20171229 Guthman.pdf17122902
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0D 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
11:14 AM
Date Notified
12/29/2017
Time Arrived
11:14 AM
Date Arrived
12/29/2017
Crash Time
11:00 AM
Crash Date
12/29/2017
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
2
X
V
N
0
D
Additional InformationPhotos, Reconstruction
Photos ByDEPUTY KEVIN GILLIS
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
VEHICLE WAS TRAVELING EAST GOING AROUND A SLIGHT CURVE. THE VEHICLE LOST CONTROL AND WENT INTO THE NORTH DITCH STRIKING A TREE. THE VEHICLE HAD DISABLING DAMAGES.
Structure Type
Y Coordinate
5104827
X Coordinate
155439.421875
Longitude
-91.450808056
Latitude
46.010273144
ON STH77 EB
266 FT E
OF AIRPORT RD
IN THE TOWN OF HAYWARD
IN SAWYER COUNTY
Location
Crash Time 11:00 AM
Crash Date 12/29/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
17122902
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0D Wisconsin Motor Vehicle
Crash Report
Special StudyAccess Control
Partial Control
Tribal Land
Crash Classification - Jurisdiction
No Special Jurisdiction
Crash Classification - Location
Public Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Weather Condition(s)
Cloudy
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Wet, Snow, Ice
Light Condition
Daylight
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
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 Left
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
Tree
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Eastbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
(Sport) Utility Vehicle
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Driver Actions
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Negotiating Curve
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
Towed Due To Disabling Damage01
Extent Of Damage
Disabling Damage
Vehicle Damage
1--Right Front Corner, 7--Left Rear Corner, 8--Left Side Rear, 9--Left Side
Middle, 10--Left Side Front, 11--Left Front Corner, 12--Front
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
UT - SPORT UTILITY VEHICLE
Color
BLK - Black
Model
CHEROKEE
Year
1996
Make
JEEP
Vehicle Identification Number
7237
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - Light Truck
License Plate Number
NP6599
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 11:00 AM
Crash Date 12/29/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
17122902
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0D Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
No Contributing Action
VE
H
I
C
L
E
UN
I
T
Address
CLAM LAKE, WI 54517 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventDitch02
EventTree03
Event
04
IndividualInsurance Company
FARMERS-AUTOMOBILE-INS-ASSOC,-THE
Policy Holder
UN
I
T
Crash Time 11:00 AM
Crash Date 12/29/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
17122902
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0D 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/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
3--Front Seat-Right Side (Train Engineers/Right
00
1
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
CLAM LAKE, WI 54517 , US
RaceWHITEDate of Birth
11/21
Sex
Female
Citations Issued
0
Driver
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 11:00 AM
Crash Date 12/29/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.