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Home My WebLink AboutMINUTES - 10071997 - C14 CLAIM 8014RG OF S:.'=E;VISORS OF CONTRA COS'A COUNTY, CALIFORNIA October 7, 1997 Claim Agairst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Gevern!nent Codes. ) the action taken on your claim by the Board of Superviscrs (Paragraph IV below), given pursuant to Government Code Amount: Jurisdiction of the Superior CourtSection 913 and 915.4. Please t CLAIMANT: Carol Allen ATTORNEY: Paul M. Schwartz, Esq. SEP 1 6 1997 2004 Cedar Street Date received COUNTYCOUNSEL ADDRESS: Berkeley, CA 94709 BY DELIVERY TO CLERK ON SeptembeTrN ?�CAYI� 7 BY MAIL POSTMARKED: September 15, 1997 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. �qIL ATCHELOR, Clerk DATED: September 16, 1997 : �eputy II. FROM: County Counsel 70: 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: /7 ? BYDeputy County Counsel T I11. 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 (J ) 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: /0 - O 7 — / 9 9 7 PHIL BATCHELOR, Clerk, ByJAI I A Deputy Clerk WARNING (Gov. code section 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. *For additional warnino see reverse side of this notice. 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: /t9- 02 — /c/2:7 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator I PAUL M. SCHWARTZ, Esq. (SB#44636) RECEIVED 2004 Cedar Street =" 2 Berkeley, CA 94709 ' SEP 161997 3 (510) 548-9800 CLERK BOARD OF SUPERVISORS 4 Attorney for Claimant I. CONTRA COSTA CO. 5 6 BEFORE THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA . 7 8 In the Matter of the Claim of 9 CAROL ALLEN CLAIM FOR PERSONAL INJURIES (Section 910 of the 10 against the COUNTY OF Government Code) CONTRA COSTA. 11 / 12 13 To: THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA: 14 CAROL ALLEN hereby makes claim against the COUNTY OF CONTRA 15 COSTA and makes the following statements in support of the claim: 16 1 . Claimant ' s name is CAROL R. ALLEN. Claimant ' s post 17 office address is 5232 Tehama Avenue, Richmond, CA 94804 . 18 Claimant ' s date of birth is 3/15/61 . 19 2 . Notices concerning the claim should be sent to 20 PAUL M. SCHWARTZ, Attorney at Law, 2004 Cedar Street, Berkeley, 21 California 94709 . 22 3 . The date and place of the accident giving rise to this 23 claim are April 2, 1997, City of Richmond, County of Contra Costa, 24 State of California. 25 4 . The circumstances giving rise to this claim are as 26 follows : On the above date at the above place, claimant was a • 1 passenger in a paratransit van . Said paratransit van is allegedly 2 owned and/or operated by COMSIS Mobility Services Inc . and/or 3 MV Transportation, Inc . , under contract with Alameda-Contra Costa 4 Transit District and/or the County of Contra Costa. 5 On the above date, claimant, a paraplegic in a wheelchair, 6 had not been properly strapped in to her wheelchair and her 7 wheelchair had not been properly restrained in the van . The 8 driver of the paratransit van drove carelessly and recklessly 9 without regard for claimant ' s safety, causing injuries to 10. claimant ' s body. 11 5 . Description of injuries to claimant as a result of this 12 accident : Severe sprain of left shoulder, back, chest and arms; 13 injuries to entire body; psychological stress and anxiety. 14 6 . Name of public employee causing the injury: Unknown at 15 this time . 16 7 . Jurisdiction over the claim would rest in the Superior 17 Court of the State of California . 18 19 Dated: September 15, 1997 AU T 20 orney f /Clai n 21 22 23 24 25 26 2 PROOF 6P SERVICE BY IdAIL I , KAREN RABAK declare that : I am employed in the County of Alameda, California. ,I am over. theaage of eighteen years and not a party to the within,-cause My_ business address . is 2004 Cedar Street, Berkeley, CA 94709. I -On September .15 1997 _. I served the within Claim for Personal. .I•njuries (Section 910 `of the Government Code) [Claimant : Carol Allen] on the BOARD OF SUPERVISORS , in said cause by placings, true COUNTY OF CONTRA COSTA copy thereof in a sealed envelope with postage thereon fully pre- paid, in the U.S . . mail at Berkeley, CA addressed as follows: Clerk of the Board of Supervisors County Administration Building 651. Pine Street , Room 106 Martinez , CA 94553-1293 I - declare under penalty of perjury that the foregoing is true and correct., and that this declaration was executed on. . Septemberj 15 , 1997 at Berkeley California. KAREN RABAK RECEIVED PAUL M. SCHWARTZ INCORPORATED 61997 ATTORNEY AT LAW 2004 CEDAR STREET BERKELEY. CALIFORNIA 94709 tXERK B�Rp OF SUPERVISORS csio� saa-seoo CORA COSTA CO. September 15, 1997 Clerk of the Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553-1293 Re : My Client and the Claimant : Carol Allen Date of the Accident : April 2, 1997 Place of the Accident : Richmond, California Dear Sir or Madam: f Enclosed please find the original and one copy of the Claim. for Personal Injuries I am filing this date against Contra Costa, County under Government Code Section 910 on behalf of my client, Carol Allen, in relation to the above accident . Please return an eridorsed-filed copy of the claim to me in the enclosed, stamped, addressed envelope, acknowledging receipt of the claim by Contra Costa County. Thank you very much for your attention and assistance . Very *HW ' AU . S PMS :kr Encls . m m 17 x rO A �. M O n b 0 z z o = d Z r� r T. gymm} D A i t v y} y4 r N l9 a+• W VI O rr rr r � Fj•�C fD p p N (D r:, > It (D cD w - rr rr p t,n ;C! rt f� r o a n t tV ` � r-+ td !1 ,C t+� O G G CN FA-It) tD um ix { 1 ( F 1 �• CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA October 7, 1997 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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 Gov �� Amount: Unknown Section 913 and 915.4. Please note all "WVS0 CLAIMANT: Mike Fritzler SEP 10 1997 ATTORNEY: Vicky L. Coon, CLA COUNTY COUNSEL MARTINEZ CALIF. Henk, Bock, Leonard & Vega Date received ADDRESS: 1337 Howe Avenue BY DELIVERY TO CLERK ON September 9, 1997 Suite 204 Sacramento, CA 95825 BY MAIL POSTMARKED: Hand Delivered via: Risk MZmt. I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 10 1997 eeHHIL BATCHELOR, Clerk DATED: p , BY: Deputy 1I. 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: % /17 BY: (.G� 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 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: /O— 07 - /99Z PHIL BATCHELOR, Clerk, By L& Deputy Clerk WARNING (Gov. code section 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. *For additional warnina see reverse side of this notice. 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: /p —�9cl:Z BY: PHIL BATCHELOR b JJ Deputy Clerk CC: County Counsel County Administrator Ile, VICTOR J. WESTMAN OFFICE;OF COUNTY COUNSEL DEPUTIES: COUNTY COUNSEL . �. PHILLIP S.ALTHOFF CONTRA COSTA COUNTY SHARON L.ANDERSON ANDREA W.CASSIDY +{ I.r"_ VICKIE L.DAWES ARTHUR W. WALENTA,JR. COUNTY ADMINISTRATION+BUILDING+ MARKE S.ESTIS t t __ __ ASSISTANT COUNTY COUNSEL P° b°' MICHAEL D.FARR 651,PINE STREET 9'ii FLOOR LILLIANT FUJII MARTINEZ; CALIFORNIA-94553-1288 CAROLS.GORDON SILVANO B. MARCHESI DENNIS C.GRAVES ASSISTANT COUNTY COUNSEL - '4X GREGORY C.HARVEY KEVIN T.KERR GAYLE MUGGLI EDWARD V.LANE,JR. VIVIAN LILY OFFICE MANAGER NOTICE OF INSUFFICIENCY MARY ANN MASON ADAM D.MILLER PHONE(510)335-1800 PAUL R.MUNIZ AND/OR VALERIE J.RANCHE FAX(510)646 1078 DAVID F.SCHMIDT NON-ACCEPTANCE OF CLAIM WILLAIAJ.MSILVER WILLM E.SIMMONS JACQUELINE Y.WOODS MARY E.WRIGHTSON TO: Vicky L. Coon, CLA Henk, Bock, Leonard&Vega 1337 Howe Avenue, Suite 204 Sacramento, CA 95825 RE: CLAIM OF: Mike Fritzler Please Take Notice as Follows: The claim you presented against the County of Contra Costa 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. [X] 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. Page 1 [X] 7. Other: The claim fails to describe any duty or obligation of the public entity and any action giving rise to the claim. VICTOR J. WESTMAN, County Counsel By: do eputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;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 addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: September /5-, 1997,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§910,910.2,920.4,910.8) Page 2 aA a � N t/1 CIO M >co Oco N L r tC � � tt) a1 rn O CO -� U ar r.i L o C: c c n- � c`+• o cz 0 -4--J: �� HENK BOCK Ron 1-larvey LEONARD SEP 0 9 1997 & VEGA 1337 Howe Avenue Telephone 916.927.8831 Su Re 204 24 hr Pager 800.825.3803 Sacramento,CA 95825 Facsimile 916.927.8854 August 25, 1997 Ron Harvey �Ep VISORS �o,.'�t3P Risk Management SDp o Qp,Co. County Administration Building Ft CONCaP 651 Pine Street, 6`h Floor Martinez, California 94553-1229 Re: Our Client: Mike Fritzler Your Insured: Contra Costa County Social Services DOL: 6/26/97 Dear Claims: Please be advised that we represent Mr. Fritzler in the above-referenced claim. Find attached our letter of authorization. Should you have any questions, please feel free to contact our offices. Very truly yours, H CK, LEONARD & VEGA Vic y L. oon, CL Personal Injury Assistant Enclosure Bocx LEONARD VEGA 1.,37 Howe Avenue Telepnone 916.927.8831 Suite 244 24 hr Pager 800.825.3803 Sacramento,CA 95825 Facsimile 916.927.9854 LE'T'TER OF DESIGNATION AND AUTHORIZATION To Whom It May Concern: i Re: /Sk I Please be advised that I have retained the law offices of HENK, BOCK, LEONARD & VEGA to represent my interests in the above-mentioned dispute. I hereby authorize HENK, BOCK, LEONARD & VEGA to prosecute my case by means of settlement, mediation, arbitration or litigation and to take all actions necessary to resolve my case, including, but not limited to, communicating, negotiating, and otherwise dealing with insurance companies, physicians, employers, accountants, attorneys, and all Federal, State and local government agencies, as may be required. Also, by signing below, I authorize any doctor, chiropractor, hospital, employer, police agency, government agency or any other person to whom a signed photocopy of this authorization is deiivered,r to furnish any information, reports of copies of records which may be requested by HENK, BOCK, LEONARD & VEGA. i Dated: 27 Signed: ice' G�- 510 939 7228 P.81 SEP-09-199? 09:29 3333 } r� vvu� �a1 J '�tAl l ill Ii.3U #4C�� Uontra COWRY clahm (510)W-4155 fk �8f1 111 f CostaRisk Adminibl ab4510)60.2014 a 56" (510)6A§-2203 Coungr AQminislMWI Building V00ww"al ReftbiLI��V►ipn (5101648-2TS 651 Pine 0~ftFN361. nt VftrkwS'0ompen%#0n (510)sa4-2926 Avrilnea,C*Iftrnie 945M3 County Fax Number (510)W-2547 CWSffiK'J: TO RWMM NWICAL R=MW Michael John Fritzler authorize the County of Coixtra ndiv Costa to disclose to the bearer, who represents Contra Costa, (Requester Count Risk aagg a ent all medical records necessary for the of Q%V= following purpose: Injured on June 2.6 , 1997 at Conta Costa County Social Service Office. 1 hereby consent and request that the hearer be permitted to examine and obtain copies of all my medical records. I hereby atic)Mowledge that I have received a copy of this consent for Release of Medical Reco2;Cis. Signature of PmtLo nt: Address: Date: These records ar13 being requested with the permission. of the attorney of record who is representing the above patient. Attorney of Ro=d: A�are�s: HENK, BOCK, LEONARD &VE 37 We v7�C enue,-Suite 204 Date: sarcamen+.. GA 95825— TOTAL P.®d a ,Q,-To F � .�cF,fy ° � t•fir ..�. —30 Ass `•3 *a y it000 7 04 y z`i n s y...b + '„r' .»�fe'tumid f r , t$ 111333 r a gala �I'i y a j { vi a tt } s ' wnx— CO owl xo:- r v Af�y : : w �. :Fr, i navy,.mac s, M' .- ' 1 r .ttd �'i _t „'"'' _ .moi.. - iy, All � .rr Ll a� .. u " 'k � 7 i4 5 �t_ 4"x �cY�,f,`3 �.. i t'G��i w� � ` •y`tk"" S. �• sr Dit> �'` *7i ti �."` �,, 'c.�rwt �a C°`6' 7 3£, - t A AS=— WWIz£"4. 'R, K t r '�• 7 t,r r�S.":` c 5�'�'R � r�r L h^ v q �, - h n �1 .i .t u..� I ? r sti'...'3 'd� !.�. a 'Et a� '`'x'�'`Tiy. » --- �-.s• �'" - "i xti '�ak' i+'+s3-; A r`r Aft?�j a, @'Jc` ��4„xC�' s"� S. �,S a'�rY' fk��'' s,� r Y .,-a �, '�' r t d•a F }�M,� i- ' i ,2• 'Ca v.§. + xiC .x`et-°{.zs Y>; r 2 t F{£:C+ w .�r. 'r. r, r ¢ R,�.'...,,, ,: �d a -n# i �.C. 'F;x s J 3 r ., dl, A..r f t XQ i 2 �s r.'XS't AA kf -�.-s'' - .r CLAIM I 60-RC OF St!==R�'ISORS OF CONTRA COSTA COUNTY, CALIFORNIA October 7, 1997 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Govern--ent Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Gove1ftFX11V Amount: Within the Jurisdiction Section 913 and 915.4. Please note all "Warnings". of the Superior Court SEP 10 1997 CLAIMANT: David R. Jeff ords COUNTY COUNSEL ATTORNEY: MARTINEZ CALIF. Date received ADDRESS: PO Box 1062 BY DELIVERY TO CLERK ON September 9, 1997 Bethel Island, CA 94511 BY MAIL POSTMARKED: Hand Delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of_the above-noted claim. Se tember 10 1997 PeHHIL BATCHELOR, Clerk DATED: p BY: Deputy 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: �! BY: Deputy County Counsel 11I. 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: /0—op —i q q:Z PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 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. *For additional warnino see reverse side of this notice. 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: �D — D 9 / 9 177 BY: PHIL BATCHELOR bySD Zl Deputy Clerk CC: County Counsel County Administrator - RECEIVED DAVID R. JEFFORDS SEP 91997 2 P.O.Box 1062 Bethel Island, Ca. 94511 CLERK BOARD OF SUPERVISORS 3 (510) 684-9737 CONTRA COSTA co. 4 5 6 LIABILITY CLAIM 7 8 In the Matter of the Claim of ) David R. Jeffords; ) 9 Claimant, ) 10 vs. ) 11 The County of Contra Costa ) Board of Supervisors, ) 12 Contra Costa County Building ) 13 Inspection Department, ) Property Conservation Division, ) 14 Code Enforcement Section. ) 15 Defendants, ) 16 17 I, David R. Jeffords, hereby present this claim to the County of Contra Costa, �8 pursuant to Government Code Section 910 and the California Tort Claims 19 Act. 20 The name and address of the claimant is: 21 David R. Jeffords 22 P.O. Box 1062 Bethel Island, Ca. 94511 23 The address to which notices regarding this claim are to be sent is: 24 25 P.O. Box 1062 Bethel Island, Ca. 94511 26 27 The county employees involved in this claim are: 28 1 Henry Cox and Larry Hogan. 2 3 The facts involved in this claim are as follows: 4 This claim involves land parcel number 003-020039 owned by Tommy M. 5 Anderson located at 50 Camino Diablo in unincorporated Contra Costa 6 7 County. Mr. Anderson had a use permit that expired in 1995 and re-applied 8 for an additional five-year permit. The use permit was to operate a 9 motorcycle park and racetrack on his property. The County planning and 10 zoning administrator denied him a renewal on the grounds of non-compliance 11 and complaints filed by neighbors regarding his past land use issues. Mr. 12 13 Anderson filed an appeal with the County Board of Supervisors and was 14 granted a land use permit (LP952020) with modifications. To date Mr. 15 Anderson is still in non-compliance with the terms of his permit and the code 16 enforcement division has failed to file a complaint with the District 17 Attorney's Office to force Mr. Anderson to comply with State and County �8 19 Laws and to revoke his permit. 20 Mr. Anderson has for years and continues to rent homes and out-buildings on 21 his property that have been modified without the proper permits and do not 22 meet building code standards. He and has refused to comply with County and 23 24 State building codes. The County building inspection department, code 25 enforcement division, was notified in writing about violations occurring on 26 this property. The last notice was on December 11, 1.996 submitted by a 27 neighbor Carol Ann Davis at 36.00 Vasco Road, Brentwood, Ca. In her 28 1 complaint, attached as Exhibit A, Ms. Davis cited concerns about the rental 2 homes and their habitability and compliance with building and health codes. 3 4 . This complaint was given to Henry Cox of the building inspection and code 5 enforcement department for investigation and action on December 17, 1995. 6 Mr. Cox according to the record in file RF 960575 failed to physically inspect 7 the buildings and homes occupied on the property to insure that'they were up 8 to rental standards and that the persons who occupied them were in no 9 10 danger from improper or substandard electrical, plumbing, heating or 11 building conditions. Mr. Cox sent a letter to Mr. Anderson dated December 12 30, 1996 advising him that a complaint was made and that the following 13 permits may be required: building, electrical, land use. Mr. Cox took no 14 further action. He failed to physically inspect the rental buildings to ensure 15 16 that they were in compliance with State and County laws. As a result of his 17 failure to fully investigate the complaints made against Mr. Anderson and to .8 report his findings, Mr. Anderson continued to rent the buildings without 19 having to bring them up to habitably and occupancy standards. 20 21 On March 12, 1997 one of the homes Mr. Anderson rented was totally 22 destroyed by fire, attached, as Exhibit B is the fire report. After an 23 investigation by the arson investigation team is was determined that the fire 24 started in the electrical panel and wiring. 25 I rented this house from Mr. Anderson at the time of the fire. I was never 26 27 contacted by anyone from code enforcement, building inspection, or any other 28 1 agency about the buildings untenantable condition. I rented this home from 2 Mr. Anderson from September 1995 until March 12, 1997. I was aware that 3 4 the building was about 60 years old when I rented it from Mr. Anderson. He 5 informed me that he had upgraded the electrical panel and wiring and that 6 the building was tenantable and up to codes. Had the building inspection 7 department conducted a physical on site inspection of the house and a permit 8 search conducted they would have determined that the building was 9 10 substandard and no permits were ever issued to upgrade the electrical wiring 11 and could have forced Mr. Anderson to comply with the law and thus 12 prevented the loss by fire. 13 I contacted Mr. Larry Hogan of the code enforcement division to question him 14 why Mr. Cox had not properly conducted this complaint investigation. I was 15 16 told that the County is shorthanded and that the building department is, 17 understaffed and that they do not have the time to properly investigate every 18 claim made. Mr. Hogan is Mr. Cox's supervisor and the senior inspector. 19 As a consequence of the defendants actions the claimant incurred a total loss 20 to all his personal property and possessions, has incurred legal expenses, 21 22 including but not limited to, attorney fees, loss of wages and earnings, 23 medical expenses, relocation expenses, and has suffered mental and 24 emotional distress caused by negligence, incompetents and the failure of the 25 County of Contra Costa to properly enforce the laws of the State of California 26 27 as directed by the Legislature. The Counties failure to provide proper staffing 28 1 or funding to the various departments does not relieve the County of that 2 responsibility to enforce the state codes and laws in a timely manor. When a 3 4 county fails to provide and is negligent it shall be held liable for any damages 5 or injury caused by that act and no immunity shall exist. 6 Therefore, the Claimant seeks recovery from the County of Contra Costa for 7 an amount within the jurisdiction of the Superior court for personal property 8 loss, wages, earnings, and mental and emotional distress and relocation 9 10 expenses. 11 12DATED: September 9, 1997 13 David R. Jeffords 14 Claimant 15 16 17 �8 19 20 21 22 23 24 25 26 27 28 CONTRA COSTA COUNTY BUILDING INSPECTION DEPARTMENT - PROPERTY CC'1SERVATION DIVISION CODE ENFORCEMENT - COMPLAINT QUES'.'IONNAIRE PLEASE PROVIDE THE FOLLOWING INFORMATION- PRINT CLEARLY AND COMPLETE THE ENTIRE FORM COMPLAINANT INFORMATION COMPLAINANT: CAROL ANN DAVIS ADDRESS; 3600 VASCO RD BRENTWOOD CA 94513 PHONE NUMBER; 510-634-3858 tAi#RARARAR#AAAfRAARtfRRiRARARRffftAR##ARRfftAflAfRAflRRRARRfARAflRif#tR•efR#ARRfRRRffARRft}RRRARRAAtAAARRRR ALLEGED VIOLA'CIONfNATURE OF COMPLAINT INrORMATION ADDRESS OF ALLEGED VIOLATION: 50 CAMINO D14BLO BRT? TWOOD CA (BYRON AREA) ASSESSORS PARCEL NUMBER: 003-010-020 _ THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSORS OFFICE OWNER NAME: TOM ANDERSON AND PARTNER THOMAS SMITII :F.O. BOX 01120 BRENTWOOD CA OWNER ADDRESS; UNKNOWN OWNER PI-1011E NUMBER: 634-0159 TENANT NAME; CIIRISTIN COWAN 50 CAMINO DIABLO TENANT PHONE t:J;.48ER: 634-2238 KEN SMITH, DAVID JF.FFORD,TAMIE ANDrRSON, •OTHERS UNKNOWN DESCRIBE IN DETAIL THE NATURE OF VIOLATION/COMPLAINT Tom Anderson has constructed OVAL• RACETRACK,SPECTATER BLEACI(ERS, ANNOUCING TOWER ELECTRICAL LIGATING, GRADING 6 ECT. NOTE: AS OF 12-I1-96 THERE RAS BEEN NO PERMITS ARE ALL THE BUILDINGS THAT PEOPLE ARE LIVING IN UP TO CODE? ARE THERE ENOUGH WELLS, SEPTIC TANKS TO ACCOMMODATE ALL THESE PEOPLE ? !AtlR!lRRA}AAAAttRAlfRff}}}fltflA}}fAlRr1♦fffftlt}ffAfAAAfjAARlRffRftAfAA::RtRRAftotA#lAff}A}}}fR1ARRfARfAiiAt vu-r- 1 -17. 77 '�� RETURN THIS FORM TO: ,� 3''3 Contra Dorlanne Fernandez /< < PROPERTY CONSERVATION DIVISIONCOStB Senior Clerk Property Conservation Division 651 PINE STREET, 4TH FLOOR County MARTINEZ CA 9x553 (510)335.1114 (510)646-4450 FAX /"'"+rte• • _�t•. Building Inspection Department 651 Pine Street- 41h Floor Martinez,CA 94553.1295 i o�>�r.. -.575 � Building Inspection DepartmentContra Franklin Lew c-eo,cL Director of Building Inspection PROPERTY CONSERVATION DIVISION Costa NEIGHBORHOOD PRESERVATION PROGRAM J L 651 Pine Street,4th Floor County Martinez,California 94553-0152 PCD 510 335-1111 c NPP (510)335-1137 FAX (510)646-4450 December 30, 1996 'x. ';: Tommy Anderson RT 2, Box 143B Brentwood CA 94513 SITE: 50 Camino Diablo, Byron APN: 003-020-039 REF: RF960575 Dear Property Owner, This is to advise you that on December 17, 1996 it was reported that bleachers and electrical lighting have been added to the above referenced site Without permits. It has also been reported that a large amount of grading has taken place without permits. The following permits may be required: BUILDING X ELECTRICAL X PLUMBING HEATING/VENTILATING GRADING X LAND USE X VARIANCE The following department approvals may be required: COD24UNITY DEVELOPMENT X HEALTH DEPARTMENT SANITARY DISTRICT_ FIRE DEPARTMENT OTHER If the above violation exists, it �s necessary for you. to apply for the required permits and/or approvals within ten (10) days. Please contact the Property Conservation Division of the Building Inspection Department at 335-1142 within ten (10) days so we may clear this report. We are open Monday through Friday except the first, third and fifth Friday of each month. Thank you for your cooperation. i Henry Cox . Building Inspector II HLC:dcf EAST DIABLO FIRE PROTECTION DISTRICT 134 Oak Street, Brentwood, CA 94513 INCIDENT REPORT Date:,A0ee4/,Z /9g.7 E.D.I. #: 270 Alarm Time: / JZo Master Incident #: 7Lo37 1 Thomas Bros. Page: Z.3149 Coordinates: �_ _� Area Code: 277 OLX Let. Num. Location: Q/,Q&Q TYPE OF INCIDENT B)/,eVAZ, Gam. Medical Aid (1) Vehicle Accident (2) Owr+er: Haz. Cond'n (3) HazMat Incident (:) Address: Smoke Inst (5) Mistaken Alarm (6) City: Fire (7) Public Service (8) Phone #: TYPE OF FIRE Occupant: Structure Vegetation (B) Phone #: Vehicle (C) Other (D) Agencies on Scene: CHP: SO: PD: Mutual Aid (E) CalTrans: CDF: Other: j0p-N"E Investigator's Name: ••rrwraraaaaarwaraarrrawwrraawarwarwwrawrawraarawraawww�rrarwwwwwwwrrraarwaaarraaawrraaararwrr• ACCIDENT DETAILS Number of Victims: (one Secondary Patient Exam for each patient) RESPONDING APPARATUS UNIT # RESPONDED ARRIVED AVAILABLE UNIT M RESPONDED ARRIVED AVAILABLE 4-67 /11-108 E-519 /R o E'_rg/ /It /5 1R�2o f9/9 tT=57 /A/7 IIZAZO /94l/ s;. A/.T. E 7041 burr. 45// 70 HAI Compiled By: Rank: AlDate: , ��/�� District Personnel On-scene: 57 �ST�,e�iLlcr/n/,�L- S/ > j �f/ East Diablo Fire Protection District-Station 57 Supplemental Fine Report 50 Camino Diablo, Byron Date: March 12"'.1997 Incident No: E.D.I.#: 2701 M.I.#: 7637 Dispatch Time: 12:06 p.m. On above date, Engines 57, 58, 52,Water Tender 57,and Battalion Chief 51,were dispatched to a structure fire at 50 Camino Diablo.While enroute to incident Engine 57 observed a column of black smoke,which was rapidly increasing in size,from Camino Diablo and Vasco roads,this was approximately 1 mile from incident Iocation,Capt. 57 then advised the Communications Center,and requested an additional Water Tender(with a capacity of 2000 gallons or greater)to respond to the incident,this request was made at 12:11 hours.At the time of dispatch Engine 58 was at Station 57 on a training drill,this facilitated an immediate response with Engine 57.After update was given communications were made with Engine 58,they were assigned to pump water for initial attack upon arrival, and Engine 57 would provide water held in tanks as well. At 12:13 Engines 57 &58 arrived on scene, Capt. 57 gave a condition report, a single story,single famiiy,older structure with heavy black smoke coming from rear, under eaves and through attic vents, as well as flames projecting 40 to 60 feet from the Northwest comer. Capt. 57 established Byron I.C. (incident command)and established channel F-16 as Tactical channel. The initial attack was made by Engine 57, utilizing an 1 1/2"jump line, pulled from Engine 58.The initial attack was focused on cooling the fire to the rear of the residence,the plan was to then make a aggresive interior attack.On approach to rear Capt.57 observed that all windows to have dark black staining,and flames coming from rear the side door and windows.There was also a large tree adjacent to residence on fire with extension to utility pole and a well structure.An attempt was made to cool the fire at the exterior,during the attack it was discovered that the northwest comer of the structure had collapsed,this hampered an interior attack, and created an unsafe condition for entry.Our attack was then modified from offensive mode to a defensive stance, concentrating on suppression and a safe environment for personnel involved.At 12:14 hours Engine 54 arrived,they pulled a 2'/:' attack line and concentrated on the North side of the structure.Engine 57 then upgraded to a 2%'attack line and focused on the South side of the structure.At approximately 12:21 hours Battalion 51 assumed i.C.,Capt. 57 became Operations Command. EAST DIABLO FIRE PROTECTION DISTRICT 134 OAK ST.BRENTWOOD,CA 94513 (510)6343400 i - CLAIM BOAR OF SI�. R�''.SO-,S OF CONTRA. COSTA. COUNTY, CALIFORNIA October 7, 1997 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Gcvern,..e�t Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $5,000.00 Section 913 and 915.4. Please note all "War "c3 awm3) CLAIMANT: Tammy L. Merrill SEP 10 1997 ATTORNEY: COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS: PO Box 1062 BY DELIVERY TO CLERK ON September 9, 1997 Bethel Island, CA 94511 BY MAIL POSTMARKED: Hand Delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: September 10, 1997 gy: Deputy "u'crr 11. 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: �(� I I� BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Coursel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOA;/.O ORDER: By unanimous vote of the Supervisors present (A 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. Gated: 7 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 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. *For additional warnino see reverse side of this notice. 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: _p _ BY: PHIL BATCHELOR b J1 AAI I d Deputy Clerk CC: County Counsel County Administrator RECEIVED 1 TAMMY L. MERRILL SEP 9 1997 2 P.O.Box 1062 Bethel Island, Ca. 94511 CLERIC BOARD OF SUPERVISORS 3 (510) 684-9737 CONTRA COSTA CO. 4 5 6 LIABILITY CLAIM 7 8 In the Matter of the Claim of ) Tammy L. Merrill, ) 9 Claimant, ) 10 vs. ) 11 The County of Contra Costa ) Board of Supervisors, ) 12 Contra Costa County Building ) 13 Inspection Department, ) Property Conservation Division, ) 14 Code Enforcement Section. ) 15 Defendants, ) 16 17 I, Tammy L. Merrill, hereby present this claim to the County of Contra Costa, =8 pursuant to Government Code Section 910 and the California Tort Claims 19 Act. 20 The name and address of the claimant is: 21 Tammy L. Merrill 22 P.O. Box 1062 . Bethel Island; Ca. 94511 23 The address to which notices regarding this claim are to be sent is: 24 25 P.O. Box 1062 Bethel Island, Ca. 94511 26 27 The county employees involved in this claim are: 28 ` 5 1 Henry Cox and Larry Hogan. 2 3 The facts involved in this claim are as follows: 4 This claim involves land parcel number 003-020039 owned by Tommy M. 5 Anderson located at 50 Camino Diablo in unincorporated Contra Costa 6 7 County. Mr. Anderson had a use permit that expired in 1995 and re-applied 8 for an.additional five-year permit. The use permit was to operate a 9 motorcycle park and racetrack on his property. The County planning and 10 zoning administrator denied him a renewal on the grounds of non-compliance 11 and complaints filed by neighbors regarding his past land use issues. Mr. 12 13 Anderson filed an appeal with the County Board of Supervisors and was 14 granted a land use permit (LP952020) with modifications. To date Mr. 15 Anderson is still in non-compliance with the terms of his permit and the code 16 enforcement division has failed to file a complaint with the District 17 18 Attorney's Office to force Mr. Anderson to comply.with State and County 19 Laws and to revoke his permit. 20 Mr. Anderson has for years and continues to rent homes and out-buildings on 21 his property that have been modified without the proper permits and do not 22 meet building code standards. He and has refused to comply with County and 23 24 State building codes. The County building inspection department, code 25 enforcement division, was notified in writing about violations occurring on 26 this property. The last notice was on December 11, 1996 submitted by a 27 neighbor Carol Ann Davis at 3600 Vasco Road, Brentwood, Ca. In her 28 1 complaint, attached as Exhibit A, Ms. Davis cited concerns about the rental 2 homes and their habitability and compliance with building and health codes. 3 4 This complaint was given to Henry Cox of the building inspection and code 5 enforcement department for investigation and action on December 17, 1995. 6 Mr. Cox according to the record in file RF 960575 failed to physically inspect 7 the buildings and homes occupied on the property to insure that they were up 8 to rental standards and that the persons who occupied them were in no 9 10 danger from improper or substandard electrical, plumbing, heating or 11 building conditions. Mr. Cox sent a letter to Mr. Anderson dated December 12 30, 1996 advising him that a complaint was made and that the following 13 permits may be required: building, electrical, land use. Mr. Cox took no 14 further action. He failed to physically inspect the rental buildings to ensure 15 16 that they were in compliance with State and County laws. As a result of his 17 failure to fully investigate the complaints made against Mr. Anderson and to 18 report his findings, Mr. Anderson continued to rent the buildings without 19 having to bring them up to habitably and occupancy standards. 20 21 On March 12, 1997 one of the homes Mr. Anderson rented was totally ' 22 destroyed by fire, attached, as Exhibit B is the fire report. After an . 23 investigation by the arson investigation team is was determined that the fire 24 started in the electrical panel and wiring. 25 I rented this house from Mr. Anderson at the time of the fire. I was never 26 27 contacted by anyone from code enforcement, building inspection, or any other 28 1 agency about the buildings untenantable condition. I rented this home from 2 Mr. Anderson from September 1995 until March 12, 1997. I was aware that 3 4 the building was about 60 years old when I rented it from Mr. Anderson. He 5 informed me that he had upgraded the electrical panel and wiring and that 6 the building was tenantable and up to codes. Had the building inspection 7 department conducted a physical on site inspection of the house and a permit 8 search conducted they would have determined that the building was 9 10 substandard and no permits were ever issued to upgrade the electrical wiring 11 and could have forced Mr. Anderson to comply with the law and thus 12 prevented the loss by fire. 13 I contacted Mr. Larry Hogan of the code enforcement division to question him 14 15 why Mr. Cox had not properly conducted this complaint investigation. I was 16 told that the County is shorthanded and that the building department is 17 understaffed and that they do not have the time to properly investigate every �8 claim made. Mr. Hogan is Mr. Cox's supervisor and the senior inspector. 19 As a consequence of the defendants actions the claimant incurred a total loss 20 to all her personal property and possessions, has incurred legal expenses, 21 22 including but not limited to, attorney fees, loss of wages and earnings, 23 medical expenses, relocation expenses, and has suffered mental and 24 emotional distress caused by negligence, incompetents and the failure of the 25 County of Contra Costa to properly enforce the laws of the State of California 26 27 as directed by the Legislature. The Counties failure to provide proper staffing 28 1 or funding to the various departments does not relieve the County of that 2 responsibility to enforce the state codes and laws in a timely manor. When a 3 4 county fails to provide and is negligent it shall be held liable for any damages 5 or injury caused by that act and no immunity shall exist. 6 Therefore, the Claimant seeks recovery from the County of Contra Costa for 7 an amount within the jurisdiction of the Municipal court for five-thousand 8 dollars ($5,000) for personal property loss, wages, earnings, and mental and 9 10 emotional distress and relocation expenses. 11 1H 12 DATED: September 9, 1997 13 Tammy L. Merrill 14 Claimant 15 16 17 -_8 19 20 21 22 23 24 25 26 27 28 CONTRA COSTA COUNTY BUILDING INSPECTION DEPARTMENT — PROPERTY COQ SERVATION DIVISION CODE ENFORCEMENT — COMPLAINT QUES-."IONNAIRE PLEASE PROVIDE THE FOLLOWING INFORMATION-- PRINT PLEARLY AND COMPLETE THE ENTIRE FORM COMPLAINANT INFORMATION COMPLAINANT: CAROL ANN DAVIS ADDRESS; 3600 VASCO RD BRENTWOOD CA 94513 PHONE NUMBER; 510-634-3858 RAARR*RA*RARRRRRRRRRRRRRRRRRRRARRRARRRARRAtRARRRARRRRARR*RRRAARAARAAAR#ArRARRRARRAR#**#RRAR*RR*RAttRR#AARR! ALLEGED VIOLA:nON1NATURE OF COMPLAINT INFORMATION ADDRESS OF ALLEGED VIOLATION; 50 CAMINO D.IABLO BRFN'CWOOD CA (BYRON AREA) ASSESSORS PARCEL NUMBER: 003-020-020 THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSORS OFFICE OWNER NAME: TOM ANDERSON AND PARTNER TII011AS SMITH :P.O. -AUK 111120 BRENTWOOD CA OWNER ADDRESS; UNKNOWN OWNER PHONE NUMBER; 634-0159 TENANT NAME: CHRISTIN COWAN 50 CA4INO DIABLO TENANT PHONE U JMBER: 634-2238 KEN SMITII, DAVID JEFFORIJAMIE ANDERSON, OTHERS UNKNOWN DESCRIBE IN DETAIL THE NATURE OF VIOLATION/COMPLAINT Tom Anderson has constructed OVAL• RACETRACK,SPECTATER BLEACHERS, ANNOUCING TOWEFZ ELECTRICAL LIGHTING, GRADING 6 ECT. NOTE: AS OF 12-11-96 THERE HAS BEEN NO PERMITS ARE ALL THE BUILDINGS THAT PEOPLE ARE LIVING IN UP TO CODE? ARE THERE ENOUGH WELLS, __ SEPTIC TANKS TO ACCOPiMODATE ALI, THESE PEOPLE ? _ A!!!A!!RRltRIRAtRRRlA#RtAtAAfARlA#ARlAAR►RARtRAAA#AAARAR�AAAAARRlA1AtRA.:AARARAARRRAtAAAAAAAAARRAAARRARA*AAR RETURN THIS FORM TO: 3'3' Contra Dorianne Fernandez if PROPERTY CONSERVATION DIVISION Costa Senior Clerk 651 PINE STREET, 4TH FLOOR Property Conservation Division �' MARTINEZ CA 94553 (5`10)(510)335.1114 (510)646-4450 FAX Building Inspection Department 651 Pine Street -41h Floor Martinez, CA 94553-1295r Building Inspection DepartmentCQnt�a Franklin Lew �.3A.s.L Director of Building Inspection PROPERTY CONSERVATION DIVISION Costa c+ NEIGHBORHOOD PRESERVATION PROGRAM C! J L 651 Pine Street,4th Floor County Martinez.California 94553-0152 PCD (510)335-1111 t r. NPP (510)335-1137 FAX (510)646-4450 V ;. a< December 30 1996 f.N. Tommy Anderson RT 2, Box 143B Brentwood CA 94513 SITE: 50 Camino Diablo, Byron APN: 003-020-039 REF: RF960575 Dear Property Owner, This is to advise you that on December 17, 1996 it was reported that bleachers and electrical lig'-,,.ting have been added to the above referenced site without permits. It has also been reported that a large amount of grading has takes place without permits. The following permits may be required: BUILDING X ELECTRICAL X PLUM";--' NG HEATING/VENTILATING GRADING X LAND U':iE X VARIANCE The following department approva '. s may be required: COMMUNITY DEVELOPMENT X HEALTH lEPARTMENT SANITARY DISTRICT— FIRE DEPARTMEI.12 OTHER If the above violation exists, it is necessary for you to apply for the required permits and/or approvals within ten (10) days. Please contact the Property ConEsrvation Division of the Building Inspection Department at 335-11=.2 within ten (10) days so we may clear this report. We are open Monday through Friday except the first, third and fifth Friday of each month. Thank you for your cooperation. Henry Cox ' Building Inspector II HLC:dcf EAST DIABLO FIRE PROTECTION DISTRICT 0 134 Oak Street, Brentwood, CA 94513 INCIDENT REPORT Date:1,0,feW /997 E.D.I. #: .270 Alarm Time: /ZQIp Master Incident #: 7ZO37 1 Thomas Bros. Page: /03& Coordinates: �z -� Area Code: .5 7 OSX Let. Num. Location:?>`Sp �,y/,�/Q Ozq&e_p TYPE OF INCIDENT B y,PQ,✓�/�,4. Medical Aid (1) Vehicle Accident (2) Ow-ger: Haz. Cond'n (3) HazMat Incident (4) Address: Smoke Invst (5) Mistaken Alarm (6) City: Fire (7) Public Service (8) Phone #: TYPE OF FIRE Occupant: Structure_A71 Vegetation (B) Phone #: Vehicle (C) Other (D) Agencies on Scene: CHP: SO: PD: Mutual Aid (E) CalTrans: CDF: Other: Ad-N-E Investigator's Name: •rrwrawr*arrwwarararwrwwrrrrwrwwrrwawwwwwaaara+wr+wrwrwaaawwaawrwwarrwrraaaarrrrwwarraarrwrrrrr ACCIDENT DETAILS Number of Victims: (one Secondary Patient Exam for each patient) RESPONDING APPARATUS Ui1IT # RESPONDED ARRIVED AVAILABLE UNIT # RESPONDED ARRIVED AVAILABLE E-57 izo� 1,2/.3 >��j B.G. 5t 1.Zo9 >z 19 1P�7 E 5� /, Doo 11Z /5 1Zz 0 1919 �/T=57 /R!7 1R.Rlo /z/Y /z 34 /-�'07 1704/ J0/4A-1/0, Compiled By: Rank: 4p,PA- A/ Date: f1 /117_ District Personnel On-scene: �-57 /r�T�,e�jLJC > / :r East Diablo Fire Protection District- Station 57 Supplemental Fire Report 50 Camino Diablo, Byron Date: March 12"', 1997 Incident No: E.D.I.# : 270/M.I.# : 7637 Dispatch Time: 12:06 p.m. On above date, Engines 57, 58, 52, Water Tender 57, and Battalion Chief 51,were dispatched to a structure fire at 50 Camino Diablo.While enroute to incident Engine 57 observed a column of black smoke,which was rapidly increasing in size, from Camino Diablo and Vasco roads,this was approximately 1 mile from incident Iocation,Capt. 57 then advised the Communications Center, and requested an additional Water Tender(with a capacity of 2000 gallons or greater)to respond to the incident, this request was made at 12:11 hours.At the time of dispatch Engine 58 was at Station 57 on a training drill,this facilitated an immediate response with Engine 57. After update was given communications were made with Engine 58,they were assigned to pump water for initial attack upon amval, and Engine 57 would provide water held in tanks as well. At 12:13 Engines 57&58 arrived on scene, Capt. 57 gave a condition report, a single story, single family,older structure with heavy black smoke coming from rear, under eaves and through attic vents, as well as flames projecting 40 to 60 feet from the Northwest comer. Capt. 57 established Byron I.C. (incident command) and established Channel F-16 as Tactical channel. The initial attack was made by Engine 57,utilizing an 1 '/z°jump line, pulled from Engine 58.The initial attack was focused on cooling the fire to the rear of the residence,the plan was to then make a aggresive interior attack.On approach to rear Capt. 57 observed that all windows to have dark black staining, and flames coming from rear the side door and windows. There was also a large tree adjacent to residence on fire with extension to utility pole and a well structure.An attempt was made to cool the fire at the exterior,during the attack it was discovered that the northwest comer of the structure had collapsed,this hampered an interior attack, and created an unsafe condition for entry.Our attack was then modified from offensive mode to a defensive stance, concentrating on suppression and a safe environment for personnel involved.At 12:14 hours Engine 54 arrived,they pulled a 2'/Z" attack line and concentrated on the North side of the structure. Engine 57 then upgraded to a 2'/z"attack line and focused on the South side of the structure.At approximately 12:21 hours Battalion 51 assumed I.C.,Capt.57 became Operations Command. &04-aft � EAST DIABLO FIRE PROTECTION DISTRICT 134 OAK ST.BRENTWOOD,CA 94513 (510)634-3400 i I CLAIM BOARD OF S'.pERV!SORS OF CONTRA COSTA COUNTY, CALIFORNIA October 7, 1997 Claim Acainst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Gever—ent Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph 1V below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note � � CLAIMANT: John and Susan Millar SEP 16 1997 ATTORNEY: Steven Austin COUNTY COUNSEL Peggy Chang Date received MARTINEZ CALIF. ADDRESS: Buresh, Kaplan, Jang, Feller BY DELIVERY TO CLERK ON Sej t. mbPr 11 , 1997 & Austin 2298 Durant Avenue BY MAIL POSTMARKED: September 10, 1997 Berkeley, CA 94704 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: September 16, 1997 �q; Deputy JJ1J I J 04�� 11. 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: -711-7 (` BY: Deputy County Counsel 11I. 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. BOAR;; 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: /D-o-7 — / 9 9 7 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 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. *For additional warnino see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that 1 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:_T n=n _ y 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 5911.2.) 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 ) John and Susan Millar ) Y TCLERK CE7;,s7- EERVISS01�S' Against the County of Contra Costa ) or ) � District) RD Fill in name RA The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ indemnity and in support of this claim represents as follows: �---_N__-- 1. When did the damage or injury occur? (Give exact date and hour) A-u�ist 13.E_19.97 Millars were served with cross-complaint. ---- _N____NN_N__ 2. Where did the damage or injury occur? (Include city and county) The plaintiff' s action involved a landslide caused by a drainage system at Holly and Claremont Streets in the City of Orinda, County of Contra Costa. 3. How did the damage or injury occur? (Give full details; use extra paper if required) Garthe sued for juisance, negligence and trespass related to drainage system created by the County. A defendant has cross-complained against the Millars. --------- --------------NN_------------N--------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or .employees caused the injury or damage? Claimants are informed and believe and on that basis claim that the County created the drainage system complained of by the Garthes.. The Millars seek indemnity and damages for erosion of their property by the public drainage systemin relationship to the plaintiff' s claims. (nvPr) ti N Li 44 s o O O 41m rd In S- fd �4 Ln al fA N rn __ll -r-I 4J V 4J E c z 44 lDiQ', N N .3 00 0 iJ 04 •,.4 NO � T-4 � r-i O O Ln z r, o�LC • ru v e . Q. 3 0 �"� c • `n -2 co - r CLAIM BOARD OF St'-:RVISG-.S OF CONTRA COSTA COUNTY, CALIFORNIA October 7, 1997 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Gcvern^.e^t Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $85.00 Section 913 and 915.4. Please note all "Warr F'CTIIIVIT) CLAIMANT: George E. Thompson SEP 10 1997 ATTORNEY: COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS: 1243 Filbert Street BY DELIVERY TO CLERK ON September 9, 1997 Richmond, CA 94801 BY MAIL POSTMARKED: September 8, 1997 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. �aIL BATCHELOR, Clerk DATED: September 10, 1997 : Deputy I1. FRO County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. Z ) 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 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; I�_fl�-,Iqq� PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 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. *For additional warnina see reverse side of this notice. 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: (n- Q 9_ 9 7 BY: PHIL BATCHELOR b) 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 personal 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. (Gov't 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 x° RECEIVED ) Against the County of Contra Costa) v 9 W7 or ) _ District) CLFRKBOARDOFSUPERVISORS (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 $_ A�_S-d d and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Wli6re did th damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra �- �p per if required) �.!/L14on�' ,�`�GL�G� �� Zl�a�`"I(��uZ�� .Y� �C-�iE-e✓�f��iG.�-P� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. What are the names of county or district officers, servants or ;+ • employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ) a 7. How was the amount claimed above computed? (Include the estimated amount of any', prospective injury or damage. ) S. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury. DATE TIME AMOUNT Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his SEND NOTICES TO: (Attorney) beha.1f. 11 Name and Address of Attorney ) (C aimant's Signa ure) (Address) Telephone No. ) Telephone No. NOTICE 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, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1, 000) , or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. • Proposal Page No. of Pages CASTANEDA IRON WORKS To Protect and Beautify Your Home ' IUNIT D, 1001 HENSLEY, RICHMOND, CA 94801 •`' (510) 234-4734 PROPO SUBMITTED TO , PHONE' / _ DATE..- ' I STREET 'f JOB NAME , 10 F::� G AIE AN IIP CODE JOB LOCATION Ile ARCHITECT .DATE OF PLANS r JOB PHONE We hereby submit speclfical;ons and estimates for. I Windows Fire Escapes Porches Doors Windows Hand Rails Fences Truck Racks I .��• ((� �,ii {1).C.�,� t')0 I li I I i ' I BLACK ❑ WHITE ❑ BROWN O OR OTHERS ❑ I UP1f ropOSP hereby to furnish material and labor — complete m accordance with above specifications, for the um of: -Flaoilf ant t ma as follows. dollars($ ). All material Is guaranteed to be as specified. All work to be Completed rri a workmanlike manner according to standard practices.Any alteration or deviation from above spec,fica. Authorized tions invoiving*airs costs will be executed only upon written orders.aria will become a�. -Signature �- estra emerge over and above the estimate An agreements contingent upon strikes.accidents or delays beyond our control.owner to carry fire,tornado and other necessary Insurance Note:This proposal may be Our workers are fully covered by workmen's Compensation Insurance w-thdrewn by us If not accep Ithln days• kaptann, of f rIItin88! The above prices,specifications ✓� n and conditions are satisfactory.and are hereby accepted.You are authariz Signatur C i, ed to do the work as specifled.'Payment will be made as outlined above. 40%down payment required upon acceptance • Signature Date of Acceptance: _ x b . M - i CLAIM C BO.RD of S.-ERv1SoRS OF CCNTRA ceS'A co. NTr, CALIFORNIA October 7, 1997 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of Ca':ifcrnia 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 ffm'may CLAIMANT: Karen Todoroff SEP 16 9997 ATTORNEY: Date received COUNTY COUNSEL MARTINEZ CALIF. ADDRESS: 1908 Dora Ave. BY DELIVERY TO CLERK ON September 15, 1997 Walnut Creek, CA 94596 BY MAIL POSTMARKED: September 12, 1997 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gqIL BATCHELOR, Clerk DATED: September 16, 1997 : Deputy H. FROM: County Counsel 70: 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: 02 /y BY: Deputy County Counsel 11I. 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. BDAR/1; ORDER: By unanimous vote of the Supervisors present (tf) This Claim is rejected in full. ( ) Other: 1 certify that this is a true and correct copy of the Board.'s Order entered in its minutes for this date. < a Dated: /0- 0 7 — i 99� PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 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. *For additional warnina see reverse side of this notice. 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: /0- p BY: PHIL BATCHELOR by Deputy Clerk CC. County counsel County Administrator �I VICTOR J. WESTMAN OFFIGEwOF COUNTY COUNSEL DEPUTIES: COUNTY COUNSEL f '`�g PHILLIP S.ALTHOFF A► COSTA COUNTY SHARON L.ANDERSON CONTR ANDREA W.CASSID_Y VICKIE L.DAWES ARTHUR W.WALENTA,.JR. COUNTY ADMINISTRATION BUILDING) MARKE S.ESTIS 11 ASSISTANT COUNTY COUNSEL 651 PINE STREET 9flf FL00R MICHAEL D.FARR i r.. r, LILLIAN T.FUJII SILVANO B. MARCHESI MARTINEZ CALIFORNIA94553-1288 CAROL S.GORDON %r t� DENNIS C.GRAVES ASSISTANT COUNTY COUNSEL GREGORY C.HARVEY KEVIN T.KERR GAYLE MUGGLI EDWARD V.LANE,JR. VIVIAN LILY OFFICE MANAGER NOTICE OF INSUFFICIENCY MARY ANN MASON ADAM D.MILLER PHONE(510)335-1800 R PPAUL ALER.MUNIZ e�mRANCHE FAX(510)646-1078 AND/OR`L/OR DAVID F.SCHMIDT NON-ACCEPTANCE OF CLAIM WILLIADIANAJ.MSILVER M E.SIMMONS JACQUELINE Y.WOODS MARY E.WRIGHTSON TO: Karen Todoroff 1908 Dora Ave. Walnut Creek, CA 94596 RE: CLAIM OF: Karen Todoroff 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: [ ] I. 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. [ 16. The claim is not signed by the claimant or by some person on his behalf. Page 1 RECEIVE® n SEP 1 5IW CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. 1 �-� -�X_�r o.�`-� � t r '\✓ �' �lit._ �J ��, v=t f �� n to cmc --c/t� 41-A Ciro- L-p a-J V,"s:, ( C4- -9 L(�� c"" _ -.,.,, 1 f �= j�, e 0 �� .p � � � .�� . � � � ;� � �., � � �� .� � , �. �; � � .. � (� � r � � � � �£.��{ -� -� � y �� -� *ice! � �,� `� �y _ J t. �� I 1.�' / � � r �. ;r.,, ; ,, r .. � � . .. r � r � . . . .. _ ;, ��. R �.5: ,. `±, .. �. "' _. _i�? CLAIM ' J BOARD OF Sl'-:?V'.SORS OF CONTRA COS'A COUNTY, CALIFORNIA October 7, 1997 Claire Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Gcvernrnent Codes. ) the action taken on your claim by the Board of Superviscrs (Paragraph IV below), given pursuant to Government Code Amount: $61.46 Section 913 and 915.4. Please note all "WaR6M aWT CLAIMANT: John Westernoff SEP 10 1997 ATTORNEY: COUNTY COUNSEL Date received MARTINEZ CALIF. ADD;E5S: 4 Doral Court BY DELIVERY TO CLERK ON September 9, 1997 Moraga, CA 94556 BY MAIL POSTMARKED: September 3, 1997 via: Risk Mpmt. 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 10 1997 QQHHIL BATCHELOR, Clerk DATED: P , 8Y: Deputy 11. 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: Q Ldp✓� ( V� Dated: BY. Deputy County Counsel 111. FROM: Clerk of the Board TO: County Coursel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BDARL 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: /D - n7 — /7 9 7 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 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. *For additional warnino see reverse side of this notice. 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: f a -p q _ i 9 9 BY: PHIL BATCHELOR by C) 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 .Lon/ Wse1VI);Z-r— ) [RE CEDED � . ) 1997 Against the County of Contra Costa ) —g or OF PERVISORS.District) TRA COSTA CO. Fill in name ) The undersigned claimant hereby makes claim agai t the County of Contra Costa or the above-named District in the sum of $ 6/: and in support of this claim represents as follows: . 1. When did the damage or injury occur? (Give exact date and hour) ---��----2 --1- f - � -'�------------------ ----------- ---------- 2. Where did the damage or injury occur? (Include city and county) ------- - l AGI SGC.Lt- ----�7 ill_ops � ;1'cez ESQ 5 e c - .L--------------------,�— ------�--- ---- 12n -- 3. How did the damage or injury occur? (Give full details; use extra paper if required) -� e,,6-0 V-e O r/e/ laO-74- 10 r �epa �c� fly e 4. What particular act or omission on the part of county or district officers, servants or .employees caused the injury or damage? d f �e,��1� SPpe�� ce whCi /7174V1,y /✓v7'G 0 6-, (over) 5. Wnat are the names of county or district officers, servants or employees causing the damage or injury? 5. - - What damage or injuries do you claim resulted? (Give full extentof injuries or damages claimed. Attach two estimates for auto damage. ee s ��Zo _S ,�Gc�,�a-r) s �----- �... _a�--------------------- 7. How was the amount claimed above computed'? (Include the estimated amount of any prospective injury or damage.) �lP --- ----- -A472-5�L--w =-- �� -------------------- $. Names and addresses of witnesses, doctors and hospitals. 9. Lis the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney)-- ' orbX some person on. hi f." Name and Address of Attorney 21-A Z�4� Claimant' gnature Do, C�- Address) -- Telephone No. Telephone No. N 0 T I C E 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, ,city or district board or officer, authorized to allow or pay the same if-genuine,, any false or fraudulent claim, bill, account, voucher, or writing; is punishable either by imprisonment in. the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. a`. ` `fit � �• � ',,�� t�• �- � ��;`.. 4t , •4` - . r �"L 64 t s, sad• S . • �{ -'`•A;`i� �i^�� x G' Y� +1 �`ta . yrs"',�� a C 44�v 7 7:77 r - _ K' Ir' u x .,�Y at r{ e;'�a£,� 7 = .•v4ge' Y. x -i 3, z �`k ' r �'6,�tak 'P`'i,,, xw��. -:a �'�.��,a3c�s��✓"�. 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