HomeMy WebLinkAbout20190124 LANE.pdfSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD74 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
07:03 AM
Date Notified
01/24/2019
Time Arrived
07:10 AM
Date Arrived
01/24/2019
Crash Time
07:02 AM
Crash Date
01/24/2019
Investigating Officer/Deputy
DEPUTY CALEB JORSTAD
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
4
V
W
D
7
4
Additional InformationNONE, PHOTOS
Photos ByDEPUTY JORSTAD
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
WAS TRAVELING NORTHBOUND ON STATE HIGHWAY 40 WHEN HE HIT A PATCH OF ICE, THE VAN ENTERED THE DITCH AND FLIPPED ON
TO THE PASSENGER SIDE.
Crash Time 07:02 AM
Crash Date 01/24/2019Wisconsin 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
6VL14VWD74 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5067104
X Coordinate
171758.703125
Longitude
-91.214905779
Latitude
45.679678158
ON STH40 NB
996 FT S
OF BLOMBERG 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)
CLEAR
Environment Factor(s)
WEATHER CONDITIONS
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY, ICE
Light Condition
DAYLIGHT
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
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
DITCH
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
NORTHBOUND
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
PASSENGER VAN01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Extent Of Damage
DISABLING DAMAGE
Vehicle Damage
3--RIGHT SIDE MIDDLE, 12--FRONT
Initial Contact Point
12--FRONT
Bus UseNOT A BUSBody Style
VN - VAN
Color
GRY - GRAY
Model
GRAND CARA
Year
2001
Make
DODGE
Vehicle Identification Number
00170101
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 07:02 AM
Crash Date 01/24/2019Wisconsin 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
6VL14VWD74 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
BRUCE, WI 54819 , US
Owner Name
01
Driver DistractionsUNKNOWN IF DISTRACTED
01
Driver Actions
SPEED TOO FAST/COND
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
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventDITCH01
EventEMBANKMENT02
Event
03
Event
04
Injury
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
TRAPPED/EXTRICATED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT EJECTED
Airbag
UNKNOWN
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
BRUCE, WI 54819 , US
Race
WHITEDate of Birth
11/16/
Sex
MALE
Citations Issued
0
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 07:02 AM
Crash Date 01/24/2019Wisconsin 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
6VL14VWD74 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
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 07:02 AM
Crash Date 01/24/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 4
This report does not include any CJIS data.