HomeMy WebLinkAbout20180723 JOHNSON.pdfSAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRX WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
NON-DOMESTICATED ANIMAL W/ NO INJURYReportable
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
03:04 PM
Date Notified
07/23/2018
Time ArrivedDate ArrivedCrash Time
03:01 PM
Crash Date
07/23/2018
Investigating Officer/Deputy
DEPUTY NATHAN FREY
Agency Crash Number
18072304
Primary Crash Document #Document Number Override
6V
L
1
3
Z
Q
K
R
X
Structure Type
NO STRUCTURE
Y Coordinate
5078221
X Coordinate
191155.328125
Longitude
-90.973542418
Latitude
45.788410925
ON CTHW
0.38 MI E
OF LAKE WINTER RD S
IN THE TOWN OF WINTER
IN SAWYER COUNTY
Location
Special StudyAccess ControlTribal Land
Crash Classification - Jurisdiction
NO SPECIAL JURISDICTION
Crash Classification - Location
PUBLIC PROPERTY
Relation To Trafficway
TRAFFICWAY - ON ROAD
Animal Type
DEER
Weather Condition(s)
Environment Factor(s)
Roadway Factor(s)Road Surface Condition(s)
Light ConditionManner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ON ROADWAY
First Harmful Event
NON DOMESTICATED ANIMAL (ALIVE)
Crash Scene
Reporting Threshold
NO
Truck Bus or HazMat
NO
Road GradeRoad CurvatureSurface Type
Traffic Control Inoperative/MissingTraffic ControlTraffic Way
Emergency Motor Vehicle UseSpecial FunctionMost Harmful Event: Collision With
NON DOMESTICATED ANIMAL (ALIVE)
Total LanesSpeed LimitPre CrashTire
Mark
Direction Of Travel
EASTBOUND
Insurance?
YES
Total HazMat Types
0
Total TrailersTotal # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
(SPORT) UTILITY VEHICLE01
Unit Type
AUTOMOBILE
Vehicle Operating As Classification
D CLASS
Unit Status
IN TRANSIT
Unit Summary
UN
IT
Vehicle
Crash Time 03:01 PM
Crash Date 07/23/2018This report does not include any CJIS data.
3of1
Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRX WISCONSIN MOTOR VEHICLE
CRASH REPORT
01
Driver DistractionsNOT DISTRACTED
01
Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
9--LEFT SIDE MIDDLE, 10--LEFT SIDE FRONT, 11--LEFT FRONT CORNER, 12--
FRONT
Initial Contact Point
11--LEFT FRONT CORNER
Bus UseBody Style
UT - SPORT UTILITY VEHICLE
Color
GRY - GRAY
Model
UTILITY
Year
2017
Make
HYUNDAI
Vehicle Identification Number
455280101
Country of Issuance
UNITED STATES
St
IL
Plate Type
AUT - AUTOMOBILE
License Plate Number
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
IndividualInsurance Company
STATE-FARM-GENERAL-INS-CO
Policy Holder
UN
I
T
Injury
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/ExtricatedEjection PathEjected
AirbagInjury 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: ILLINOIS COUNTRY: UNITED STATES
Address
PRINCETON, IL 61356 , US
Race
WHITEDate of Birth
03/02
Sex
MALE
Citations Issued
0
Driver
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 03:01 PM
Crash Date 07/23/2018This report does not include any CJIS data.
3of2
Wisconsin Motor Vehicle Crash
Form DT4000
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13ZQKRX 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 UseSuspected Alcohol Use
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 03:01 PM
Crash Date 07/23/2018This report does not include any CJIS data.
3of3
Wisconsin Motor Vehicle Crash
Form DT4000