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First Harmful Event Non-Collision Collision Non-Fixed Object Collision with Fixed Object First Harmful Event
1 Overturn/Rollover 10 Pedestrian 19 Impact Attenuator/Crash 30 Concrete Traffic Barrier Location 1 On Roadway
2 Fire/Explosion 11 Pedalcycle Cushion 31 Other Traffic Barrier
8 3 Immersion
4 Jackknife
12 Railway Vehicle (train,
engine)
20 Bridge Overhead Structure 32 Tree (standing)
21 Bridge Pier or Support 33 Utility Pole/Light Support
2 Off Roadway
3 Shoulder
First Harmful Event
5 Cargo/Equipment
Loss or Shift
13 Animal
14 Motor Vehicle in Transport
22 Bridge Rail
23 Culvert
34 Traffic Sign Support
35 Traffic Signal Support
2 4 Median
6 Gore
within Interchange 6 Fell/Jumped From 15 Parked Motor Vehicle 24 Curb 36 Other Post, Pole or Support 7 Separator
Motor Vehicle 16 Work Zone/Maintenance 25 Ditch 37 Fence 8 In Parking Lane or Zone
1 No 7 Thrown or Falling Equipment 26 Embankment 38 Mailbox 9 Outside Right-of-way
10 Roadside
1 2 Yes
88 Unknown
Object 17
8 Ran into Water/Canal Cargo
Struck by Failling, Shifting 27 Guardrail Face
28 Guardrail End
39 Other Fixed Object
building, tunnel, etc.)
(wall,
88 Unknown
9 Other Non-Collision 18 Other Non-Fixed Object 29 Cable Barrier
First Harmful Event Relation to Contributing Circumstances: Road Contributing Circumstances:
Junction 9 Worn, Travel-Polished Surface Environment
10 Road Surface Condition (wet,
5 Railway Grade Crossing icy, snow, slush, etc.)
1 14 Entrance/Exit Ramp 1 11 Obstruction in Roadway
15 Crossover - Related
16 Shared-Use Path or Trail
12 Debris
13 Traffic Control Device
1
1 Non-Junction 1 None
2 Intersection 17 Acceleration/Deceleration Lane 4 Work Zone (construction/ Inoperative, Missing or Obscured 1 None 5 Animal(s) in Roadway
3 Intersection-Related 18 Through Roadway maintenance/utility) 14 Non-Highway Work 2 Weather Conditions 77 Other, Explain in
4 Driveway/Alley Access 77 Other, Explain in Narrative 6 Shoulders (none, low, soft, high) 77 Other, Explain in Narrative 3 Physical Obstruction(s) Narrative
Related 88 Unknown 7 Rut, Holes, Bumps 88 Unknown 4 Glare 88 Unknown
Work Zone Related Crash in Work Zone Type of Work Zone Workers in Work Zone Law Enforcement in
1 No 1 Before the First Work Zone 1 Lane Closure 1 No Work Zone
2 Yes Warning Sign 2 Lane Shift/Crossover 2 Yes 1 No
1 88 Unknown 2 Advance Warning Area
3 Transition Area
3 Work on Shoulder or Median
4 Intermittent or Moving Work
88 Unknown 2 Officer Present
3 Law Enforcement Vehicle
4 Activity Area 77 Other, Explain in Narrative Only Present
5 Termination Area
WITNESSES
NAME ADDRESS CITY & STATE ZIP CODE
TRAILER # LICENSE NUMBER STATE REGISTRATION EXPIRES Check if Permanent VIN YEAR MAKE LENGTH AXLES
Registration
VEHICLE N S E W Off-Road Unknown ON STREET, ROAD, HIGHWAY AT EST. SPEED POSTED SPEED TOTAL LANES
TRAVELING
X 1650 NORTH OCEAN BLVD 50
HAZ. MAT. RELEASED HAZ. MAT. PLACARD HAZ. MAT. NUMBER HAZ. MAT. CLASS
1 No 1 No
2 Yes
88 Unknown
2 Yes
88 Unknown
.
MOTOR CARRIER NAME US DOT NUMBER
MOTOR CARRIER ADDRESS CITY & STATE ZIP CODE PHONE NUMBER
Page 2 of 5
HSMV 90010 S (V/P) (rev 10/10)
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
PERSON # 1 18-001722 85931830
1 Driver VEHICLE # NAME PHONE NUMBER Check if
2 Non-Motorist
3 Passenger 1 1 JAMES A. MUCCIACCIO JR
Recommend
Driver Re-exam
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
2 EMS 3 Law Enforcement
77 Other, Explain in Narrative 88 Unknown
PERSON # VEHICLE # NAME DATE OF BIRTH INJ SEX LOC: S R O EJECT HU EP ABD RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
2 EMS 3 Law Enforcement
77 Other, Explain in Narrative 88 Unknown
HSMV 90010 S (V/P) (rev 10/10)
Page 3 of 5
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
NARRATIVE
18-001722 85931830
North Ocean Blvd is a two-way undivided local road that supports one lane of travel north
and one lane of travel south. At the end of N. Ocean Blvd there is a one-way roundabout.
Just north of the roundabout is the Palm Beach Inlet Dock. Between the dock and the
roundabout is an enclosed, paved rest area for cyclists and pedestrians that is separated
by a metal gate.
V1 was traveling north on N. Ocean Blvd, drove off the roadway, through the open gate and
was parked on the Inlet dock. V1 then attempted to reverse back onto the roadway however,
D1 then proceeded to deliberately drive off the end of the dock at top speed. V1 crashed
into the water at the inlet, floated approximately 50ft west until ultimately sinking to
the bottom of the inlet. V1 sideswiped a ladder railing causing minor damage.
PBPD Dive Team and Code 3 Divers (Louis McNeill 954-393-5588) recovered the vehicle from
the bottom of the inlet using airbags then towed the vehicle to Jim Barry Park (1800
Broadway Ave, Riviera Beach, FL, 33404), where the vehicle was then removed by Sheehan`s
Towing on a flat bed.
PBPD Fire Rescue responded to the scene and cleared D1 of any injuries. Vehicle 805`s
in-car video captured the incident, which was submitted to PBPD CSEU.
**END**
ADDITIONAL PASSENGERS
PERSON # VEHICLE # NAME DATE OF BIRTH INJ SEX LOC: S R O EJECT HU EP ABD RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
2 EMS 3 Law Enforcement
77 Other, Explain in Narrative 88 Unknown
PERSON # VEHICLE # NAME DATE OF BIRTH INJ SEX LOC: S R O EJECT HU EP ABD RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
2 EMS 3 Law Enforcement
77 Other, Explain in Narrative 88 Unknown
ADDITIONAL VIOLATIONS
PERSON # NAME OF VIOLATOR FL STATUTE NUMBER CHARGE CITATION NUMBER
REPORTING OFFICER
ID/BADGE NUMBER RANK & NAME DEPARTMENT FHP SO PD OTHER
PALM BEACH POLICE
0291550 PO MAZZA, JEFFREY DEPARTMENT
X
HSMV 90010 S (N/D) (rev 10/10)
Page 4 of 5
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
DIAGRAM
18-001722 85931830
Page 5 of 5