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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.