20171229 Demain Schultz-Yoder.pdf17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 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
02
Total Units
02
Time Notified
05:10 PM
Date Notified
12/28/2017
Time Arrived
05:14 PM
Date Arrived
12/29/2017
Crash Time
05:10 PM
Crash Date
12/28/2017
Investigating Officer/Deputy
DEPUTY DARIN JENSEN
Agency Crash Number
17122803
Primary Crash Document #Document Number Override
6V
L
1
3
K
D
6
N
3
Additional InformationPhotos
Photos ByNICOLE RIPCZINKSI
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS TRAVELING SOUTHBOUND AND SLIDE THROUGH THE STOP SIGN INTO THE INTERSECTION. UNIT 2 WAS TRAVELING WESTBOUND WITH THE RIGHT OF WAY WHEN UNIT 2 STRUCK UNIT 1 DUE TO UNIT 1 FAILING TO STOP AT THE STOP SIGN.
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON CTHE SB
0 FT N
OF STH70 SB
IN THE TOWN OF SAND LAKE
IN SAWYER COUNTY
Location
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
Special StudyAccess Control
No 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)
Clear
Environment Factor(s)
Weather Conditions
Roadway Factor(s)
Road Surface Condition (Wet, Icy, Snow, Slush, Etc)
Road Surface Condition(s)
Snow
Light Condition
Dark/Unlit
Manner of Collision
08--Front To Side
First Harmful Event Location
On Roadway
First Harmful Event
Motor Veh In Transport
Crash Scene
Intersection Type
Four-Way Intersection
Junction Location
Intersection
Within Interchange Area
NO
Time Roadway RepairedDate Roadway RepairedTime All Lanes Open
08:08 PM
Date All Lanes Open
12/28/2017
Time Initial Lane/Road Closed
07:10 PM
Date Initial Lane/Road Closed
12/28/2017
Reasons for Closure
Law Enforcement, Fire/EMS
Closure Type
Lane Closure
Reporting Threshold
No
Truck Bus or HazMat
No
Road Grade
Level
Road Curvature
Straight
Surface Type
Blacktop (Bituminous)
Traffic Control Inoperative/Missing
NO
Traffic Control
Stop Sign
Traffic Way
Two-Way, Not Divided
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Motor Veh In Transport
Total Lanes
2
Speed Limit
45Pre CrashTire
Mark
Direction Of Travel
Southbound
Insurance?
NO
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
6
Train/Bus # InjuredTotal Occs
2
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 Removed ByTowed Due To Damage
Extent Of Damage
Disabling Damage
Vehicle Damage
7--Left Rear Corner, 8--Left Side Rear, 9--Left Side Middle, 10--Left Side Front,
11--Left Front Corner
Initial Contact Point
9--Left Side Middle
Bus UseNot A BusBody Style
HB - HATCHBACK
Color
BLK - Black
Model
ECLIPSE
Year
2000
Make
MITSUBISHI
Vehicle Identification Number
7036
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
AAG3582
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
Driver DistractionsSmoking Related
Driver Actions
Speed Too Fast/Cond, Failed To Yield Right-Of-Way, Failure To Control
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
SARONA, WI 54870 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventMotor Veh In Transport02
Event
03
Event
04
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
Individual Condition
Under The Influence Of Medications/Drugs/ Alcohol
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 MEDICAL CENTER
EMS Run #EMS Agency Identifier
6001346
Medical Transport
EMS Air
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Deployed-Front
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
None Used - Vehicle Occupant
On Duty Crash
01
Driver License NumberAddress
HAYWARD, WI 54843 , US
RaceDate of Birth
07/08
Sex
Male
Citations Issued
6
Driver
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
Individual Condition
Under The Influence Of Medications/Drugs/ Alcohol
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
2
01
Time of DeathDate of DeathHospital
ST MARYS MEDICAL CENTER
EMS Run #EMS Agency Identifier
6001349
Medical Transport
EMS Air
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Deployed-Front
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
3--Front Seat-Right Side (Train Engineers/Right
00
2
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
SARONA, WI 54870 , US
RaceDate of Birth
12/06/
Sex
Female
Citations Issued
0
Passenger
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Violations
DescriptionCAUSE INJURY/OPERATE RESTRICTED CONTROL SUBSSeq Num008Statute Number346.63(2)(a)3Issue To?
001
UTC Number
AE01455301
DescriptionKNOWINGLY OWL / CAUSE GREAT BODILY HARMSeq Num012Statute Number343.05(3)(a)Issue To?
001
UTC Number
AE01455402
DescriptionDRIVING TOO FAST FOR CONDITIONSSeq Num001Statute Number346.57(3)Issue To?
001
UTC Number
AE01455503
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
DescriptionOPERATE MOTOR VEHICLE W/O INSURANCESeq Num001Statute Number344.62(1)Issue To?
001
UTC Number
AE01455604
DescriptionFAIL/STOP AT STOP SIGNSeq Num001Statute Number346.46(1)Issue To?
001
UTC Number
AE01455705
DescriptionRECKLESS DRIVING-ENDANGER SAFETYSeq Num002Statute Number346.62(2)Issue To?
001
UTC Number
AE01455806
Reporting Threshold
No
Truck Bus or HazMat
No
Road Grade
Level
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
Motor Veh In Transport
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Westbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
4
Operating As EndorsementsVehicle Type
(Sport) Utility Vehicle
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
02
Unit Summary
Driver DistractionsNot Distracted
Driver Actions
No Contributing Action
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
02
Extent Of Damage
Disabling Damage
Vehicle Damage
12--Front
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
UT - SPORT UTILITY VEHICLE
Color
SIL - Silver (Aluminum)
Model
MOUNTAINEE
Year
2006
Make
MERCURY
Vehicle Identification Number
2133
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
269YLW
VE
H
I
C
L
E
UN
I
T
02
Vehicle
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 6 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 Wisconsin Motor Vehicle
Crash Report
Address
STONE LAKE, WI 54876 , US
Individual
(02
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
Event
02
Event
03
Event
04
IndividualInsurance Company
ALLSTATE-INS-CO
Policy Holder
UN
I
T
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 7 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 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
3
02
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
Deployed-Front
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
3
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
02
ber
State: Wisconsin Country: UNITED STATES
Address
STONE LAKE, WI 54876 , US
RaceWHITEDate of Birth
02/23/
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 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 8 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 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
4
02
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
4
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
02
Driver License NumberAddress
STONE LAKE, WI 54876 , US
RaceDate of Birth
04/27/
Sex
Female
Citations Issued
0
Passenger
(
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 9 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 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
5
02
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
4--Second Seat-Left Side(Motorcycle/Bicycle Pa
00
5
Safety Equipment
Child Restraint System - Forward Facing
On Duty Crash
02
Driver License NumberAddress
STONE LAKE, WI 54876 , US
RaceDate of Birth
06/05/
Sex
Male
Citations Issued
0
Passenger
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 10 of 11
This report does not include any CJIS data.
17122803
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13KD6N3 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
6
02
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
6--Second Seat-Right Side
00
6
Safety Equipment
Booster Seat
On Duty Crash
02
Driver License NumberAddress
STONE LAKE, WI 54876 , US
RaceDate of Birth
09/15/
Sex
Female
Citations Issued
0
Passenger
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 05:10 PM
Crash Date 12/28/2017Wisconsin Motor Vehicle Crash
Form DT4000 11 of 11
This report does not include any CJIS data.