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Home My WebLink About20180817 ASP-ANDERSON.pdf18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 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 02 Time Notified 09:19 AM Date Notified 08/17/2018 Time Arrived 09:22 AM Date Arrived 08/17/2018 Crash Time 09:19 AM Crash Date 08/17/2018 Investigating Officer/Deputy DEPUTY DARIN JENSEN Agency Crash NumberPrimary Crash Document #Document Number Override 6V L 1 3 K D 6 N 6 Additional InformationNONE Photos By Reconstruction ByDiagram Description Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. OPERATOR OF THE PICK UP PULLED OUT OF A GRAVEL DRIVEWAY TO HEAD SOUTH ON US HIGHWAY 63, STATED HE DID NOT SEE A MOTORCYCLE AT ALL. THE OPERATOR THEN STATED HE WAS TRAVELING ABOUT 10 MPH WHEN HE WAS SIGNALING TO MAKE A RIGHT HAND TURN. THE OPERATOR STATED HE DID NOT SEE THE MOTORCYCLE APPROACH HIM FROM BEHIND. Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of1 Wisconsin Motor Vehicle Crash Form DT4000 18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 WISCONSIN MOTOR VEHICLE CRASH REPORT Structure Type Y CoordinateX Coordinate LongitudeLatitudeON USH63 SB 0.40 MI S OF GREENWOOD LANE IN THE TOWN OF HAYWARD 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) CLEAR Environment Factor(s) NONE Roadway Factor(s) NONE Road Surface Condition(s) DRY Light Condition DAYLIGHT Manner of Collision 02--FRONT TO REAR First Harmful Event Location ON ROADWAY First Harmful Event MOTOR VEH IN TRANSPORT 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 STRAIGHT Surface Type BLACKTOP (BITUMINOUS) Traffic Control Inoperative/Missing NO Traffic Control NO CONTROL Traffic Way TWO-WAY, NOT DIVIDED Emergency Motor Vehicle Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 45Pre 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 UTILITY TRUCK/PICKUP TRUCK01 Unit Type TRUCK Vehicle Operating As Classification D CLASS Unit Status IN TRANSIT Unit Summary UN IT Extent Of Damage FUNCTIONAL DAMAGE Vehicle Damage 6--REAR Initial Contact Point 6--REAR Bus UseNOT A BUSBody Style TK - TRUCK Color BLK - BLACK Model F150 Year 2018 Make FORD Vehicle Identification Number 000350101 Country of Issuance UNITED STATES St WI Plate Type LTK - LIGHT TRUCK License Plate Number VE H I C L E UN I T Vehicle Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of2 Wisconsin Motor Vehicle Crash Form DT4000 18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 WISCONSIN MOTOR VEHICLE CRASH REPORT 01 Driver DistractionsNOT DISTRACTED 01 Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed By OWNER Towed Due To Damage NOT TOWED UN I T VE H I C L E Address HAYWARD, WI 54843 , US Individual VE H I C L E OW N E R UN I T Vehicle Owner Sequence Of Events EventMOTOR VEH IN TRANSPORT01 Event 02 Event 03 Event 04 IndividualInsurance Company COUNTRY-MUTUAL-INSURANCE-CO Policy Holder UN I T Injury Airbag NON DEPLOYED Injury 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: WISCONSIN COUNTRY: UNITED STATES Address HAYWARD, WI 54843 , US Race WHITE Date of Birth 07/04 Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of3 Wisconsin Motor Vehicle Crash Form DT4000 18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 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 EMS Run #EMS Agency IdentifierMedical Transport NOT TRANSPORTED Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT EJECTED UN I T Non Motorist IN D I V I D U A L 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 Use NOT APPLICABLE Special Function NO SPECIAL FUNCTIONMost Harmful Event: Collision With MOTOR VEH IN TRANSPORT Total Lanes 2 Speed Limit 45Pre 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 MOTORCYCLE02 Unit Type MOTORCYCLE Vehicle Operating As Classification M CLASS Unit Status IN TRANSIT Unit Summary UN IT Initial Contact Point 12--FRONT Bus UseNOT A BUSBody Style MC - MOTORCYCLE Color BLK - BLACK Model GS500FK Year 2006 Make SUZUKI Vehicle Identification Number 11440202 Country of Issuance UNITED STATES St WI Plate Type CYC - CYCLE License Plate Number Vehicle Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of4 Wisconsin Motor Vehicle Crash Form DT4000 18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 WISCONSIN MOTOR VEHICLE CRASH REPORT 02 Driver DistractionsNOT DISTRACTED 02 Driver Actions NO CONTRIBUTING ACTION Driver Prior Action Other Vehicle Factors NOT APPLICABLE What Driver Was Doing GOING STRAIGHT Vehicle Removed ByTowed Due To Damage TOWED DUE TO DISABLING DAMAGE Extent Of Damage DISABLING DAMAGE Vehicle Damage 12--FRONT VE H I C L E UN I T UN I T VE H I C L E Address GRAND VIEW, WI 54839 , US Individual VE H I C L E OW N E R UN I T Vehicle Owner Sequence Of Events EventMOTOR VEH IN TRANSPORT01 Event 02 Event 03 Event 04 IndividualInsurance Company PROGRESSIVE-CLASSIC-INS-CO Policy Holder UN I T Helmet Compliance APPROVED Helmet Use FULL-FACE Seat Position 1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY Protective Gear GLOVES, BOOTS, LONG PANTS On Duty Crash Driver License Number STATE: WISCONSIN COUNTRY: UNITED STATES Address GRAND VIEW, WI 54839 , US Race WHITE Date of Birth 11/04 Sex MALE Citations Issued 0 Driver IT Equipment Individual UN IN D I V ID U A L Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of5 Wisconsin Motor Vehicle Crash Form DT4000 18081701 SAWYER COUNTY SHERIFFS DEPT 15880 EAST FIFTH STREET HAYWARD, WI 54843 (715) 634-4858 6VL13KD6N6 WISCONSIN MOTOR VEHICLE CRASH REPORT Injury Drug & Alcohol Individual Condition CONFUSED OR DISORIENTED (NON LUCID) Drug Type 00 2 02 Drug Test ResultsDrug Test TypeDrug Test Given TEST 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 ST JOSEPHS COMMUNITY HOSP-WEST BEND EMS Run #EMS Agency Identifier 6000954 Medical Transport EMS GROUND Trapped/Extricated NOT TRAPPED Ejection Path NOT EJECTED/NOT APPLICABL Ejected NOT APPLICABLE Airbag NON DEPLOYED Injury Severity SUSPECTED SERIOUS INJUR00 2 02 Tint Compliance NO Eye Protection YES: WORN UN I T Non Motorist IN D I V I D U A L Crash Time 09:19 AM Crash Date 08/17/2018This report does not include any CJIS data. 6of6 Wisconsin Motor Vehicle Crash Form DT4000