20171109 Jones17110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJW 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
02:38 PM
Date Notified
11/09/2017
Time Arrived
03:08 PM
Date Arrived
11/09/2017
Crash Time
02:30 PM
Crash Date
11/09/2017
Investigating Officer/Deputy
SERGEANT GREG RIPCZINSKI
Agency Crash Number
17110908
Primary Crash Document #Document Number Override
6V
L
1
5
C
P
T
J
W
Additional InformationPhotos
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 ON BASS LAKE ROAD, AS OPERATOR NEGOTIATED A CURVE IN THE ROAD, VEHICLE LOST TRACTION AND SLID INTO THE SLIGHT DITCH IN THE ROAD, STRIKING A TREE ON THE SHOULDER OF THE NORTHBOUND LANE COMING TO REST
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON BASS LAKE ROAD
0.75 MI N
OF TOWER HILL ROAD
IN THE TOWN OF WINTER
IN SAWYER COUNTY
Location
Crash Time 02:30 PM
Crash Date 11/09/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
17110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJW Wisconsin Motor Vehicle
Crash Report
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)
Weather Conditions
Roadway Factor(s)
Loose Gravel
Road Surface Condition(s)
Snow
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
Curve Left
Surface Type
Dirt
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
Tree
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
Driver Actions
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Negotiating Curve
Vehicle Removed ByTowed Due To Damage
Towed Due To Disabling Damage01
Extent Of Damage
Functional Damage
Vehicle Damage
11--Left Front Corner
Initial Contact Point
11--Left Front Corner
Bus UseNot A BusBody Style
4H - HATCHBACK 4 DOOR
Color
MAR - Maroon (Burgundy)
Model
EQUINOX
Year
2011
Make
CHEVROLET
Vehicle Identification Number
343
Country of Issuance
UNITED STATES
St
MI
Plate Type
AUT - Automobile
License Plate Number
CLH2434
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 02:30 PM
Crash Date 11/09/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJW Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
No Contributing Action
VE
H
I
C
L
E
UN
I
T
Address
PERRY, MI 48872 9172, US
IndividualBRIAN LEE JONES01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDitch01
EventTree02
Event
03
Event
04
Individual
BRIAN JONES
Insurance Company
PROASSURANCE-CASUALTY-CO
Policy Holder
UN
I
T
Crash Time 02:30 PM
Crash Date 11/09/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJW 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
D mberJ
State: Michigan Country: UNITED STATES
Address
PERRY, MI 48872 9172, US
RaceWHITEDate of Birth
06/05/
Sex
Male
Citations Issued
0
DriverBRIAN LEE JONES
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Address
, ,
Unknown
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 02:30 PM
Crash Date 11/09/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17110908
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTJW Wisconsin Motor Vehicle
Crash Report
Damage Tag NumberStruck Object
Ditch
Striking Unit
0101
Damage Tag NumberStruck Object
Tree
Striking Unit
0102
Crash Time 02:30 PM
Crash Date 11/09/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.