HomeMy WebLinkAbout20181107 SORENSEN.pdf18110701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0P 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
01
Time Notified
07:47 AM
Date Notified
11/07/2018
Time Arrived
08:14 AM
Date Arrived
11/07/2018
Crash Time
07:45 AM
Crash Date
11/07/2018
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
2
X
V
N
0
P
Additional InformationPHOTOS
Photos ByDEPUTY KEVIN GILLIS
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
VEHICLE WAS TRAVELING WEST ON STH 77 WHEN IT CROSSED INTO THE EASTBOUND LANE THEN INTO THE SOUTH SIDE DITCH. THE VEHICLE
ROLLED AN UNKNOWN AMOUNT OF TIMES AND CAME TO REST IN THE SOUTH SIDE DITCH ON ITS TOP.
Crash Time 07:45 AM
Crash Date 11/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
18110701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0P WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5109999
X Coordinate
181768.671875
Longitude
-91.115079469
Latitude
46.069431251
ON STH77 WB
0.49 MI W
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
Weather Condition(s)
SNOW
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
WET, SNOW, SLUSH
Light Condition
DAYLIGHT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ON ROADWAY
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
LEVEL
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 Use
NON-EMERGENCY, NON-TRANSPORT
Special Function
NO SPECIAL FUNCTIONMost Harmful Event: Collision With
OVERTURN/ROLLOVER
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
(SPORT) UTILITY VEHICLE01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Extent Of Damage
MINOR DAMAGE
Vehicle Damage
8--LEFT SIDE REAR, 11--LEFT FRONT CORNER, TOP
Initial Contact Point
12--FRONT
Bus UseNOT A BUSBody Style
UT - SPORT UTILITY VEHICLE
Color
PLE - PURPLE
Model
CHEROKEE
Year
1999
Make
JEEP
Vehicle Identification Number
41570101
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 07:45 AM
Crash Date 11/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
18110701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0P WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
01
Driver DistractionsUNKNOWN IF DISTRACTED
01
Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
TOWED DUE TO DISABLING DAMAGE
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
EventDITCH02
EventOVERTURN/ROLLOVER03
Event
04
IndividualInsurance Company
GEICO-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
HAYWARD, WI 54843 , US
Race
WHITE
Date of Birth
03/31/
Sex
MALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 07:45 AM
Crash Date 11/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
18110701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN0P 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
Crash Time 07:45 AM
Crash Date 11/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.