HomeMy WebLinkAbout20181017 BREMER.pdf18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB 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
03
Total Units
01
Time Notified
11:37 PM
Date Notified
10/17/2018
Time Arrived
11:37 PM
Date Arrived
10/17/2018
Crash Time
11:37 PM
Crash Date
10/17/2018
Investigating Officer/Deputy
DEPUTY MATTHEW JEFSON
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
5
1
T
J
N
B
Additional InformationPHOTOS
Photos ByDEPUTY MATTHEW JEFSON
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
I, DEPUTY MATTHEW JEFSON WAS PURSUING THIS VEHICLE FOR AROUND 21 MILES WHEN IT LOST CONTROL ON CTH B NEAR UNIVERSAL DR. THE
VEHICLE THAN CRASHED INTO THE NORTH DITCH OF CTH B.
Crash Time 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 6
This report does not include any CJIS data.
18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y Coordinate
5089853.5
X Coordinate
193090.890625
Longitude
-90.95610733
Latitude
45.893721131
ON CTHB EB
178 FT S
OF UNIVERSAL WAY
IN THE TOWN OF WINTER
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 - NOT 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
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER LEFT
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
CURVE RIGHT
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
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTIONMost Harmful Event: Collision With
DITCH
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
EASTBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # InjuredTotal Occs
3
Operating As EndorsementsVehicle Type
PASSENGER CAR01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
1--RIGHT FRONT CORNER, 2--RIGHT SIDE FRONT, 3--RIGHT SIDE MIDDLE, 12-
-FRONT, UNDERCARRIAGE
Initial Contact Point
1--RIGHT FRONT CORNER
Bus UseNOT A BUSBody Style
CV - CONVERTIBLE
Color
GRY - GRAY
Model
ECLIPSE
Year
2003
Make
MITSUBISHI
Vehicle Identification Number
57020101
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 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 6
This report does not include any CJIS data.
18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
MENOMONIE, WI 54751 , US
Owner Name
01
Driver DistractionsNOT DISTRACTED
01
Driver Actions
EXCEED SPEED LIMIT, FAILURE TO CONTROL, FAILED TO KEEP IN DESIGNATED LANE, OPERATED MOTOR VEHICLE IN
AGGRESSIVE/RECKLESS MANNER, OVER-CORRECTING/OVER-STEERING
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
ROAD RUNNER
Towed Due To Damage
TOWED BUT NOT DUE TO DISABLING DAMAG
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventDITCH01
Event
02
Event
03
Event
04
Injury
EMS Run #EMS Agency IdentifierMedical Transport
LAW ENFORCEMENT
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
SUSPECTED MINOR INJURY00
1
01
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
MENOMONIE, WI 54751 , US
Race
WHITEDate of Birth
03/15/
Sex
MALE
Citations Issued
1
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 6
This report does not include any CJIS data.
18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
EMOTIONAL (DEPRESSED, ANGRY, DISTURBED, ETC), UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
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
YES
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
HAYWARD AREA MEM HOSP
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
HAYWARD AREA MEM HOSP
EMS Run #
18101614793
EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
DEPLOYED-FRONT
Injury Severity
SUSPECTED MINOR INJURY00
2
01
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
3--FRONT SEAT-RIGHT SIDE (TRAIN ENGINEER
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
GREEN BAY, WI 54304 , US
Race
WHITEDate of Birth
03/28/
Sex
FEMALE
Citations Issued
0
Passenger
IT
Equipment
Non Motorist
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 6
This report does not include any CJIS data.
18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
2
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
UN
I
T
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
SUSPECTED MINOR INJURY00
3
01
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
6--SECOND SEAT-RIGHT SIDE
Safety Equipment
RESTRAINT USE UNKNOWN
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
BLK RIVER FALLS, WI 54615 , US
Race
WHITEDate of Birth
03/14/
Sex
MALE
Citations Issued
0
Passenger
IT
Equipment
Non Motorist
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 6
This report does not include any CJIS data.
18101701
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL151TJNB WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00
3
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
UN
I
T
IN
D
I
V
I
D
U
A
L
Violations
DescriptionFAILURE TO KEEP VEHICLE UNDER CONTROLSeq Num007Statute Number346.57(2)Issue To?
001
UTC Number
BB32929301
Crash Time 11:37 PM
Crash Date 10/17/2018Wisconsin Motor Vehicle Crash
Form DT4000 6 of 6
This report does not include any CJIS data.