HomeMy WebLinkAbout20180728 MARTIN.pdf18072807
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTK6 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
02
Total Units
01
Time Notified
04:24 PM
Date Notified
07/28/2018
Time Arrived
04:40 PM
Date Arrived
07/28/2018
Crash Time
04:24 PM
Crash Date
07/28/2018
Investigating Officer/Deputy
SERGEANT GREG RIPCZINSKI
Agency Crash Number
18072807
Primary Crash Document #Document Number Override
6V
L
1
5
C
P
T
K
6
Additional InformationNone, Photos
Photos BySGT GREG RIPCZINSKI
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT # 1 WAS EASTBOUND ON STH 70, WHILST NEGOTIATING A CURVE IN THE ROADWAY, OPERATOR STATED STEERING FAILED, SKIDDING INTO THE DITCH LINE AREA OF THE EASTBOUND LANE. OPERATOR AND PASSENGER WERE THROWN FROM THE VEHICLE, WHERE UNIT #1 THEN
COLLIDED WITH THE OPERATOR COMING TO REST.
Crash Time 04:24 PM
Crash Date 07/28/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
18072807
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTK6 Wisconsin Motor Vehicle
Crash Report
Structure Type
No Structure
Y Coordinate
5083256.5
X Coordinate
213883.375
Longitude
-90.684747487
Latitude
45.843425592
ON STH70 EB
52 FT W
OF TN RD 30
IN THE TOWN OF DRAPER
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 - On Road
Animal Type
Weather Condition(s)
Cloudy
Environment Factor(s)
None
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
Ditch
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
Two-Way, Not Divided
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Fell/Jumped From Motor Vehicle
Total Lanes
2
Speed Limit
55Pre CrashTire
Mark
Direction Of Travel
Eastbound
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
2
Operating As EndorsementsVehicle Type
Motorcycle
Unit Type
Motorcycle
Vehicle Operating As Classification
M CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Minor Damage
Vehicle Damage
10--Left Side Front
Initial Contact Point
9--Left Side Middle
Bus UseNot A BusBody Style
MC - MOTORCYCLE
Color
RED - Red
Model
FXST CUSTO
Year
1989
Make
HARLEY DAVIDSON
Vehicle Identification Number
1HD1BKL15K
Country of Issuance
UNITED STATES
St
WI
Plate Type
CYC - Cycle
License Plate Number
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 04:24 PM
Crash Date 07/28/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
18072807
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTK6 Wisconsin Motor Vehicle
Crash Report
Driver DistractionsUnknown If Distracted
Driver Actions
No Contributing Action
Driver Prior Action Other
Vehicle Factors
Steering
What Driver Was Doing
Negotiating Curve
Vehicle Removed By
OWNER
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Address
PHILLIPS, WI 54555 , US
Individual
01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventDitch01
EventFell/Jumped From Motor Vehicle02
Event
03
Event
04
IndividualInsurance Company
AMERICAN-FAMILY-INS-CO
Policy Holder
UN
I
T
Crash Time 04:24 PM
Crash Date 07/28/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
18072807
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTK6 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
FLAMBEAU HOSPITAL
EMS Run #EMS Agency Identifier
6000182
Medical Transport
EMS Ground
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Applicable
Airbag
Not Applicable
Injury Severity
Suspected Serious Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint Compliance
UNKNOWN
Eye Protection
Yes: Worn and Windshield
Helmet Compliance
Unknown
Helmet Use
No
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
1
Protective Gear
Gloves, Jacket
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
PHILLIPS, WI 54555 , US
RaceWHITEDate of Birth
11/08
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
Crash Time 04:24 PM
Crash Date 07/28/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
18072807
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL15CPTK6 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 Applicable
Airbag
Non Deployed
Injury Severity
Possible Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint Compliance
UNKNOWN
Eye Protection
Yes: Worn and Windshield
Helmet Compliance
Unknown
Helmet Use
No
Seat Position
4--Second Seat-Left Side(Motorcycle/Bicycle Pa
00
2
Protective Gear
Boots, Jacket
On Duty Crash
01
ber
State: Wisconsin Country: UNITED STATES
Address
PHILLIPS, WI 54555 , US
RaceWHITEDate of Birth
11/11/
Sex
Female
Citations Issued
0
Passenger
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 04:24 PM
Crash Date 07/28/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.