20170818 Burt17081802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN2 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
12:36 AM
Date Notified
08/18/2017
Time Arrived
12:46 AM
Date Arrived
08/18/2017
Crash Time
12:15 AM
Crash Date
08/18/2017
Investigating Officer/Deputy
DEPUTY MATTHEW JEFSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
5
1
T
J
N
2
Additional InformationNone
Photos By
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I WAS DISPATCHED TO A VEHICLE REPORTED TO BE IN THE CHIPPEWA FLOWAGE. I ARRIVED AND NOTICED THE VEHICLE IN THE WATER. THE WATER WAS COMING INTO THE VEHICLE ON THE DRIVERS SIDE. THE WATER WAS ABOUT 2 TO 3 FEET DEEP ALSO THE REAR DRIVERS SIDE TIRE
WAS BENT OUT. THERE WAS NOONE AROUND THE VEHICLE. I DID A RECORDS CHECK OF THE REGISTRATION. I THEN HAD ANOTHER DEPUTY
RESPOND TO THE KNOWN DRIVERS ADDRESS. HE MADE CONTACT WITH HER AND SHE WAS FINE. I THEN SPOKE TO THE PERSON THAT GAVE HER
A RIDE HOME AND HE STATED THAT SHE DID USE HIS PHONE TO MAKE SEVERAL CALLS NONE OF WHICH WERE TO THE SHERIFF'S OFFICE TO
NOTIFY OF THE CRASH. ROAD RUNNER ARRIVED AND REMOVED THE VEHICLE AND TOOK IT TO THERE YARD. I THEN CLEARED.
Crash Time 12:15 AM
Crash Date 08/18/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
17081802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN2 Wisconsin Motor Vehicle
Crash Report
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON CTHCC SB
0.25 MI S
OF LAKE CHIPPEWA CAMPGROUND LN
IN THE TOWN OF HUNTER
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 - Not On Road
Animal Type
Weather Condition(s)
Clear
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Dark/Unlit
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Shoulder Left
First Harmful Event
Ditch
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
Divided Hwy W/O Traffic Barrier
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Ditch
Total Lanes
2
Speed Limit
25Pre CrashTire
Mark
Direction Of Travel
Southbound
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
2
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
Disabling Damage
Vehicle Damage
All Areas
Initial Contact Point
Non-Collision
Bus UseNot A BusBody Style
SD - SEDAN
Color
BLU - Blue
Model
TAURUS
Year
2017
Make
FORD
Vehicle Identification Number
012
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
967YTX
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 12:15 AM
Crash Date 08/18/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
17081802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN2 Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver Actions
Failure To Control
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Negotiating Curve
Vehicle Removed By
ROAD RUNNER
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Address
EXELAND, WI 54835 , US
IndividualJUDY A RUDOLF01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventCross Median01
EventImmersion, Full or Partial02
Event
03
Event
04
Crash Time 12:15 AM
Crash Date 08/18/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
17081802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN2 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
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
Restraint Use Unknown
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
EXELAND, WI 54835 , US
RaceWHITEDate of Birth
05/12
Sex
Female
Citations Issued
2
DriverJODI L BURT
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionFAILURE OF OCCUPANT TO NOTIFY POLICE OF ACCIDENTSeq Num004Statute Number346.70(1)Issue To?
001
UTC Number
E53834401
DescriptionFAILURE TO KEEP VEHICLE UNDER CONTROLSeq Num007Statute Number346.57(2)Issue To?
001
UTC Number
E53834502
Crash Time 12:15 AM
Crash Date 08/18/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.