20170609 Whalley17060909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6R 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
10:13 PM
Date Notified
06/09/2017
Time ArrivedDate ArrivedCrash Time
10:00 PM
Crash Date
06/09/2017
Investigating Officer/Deputy
DEPUTY NICOLE RIPCZINSKI
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
1
B
Q
6
R
Structure Type
Y Coordinate
5062588
X Coordinate
171429.734375
Longitude
-91.216069315
Latitude
45.638982934
ON STH40 NB
90 FT N
OF COUNTY LINE RD
IN THE TOWN OF WEIRGOR
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
2
Operating As EndorsementsVehicle Type
Passenger Van
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Vehicle
Crash Time 10:00 PM
Crash Date 06/09/2017This report does not include any CJIS data.
4of1
Wisconsin Motor Vehicle Crash
Form DT4000
17060909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6R Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed ByTowed 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
12--Front
Initial Contact Point
12--Front
Bus UseBody Style
VN - VAN
Color
BRO - Brown
Model
ODESSEY
Year
2012
Make
HONDA
Vehicle Identification Number
27526
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
837RXT
VE
H
I
C
L
E
UN
I
T
01
Individual
JONATHAN WHALLEY
Insurance Company
ACUITY,-A-MUTUAL-INSURANCE-CO
Policy Holder
UN
I
T
Crash Time 10:00 PM
Crash Date 06/09/2017This report does not include any CJIS data.
4of2
Wisconsin Motor Vehicle Crash
Form DT4000
17060909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6R 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/ExtricatedEjection PathEjected
AirbagInjury 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
er
State: Wisconsin Country: UNITED STATESMADISON, WI 53719 , US
RaceWHITEDate of Birth
05/21/
Sex
Male
Citations Issued
0
DriverJONATHAN M WHALLEY
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
Crash Time 10:00 PM
Crash Date 06/09/2017This report does not include any CJIS data.
4of3
Wisconsin Motor Vehicle Crash
Form DT4000
17060909
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6R 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
2
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 ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
2
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
er
State: Wisconsin Country: UNITED STATES
Address
MADISON, WI 53719 , US
RaceWHITEDate of Birth
07/28
Sex
Female
Citations Issued
0
PassengerEMILY K WHALLEY
IN
D
I
V
I
D
U
A
L
UN
I
T
Drug &
Alcohol
Injury
Equipment
Non Motorist
Individual
Crash Time 10:00 PM
Crash Date 06/09/2017This report does not include any CJIS data.
4of4
Wisconsin Motor Vehicle Crash
Form DT4000