FLORIDA TRAFFIC CRASH REPORT LONG FORM SHORT FORM (Electronic Version) HIGHWAY SAFETY 8: MOTOR VEHICLES, TRAFFIC CRASH RECORDS NEIL KIRKMAN BUILDING, TALLAHASSEE, FL 32399-0537 UPDATE Date of Crash Time 01 Crash Date ot Report Invest. Agency Report Number HSMV Crash Report Number 07/ll1'lari20'l4 01:24 AM 07lMar.v'2014 01:24 AM 07fMarI2014 02:56 AM FHPE14OFF01 2807 83278883 CRASH IDENTIFIERSI County Code City Code County 01 Crash Piace or City of Crash Within City Limits Time Reported TTme Dispatched 38 071M /2014 07/'till /2014 30 MONROE ISLAMORADA Yes 01:53; AM Time on Scene Time Cleared Scene Completed Reason (it Investigation NOT Completed) Notified By o7IMar/fi?rHl4_ ormar/ERH14 04:45 Yes Law Entorcement 02:32 ROADWAY INFO RMATION Crash Occured On Street, Road, Highway 0 At Street Address# 0 At Lattitude and Longitude U31 SBND MM 81 2491047 -80.644159999999999 At Feet Or Miles Direction 0From Intersection With Street, Road, Highway 0 Or From Milepost 500 BEACH no. Road System ldentitier 2 U.S. Type 01 Shoutder Type 01 Intersection 1 Paved 1 Not at Intersection CRASH INFORMATION (Check if Pictures Taken) El A --.. light Condition Weather Condition Roadway Surface Condition School Bus Related Manner Ot Collision 4 Dark-Lighted 1 Clear 1 Dry 1 No 3 Angle First Harmtul Event Type First Harmtul Event First Harmtul Event Location Within Interchange First Harmful Event Relation to Junction 14 1 On Roadway N0 1 Non.Junction Contributing Circumstances: Road Contributing Circumstances: Road Contributing Circumstances: Road 1 None Contributing Circumstances: Environment Contributing Circumstances: Environment Contributing Circumstances: Environment None 1 Work Zone Related Crash In Work Zone Type Ot Work Zone Workers In Work Zone Law Enforcement In Work Zone 1 No VEHICLE (Check it Commercial) Vehicle Motor Vehicle Type Hit and Run Veh license Number State Reg. Expires Permanent Reg. VIN 2 1 Vehicfe in Transpon 1 No ooesvs Ft. 31/Dec/2014 No Year Make Model Style Color Extent ot Damage Est, Damage Towed Due To Damage Vehicle Removed By Rotation 2o1o STLG STERLINC TR can Functional 1000 No Insurance Company Insurance Policy Number - HARTFORD FIRE AND CASUALTY Name ot Vehicle Owner (Check Box It Business) 1 Current Address (Number and Street) City and State Zip Code PUB I-IX SUPER MARKETS INC 3300 Pusux CORPORATE PKWY LAKELAND FL 33311-3311 Trailer License Number State Reg. Expires Permanent Reg. VIN Year Make Length Axtes One: C9641Z Yes 1UYVS2481 7541080019 200? UTIL 48 2 Traitor License Number State Reg. Expires Permanent Reg. VIN Year Make Length Axles wo: Vehicle Direction On Street, Road, Highway At Est. Speed Posted Speed Total Lanes Traveling. South us1 SBND MM 81 35 45 2 CMV Configuration Cargo Body Type Area of Initial Impact Most Damaged Area 3 Comm Trailer Type (trailer one) Trailer Type (trailer two) 13- Ur 2 10,001-26,000 kg) Single Semi Trailer 5 19- UVOPIUM Haz. Mat. Release Haz Mat. Placard Number Class 9 21_Tmj]gf 1 1 Motor Carrier Name US DOT Number PUBLIX SUPERIVIARKETS INC 4392520 Motor Carrier Address City and State Zip Code Phone Number 1936 GEORGE JENKINS BLVD LAKEI-AND FL 33801 Comm/Non-Commercial Vehicle Body Type Vehicle Detects (one) Vehicle Detects (two) Emergency Vehicle Use Speciual Function 01 MV with a Continuous Lett Turn Ob]ect 19 0th (10,000 figs gr 1 None 1 No 1 No Special Function less) . Vehicle Maneuver Action Tratficway Roadway Grade Roadway Alignment Most Harmful Event Most I-armtul Event Detail 1 Ahead 2 TWO-WHY. N01 DIVIUBCL 1 Level 1 Straight 2 Collision Non-Fixed 14 Motor Vehicle in Transport Lane Trattic Control Device For This Vehicle 1 No Controls First (1) Sequence ot Events 2 Collision w_ith Non-Fixed Object 14 Motor Vehicle in Transport . Second (2) Sequence 01 Events I Third (3) Sequence 01 Events Fourth (4) Sequence of Events VEHICLE (Check It Commercial) (3 Vehicle Motor Vehicle Type Hit and Run Veh License Number State Reg. Expires Permanent Reg. VIN 1 1 Vehicle in Transport 1 No R938LP - FL 30/Junl2014 No Year Make Model Style Color Extent of Damage Est. Damage Towed Due To Damage Vehicle Removed By Rotation in 2 in HSMV 90010 3 page 1 of 4 Official copy obtained through Buycrasncom Dale oi Gvaeh Dale ax mp-m luvcsi Agave] mun Numbrv mm nauun Numbav um um -17/Nlaurzau oi 2A AM mzsuarrmzaur lusm-ca Gampany lnxmam-5 pm Nmnbev Mm mom>> PvHo1.mNa Conn Mm) awn oaumno FL 32321 mun gm. 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Yn 7 PERSONRECCRD V=mc]al arm: '7 Duh nlfi sax Ewtfinn 2 . um Kivmsiuuk mu>> 1Nana gm 1 PERSON RECORD Vafiuden Nxmi Dam umum 7' PM-neNumbev Ru kmu 3 I Dnvar 2 NICOLAS GUIMYANA HERENA -1964 1 Mal: Na Nklress 7 Cry '7 Stais wuflnih I'iI5'(Tsl] vn mm ammr Drmr17x?*ml?aHy - Feaaz M4 we 3! copy obiamezl mmugn EluyCIas .cum Date oi Crash 07/Ma M2014 01:24 AM Date oi Report 07IMar/2014 01:24 AM HSMV Crash Report Number invest. Agency Report Number 83278883 FHPE14OFF012807 Drivers Actions at Time 01 Crash (third) Drivers Actions at fime of Crash (fourth) Drivers Condition at Time of Crash 1 Apparently Normal Suspected Alcohol Use No Gwen Aicohol Tested 1 Test Not Alcohol Test Type Alcohol Test Result Drug Test Type Drug Test Result BAC Drug Tested Suspected Drug Use 1 No 1 Test Not Given Source ot Transport to Medical Facility 1 Not Transported EMS Agency Name or EMS Run Number Medical Facility Transported To lanes of travei on S1 to enter Cheeca Lodge appro_aching_ the 81 mile marker. V2 was traveling to activate his headlights and V1 ente let__t midsection_ot V1 pushing V1 sou driver's into the rocery store parking lot. No in oncoming trattic. A slig odor of alcohol was deteote VIOLATIONS Person# Name Florida Statute Number Charge Citation 1 MATHEW KYLE REYES 31e.125(1) FAILED TO AT SIDEWALK - FROM A1 RPAEE PRIVATE ROAD NARRATIVE ID Number Rank Name Troop I Post Oflicer Agentg Phone Number Date Created 2305 TROOPER G.B. PERLMAN FLORID HI HWAY PATROL 305-239-zson Mar 07, 2014 V1 backed out at a arking space in front ot a [grocery store at 81868 Overseas Highway (US1 I State Rd. 5 mile marker 81. V1 driver was attempting to cross over both esort entranceway iocated directly across the street trom the grocer at a reduced speed, and is a tractor cab with attached 48 toot enc used semi trailer, carryin a full load. V1 driver tailed red into the southbound lane of U531, directly in front at V2. V1 was traveling in an eastbound direction. thbound tor several _teet. Both vehicles came to tinal rest in the southboun uries were sustained by the driver's or passenger. V1 driver and tieid sobriety exercises were initiated. No detection ot impairment was observed. store. V2 was traveling southbound on U31 and was he tront of V2 struck the lane_ot U81 and were immediately moved by_hoth V1 driver was issued a citation for tailure to yield to REPORTING OFFICER lD/Badge 2305 Rank and Name TROOPER G. B. PE RLMAN Department Type 01 Department FLORIDA HIGHWAY PATROL FHP Page 3 014 Official Copy obtained through %LiyCrasi"i,com Dane 01 Crash D7lMar/2014 01:24 AM Dane 01 Fiepori 07.fNEar/2014 01:24 AM Invest Agency Repofl Number FHPE140FF012807 HSMV Crash Report Number STATE RD. 5 MILE MABRHER 81 5% PRNATE RESQRT - 1- - I ha 1 83278883 NCRT SESALE STORE '$1355 aveasas HWY Page4 014 tar Qff?cEa? copy obtained through