20171130 Scalzo.pdf17113016389
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HKD 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
07:45 AM
Date Notified
11/30/2017
Time ArrivedDate ArrivedCrash Time
07:40 AM
Crash Date
11/30/2017
Investigating Officer/Deputy
DEPUTY AMBER ALMOGHRABI
Agency Crash Number
17113002
Primary Crash Document #Document Number Override
6V
L
1
3
W
8
H
K
D
Structure Type
No Structure
Y Coordinate
5104859.5
X Coordinate
155087.265625
Longitude
-91.455366247
Latitude
46.010385341
INTERSECTION
ON STH77 EB
AT DUFFY 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
Eastbound
Insurance?
YES
Total HazMat Types
0
Total TrailersTotal # Citations Issued
0
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
Vehicle
Crash Time 07:40 AM
Crash Date 11/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 3
This report does not include any CJIS data.
17113016389
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HKD Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed By
OWNER
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Functional Damage
Vehicle Damage
1--Right Front Corner, 12--Front
Initial Contact Point
12--Front
Bus UseBody Style
4D - 4DR
Color
BLK - Black
Model
FUSION
Year
2014
Make
FORD
Vehicle Identification Number
3 287
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
563XKB
VE
H
I
C
L
E
UN
I
T
01
Individual
MYCAELA SCALZO
Insurance Company
STATE-FARM-MUTUAL-AUTOMOBILE-INS-CO
Policy Holder
UN
I
T
Crash Time 07:40 AM
Crash Date 11/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 3
This report does not include any CJIS data.
17113016389
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HKD 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
ber
State: Wisconsin Country: UNITED STATES
Address
HAYWARD, WI 54843 , US
RaceWHITEDate of Birth
08/07/
Sex
Female
Citations Issued
0
DriverMYCAELA R SCALZO
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 07:40 AM
Crash Date 11/30/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 3
This report does not include any CJIS data.