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Home My WebLink About20181110 CAPRA-ROSS.pdfSAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 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 10:30 AM Date Notified 11/10/2018 Time Arrived 10:53 AM Date Arrived 11/10/2018 Crash Time 10:28 AM Crash Date 11/10/2018 Investigating Officer/Deputy DEPUTY NATHAN FREY Agency Crash Number 18111002 Primary Crash Document #Document Number Override 6V L 1 3 Z Q K S 1 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 TRAVELING WEST ON HIGHWAY 77. UNIT 2 WAS NEGOTIATING A LEFT TURN OFF OF HIGHWAY 77 ONTO ROSS ROAD. UNIT ONE STRUCK THE REAR BUMPER OF UNIT 2. UNIT 1 SUSTAINED A DAMAGED FRONT PASSENGER TIRE AND FENDER/ BUMPER. UNIT 2 RECEIVED DAMAGE TO REAR LIFT-GATE AND THE BUMPER COVER. Crash Time 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5110082 X Coordinate 182554.125 Longitude -91.1050044 Latitude 46.070541136 INTERSECTION ON STH77 WB AT 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 Weather Condition(s) SNOW Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) WET Light Condition DAYLIGHT Manner of Collision 08--FRONT TO SIDE First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT Crash Scene Intersection Type T-INTERSECTION Junction Location INTERSECTION Within Interchange Area NO Truck Bus or HazMat NO Road Grade HILLCREST 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 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 WESTBOUND 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 FUNCTIONAL DAMAGE Vehicle Damage 1--RIGHT FRONT CORNER, 12--FRONT Initial Contact Point 12--FRONT Bus UseNOT A BUSBody Style PK - PICKUP Color BLU - BLUE Model RAM TRUCK Year 2012 Make DODGE Vehicle Identification Number 53090101 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 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address CUMBERLAND, WI 54829 , US Owner Name 01 Driver DistractionsUNKNOWN IF DISTRACTED 01 Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT 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 Event 02 Event 03 Event 04 IndividualInsurance Company STATE-FARM-GENERAL-INS-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 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 CUMBERLAND, WI 54829 , US Race WHITE Date of Birth 12/20/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 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 NO Road Grade HILLCREST 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 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 EASTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type PASSENGER VAN02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 5--RIGHT REAR CORNER, 6--REAR, 7--LEFT REAR CORNER Initial Contact Point 5--RIGHT REAR CORNER Bus UseNOT A BUSBody Style VN - VAN Color BLU - BLUE Model GRAND CARA Year 2016 Make DODGE Vehicle Identification Number 95330202 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 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 02 Driver DistractionsUNKNOWN IF DISTRACTED 02 Driver Actions IMPROPER TURN Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing LEFT TURN 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 Individual PRUDENCE ROSS Insurance Company PROGRESSIVE-UNIVERSAL-INSURANCE-COMP 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 Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address HAYWARD, WI 54843 , US Race WHITE Date of Birth 09/14 Sex FEMALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13ZQKS1 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 Crash Time 10:28 AM Crash Date 11/10/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.