20121209 olsonSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G4NQ6T 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
08:31 AM
Date Notified
12/12/2020
Time Arrived
08:31 AM
Date Arrived
12/12/2020
Crash Time
08:00 PM
Crash Date
12/11/2020
Investigating Officer/Deputy
DEPUTY CRAIG DEPEW
Agency Crash Number
20121209
Primary Crash Document #Document Number Override
6VL0G4NQ6TAdditional InformationPHOTOS
Photos ByDEPUTY C DEPEW
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
OPERATOR AND PASSENGER WERE TRAVELING SOUTHBOUND ON COLBROTH LAKE ROAD AT APPROXIMATELY 8 PM . OPERATOR AND PASSENGER STATED
THAT BOTH OF THEM WERE DRINKING INTOXICATING BEVERAGES. OPERATOR STATED THAT THE ROAD HAD A SHARP CORNER AND WAS ICE COVERED AND
CAUSED HIM TO LOOSE CONTROL CAUSING THE VEHICLE TO HIT THE DITCH AND OVERTURN. OPERATOR AND PASSENGER WERE ABLE TO EXIT VEHICLE
AND HAD LEFT THE SCENE DUE TO BEING INTOXICATED.
Crash Time 08:00 PM
Crash Date 12/11/2020Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G4NQ6T WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5098980.5
X Coordinate
149999.640625
Longitude
-91.516579426
Latitude
45.955060075
ON COLBROTH RD
0.57 MI S
OF RAINBOW RD
IN THE TOWN OF BASS LAKE
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)
UNKNOWN
Environment Factor(s)
NONE
Roadway Factor(s)
NOT APPLICABLE
Road Surface Condition(s)
ICE, GRAVEL
Light Condition
UNKNOWN
Manner of Collision
00 - NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ON ROADWAY
First Harmful Event
OVERTURN/ROLLOVER
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
DOWNHILL
Road Curvature
CURVE LEFT
Surface Type
DIRT
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
35
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
NO
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # RecordedTotal Occs
2
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01 Unit Type
TRUCK
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
99 - UNKNOWN
Bus UseBody Style
PK - PICKUP
Color
BLU - BLUE
Model
DAKOTA
Year
1994
Make
DODGE
Vehicle Identification Number
29440101 Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 08:00 PM
Crash Date 12/11/2020Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G4NQ6T WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
0101Driver Actions
SPEED TOO FAST/COND
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UNITVEHICLE Sequence Of Events
Event
OVERTURN/ROLLOVER01
Event
02Event
03Event
04Distracted By
Injury
LocationStriking Unit #
Distracted By Action
NOT DISTRACTED
Distracted By Source
NOT APPLICABLE (NOT DISTRACTED)
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
POSSIBLE INJURY00101 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
07 - LEFT
Row
01 - FRONT ROW
Safety Equipment
NONE USED - VEHICLE OCCUPANT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
10/12/
Sex
MALE
Citations Issued
1
Driver
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 08:00 PM
Crash Date 12/11/2020Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G4NQ6T WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
NOT OBSERVED
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug UseSuspected Alcohol Use
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
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00201 Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
09 - RIGHT
Row
01 - FRONT ROW
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
11/28/
Sex
MALE
Citations Issued
0
Passenger
ITSafety Equipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 08:00 PM
Crash Date 12/11/2020Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0G4NQ6T WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL, NOT OBSERVED
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
UNITINDIVIDUAL Violations
DescriptionFAILURE OF OPERATOR TO NOTIFY POLICE OF ACCIDENTStatute Number346.70(1)Issue To?
001
UTC Number
BE65001901
Crash Time 08:00 PM
Crash Date 12/11/2020Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.