20170502 Grover17050202
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3F 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
01:15 AM
Date Notified
05/02/2017
Time Arrived
01:22 AM
Date Arrived
05/02/2017
Crash Time
01:13 AM
Crash Date
05/02/2017
Investigating Officer/Deputy
SERGEANT JEFF JOHNSON
Agency Crash Number
17050202
Primary Crash Document #Document Number Override
6V
L
1
3
Q
B
C
3
F
Additional InformationNone, Photos, Reconstruction
Photos BySGT. JEFF 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.
UNIT 1 WAS TRAVELING SOUTH ON CTH NN, JUST NORTH OF GREEN LAKE RD IN HAYWARD TWSP. THE DRIVER OF UNIT 1 STATED SHE CAME OVER THE HILLCREST AND SAW A DEER STANDING IN HER LANE. SHE HIT THE BRAKES AND SWERVED LEFT TO AVOID THE DEER, CAUSING HER
VEHICLE TO BEGIN SKIDDING COUNTERCLOCKWISE. UNIT 1 THEN SLID INTO THE LEFT DITCH AND STRUCK A TREE.
Crash Time 01:13 AM
Crash Date 05/02/2017This report does not include any CJIS data.
4of1
Wisconsin Motor Vehicle Crash
Form DT4000
17050202
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3F Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5097864
X Coordinate
165517.8125
Longitude
-91.316134177
Latitude
45.952772637
ON CTHNN
1069 FT N
OF GREEN LAKE
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
Deer
Weather Condition(s)
Rain, Snow
Environment Factor(s)
Weather Conditions, Animal (s) in roadway
Roadway Factor(s)
None
Road Surface Condition(s)
Wet
Light Condition
Dark/Unlit
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Off Roadway, Location Unknown
First Harmful Event
Tree
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
Hillcrest
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
Tree
Total Lanes
2
Speed Limit
55Pre 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
Passenger Car
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, 2--Right Side Front, 12--Front
Initial Contact Point
1--Right Front Corner
Bus UseNot A BusBody Style
4D - 4DR
Color
WHI - White
Model
GRAND PRIX
Year
2004
Make
PONTIAC
Vehicle Identification Number
4690
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
B083
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 01:13 AM
Crash Date 05/02/2017This report does not include any CJIS data.
4of2
Wisconsin Motor Vehicle Crash
Form DT4000
17050202
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3F Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver Actions
No Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
OWNER
Towed Due To Damage
Towed But Not Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
HAYWARD, WI 54843 , US
IndividualDANIELLE V GROVER
(01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventRun Off Roadway Left01
EventTree02
Event
03
Event
04
Individual
DANIELLE GROVER
Insurance Company
RURAL-COMMUNITY-INSURANCE-COMPANY
Policy Holder
UN
I
T
Crash Time 01:13 AM
Crash Date 05/02/2017This report does not include any CJIS data.
4of3
Wisconsin Motor Vehicle Crash
Form DT4000
17050202
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13QBC3F Wisconsin Motor Vehicle
Crash Report
Individual Condition
Not Observed
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
09/03/
Sex
Female
Citations Issued
0
DriverDANIELLE V GROVER
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
Crash Time 01:13 AM
Crash Date 05/02/2017This report does not include any CJIS data.
4of4
Wisconsin Motor Vehicle Crash
Form DT4000