20170602 ChambersSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713L Wisconsin Motor Vehicle
Crash Report
Secondary
CrashAmendedCrash Type
Non-Domesticated Animal w/ No InjuryReportable
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
04:19 PM
Date Notified
06/02/2017
Time ArrivedDate ArrivedCrash Time
04:19 PM
Crash Date
06/02/2017
Investigating Officer/Deputy
DEPUTY RYAN SCHICK
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
C
7
1
3
L
Structure Type
No Structure
Y Coordinate
5108320.5
X Coordinate
152705.625
Longitude
-91.488553505
Latitude
46.040238302
ON STH27 NB
0.25 MI N
OF SLEEPY HOLLOW RD
IN THE TOWN OF HAYWARD
IN SAWYER COUNTY
Location
Special StudyAccess ControlTribal Land
Crash Classification - Jurisdiction
No Special Jurisdiction
Crash Classification - Location
Public Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Deer
Weather Condition(s)
Environment Factor(s)
Roadway Factor(s)Road Surface Condition(s)
Light ConditionManner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
First Harmful Event
Non Domesticated Animal (Alive)
Crash Scene
Reporting Threshold
No
Truck Bus or HazMat
No
Road GradeRoad CurvatureSurface Type
Traffic Control Inoperative/MissingTraffic ControlTraffic Way
Emergency Motor Vehicle UseSpecial FunctionMost Harmful Event: Collision With
Non Domesticated Animal (Alive)
Total LanesSpeed LimitPre CrashTire
Mark
Direction Of Travel
Northbound
Insurance?
YES
Total HazMat Types
0
Total TrailersTotal # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Motorcycle
Unit Type
Motorcycle
Vehicle Operating As Classification
M CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Vehicle
Crash Time 04:19 PM
Crash Date 06/02/2017This report does not include any CJIS data.
3of1
Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713L Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed By
A-1 TOWING
Towed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Disabling Damage
Vehicle Damage
7--Left Rear Corner, 11--Left Front Corner, 12--Front
Initial Contact Point
12--Front
Bus UseBody Style
MC - MOTORCYCLE
Color
SIL - Silver (Aluminum)
Model
INDIAN
Year
2016
Make
POLARIS
Vehicle Identification Number
3174
Country of Issuance
UNITED STATES
St
WI
Plate Type
CYC - Cycle
License Plate Number
287FD
VE
H
I
C
L
E
UN
I
T
01
Individual
RICKIE CHAMBERS
Insurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UN
I
T
Crash Time 04:19 PM
Crash Date 06/02/2017This report does not include any CJIS data.
3of2
Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713L Wisconsin Motor Vehicle
Crash Report
Individual Condition
Drug Type
Drug Test ResultsDrug Test TypeDrug Test Given
Alcohol Test ResultsAlcohol Test TypeAlcohol Test 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/ExtricatedEjection PathEjected
AirbagInjury Severity
No Apparent Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint Compliance
UNKNOWN
Eye Protection
Yes: Worn and Windshield
Helmet Compliance
Unknown
Helmet Use
No
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
1
Protective Gear
Boots, Jacket, Long Pants
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
HAYWARD, WI 54843 , US
RaceWHITEDate of Birth
08/17
Sex
Male
Citations Issued
0
DriverRICKIE G CHAMBERS
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
Crash Time 04:19 PM
Crash Date 06/02/2017This report does not include any CJIS data.
3of3
Wisconsin Motor Vehicle Crash
Form DT4000