20171030 Quaderer17103003
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3L 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
01
Time Notified
09:58 PM
Date Notified
10/30/2017
Time Arrived
09:58 PM
Date Arrived
10/30/2017
Crash Time
09:58 PM
Crash Date
10/30/2017
Investigating Officer/Deputy
SERGEANT JEFF JOHNSON
Agency Crash Number
17103003
Primary Crash Document #Document Number Override
6V
L
1
3
Q
B
C
3
L
Additional InformationNone, Photos, Reconstruction
Photos BySGT. J. JOHNSON
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON 10/30/17, I, SGT. JEFF JOHNSON WAS TRAVELING WESTBOUND ON CTH B NEAR THE SAWYER CO HWY SHOP IN HAYWARD TWSP AFTER JUST
CLEARING FROM A VEHICLE IN THE DITCH TO THE EAST OF THAT LOCATION. I OBSERVED AN EASTBOUND VEHICLE THAT I HAD ON RADAR
TRAVELING AT 36 MPH IN THE POSTED 55 MPH ZONE. DUE TO THE SNOW AND SLUSH COVERED ICE ON THE HWY, I WAS ALSO TRAVELING AT A
MUCH SLOWER SPEED THAN THE POSTED LIMIT. I OBSERVED THE ONCOMING VEHICLE BEGAN SLIDING COUNTERCLOCKWISE, THEN CLOCKWISE
AS IT BEGAN SLIDING INTO THE DITCH ON THE SOUTH SIDE OF CTH B. AS THE VEHICLE LEFT THE ROADWAY, I OBSERVED IT ROLL OVER NEARLY 2
TIMES. I LEARNED THAT THE DRIVER AND PASSENGER OF THE VEHICLE WERE NOT INJURED. NO CITATIONS WERE ISSUED DUE TO THE TERRIBLE ROAD CONDITIONS.
Crash Time 09:58 PM
Crash Date 10/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
17103003
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3L Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5103236.5
X Coordinate
157367.65625
Longitude
-91.424835298
Latitude
45.996964581
ON CTHB
0.39 MI E
OF BENDER RD
IN THE TOWN OF HAYWARD
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)
Snow, Sleet/Hail, Freezing Rain or Freezing Drizzle
Environment Factor(s)
Weather Conditions
Roadway Factor(s)
Road Surface Condition (Wet, Icy, Snow, Slush, Etc)
Road Surface Condition(s)
Snow, Ice
Light Condition
Dark/Unlit
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Roadside
First Harmful Event
Ditch
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Non-Junction
Within Interchange Area
NO
Time Roadway Repaired
11:20 PM
Date Roadway Repaired
10/30/2017
Time All Lanes Open
11:20 PM
Date All Lanes Open
10/30/2017
Time Initial Lane/Road Closed
10:15 PM
Date Initial Lane/Road Closed
10/30/2017
Reasons for Closure
Law Enforcement, Tow truck
Closure Type
Full closure
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
Ditch
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
2
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
Model
TAHOE
Year
2001
Make
CHEVROLET
Vehicle Identification Number
3181
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
530YVP01
Vehicle
Crash Time 09:58 PM
Crash Date 10/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17103003
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3L Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed ByTowed Due To Damage
Towed But Not Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Functional Damage
Vehicle Damage
6--Rear, 7--Left Rear Corner, 8--Left Side Rear, Top
Initial Contact Point
Top
Bus UseNot A BusBody Style
4T - HARDTOP 4 DOOR
Color
MAR - Maroon (Burgundy)
VE
H
I
C
L
E
UN
I
T
Address
HAYWARD, WI 54843 , US
IndividualADRIEN L QUADERER01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDitch01
EventTree02
Event
03
Event
04
Individual
HEATHER MARTINSON
Insurance Company
STATE-AUTO-INSURANCE-CO-OF-WISCONSIN
Policy Holder
UN
I
T
Crash Time 09:58 PM
Crash Date 10/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17103003
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3L 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
HAYWARD, WI 54843 , US
RaceINDIANDate of Birth
04/09/1
Sex
Female
Citations Issued
0
DriverHEATHER R MARTINSON
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 09:58 PM
Crash Date 10/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17103003
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3L 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
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
3--Front Seat-Right Side (Train Engineers/Right
00
2
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
Driver License NumberT5361129970609
State: Wisconsin Country: UNITED STATES
Address12741 W DAYCARE DR
HAYWARD, WI 54843 , US
RaceINDIANDate of Birth
06/06 9
Sex
Female
Citations Issued
0
PassengerCODY L TAINTER
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 09:58 PM
Crash Date 10/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.