20170625 WilliamsNarrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON JUNE 25, 2017 I, DEPUTY RIPCZINSKI WAS DISPATCHED TO THE AREA OF STATE HWY 27 AND RAY'S RD IN THE BASS LAKE TOWNSHIP FOR A REPORT OF A ONE VEHICLE ACCIDENT WITH INJURIES. UPON APPROACHING THE SCENE, I OBSERVED TIRE MARKS PROCEEDING DOWNWARD ON
THE WEST SIDE OF STATE HWY 27 DOWN AN EMBANKMENT AND PROCEEDING BETWEEN A POWER POLE AND POWER LINE. I NOTED WHEN I
ARRIVED ON-SCENE THAT THE VEHICLE HAD TRAVELED OVER RAYS RD WHICH RUNS EAST TO WEST FROM STATE HWY 27 AND PROCEEDED
SOUTH INTO THE ADJOINING CORN FIELD WHERE IT CAME TO A STOP. I ARRIVED ON-SCENE ALONG WITH WARDEN PETERS AND WARDEN
MCCORMICK AS WELL AS A WITNESS AND FIRST RESPONDERS WHO WERE ALREADY ON-SCENE. UPON APPROACHING THE VEHICLE, WARDEN
MCCORMICK AND FIRST RESPONDER HEADLEY WERE TENDING TO THE VICTIM, IDENTIFIED AS THE REGISTERED OWNER OF THE VEHICLE. WARDEN MCCORMICK SPOKE TO THE OPERATOR/VICTIM WHO KNEW HIS NAME AND WHERE HE WAS, BUT WAS CONFUSED AND UNSURE OF DATE
AND TIME. RESPONDERS ON-SCENE ADVISED THAT VICTIM HAS SEVERAL HEALTH ISSUES, INCLUDING HEART PROBLEMS AND DIABETES.
PARAMEDICS AND EMT'S ARRIVED ON-SCENE TO TRANSPORT VICTIM WHO APPEARED TO HAVE A LARGE LACERATION TO THE TOP OF HIS
FOREHEAD FROM HITTING THE DRIVERS SIDE DOOR WINDOW, WHICH WAS PARTIALLY SHATTERED FROM THE INSIDE OUT AND FOLDED
DOWNWARD OUT OF THE DOOR FRAME. A FIRST RESPONDER ADVISED THAT THE VICTIM WAS PROPERLY BUCKLED IN THE VEHICLE. MEDICAL
17062502
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6S 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
01
Total Units
01
Time Notified
01:56 PM
Date Notified
06/25/2017
Time Arrived
02:04 PM
Date Arrived
06/25/2017
Crash Time
01:56 PM
Crash Date
06/25/2017
Investigating Officer/Deputy
DEPUTY NICOLE RIPCZINSKI
Agency Crash Number
17062502
Primary Crash Document #Document Number Override
6V
L
1
3
1
B
Q
6
S
Additional InformationPhotos, Witness Statements
Photos ByM. JEFSON
Reconstruction ByDiagram
Description
Crash Time 01:56 PM
Crash Date 06/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
STAFF AND FIRST RESPONDERS WERE ABLE TO MOVE SUBJECT ONTO BACKBOARD AND INTO THE AMBULANCE WHICH TRANSPORTED THE
PATIENT TO A HELICOPTER WHICH WAS THEN FLOWN OUT TO ST. MARY'S HOSPITAL IN DULUTH, MN. I REQUESTED THE ASSISTANCE OF DEPUTY
MATT JEFSON TO TAKE PHOTOGRAPHS OF THE SCENE AND WARDEN PETERS OBTAINED A STATEMENT FROM THE WITNESS WHO WAS AT THE STOP SIGN ON RAYS RD WHEN THE VEHICLE PROCEEDED AIRBORNE OVER RAYS RD BEHIND THE WITNESS. NO OTHER PERSON WAS INJURED IN
THIS ACCIDENT. THE VEHICLE SUSTAINED SEVERE FRONT END DAMAGED AND WAS TOWED BY ROADRUNNER. END OF REPORT.
17062502
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6S Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5093311.5
X Coordinate
150983.6875
Longitude
-91.499796904
Latitude
45.904694896
ON STH27 SB
0.31 MI N
OF RAYS RD
IN THE TOWN OF BASS LAKE
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 - Not On Road
Animal Type
Weather Condition(s)
Cloudy
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 Right
First Harmful Event
Embankment
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
Downhill
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
Embankment
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Southbound
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
3
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Utility Truck/Pickup Truck
Unit Type
Truck
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Vehicle DamageInitial Contact Point
Bus UseNot A BusBody Style
PK - PICKUP
Color
BLK - Black
Model
RAM 1500
Year
2006
Make
DODGE
Vehicle Identification Number
269
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - Light Truck
License Plate Number
JW392401
Vehicle
Crash Time 01:56 PM
Crash Date 06/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17062502
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6S Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver ActionsFailure To Control, Ran Off Roadway
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
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
9--Left Side Middle, 10--Left Side Front, 12--Front
11--Left Front CornerVE
H
I
C
L
E
UN
I
T
Address
HAYWARD, WI 54843 , US
IndividualJOHN PAUL WILLIAMS01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventRun Off Roadway Right01
EventEmbankment02
EventOther Post, Pole or Support03
EventOther Non-Collision04
Crash Time 01:56 PM
Crash Date 06/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17062502
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6S Wisconsin Motor Vehicle
Crash Report
Individual Condition
Confused or Disoriented (Non Lucid)
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
ST MARYS HOSPITAL
EMS Run #
17062508293
EMS Agency Identifier
6000954
Medical Transport
EMS Air
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Non Deployed
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
Shoulder & Lap Belt
On Duty Crash
01
er
State: Wisconsin Country: UNITED STATES
Address
HAYWARD, WI 54843 , US
RaceWHITEDate of Birth
08/14/1
Sex
Male
Citations Issued
3
DriverJOHN PAUL WILLIAMS
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionOPERATE W/O VALID LICENSESeq Num002Statute Number343.05(3)(a)Issue To?
001
UTC Number
AE01412001
DescriptionFAILURE TO KEEP VEHICLE UNDER CONTROL (2ND+)Seq Num008Statute Number346.57(2)Issue To?
001
UTC Number
AE01412102
DescriptionNON-REGISTRATION OF AUTO, ETCSeq Num001Statute Number341.04(1)Issue To?
001
UTC Number
AE01412203
Crash Time 01:56 PM
Crash Date 06/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17062502
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL131BQ6S Wisconsin Motor Vehicle
Crash Report
STONE LAKE, WI 54876 , US
IndividualJOSEPH MARTIN
(715) 634-8648
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Damage Tag Number
0
Struck Object
Embankment
Striking Unit
0101
ASHLAND, WI 54806 , US
Organization/CompanyEXCEL ENGERY
(715) 682-6936
PR
O
P
OW
N
E
R
02
Property Owner
Fixed Objects Struck
Damage Tag Number
0
Struck Object
Other Post, Pole or Support
Striking Unit
0102
Date of Birth
09/24STONE LAKE, WI 54876 , US
IndividualCHRISTIAN D GRAVES
(715) 638-065201
WI
T
N
ES
S
Witness
Crash Time 01:56 PM
Crash Date 06/25/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.