20170921 French Cecil17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Secondary
CrashAmendedCrash Type
DT4000 (Standard Crash)Reportable
TagsSchool Bus Related
NoActive School ZoneGovernment
Property
Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
02
Time Notified
07:27 AM
Date Notified
09/21/2017
Time Arrived
08:04 AM
Date Arrived
09/21/2017
Crash Time
07:27 AM
Crash Date
09/21/2017
Investigating Officer/Deputy
DEPUTY JAY POPLIN
Agency Crash Number
17092113129
Primary Crash Document #Document Number Override
6V
L
1
3
J
5
5
K
1
Additional InformationPhotos, Reconstruction
Photos ByPOPLIN
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS GOING WEST ON STATE HWY 48 AND UNIT 2 WAS GOING EAST ON STATE HWY 48. THE DRIVER OF UNIT 2 SAID SHE OBSERVED THE ONCOMING CAR GO OVER THE CENTER LINE INTO HER LANE. THE DRIVER OF UNIT 2 SAID SHE WENT PARTIALLY INTO THE GRAVEL ON THE SIDE
OF THE ROAD TO TRY TO AVOID THE COLLISION. THE DRIVER OF UNIT 1 SAID HE COULD HAVE BEEN OVER THE CENTER LINE BUT WASN'T SURE
AND KNOWS HE WAS CLOSE TO THE CENTER WHEN THE COLLISION OCCURRED. I OBSERVED BRAKING AND TIRE MARKS IN THE GRAVEL ON UNIT
2'S SIDE OF THE ROAD. I ALSO OBSERVED A BROKEN PIECE OF A MIRROR DIRECTLY IN THE MIDDLE OF THE DOUBLE YELLOW CENTERLINE
INDICATING THE IMPACT OCCURRED ON THE EAST BOUND SIDE OF STATE HWY 48. THIS SHOWS THAT UNIT 1 WAS OPERATING LEFT OF CENTER
AND CAUSED THIS CRASH.
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Structure Type
Y Coordinate
5068083.5
X Coordinate
156799.484375
Longitude
-91.407125905
Latitude
45.681225466
ON STH48 WB
0.63 MI E
OF STONY HILL RD 10
IN THE TOWN OF METEOR
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)
Glare
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Daylight
Manner of Collision
06--Sideswipe/Opposite Direction
First Harmful Event Location
On Roadway
First Harmful Event
Motor Veh In Transport
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Non-Junction
Within Interchange Area
NO
Reporting Threshold
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
Two-Way, Not Divided
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Motor Veh In Transport
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Westbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Passenger Car
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Functional Damage
Vehicle Damage
7--Left Rear Corner, 8--Left Side Rear, 9--Left Side Middle, 10--Left Side Front,
11--Left Front Corner
Initial Contact Point
11--Left Front Corner
Bus UseNot A BusBody Style
4D - 4DR
Color
SIL - Silver (Aluminum)
Model
LACROSSE
Year
2006
Make
BUICK
Vehicle Identification Number
337
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
J1997T
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver Actions
Failure To Control, Failed To Keep In Designated Lane
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
OPERATOR
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Address
EXELAND, WI 54835 , US
IndividualDUSTIN BLAKE WHITE FRENCH01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
Event
02
Event
03
Event
04
Individual
CHEDRA WHITE
Insurance Company
STATE-FARM-COUNTY-MUTUAL-INS-CO-OF-TEX
Policy Holder
UN
I
T
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal
Drug Type
Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
Test Not Given
Suspected Drug UseSuspected Alcohol Use
Action Other
IN
D
I
V
I
D
U
A
L
UN
I
T
Action
To/From SchoolLocationPrior ActionStriking Unit #
00
1
01
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 Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
1
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
EXELAND, WI 54835 , US
RaceWHITEDate of Birth
04/26
Sex
Male
Citations Issued
1
DriverDUSTIN BLAKE WHITE FRENCH
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionOPERATING LEFT OF CENTER LINESeq Num001Statute Number346.05(1)Issue To?
001
UTC Number
AE53881001
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Reporting Threshold
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
Two-Way, Not Divided
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Motor Veh In Transport
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Eastbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Passenger Car
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
02
Unit Summary
Driver DistractionsUnknown If Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
OPERATOR
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
02
Extent Of Damage
Functional Damage
Vehicle Damage
7--Left Rear Corner, 8--Left Side Rear, 10--Left Side Front, 11--Left Front
Corner, 12--Front
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
4D - 4DR
Color
GRN - Green
Model
S-TYPE
Year
2001
Make
JAGUAR
Vehicle Identification Number
4461
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
ABA3405
VE
H
I
C
L
E
UN
I
T
02
Vehicle
Address
BIRCHWOOD, WI 54817 , US
Organization/CompanyRAIMER CONCRETE LLC
(
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Event
02
Event
03
Event
04
Organization/Company
RAIMER CONCRETE LLC
Insurance Company
SOCIETY-INS-A-MUTUAL-CO
Policy Holder
UN
I
T
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 6 of 7
This report does not include any CJIS data.
17092101
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55K1 Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal
Drug Type
Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
Test Not Given
Suspected Drug UseSuspected Alcohol Use
Action Other
IN
D
I
V
I
D
U
A
L
UN
I
T
Action
To/From SchoolLocationPrior ActionStriking Unit #
00
2
02
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 Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
2
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
02
ber
State: Wisconsin Country: UNITED STATES
Address
BIRCHWOOD, WI 54817 , US
RaceWHITEDate of Birth
12/24
Sex
Female
Citations Issued
0
DriverALISON J CECIL
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 07:27 AM
Crash Date 09/21/2017Wisconsin Motor Vehicle Crash
Form DT4000 7 of 7
This report does not include any CJIS data.