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20171228 Kahl Lapointe.pdf17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 Wisconsin Motor Vehicle Crash Report Secondary CrashAmendedCrash Type Private Property/Parking LotReportable TagsSchool Bus Related NoActive School ZoneGovernment Property Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 00 Total Injured 00 Total Units 02 Time Notified 08:52 AM Date Notified 12/28/2017 Time Arrived 09:09 AM Date Arrived 12/28/2017 Crash Time 08:52 AM Crash Date 12/28/2017 Investigating Officer/Deputy DEPUTY JEFF CAIN Agency Crash Number 17122802 Primary Crash Document #Document Number Override 6V L 1 3 M V 8 W 7 Additional InformationNone, Photos Photos ByDEPUTY JEFF CAIN Reconstruction ByDiagram Description Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. UNIT 1 DROVE INTO A PRIVATE DRIVEWAY TO TURN AROUND. AS IT STOPPED TO BACK UP, UNIT 2 BEGAN BACKING UP TO TURN AND EXIT THE DRIVEWAY AND COLLIDED WITH UNIT 1. Structure Type Fire Y Coordinate 5098622.5 X Coordinate 151817.234375 Longitude -91.492937384 Latitude 45.95277231 PRIVATE PROPERTY 8790W STH27 NB (FIRE 8790W) IN THE TOWN OF BASS LAKE IN SAWYER COUNTY Location Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 Wisconsin Motor Vehicle Crash Report Special StudyAccess Control No Control Tribal Land Crash Classification - Jurisdiction Private Property Crash Classification - Location Private Property Relation To Trafficway Non Trafficway - Other Animal Type Weather Condition(s) Snow Environment Factor(s) Weather Conditions Roadway Factor(s) None Road Surface Condition(s) Snow Light Condition Daylight Manner of Collision 07--Rear To Side First Harmful Event Location Off Roadway, Location Unknown First Harmful Event Motor Veh In Transport Crash Scene Intersection Type Not an Intersection Junction Location Non-Junction Within Interchange Area NO Reporting Threshold No Truck Bus or HazMat Any vehicle designed to carry 9 or more ppl, including driver Road Grade Level Road Curvature Straight Surface Type Slag, Gravel, or Stone Traffic Control Inoperative/Missing NO Traffic Control No Control Traffic Way Parking Lot or Private Property Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Motor Veh In Transport Total LanesSpeed Limit N/APre CrashTire Mark Direction Of Travel Not On Roadway Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # Injured 0 Total Occs 2 Operating As Endorsements P - PASSENGER BUS Vehicle Type Passenger Bus/Transit Bus Unit Type Bus Vehicle Operating As Classification C CLASS Unit Status In Transit UN I T 01 Unit Summary Driver Actions Driver Prior Action Other STOPPED/PREPAIRING TO BACK Vehicle Factors Not Applicable What Driver Was Doing Other Vehicle Removed By OPERATOR Towed Due To Damage Not Towed01 Extent Of Damage No Damage Vehicle Damage No Damage Initial Contact Point 8--Left Side Rear Bus UseTransit/CommuterBody Style BU - BUS Color WHI - White Model E450 SUPER Year 2011 Make FORD Vehicle Identification Number 0041 Country of Issuance UNITED STATES St WI Plate Type MUN - Municipal License Plate Number 89503 VE H I C L E UN I T 01 Vehicle Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 Wisconsin Motor Vehicle Crash Report Driver DistractionsNot Distracted Other Contributing Action VE H I C L E UN I T Address HAYWARD, WI 54843 , US Government 01 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 GovernmentInsurance Company TRANSIT-MUTUAL-INS-CORP-OF-WISCONSIN Policy Holder UN I T Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 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 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 WINTER, WI 54896 , US RaceWHITEDate of Birth 11/02/ 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 , , Name Source DriverUse Vehicle Owner Same as Carrier 01 Carrier Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 Wisconsin Motor Vehicle Crash Report Measured WeightMeasured WidthMeasured LengthMeasured Height Escort Vehicle PresentEscort Vehicle Required By Permit Permitted Vehicle On Permitted Route WI Permit NumberOS/OW Load Permitted Load Not Applicable Carrier TypeUS DOT # Cargo Body Type Bus (Seats For More Than 15 Occupants, Including Driv Vehicle Configuration Bus(Seats For More Than 15 Occupants, Includi GVWR Not Applicable TR U C K B U S UN I T Reporting Threshold No Truck Bus or HazMat No Road Grade Level Road Curvature Straight Surface Type Slag, Gravel, or Stone Traffic Control Inoperative/Missing NO Traffic Control No Control Traffic Way Parking Lot or Private Property Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Motor Veh In Transport Total LanesSpeed Limit N/APre CrashTire Mark Direction Of Travel Not On Roadway Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # 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 02 Unit Summary Driver Distractions Driver Actions Operated Motor Vehicle In Inattentive, Careless or Erratic Manner Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Backing Vehicle Removed By OPERATOR Towed Due To Damage Not Towed VE H I C L E UN I T 02 Extent Of Damage Minor Damage Vehicle Damage 6--Rear Initial Contact Point 6--Rear Bus UseNot A BusBody Style 4D - 4DR Color SIL - Silver (Aluminum) Model JETTA SE Year 2011 Make VOLKSWAGEN Vehicle Identification Number 7262 Country of Issuance UNITED STATES St WI Plate Type AUT - Automobile License Plate Number 616VMB VE H I C L E UN I T 02 Vehicle Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 Wisconsin Motor Vehicle Crash Report Unknown If Distracted Address BAYFIELD, WI 54814 , 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 STATE-FARM-GENERAL-INS-CO Policy Holder UN I T Crash Time 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 17122802 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13MV8W7 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 2 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 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl 00 2 Safety Equipment Shoulder & Lap Belt On Duty Crash 02 ber State: Wisconsin Country: UNITED STATES Address HAYWARD, WI 54843 , US RaceINDIANDate of Birth 12/29/ 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 08:52 AM Crash Date 12/28/2017Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.