20171102 Barnett-Lewis17110205
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15G5WRJ 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
04:44 PM
Date Notified
11/02/2017
Time Arrived
04:45 PM
Date Arrived
11/02/2017
Crash Time
04:43 PM
Crash Date
11/02/2017
Investigating Officer/Deputy
SERGEANT NICK ALMOGHRABI
Agency Crash Number
17110205
Primary Crash Document #Document Number Override
6V
L
1
5
G
5
W
R
J
Additional InformationMeasurements, Photos
Photos BySGT NICK ALMOGHRABI
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I, SGT. NICK AL-MOGHRABI, WAS DISPATCHED TO STH 77 NEAR THE HAYWARD HOSPITAL FOR A VEHICLE CRASH UNKNOWN HOW MANY VEHICLES OR IF THERE WERE INJURIES ON 11/2/17 AT 1644. I ARRIVED AT 1645 AND OBSERVED A GMC JIMMY LEAVING THE SOUTH SHOULDER OF STH 77
AND PULLING INTO THE PARKING LOT OFF THE EAST ENTRANCE TO THE HOSPITAL. I BRIEFLY MET WITH TWO OTHER SUBJECTS PARKED ON STH
77 WHO STATED THEY STOPPED TO SEE IF HE WAS ALRIGHT. I PROCEEDED TO MEET WITH THE OPERATOR OF THE VEHICLE, IDENTIFIED AS
WILLIAM BARNETT-LEWIS OF HAYWARD. BARNETT-LEWIS ADVISED HE WAS COMING HOME FROM DULUTH AND WAS TIRED AFTER HAVING A LONG
DAY. BARNETT-LEWIS ADVISED HE HADN'T FALLEN ASLEEP BUT HAD NODDED HIS HEAD DOWN (MAKING THE MOTION OF) AND LEFT THE
ROADWAY. BARNETT-LEWIS STATED HE HAD HIT A DRIVEWAY (11081N STH 77) AND WENT AIRBORNE THEN STRUCK A "NO PASSING ZONE" SIGN AND WAS ABLE TO BRING THE VEHICLE BACK ONTO THE ROADWAY. BARNETT-LEWIS ADVISED HE WASN'T INJURED AND HAD BEEN WEARING HIS
SEATBELT. I DIDN'T DETECT ANY INDICATORS OF IMPAIRMENT WHILE SPEAKING WITH HIM. I OBSERVED DAMAGED TO THE FRONT RIGHT CORNER
OF HIS VEHICLE CAUSED FROM THE SIGN POST. BARNETT-LEWIS HAD TRAVELED 122 FEET UPON LEAVING THE BACK TOP BEFORE BECOMING
AIRBORNE ON THE DRIVEWAY.
Crash Time 04:43 PM
Crash Date 11/02/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
17110205
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15G5WRJ Wisconsin Motor Vehicle
Crash Report
Structure Type
Y Coordinate
5107662.5
X Coordinate
152678.234375
Longitude
-91.488427644
Latitude
46.034323182
ON STH27 SB
808 FT N
OF HOSPITAL DR
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 - 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
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
Traffic Sign Post
Total Lanes
2
Speed Limit
45Pre CrashTire
Mark
Direction Of Travel
Southbound
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
Functional Damage
Vehicle Damage
1--Right Front Corner
Initial Contact Point
1--Right Front Corner
Bus UseNot A BusBody Style
UT - SPORT UTILITY VEHICLE
Color
BLU - Blue
Model
JIMMY
Year
2000
Make
GENERAL MOTORS COR
Vehicle Identification Number
40211
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
AAD3205
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 04:43 PM
Crash Date 11/02/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17110205
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15G5WRJ Wisconsin Motor Vehicle
Crash Report
Driver DistractionsOther Distraction
Driver Actions
Failure To Control
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
HAYWARD, WI 54843 , US
IndividualWILLIAM ANDREW BARNETT-LEWIS01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDitch01
EventTraffic Sign Post02
Event
03
Event
04
Individual
WILLIAM BARNETT-LEWIS
Insurance Company
PROCENTURY-INSURANCE-CO
Policy Holder
UN
I
T
Crash Time 04:43 PM
Crash Date 11/02/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17110205
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15G5WRJ 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
mber7
State: Wisconsin Country: UNITED STATES
Address E
HAYWARD, WI 54843 , US
RaceWHITEDate of Birth
09/30/
Sex
Male
Citations Issued
0
DriverWILLIAM ANDREW BARNETT-LEWIS
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Address14688W CTH B
HAYWARD, WI 54843 , US
GovernmentSAWYER COUNTY HIGHWAY DEPARTMENT
(715) 634-2692
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 04:43 PM
Crash Date 11/02/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17110205
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15G5WRJ Wisconsin Motor Vehicle
Crash Report
Damage Tag Number
208231
Struck Object
Traffic Sign Post
Striking Unit
0101
Crash Time 04:43 PM
Crash Date 11/02/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.