20170512 Charles17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q 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
02
Total Units
01
Time Notified
03:26 PM
Date Notified
05/12/2017
Time Arrived
03:31 PM
Date Arrived
05/12/2017
Crash Time
03:26 PM
Crash Date
05/12/2017
Investigating Officer/Deputy
DEPUTY NICOLE RIPCZINSKI
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
1
B
Q
6
Q
Additional InformationPhotos, Witness Statements
Photos By
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON MAY 12, 2017 AT APPROXIMATELY 3:26 PM, I DEPUTY RIPCZINSKI RESPONDED TO A ONE VEHICLE ACCIDENT WITH ENTRAPMENT. I ARRIVED ON-SCENE AT 3:31 PM AND OBSERVED A VEHICLE IN A DRIVEWAY OFF OF COUNTY HWY C, JUST NORTH OF VICTORIA LN. THE VEHICLE WAS
SEVERELY DAMAGED. I MADE CONTACT WITH TWO FEMALE OCCUPANTS TO STATED THEY WERE TRAVELING FROM MINNEAPOLIS TO EXELAND,
WI. DRIVER STATED SHE THOUGHT SHE FELL ASLEEP AND PASSENGER ADVISED SHE WAS SLEEPING UNTIL THE CRASH. DRIVER ADVISED SHE
WAS NOT TEXTING OR USING HER PHONE. BOTH OCCUPANTS STATED THEY WERE IN PAIN, HOWEVER DID NOT APPEAR TO BE TRAPPED. THE
DRIVER SIDE DOOR WAS PINCHED BETWEEN TREES, HOWEVER NOT ON TOP OF DRIVERS BODY. MEDICS ARRIVED. UPON OBSERVATION OF THE
AREA, THE VEHICLE WAS TRAVELING SB ON CTH C, CROSSED INTO THE NB LANE, WENT OVER AN EMBANKMET CAUSING THE VEHICLE TO GO AIRBORNE. VEHICLE HIT A PART OF A TREE APPROXIMATELY 35-40 FEET UP THE TREE AND BROKE IT OFF. VEHICLE CONTINUED THROUGH A
PASTURE, APPEARED TO HAVE HIT GROUND WITH THE FRONT OF THE VEHICLE THREE TIMES BEFORE COMING TO REST APPROXIMATELY 200
FEET FROM WHERE IT LEFT THE ROADWAY, FACING WEST IN A DRIVEWAY NEXT TO A GROUP OF TREES. SEVERE DAMAGE TO VEHICLE, TOWED BY
A-1 TOWING AND RECOVERY. INSURANCE WAS PROVIDED TO ME BY THE PASSENGER. BOTH OCCUPANTS WERE TRANSPORTED TO A LOCAL
HOSPITAL. END OF REPORT.
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of1
Wisconsin Motor Vehicle Crash
Form DT4000
17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5070683.5
X Coordinate
160748.671875
Longitude
-91.358377687
Latitude
45.706502431
ON CTHC
896 FT N
OF VICTORIA LN
IN THE TOWN OF METEOR
IN SAWYER COUNTY
Location
Special StudyAccess Control
No Control
Tribal Land
Crash Classification - Jurisdiction
Private Property
Crash Classification - Location
Private Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Weather Condition(s)
Clear
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 Left
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
Level
Road Curvature
Curve Right
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
Embankment
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
2
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
Disabling Damage
Vehicle Damage
All Areas
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
4D - 4DR
Color
RED - Red
Model
CR-V
Year
2011
Make
HONDA
Vehicle Identification Number
6613
Country of Issuance
UNITED STATES
St
MN
Plate Type
AUT - Automobile
License Plate Number
631EKA
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of2
Wisconsin Motor Vehicle Crash
Form DT4000
17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q Wisconsin Motor Vehicle
Crash Report
Driver DistractionsDistraction/Inattention
Driver Actions
Failure To Control
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Negotiating Curve
Vehicle Removed ByTowed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
NEW BRIGHTON, MN 55112 , US
IndividualTANYA MARIE KESSLER01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventCross Centerline02
EventTree03
EventEmbankment04
Individual
TANYA KESSLER
Insurance Company
AMERICAN-FAMILY-INS-CO
Policy Holder
UN
I
T
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of3
Wisconsin Motor Vehicle Crash
Form DT4000
17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal, 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
HAYWARD AREA MEMORIAL HOSPITAL
EMS Run #
17051205903
EMS Agency Identifier
6000954
Medical Transport
EMS Ground
Trapped/Extricated
Trapped/Extricated
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Deployed-Combination
Injury Severity
Suspected Serious 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
Restraint Use Unknown
On Duty Crash
01
mber
State: Minnesota Country: UNITED STATES
Address
NEW BRIGHTON, MN 55112 , US
RaceWHITEDate of Birth
08/19/
Sex
Female
Citations Issued
0
DriverINDIA MARIE CHARLES
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of4
Wisconsin Motor Vehicle Crash
Form DT4000
17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal, 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
2
01
Time of DeathDate of DeathHospital
HAYWARD AREA MEMORIAL HOSPITAL
EMS Run #
17051205903
EMS Agency Identifier
6000954
Medical Transport
EMS Ground
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Deployed-Combination
Injury Severity
Suspected Minor Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
2--Front Seat-Middle
00
2
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
mber
State: Minnesota Country: UNITED STATES
Address
NEW BRIGHTON, MN 55112 , US
RaceWHITEDate of Birth
09/14/
Sex
Female
Citations Issued
0
PassengerTANYA MARIE KESSLER
(
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
EXELAND, WI 54835 , US
IndividualSTEVE KORMANN
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of5
Wisconsin Motor Vehicle Crash
Form DT4000
17051203
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6Q Wisconsin Motor Vehicle
Crash Report
Damage Tag NumberStruck Object
Tree
Striking Unit
0101
Damage Tag NumberStruck Object
Embankment
Striking Unit
0102
Date of Birth
12/09/HAYWARD, WI 54843 , US
IndividualJENNY M SCHLENDER01
Witness
WI
T
N
ES
S
Crash Time 03:26 PM
Crash Date 05/12/2017This report does not include any CJIS data.
6of6
Wisconsin Motor Vehicle Crash
Form DT4000