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HomeMy WebLinkAboutMINUTES - 08211990 - 1.12 CLAIM �Z • BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21., 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant toernment Code Amount: Undetermined Section 913 and 915.4. Please note all "Wail{ . �(f G CLAIMANT: CENTENNIAL CIVIL ENGINEERS, INC. Cp 37990 T,"ICOU ATTORNEY: Jane Curran Pandell, Esq. eta Pandell, Novich & Borsuk Date received CQF ADDRESS: 2033 North Main St. , Suite 450 BY DELIVERY TO CLERK ON July 30, 1990 Walnut Creek, CA 94596 BY MAIL POSTMARKED: July 27, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg DATED: August 1, 1990 BYIL DeputyLOR, Clerl II. FROM: County Counsel TO: .Clerk of the Board of ervisors ( ) This claim complies substantially with Sections 910 and 910.2. � ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: N BY: ( "442S_ / i n Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORpER: By unanimous vote of the Supervisors present ( ✓) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: A U G 2 1 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code s i 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 4 199Q BY,: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Jane rran Pandell, Esq. Pandell, vich & Borsuk 2033 North St. , Suite 450 Walnut Creek, C 45. 6 Re: Claim of CENTENNIAL CIVIL ENGINEERS, INC. Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: _1 . The claim fails to state the name and post office address of the claimant. _2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. x 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. _4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10, 000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10, 000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. _6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: - Deputy Cbilnty Couns CERTIFICATE OF SERVICE BY MAIL C.C.P. _§§ 1012, 1013a, 2015 .5; Evid. C. SS 641 , 664 ) My business address is the County Counsel' s Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s) having delivery service by U.S . Mail) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: D , at Martinez, California. cc: Clerk of the Board of Supervisors riginal) Risk Management ,/ (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 21 920 . 4, 910 . 8) PANDELL,NOVICH &BORSUK ATTORNEYS AT LAW LEE J. NOVICH PERI EXECUTIVE CENTRE SAN FRANCISCO OFFICE JANE CURRAN PANDELL 2033 N. MAIN STREET. SUITE 450 525 MARKET STREET SUITE 3400 DEFIER.L.BORSUK WALNUT CREEK. CALIFORNIA 94596 SAN FRANCISCO.CA 94105 DAVID W.GINNNN JAMES D.CURRAN TELEPHONE:141517488800 TELEPHONE:14151304 9770 KRIS A.COX TELECOPIER:(415)746 8898 TELECOPIER:14151394.9401 CAMERON C.WARD DENNIS L. FAORO _ SUSAN M. BRADLEY July 27, 1990 EEBOAR-D VED July 1990 Contra Costa County Board of Supervisors County Administration Building SUPERVISORS 651 Pine Street, Room 106 STA CO. Martinez, CA 94553 Attn: Ms. Jean Bosarge, Deputy Cleric Re: Susanne Peterson v. Bay Cities Paving & Grading Our File No. 410/90617 Dear Ms. Bosarge: we received your correspondence of June 26, 1990 requesting further information pertaining to the Notice of Claim of the complaint filed against Centennial Engineers regarding the death of Suzanne Peterson at Construction on State Route 4 . I am puzzled by the request for information pertaining to the date that the earlier cross-complaint was served on Centennial Engineers by Bay Cities Paving & Grading. The date of service of Bay Cities' cross-complaint is not relevant in our opinion to the acceptance or denial of Centennial Engineers' claim based on the recent service of plaintiff's complaint against Centennial Engineers. Please have county counsel contact me directly if you require any further information. Ve y ruly yours, P DEL , NOVICH BOR K Su an Bradley SMB:cal PANDELL,NOVICH &BORSUK ATTORNEYS AT LAW LEE J.NOVICH PERI EXECUTIVE CENTRE SAN FRANCISCO OFFICE JANE CURRAN PANDELL 2033 N. MAIN STREET. SUITE 450 525 MARKET STREET JEFFERY L BORSUK WALNUT CREEK. CALIFORNIA 94596 iu1TE S.00 DAVID W.GINN SAN FRAwcuco CA 9,10, JAMES D CURRAN TELEPHONE:f4151 746-8800 TELERNONE 11151201-6770 KRIS A COX TELECOPIER:14151746 8898 TELEConER (4151304 5401 CAMERON C WARD DENNIS L FAORO June 5, 1990 SUSAN M BRADLEY RECEIVED Board of Supervisors 'JUN 8 1990 Contra Costa County PH!! BATCHELOR 651 Pine Street C:" JARD OF SUPEERVISORS Martinez, CA 94553 a COSTA CO. Decuty Re: NOTICE OF GOVERNMENT CLAIM LT Death of Susanne Petersen at construction on State Route 4 East of Willow Pass Road Our File No. : 406/90617 Dear Sir/Madam: Previously, Centennial Engineers, Inc. submitted a claim based on service of the cross-complaint of Bay Cities Grading & Paving, et al . Our prior notice of government claim is enclosed for your review. Recently, Centennial Engineers, Inc. was served as a Doe defendant to the complaint of Susanne Petersen and Gary Hall. Pursuant to Government Code Section 910, et. seq. , Centennial Engineers, Inc. by and through its attorneys, makes an additional claim based upon the complaint. All of the particulars regarding this complaint are set forth in the attached notice of government claim letter previously submitted. Please respond to this claim directly to Jane Curran Pandell, Esq. , Pandell, Novich & Borsuk, 2033 North Main Street, Suite 450, Walnut Creek, CA 94596. If you have any questions regarding this claim or if we can be of any further assistance, please do not hesitate to contact Susan Bradley or myself. ry truly yours, P DELL, NOVAandel RSUK l.� ne Cur an JCP:kmw Encls. Notice of Government Claim Re : Death of Susanne Peterson April 23 , 1990 Page 2 3 . Circumstances of Occurrence Giving Rise to Claims and General Description of Indebtedness . Oblieation ._ Iniurv . Damage or Loss : Theresa Marie Hall died as a result of an automobile collision in the area of construction described above on April 23 , 1989 . 9 . Description of Damages : No amount has been fired as of this date ; however , CENTENNIAL ' s claim based on indemnity will be in excess. of $1 . 6 million according to the Complaint and Statement of Damages filed by SUSANNE PETERSEN AND GARY HALL . The damages which CENTENNIAL seeks in this claim are in the nature of the potential liability for contribution or indemnity payments to other parties in this action , its potential liability for damages to Plaintiffs in the above-described lawsuit , and its attorney' s fees and costs incurred defending this suit . 5 . Name of Public Emnlovee( s) Causing Damage or Loss : Claimant cannot provide a full and complete list of all public employees responsible for the loss under this claim because discovery of this matter fins begun only recently and _. CENTENNIAL first received notice of this matter less than 60 days agc . -However , claimant isinformed and believes that the County Engineer , members of _ts sta_f , the Cour.- 3Lildi. _ Department , and/o_ its sta t , and/or thee Ccunty�P'_ann_. _ Department , and/cr its staff , were public em=_c. e i,ciid 'would have had d_reCt involvement and would have been responsitle for i.^.vestioating , communicating regarding , ant,/c.- approving cor..struction techniques and safety recommendations regarding Route S construction. Very truly yours , CENTENNIAL_CIVIL ENGINEERS , INC . By and throuch its Attorneys , PANDELL, NOVICH a BORSJK AV W.'0 By . JCF; . �:T : :�J i { ti u 1 04 0 ro N >2 ` x . . oa z r �+ 0 0 rs t o� Rf u7 pa E� -ri Q3 OS J •r-i j) U 0 0 G] Y n o u +� 1 I m O � Q W a Chi ~ z m 0 H LL U �+ W < s U O � z < w Q Z W S w u pz z 2 0 m d � 0 a _ CLAIM Z BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Y' Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21, 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $75;,000:00. Section 913 and 915.4. Please note all "Warnings". pFr;FIVED CLAIMANT: COLLINS, Charles JUL ` ryry 901 Court Street, B-Mod #14 ATTORNEY: Martinez, CA 94553 COUNTY COUNSEL Date received MARTINEZ, CALOR ADDRESS: BY DELIVERY TO CLERK ON July 19, 1990 (hand delivered) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH gg DATED: July 27, 1990 8(�IL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Jr Ld0 BY: J Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER:, By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG Z1 1J60 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec 3) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an 'attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated:41n� BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM T0: Ch es Collins 901 Cc Street, B-Mod #14 Martinez, 94553 Re: Claim of CHARLES LINS Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: _1 . The claim fails to state the name and post office address of the claimant. _2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. x 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. _4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10, 000) . If the claim totals less than ten thousand dollars ( $10,000 ) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10, 000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. _6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: qA S i L1 Deputy C6111ty Counsel NQ CERTIFICATE OF SERVICE BY MAIL C__C._P, §§ 1012 , 1013a, 2015 .5; Evid. C. §§ 641 , 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s ) having delivery service by U.S. Mail) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: '� , at Martinez, California. cc: Clerk of the Board of Supervisors (o 'ginal) / Risk Management vvv (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 21 920 . 41 910 . 8) Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2. ) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp r ) _ RECEIVED Against the County of Contra Costa ) or ) X 1 91) 3 "17"o District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ S, p0tq , D D and in support of this claim represents as follows: ------------ ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and / hour) / �l �5 e_ocU to {u E� lro� oc� rs b4�� �/na� [ v� 1"�ALI 7 --------- -,� --1'x+1 - -- ----------------------------------------------/---------- 2. Where did the damage or injury occur? (Include city and county) �v/da� 3. How did the damage or injury occur? (Give full details; use extra paper if required) t' p �� I / .� �t -/-�C'�Ay (Y�� o-C��c-yrs-t—o f �(eGtwtov�4 �olre $�w6i� Vial $7,1FS o4 K"F__ h� lob Ytf_u bevy o � ---------(-------------------- ------------------------------------------- 4. ---------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST '21, 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT• DAVIS, Charles Franklin ATTORNEY: Walter K. Dods Attorney at Law Date received ADDRESS: 7 Mt. Lassen Dr. , Ste. C-150 BY DELIVERY TO CLERK ON July 11, 1990 San Rafael, CA 94903 (filed with legal documents — hand delivered) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. U DATED: August 1, 1990 JAIL BAATTCHELOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors � ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( } Other: Dated: �jT2 1G�i BY: Deputy County Counsel U_ INA III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). .IV. BOARD ORQER. By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 2 1 19 90 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code se tion 3) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: A U G 24 ]990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator P RECEIVED CLAIMV . PUBLIC ENTITY JUL I TO: CLERK BOARD OF SUMV1 CONTRA CO VACO.L County of Contra Costa Board of Supervisors 651 Pine Martinez , CA 94553 CLAIMANT: CHARLES FRANKLIN DAVIS CENTRAL CONTRA COSTA TRANSIT AUTHORITY 2477 Arnold Industrial Way Concord , CA 94520 MAILING ADDRESS: Walter K . Dods Attorney at Law 7 Mt. Lassen Drive , Suite C- 150 San Rafael , CA 94903 ( 415 ) 499- 1238 DATE OF INJURY, DAMAGE OR LOSS: June 5 , 1989 PLACE OF INJURY, DAMAGE OR LOSS: At the intersection of Arrowwood Court and North Larwin Avenue in Concord, California. GENERAL DESCRIPTION OF LOSS OR DAMAGE OR CIRCUMSTANCES: This is a claim for contribution and indemnity which arises out of a lawsuit filed by Douglas A . Simle , a minor, by and through Joy Simle , his Guardian ad Litem, as the result of an accident which occurred on June 5 , 1989 . A copy of the Simle complaint in Contra Costa Superior Court action No. C90-00648 is attached hereto for reference purposes. 1 /C -- - —WALTER K . DODS 2 l CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21, 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $290.00 Section 913 and 915.4. Please note all "Warnir041VE® CLAIMANT: HANEEF, Taras R. JUL `�' 7 1990 P.O. Box D24999 ATTORNEY: Tamal, CA 94794 COUNTY COUNSEL Date received MARTINEZ, CALIF. ADDRESS: BY DELIVERY TO CLERK ON July 24. 1990 (via P_0_ Boxl BY MAIL POSTMARKED: July 20, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. BHHIL DATCHELOR, Clerk DATED: July 27 1990 eputy I1.\FROM: County Counsel TO: Clerk of the Board of Supervisors N ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �F Iqo BY: J- Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOER: By unanimous vote of the Supervisors present BOARD ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 2 1 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. codes d o 913) .e Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: A U G 24 IM BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator OF CONTRA CO!V BOARD OF SUPERVISORS urRSP e� ',Tv 91 applIcatlem M Instructions to Claimant Clerk of the Board P.O.Box 911 Wrlinez,California 94533 A. Claims relating to causes of action for death or mor in.3ury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the" accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be- filed with the Clerk of the Board ofSupervisors at its office in Room 106 , Coun;y .:,kdministration Building, 651 Pine Street, Martinez , California 94553'. C. If claim is against a district governed by the Board of Supervisors , rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each.,public entity. .' E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserved for Clerk' s .'"iling stamps RECEIVED Against the COUNTY OF CONTRA COSTA). JUL 2 4 1990 or DISTRICT) (Fill in name) CLERKBOARDO)rsu RvisoRF -CONTRAOST CO. . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 41;�jq() =-- and in support of this claim represents as follows: - ----------------------------r-------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ASM ----- - ----- ---- --- ------- 2. Whew did the damage---o_r~1n_3ury occur? (Include city and-county) K 3. How did the damage or injury occur? (Give full details,_use_extra . sheets if required) ot 4-.---W-h-a-t-p--aitic-ala-r--act--o-r--o-m.�ission on the part of county or distract- officers , istrictofficers , servants or employees caused the injury or damage? (over) 12 1 '7Z) bylu 7) ACTION TAKEN/RECOMMENDED: SUpERvISOR # OPER TT N DIRECT R REPORTING EMPL YEE # L.D_,R0,UT1,NG11TRICTIONI,__ Yellow to Booking File Goldenrod to inmate BPage W,nite to Facility Manager age one of Pink to Lineup Board Rev. 3/85 d. r i • Nd �N y�v Q 07 N o V - - — - -- - — -- --- - - -- RECEIVED - - -- - LERK G-2 31990 RD Of SUPERVISORS. ___-TRA COSTA CO. t ---- - u�c - -- _-AaA� k _�U-_J- - US 1% 1 31 Qs sZaaT • RECEIVED AUG 2 3 luau CLE OF SUPERVISORS CONTRA STA CO. CLERK -0 Cl pq (vAl rT C`l CLAIM 4 � BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA �•�'� Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21, 1990 and Board Action: All Section references are to ) The copy of this document mailed to you is your notice of _California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $45.00 Section 913 and 915.4. Please note all "Warnings"RECEIVED CLAIMANT: TAI, Joe JUL 2' 7 1990 44 Parkview Terrace Drive COUNTY COUNSEL ATTORNEY: San Pablo, CA 94806 MARTINEZ, CALIF Date received ADDRESS: BY DELIVERY TO CLERK ON July 25, 1990 (via Risk Mamt) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, pH BATCHELOR, DATED: July 27, 1990 EVIL Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors �(v ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: '3U Ir10 BY: Deputy County Counsel —1 III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( /) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: A U G 2 1 1920 PHIL BATCHELOR, Clerk,, By Deputy Clerk WARNING (Gov, code sects 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government.Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 4 14go BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or, for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than' the 100th day after the accrual of the cause of action. Claims relating to causes of action .for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any,other cause of action must be presented not later than one .year after the accrual of•.the cause of,action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim_is. against a district governed by the Board of Supervisors, rather than the County, the name of -the District 'should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ... * * * * * * * * '* '* * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp 3'oe ) - -�-0 4C % ) RECEIVED Cq- via (Zis Against the County of Contra Costa or )- CLEgK OAR0OPSUpeRVIS f r� ✓t J����' Sia`�p `T District) CONTRA COSTA CO. (Fill in name) ) The undersigned claimant hereby makes claim ai the County of Contra Costa or the above-named District in -the sum of $ 00 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ------=--= ------`----=------=------------------------------- ------------ 2. Where did the damage or injury occur? (Include city and county) --------I�1 ► Ic rte+ d t-- -�-- b -c ------ � a r � � 3. How did the damage or injury occur? (Give full details;1 use extra aper if required) S b-e d C1_W Lb �C c C 2 'rruGam. N e..s-�cuktp, b aP�d hcx.d --------- ------ ------------------------------------------------------------ 4. What particUl;P act or omission on the part of county or district. officers, servants or employees caused the injury or damage? n (over) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21, 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $97.00 Section 913 and 915.4. Please note all "Warnings,4rcavw CLAIMANT: HALL, Julius A. JUL ,, , 1247 S. Wilson Way "' 1990n tJ ATTORNEY: Stockton, CA 95205 COUNTY COUNSEL Date received MARTINEZ, CALIF. ADDRESS: BY DELIVERY TO CLERK ON July 24, 1990 BY MAIL POSTMARKED: July 19, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 27, 1990 IL BATCHELOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors -Aki ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ). Other: Dated: � �yA BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORD R: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 2 1 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code s 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I. deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 4 199a BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LOST PROPERTY CLAIM Return original application to: Clerk of the Board PO Box 911 Martinez, CA 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause` of action must be. presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at it's office in Room 106, County Administration Building, 651 Pine Street, r Martinez, CA 94553. C. If claijg is against a district governed by the Board of Supervisors, rather than the county, the name of the district should be filled in. D. If the claim is against more than one public entity, separate claims must be'=filed against each public entity. E. Fraud .- Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, town, city district, ward, or village board or officer, authorized to allow or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is guilty of a felony. " JCJ J.J.J J.J.J.J.J J._ J..4 J.J J.J J J J.J.J._ J.J_. J .J..4✓.JC�C i�n•'�iC:c'''J'•'•'F:k iCk 'xkn•�:9c'/t)4•I.J.'4)Yx:C:c%cx:c''::c JC x`''c'x Jc**�:n"'�.�:�'c'x'F'x RE: Claim By Reserved for Clerk's-filing stamps RECEIVED J2 1-17 S: L)f'1sagj S t- �6C JZA - C14 9�-a o�T ,h1L 2 4 1990 Against the COUNTY OF CONTRA COSTA or7�ive2 �� = CLERK BOARD OFSUPFRVI CONTRA COSTA CO. (Fill in naive) (77 The undersigned claimant hereby makes claim against the County of Contra. Costa or the above-named District in the sum .of $ _and in support of this claim re presents as follows: _ 1. When did the damage or injury occur? (Give exact. date and hour) 2. Where did the damagp or injury occur: (include city and county.) colvkgr4 CoSr4 joef�IVtIvA) fa-Ci/i'y �.yn�r �;ive2 CA. 3. How did the dama;e or in ur occur? (Give full details; use extra shee s if required.) ! YON` DW �.gas (LeteCA-S e 49N 4. What particular act or omission on th part of county or district o ficers, servants,. or employees caused the injury or damage? f,Ney �lo-f�es f� over - CONTRA COSTA DETENTI01 ' ,1, a CLOTHING REC DATE: " REC: TIME: FACILITY: NAME (L, F, M): D.0. NALl AI _... :• BOOKING NBR: --" Q SHIRT/BLOUSE 4SKIRT Q COAT/JACKET 0 BOOTS � PANTIES :::]CC- BRA B E C YLONS QHAT/PURSE EATER/SWT. SHIRT Q DRESS 0 OTHER BKG OFC: X INMATE SIGNATURE DATE: I HAVE RECEIVED ALL OF MY� CLOTHING. REL OFC: pc CL A rl� x (Zecel -i�,lJ INMATE SIGNATURE CORRECTED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 21, 1990 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of Calrfornia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MARTELL , Sharon ATTORNEY: Paul B . Engler,* Esq .. 961 Ygnacio Valley Road Date received ADDRESS: Walnut Creek, CA 94596 BY DELIVERY TO CLERK ON July 12 , 1990 (Via Counsel) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 8 1990 PpHHIL BATCHELOR, Clerk DATED: g BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of upervisors � ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ' BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 2 1 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec ti 913) Subject to certain exceptions, you have only six (6) months fro he date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: `A U G3 24 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator BOARD OF SUPERVISORS, CONTRA COSTA COUNTY, CALIFORNIA AFFIDAVIT OF MAILING In. the Matter of: SHARON MARTELL I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18 ; and that today I deposited in the United States Postal Service in Martinez , California, postage fully prepaid, a certified copy of: notice to claimant of lack of jurisdiction, and original claim to the following: Law Offices of Paul B. Engler, Esq. 961 Ygnacio Valley Road Walnut.'Creek, CA 94596 o ud 8` z ► I ICY I declare under penalty of perjury that the foregoing is true and correct. Dated August 3, 1990 at Martinez, California eputy Tlerk • • • Phil Batchelor The Board of Supervisors Contra Clerk of the Board and County Administration BuildingCostaCounty Administrator 651 Pine St., Room 106 (415)646-2371 Martinez, California 94553 County Tom Powers,1st District F Nancy C.Fanden,2nd District Robert I.Schroder,3rd District Sunne Wright MCPeaK 4th District Tom Torlakson,Sth District f�q-COUF'n July 31, 1990 Law Offices of Paul B. Engler, Esq. 961 Ygnacio Valley Road Walnut Creek, CA 94596 Subject: Claim of Sharon Martell v. City of Lafayette Dear Mr. Engler: On ,June 20, 1990 you filed a claim against the City of Lafayette with the Clerk of the Contra Costa County Board of Supervisors. Following review of your claim by County Counsel, it has been ascertained that the County of Contra Costa Board of Supervisors does not have jurisdiction over the City of Lafayette and is not the entity with which your claim should be filed. Phil Batchelor, Clerk By: . Bosarge Deputy Clerk Enclosure s 1 OICTOR J. WESTMAN 1 • ' _ CONTRA COSTA COUNTY COUNSEL TO P.O. BOX 69. CO. ADMIN. BLDG.. MARTINEZ, CA 94553 DATE_ SUBJECT i p OE Sc�SPCO O C� GO f J -Sheriff-Coroner S Richard K. Rainey Contra Costa County SHERIFF-CORONER Warren E.Rupf P.O. Box 391 RECEIVED Assistant Sheriff Martinez, California 94553-0039 Gerald T.Mitosinka (415) 646- JUL 10 1990 Assistant Sheriff Rodger L.Davis COUNTY COUNSEL 9, 1990 Assistant Sheriff JUL To: Victor Westman, County Counsel MARTINEZDCAUF, y From: Assist. Sher. Gerald Mito 'nka Subject: Notice of Claim by By: Lt. Lyle Shores Sharon Martell The attached claim was received by Lt. -Lyle -Shores on Monday, July 9, 1990. am forwarding this- document to you for your review and will await your advice on how to proceed. If you have any questions please call me at 646-2346'. LS:mr Attachments cc: Risk Management Suit File AN EQUAL OPPORTUNITY EMPLOYER PRODUCT 102';E IRECTLY ON THIS UNE • 01471.1oOWPHOW TOLL FREE 1AOa5616) CITY OF LAFAYME 251 Lafayette Circle #350 LAFAYETTE, CALIFORNIA 94549 (415) 284-1968 DATE TO SUBJECT 7— ...................... .................................. C .......................................... 7r >-1 7— 6 Q s L rJ C D 1Za Yj Q L I >v 2 -4T ............................................................... Nz. L 5 CD ............ ...... ............................... ......................-......... .........- --------_-................------ ......... ts 4- 17-. A s-)-7 v ................. ...................... .............. SN � arc 7 A ............ .......... T= Is .......... -7-0 7_1H 7— ............. .................. ...... ................ L-) A C:71 SIG$ F PLEASE REP NO REPLY NECES! LY RY RODU­. Im.GrMm.hi,u 01471.To Or=NONE TOLL FREE Ii0 MZ M • LAW OFFICES OF PAUL E. ENGLER 961 YGNACIO VALLEY ROAD PAUL B. ENGLER WALNUT CREEK, CALIFORNIA 94596 HENRY A. DAHUT TEL. 14151 938-2460 June 20, 1990 CERTIFIED —RETURN RECEIPT REQUESTED Robert Adams, City Clerk City of Lafayette 251 Lafavette Circle, Suite 350 Lafayette, CA 94549 Re : Sharon Martell v . City of Lafayette Lafayette Police Department, Officer Olivera et al . Notice of Claim Pursuant to Section 910 of the California Government Code Dear Mr . Adams : The Law Office of Paul Engler hereby presents this claim on behalf of Sharon Martell to the City of Lafayette pursuant to Section 910 of the California Government Code . 1 . The name and post office address of this law office is as follows : Law Office of Paul Engler 961 Ygnacio Valley Road Walnut Creek, CA 94596 2 . This law office on behalf of Sharon Martell desires notice of this claim to be sent to the city attorney of Lafayette and the chief of police of Lafayette . 3 . On January 21, 1990 in the early afternoon, in a parking lot located near or about Lafayette Circle and Mount Diablo Blvd . , Lafayette, claimant received personal injuries under the following circumstances : The claimant, after spending some time with a friend, returned to her vehicle alone and intended on leaving the parking lot . The claimant did not ingest an alcoholic beverage . Upon entering her vehicle, two police officers, Officer Olivera and Officer Gilbert were in the process of investigating a potential DUI offender who was in another vehicle . During this investigation, the claimant did nothing other than to remain seated in her vehicle . Officer Olivera proceeded to walk over to claimant' s car . Officer Olivera began to make remarks at the claimant and then physically _-W OFFICES OF • is B. ENGLER Robert Adams, City Clerk June 20, 1990 Page Two pulled her out of the car and threw her against the vehicle causing permanent and severe injuries as herein more fully set forth. In violation of Officer Olivera' s duty he intentionally and with excessive force battered and assaulted claimant, proximately and factually causing the injuries herein complained of . Furthermore, Officer Olivera was grossly negligent in the manner of his contact with the claimant . 9 . So far as it is known to this office, at the date of filing this claim Sharon Martell suffered severe and permanent injuries to her neck and back and contusions to her arm, body and limbs . As far as it is known at the date of filing, Sharon Martell incurred medical costs in excess of $500 . Furthermore, there have been positive symptoms of radiculopathy extending into her upper extremities which are indicative of disk or nerve root damage . Claimant will therefore be expending additional sums for diagnostic treatment including but not limited to an MRI examination as well as a complete neurological examination . 5 . So far as it is known to Sharon Martell at the date of filing this claim, the public employees causing this injury is Officer Olivera of the Lafayette Police Department . Also by his omission and failure to intervene in the malicious conduct of Officer Olivera,' is Officer Gilbert who was also at the scene . The names of officers not known to date are hereby considered doe defendants and claimant reserves her right to amend or alter the claim as additional information is obtained through discovery . 6 . At the time of presentation of this claim, claimant seeks special damages in the amount of approximately $500 plus any and all reasonably necessary medical care and treatment she will incur in the future as a result of the incident . Should surgery be necessary due to a damaged disk and/or nerve root impingement, medical . specials will well exceed $25, 000 . Claimant will also be claiming punitive damages in the amount of $500, 000 . General damages suff red now and in the future are approximately $250, 000 . Vey truly ours, H RY A. AHUT HAD : jv CC : City Attorney, Charles William Chief of Police, Lafayette LAW OFFICES OF PAUL B. ENGLER 961 YGNACIO VALLEY ROAD PAUL B. ENGLER HENRY A. DAHUT WALNUT CREEK. CALIFORNIA 94596 TEL, 141S1 936-2460 June 20, 1990 CERTIFIED - RETURN RECEIPT REQUESTED Robert Adams, City Clerk City of Lafayette 251 Lafayette Circle, Suite 350 Lafayette, CA 94549 Re : Sharon Martell v. City -of Lafayette Lafayette Police Department, Officer Olivera et al . Notice of Claim Pursuant to Section 910 of the California Government Code Dear Mr . Adams : The Law Office of Paul Engler hereby presents this claim on behalf of Sharon Martell to the City of Lafayette pursuant to Section 910 of the California Government Code . 1 . The name and post office address of this law office is as follows : Law Office of Paul Engler 961 Ygnacio Valley Road Walnut Creek, CA 94596 2 . This law office on behalf of Sharon Martell desires notice of this claim to be sent to the city attorney of Lafayette and the chief of police of Lafayette . 3 . On January 21, 1990 in the early afternoon,, in a parking lot located near or about Lafayette Circle and Mount Diablo Blvd. , Lafayette, claimant received personal injuries under the following circumstances : The claimant, after spending some time with a friend, returned to her vehicle alone and intended on leaving the parking lot . The claimant did not ingest an alcoholic beverage . Upon entering her vehicle, two police officers, Officer Olivera and Officer Gilbert were in the process of investigating a potential DUI offender who was in another vehicle . During this investigation, the claimant did nothing other than to remain seated in her vehicle . Officer Olivera proceeded to walk over to claimant' s car . Officer Olivera began to make remarks at the claimant and then physically _vn,• OFciC ES OF i P y17L B. ENGLER Robert Adams, City Clerk June 20, 1990 Page Two pulled her out of the car and threw her against the vehicle causing permanent and severe injuries as herein more fully set forth. In violation of Officer Olivera' s duty he intentionally and with excessive force battered and assaulted claimant, proximately and factually causing the injuries herein complained of . Furthermore, Officer Olivera was grossly negligent in the manner of his contact with the claimant . 4 . So far as it is known to this office, at the date of filing this claim Sharon Martell suffered severe and permanent injuries to her neck and back and contusions to her arm, body and limbs . As far as it is known at the date of filing, Sharon Martell incurred medical costs in excess of $500 . Furthermore, there have been positive symptoms of radiculopathy extending into her upper extremities which are indicative of disk or nerve root damage . Claimant will therefore be expending additional sums for diagnostic treatment including but not limited to an MRI examination as well as a complete neurological examination . 5 . So far as it is known to Sharon Martell at the date of filing this claim, the public employees causing this injury is Officer Olivera of the Lafayette Police Department . Also by his omission and failure to intervene in the malicious conduct of Officer Olivera, is Officer Gilbert who was also at the scene . The names of officers not known to date are hereby considered doe defendants and claimant reserves her richt to amend or alter the claim as additional information is obtained through discovery . 6 . At the time of presentation of this claim, claimant seeks special damages in the amount of approximately $500 plus any and all reasonably necessary medical care and treatment she will incur in the future as a result of the incident . Should surgery be necessary due to a damaged disk and/or nerve root impingement, medical specials will well exceed $25, 000 . Claimant will also be claiming punitive damages in the amount of $500, 000 . General damages suff red now and in the future are approximately $250, 000 . Ve: truly ours, f I , RY A. ABUT HAD : jv cc : City Attorney, Charles William Chief of Police, Lafayette Sheriff-Coroner _ Richard K. Rainey Field Operations SHERIFF-CORONER Warren E. Rupf 1980 Muir Road Assistant Snerift Martinez, California 94553-0039 (415) 646- Gerald T.Mitosinka Assistant Sheiiff To: ,14 Date: '+ -`l C Rodger L. Davis Assistant Sheriff From: 7ctvT`i !� 64 L-5i:r' Subject: ILA A.'_"LLL. G10— 1;�7� .�1 C_� 1. I"�-C l� L) _L F\%2-�2E�? l�'r' �Jl �r�'12C:IJL .2 57171 _srr:�,zG�i LES /L�A�'TELL- ��i2:� L`l7 /Z� L✓� 3 / L�F'IGC/ZS C�r�!cX' ,47k2;',') Cu ✓c,L',4 rC//F l 7-C-7-L- c Fus eU 'TD TA I'46 <( C!!E-M i c ,I L- c5;1 r4A ri /D 3 2CvCL o 2C 4- Mrai2rL-1•+� 3ti=Ccs;-i. V.c��ov� 1 ra Ca L'- , AD02 �. i r-t=•r1' J C.t_'C�O i7�. rla 1 Tr-p� �. 012-1 -TC N1 D F• r.-%67 or-A N1�1=TELL1`� C.fL�JSc� �TJt L5 ' CJ l� ( GW.�G'. t✓1:�=T�Z L 'S C D:_ cjL 1`� __ (�, - i 3 -n U Mc r i ury ;G �a • '1SS t�J t p._tJC C kit 1k►'-i rJ C- t ,� r� ,{ -n C. M u r,i iC-I, A-L. CZ10 lo- OUT `7- 2f,-0%pCA) t2 '.30 Tt ' 1 "3 '1-kc LA� . C . �t�En1 J%t':i;� .• '�i.I C K L L Y .�C I-1.rJ i N\ . ( "I '2�' _..![r. AN EQUAL OPPORTUNITY EMPLOYER ' ae File Cher s Det 9c y J2t- Na ast,First Mid Citation No. INTOXICATED DRIVER REPORT Re " nee r Ida n CONTRA COSTA COUNTY "�S -7069 P SHERIFF-$DEPARTMENT Business Address City Business-Ptone` ,✓f oCoC- Flo aG3 CITY OF:!/ll� -*py Locals of Arras � l �. —� Time oArrest�� Driveri L0 1 � S0 o _ LlcpnseStatus �O SFIX H Eyes Hei ht Wei t Dat of t Date/Time Bo d Social Sec n3sL /V�1 IV/ 1 1410 z i Al-70 ,� i �� 3 9,V7 tr/D &-T: 0-cy�e�d1 /,/� LpcatiM L;l-? Date/Time DDL Req.Sent Method Sent —T:W-Cy0/�Jc(/ V '!7�(TL �i��]Fi/f []TT Omail ophone VEHICLE INFORMATION Vehicle i e� r/ 5}ptp_ Ye `#V78l� M� '^ Body TNypes/K Col C Registered Owner lfotsame as Driver R/O Address EFSeme as Driver Passengers I Stored Nalne 9f Gara�tge�/JR'elessed to / Address d w _ _�.I�� M Ve F (!/f.+(/✓DI't �OW C,/T'��7 c i F s ❑No .r+ FIELD SOBRIETY TEST Was Subject's Vechile Involved in an Collision Report Number Heel to Toe/Walking Line Test QL.Foot O R.Foot Accident?. `� n O ` Yes No % f.. Atlmin ;eq7 Yes ❑No Breath:Order of Alcoholic Beverageroet Ay 9 19(stronQ M moderate' 0 Weak Glasses/Lenses EyesA14719W. a 'l El Yes 115No E444S (Coot � ^/ V speech +/�� �J �jJ1 15"4A&A &464& ��GI^moi/` A1Gs'e" Vl e AW-;Z" Clothing Worn/Condition and Description balance- ! / / ,✓ LT. .Ile✓a-7(3a/G� " 14,10DLE GT.f/EDF C �')G u�.✓E» E Td �T p uEtKr rTd /t/A/ .!frr / . — r owewe ucdti'r- Do/t" [7d .tTl1r Other: ... De ribn Test Location.S .1ce.Weather and Liphtin ��+ /GS�Y./rte �G�.(/.�,iJ/bt/V/r� tr IMPLIED CONSENT 23157 V.G. 1. YOU ARF.REOUIRED BY STATE LAW TO SUBMIT TO A CHEMICAL TEST TO DETERMINE THE ALCOHOL AND DRUG CONTENT OF YOUR BLOOD. 2. YOU HAVE A CHOICE OF WHETHER THE TEST IS TO BE OF YOUR BLOOD.BREATH OR URINE. WHEN APPLICABLE:SINCE MEDICAL TREATMENT IS NEEDED.YOUR CHOICE OF A TESTIS LIMITED TO' TESTIS) NAME THESE ARE THE ONLY TESTS AVAILABLE AT: /I(/J J�� /j�� BRIEFLY EXPLAIN NEED FOR MEDICAL TREATMENT:j�� . , ,/J dabs �.C, 3(67 CSF`� r 3. IF YOU REFUSE TO SUBMIT TO.OR FAIL TO COMPLETE A TFST.YOUR DRIVING PRIVILEGE WILL BE SUSPENDED 6 MONTHS.OR REVOKED FOR 2 OR 3 YEARS.A 2"YEAR REVOCATION WILL RESULT IF YOU HAVE BEEN CONVICTE,WITHIN THE LAST S YEARS OF DRIVING UNDER THE INFLUENCE.INCLUDING SUCH A CHARGE REDUCED TO RECKLESS DRIVING. A. A 3-YEAR REVOCATION WILL RESULT If OU HAD MORE THAN ONE OF THESE CONVICTIONS WITHIN THE LAST 5 YEARS.REFUSAL OR FAILURE TO COMPLETE A TEST MAYBE USED AGAINST YOU IN COURT.REFUSAL OR FAILURE TO COMPLETE A TEST WILL ALSO RESULT INA FINE AND IMPRISONMENT IF THIS ARREST RESULTS INA CONVICTION OF DRIVING UNDER THE INFLUENCE. 5YOU DO NOT HAVE THE RIGHT TO TALK TO AN ATTORNEY OR HAVE AN ATTORNEY PRESENT BEFORE STATING WHETHER YOU WILL SUBMIT TO A TEST.BEFORE DECIDING WHICH TEST TO TAKE.OR DURING THE TEST. 6. IF YOU CANNOT COMPLETE THE TEST YOU CHOOSE.YOU MUST SUBMIT TO AND COMPLETE A REMAINING TEST. THE ABOVE STATEMENT WAS READ TO THE ARRESTEE BY: I.D. TIME TIME LD.OF SAMPLE RESULT FAVAI BLE DISPOSITION OF SAMPLE BLOOD BREATH ❑URINE ❑OL 367 COMPLETED [DREFUSED (� 3 �1!/L�f/f a(� 7 E ?Z Y� DRUG ADMONITION ✓111����/// p ATTACHED IDL 367A) L AT ERE TEST DUC NA:!E OF PERSCt,1 GIVING TEST T KING SAMPLE REV.I:B6 MARTINEZ PRINTING (J\ CS`FQYdt• /`''`�•'/',`/` A. tHE BREATH TESTING EDUIrMAN T DOES NOT RETAIN^NY BREATH SAMPLE FOR LATER ANALYSIS BY YOU OR ANYONE ELSE. B. IF YOU WANT A SAMPLE RETAINED.YOU MAY PROVIDE A BLOOD OR URINE SAMPLE THAT WILL BE RETAINED AT NO COST TO YOU.IF YOU DO SO,THE BLOOD OR URINE SAMPLE MAY (.BEEtTESTED FOR ALCOHOLIC OR DRUG CONTENT BY EITHER PARTY IN A CRIMINAL PROSECUTION. OFFICER TIME READ ` � LOCATION ' ADMONITION OF RIGHTS 1.YOU HAVE THE RIGHT TO REMAIN SILENT, ],YOU HAVE THE RIGHT TO TALK TO A LAWYER A.IF YOU CANNOT AFFORD TO HIRE A LAWYER. 2.ANYTHING YOU SAY CAN AND WILL BE USED AND HAVE HIM PRESENT WITH YOU WHILE YOU ONE WILL BE APPOINTED TO REPRESENT YOU AGAINST YOU IN A COURT OF LAW. ARE REIN ESTIONED. 3BEFORE QUESTIONING.IF YOU WISH ONE. t.1✓� THE ABOVE STATEMENT WAS READ TO THE ARRESTEE BY: I.D. -71-70 TMF �ro E YO NUNDEERSTTA D EACH OF THESE RIGHTS I HAVE ALK HAVING THESE NOW?RIGHTS IN MIND.DO YOU WISH TO �BJECTS WAIVER STATEMENT �F Y G9wY vE5 NO YES O /''t - - INTERROGATION DO YOU KNOW OF ANYTHING MECHANICALLY WRONG WITH YOUR VEHICLE? ARE YOU SICK OR INJURED? DESCRIBE DESCRIBE ❑YES ❑NO ❑YES ❑NO ARE YOU DIABETIC OR EPILEPTIC? DO YOU TAKE INSULIN?(PILLS OR DO YOU HAVE ANY PHYSICAL DEFECTS? DESCRIBE INJECTION) ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO WHEN DID YOU LAST SLEEP? HOW LONGI WHEN DID YOU LAST EAT? DESCRIBE WERE YOU DRIVING THE VEHICLE? IF NO.WHO? - WHERE DID YOU START DRIVING?, WHERE WERE YOU GOING? EDYES [INO [I N/A WHERE ARE YOU NOW? WHAT HAVE YOU BEEN DRINKING? HOW MUCH? TIME STARTED TIME STOPPED WHERE WERE YOU DRINKING? DO YOU FEEL THE EFFECTS OF THE DRINKS? DESCRIBE ❑YES ❑NO - ARE YOU UNDER CARE OF DOCTOR IF YES.NAME a ADDRESS. OR DENTIST? ❑YES ❑NO HAVE YOU TAKEN ANY MEDICINE IF YES.WHAT HOW MUCH? TIME OF LAST DOSAGE OR DRUGS? ......._.. _' ❑YES.... NO DO YOU FEEL THE EFFECTS OF THE DRUGS? DESCRIBE WITNESS AGE SEK NAME [)PASSENGER ❑VICTIM ADDRESS - PHONE -- RES BUS . ❑ ❑ CIRCUMSTANCES DO�TionlA-L C�-E�'E ago Com► c/c— uN46Garmn:) �cccf rD(�'R•v�•.J p�' COcc�-�' P/1c�i3A'R�r1 (=lo— AHREii C FFIC IN E S RANK ,ryp��� gU►ERV)SOR(NAME B RANK) LD.NO DATC Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO (Arrest ❑SI 1�ON=. 2. ity o 3.Cri ClaL%aLcation 4.Detail 1 5.Reclassi- 7 3 u 2. &foe0 dv fication 6. 04P'be(L,F,M) '7.Dam=Orig.Repgrt B.EmDloy�N�Q ❑ O C%/ Z 90 3 / 9.AdIlress cation of Occurrevee - 10.Sus 's Name((L,F. 11.Property Description:�'- Impounded.Recovered,Found.Lost,Stolen-Item Number,Article,Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes:B)Jewelry,C)Clothing,Furs;D)Vehicles;E)Office Equipment;F)Radio.TVs,etc.; G)Firearms;H)Household Goods;1)Misc. 12.Recovered Property$ 13.Narrati Statements �� One-o 12) T /WO 1%ACC A. 44T IAA (4) Gc/�/.rTc. LoK-6*00' AtO 4T r XS- �� fi,�td�`'�� ,5, �✓,✓. Z 4e4ot- 60 l v`7d � �.r�-��"�s &-7- � WeE .Be7F...0a 31.�.r" .4)WAirc0 .t6u/�, i9vo 4 ?lac ��+! �'i co Cry m %' '.02� S4dT D a6z* 4V6 Lo�GOY'. Z ,e) o% L.r(GIG. wlb r .C�u�Ci/ (10) S �— (/`�!� I `��� (4/ !7 (11) Ltd -Z7 &467%x-f(F- 1v�""'O IReil (12,f�iS 4--- rm E)<fi gContinuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat Supplemental P.O. Box 391, Martinez,California 94553-0039 [j HRO P Arrest ❑SI N-./U0 2/ 2 ity a 3. a/Clas�ation 4.DetailReclassi- 2 J p,/ ticaGon 6.Victi ame(L,F,M) I 7.y�OVe{?4:0 tQ 8.Yyl ypeee�(r0 Li 7 3 ` 9.Address/Lo tion of Oc rr nce/f 10.Su is Name(L.F 11.Property Description: Impounded,Recovered,Found,Lost.Stolen-Item Number,Article.Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs:D)Vehicles:E)Office Equipment;F)Radio,TVs,etc.; G)Firearms;H)Household Goods;1)Misc. 12.Recovered Property$ 19.Narra Mate n / /70/�� //►G^•�✓Q /-' / /�/,wL ,21/ E 1, C A/w /` I /*0f J oW LEFT= ,� p�7Td (6) Gt7- GIiC/�/ /tTTdE c$!�o/� Cf7✓l�1 �S E77� (9) (10) E �.CownJrCL� � r9,o � T C'oGGraE� Gr/ll1! (12) �. n', �A: , s�� /L/ (13) /I "� Cfi�VW�� �Gilr,�G �j(�lM(/ ( /i'V�G.I►� �'4 / (14)Ar/��� •/" ,yDUle:il (15) je/(.VWI* G^`v[�C. �� (6E (16aTcWAoo4 VZrr .hoc%/ /6446b /WA7'a 14 (17) NW Ds✓ 7�� Le�-5 IAOe,SOF p�ir�x��6 Lo7' (1s) Ocrr �Lt/p /l�K�✓� Situ! 1�1f/�D /�� //yTi�Ol, (��I// (19) �/f T,we- Z 6CIcFX aA47- (20) SwS u �7 �E s�Co� +'GCE �1/C,'/T� (21) �. 54014/417 %04FE25lCr uP 7Z) 7WIE &Le,00ci (22) o /CDA117Nuir--2� W �e C lAolE r✓ (23) �( • (24) WZ Cab E Det(/D-5-/gyeK -;O el ae (25)_:Z S/Ttn E �� I-elf r S ��� 14.Distribution 15.Additional Routing ❑B ❑C ❑DA ❑DE ❑L ❑0 ❑SR ❑V ❑Investigation ❑Vice Narcotics ❑Juv ❑Coroner ❑Property Ck. ❑ACS Intelf. ❑R.O. ❑SHC 1C.6 epornng pu Print 17 D e Ty'�rI�.Writt/e p/ is ❑Patrol Captain ❑Compl.Ofc. [D Marine Patrol • / [ r ❑Other 19.Approving Supv.(Print) 20.Sup v No. 21.Date —ot Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ` ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO F Arrest ❑SI /e* 2. ry o 3.Cn/�e�/Cla siJis 4.DetailReclassi- Jf .L�. (i/., -- 2. 6J fication 6.Victir%Xjm ,F,M) - 7.Date Ori 7pc 6.EmployrQ j�o. ❑ V6;1 `Tta : (( !7o 9.Addres / ocati n o O� 10.Sus 's Name(L.F. ) it.Property Description: Impounded,Recovered.Found,Lost Stolen-Item Number,Article,Ouantity,Brand/Make/Manufacturer's Model Number.Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes:B)Jewelry,C)Clothing,Furs;D)Vehicles;E)Office Equipment;F)Radio.TVs,etc.: G)Firearms;H)Household Goods;1)Misc. J 12.Recovered Property$ i) Narr 1Sia/c /r(Cot (2) T E fir✓ �GG•6Cey✓ LoO�� ,couf L>lr (4) flYVn oEj T 70 /`��. E 7,71e-A-1(5) /401-0 CLEtI� �r �fZt/ d5A7 1X T11E 1i10� i (6)S �b� 7VS�� �l �� f CICc�✓1"E, %o� (7) �l LC/�9'GG�'T'- Amt /T �f r✓� / Cor/�J iC�L I6)DOfltff A✓eNS (r-~. E 12*t tDEb /54- 141�VZoftr (10) r / ii W.l .F/"�' VC�`"'S Z(a-2VS6- /lam.,. ..JGG-" `e)P G# / WA wfr6w 6cIWO#Ar-S 4/0-r AS,'AI4' •o,�. r E (12) E-tvo G��✓ ASF- cv/h-s �o ri�� As' ��,� ,(•� (14) XS &ee4Z&Y U� �' /`�� (.c�uLO �tG c.S7/Z2o t/¢ (15)©QDild— iE 7A;r O`-I f� FIV GCo�W06(C- E P1e;9 'E 6 � /^� / / '•"r . If 6)I I E Ahs ZU4&�9 �l � '" /�(SG/^�• r (20) XSlCG//�f /L/` C/a�C�,/ /F I//T/V w�+ �-/TvJ' JA �� Jl�� ��p , �.or V (211 122) (23) �,/�y� �rr �r� `T/� / E (23)A%,,-r7a f.G /J,®J J G J 406 (25) H t'CNJ�oe /�O� v /KTX p/C //✓f�./ ��� 14.Distribution 15.Additional Routing ❑B ❑C ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property Ck. ❑ACS ❑Intell. ❑R.O. ❑SHC 16. a rtin a fPr }j„.A - 17 Dyje yii� tlery 1 ispo. ❑Patrol Captain ❑Compl.Ofc. ❑Marine Patrol . I ❑Other r;—A7P!`r701ng Supv.(Print) 20.Supv.No. 21.Date 22. o Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 HRO 07 Arrest ❑SI 1y�,No. p / 2. rt C 3.Ctf�1�7 tCanon 4.Detail S.Reclassi- 6.Vict3e(L.F,MI Z Date Orjp./_pey, B.Employo�`70 ❑ 9.Atltlr ss Lo 'on f c ce /f� to. ISusp/7`I/s/Na`mte 11.Property Description: /`i, /f�R"d/C• Impounded,Recovered.Found,Lost Stolen-Item Number,Article,Ouantity.Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value.Include Total Loss-UST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs;D)Vehicles;E)Office Equipment:F)Radio.TVs,etc.: G)Firearms;H)Household Goods:p Misc. ^J7� ,(�/+ 12.Recovered Property 5 13(')'Warr YL, Sta?Z?Y / �� /J�� d�J/ 8 t...f,O 7��ce6t y.� /J (2) Com ' G'V/ �"//V��� --- G to r, (4) cry LOQ cr' C v.G � /7- 70 /41 11E- (5) / 497&- ff*-*e-70 ArT &/ e" 147V40 &RPfAl �io/•✓6 �Coe4ce (6) E C G4 Vt' 0?C, WC IWO* .1 e29-uP /-/c 17te (6) 14SAZr2!> , �4eozeegl //C- E-4 �pME o A✓a t„1 �+wyt/ /Ll� yrs✓ /�/y�' //l,�ii✓� 77� /EL�jI,}�♦�`ll �<{$�f���t r fl ,�e— (12) /4 �,l/B�KJ •�'„/ FSM`-*'�K� / �G!'/ C-/^i i,�(�d/ ©� (13)/ry �/ICGL� //V ..� 0/"*VeZr- (14) S /!/'1 e e%/ C EKE j!5"i&eex--/— IfAet!Q �7%lo (15) 7W45 to 5yl-ne» 1�S' � GLE S f�i`F�T ,BWeW!-Z� (16) q; T����L�%o�.*fCX Gr/4:E £1.� puto t-f1A11J7EV- ��i' 7Z o (16) ^,�1�iZCCRT-39 119) //�� eD A4' � /'/,/AIWCO7 ff37 (20) / 11517 ,�, '��G6y[�iV//� Alweew/�Gy f ��I(���yT � (22) S ld 1S LZ—p tda fnAze;\/'f��j/ ir—/ E �� u/✓DC IGS /�y�G/� (23) /CJ” �/ e t + i' tO (24) �- o , / �%// oejl^c 14.Distribution - 15.Additional Routing ❑B ❑C [DDA []DE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑PropertyCk []ACS ❑Intell. ❑R.O. ❑SHC 16. ti ep ri�``y/dy 17 Da /T1 IN tterl p . [:]Patrol Captain ❑Compl.Ofc. ❑Marine Patrol G�./� -2( /C.7 (6 ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21,Date 22./g gge 1101 ($Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO [MArrest ❑SI No. rn, 2. it COAT 3. /CI ation 4.Detail 1 5.Reclassi. ��/C13� �( 2. ficatlon 6.Victi��L,F,M) 7.DOat�Ori epgt0 8.Empy�pyrNy.�,� ❑ 9.Addr ss L tion of nce�/' 10.Syd's Name me(l,F,M)�� 11.Property Description: (�/ / Impounded,Recovered,Found,Lost,Stolen-Item Number,Article,Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes:B)Jewelry;C)Clothing,Furs;D)Vehicles:E)Office Equipment;F)Radio.TVs,etc.; G)Firearms;H)Household Goods;1)Misc. 12.Recovered Property$ 13.N /S ets a w...,� ` /,rt, (3) T �7"fOn1 i l C E /<i74,006Foo&67 J° %�3`l-f (4) �.ST�b moi✓ 'E / c+�lc�'1. u�n/ C.orrr%E��n/Di' (5) L' ZI-r7& moo. O-5/&e/`> 7-T- =7 14F?-7" (S) Gc�/¢-S' ''0a afTa?CiC 477E TO JI/.-0r(IEs- (7) �•9C ,�uC'+eGE7 G�� .G (9) /. ���4�Y S ��✓ (�C�j �G�C=rel.L�'7' /�'a /r!`7' L �G.rc�C�f=�� �.�V �f-/�3•�L .�Ir (13) 14,r C�// �`'a1�t (/1) llet Z (14) My 7c7 I�c'JP.9N17 -7'� -M u/01 14v%ov C�GC'7'1 Cir (15) T 7/ -�S�bR► ,QuCCLC'"�' 'Tb (17) AJWicE (,a) ,�o ©/C ucc2e"t'-oe E cgflo E /9SNT Or�✓c� ;70- (19) (19) Avy 7FSrs 1 -/-0ue4C:- 7 Fir Drfv � WA 122) / U• /n�rte( . / r. �/f� (23 D G..fr/ �I-/ aU 6 � (. :Z- l,1Lo O cL�E.��I)L�-t' (4117;-1 Li`l. eX1�10 (251 4 D 2111 C _7111C �//7 / 14.Distribution 15.Additional Routing ❑S ❑C EDA ❑DE ❑L ❑O ❑SR F1 ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑PropertyCk. [:]ACS ❑Intell. ❑R.O. ❑SHC 1Prinil 17.Date/Tirtlp+(J,' , ❑Patrol Captain ❑Compl.Ofc. ❑Marine Patrol J ! (-`w U ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21,Date 22.!jge /,of Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO P Arrest ED sl 1' 2. iry 3. i Clad" a 4.Detail 1 5.Reciassi- 2. fication 6.Victim N ,M) 7.Date Dri 6.Emplpy 77 ❑ A,21r�J �s o 10.Sus s 11.Property Description: �� ,G`•�'G �L•�" Impounded,Recovered,Found.Lost.Stolen-Item Number,Article,Ouantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-UST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry;C)Clothing,Furs;D)Vehicles;E)Office Equipment;F)Radio.TVs.etc.; G)Firearms;H)Household Goods;0 Misc. 12.Recovered Property$ 13.Narrative/State (2) ^Z&l (Wy 7 /A A40 Il Oi✓iz� �Tj�E (3) �/'E OTfra jWi�'fl G�irS �i�✓ol��,. b /o / .' (4) ?" /SS/ &v,cS S �i�li�✓/JTf�4b �c fi cJT (5) ��TT , cGe�: ,6ucY. Gt�bctGo �S'GoG✓GY - (6) 46G0&j IJVI�Z 721E �j� {- t=cF v �✓�Sucrc p/�/ E (7) (6) ,G/^f'T O�✓ ? E NTl»C/L72�x- -LiC � O� f� r (8) /(/�,Qj�tZLlGj� r(� /��C�c/T �Lc�U/.•✓Ei /�/ Q,c/E /.i✓D�/J (10) ,O/ (11) � � Y �. . (12) �,,�_� ��,,c'i/rte .C��./,GG//J� (/4) Er/ G,G 7 /eC AoPJ 25& ' Y %KED✓ �� low%Ko (15) ��X-�IJ�- CEGE. 77t1C AeY"cT DG 751le- Se- 4AV &ec';l0r7�A*S 04 n6) . / 7 'elo '. . (17) 7 e�Tn/u" 7vliCtJ ��-T�T O�✓ (16) LWC0!Zey be-1- .,2.2 4f/,Of (1g) /etcuLT. (20) 527 c9u,eSZr (21) 1,144Ex"171 7,,�S'T -,;z ,6aC :e5rr.,/= T tp- !fir Ar-We- �o/�i .✓�Eb (22) /�^ p /t/ /;E (2 4) l ': 06y /�'j//Y// .A DA 7; G/C.-7 QF E (25) � l/�� oetf. 14.Distribution 15.Additional Routing ❑8 ❑C ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice [:)Narcotics ❑Juv [:)Coroner ❑PropertyCk. ❑ACS ❑Intell. ❑R.O. ❑SHC 16. ❑ p inen Patrol Captain ❑Compl.Ofc. [D Marine Patrol 4— (,3o isoo []Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 2 ge Of Ea,Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat 44 ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO 41 rrest ❑SI 3.C /CI i n 4.Detail1. 5.Reclassi- p 3 �.(�C,�^ 2, ficanon 6.Vic ti (L,F,M) 7.Date Qrig.Rwor B.Er 71<Jq,O ❑ 40 9.Addr s io ,'�ce ^ 10.S us"/{/_ iJG�aprQ,jL,f611r J' 11,Property Description: (I(�L(•� Impounded,Recovered,Found,Lost stolen-Item Number,Article,Ouantity,Brand/Make/Manufacturers Model Number,Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry;C)Clothing,Furs;D)Vehicles;E)Office Equipment;F)Radio,TVs,etc.; G)Firearms;H)Household Goods;I)Misc. 12.Recovered Property$ 13.Nar /State C _ _� E. / 7V 7Reqr- (2) �77 /�''(�� /TO �C. Lewd-�'"�,G I � (3) we OCAAer CcI^Lr� Ek 7��% t{AvJ� E �i�i✓ .QC�?T (6) E GIv4' /�✓�o.P✓�'1i477�✓ �Ea ��.J u�/_ (7) P I ._.1� �On/�4o 'b f�� !t/?� ;O'S At 0 (6) � � u7— C?b"Ii✓ (9) IA/ dc-ecet-ers' voefr zfe-emE (10) 2Y S ��% �� Cp00Y Wil Ar ,mac 7v ,C� � �JCi1�JZD/JZ3�Z a) ��'• ,/ (13) re)eVC � e;/, //' / Z � 7J �I�✓T7_�a_�/ �//(.G� 4 c (15) E o -Z3�sa 6 c, (17 (18) (20) (21) (23) � ��i rrr C.i• J/ �'�7 IV~ (24)QL— ,r>fGcfS / XiGYlEK- L��P TAT EC�G�J'T" (25) 14.Distribution 15.Additional Routing •:=, .. ❑B ❑C ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice [:)Narcotics ❑Juv [:]Coroner ❑PropertyCk. []AGS ❑Intell. ❑R.O. ❑SHC 16 e_ ting epu Pin) 17.Date rlen/ ❑Patrol Captain ❑Compt.Ofc. ❑Marine Patrol ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.�e/ 0 CONTRA COSTA COUNTY SHERIFF-CORONER ABANDONED, IMPOUNDED, RECOVERED LAFAYETTE - DANVILLE❑ SAN RAMON❑ ORINDA❑ STORED OR RELEASED VEHICLE REPORT CRIME B A7 DATE FCNa CASE FILE a r a .� Y) 8. °l - 7YPE OF FEPORT HECK O I IF A RECOVERED STOLEN VEHICLE,HAS NEIGHBORHOOD OR AREA BEEN CHECKED FOR ❑ABANDONED ❑IMPOUNDEDSTORED LEADS OR CLUEST ❑ABATED ElRECOVERED XRELEASED I ❑YES ❑NO (LIST LEADS OR CLUES IN REMARKS OR SEPARATE SHEET) PERSON REPORTING OCCURRENCE - ADDRESS PHONE _ TIME AND DATE 1 REPORTS 61 1V A r St�ii F ,t( e, i �G DESCRIPTION AND OWNERSHIP vEeR MAKE MODEL BODY TYPE LICENSE NUMBERISI YEAR STATE COLOR ICOMBIN TI NI VEHICLE IDENTIFICATION NUMBERS(VIN) GOES vINCOMPARE DOES VIN APPEAR IS VIN CLEAR IN LIC, NUMBERISI ENGINE NUMBER(ENI WII .REG CARD, ALTERED ' S Y ST E M , CL AR INSVS" !, ^ YE5 ❑NO ❑YES 1J9,.v0 ES ❑NO YES ❑NO UNKNOWN IF STOLEN NAME DALE AND CA$ UMBER OF REPORTING AGENCY WAS VEH RETURNED TO STORAGE AUTHORITY OWNER' y--/ ❑YES LTJ NO /I LOCAT 10%TOWED FROM WHERE STORFD TIME AND DATE TOWED c)I,&k C 1,At7A-jP_'_lI7E CAP-, I.-Al-iDLAChA1 NAMED ARAGE ADDRESS PHONE ... _ _ N LlJ REGIST ERE O OWNER ADDRESS PHONE I2 0 �sN A 2x.ta� v� � An-S G `/ LEGAL OWNER ADDRESS PHONE CONDITION AND INVENTORY ODOMETER PEADING DRIVEABLE" I� WRECKED STRIPPED HAVE YOU ENTERED MISSING.IDENTIFIABLE YES ❑N ❑O UNKNOWN- Cl YES IxNO - ❑YESI`INo PARTS IN SVS? ❑YES O ITEMS YES NO ITEMS YES ,NO I ITEMS YES NO ITEMS YES NO ITEMS CONDITION 6ealsl Bu!Ael Cbck En9'ne I Tq Mm15slan 71re5'Wneel$ tima11FIon'1 I9nill.ln Key CarbyrelollSl Ay IomePc 1 1 Lell Fronl ':^ar lP.an He941rabon Allernamr 3-SPee01 I X RIyM F'oM a. - Ramo Dr Llgms I• ) Generator _ So a Letl Ree' TapC Dec• $ My'o'I51 I• 1 Ba lle'Y 7v HyE Ce051• I pqm Rear Tapes I• GIP, Ay CII,dd,Oner Map vw e." s0a'e LIST PROP I TOOLS.AND DESCRIBE VEHICLE DAMAGE IN REMARKS SPACE REMARKS IF ARREST MADE INDICa rE FULL NAMES.CHARGES AND WHERE DETAINED; IUSE AODOT ONAL BLANK SHEETS IF REQUIREDI bAkAr OFFICER ORDERING VEHICLE STORED- REVIEWED BY GARAGE PRINCIPAL OR AGENT STORING VEH ISIGNATIORE TIME AND DATE I 1Gp X { 1 x 1 (FOR OFFICE USE ONLY) APPRAISAL.RELEASE.DIS OSITION RECOVERY TELETYPE(DATE AND REQUIRED NOTICES SENT TO REGIS- TO STORAGE AUTHORITY CONCERED DATE NUMBER) TERED 8 LEGAL OWNERS 8 GARAGE (SEC 22852) ❑YES ❑NO IF NO IS CHECKED.INDICATE REASON❑AVA PROGRAM RELEASE VEHICLE TO APPRAISED TIME AND DATE SIGNATURE OF PERSON AUTHORIZING RELEASE VALUE OF APPRAISAL APPRAISING OFFICER'S SIGNATURE I D NUMBER SEC 22704 VC ADDRESS ROUTE TO CRIME vs CORONER OTHER CERTIFICATION. 1. THE UNDERSIGNED DO HEREBY CERTIFY THAT PERSONS I Alf LFG4LLY AUTHORIZED AND ENTITLED TO TA KE POSSESION OFA BO VE DESCRIBED I'EHICLF. CRIME vs SPEC SVCS PATROL SIGNATURE OF PERSON 1 AXING POSSESION PROPERTY .-19P REV 106 _ rmrea rrwAM 90 ItARM �- lMIfIInpMMIO,J,,. FFICER .S TEMENT, SECTION 13353 V HICLE CODE 367 q P,,a��diftie Sewiee/A�9e,g,(�KC�1QC ,� (COMPLETE IN BLACK OR BLUE►NIQ Onyl�l' Zc7 at TIME LOCATION / ` • rte'" Y was arrested, Citation No. for #2 MME --- VIRAIION Address STREET CITY SIAIL [IP CODE Dr. Lic. No. State D.O.B. Veh. Lic. No. Traffic Accident: ❑ YES ❑ NO NOTE: If subject does not have a California Driver's License in possession, please supply full physical description. RIGHT THUMB PRINT Sex Age Wt. Ht. Hair Eyes At the time of arrest,I had reasonable cause to believe the person arrested had been driving a motorvehicle in violation of Section 23152 V.C. or 23153 V.C. Among those actions which led me to that belief were: Probable cause for stop or contact: How did officer determine subject was driver: Objective symptoms of intoxication: NOTE: If arrest made by another officer or citizen, or, there are witnesses to accident, supply names and addresses on appropriate line. Arrest Witness CHEMICAL TEST ADMONITION (23157 V.C.) �1. You are required by state law to submit to a chemical test to determine the alcoholic and drug content of your blood. 2. You have the choice of whether the test is to be of your blood, breath, or urine. WHEN APPLICABLE: Since you need medical treatment, your choice is limited to TESTIS)NNE These are the only tests available at FACILITY NAME Briefly explain need for medical treatment 3. If you refuse to submit to,or fail to complete,a test,your driving privilege will be suspended 6 months,or revoked for 2 or 3 years.A 2-year revocation will result if this refusal occurred within 7 years of a separate violation of driving under the influence which resulted in a conviction,including such a charge reduced to reckless driving.A 3-year revocation will result if you had more than one of these violations within the last 7 years. 4. Refusal or failure to complete a test may be used against you in court.Refusal or failure to complete a test will also result in a fine and imprisonment if this arrest results in a conviction of driving under the influence. � 5. You do nothavetherightto talkto an attorney or have an attorney present before stating whether you will submittoa test,before deciding which testtotake,or during the test. 6. If you cannot complete the test you choose,you must submit to and complete a remaining test. The above Chemical Test Admonition was read to the arrestee by: ❑ Given in Spanish NAMF Response to: Will you take a breath test? urine test? blood test? The person arrested refused to submit to or failed to complete any such test.The refusal or failure was indicated by the following statements or actions: Com.,Olt RKISI,I I,Ke3H,y'. ❑ Drug Admonition given certify, under penalty of perjury, that the information on both sides of this form is true and correct. Date City County California Badge No. Leave Signature of Officer: or I.D. No.: Dates: Name of Officer(Printed or Typed) Agency Area NOTE: Attach any forms subject signed or refused to sign. MAIL TO: P. 0. Box 942890, Sacramento, CA 94290-0001 Agency Telephone No. ( } T-st C jh-.-ct 'lodel 4011A INTOXILYZER BREATH TEST Operator ®Ll✓t7r.A - - -- - --- - - - - - - PRECAUTIONARY CHECK LIST FOR INTOXILYZER Wait at least 15 minutes prior to collection of the breath sample, during which time the subiect must not have in.iested alcoholic beverages or other fluids nor regurgitated, vomited, eaten or smoked or used a mouth spray and has been under constant observation. Initial that 15 minute waiting period was observed. �1. Turn on/off switch to ON and mode selector to zero set. READYING CAUTION: Wait until READY LIGHT comes_o_n_ and ERROR ljjht aoes off. THE ✓2. Connect pump tube to breath tube INSTRUMENT �3. Mode to AIR BLANK, - purge �4 Mode to ZERO SET and adiust .000 to 003 AIR BLANK . ERROR light off - insert test card to LINE 6. Mode to AIR BLANK (d) FIRST W ✓ 7. Mode to ZERO SET - re-zero •000 to .003 BREATH 8. Mode to BREATH Note time: 3 SAMPLE 9. Insert a new mouthpiece into breath tube - have subject blow AIR BLANK �✓ AO. Remove mouthpiece & discard - connect pump tube to breath tube ✓ 11. Mode to AIR BLANK SECOND (� 12. Mode to ZERO SET - re-zero 000 to 003 BREATH 17 x/13. Mode to BREATH Note time: SAMPLE ' _x`14. Insert a new mouthpiece into breath tube - have subiect blow AIR BLANKy 15. - Remove -mouthpiece and discard (if results are within 0.02`: between 2 breath samples) . If no 0.02% agreement exists, repeat steps 11 through 15 until two samples with n.02% agreement are obtained . Connect pump tube to breath tube 16. Mode to AIR BLANK LEAVING 17. Complete the log book and test record THE rn on/off switch to OFF INSTRUMENT 1?. Sen rd section of test card to the laboratory (or place in designated rv) , give suh.iect first paper copy, and _ `orward one copy to Distr orney's Office. Please make sure subject 's name is legible. 90_��3� . cL-056 2/88 ti T-st lj� )`-ct &CoceY Model 4011A � ItITOXILYZER BREATH EATH TEST Op..rator -,at" . PRECAUTIONARY CHECK LIST FOR INTOXILYZER Wait at least 15 minutes prior to collection of the breath sample, during which time the subiect must not have infested alcoholic beverages or other flubs nor regurgitated, vomited, eaten or smoked or used a mouth spray and has been under constant observation. Initial that 15 minute waiting period was observed. 1. Turn on/off switch to ON and mode selector to zer READYING CAUTION: Wait until READY LIGHT comes on _ OR li hg t goes off. THE 2. Connect pump tutee to breath tube — INSTRUMENT 3. Mode to AIR BLANK - pur e 4 Mode to ZERO SET fust .000 to 003 AIR BLANK ERROR light off - insert test card to LINE 6. Mode to AIR BLANK (d) 7. Mode to ZERO SET - re-zero .000 to .003 BREATH i Z Mode to BREATH Note time: S3 SAMPLE ✓9. Insert a new mouthpiece into breath t bu e - have subiect blow AIR BLANK — 10. Remove mouthpiece & discard - connect pump tube to breath tube 11. Mode to AIR BLANK 12. Mode to ZERO SET - re-zero 000 to ,0 3 BREATH _ �� -L7'13. Mode to BREATH Note time: -Z S _ SAMPLE __�; �14. Insert a new mouthpiece into breath tube - have subiect blow AIR BLANK V/0�15. Remove mouthpiece and discard (if results are within 0.021 between 2 breath samples) . If no 0.02% agreement exists, repeat steps 11 through 15 until two samples with 0.02% agreement are obtained. Connect pump tube to breath tube 16. Mode to AIR BLANK LEAVING P/ 17. Complete the log book and test record THE I Turn on/off switch to OFF INSTRUMENT 1'1. Send cardboard section of test card to the laboratory (or place in designated depository) , give suh.ject first paper copy, and rorward one copy to District Attorney's Office. Please make sure subject 's name is legible. IFO -lee CL-056 2/88 V T 6 6 1 p F T-I)R :i i7 T m 0 1, A T C H E IT, OV . 'rl"N#F/N* T D, n,, r A 1-1 EINFORCEMENT "'-v r)NTr v DL/1:O :II035.1160*B/D : 04-28-36*P•IAiiE: E'JCkLEY „C :1 .:SLVI'It ADDR AS OF OJ-O8-57 : _50 SHAR I�j L" r ,I pl 0 ,1 T,Jm ^DIV A 9.1 C.- iDEITT T—Yjfy� -%TrOr'lJAT- ar �.Q �;. T 0 Jj SEX : ',,IAL--*14.-' ID BROWN*EYE-S : GRAJ*FT : 5- ' no*omUj .- nrR AS OF 0 -1 ?-86: 4081� "Ir. DIE FLORES 11 AP m--.;iE.7 rT �-C/ISS : ,19-'-5-"6*EYP/BD : 90*("7*-ASS : "-I * LATEST APP: DLTV D 1.1 L' r Vim`*iSS (nnTE : vl C 71"B A TZ S 0 0 L I C E"ZZ E S T J:T U V.;r-D* nlTV'-'--.RTllENT AL '.Cm. 1 CllS �OM7 T f-M TI)N C I- L, -�-� �TI)NC VTO. T In' np N11!nm f) r"v m Jzln n ir c o T r. 01-17-84 01- 17- 0-T. 73 C, a C. *COURT PROB 01 YR 03-13-86 12-09-87 23 T -. CONSENT - DATTE nj -0� op *COURT RSTR , T.ERH NOT R-EPT ' -n *COURT PROB 03 YR COURT PROBATION TER,''S -1 H ! S E O'Jf-,7u 1 2- OR- ?r,' , VIOLATION DATE DOCIrr" ::U: EER J)325 3i SHALL Ofn CoLiX I rr C 0 T Ij q It.y , r M . I , - A* mvc..m I op. DRI%IE 11 p'. T C T T.1 11VIPM COPOI 00n 1—�l AL nBt-V ALL r A r.TS COHPLY WITH SENTTZ"rCT27r- CONSMME NO ",r—CCPJL DRIVE OHL Y IF I Tr'E!,":'rD ,ND T"S U P ED REPCRT CH.'- NIOT OF O3CT-'VNC-17ijnr n V!I r"l T CTPEP FAILURES TO APPEAR : r ?I(')�T 11 A,� Acc�'DENTS : .j NONE CONTRA COSTA COUNTY SHERIFF-CORONER CRIMINALISTICS LABORATORY - - N(OXILYZER TEST RECORD aco LIN ebpOD INDICATE BY INITIALING • -'-� -- BELOW THAT SUBJECT WA. B '1 9 OBSERVED FOR 15 MINUTE: • . BEFORE TEST AND CHECKLI S 1 � A 0 0 AS USED. W g •Z 2 INmALS. . 1 A •Q V FOR INSTRUMENT ACCURACY DETERMINATION: Q 1 7 OPERATOR wmALS • TEMP. SIMULATOR A 0 Q SOLUTION NO. IO NT X ILYZE R PRINT CODE B 1 4 A AIR BLANK A 0 0 B BREATH C-CALIBRATOR lator 1 (Simulator) rr44 4t L 0 _- z A 0 \ U O z 1 < Z. z w w u O J 1 Uf N 4 Z WZ O f` w w w n 2 �• I 7 1 — f O 3 �l N Z Z O \ _ t 7 1 w C .......................................................... l �1 z `) z 4 / � 7Z `� o Case File No. Icharges Date (-Io- i&2� f.3t "L c� cvc 1 I i1 Name(Last,First,Middle) Citation No. INTOXICATED DRIVER REPORT A' . ��{per2ii� l-t Residence Address City Residence Phone CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT LC' Business s Add ss,�,,,� City Business/Phone r� /� _ ' F G+-{�:.(-�'l� >^ji(�I -Q�. D &S, (p-','x /00 CITY OF: A�_ rl-k I Location of Arrest Time of Arrest r7 Driver's Li[.p Stta�te License Status !lf— eiK. ��'+I/(:S�.�I <�^l.?.'1:.C:. �9 ! tJ.7zI �r CJ jJ l�fj Sen Hair Eyes Height Weight Date of Birth Date/Time Booked Social Security p / Q i {� PX•N (_7f-'tl �L{ IZ:J ".Z7i")� � (G'GI- �I— ?�3(�_ -Date 8 Tree-O� lx ccred-,-11� - i '11 (( Location Code Date/Time DDL Req.Sent Method Sent Z{ "'It,./ P— I t`1 '7zA 3 ❑TT❑Mail❑Phone VEHICLE INFORMATION Vehicle License Nu her Stale Year of Ve icle M Body Type Color 2CMG I $ CIA ,7 � r,���L�;�1 yt�)4 Registered Owner Same as Driver R/O Address ,g Same as Driver Passenaers I Stored tNtame of Garage/Released to Address M l F Yes ❑No 1- M-Lfai N+ r'� —1 FIELD SOBRIETY TEST Was Subject's Vechile Involved in an Collision Report Number Heel to Toe/Walking Line Test L.Foot O R.Foot Accident? �i•�- Ves 9'40 Administered? ❑Yes ❑No Breath:Order of Alcoholic Beverage Strong Moderate nWeak Glasses/Lenses Eyes ED Yes XNo Speech �,0�� Clothing Worn/Condition and Description f ae;r c5U1E1q-7CXn 36,11al1 —1 -5#-14T 10.477r Finger to Nose: Balance: v r Other: Describe Test Location.Surface,Weather and Lighting -7:AV-4,y-, fir. IMPLIED CONSENT 231.57 V.C. 1. YOU ARE REOUIRED BY STATE LAW TO SUBMIT TOA CHEMICAL TEST TO DETERMINE THE ALCOHOL AND DRUG CONTENT OF YOUR BLOOD. 2, YOU HAVE A CHOICE OF WHETHER THE TEST IS TO BE OF YOUR BLOOD.BREATH OR URINE. WHEN APPLICABLE:SINCE MEDICAL TREATMENT IS NEEDED,YOUR CHOICE OF A TEST 15 LIMITED TO: THESE ARE THE ONLY TESTS AVAILABLE AT: TEST(S) ...E BRIEFLY EXPLAIN NEED FOR MEDICAL TREATMENT: 3 IF YOU REFUSE TO SUBMIT TO.OR FAIL TO COMPLETE A TEST.YOUR DRIVING PRIVILEGE WILL BE SUSPENDED 6 MONTHS,OR REVOKED FOR 2 OR 3 YEARS.A 2-YEAR REVOCATION WILL RESULT IF YOU HAVE BEEN CONVICTED WITHIN THE LAST 5 YEARS OF DRIVING UNDER THE INFLUENCE.INCLUDING SUCH A CI4ARGE REDUCED TO RECKLESS DRIVING. 4. A3-YEAR REVOCATION WILL RESULT IF YOU HADMORETHAN ONE OFTHESE CONVICTIONS WITHIN THE LAST 5 YEARS.REFUSAL OR FAILURE TO COMPLETE ATEST MAY BE USED AGAINST YOU IN COURT.REFUSAL OR FAILURE TO COMPLETE A TEST WILL ALSO RESULT IN A FINE AND IMPRISONMENT IF THIS ARREST RESULTS IN A CONVICTION OF DRIVING UNDER THE INFLUENCE. 5. YOU DO NOT HAVE THE RIGHT TO TALK TO AN ATTORNEY OR HAVE AN ATTORNEY PRESENT BEFORE STATING WHETHER YOU WILL SUBMIT TO A TEST.BEFORE DECIDING WHICH TEST TO TAKE.OR DURING THE TEST. . 6. IF YOU CANNOT COMPLETE THE TEST YOU CHOOSE.YOU MUST SUBMIT TO AND COMPLETE A REMAINING TEST. THE ABOVE STATEMENT WAS READ TO THE ARRESTEE BY: G'tJ 11J�L%�/ ID, 371L—L— TIME TIME I.D.OF SAMPLE RESULTS.IF AVAILABLE DISPOSITION OF SAMPLE []BLOOD ❑BREATH ❑URINE DL 367 COMPLETED 0REFUSED ��' /�A DRUG ADMONITION , i-7 L) ®ATTACHED IDL 367AI LOCATION WHERE TEST CONDUCTED NAME AND TITLE OF PERSON GIVING TEST OR TAKING SAMPLE • A. THE BREATH TESTING EQUIPMENTLOT RETAIN ANY BREATH SAMPLE FOR LATER ANALYSIS BY R ANYONE ELSE. ^ B. IF YOU WANT A SAMPLE RETAINED.Y AY PROVIDE A BLOOD OR URINE SAMPLE THAT WILL BE RET AI D AT NO COST TO YOU IF YOU DO SO.THE BLOOD OR URINE ' SAMPLE MAY BE TESTED FOR ALCOHOLIC OR DRUG CONTENT By EITHER PARTY IN A CRIMINAL PROSECUTION. OFFICER_ TIME READ LOCATION ADMONITION OF RIGHTS 1.YOU HAVE THE RIGHT TO REMAIN SILENT, 3. YOU HAVE THE RIGHT TO TALK TO A LAWYER 6.IF YOU CANNOT AFFORD TO HIRE A LAWYER. 2,ANYTHING YOU SAY CAN AND WILL BE USED AND NAVE HIM PRESENT WITH YOU WHILE YOU ONE WILL BE APPOINTED TO REPRESENT YOU AGAINST YOU IN A COURT OF LAW, ARE BEIIN�G QUESTIONED. BEFORE QUESTIONING.IF YOU WISH ONE. THE ABOVE STATEMENT WAS READ TO THE ARRESTEE BY: C"'3_� �l L'�JC�L-t-� 10 TIME ' 3's DO YOU UNDERSTAND EACH OF THESE RIGHTS I HAVE HAVING THESE RIGHTS IN MIND.DO YOU WISH TOSUBJECT'S WAIVER STATEMENT EXPLAINED TO YOU? TALK TO US NOW? tl µ� to%LH RCS l lti,, IS MY YES n NO MYES IN NO it INTERROGATION 00 YOU KNOW OF ANYTHING MECHANICALLY WRONG WITH YOUR VEHICLE? ARE YOU SICK OR INJURED? DESCRIBE DESCRIBE ❑YES Cl NO ❑YES ❑NO ARE YOU DIABETIC OR EPILEPTIC? DO YOU TAKE INSULIN?(PILLS OR DO YOU HAVE ANY PHYSICAL DEFECTS? DESCRIBE INJECTION) ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO WHEN DID YOU LAST SLEEP? HOW LONG? WHEN DID YOU LAST EAT? DESCRIBE WERE YOU DRIVING THE VEHICLE? IF NO.WHO? WHERE DID YOU START DRIVING WHERE WERE YOU GOING? ❑YES ❑NO ❑N/A WHERE ARE YOU NOW7 WHAT HAVE YOU BEEN DRINKING? OW MUCH? TIME STARTED TIME STOPPED WHERE WERE YOU DRINKING? DO YOU AFEEL FECTS OF THE DRINKS? DESCRIBE YES ❑NO ARE YOU UNDER CARE OF DOCTOR IF YES,NAM DRESS OR DENTIST? ❑YES ❑NO HAVE YOU TAKEN ANY MEDT IF YES.WHAT HOW MUCH? TIME OF LAST DOSAGE OR DRUGS? ES ❑NO 00 YO L THE EFFECTS OF THE DRUGS? DESCRIBE WITNESS AGE SEx NAME ❑PASSENGER o VICTIM ADDRESS p PHONE RES ❑ ❑ CIRCUMSTANCES �I�`rrER- �o Ass�lra�� La iPv(L` AI ?ESTI G OFFICER(NAME&RANK( JID.Na SUPERVISOR(NAME B RANK) I.D.NO DATE - �Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat �0 ❑Supplemental P.O. Box 391,Martinez,California 94553-0039 ❑HRp Arrest ❑S( 1.PP No. 2.City Code 3.Crime/Classification 4.Detail 1 2_3 t S Zh_ 5.Rectassi- L,1I "1 N 3 . I 2. fication. 6.Victim Name(L,F.M) 7.Date Ong.Report 8.Employee No. ❑ 9.Address/Location of Occurrence 10.Suspect's Name(L,F,M) 11.Property Description: Impounded.Recovered,Found,Lost Stolen"Item Number,Article,Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs:D)Vehicles;E)Office Equipment:F)Radio.TVs,etc.: G)Firearms:H)Household Goods:1)Misc. 12.Recovered Property$ 13.Narrative/Statements (1) (2) A-r- — -i �1=�`+"_ �h O( f,Lc64 `�. Gc tit � <<.` � D ,c) (3) S OC_.4-�-1 IL-A4-A'46t t 4:- Cc- (4) (4)—' rr'-+ v'�� CeFA a (5) //C—S i:I-> E n� -•->!0 h7� &C/eLC -/' &v-A- (6) tc,6 = 0U oer?-`� //QS%0vC,7eZ> / lc- 70 rat. 4 (8)-r1 � �uittsv ✓f(� �Z4,?.c.`E+� .yJ`- �UC�GL=z� GJC1'_ it �t�,� /�r'cT��� (9) CLY_A-770 c\l o d 4 D aPeWC-3y;' .5 C-�4 `=7.'_ D�'-- (10) �F ?ffE r�'�w.J-D006t�: �E,c/ i�J�, 0 77- a� GA►Z' -Z/2 `Ci 0)AS � �Y� . REQS S (12) As'� _/— Pte— G6c, 1 6h S T . r-05C=� 1G f (1 �c S k � '� OK ; . , ot) 74 �`� 14ta_n f ►�,��� M A�-iG ,II AS (14) S- t�lR �� _ -� t (� +ick il. �'�S Imo` 5c=�•1�Z G`� G��r� (15) 4 p" !f> �N OL��F— 6) if eaC6 (16) Yf-- 4d ASS i' ,dCv (17) LoaaS�o' As✓--n &(Cel fVJ 774,+7— 145 �i�t k!�.�iC� 775 d, lCi=� 064 vfc4A , A,l� (201 i104 ES AL1 i Od ti i N6r:C> 7t 1315 iJ, 774 4JS, r/ (21) �3' - 7�ql5 -7 7 tih5- OIFCi- . C.1 Jck'ra /1,i LU (22) �xce �cy llf- /5�if Vc- ( l-1 L(x 4'rrc (23) L)c/-/i ��j•ttd .SCS c/(- �1IJG G7� L17�li /.%�� �' UL;rLiC- -I Qn,� (24) /��+P:-�e� fes—' c '�' ,JA � = ^Zi "cc irC 6t e e'c�;a �.- S - (2s1 DF I 14.Distribution 15.Additional Routing E]13 ❑C ❑DA [3 DE ❑L 0 Fl.SR ❑V ❑Investigation ❑Vice [:]Narcotics ❑Juv ❑Coroner ❑Property Ck. ❑ACS ❑Intell. ❑R.O. ❑SHC I Ve oning Deputy(Print) 177.Date/T me riven 18.Dispo. ❑Patrol Captain E]Compt.Ofc. ❑Marine Patrol C� 7 / �/'��1 /Fri L0V;LV ❑Other 19.Approving Supe(Print) 20.Supv.No. 21.Date 22..}ge _ot_ �1 Continuation CONTRA COSTA COUNTY SHERIFFS DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRo rjArrest ❑SI 1.DF.No. R� 2.CittyCo-de 3.Crime/Classification 4.Detail 1 ,;?3 t_,ZA 5.Reclassi CLI — 1 W �t,y�T 'i pJ 1L_ a J..:Sa 2. ficaoon 6.Victim Name(L.F,M) 7.Date Orig.Report 8.Employee No. ❑ 9.Address/Location of Occurrence 10.Suspect's Name(L,F,M) 11.Property Description: Impounded,Recovered.Found,Lost,Stolen-Item Number,Article.Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-UST IN FOLLOWING ORDER:A)Currency,Notes:B)Jewelry,C)Clothing,Furs:D)Vehicles;E)Office Equipment:F)Radio,TVs,etc.; G)Firearms:H)Household Goods;1)Misc. 12.Recovered Property$ 13.Narrative/Statements 12) cu CN I C= /7 ii � ��etik= ,��(3) ..a- S i (4) � . — r���K�� t -�'- _KD (6) �r- m (8) ASD �-7k,-,J 7p Ov' � j 4 � F S 7 �S r�cJT c�rF� i (s1 Ll7 ,R-/C �• (10) --....._....r-1^1 ,_� y . ..e!f 1CC4-- r1l v' 5 - (12) Cly-`N �C,t% -706 C.— 5h1C WAS c OA;51�'r� ' /^ � / (13) (.�� / .+7u0 /`r0✓7� r=n-c. cv:�4,. TCF r /L.I.V�—>•� It 4) ,A'VL7 f T t7Cf=- �j jl � C;iL-r) 'L t't9 T Tf><c� �7• Uti�s� �� (15) W1,b AoT GQ�� A�D!� ��Sc=� 7Z? -Ai!� ,-77J V FIS 's d (16) 066)1005 774*-r- S-/L/Ar' U A)A-S U&)an�' 714E (17) /of F6 00AjC45' 0/'::7 A(-Z41-D C X470 0 40-,95 e;D u.� -7G A }5� AZ n61 31 52 &VC . h - 1-4+ -r LC- , .45 L,154Y4j[7 vL=g--�4,-1 ns) rO yi�L 4T N� S /.-JC, lir TTiG �Ji3r -'f{tr3 ALL (20) irV!` . { 1 U S- /`/A TELLons -C-4-t5n t.-)7Z) 7,47-A4, eol-7712- . (21) (22) 77�&'v 50-TC/ SMV . FJ (23) 45 4Z' .:5- lei =CZE Lr/�= �r7r k` int ouL t� !`r�!!-G� 'Cr f<E!(�CGAL� (241 ',� 7'c� %�G` r(-C r ti (� t tt�C t�fC;(�i rti)r1�l (AS f-'�� 6--tw (25) ��- r�R r�zt� 4 ,17 c�;-,<U u -L�� A( T � AA-) ;3a}ki SC- 14.Distribution 15.Additional Routing ❑B ❑C ❑DA ❑DE ❑L ❑O ❑SR ❑V ` ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property Ck. []ACS ❑Intell. ❑R.O. ❑SHC 16.Reporting Deputy(Print) 17.Date!Time Written 1.8.Dispo. ❑Patrol Captain ❑Compl.Ofc. ❑Marine Patrol ^+'��-7 —X7.1—Cf 0% ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.TP _of_ Vj Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat ❑Supplemental P.O. Box 391, Martinez, California 94553-0039 HRo Arrest ❑SI 1.G( No. 2.City code 3.Crime/Classification 4.Detail 1 5)5 j,A 5.Reclassi- al�kll0— ✓ - f Li NIL l2(:t V. .�:(-� 2. ficaoon 6.Victim Name(L,F.M) 7.Date Ong.Report 8.Employee No. ❑ 9.Address/Location of Occurrence 10.Suspect's Name(L,F,M) 11.Property Description: Impounded,Recovered,Found,Lost,Stolen-Item Number,Article,Ouantity,Brand/Make/Manufacturer 5 Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs;0)Vehicles:E)Office Equipment;F)Radio,TVs,etc.; G)Firearms;H)Household Goods;1)Misc. 12.Recovered Property$ t3.Narrative/Statements 11, (4) �.4i.J <Sf-460 TD 774 (5) - >Ct/Sc AL � Z- fft (6) - 14JQ'44r� ti l�S �1 � G/ c'X J�-O -7— J�- (9) �O R 5 eT? w At / 1len f l)a (lo) A —52M f 3 7 Z CCC 33�. i' 44 Gc)AS (12) c%7 `,(,1,J e:P-A tj—f-- A-P— ,/ ' 113)— LC.4,L (14) (15) 1.4 Ca =OEQ�'--L C( -Q r'?z til A- (17) Co 0- ."--#3- i ?r'AI.—NCG . (16) (19) M 'e:L -4� (20) IZa,���it wr1-C-'f'� 6 /4e (21) (22) (23) (24) -j-0 lc� r JE� i^�Ti`.-9C r ^� IG C��/-4 t (251 14.Distribution 15.Additional Routing ❑B ❑C ODA ODE ❑L 00 ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property Ck. ❑ACS ❑Intell. ❑R.O. ❑SHCt6. oVrting Deputy(Print) 17.Dat /Tpe�Written t ispo. i ❑ Patrol Captain E)Compl.Ofc. ❑Marine Patrol (�71..C�. ���� ���•� ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.Page S ti—of •J)-�Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat V-C ❑Supplemental P.O. Box 391,Martinez,California 94553-0039 HRO ®Arrest ❑Sl 1.D No. City Cie rime/Classificati 4.Detail 1 �,_, f i*., 5.Reclassi- 1�i�^3; �� „�,. L- X-I Ji RC1 2 fica7on 6.Victim Name L.F,M) 7.Date Orig.Report 8.Employee No. ❑ 9.Address/Location of Occurrence 10.Suspect's Name(L,F,M) 11.Property Description: Impounded.Recovered,Found,Lost Stolen-Item Number,Article.Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken.Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs:D)Vehicles;E)Office Equipment;F)Radio,TVs.etc.: G)Firearms:H)Household Goods;1)Misc. 12.Recovered Property$ 13.Narrative/Statements (1) (2) (3) pct ">t•TiGr.1^�'�.� l 'i�-f-Cr'ki"t O r'� AP (4) L —1 ec,-n 1JC-r Gr— - � .tGrLLe-/ (5) 03 (7-1. I ;a l '--:I eIF m (8) (9) �JGr i �• CE W, r�-v J r s c[� o f T7kt. t n�c : o�T p (10) og-cliao --nA-15 (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) 14.Distribution 15.Additional Routing ❑B ❑C ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property CIL ❑ACS ❑Intell. ❑R.O. ❑SHC 16.Reporting Deputy(Print) 17.Date/Time Written 18.Dispo. ❑Patrol Captain ❑Compl.Otc. ❑Marine Patrol ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.Page 4"of mnruurw.0 ' —` "Ae�� ' N'W.l0T� OFFICER STATEMENT, SECTION 13353 VEHICLE CODE 367 A PaO& Set"m�� Afeww (COMPLETE IN BLACK OR BLUE INK) On t ZI `lO at AM-PM at _L-iA-A:2\gE17 _ ___?C=L.IC�F_ L-F-P DAIS "ME EOCANON 6INQ {-IAi2onl Z� �1i�92 ZL was arrested, Citation No. 90 '/ 3 for µ.3i -= Address,8 7 i�5"o� ��� 1-1014 --7:1 �ou,o�� �o SIREEI'/ Cm SIAIE IIP CODE Dr. Lic. No. �921293 State itq D.O.B. 13/5 I Veh. Lic. No. -9 4? `�� Traffic Accident: ❑ YES IN NO NOTE: If subject does not have a California Driver's License in possession, please supply full physical description. RIGHT THUMB PRINT Sex r Age J - Wt. 5' Ht. IZS Hair Eyes 6 At the time of arrest,I had reasonable cause to believe the person arrested had been driving a motor vehicle in violation of Section 23152 V.C. or 23153 V.C. Among those actions which led me to that belief were: Probable cause for stop or contact:• M A4Te_ L.. WA 5 6ML,-Lo;r-� S — hx -1et=i.f!�:�/ Ao:p Z) l,:a tom rlE.4 r,j,1+S .455c": r --o How did officer determine subject was driver: 66-z'l ti;-DL(V 4_ 2),46/J,06. 4-4-5e �$-4o AS hoz E Q'GLi?.470 T ,haJ /o o F vo- /Ic.,'67. Objective symptoms of intoxication: 6La66y E YEs, NOTE: If arrest made by another officer o cir tizen, or, there are witnesses to accident, supply names and addresses on appropriate line. Arrest Witness G -Ut= 47170 CHEMICAL TEST ADMONITION (23157 V.C) 1. You are required by state law to submit to a chemical test to determine the alcoholic and drug content of your blood. ✓2. You have the choice of whether the test is to be of your blood, breath, or urine. WHEN APPLICABLE: Since you need medical treatment, your choice is limited to IEST(S)XAME These are the only tests available at EACIEIIr XAME Briefly explain need for medical treatment (AnR„ur M rt,rnr,IOrttfJrry 3. If you refuse to submitto,orfail to complete,a test,your driving privilege will besuspended 6 months,orrevoked for2 or3 years.A 2-year revocation will result if this refusal occurred within 7 years of a separate violation of driving under the influence which resulted in a conviction,including such a charge reduced to reckless driving. A 3-year revocation will result if you had more than one of these violations within the last 7 years. 4. Refusal or failure to complete a test may be used against you in court.Refusal or failure to complete a test will also result in a fine and imprisonment if this arrest results in a conviction of driving under the influence. ✓5. You do not have the right to talk to an attorney or have an attorney present before stating whetheryou will submit to a test,before deciding which test to take,or during the test. ✓' 6. If you cannot complete the test you choose, you must submit to and complete a remaining test. 1sj The above Chemical Test Admonition was read to the arrestee by: i :_1 i , 0i4,64fz. 7_ ❑ Given in Spanish NIJIf Response to: Will you take a breath test? /,/O urine test? �C) blood test? �_ The /person arrested refused to submit to or failed to complete any such test. The refusal or failure was indicated by the following statements or actions: w�SNr"i 6-1 A PA;_> thEJ� Cmonor m nwrx n nruurry. ❑ Drug Admonition given certify, under penalty of perjury,that the information on both sides of this form is true and correct. Date,211`r City /- -Ig 4`1�� -' County4��, A - California 1 Bad No. Leave Signature of Offic ^c" �� or LD. No. 7*/0 Dates: Name of Officer(Printed o Typed) �yp C� l�-r»� 471�G(r Agency Area NOTE: Attach any forms subject signed or refused to sign. ) -� �, MAIL TO: P. 0. Box 942890, Sacramento, CA 94290-0001 Agency Telephone No. (`�I ~� CONTRA COSTA COUNTY SHERIFF-CORONER ABANDONED, IMPOUNDED, RECOVERED LAFAYETTE DANVILLE❑ SAN RAMON❑ ORINDA❑ STORED OR RELEASED VEHICLE REPORT CRIME BEAT DATE FCN- CASE FILE -4, G _ TYPE OF REPOR ICHECK ONE) IF A RECOVERED STOLEN VEHICLE,HAS NEI(:,HBORHOOD OR AREA BEEN CHECKED FOR ❑ABANDONED ❑IMPOUNDED TORED LEADS OR CLUESn ❑ABATED ❑RECOVERED R LEASED 1 ❑YES ❑NO (LIST LEADS OR CLUES IN REMARKS OR SEPARATE EET) PERSON REPORTING OCCURRENCE ADDRESS PHONE TIME AND DAT _ REPOR D DESCRIPTION AND OWNERSHIP YEAR MAKE MODEL 800Y TYPE LICENSE NUMBERISI YEAR STATE COLOR ICOMBINATIONI -- V"ICLE I ENIIFICATION NUMBERS IVINI DOES VIN COMPARE DOES VIN APPEAR IS VIN CLEAR IN LIC NUMBERISI ENGINE NUMBER(ENT WITH REG CARD' ALI EKED}T'{P,( ��SSYaaaSTEM, yy�CLEAR IN SVST I P 8P46 c 7Ec�l ES ❑NO [DYES Ij�NO ES ❑NO -1 ❑NO UNKNOWN // N"' /_ IF STOLEN NAME DATE AND CASE NUMBER OF REPORTING AGENCY WAS VEH RETURNED TO STORAGE AUTHORITY OWNER' ❑YES NO vn- LOCATION TOWED FROM WHERE STORED' TIME AND DATE TOWED _) 1 OLD 1 _ 1_ 15 NAME OFG RAGE ADDRESS PHONE CJ r t1� lon#4 d EGp,vi) REGISTERED OWNER ADDRESS PHONE aN.aeo•3 9.087 A SGC 1 A Q 04 M A LEGAL OWNER ADDRESS PHONE 5 CONDITION AND INVENTORY ODOMCS ER°.EApu+G ORIVEA&LET WRECKED'ISTRIPPE n HAVE YOU ENTERED MISSING,IDENTIFIABLE ES ❑NO ❑UNKNOWN 13YES O ❑YES PARTS IN SVS? ❑YES E:1 NO ITEMS YES NO ITEMS YES NO ITEMS YES NO ITEMS YES NO ITEMS CONDITION S-m-y, E-..nel Clxx Tues/WDKIs tial lFrKer AutomaliCI I LeIIFrOnt •i.al•R.a•1 Re4,ig40n Ahernetor J-SPeeo I I Rrgm FrOnl a Ratio Dr Lrgn6 l• 1 -enpAO• a-Speen LAR ReA Tape Decm S M.r•o•Isl la F 1 Battery Hum GOP,(a 1 Rion.Ree, Tams la -G,-II A•,I-0a.one, I K191 MAR Wneert $pare LIST PROP )PARITY.TOOLS.AND DESCRIBE VEHICLE DAMAGE IN REMARKS SPACE REMARKS..F ARREST MADE INDICA t FULL NAMES,CHARGES.AND WHERE DETAINED: IUSE ADDITIONAL BLANK SHEETS IF REOJIREDI ` I� E-:: c v� 3 15 0, OFFICER ORDERING VEHICLE STOREDREVIEWED BY GARAGE PRINCIPAL OR AGENT STORING VEH (SIGNATUREI T.ME ANO DATE x `2 r if)" _."V x �C (FOR OFFICE USE OA'LY) APPRAISAL.RELEASE,DISP SITION ' RECOVERY TELETYPE(DATE AND REOUIRED NOTICES SENT TO REGIS- TO STORAGE AUTHORITY CONCERED DATE NUMBER) TERED 8 LEGAL OWNERS 8 GARAGE (SEC 22852) ❑YES ❑NO IF NO IS CHECKED.INDICATE REASON❑AVA PROGRAM RELEASE VEHICLE TO APPRAISED TIME AND DATE SIGNATURE OF PERSON AUTHORIZING RELEASE VALUE OF APPRAISAL APPRAISING OFFICER'S SIGNATURE I D NUMBER SEC 2270A VC ADDRESS ROUTE TO CRIME Ys CORONER OTHER CERTIFICATION. I. THE UNDERSIGNED DO HEREB)'CERTIF)'THAT PERSONS I AM LEG4LLY.4 C.'THORIZF.D AND ENTITLED TO TAKE POSS£-SION OFA BOt'E DESCRIBED I'EHICLE. CRIME vs SPEC SVCS PATROL SIGNATURE OF PERSON TAKING POSSESION _ PROPERTY my R =°..g R=V 1 86 Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat e Supplemental P.O. Box 391,Martinez, California 94553-0039 HRO Arrest ❑SI 1j!!!j,ONo� � 2. ry Co 3.C Clan. _sitjcation 4.Detail 1 5.Reclassi- 2. 6.ViMe It.,F.M) ate Ofiq�Fe{�O 8.Emp4 jfllpt_ ❑ 9.Address/Location o,Occurrence 10.ISuspe�d's Name{L.F,M) 3%'!J 11.Property Description: Impounded,Recovered,Found,Lost Stolen-Item Number,Article.Ouantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs:D)Vehicles;E)Office Equipment;F)Radio.TVs.etc.; G)Firearms:H)Household Goods;1)Misc. 12.Recovered Property$ (;.Narrati / latements IAS , / et-4at C //LW (2) G /s��a 8 3 / �r,�,z Exo,.r.� (3) sF� C� 9o- / / .44 - gown,/ Z?W1AF (4) S G1ee7Vse- ltt�2ZAA?E- fe,?oE�- (V Gc,/.A-S .� ,✓�uo�, (5) � cS " Ong Y L� Z !.4/AS 7? t' 6Zt .(6) S/� / 7A-14OUteAl TSE dee- (7) 7;IC 4&?:M7-S.oE pF f77 iT &tom- ©F 1-; 1C /ir f�jWe S 12peZ. ,✓ (9) ,(Gly' S�,roo G✓/%1��✓ /¢' �oT �i� �TT7r�6 / .rv.L (14) V`LL7eve7 oyeye (,5) 1&e.aWA) (CLE' (,c/�(GsF (.(/A-S ✓r�J �8Y 447CZL- (16) .= T 77WIC l ✓ p f' / E � = A-Sdc rinT ) Oe:r �K Ct c.6E�?feT, t1 (16) Gf/o /�f�t'[G 4�GT &JI� /",i/'FfL ,� E (19) 6zcCA/j; #4'r- I e: 14.5 S;(e- aoAr ii (r✓ oA ..i (20) /� S/c'+�ZC �7iU,v✓G' DDO.te- /�£ �✓ OG/G ,�(/�?CA4G (22) S sLEb / [/9Y ��tS (iCJ i'•fc �0 (24) (25) �cMEYlv4I � 4F �Amz- 07Z D 14.Distribution 15.Additional Routing ❑B QC ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property Ck. ❑ACS ❑Intell. ❑R.O. ❑SHC 16.R or g pu Print) 17. /T �pys�o'f0 ❑Patrol Captain ❑Compl.Ofc. ❑Marine Patrol . ❑Other 19.Approving Supe(Print) 20.Supv.No. 21.Date 22.Pape 0 ❑Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat [�Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO jj Arrest ❑S( No. 2.C' tl 3.Cr lessifi a on 4.Detail 1 h' 5.Reclassi- Q� 3� C 2. ucavon 6.Vic ^me✓s(L.F,M) 7.Date On l7eyorL,Q 6.!, pli7ej 119„ ❑ s ( J 9.Address/Location of Occurrence 10.Suspect's Name(L,F.M) 11.Property Description: Impounded,Recovered.Found,Lost Stolen-Item Number,Article,Quantity,Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description,Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes;B)Jewelry,C)Clothing,Furs;D)Vehicles;E)Office Equipment;F)Radio.TVs.etc.; G)Firearms;H)Household Goods;1)Misc. 12.Recovered Property$ ;),Nar / atements �A'� �` �^�O �• L �_ (2) -�oIni� 7� o AVY0 (3) 441) /7- 4,�1s�c�✓7V�-+FK 4f�6 (.E'- (5) O x� A,fi✓r �l.�c//n/c� Gc� � /r/R� Ifs (6) ��/L ~� G!n/ - c� /✓�LuC�'�C� 23 �L re►/ (10)—/—D C--re7- &V7- OF WeX-- �44ee-. (,2) Ui✓`► Y tel`/ GK- /�"�'�u�rf-rr /��, /�/�?�67 Or� , (13) 1 � Z&-7- {�^ \G+4��. �7-1/ (14) Z7 (15) C%V G je—. 6 / &Af l` /(�6/ �i /`�/l Vf�Cy W�, /v A:24 i oC �- (17) 7571eJ -77.o-4C �� `^�� Cw(e a AAvla (16) 2-00�C l/ 007D / G�- �iC`�AC�-�s ' /5f: 1 (- ' �� �/i��� /�J/��y //(/�goh � (20) E �TJLvc, r G�/s/<eE q�� e-�'icQE�u/e�x-T (21) if?gWAo -70 (22) PZ-& � i. r� 77OZ/ETsrc (23) (24) 6f f:q '` &Tl& t4ee'/CE �oN 14.Distribution 15.Additional Routing ED ❑C ❑DA ❑DE ❑L ❑0 ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv - ❑Coroner ❑Property Ck. ❑ACS ❑Intell. ❑R.O. ❑SHC 16a tin ep (Pri ) 1 I /ii ritten 4 Dispo. ❑Patrol Captain ❑Compl.Ofc. ❑Marine Patrol C) •�� (]Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.Page aq o— rn....n .._.. •.oma. ❑Continua5on CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat A Supplemental P.O. Box 391, Martinez, California 94553-0039 ❑HRO [�Arrest ❑SI O I ' iz ry� 2 ty 3.�CWssi cat 4.Detail 1 d/ 5.Reclassi- ((.XXJ� 2 ficaoon 6.Vic ti me(L,F,M) 7.Date Orjy i--T o 6.Emp yo 7 ❑ s .0 `Y 7 r J 9.Address/Location of Occurrence 10.Suspect's Name(L,F,M) 11.Property Description: Impounded.Recovered,Found,Lost Stolen-Item Number,Article,Ouantity.Brand/Make/Manufacturer's Model Number,Serial Number,Miscellaneous Description.Location Where Taken,Value,Include Total Loss-LIST IN FOLLOWING ORDER:A)Currency,Notes:B)Jewelry;C)Clothing,Furs;D)Vehicles;E)Office Equipment:F)Radio,TVs,etc.: G)Firearms:H)Household Goods;1)Misc. 12.Recovered Property S 3. avSeemeriti / 7 /( � � (2) . �Y 6:1-7- . (3) coxer�� (4) -- E may' mei--s �-x- err✓ .36 7. (5) .c �i� &7ej'N4 i47 it��� .S'�-/E G✓ASlv�T cS-D1,A6 73 (61 ti4 (9) /f/o 141 ,rIL, Ie2- ,07 (14) l (16) (17) (18) (19) (20) (21) (22) 123) (24) (25) 14.Distribution 15.Additional Routing ❑B ❑C ODA ODE ❑L ❑O ❑SR ❑V ❑Investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner ❑Property CK. ❑ACS ❑Intell. ❑R.O. ❑SHC 16. ming u riot d le,r�T,jrye Oen /j� 1 oo. ❑Patrol Captain ❑Compl.Otc. ❑Marine Patrol lCJ7 ?f_7 // ❑Other 19.Approving Supv.(Print) 20.Supv.No. 21.Date 22.5e ot_