HomeMy WebLinkAbout20181007 carmicle.pdf18100802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD73 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
PRIVATE PROPERTY/PARKING LOTReportable
TagsSchool Bus Related
NOActive School ZoneGovernment
Property
Reporting
ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
02
Time Notified
12:02 PM
Date Notified
10/08/2018
Time Arrived
12:22 PM
Date Arrived
10/08/2018
Crash Time
10:30 AM
Crash Date
10/07/2018
Investigating Officer/Deputy
DEPUTY SEAN ANDERSON
Agency Crash Number
18100802
Primary Crash Document #Document Number Override
6V
L
1
4
V
W
D
7
3
Additional InformationNONE
Photos By
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
UNIT 1 WAS LEGALLY PARKED IN PARKING AREA. OWNER OF UNIT 1 PARKED UNIT 1 AT APPROXIMATELY 10:30 AM. OWNER OF UNIT 1 RETRIEVED
VEHICLE AT APPROXIMATELY 6:30 PM. DURING THAT TIME A WHITE VEHICLE, POSSIBLY ANOTHER PICKUP TRUCK, BACKED OUT OF PARKING SPOT
AND STRUCK UNIT 1 IN LEFT REAR PANEL. DENT ON UNIT 1 WAS FROM TOP OF BED TO BOTTOM OF FENDER. THERE WAS WHITE PAINT TRANSFER FROM UNIT 2 ON UNIT 1.
Crash Time 10:30 AM
Crash Date 10/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
18100802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD73 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
NO STRUCTURE
Y Coordinate
5086514.5
X Coordinate
148104.09375
Longitude
-91.531836041
Latitude
45.84224613
PARKING LOT
SAND LAKE RD LOT
IN THE TOWN OF SAND LAKE
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
Crash Classification - Jurisdiction
PRIVATE PROPERTY
Crash Classification - Location
PRIVATE PROPERTY
Relation To Trafficway
NON TRAFFICWAY - PARKING LOT
Animal Type
Weather Condition(s)
CLOUDY
Environment Factor(s)
NONE
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
IN PARKING LANE OR ZONE
First Harmful Event
MOTOR VEH IN TRANSPORT
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
STRAIGHT
Surface Type
DIRT
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
PARKING LOT OR PRIVATE PROPERTY
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTIONMost Harmful Event: Collision With
MOTOR VEH IN TRANSPORT
Total Lanes
0
Speed Limit
N/APre CrashTire
Mark
Direction Of Travel
NOT ON ROADWAY
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
0
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK01
Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
LEGALLY PARKED
Unit Summary
UN
IT
Extent Of Damage
MINOR DAMAGE
Vehicle Damage
7--LEFT REAR CORNER
Initial Contact Point
9--LEFT SIDE MIDDLE
Bus UseNOT A BUSBody Style
PK - PICKUP
Color
BLK - BLACK
Model
SILVERADO
Year
2009
Make
CHEVROLET
Vehicle Identification Number
64660101
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 10:30 AM
Crash Date 10/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
18100802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD73 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
STONE LAKE, WI 54876 , US
Owner Name
01
Driver DistractionsNOT DISTRACTED
01
Driver Actions
NO CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
LEGALLY PARKED
Vehicle Removed By
OWNER
Towed Due To Damage
NOT TOWED
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventMOTOR VEH IN TRANSPORT01
Event
02
Event
03
Event
04
IndividualInsurance Company
STATE-FARM-GENERAL-INS-CO
Policy Holder
UN
I
T
Truck Bus or HazMat
NO
Road Grade
UNKNOWN
Road Curvature
UNKNOWN
Surface Type
UNKNOWN
Traffic Control Inoperative/Missing
UNKNOWN
Traffic Control
UNKNOWN
Traffic Way
UNKNOWN
Emergency Motor Vehicle Use
UNKNOWN
Special Function
UNKNOWNMost Harmful Event: Collision With
BRIDGE PARAPET END
Total LanesSpeed LimitPre CrashTire
Mark
Direction Of Travel
UNKNOWN
Insurance?
UNKNOWN
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
UTILITY TRUCK/PICKUP TRUCK02
Unit Type
TRUCK
Vehicle Operating As Classification
D CLASS
Unit Status
HIT AND RUN
Unit Summary
UN
IT
Country of IssuanceStPlate TypeLicense Plate Number
Vehicle
Crash Time 10:30 AM
Crash Date 10/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
18100802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD73 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
, ,
Owner Name
02
Driver DistractionsUNKNOWN IF DISTRACTED
02
Driver Actions
UNKNOWN
Driver Prior Action Other
Vehicle Factors
UNKNOWN
What Driver Was Doing
UNKNOWN
Vehicle Removed By
OPERATOR
Towed Due To Damage
NOT TOWED
Extent Of Damage
UNKNOWN
Vehicle Damage
UNKNOWN
Initial Contact Point
UNKNOWN
Bus UseNOT A BUSBody StyleColor
ModelYearMakeVehicle Identification Number
0202
VE
H
I
C
L
E
UN
I
T
UN
I
T
VE
H
I
C
L
E
Sequence Of Events
EventPARKED MOTOR VEHICLE01
Event
02
Event
03
Event
04
Helmet ComplianceHelmet Use
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Safety Equipment
NONE USED - VEHICLE OCCUPANT
On Duty Crash
Driver License NumberAddress
, ,
RaceDate of Birth
SexCitations Issued
0
Driver
UNKNOWN UNKNOWN
IT
Equipment
Individual
UN
IN
D
I
V
ID
U
A
L
Crash Time 10:30 AM
Crash Date 10/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
18100802
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL14VWD73 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Injury
Drug & Alcohol
Individual Condition
NOT OBSERVED
Drug Type
00
1
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
EMS Run #EMS Agency IdentifierMedical Transport
NOT TRANSPORTED
Trapped/Extricated
NOT APPLICABLE
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT APPLICABLE
Airbag
NOT APPLICABLE
Injury Severity
NO APPARENT INJURY00
1
02
Tint ComplianceEye Protection
UN
I
T
Non Motorist
IN
D
I
V
I
D
U
A
L
Crash Time 10:30 AM
Crash Date 10/07/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.