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Home My WebLink About20180609 Yohn Van Cuick.pdf18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Secondary CrashAmendedCrash Type DT4000 (Standard Crash)Reportable TagsSchool Bus Related NoActive School ZoneGovernment Property Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency Total Killed 00 Total Injured 00 Total Units 02 Time Notified 11:45 AM Date Notified 06/09/2018 Time Arrived 11:55 AM Date Arrived 06/09/2018 Crash Time 11:44 AM Crash Date 06/09/2018 Investigating Officer/Deputy DEPUTY AMANDA REED Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 3 J 5 5 K F Additional InformationPhotos Photos ByDEPUTY AMANDA REED Reconstruction ByDiagram Description Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. SEE CASE# 18060903 FOR NARRATIVE Structure Type No Structure Y Coordinate 5105598 X Coordinate 152874.96875 Longitude -91.484391838 Latitude 46.015897328 INTERSECTION ON THIRD ST AT KANSAS AVE IN THE CITY OF HAYWARD IN SAWYER COUNTY Location Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report 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 Daylight Manner of Collision 08--Front To Side First Harmful Event Location On Roadway First Harmful Event Motor Veh In Transport Crash Scene Intersection Type Four-Way Intersection Junction Location Intersection Within Interchange Area NO Reporting Threshold 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 UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Motor Veh In Transport Total Lanes 2 Speed Limit 15Pre CrashTire Mark Direction Of Travel Northbound Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 2 Operating As EndorsementsVehicle Type Utility Truck/Pickup Truck Unit Type Truck Vehicle Operating As Classification D CLASS Unit Status In Transit UN I T 01 Unit Summary Driver Actions Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Going Straight Vehicle Removed By OPERATOR Towed Due To Damage Not Towed01 Extent Of Damage Minor Damage Vehicle Damage 12--Front Initial Contact Point 12--Front Bus UseNot A BusBody Style 4D - 4DR Color RED - Red Model F150 Year 2005 Make FORD Vehicle Identification Number 41210 Country of Issuance UNITED STATES St WI Plate Type LTK - Light Truck License Plate Number HJ3334 VE H I C L E UN I T 01 Vehicle Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Driver DistractionsNot Distracted No Contributing Action VE H I C L E UN I T Address HAYWARD, WI 54843 , US IndividualCOLLEEN L VAN CUICK01 VE H I C L E OW N E R Vehicle Owner Sequence Of Events EventMotor Veh In Transport01 EventMotor Veh In Transport02 Event 03 Event 04 Individual LEROY YOHN Insurance Company RURAL-TRUST-INSURANCE-COMPANY Policy Holder UN I T Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Individual Condition Appeared Normal Drug Type Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given Test Not Given Suspected Drug UseSuspected Alcohol Use Action Other IN D I V I D U A L UN I T Action To/From SchoolLocationPrior ActionStriking Unit # 00 1 01 Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport Not Transported Trapped/Extricated Not Trapped Ejection Path Not Ejected/Not Applicable Ejected Not Ejected Airbag Non Deployed Injury Severity No Apparent Injury IN D I V I D U A L UN I T Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl 00 1 Safety Equipment Shoulder & Lap Belt On Duty Crash 01 ber State: Wisconsin Country: UNITED STATES Address HAYWARD, WI 54843 , US RaceWHITEDate of Birth 12/18/ Sex Male Citations Issued 0 DriverLEROY L YOHN IN D I V I D U A L UN I T Injury Drug & Alcohol Individual Non Motorist Equipment Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Individual Condition Appeared Normal Drug Type Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given Test Not Given Suspected Drug UseSuspected Alcohol Use Action Other IN D I V I D U A L UN I T Action To/From SchoolLocationPrior ActionStriking Unit # 00 2 01 Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport Not Transported Trapped/Extricated Not Trapped Ejection Path Not Ejected/Not Applicable Ejected Not Ejected Airbag Non Deployed Injury Severity No Apparent Injury IN D I V I D U A L UN I T Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 4--Second Seat-Left Side(Motorcycle/Bicycle Pa 00 2 Safety Equipment Shoulder & Lap Belt On Duty Crash 01 State: Wisconsin Country: UNITED STATES Address HAYWARD, WI 54843 , US RaceWHITEDate of Birth 10/05 Sex Female Citations Issued 0 PassengerBARBARA E YOHN IN D I V I D U A L UN I T Injury Drug & Alcohol Individual Non Motorist Equipment Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 5 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Reporting Threshold No 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 UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Motor Veh In Transport Total Lanes 2 Speed Limit 15Pre CrashTire Mark Direction Of Travel Eastbound Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type (Sport) Utility Vehicle Unit Type Automobile Vehicle Operating As Classification D CLASS Unit Status In Transit UN I T 02 Unit Summary Driver DistractionsLooked But Did Not See Driver ActionsNo Contributing Action Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Going Straight Vehicle Removed By OPERATOR Towed Due To Damage Not Towed VE H I C L E UN I T 02 Extent Of Damage Minor Damage Vehicle Damage 1--Right Front Corner Initial Contact Point 1--Right Front Corner Bus UseNot A BusBody Style 4D - 4DR Color RED - Red Model GRAND CHER Year 2011 Make JEEP Vehicle Identification Number 1 71126 Country of Issuance UNITED STATES St WI Plate Type AUT - Automobile License Plate Number 281VSY VE H I C L E UN I T 02 Vehicle HAYWARD, WI 54843 , US IndividualCOLLEEN L VAN CUICK02 VE H I C L E OW N E R Vehicle Owner Sequence Of Events EventMotor Veh In Transport01 Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 6 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report EventMotor Veh In Transport02 Event 03 Event 04 Individual COLLEEN VAN CUICK Insurance Company SECURA-INS-A-MUTUAL-CO Policy Holder UN I T Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 7 of 8 This report does not include any CJIS data. 18060903 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13J55KF Wisconsin Motor Vehicle Crash Report Individual Condition Appeared Normal Drug Type Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given Test Not Given Suspected Drug UseSuspected Alcohol Use Action Other IN D I V I D U A L UN I T Action To/From SchoolLocationPrior ActionStriking Unit # 00 3 02 Time of DeathDate of DeathHospital EMS Run #EMS Agency IdentifierMedical Transport Not Transported Trapped/Extricated Not Trapped Ejection Path Not Ejected/Not Applicable Ejected Not Ejected Airbag Non Deployed Injury Severity No Apparent Injury IN D I V I D U A L UN I T Tint ComplianceEye Protection Helmet ComplianceHelmet Use Seat Position 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl 00 3 Safety Equipment Shoulder & Lap Belt On Duty Crash 02 Driver License NumberV5221124595006 State: Wisconsin Country: UNITED STATES Address9631 WEST BRANT ROAD HAYWARD, WI 54843 , US RaceWHITEDate of Birth 12/10/1945 Sex Female Citations Issued 0 DriverCOLLEEN L VAN CUICK (715) 462-9491 IN D I V I D U A L UN I T Injury Drug & Alcohol Individual Non Motorist Equipment Crash Time 11:44 AM Crash Date 06/09/2018Wisconsin Motor Vehicle Crash Form DT4000 8 of 8 This report does not include any CJIS data.