HomeMy WebLinkAbout20181116 schumacher-mussehl.pdf18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ 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
02
Total Units
02
Time Notified
06:05 PM
Date Notified
11/16/2018
Time Arrived
06:26 PM
Date Arrived
11/16/2018
Crash Time
06:04 PM
Crash Date
11/16/2018
Investigating Officer/Deputy
DEPUTY AMANDA REED
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
J
5
5
K
Q
Additional InformationPHOTOS, RECONSTRUCTION
Photos ByDEPUTY AMANDA REED
Reconstruction BySTATE PATROL DOC NUMBERS
ONLY
Diagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
SEE NARRATIVE FOR CASE # 18111611
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5067730.5
X Coordinate
147871.140625
Longitude
-91.521165934
Latitude
45.673584358
INTERSECTION
ON STH48 WB
AT CTHF NB
IN THE TOWN OF EDGEWATER
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
08--FRONT TO SIDE
First Harmful Event Location
ON ROADWAY
First Harmful Event
MOTOR VEH IN TRANSPORT
Crash Scene
Intersection Type
T-INTERSECTION
Junction Location
INTERSECTION-RELATED
Within Interchange Area
NO
Time Scene Cleared
09:23 PM
Date Scene Cleared
11/16/2018
Time All Lanes Open
09:20 PM
Date All Lanes Open
11/16/2018
Time Initial Lane/Rd Closed
06:30 PM
Date Initial Lane/Rd Closed
11/16/2018
Reasons for Closure
LAW ENFORCEMENT, TOW TRUCK, FIRE/EMS
Closure Type
FULL CLOSURE
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 FUNCTION
Most Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
2
Speed Limit
55
Pre CrashTire
Mark
Direction Of Travel
WESTBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
2
Train/Bus # InjuredTotal Occs
2
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
Model
TUNDRA
Year
2006
Make
TOYOTA
Vehicle Identification Number
04280101
Country of Issuance
UNITED STATES
St
WI
Plate Type
LTK - LIGHT TRUCK
License Plate Number
Vehicle
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
JUNEAU, WI 53039 , US
Owner Name
01
Driver DistractionsLOOKED BUT DID NOT SEE
01
Driver Actions
FAILED TO YIELD RIGHT-OF-WAY
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
U TURN
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
8--LEFT SIDE REAR, 9--LEFT SIDE MIDDLE, 10--LEFT SIDE FRONT, 11--LEFT
FRONT CORNER
Initial Contact Point
9--LEFT SIDE MIDDLE
Bus UseNOT A BUSBody Style
4D - 4DR
Color
MAR - MAROON (BURGUNDY)
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
EventMOTOR VEH IN TRANSPORT02
Event
03
Event
04
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
HORICON, WI 53032 , US
Race
WHITE
Date of Birth
03/09
Sex
MALE
Citations Issued
2
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00
1
01
Drug Test ResultsPENDING
Drug Test Type
BLOODDrug Test GivenTEST GIVEN
Alcohol Test Results
PENDING
Alcohol Test Type
BLOOD
Alcohol Test Given
TEST GIVEN
Suspected Drug Use
YES
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
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00
1
01
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
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
2
01
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
JUNEAU, WI 53039 , US
Race
WHITEDate of Birth
08/13/
Sex
MALE
Citations Issued
0
Passenger
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
2
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
DescriptionCAUSE INJURY/OPERATE WHILE UND INFLUENCESeq Num001Statute Number346.63(2)Issue To?
001
UTC Number
AD01192801
DescriptionOPERATING W/PAC-(1ST W/PASS <16 YRS) (PAC>=0.15)Seq Num033Statute Number346.63(1)(b)Issue To?
001
UTC Number
AD01192902
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
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
55Pre CrashTire
Mark
Direction Of Travel
EASTBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
2
Operating As EndorsementsVehicle Type
PASSENGER CAR02
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Bus UseNOT A BUSBody Style
4D - 4DR
Color
BLK - BLACK
Model
OUTLOOK
Year
2000
Make
SATURN
Vehicle Identification Number
0420202
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
WINTER, WI 54896 , US
Owner Name
02
Driver DistractionsNOT DISTRACTED
02
Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
TOWED DUE TO DISABLING DAMAGE
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
12--FRONT
Initial Contact Point
12--FRONT
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
EventMOTOR VEH IN TRANSPORT02
Event
03
Event
04
IndividualInsurance Company
PROGRESSIVE-UNIVERSAL-INSURANCE-COMP
Policy Holder
UN
I
T
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
WINTER, WI 54896 , US
Race
WHITE
Date of Birth
07/20/
Sex
FEMALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 6 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
3
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
LAKEVIEW MEDICAL CENTER
EMS Run #
1
EMS Agency Identifier
1
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
DEPLOYED-FRONT
Injury Severity
SUSPECTED SERIOUS INJUR00
3
02
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Injury
EMS Run #
1
EMS Agency Identifier
1
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
DEPLOYED-SIDE
Injury Severity
SUSPECTED MINOR INJURY00
4
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 NumberAddress
WINTER, WI 54896 , US
Race
WHITEDate of Birth
03/03
Sex
MALE
Citations Issued
0
Passenger
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 7 of 8
This report does not include any CJIS data.
18111611
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KQ WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00
4
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
LAKEVIEW MEDICAL CENTER
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 06:04 PM
Crash Date 11/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 8 of 8
This report does not include any CJIS data.