HomeMy WebLinkAbout20181111 SACKETT-CHENOWITH.pdfON NOVEMBER 11, 2018, I, DEPUTY AMBER AL-MOGHRABI WAS WORKING PATROL FOR THE SAWYER COUNTY SHERIFF'S DEPT. AT
APPROXIMATELY 12:29 I WAS DISPATCHED TO FARNSWORTH ROAD FOR A REPORT OF A 2 VEHICLE ACCIDENT WITH NO INJURIES.
DISPATCH ADVISED ME THAT THEY HAD BOTH VEHICLE INFORMATION AND ONE OF THE DRIVERS, BUT NEEDED THE OTHER DRIVER INFORMATION. UPON ARRIVAL AT 12:43 I MET WITH TWO MALE SUBJECTS STANDING OUTSIDE THEIR VEHICLES. I ASKED THEN WHAT HAD HAPPENED. ONE OF
THE MALES IDENTIFIED HIMSELF AS AND STATED THAT HE WAS DRIVING THE WHITE CHEVY SILVERADO. HE STATED HE
HAD JUST LEFT HIS HOUSE FROM UP THE ROAD AND WAS TRAVELING SOUTHBOUND ON FARNSWORTH ROAD AT APPROXIMATELY 10 MPH. HE
STATED HE WAS JUST STARTING TO GO AROUND THE CURVE DOWNHILL, AS THE OTHER VEHICLE WAS COMING TOWARDS HIM UPHILL. HE
STATED THAT THE ROADS WERE VERY SLIPPERY AND THAT HE WAS ABLE TO KEEP CONTROL OF HIS VEHICLE, BUT THE OTHER VEHICLE STARTED
TO SLIDE AND THEIR BACK ENDS HIT. STATED THAT HE WAS WEARING HIS SEATBELT AND HE HAD PROGRESSIVE INSURANCE. I THEN SPOKE WITH THE OTHER MALE PARTY. I ASKED FOR HIS DRIVER'S LICENSE AS THAT WAS THE ONE I DID NOT HAVE. HE WAS IDENTIFIED BY HIS
DRIVER'S LICENSE AS . STATED THAT HE WAS HEADED NORTHBOUND ON FARNSWORTH ROAD TRAVELING AT APPROXIMATELY
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 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
00
Total Units
02
Time Notified
12:27 PM
Date Notified
11/11/2018
Time Arrived
12:43 PM
Date Arrived
11/11/2018
Crash Time
12:20 PM
Crash Date
11/11/2018
Investigating Officer/Deputy
DEPUTY AMBER ALMOGHRABI
Agency Crash Number
18111104
Primary Crash Document #Document Number Override
6V
L
1
3
W
8
H
L
7
Additional InformationPHOTOS
Photos ByDEPUTY AMBER AL-MOGHRABI
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 6
This report does not include any CJIS data.
13 MPH. HE STATED THAT THE ROAD WAS SLIPPERY AND HE NOTICED THE OTHER VEHICLE COMING INTO HIS LANE SO HE ATTEMPTED TO GET
OUT OF THE WAY AND WENT INTO THE YARD OF FARNSWORTH ROAD. HE STATED THAT AT THAT TIME THEIR BACK BUMPERS HIT.
STATED THAT THE VEHICLE THAT HE WAS DRIVING BELONGED TO HAYWARD POWER SPORTS AND THAT THERE WAS NO DAMAGE TO THE VEHICLE. I WENT AND LOOKED AT THE DAMAGE TO THE CHEVY TRUCK. THERE WAS A SIGNIFICANT AMOUNT OF DAMAGE TO THE DRIVER SIDE
BACK BUMPER AND THE REAR DRIVER SIDE TIRE HAD BEEN SLASHED OPEN AND WAS DEFLATED. THERE WERE ALSO LARGE SCRATCHES AND
DENTS TO THE DRIVER SIDE REAR DOOR. SEE REPORT.
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5108312.5
X Coordinate
168922.015625
Longitude
-91.279568556
Latitude
46.048199995
ON FARNSWORTH RD
0.42 MI N
OF TWIN LAKE RD 6
IN THE TOWN OF ROUND 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, SNOW
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
SNOW, ICE
Light Condition
DAYLIGHT
Manner of Collision
04--REAR TO REAR
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
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
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
25Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
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
Model
SILVERADO
Year
2017
Make
CHEVROLET
Vehicle Identification Number
63700101
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 6
This report does not include any CJIS data.
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
01
Driver DistractionsNOT DISTRACTED
01
Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
A-1 TOWING
Towed Due To Damage
TOWED BUT NOT DUE TO DISABLING DAMAG
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
6--REAR, 7--LEFT REAR CORNER, 8--LEFT SIDE REAR
Initial Contact Point
7--LEFT REAR CORNER
Bus UseNOT A BUSBody Style
PK - PICKUP
Color
WHI - WHITE
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
Event
02
Event
03
Event
04
IndividualInsurance Company
PROGRESSIVE-CLASSIC-INS-CO
Policy Holder
UN
I
T
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
HAYWARD, WI 54843 , US
Race
WHITEDate of Birth
05/27
Sex
MALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 6
This report does not include any CJIS data.
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
1
01
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
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
1
01
Tint ComplianceEye Protection
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
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 FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
25
Pre 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
UTILITY TRUCK/PICKUP TRUCK02
Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Model
F250 SUPER
Year
2004
Make
FORD
Vehicle Identification Number
68140202
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 6
This report does not include any CJIS data.
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
02
Driver DistractionsNOT 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
Extent Of Damage
NO DAMAGE
Vehicle Damage
NO DAMAGE
Initial Contact Point
7--LEFT REAR CORNER
Bus UseNOT A BUSBody Style
PK - PICKUP
Color
GRY - GRAY
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
Event
02
Event
03
Event
04
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
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
03/15/
Sex
MALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 6
This report does not include any CJIS data.
18111116130
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13W8HL7 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
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
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00
2
02
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 12:20 PM
Crash Date 11/11/2018Wisconsin Motor Vehicle Crash
Form DT4000 6 of 6
This report does not include any CJIS data.