20171211 Henk.pdfNarrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON DECEMBER 11, 2017, I, DEPUTY RYAN SCHICK OF THE SAWYER COUNTY SHERIFF'S DEPT WAS ON PATROL. I WAS IN A MARKED SQUAD CAR AND DRESSED IN UNIFORM. AT APPROXIMATELY 22:38, I WAS ASKED BY DISPATCH TO RESPOND TO PENINSULA RD IN FRONT OF ADDRESS
FOR A ONE VEHICLE ROLLOVER WITH A MALE SUBJECT STILL INSIDE OF THE VEHICLE . I ARRIVED ON SCENE AT APPROXIMATELY 23:18. THE MALE
HAD GOTTEN OUT OF THE VEHICLE AT THIS TIME AND WAS CURRENTLY BEING CHECKED OUT BY EMS IN THEIR AMBULANCE. I WENT INTO THE
AMBULANCE AND SPOKE TO THE MALE. THE MALE, IDENTIFIED AS IDENTIFIED BY A WI DRIVERS LICENSE STATED HE WAS
TRAVELING WEST ON PENINSULA RD, WHERE HE HIT A PATCH OF ICE AND THEN WENT INTO THE NORTH SIDE DITCH AND ROLLED OVER.
STATED HE WAS ONLY TRAVELING APPROXIMATELY 35MPH-40MPH IN THE 45MPH POSTED SPEED ZONE. ADVISED HE HAD BOTH A SHOULDER AND LAP BELT ON. ADVISED HE HAD USAA FOR AN INSURANCE COMPANY. EMS ADVISED HE HAD NON-LIFE THREATENING
INJURIES WITH ONLY AN APPARENT MINOR INJURY. ADVISED HE WAS NEVER UNCONSCIOUS AND WAS MORE SHAKEN UP THAN ANYTHING
ELSE. I EXITED THE AMBULANCE SO THEY COULD TAKE TO THE HAYWARD HOSPITAL TO GET CHECKED OVER. I PHOTOGRAPHED THE
VEHICLE AND CALLED FOR A TOW. TOWING ARRIVED ON SCENE AND REMOVED THE VEHICLE. PENINSULA RD WAS SHUT DOWN FOR
APPROXIMATELY 45 MINUTES WHILE THE VEHICLE GOT REMOVED FROM THE DITCH AS IT WAS A VERY NARROW ROADWAY AND SLIPPERY. ALL
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Q 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
10:38 PM
Date Notified
12/11/2017
Time Arrived
11:18 PM
Date Arrived
12/11/2017
Crash Time
10:36 PM
Crash Date
12/11/2017
Investigating Officer/Deputy
DEPUTY RYAN SCHICK
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
C
7
1
3
Q
Additional InformationPhotos
Photos ByDEPUTY RYAN SCHICK
Reconstruction ByDiagram
Description
Crash Time 10:36 PM
Crash Date 12/11/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
UNITS THEN CLEARED FROM THE CRASH.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Q Wisconsin Motor Vehicle
Crash Report
Structure Type
House/Building
Y Coordinate
5104745
X Coordinate
159532.875
Longitude
-91.39803166
Latitude
46.011580221
ON 13988 PENINSULA RD
0.32 MI E
OF O BRIEN HILL RD
(HOUSE/BUILDING 13988)
IN THE TOWN OF HAYWARD
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)
Cloudy
Environment Factor(s)
Weather Conditions
Roadway Factor(s)
Road Surface Condition (Wet, Icy, Snow, Slush, Etc)
Road Surface Condition(s)
Snow, Ice
Light Condition
Dark/Unlit
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Outside Right-Of-Way (Trafficway)
First Harmful Event
Overturn/Rollover
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Non-Junction
Within Interchange Area
NO
Time Roadway Repaired
12:15 AM
Date Roadway Repaired
12/12/2017
Time All Lanes Open
12:15 AM
Date All Lanes Open
12/12/2017
Time Initial Lane/Road Closed
11:30 PM
Date Initial Lane/Road Closed
12/11/2017
Reasons for Closure
Tow truck
Closure Type
Full closure
Reporting Threshold
No
Truck Bus or HazMat
No
Road Grade
Hillcrest
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
Overturn/Rollover
Total Lanes
2
Speed Limit
45Pre CrashTire
Mark
Direction Of Travel
Westbound
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
Truck
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - Light Truck
License Plate Number
LZ479501
Vehicle
Crash Time 10:36 PM
Crash Date 12/11/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Q Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
A1 TOWING
Towed 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
All Areas
Initial Contact Point
3--Right Side Middle
Bus UseNot A BusBody Style
PK - PICKUP
Color
GRY - Gray
Model
DAKOTA
Year
2006
Make
DODGE
Vehicle Identification Number
14887
VE
H
I
C
L
E
UN
I
T
Address
HAYWARD, WI 54843 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventRun Off Roadway Right02
EventOverturn/Rollover03
Event
04
IndividualInsurance Company
USAA-CASUALTY-INS-CO
Policy Holder
UN
I
T
Crash Time 10:36 PM
Crash Date 12/11/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Q 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
HAYWARD AREA MEMORIAL HOSPITAL
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS Ground
Trapped/Extricated
Trapped/Not Extricated
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Non Deployed
Injury Severity
Possible 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
03/21
Sex
Male
Citations Issued
0
Driver
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Address
, ,
Unknown
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 10:36 PM
Crash Date 12/11/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Q Wisconsin Motor Vehicle
Crash Report
Damage Tag NumberStruck Object
Ditch
Striking Unit
0101
Crash Time 10:36 PM
Crash Date 12/11/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.