HomeMy WebLinkAbout20180726 OLSON.pdf18072609
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14ZCGFC 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
01
Time Notified
08:03 PM
Date Notified
07/26/2018
Time Arrived
08:33 PM
Date Arrived
07/26/2018
Crash Time
08:03 PM
Crash Date
07/26/2018
Investigating Officer/Deputy
DEPUTY SEAN ANDERSON
Agency Crash Number
18072609
Primary Crash Document #Document Number Override
6V
L
1
4
Z
C
G
F
C
Additional InformationPhotos
Photos ByS ANDERSON
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
DRIVER OF UNIT 1 WAS TRAVELING SOUTH ON HIGHLINE RD. DRIVER STATES 2 DEER JUMPED OUT IN FRONT OF HIM. DRIVER APPLIED THE BRAKES AND RIGHT SIDE TIRES WENT INTO DITCH ON WEST SIDE OF ROAD. DRIVER OF UNIT 1 WAS ABLE TO GET TRUCK ONTO ROAD BUT LOST
CONTROL. UNIT 1 SKIDDED ACROSS HIGHLINE ROAD AND WENT INTO DITCH ON EAST SIDE OF ROAD. UNIT 1 THEN ROLLED OVER ONTO ITS ROOF.
Crash Time 08:03 PM
Crash Date 07/26/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
18072609
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14ZCGFC Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5099649
X Coordinate
154600.09375
Longitude
-91.457878025
Latitude
45.963389338
ON HIGHLINE RD
0.56 MI N
OF WILLIAMS RD
IN THE TOWN OF BASS LAKE
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
Deer
Weather Condition(s)
Cloudy, Rain
Environment Factor(s)
Animal (s) in roadway
Roadway Factor(s)
None
Road Surface Condition(s)
Wet
Light Condition
Daylight
Manner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
Shoulder Left
First Harmful Event
Ditch
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Non-Junction
Within Interchange Area
NO
Time Roadway Repaired
10:35 PM
Date Roadway Repaired
07/26/2018
Time All Lanes Open
10:35 PM
Date All Lanes Open
07/26/2018
Time Initial Lane/Road Closed
09:44 PM
Date Initial Lane/Road Closed
07/26/2018
Reasons for Closure
Tow truck
Closure Type
Full closure
Reporting Threshold
One or more vehicles towed due to disabling damage
Truck Bus or HazMat
Any truck or truck combination > 10,000lbs GVWR/GCWR
Road Grade
Hillcrest
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
Overturn/Rollover
Total Lanes
2
Speed Limit
40Pre CrashTire
Mark
Direction Of Travel
Southbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
Straight Truck (Insert Truck)
Unit Type
Truck
Vehicle Operating As Classification
C CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Model
WORKHORSE
Year
2009
Make
NAVISTAR
Vehicle Identification Number
5B4JPD28993
Country of Issuance
UNITED STATES
St
WI
Plate Type
HTK - Heavy Truck
License Plate Number
01
Vehicle
Crash Time 08:03 PM
Crash Date 07/26/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
18072609
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14ZCGFC Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver ActionsSwerved or Avoided Due To Wind, Slippery Surface, Motor Vehicle, Object, Non-Motorist In Roadway, Etc.
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Going Straight
Vehicle Removed By
SWANT TOWING
Towed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Disabling Damage
Vehicle Damage
1--Right Front Corner, 2--Right Side Front, 3--Right Side Middle, 4--Right Side
Rear, 5--Right Rear Corner, Top
Initial Contact Point
Non-Collision
Bus UseNot A BusBody Style
TK - TRUCK
Color
BRO - Brown
VE
H
I
C
L
E
UN
I
T
Address
ANAHEIM, CA 92805 6441, US
Organization/Company
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventNon Domesticated Animal (Alive)01
EventRun Off Roadway Right02
EventDitch03
EventOverturn/Rollover04
Organization/CompanyInsurance Company
LIBERTY-MUTUAL-INS-CO
Policy Holder
UN
I
T
Crash Time 08:03 PM
Crash Date 07/26/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
18072609
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14ZCGFC 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
SPOONER, WI 54801 , US
RaceWHITEDate of Birth
11/02
Sex
Male
Citations Issued
0
Driver
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Address
ANAHEIM, CA 92805 6441, US
Name
Source
DriverUse Vehicle Owner Same as Carrier
01
Carrier
Crash Time 08:03 PM
Crash Date 07/26/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
18072609
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14ZCGFC Wisconsin Motor Vehicle
Crash Report
Measured WeightMeasured WidthMeasured LengthMeasured Height
Escort Vehicle PresentEscort Vehicle Required
By Permit
Permitted Vehicle On
Permitted Route
WI Permit NumberOS/OW Load
Permitted Load
Not Applicable
Carrier Type
Interstate Carrier
US DOT #
21800
Cargo Body Type
Van/Enclosed Box
Vehicle Configuration
Single-Unit Truck (2-Axle and GVWR More Than
GVWR
10,001-26,000 Lb
TR
U
C
K
B
U
S
UN
I
T
Crash Time 08:03 PM
Crash Date 07/26/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.