20170112 TrombergSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14MH5JR Wisconsin Motor Vehicle
Crash Report
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
07:11 AM
Date Notified
01/12/2017
Time Arrived
07:21 AM
Date Arrived
01/12/2017
Crash Time
07:10 AM
Crash Date
01/12/2017
Investigating Officer/Deputy
DEP/DEPU AMANDA REED
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
4
M
H
5
J
R
Structure Type
No Structure
Tribal Land
Override
On Roadway Link Offset
1997
On Roadway Link ID#
5327415
Y Coordinate
5103340
X Coordinate
150510.7031
Access ControlLat/LongSource
TLT/ILT
Longitude
-91.5131879
Latitude
45.99443435
ON USH63 SB
802 FT W
OF OGREN 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 - On Road
Animal Type
Weather Condition(s)
Clear
Roadway Factor(s)
Road Surface Condition (Wet, Icy, Snow, Slush, Etc)
Environment Factor(s)
Weather Conditions
Road Surface Condition(s)
Ice
Light Condition
Dawn
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
First Harmful Event
Traffic Sign Post
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
Uphill
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
55Pre CrashTire
Mark
Direction Of Travel
Southbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
00
Train/Bus # InjuredTotal Occs
01
Operating As EndorsementsVehicle Type
Passenger Car
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
01
Unit Summary
Individual Type
IndividualUse Driver
Address
Citations Issued
0
RoleDriver
Crash Time 07:10 AM
Crash Date 01/12/20174Of1Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14MH5JR Wisconsin Motor Vehicle
Crash Report
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
IN
D
I
V
I
D
U
A
L
UN
I
T
Individual Condition
Appeared Normal
Action Other
ActionPrior Action
To/FromSchoolLocationStriking Unit #
01
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedicalTransport
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/Bicy
Safety Equipment
Shoulder & Lap Belt
On Duty Accident
01
DL Expire Year2022License Status
Valid License
License Type
Non-CDL Driver's License
Country of Issuance
UNITED STATES
License Jursidiction
State
State
WI
Driver's License Number
Phone NumberWeight170Height
604
EyesBLUEHairBROWNRaceWSex
M
DOB
07/17
Country of Residence
UNITED STATES
Zip Code
54855
State
WI
City
MARENGO
PO BoxStreet Address 2Street Address
SuffixMiddle Initial
A
First Name
MITCHELL
Last Name
TROMBERG
IN
D
I
V
I
D
U
A
L
01
UN
I
T
01
Injury
Drug & Alcoh
Non Motorist
Equipment
Vehicle DamageInitial Contact Point
Color
RED - Red
Body Style
4D - 4DR
Model
F150
Make
FORD
Year
2017
Vehicle Identification Number
D58022
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - Light Truck
License Plate Number
HS657001
01
Crash Time 07:10 AM
Crash Date 01/12/20174Of2Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14MH5JR Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot DistractedDriver ActionsNo Contributing Action
Bus UseNot A BusDriver Prior Action OtherWhat Driver Was Doing
Going Straight
Vehicle Removed By
Vehicle Factors
Not Applicable
Towed Due To Damage
Not Towed
Extent Of Damage
Minor Damage
9--Left Side Middle, 10--Left Side Front, Undercarriage
10--Left Side FrontVE
H
I
C
L
E
UN
I
T
EventMotor Veh In Transport01
EventRun Off Roadway Right02
Event
03
Event
04
Telephone Number
Country of Residence
UNITED STATES
Zip Code
54855
St
WI
City
MARENGO
PO BoxStreet Address2Street Address
Date of Birth
07/17
SuffixMiddle Initial
A
First Name
MITCHELL
Last Name
TROMBERG
Company NameOrganization Type
Individual
Use Operator AddressVehicle Owner Same As Operator
VE
H
I
C
L
E
O
W
N
E
R
01
UN
I
T
01
Policy Holder CompanyFirst Name
MITCHELL
Last Name
TROMBERG
Organization Type
Individual
Policy Holder Same As DriverPolicy Holder
Same As Owner
Insurance Company
AMERICAN-FAMILY
HO
L
DE
R
01
UN
I
T
Address14688 W COUNTY ROAD B
HAYWARD, WI 54843 , US
GovernmentSAWYER COUNTY HIGHWAY DEPARTMENT
(715) 634-2691
PR
O
P
OW
N
E
R
01
Fixed Objects Struck
Property Owner
Damage Tag Number
01
Struck Object
Traffic Sign Post
Striking Unit
0101
Reconstruction ByDiagram
Description
Crash Time 07:10 AM
Crash Date 01/12/20174Of3Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14MH5JR Wisconsin Motor Vehicle
Crash Report
Additional InformationPhotos
Photos ByDEPUTY AMANDA REED
Narrative
ON JANUARY 12TH, 2017, I, DEPUTY REED RESPONDED TO A ONE VEHICLE ACCIDENT ON USH 63 NEAR STRESS ROAD. I ARRIVED ON SCENE AT
APPROXIMATELY 07:21AM. I FOUND A RED FORD TRUCK HAD SLID OFF THE ROADWAY HITTING A SPEED LIMIT SIGN BEFORE COMING TO A
RESTING STOP. THE TRUCK HAD BEEN TRAVELING SOUTHBOUND PRIOR TO SLIDING INTO THE DITCH. THE TRUCK HAD A DAMAGED DRIVER'S SIDE
RUNNING BOARD, AND THE DRIVER'S SIDE PASSENGER DOOR WAS DENTED AND MISSING A DOOR HANDLE FROM COLLIDING WITH THE SIGN. I PHOTOGRAPHED THE DAMAGE TO THE TRUCK AND THE SCENE. THE TRUCK WAS PULLED OUT OF THE DITCH BY ROADRUNNER TOWING. THE
TRUCK WAS DRIVEABLE. THIS IS ALL THE INFORMATION I HAVE AT THIS TIME.
Crash Time 07:10 AM
Crash Date 01/12/20174Of4Wisconsin Motor Vehicle Crash
Form DT4000