HomeMy WebLinkAbout20181015 GEERTRUIDA.pdfSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13SSFB8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
DT4000 (STANDARD CRASH)Reportable
TagsSchool Bus Related
NOActive School ZoneGovernment
Property
Reporting
ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
01
Total Units
01
Time Notified
07:37 AM
Date Notified
10/16/2018
Time Arrived
07:47 AM
Date Arrived
10/16/2018
Crash Time
07:35 AM
Crash Date
10/15/2018
Investigating Officer/Deputy
DEPUTY CRAIG DEPEW
Agency Crash Number
18101502
Primary Crash Document #Document Number Override
6V
L
1
3
S
S
F
B
8
Additional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS NORTHBOUND ON STH 27 NEAR THE INTERSECTION OF OLD 27 RD. THE ROADS WERE ICE COVERED AND SLIPPERY. THE DRIVER
STATED THAT SHE WAS SLOWING DOWN DUE TO THE ROAD CONDITIONS WHEN SHE LOST CONTROL OF THE VEHICLE AND AS IT SLID TO THE
SHOULDER THE VEHICLE OVERTURNED LANDING ON THE PASSENGER SIDE.
Crash Time 07:35 AM
Crash Date 10/15/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13SSFB8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON CTH27
100 FT S
OF OLD HWY 27
IN THE TOWN OF BASS 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
Weather Condition(s)
CLOUDY
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
NONE
Road Surface Condition(s)
ICE
Light Condition
DAYLIGHT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ON ROADWAY
First Harmful Event
OVERTURN/ROLLOVER
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
UPHILL
Road Curvature
CURVE LEFT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTIONMost Harmful Event: Collision With
OVERTURN/ROLLOVER
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
NORTHBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
3--RIGHT SIDE MIDDLE, 5--RIGHT REAR CORNER
Initial Contact Point
1--RIGHT FRONT CORNER
Bus UseNOT A BUSBody Style
4D - 4DR
Color
MAR - MAROON (BURGUNDY)
Model
BLAZER
Year
1994
Make
CHEVROLET
Vehicle Identification Number
16900101
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
VE
H
I
C
L
E
UN
I
T
Vehicle
Crash Time 07:35 AM
Crash Date 10/15/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13SSFB8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
01
Driver DistractionsUNKNOWN IF DISTRACTED
01
Driver Actions
SPEED TOO FAST/COND
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
EventOVERTURN/ROLLOVER02
Event
03
Event
04
Injury
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
TRAPPED/NOT EXTRICATED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED MINOR INJURY00
1
01
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
SHOULDER & LAP BELT
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
STONE LAKE, WI 54876 , US
Race
WHITEDate of Birth
03/14/
Sex
FEMALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 07:35 AM
Crash Date 10/15/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13SSFB8 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
1
01
Drug Test ResultsDrug Test TypeDrug Test GivenTEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 07:35 AM
Crash Date 10/15/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.