20170925 Anthony17092507
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJV 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
01
Total Units
01
Time Notified
02:09 PM
Date Notified
09/25/2017
Time Arrived
02:30 PM
Date Arrived
09/25/2017
Crash Time
02:00 PM
Crash Date
09/25/2017
Investigating Officer/Deputy
SERGEANT GREG RIPCZINSKI
Agency Crash Number
17092507
Primary Crash Document #Document Number Override
6V
L
1
5
C
P
T
J
V
Additional InformationNone, Photos
Photos BySGT GREG RIPCZINSKI
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT #1 WAS NORTHBOUND WHEN IT STRAYED OFF THE ROADWAY ALONG THE SHOULDER OF THE NORTHBOUND LANE. UNIT #1 COLLIDED WITH THE DITCH, STRIKING A CULVERT ALONG THE DRIVEWAY TO A RESIDENCE LOCATED AT 5178 CTH W. VEHICLE THEN STRUCK A MAILBOX,
CONTINUED ALONG THE DITCH AND OVERTURNED COMING TO REST, FACING SOUTHBOUND, IN THE DITCH AREA OF THE NORTHBOUND LANE.
Crash Time 02:00 PM
Crash Date 09/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
17092507
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJV Wisconsin Motor Vehicle
Crash Report
Structure Type
Fire
Y Coordinate
5084548.5
X Coordinate
187198.78125
Longitude
-91.028421592
Latitude
45.84344185
ON N5718 CTHW
605 FT N
OF OLMSTEAD RD
(FIRE N5718)
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 - Not On Road
Animal Type
Weather Condition(s)
Cloudy
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Daylight
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Shoulder Right
First Harmful Event
Ditch
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
Other Post, Pole or Support
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Northbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
(Sport) Utility Vehicle
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Disabling Damage
Vehicle Damage
1--Right Front Corner
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
4H - HATCHBACK 4 DOOR
Color
GRY - Gray
Model
VUE
Year
2005
Make
SATURN
Vehicle Identification Number
3160
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
955VUZ
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 02:00 PM
Crash Date 09/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17092507
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJV Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver Actions
Failure To Control
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed ByTowed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
WINTER, WI 54896 , US
IndividualMELISSA N ANTHONY01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDitch01
EventCulvert02
EventOverturn/Rollover03
EventOther Post, Pole or Support04
Individual
KRISTOPHER MILLER
Insurance Company
SENTRY-CASUALTY-CO
Policy Holder
UN
I
T
Crash Time 02:00 PM
Crash Date 09/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17092507
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJV 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
HAYWARD AREA MEMORIAL HOSPITAL
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS Ground
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Non Deployed
Injury Severity
Suspected Minor 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
WINTER, WI 54896 , US
RaceWHITEDate of Birth
02/12/
Sex
Male
Citations Issued
0
DriverKRISTOPHER M MILLER
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
WINTER, WI 54896 , US
IndividualJEFFERY M SWARD
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 02:00 PM
Crash Date 09/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17092507
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJV Wisconsin Motor Vehicle
Crash Report
Damage Tag NumberStruck Object
Other Post, Pole or Support
Striking Unit
0101
Crash Time 02:00 PM
Crash Date 09/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.