6TLBFKD7C 17-7757 6TLBFKD7C Document Number Override Crash Date 6/11/217 Date tified 6/11/217 On Emergency Government Property Reportable Description Diagram Primary Crash Document # Crash Time 4:25 PM Time tified 4:29 PM Hit and Run Active School Zone Lane Closure Crash Type DT4 (Standard Crash) Agency Crash Number 17-7757 Date Arrived 6/11/217 Total Units 2 School Bus Related Work Zone 13 LANGE COURT (68) 356-4895 Investigating Officer/Deputy DEPUTY H. LARKIN Time Arrived 4:44 PM Total Injured 1 Tags Trailer or Towed Amended Total Killed 1 Reconstruction By SAUK COUNTY SHERIFF Secondary Crash Photos By DEPUTY H LARKIN/SAUK COUNTY RECON Additional Information Photos, Reconstruction, Fatal Crash Supplement Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report. 1 WAS TRAVELING SB ON STH 113. 2 WAS TRAVELING NB ON STH 113. 1 CROSSED THE CENTER LINE AND ENTERED THE NB LANE OF STH 113 STRIKING 2. Location ON STH113 SB.42 MI N OF STH78 SB IN THE TOWN OF MERRIMAC IN SAUK COUNTY Latitude 43.378943585 X Coordinate 28352.875 Structure Type Longitude -89.678115462 Y Coordinate 486381 Crash Form DT4 1 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 Crash Scene First Harmful Manner of Collision 6--Sideswipe/Opposite Direction Road Surface Condition(s) Dry Environment Factor(s) ne First Harmful Location On Roadway Light Condition Daylight Roadway Factor(s) ne 13 LANGE COURT (68) 356-4895 1 1 Weather Condition(s) Clear Animal Type Crash Classification - Location Public Property Tribal Land Within Interchange Area NO Closure Type Full closure Date Initial Lane/Road Closed 6/11/217 Date All Lanes Open 6/11/217 Unit Summary Unit Status In Transit Vehicle Type Passenger Car Total Occs 1 Insurance? YES Most Harmful : Collision With Traffic Way Two-Way, t Divided Surface Type Blacktop (Bituminous) Truck Bus or HazMat Vehicle License Plate Number 64ZPB Vehicle Identification Number 1G8AJ55F46Z133418 Color GLD - Gold Initial Contact Point 11--Left Front Corner Extent Of Damage Disabling Damage Towed Due To Damage Junction Location n-junction Time Initial Lane/Road Closed 4:46 PM Time All Lanes Open 8:13 PM Train/Bus # Injured Direction Of Travel Southbound Relation To Trafficway Trafficway - On Road Crash Classification - Jurisdiction Special Jurisdiction Access Control Control Intersection Type t an Intersection Reasons for Closure Law Enforcement, Tow truck, Fire/EMS Date Roadway Repaired Vehicle Operating As Classification D CLASS Total # Citations Issued Special Function Special Function Traffic Control Control Pre CrashTire Mark Road Curvature Straight Plate Type AUT - Automobile Make SATURN Body Style 4D - 4DR Vehicle Damage Vehicle Removed By Reporting Threshold Total Trailers Speed Limit 55 St WI Year 26 Time Roadway Repaired Unit Type Automobile Operating As Endorsements Emergency Motor Vehicle Use Road Grade Level Total Lanes 2 Special Study Total HazMat Types Traffic Control Inoperative/Missing NO Country of Issuance ED STATES Model ION LEVEL Bus Use t A Bus 9--Left Side Middle, 1--Left Side Front, 11--Left Front Corner, 12--Front, Top, Undercarriage Crash Form DT4 2 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 13 LANGE COURT (68) 356-4895 1 Towed Due To Disabling Damage What Driver Was Doing Going Straight Driver Prior Action Other Driver Actions Failed To Keep In Designated Lane MIKES TOWING Vehicle Factors Driver Distractions t Distracted 1 OWNER Vehicle Owner GUENOVERE BLEU LENERZ (68) 477-8869 25 HOLLY CT PRAIRIE DU SAC, WI 53578, US 1 2 Sequence Of s Cross Centerline 3 4 Policy Holder Insurance Company STATE-FARM-MUTUAL-AUTOMOBILE-INS-CO HELEN WALSH Crash Form DT4 3 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 Driver GUENOVERE BLEU LENERZ (68) 477-8869 25 HOLLY CT PRAIRIE DU SAC, WI 53578, US Citations Issued Date of Birth Driver License Number 13 LANGE COURT (68) 356-4895 Sex Female Race WHITE State: Wisconsin Country: ED STATES 1 1 Equipment Helmet Use On Duty Crash Seat Position 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl Safety Equipment Restraint Use Unknown Helmet Compliance Eye Protection Tint Compliance Ejected t Ejected Medical Transport EMS Ground Hospital SAUK PRAIRIE MEMORIAL HOSPITAL Action Injury Severity Suspected Minor Injury Striking Unit # Prior Action Airbag Deployed-Front Ejection Path t Ejected/ EMS Agency Identifier 6555 Date of Death Location Trapped/Extricated Trapped/Extricated EMS Run # 176665 Time of Death To/From School 1 1 Injury n Motorist Action Other Drug & Alcohol Alcohol Test Given Test Given Drug Test Given Test Given Suspected Alcohol Use Suspected Drug Use Alcohol Test Type Blood Drug Test Type Blood Alcohol Test Results Pending Drug Test Results Pending Drug Type Condition Appeared rmal Crash Form DT4 4 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 2 2 2 Unit Summary Unit Status In Transit Vehicle Type Motorcycle Total Occs 1 Insurance? YES Most Harmful : Collision With Traffic Way Two-Way, t Divided Surface Type Blacktop (Bituminous) Truck Bus or HazMat Vehicle License Plate Number 7472G Vehicle Identification Number 1HD1GHL11SY36436 Color MAR - Maroon (Burgundy) Initial Contact Point 12--Front Extent Of Damage Disabling Damage Train/Bus # Injured Direction Of Travel rthbound Towed Due To Damage Towed Due To Disabling Damage What Driver Was Doing Going Straight Driver Prior Action Other Driver Actions Contributing Action Vehicle Operating As Classification M CLASS Total # Citations Issued Special Function Special Function Traffic Control Control Pre CrashTire Mark Road Curvature Straight Plate Type CYC - Cycle Make HARLEY DAVIDSON Body Style MC - MOTORCYCLE Vehicle Damage All Areas Vehicle Removed By BILLS TOWING Vehicle Factors Reporting Threshold Total Trailers Speed Limit 55 St WI Year 1995 13 LANGE COURT (68) 356-4895 Unit Type Motorcycle Operating As Endorsements Emergency Motor Vehicle Use Traffic Control Inoperative/Missing NO Road Grade Level Model FXD Bus Use t A Bus Total HazMat Types Total Lanes 2 Country of Issuance ED STATES Driver Distractions Unknown If Distracted 2 OWNER Vehicle Owner LILAC M SUNDSMO 51 GRAND AVE PRAIRIE DU SAC, WI 53578, US 1 Sequence Of s Crash Form DT4 5 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 2 13 LANGE COURT (68) 356-4895 3 4 Policy Holder Insurance Company PROGRESSIVE-ADVANCED-INSURANCE-CO LILAC SUNDSMO Crash Form DT4 6 of 7 Crash Date 6/11/217 Crash Time 4:25 PM
6TLBFKD7C 17-7757 Driver LEONARD J SUNDSMO W1885 FOX GLEN RD POYNETTE, WI 53955, US Citations Issued Date of Birth Driver License Number 13 LANGE COURT (68) 356-4895 Sex Male Race WHITE State: Wisconsin Country: ED STATES 2 2 Equipment Helmet Use On Duty Crash Seat Position 1--Front Seat-Left Side (Driver/Motorcycle/Bicycl Protective Gear Gloves Helmet Compliance Unknown Ejected Medical Transport t Transported Hospital Injury Severity Fatal Injury Airbag Ejection Path t Ejected/ EMS Agency Identifier Date of Death 6/11/217 Trapped/Extricated EMS Run # Time of Death 18:25 Striking Unit # Prior Action Location To/From School Action 2 2 Eye Protection Unknown Injury Tint Compliance UNKNOWN n Motorist Action Other Drug & Alcohol Alcohol Test Given Test t Given Drug Test Given Test t Given Suspected Alcohol Use Suspected Drug Use Alcohol Test Type Drug Test Type Alcohol Test Results Drug Test Results Drug Type Condition t Observed Crash Form DT4 7 of 7 Crash Date 6/11/217 Crash Time 4:25 PM