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Home My WebLink About20181019 CULHANE-HAYNES.pdf18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F 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 10:52 PM Date Notified 10/19/2018 Time Arrived 10:55 PM Date Arrived 10/19/2018 Crash Time 10:52 PM Crash Date 10/19/2018 Investigating Officer/Deputy DEPUTY IAN HALL Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 3 0 3 P 3 F Additional InformationRECONSTRUCTION Photos By Reconstruction BySAWYER COUNTY SHERIFFDiagram Description I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. SEE SAWYER COUNTY CASE #18101908 Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type NO STRUCTURE Y Coordinate 5086217.5 X Coordinate 152630.34375 Longitude -91.473511925 Latitude 45.841872064 ON SAND LAKE RD 38 FT W OF CTHF WB IN THE TOWN OF SAND LAKE IN SAWYER COUNTY Location Special StudyAccess Control PARTIAL 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) CLEAR Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DARK/UNLIT Manner of Collision 06--SIDESWIPE/OPPOSITE DIRECTION 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 LEVEL Road Curvature STRAIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control STOP SIGN Traffic Way TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NON-EMERGENCY, NON-TRANSPORT Special Function POLICEMost Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 45Pre 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 (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 7--LEFT REAR CORNER Initial Contact Point 7--LEFT REAR CORNER Bus UseNOT A BUSBody Style UT - SPORT UTILITY VEHICLE Color BLK - BLACK Model EXPLORER Year 2018 Make FORD Vehicle Identification Number 88170101 Country of Issuance UNITED STATES St WI Plate Type MUN - MUNICIPAL License Plate Number VE H I C L E UN I T Vehicle Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F 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 SLOW/STOPPING 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 GovernmentInsurance Company COUNTRY-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 POLICE STATE: WISCONSIN COUNTRY: UNITED STATES Address MINONG, WI 54859 , US Race WHITE Date of Birth 05/20/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F 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 STOP SIGN 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 45Pre CrashTire Mark Direction Of Travel WESTBOUND Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 2 Operating As EndorsementsVehicle Type (SPORT) UTILITY VEHICLE02 Unit Type AUTOMOBILE Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage MINOR DAMAGE Vehicle Damage 11--LEFT FRONT CORNER Initial Contact Point 11--LEFT FRONT CORNER Bus UseNOT A BUSBody Style UT - SPORT UTILITY VEHICLE Color DBL - BLUE, DARK Model WRANGLER Year 2007 Make JEEP Vehicle Identification Number 31630202 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 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F WISCONSIN MOTOR VEHICLE CRASH REPORT Owner Address 6241N MORNINGSIDE LN STONE LAKE, WI 54876 , US Owner Name ZANE G HAYNES 02 Driver DistractionsUNKNOWN IF DISTRACTED 02 Driver Actions FAILED TO KEEP IN DESIGNATED LANE Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing RIGHT TURN Vehicle Removed ByTowed Due To Damage TOWED BUT NOT DUE TO DISABLING DAMAG UN I T VE H I C L E Sequence Of Events EventMOTOR VEH IN TRANSPORT01 EventRIGHT TURN02 Event 03 Event 04 IndividualInsurance Company ERIE-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 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 STONE LAKE, WI 54876 , US Race WHITE Date of Birth 08/01/ Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL Drug Type 00 2 02 Drug Test ResultsDrug Test TypeDrug Test GivenTEST NOT GIVEN Alcohol Test Results PENDING Alcohol Test Type BLOOD Alcohol Test Given TEST GIVEN Suspected Drug Use NO Suspected Alcohol Use YES 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 STONE LAKE, WI 54876 , US Race WHITEDate of Birth 11/26/ Sex MALE Citations Issued 0 Passenger IT Equipment Non Motorist Individual UN IN D I V ID U A L Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 7 This report does not include any CJIS data. 18101908 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL1303P3F WISCONSIN MOTOR VEHICLE CRASH REPORT Drug & Alcohol Individual Condition APPEARED NORMAL, UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL 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 Crash Time 10:52 PM Crash Date 10/19/2018Wisconsin Motor Vehicle Crash Form DT4000 7 of 7 This report does not include any CJIS data.