HomeMy WebLinkAbout20181108 smith.pdfSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12WMLW1 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
08:32 PM
Date Notified
11/08/2018
Time Arrived
09:48 PM
Date Arrived
11/08/2018
Crash Time
08:32 PM
Crash Date
11/08/2018
Investigating Officer/Deputy
DEPUTY CASEY CULHANE
Agency Crash Number
18110807
Primary Crash Document #Document Number Override
6V
L
1
2
W
M
L
W
1
Additional InformationNONE, PHOTOS,
RECONSTRUCTION
Photos ByDEPUTY CULHANE
Reconstruction BySAWYER COUNTY SHERIFFDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS TRAVELING SOUTH ON HWY 40 NEGOTIATING A LEFT TURN. UNIT 1 LEFT THE ROADWAY WHEN THE ROAD STRAIGHTENED OUT. UNIT 1
THEN ROLLED OVER LANDING IN THE WEST DITCH ON ITS ROOF. THE ROAD CONDITIONS AT THE TIME WERE SNOW COVERED AND SLIPPERY.
Crash Time 08:32 PM
Crash Date 11/08/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12WMLW1 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5070435.5
X Coordinate
171130.40625
Longitude
-91.225207219
Latitude
45.709286089
ON STH40 SB
0.66 MI S
OF BALCZEWSKI RD
IN THE TOWN OF WEIRGOR
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)
SNOW, FREEZING RAIN OR FREEZING DRIZZLE
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
ROAD SURFACE CONDITION (WET, ICY, SNOW, SLUSH,
ETC)
Road Surface Condition(s)
SNOW, ICE
Light Condition
DARK/UNLIT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
SHOULDER RIGHT
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 LEFT
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
OVERTURN/ROLLOVER
Total Lanes
02
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
NO
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
01
Train/Bus # InjuredTotal Occs
01
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
FUNCTIONAL DAMAGE
Vehicle Damage
TOP
Initial Contact Point
TOP
Bus UseNOT A BUSBody Style
4D - 4DR
Color
BLK - BLACK
Model
G6
Year
2006
Make
PONTIAC
Vehicle Identification Number
21600101
Country of Issuance
UNITED STATES
St
OK
Plate Type
AUT - AUTOMOBILE
License Plate Number
VE
H
I
C
L
E
UN
I
T
Vehicle
Crash Time 08:32 PM
Crash Date 11/08/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12WMLW1 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner AddressOwner Name
01
Driver DistractionsUNKNOWN IF DISTRACTED
01
Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed By
ROADRUNNER TOWING
Towed Due To Damage
TOWED BUT NOT DUE TO DISABLING DAMAG
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventOVERTURN/ROLLOVER01
Event
02
Event
03
Event
04
Injury
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
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
, US
Race
WHITEDate of Birth
06/17
Sex
MALE
Citations Issued
01
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 08:32 PM
Crash Date 11/08/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 4
This report does not include any CJIS data.
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12WMLW1 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
NOT OBSERVED
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
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Violations
DescriptionOPERATE MOTOR VEHICLE W/O INSURANCESeq Num001Statute Number344.62(1)Issue To?
001
UTC Number
BB32846601
Crash Time 08:32 PM
Crash Date 11/08/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.