20171222 Olson Griffin.pdf17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
02
Time Notified
05:09 PM
Date Notified
12/22/2017
Time Arrived
05:28 PM
Date Arrived
12/22/2017
Crash Time
05:08 PM
Crash Date
12/22/2017
Investigating Officer/Deputy
DEPUTY MATTHEW JEFSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
5
1
T
J
N
5
Additional InformationPhotos
Photos ByM. JEFSON
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I WAS DISPATCHED TO A VEHICLE VS. DEER ACCIDENT ON STH 77 NEAR ROSS RD. DISPATCH ADVISED ONE VEHICLE WAS BLOCKING ROAD AND ANOTHER WAS IN THE DITCH. I ARRIVED ON SCENE AND FOUND OUT THAT IT WAS A CAR VS. DEER THEN A CAR VS. CAR. I SPOKE WITH EVERYONE
INVOLVED AND NO ONE WAS HURT. EVERYONE WAS CHECKED OUT BY MEDICS. I THEN TALKED TO THE DRIVER THAT HIT THE DEER AND SHE
STATED THAT SHE HIT THE DEER RIGHT AS ANOTHER VEHICLE WAS COMING IN THE OTHER LANE. SHE STATED HER VAN THEN WENT OVER THE
CENTER LINE AND THE OTHER VEHICLE HIT HER FRONT END. THE DRIVER OF THE SECOND VEHICLE HAD THE SAME STORY. BOTH VEHICLE WERE
TOWED DUE TO DAMAGE AND DRIVERS FOUND OTHER RIDES.
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 Wisconsin Motor Vehicle
Crash Report
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON STH77 WB
0.50 MI E
OF ROSS RD
IN THE TOWN OF SPIDER LAKE
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 - On Road
Animal Type
Deer
Weather Condition(s)
Clear
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Dark/Unlit
Manner of Collision
08--Front To Side
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
Downhill
Road Curvature
Straight
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
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
Passenger Van
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
1--Right Front Corner, 11--Left Front Corner, 12--Front
Initial Contact Point
12--Front
Bus UseNot A BusBody Style
VN - VAN
Color
SIL - Silver (Aluminum)
Model
ODYSSEY EX
Year
2005
Make
HONDA
Vehicle Identification Number
1430
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
522XNE
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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 ByTowed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Address
MELLEN, WI 54546 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDomesticated Animal - Alive01
EventCross Centerline02
EventMotor Veh In Transport03
Event
04
IndividualInsurance Company
GEICO-GENERAL-INS-CO
Policy Holder
UN
I
T
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
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
1
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
MELLEN, WI 54546 , US
RaceWHITEDate of Birth
12/15/
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 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 4 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
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
4--Second Seat-Left Side(Motorcycle/Bicycle Pa
00
2
Safety Equipment
Child Restraint System - Forward Facing
On Duty Crash
01
Driver License NumberAddress
MELLEN, WI 54546 , US
RaceWHITEDate of Birth
04/19/
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 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 5 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
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
5--Second Seat-Middle
00
3
Safety Equipment
Child Restraint System - Forward Facing
On Duty Crash
01
Driver License NumberAddress
MELLEN, WI 54546 , US
RaceWHITEDate of Birth
04/09
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 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 6 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
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
6--Second Seat-Right Side
00
4
Safety Equipment
Child Restraint System - Rear Facing
On Duty Crash
01
Driver License NumberAddress
MELLEN, WI 54546 , US
RaceWHITEDate of Birth
08/26/
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 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 7 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 Wisconsin Motor Vehicle
Crash Report
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
Divided Hwy W/O Traffic Barrier
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
Eastbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
2
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 ActionsNo 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
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
BLU - Blue
Model
HIGHLANDER
Year
2016
Make
TOYOTA
Vehicle Identification Number
2313
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
767YRM
VE
H
I
C
L
E
UN
I
T
02
Vehicle
Address
MELLEN, WI 54546 , US
Individual
02
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 8 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 Wisconsin Motor Vehicle
Crash Report
EventDitch02
Event
03
Event
04
IndividualInsurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UN
I
T
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 9 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
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
5
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
02
ber
State: Wisconsin Country: UNITED STATES
Address
GORDON, WI 54838 , US
RaceWHITEDate of Birth
05/15/
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
Crash Time 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 10 of 11
This report does not include any CJIS data.
17122206
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJN5 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
3--Front Seat-Right Side (Train Engineers/Right
00
6
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
02
ber
State: Wisconsin Country: UNITED STATES
Address
GORDON, WI 54838 , US
RaceWHITEDate of Birth
01/26/
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 05:08 PM
Crash Date 12/22/2017Wisconsin Motor Vehicle Crash
Form DT4000 11 of 11
This report does not include any CJIS data.