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HomeMy WebLinkAbout20180706 smith.pdf18070606 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL12XVN0J 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 01 Total Units 01 Time Notified 03:16 PM Date Notified 07/06/2018 Time Arrived 03:31 PM Date Arrived 07/06/2018 Crash Time 03:00 PM Crash Date 07/06/2018 Investigating Officer/Deputy DEPUTY KEVIN GILLIS Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 2 X V N 0 J Additional InformationPhotos, Reconstruction Photos ByDEPUTY KEVIN GILLIS Reconstruction BySAWYER COUNTY SHERIFFDiagram Description Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. VEHICLE WAS TRAVELING NORTH ON CTH NN BY WORLDS END RD. THE DRIVER AVOIDED A BEAR AND BY DOING SO THE VEHICLE'S PASSENGER SIDE TIRES HIT THE EAST SIDE GRAVEL SHOULDER. THE VEHICLE LOST CONTROL AND ROLLED AN UNKNOWN AMOUNT OF TIMES BEFORE COMING TO REST ON ITS TOP APPROX 330 FEET FROM THE INITIAL CONTACT POINT WITH THE SHOULDER. Crash Time 03:00 PM Crash Date 07/06/2018Wisconsin Motor Vehicle Crash Form DT4000 1 of 4 This report does not include any CJIS data. 18070606 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL12XVN0J Wisconsin Motor Vehicle Crash Report Structure Type Y Coordinate 5100002 X Coordinate 165602.28125 Longitude -91.316540084 Latitude 45.972001801 INTERSECTION ON CTHNN AT WORLDS END RD IN THE TOWN OF HAYWARD 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 Bear Weather Condition(s) Clear Environment Factor(s) Animal (s) in roadway Roadway Factor(s) None Road Surface Condition(s) Dry Light Condition Daylight Manner of Collision No Collision W/Vehicle In Transport First Harmful Event Location On Roadway First Harmful Event Overturn/Rollover Crash Scene Intersection Type Not an Intersection Junction Location Non-Junction Within Interchange Area NO Reporting Threshold 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 Divided Hwy W/O Traffic Barrier Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With Overturn/Rollover Total Lanes 2 Speed Limit 55Pre CrashTire Mark Direction Of Travel Northbound Insurance? YES Total HazMat Types 0 Total Trailers 0 Total # Citations Issued 0 Train/Bus # InjuredTotal Occs 1 Operating As EndorsementsVehicle Type Passenger Car Unit Type Automobile Vehicle Operating As Classification D CLASS Unit Status In Transit UN I T 01 Unit Summary Extent Of Damage Disabling Damage Vehicle Damage All Areas Initial Contact Point Unknown Bus UseNot A BusBody Style 4D - 4DR Color BLU - Blue Model ACCORD Year 2006 Make HONDA Vehicle Identification Number 1HGCM56166A Country of Issuance UNITED STATES St WI Plate Type AUT - Automobile License Plate Number VE H I C L E UN I T 01 Vehicle Crash Time 03:00 PM Crash Date 07/06/2018Wisconsin Motor Vehicle Crash Form DT4000 2 of 4 This report does not include any CJIS data. 18070606 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL12XVN0J Wisconsin Motor Vehicle Crash Report Driver DistractionsUnknown If Distracted Driver Actions No Contributing Action Driver Prior Action Other Vehicle Factors Not Applicable What Driver Was Doing Going Straight Vehicle Removed By ROADRUNNER TOWING Towed Due To Damage Towed Due To Disabling Damage VE H I C L E UN I T 01 Address RICE LAKE, WI 54868 , US Individual 01 VE H I C L E OW N E R Vehicle Owner Sequence Of Events EventOverturn/Rollover01 Event 02 Event 03 Event 04 IndividualInsurance Company PEKIN-INS-CO Policy Holder UN I T Crash Time 03:00 PM Crash Date 07/06/2018Wisconsin Motor Vehicle Crash Form DT4000 3 of 4 This report does not include any CJIS data. 18070606 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL12XVN0J 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 HAYWARD AREA MEMORIAL HOSPITAL EMS Run #EMS Agency IdentifierMedical Transport Other Trapped/Extricated Not Trapped Ejection Path Not Ejected/Not Applicable Ejected Not Ejected Airbag Unknown Injury Severity Possible 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 Driver License NumberS5302050016907 State: Wisconsin Country: UNITED STATES Address2626 15TH ST RICE LAKE, WI 54868 , US RaceWHITEDate of Birth 05/09/2000 Sex Male Citations Issued 0 DriverETHAN E SMITH IN D I V I D U A L UN I T Injury Drug & Alcohol Individual Non Motorist Equipment Crash Time 03:00 PM Crash Date 07/06/2018Wisconsin Motor Vehicle Crash Form DT4000 4 of 4 This report does not include any CJIS data.