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Home My WebLink About20181101 MOORE-HUMER.pdf18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 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 05:02 PM Date Notified 11/01/2018 Time Arrived 05:10 PM Date Arrived 11/01/2018 Crash Time 05:00 PM Crash Date 11/01/2018 Investigating Officer/Deputy SERGEANT NICK ALMOGHRABI Agency Crash Number 18110106 Primary Crash Document #Document Number Override 6V L 1 5 G 5 W S 1 Additional InformationPHOTOS, OTHER DOCUMENTS Photos BySGT ALMOGHRABI Reconstruction ByDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. I, SGT. AL-MOGHRABI, WAS DISPATCHED TO A TWO VEHICLE PROPERTY DAMAGE CRASH IN THE SUBWAY PARKING LOT LOCATED AT 13827W CTH B IN THE TOWNSHIP OF HAYWARD ON 11/01/18 AT 1702. UPON ARRIVAL, I MET WITH THE TWO OPERATORS WHO WERE IDENTIFIED AS AND BOTH OF HAYWARD. WAS PULLING IN TO ONE OF THE WEST SIDE PARKING STALLS WHEN WAS BACKING UP FROM BEING PARKED IN FRONT OF SUBWAY ADVISED SHE DIDN'T SEE VEHICLE PULLING IN AS SHE BACKED UP. STATED HE SAW WAS BACKING UP SO HE OPTED TO TAKE THE PARKING SPOT WHERE HE DID. THE BACK OF FORD F150 STRUCK THE REAR DRIVER'S SIDE CORNER OF HUMER'S DODGE DAKOTA CAUSING DAMAGE TO THE REAR CORNER, REAR DRIVER'S SIDE BOX, AND THE WHEEL. BOTH HAD EXCHANGED INFORMATION PRIOR TO MY ARRIVAL INCLUDING INSURANCE INFORMATION. NO CITATIONS WERE ISSUED IN THIS CRASH HOWEVER MOORE WAS ADVISED THE CRASH REPORT WOULD INDICATE UNSAFE BACKING. Crash Time 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 6 This report does not include any CJIS data. 18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type HOUSE/BUILDING Y CoordinateX Coordinate LongitudeLatitudePARKING LOT CTHK LOT 13827W (HOUSE/BUILDING 13827W) IN THE TOWN OF HAYWARDIN SAWYER COUNTY Location Special StudyAccess Control NO CONTROL Tribal Land Crash Classification - Jurisdiction PRIVATE PROPERTY Crash Classification - Location PRIVATE PROPERTY Relation To Trafficway NON TRAFFICWAY - PARKING LOT Animal Type Weather Condition(s) CLEAR Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 07--REAR TO SIDE First Harmful Event Location OFF ROADWAY, LOCATION UNKNOWN First Harmful Event DOMESTICATED ANIMAL - DEAD 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 PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH TRAN OTHER RDWY Total Lanes 0 Speed Limit N/APre CrashTire Mark Direction Of Travel NOT ON ROADWAY 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 MINOR DAMAGE Vehicle Damage 6--REAR Initial Contact Point 6--REAR Bus UseNOT A BUSBody Style TK - TRUCK Color GRN - GREEN Model F150 Year 2007 Make FORD Vehicle Identification Number 591180101 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 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 6 This report does not include any CJIS data. 18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , US Owner Name 01 Driver DistractionsUNKNOWN IF DISTRACTED 01 Driver Actions UNSAFE BACKING Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing BACKING Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UN I T VE H I C L E Sequence Of Events EventMOTOR VEH TRAN OTHER RDWY01 Event 02 Event 03 Event 04 IndividualInsurance Company MADISON-MUTUAL-INSURANCE-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 INDIAN Date of Birth 04/03/ Sex FEMALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 6 This report does not include any CJIS data. 18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 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 LEVEL Road Curvature STRAIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control NO CONTROL Traffic Way PARKING LOT OR PRIVATE PROPERTY Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH TRAN OTHER RDWY Total Lanes 0 Speed Limit N/APre CrashTire Mark Direction Of Travel NOT ON ROADWAY 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 TRUCK02 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage MINOR DAMAGE Vehicle Damage 7--LEFT REAR CORNER, 8--LEFT SIDE REAR Initial Contact Point 7--LEFT REAR CORNER Bus UseNOT A BUSBody Style TK - TRUCK Color WHI - WHITE Model DAKOTA Year 1997 Make DODGE Vehicle Identification Number 84700202 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 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 6 This report does not include any CJIS data. 18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address HAYWARD, WI 54843 , 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 PARK MANEUVER Vehicle Removed By OPERATOR Towed Due To Damage NOT TOWED UN I T VE H I C L E Sequence Of Events EventMOTOR VEH TRAN OTHER RDWY01 Event 02 Event 03 Event 04 IndividualInsurance Company SENTRY-INS-A-MUTUAL-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 Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address HAYWARD, WI 54843 , US Race WHITE Date of Birth 02/08/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 6 This report does not include any CJIS data. 18110106 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL15G5WS1 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 05:00 PM Crash Date 11/01/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 6 This report does not include any CJIS data.