HomeMy WebLinkAbout20181216 ELLIS.pdf18121602
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
PRIVATE PROPERTY/PARKING LOTReportable
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
10:17 AM
Date Notified
12/16/2018
Time Arrived
10:21 AM
Date Arrived
12/16/2018
Crash Time
10:17 AM
Crash Date
12/16/2018
Investigating Officer/Deputy
DEPUTY RYAN SCHICK
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
C
7
1
3
Z
Additional InformationNONE, PHOTOS
Photos ByOFFICER MARUCHA
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON DECEMBER 16, 2018, I, DEPUTY RYAN SCHICK OF THE SAWYER COUNTY SHERIFF'S DEPT WAS ON PATROL. I RECEIVED A REPORT OF A
VEHICLE STRIKING ANOTHER VEHICLE AT THE EDELWEISS MOTEL. I ARRIVED ON SCENE AND STOPPED THE SUSPECT VEHICLE ON PARK RD. THE
ACCIDENT OCCURRED IN THE PARKING LOT OF EDELWEISS MOTEL, HOWEVER. I MADE CONTACT WITH THE SUSPECT, . APPEARED TO BE INTOXICATED. REFUSED FIELD SOBRIETY BUT WAS PLACED IN CUSTODY FOR OWI AS SHE HAD MULTIPLE INDICATORS OF
IMPAIRMENT SUCH AS SLURRED SPEECH, STRONG ODOR, BLOODSHOT AND GLOSSY EYES, AND SWAYED WHILE STANDING. THE VICTIM AND
OWNER OF EDELWEISS, SHOWED ME HIS VEHICLE THAT GOT STRUCK AND PUSHED COMPLETELY OUT OF ITS PARKING STALL IN
FRONT OF THE MOTEL. HE STATED THERE WAS A LOT OF DAMAGE UNDERNEATH THE TRUCK AND POSSIBLE AN AXEL THAT BROKE AS WELL.
OFFICER MARUCHA PHOTOGRAPHED THE SCENE FOR ME WHILE I TRANSPORTED TO THE SAWYER COUNTY JAIL. PLEASE SEE SWSO CASE
#: 18121602 FOR MORE DETAILS.
Crash Time 10:17 AM
Crash Date 12/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
18121602
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5102826.5
X Coordinate
151670.578125
Longitude
-91.497882842
Latitude
45.990420576
ON PARK RD
140 FT E
OF STH27 NB
IN THE TOWN OF HAYWARD
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
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
08--FRONT TO SIDE
First Harmful Event Location
IN PARKING LANE OR ZONE
First Harmful Event
PARKED MOTOR VEHICLE
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 IN TRANSPORT
Total Lanes
0
Speed Limit
15Pre 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
0
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01
Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
LEGALLY PARKED
Unit Summary
UN
IT
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
4--RIGHT SIDE REAR, 5--RIGHT REAR CORNER, 6--REAR
Initial Contact Point
5--RIGHT REAR CORNER
Bus UseNOT A BUSBody Style
PK - PICKUP
Color
BLK - BLACK
Model
SILVERADO
Year
2001
Make
CHEVROLET
Vehicle Identification Number
74790101
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 10:17 AM
Crash Date 12/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
18121602
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Z 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
LEGALLY PARKED
Vehicle Removed By
OWNER
Towed Due To Damage
NOT TOWED
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventPARKED MOTOR VEHICLE01
EventMOTOR VEH IN TRANSPORT02
Event
03
Event
04
IndividualInsurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UN
I
T
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
PARKED MOTOR VEHICLE
Total Lanes
0
Speed Limit
15Pre CrashTire
Mark
Direction Of Travel
NOT ON ROADWAY
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
1
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER CAR02
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - AUTOMOBILE
License Plate Number
Vehicle
Crash Time 10:17 AM
Crash Date 12/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
18121602
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
HAYWARD, WI 54843 , US
Owner Name
02
Driver DistractionsOTHER DISTRACTION
02
Driver Actions
OTHER CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
GOING STRAIGHT
Vehicle Removed ByTowed Due To Damage
NOT TOWED
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
1--RIGHT FRONT CORNER, 12--FRONT
Initial Contact Point
12--FRONT
Bus UseNOT A BUSBody Style
4H - HATCHBACK 4 DOOR
Color
WHI - WHITE
Model
SANTA FE
Year
2013
Make
HYUNDAI
Vehicle Identification Number
47600202
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
EventPARKED MOTOR VEHICLE02
Event
03
Event
04
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
WHITEDate of Birth
03/18/
Sex
FEMALE
Citations Issued
01
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 10:17 AM
Crash Date 12/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
18121602
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13C713Z WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
UNDER THE INFLUENCE OF MEDICATIONS/DRUGS/ ALCOHOL
Drug Type
00
1
02
Drug Test ResultsDrug Test TypeDrug Test Given
TEST 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
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
NON DEPLOYED
Injury Severity
NO APPARENT INJURY00
1
02
Tint ComplianceEye Protection
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Violations
DescriptionOPERATING WHILE UNDER THE INFLUENCE(3RD)Seq Num003Statute Number346.63(1)(A)Issue To?
001
UTC Number
AE53858201
Crash Time 10:17 AM
Crash Date 12/16/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.