR02 Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
LEGALLY PARKED
Unit Summary
UNITVehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
MINOR DAMAGE
Vehicle Damage
07 - LEFT REAR CORNER
Initial Contact Point
07 - LEFT REAR CORNER
Bus UseBody Style
4D - 4DR
Color
DGR - GREEN, DARK
Model
CAMRY HYBR
Year
2010
Make
TOYOTA
Vehicle Identification Number
48150202 Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 02:30 PM
Crash Date 12/08/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
20120813
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G5WRBK WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
CABLE, WI 54821 , US
Owner Name
0202Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
LEGALLY PARKED
UNITVEHICLE Sequence Of Events
Event
PARKED MOTOR VEHICLE01
Event
02Event
03Event
04Individual
Insurance Company
USAA-CASUALTY-INS-CO
Policy Holder
UNITCrash Time 02:30 PM
Crash Date 12/08/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.