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HomeMy WebLinkAbout20181112 VISOCKY-BJORK.pdfSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 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 02 Time Notified 10:53 AM Date Notified 11/12/2018 Time Arrived 11:01 AM Date Arrived 11/12/2018 Crash Time 10:53 AM Crash Date 11/12/2018 Investigating Officer/Deputy DEPUTY NATHAN FREY Agency Crash Number 18111204 Primary Crash Document #Document Number Override 6V L 1 3 Z Q K S 3 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 ONE WAS NEGOTIATING RIGHT TURN AND LOST TRACTION TO STEERING TIRES. UNIT ONE CROSSED THE CENTER OF THE ROAD, STRIKING UNIT 2 ON THE DRIVERS SIDE STEER TIRE. UNIT 1 HAD AIRBAG DEPLOYMENT AND CAME TO REST IN OPPOSITE LANE DITCH. Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y Coordinate 5112789 X Coordinate 175478.28125 Longitude -91.198104561 Latitude 46.091521835 ON UPPER A RD 0.44 MI S OF SOUTH 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 Weather Condition(s) CLOUDY Environment Factor(s) WEATHER CONDITIONS Roadway Factor(s) NONE Road Surface Condition(s) SNOW, ICE Light Condition DAYLIGHT Manner of Collision 06--SIDESWIPE/OPPOSITE DIRECTION First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type NOT AN INTERSECTION Junction Location NON-JUNCTION Within Interchange Area NO Truck Bus or HazMat NO Road Grade SAG(BOTTOM) Road Curvature CURVE RIGHT 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 MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55Pre CrashTire Mark Direction Of Travel NORTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type UTILITY TRUCK/PICKUP TRUCK01 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage DISABLING DAMAGE Vehicle Damage 11--LEFT FRONT CORNER, 12--FRONT Initial Contact Point 12--FRONT Bus UseNOT A BUSBody Style PK - PICKUP Color GLD - GOLD Model SONOMA Year 1998 Make GENERAL MOTORS COR Vehicle Identification Number 32330101 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VE H I C L E UN I T Vehicle Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address CABLE, WI 54821 , US Owner Name 01 Driver DistractionsNOT DISTRACTED, UNKNOWN IF DISTRACTED 01 Driver Actions FAILURE TO CONTROL 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 EventRIGHT TURN02 Event 03 Event 04 IndividualInsurance Company FEDERATED-MUTUAL-INS-CO Policy Holder UN I T Injury Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag DEPLOYED-FRONT Injury Severity POSSIBLE 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 CABLE, WI 54821 , US Race WHITE Date of Birth 05/23/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 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 EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UN I T Non Motorist IN D I V I D U A L Truck Bus or HazMat TRUCK OR TRUCK COMBINATION > 10,000LBS GVWR/GCWR Road Grade SAG(BOTTOM) 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 MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 55Pre CrashTire Mark Direction Of Travel SOUTHBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 2 Operating As EndorsementsVehicle Type TRUCK TRACTOR (NOT ATTACHED)02 Unit Type TRUCK Vehicle Operating As Classification B CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage MINOR DAMAGE Vehicle Damage 1--RIGHT FRONT CORNER Initial Contact Point 11--LEFT FRONT CORNER Bus UseNOT A BUSBody Style CB - CAB CHASSIS Color RED - RED Model NO DATA FO Year 2007 Make STERLING Vehicle Identification Number 34760202 Country of Issuance UNITED STATES St WI Plate Type TOR - TRACTOR License Plate Number VE H I C L E UN I T Vehicle Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address CABLE, WI 54821 , US Owner Name 02 Driver DistractionsUNKNOWN IF DISTRACTED 02 Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing NEGOTIATING CURVE Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UN I T VE H I C L E Sequence Of Events EventMOTOR VEH IN TRANSPORT01 EventLEFT TURN02 Event 03 Event 04 Organization/CompanyInsurance Company UNITED-FIRE-&-CASUALTY-CO Policy Holder UN I T Injury Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00 2 02 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Safety Equipment SHOULDER & LAP BELT On Duty Crash EMT/FIRST-RESPONDER Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address CABLE, WI 54821 , US Race WHITE Date of Birth 03/25/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00 2 02 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 EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED UN I T Non Motorist IN D I V I D U A L Injury To/From SchoolLocationPrior ActionStriking Unit # Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED Airbag NON DEPLOYED Injury Severity NO APPARENT INJURY00 3 02 Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER Safety Equipment SHOULDER & LAP BELT On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address CABLE, WI 54821 , US Race WHITEDate of Birth 08/12/ Sex MALE Citations Issued 0 Passenger IT Equipment Non Motorist Individual UN IN D I V ID U A L Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS3 WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL Drug Type 00 3 02 Drug Test ResultsDrug Test TypeDrug Test Given TEST NOT GIVEN Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given TEST NOT GIVEN Suspected Drug Use NO Suspected Alcohol Use NO Action Other Action UN I T IN D I V I D U A L 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 Type OTHER OPERATION/NOT SPECIFIED US DOT # 1356325 Cargo Body Type DUMP Vehicle Configuration SINGLE-UNIT TRUCK (2-AXLE AND GVWR MORE THA GVWR MORE THAN 26,000 LB 01 Address CABLE, WI 54821 , US Name USDOT# 1356325 02 Source DRIVERUse Vehicle Owner Same as Carrier Carrier CK BU S UN IT TR U Crash Time 10:53 AM Crash Date 11/12/2018Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.