20171127 Beach.pdf17112705
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRP 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
05:10 PM
Date Notified
11/27/2017
Time Arrived
06:01 PM
Date Arrived
11/27/2017
Crash Time
05:10 PM
Crash Date
11/27/2017
Investigating Officer/Deputy
DEPUTY NATHAN FREY
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
Z
Q
K
R
P
Additional InformationNone
Photos By
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
DISPATCHED TO VEHICLE CRASH STATE HIGHWAY 70 NEAR OJIBWE PARK FOR A DEER VS. VEHICLE WITH INJURY. ARRIVED ON SCENE AND OBSERVED A SUBARU STATION WAGON PARTIALLY IN THE EASTBOUND LANE OF STATE HIGHWAY 70 1/4 MILE WEST OF DORSHEID ROAD. THE
ANIMAL WAS DISPATCHED AND THE DRIVER PROVIDED HER INFORMATION PRIOR TO BEING TRANSPORTED TO LADYSMITH HOSPITAL. THE
VEHICLE WAS TOWED BY ROADRUNNER TOWING.
Crash Time 05:10 PM
Crash Date 11/27/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
17112705
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRP Wisconsin Motor Vehicle
Crash Report
Structure Type
Y Coordinate
5080960.5
X Coordinate
183596.703125
Longitude
-91.072339873
Latitude
45.80958563
ON STH70 EB
0.38 MI W
OF DORSCHEID RD
IN THE TOWN OF OJIBWA
IN SAWYER COUNTY
Location
Special StudyAccess Control
Full Control
Tribal Land
Crash Classification - Jurisdiction
No Special Jurisdiction
Crash Classification - Location
Public Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Deer
Weather Condition(s)
Cloudy
Environment Factor(s)
Animal (s) in roadway
Roadway Factor(s)
None
Road Surface Condition(s)
Dry, Snow
Light Condition
Dark/Unlit
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
First Harmful Event
Non Domesticated Animal (Alive)
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
Uphill
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
Non Domesticated Animal (Alive)
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
Passenger Car
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Disabling Damage
Vehicle Damage
5--Right Rear Corner, 6--Rear, 7--Left Rear Corner
Initial Contact Point
6--Rear
Bus UseNot A BusBody Style
SW - STATIONWAGON
Color
SIL - Silver (Aluminum)
Model
OUTBACK
Year
2014
Make
SUBARU
Vehicle Identification Number
4536
Country of Issuance
UNITED STATES
St
PA
Plate Type
AUT - Automobile
License Plate Number
HHZ3047
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 05:10 PM
Crash Date 11/27/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
17112705
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRP Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver Actions
No Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
NEWTOWN, PA 18940 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventNon Domesticated Animal (Alive)02
Event
03
Event
04
IndividualInsurance Company
USAA-CASUALTY-INS-CO
Policy Holder
UN
I
T
Crash Time 05:10 PM
Crash Date 11/27/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
17112705
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRP 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
RUSK COUNTY MEMORIAL HOSPITAL AND NU
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS Ground
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Deployed-Other (Knee, Air Belt, Etc)
Injury Severity
Suspected Minor 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
nse Number
State: Pennsylvania Country: UNITED STATES
Address
NEWTOWN, PA 18940 , US
RaceWHITEDate of Birth
12/20/
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
Address
, ,
Unknown
PR
O
P
OW
N
E
R
01
Property Owner
Fixed Objects Struck
Crash Time 05:10 PM
Crash Date 11/27/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
17112705
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRP Wisconsin Motor Vehicle
Crash Report
Damage Tag NumberStruck Object
Domesticated Animal - Alive
Striking Unit
0101
Crash Time 05:10 PM
Crash Date 11/27/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.