20171005 Tester17100503
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD6R Wisconsin Motor Vehicle
Crash Report
Secondary
CrashAmendedCrash Type
Non-Domesticated Animal w/ No InjuryReportable
TagsSchool Bus Related
NoActive School ZoneGovernment
Property
Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
01
Time Notified
04:50 AM
Date Notified
10/05/2017
Time ArrivedDate ArrivedCrash Time
04:41 AM
Crash Date
10/05/2017
Investigating Officer/Deputy
DEPUTY MICHAEL SIMPSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
4
V
W
D
6
R
Structure Type
No Structure
Y Coordinate
5110259.5
X Coordinate
186138.328125
Longitude
-91.058891331
Latitude
46.073788433
INTERSECTION
ON CTHS
AT STH77 WB
IN THE TOWN OF SPIDER LAKE
IN SAWYER COUNTY
Location
Special StudyAccess ControlTribal Land
Crash Classification - Jurisdiction
No Special Jurisdiction
Crash Classification - Location
Public Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Deer
Weather Condition(s)
Environment Factor(s)
Roadway Factor(s)Road Surface Condition(s)
Light ConditionManner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
First Harmful Event
Non Domesticated Animal (Alive)
Crash Scene
Reporting Threshold
No
Truck Bus or HazMat
No
Road GradeRoad CurvatureSurface Type
Traffic Control Inoperative/MissingTraffic ControlTraffic Way
Emergency Motor Vehicle UseSpecial FunctionMost Harmful Event: Collision With
Non Domesticated Animal (Alive)
Total LanesSpeed LimitPre CrashTire
Mark
Direction Of Travel
Westbound
Insurance?
YES
Total HazMat Types
0
Total TrailersTotal # 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
01
Unit Summary
Vehicle
Crash Time 04:41 AM
Crash Date 10/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 3
This report does not include any CJIS data.
17100503
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD6R Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed By
OWNER
Towed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Disabling Damage
Vehicle Damage
1--Right Front Corner, 11--Left Front Corner, 12--Front
Initial Contact Point
12--Front
Bus UseBody Style
4D - 4DR
Color
BRO - Brown
Model
CEP
Year
2016
Make
TOYOTA
Vehicle Identification Number
6662
Country of Issuance
UNITED STATES
St
MN
Plate Type
AUT - Automobile
License Plate Number
865TUZ
VE
H
I
C
L
E
UN
I
T
01
Individual
MARK TESTER
Insurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UN
I
T
Crash Time 04:41 AM
Crash Date 10/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 3
This report does not include any CJIS data.
17100503
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD6R 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/ExtricatedEjection PathEjected
AirbagInjury 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
mber
State: Minnesota Country: UNITED STATES
Address
OTSEGO, MN 55330 , US
RaceWHITEDate of Birth
07/13/1
Sex
Male
Citations Issued
0
DriverMARK B TESTER
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 04:41 AM
Crash Date 10/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 3
This report does not include any CJIS data.