20171012 Dusell Mosley17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 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
01:06 PM
Date Notified
10/12/2017
Time Arrived
01:22 PM
Date Arrived
10/12/2017
Crash Time
01:06 PM
Crash Date
10/12/2017
Investigating Officer/Deputy
DEPUTY JEFF CAIN
Agency Crash Number
17101206
Primary Crash Document #Document Number Override
6V
L
1
3
M
V
8
W
2
Additional InformationPhotos, Witness Statements
Photos ByDEPUTY JEFF CAIN
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 A 1999 NEW HOLLAND MODEL FX58 CORN CHOPPER PULLING A 2016 MEYER CHOPPER TRAILER NORTHBOUND ON HWY 27. UNIT 2 WAS A 2009 CHEVROLET K2500HD PICKUP TRUCK ALSO NORTHBOUND ON HWY 27. UNIT 1 WAS OPERATING WITH YELLOW FLASHERS ON. ALL
FLASHERS FUNCTIONED EXCEPT THE LEFT REAR ON THE NEW HOLLAND CHOPPER. UNIT 1 ACTIVATED THE LEFT TURN SIGNAL PRIOR TO
ATTEMPTING A TURN INTO A FARM FIELD. THE LEFT TURN SIGNAL FUNCTIONED ON THE MEYER TRAILER, BUT DID NOT FUNCTION ON THE NEW
HOLLAND CHOPPER. UNIT 2 PASSED A FOLLOWING VEHICLE, PULLED BACK INTO THE NORTHBOUND LANE, THEN PULLED OUT TO PASS UNIT 1 ON
THE LEFT AS UNIT 1 BEGAN TO MAKE A LEFT TURN. THE RIGHT SIDE OF UNIT 2 COLLIDED WITH THE LEFT FRONT CORNER OF UNIT 2 CAUSING
DAMAGE TO BOTH VEHICLES.
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 Wisconsin Motor Vehicle
Crash Report
Structure Type
Y Coordinate
5073966
X Coordinate
180182.015625
Longitude
-91.11154986
Latitude
45.745216536
ON STH27 NB
0.35 MI N
OF IRVINE DR
IN THE TOWN OF RADISSON
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)
Cloudy
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Daylight
Manner of Collision
05--Sideswipe/Same Direction
First Harmful Event Location
On Roadway
First Harmful Event
Motor Veh In Transport
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Driveway Access
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
Northbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
1
Total # Citations Issued
1
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Other Working Machine
Unit Type
Equipment
Vehicle Operating As Classification
O CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Functional Damage
Vehicle Damage
11--Left Front Corner
Initial Contact Point
11--Left Front Corner
Bus UseNot A BusBody Style
SP - SPECIAL DESIGN VEHICLE
Color
YEL - Yellow
Model
FX58
Year
1999
Make
JOHN DEERE
Vehicle Identification Number
265110005
Country of IssuanceStPlate TypeLicense Plate Number
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 Wisconsin Motor Vehicle
Crash Report
Driver Distractions
Driver Actions
Driver Prior Action Other
Vehicle Factors
Turn Signals
What Driver Was Doing
Left Turn
Vehicle Removed By
OPERATOR
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Address
LADYSMITH, WI 54848 , US
IndividualTERRY G DUSELL01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventLeft Turn02
Event
03
Event
04
Individual
TERRY DUSELL
Insurance Company
MOUNT MORRIS MUTUAL INS
Policy Holder
UN
I
T
Trailer/Towed
Vehicle Identification Number
17T5201
Address
LADYSMITH, WI 54848 , US
IndividualTERRY G DUSELLUnit Type
Equipment
Country of IssuanceStateMake
MEYER
Plate TypeTrailer Plate #
TR
A
I
L
E
R
/
TO
W
E
D
UN
I
T
01
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 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
Restraint Use Unknown
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
AddressW7
LADYSMITH, WI 54848 , US
RaceWHITEDate of Birth
01/15/
Sex
Male
Citations Issued
1
DriverEVAN J DUSELL
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionFAIL/SIGNAL TURN/UNSAFE TURNSeq Num001Statute Number346.34(1)Issue To?
001
UTC Number
AE01462401
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 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
Northbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
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
02
Unit Summary
Driver DistractionsUnknown If Distracted
Driver ActionsFailed To Yield Right-Of-Way, Improper Overtaking / Passing Left
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Overtake Left
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
1--Right Front Corner, 2--Right Side Front, 3--Right Side Middle, 4--Right Side
Rear, 5--Right Rear Corner, 6--Rear
Initial Contact Point
1--Right Front Corner
Bus UseNot A BusBody Style
PK - PICKUP
Color
BLK - Black
Model
SILVERADO
Year
2009
Make
CHEVROLET
Vehicle Identification Number
27078
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - Light Truck
License Plate Number
KB8628
VE
H
I
C
L
E
UN
I
T
02
Vehicle
Address
AUGUSTA, WI 54722 , US
IndividualMICHAEL WILLARD MOSLEY02
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 Wisconsin Motor Vehicle
Crash Report
Event
02
Event
03
Event
04
Individual
MICHAEL MOSLEY
Insurance Company
UNITED-SERVICES-AUTOMOBILE-ASSN
Policy Holder
UN
I
T
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 6 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 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
AUGUSTA, WI 54722 , US
RaceWHITEDate of Birth
06/21
Sex
Male
Citations Issued
1
DriverMICHAEL WILLARD MOSLEY
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionPASSING VEHICLE INDICATING LEFT TURNSeq Num001Statute Number346.09(4)Issue To?
002
UTC Number
AE01462502
Date of Birth
01/07/1975
AddressIndividual
01
Witness
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 7 of 8
This report does not include any CJIS data.
17101206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13MV8W2 Wisconsin Motor Vehicle
Crash Report
EXELAND, WI 54835 , US
MARK W LONG
WI
T
N
ES
S
Date of Birth
10/15/1OJIBWA, WI 54896 , US
IndividualTHOMAS A WINIARCZYK02
WI
T
N
ES
S
Witness
Crash Time 01:06 PM
Crash Date 10/12/2017Wisconsin Motor Vehicle Crash
Form DT4000 8 of 8
This report does not include any CJIS data.