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HomeMy WebLinkAboutMINUTES - 01062009 - C.13 (13) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION JANUARY,,06,2009 � ; " Claim Against the County, or District Governed by r the Board of.Supervisois, Routing Endorsements, NOTICE TO CLAIMANT and Board Action. All Section references are to 0 Ohe copy of this document mailed to California Government Codes. you is your notice of the action taken on your claim by the Board of DEC91 Supervisors. (Paragraph IV below), 3 208 given Pursuant to Government Code AMOUNT: UNMOWN - TRECDVOYMOUNSEL Section 913 and 915.4. Please note all PENDING MARTINEZ CALIF. "Warnings".. CLAIMANT: BALJIT SINGH, GIAN SINGH ATTORNEY: JOHN A. PETTIS DATE RECEIVED:. DEC.E rRFu 01, 2.008 JOHN A. PETTIS & ASSOCIATES ADDRESS: 3000 DANVILLE BLVD. BY DELIVERY TO CLERK ON: DECEMBER 03, 2008 ALAMO, CA. 94507-9825 BY MAIL POSTMARKED: DECEMBER 02, . 2008 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DAVID TWA, CI Dated: DECEMBER M 2008 By: Deputy 4� 1I. FROM: County Counsel TO: Clerk of the Board of Mpervisor7 (tis 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: Z `f�' By: rn CG-GX —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. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dat4 "oo;, v�Df DAVID TWA, CLERK, By, DeputyClerk WARNINGki' ov. code section 913) U 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 Warning 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. Date DAVID TWA, CLERK, By e. Deputy Clerk r� 41 +! � This warning does;not,a,pply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific reiiefsuch as mandamus or injunction, or Federal Civil1Rights claims. The above list is not exhaustive.and legal,;,r• consultation is essential to u'nd'erstand-all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra. Costa does not waive any of its:rights under California Tort Claims Act a nor-does,it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAEAANT A. A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented not later than one year after the accrual of the cause of action. (Gov. 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 eacli. public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. an me RXRnnRRaRR■Rana man gas RaRnnn Rcn Rn R■RnRau R■■■-as rncan Rdaaa■■RRaRanaaaRa■a cc no RE: Claim By: Reserved for Clerk's filing stamp - � " T SJ4 16 , sl � ) � DECEIVED Against the County of Contra Costa or ) DEQ 0 3 2009 District) ..( ,(Yill in the e) 44am-, ) tVM►Q� The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district iR the $pnd in support of this claim represents as follows: 1. -Whhtnn did the damage or injury( oc ? (Give exact date and hour) Pbo 1,13 e�: .l I �K- 2. Where did the damage or injury occur? (Include city and coon AA OA wow 3. H_ ow did the ��jury occur? (Give full d�etai��.se extra�Rer if required) At�/I,,,,,J,� 4. What parh'Lular act or orris on e part of counor district officerservants, or employees " -I caused the injury or damage? What are the names of county or district officers, servants, or employees causing the damage or injury? 6. IAI at damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach o es ' a for auto damage.) ir 7. How was e amo t claimed above computed? (Include the estimated amount of any prospective injury or d amage..) ttD tor ur� 1 S. Names and addres es of tnesse , doctors, and hosp als: 9. List the expenditures you made on account of this accident or injury: DATE TWE AMOUNT 2 a a a a a a a a a a■s[a■[a[a ■ [a a[[r[■aaa[aa[[[aa[aa[aa a aaaaaaar[a■■ua[a[ [aaa[aaaaaa[[� ) .Gov. Code Sec. 910.2 providesp"The claim shall be ) signed by the claimant or by so 'e pe son on his ) behalf." SEND NOTICES TO: (Attorney Name and address of Attorney (Claim is Signature 300 �►Y� (� �d #373 ) � ni� > ! 2 lu e� �© t C Lq ` � ) (Address) QQdg� 13 Telephone No."/) 'a,:V-I'09 00 ) Telephone No. a[aa[ar[aafa a a[a■aa Kansai a■aaa[ara[aa[asarraaaaaa[[aa[[[[[[aa[[ar[[[[fcaa aafa[[raraal PUBLIC RECORDS NOTICE: Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any attachments, addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. a Exxon■Evans Mae aa[[Stan a a a as■[aa[va[[a■aaa a aown aaa[[aaaa■a[aaaruaa■man on a[aaaaraai 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 dollars ($1,000.00), 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. -STATEOP-CJ1�IF�i6 NIA TRAFFIC COLLISION REPORT �g CHP'555(.'ARS Pege 1 (Rev 1-03)OPI 061t)}'t i Page I of SPECIAL CONDITIONS uuemeR .174 Run CITY JUDICIAL DISTRICT LOCAL. REPORT NUMBER ON-DUTY EMERGENCY VEHICLE '"J"qeD F.LONY 0 UNINC.COLO DELTA COURT nul,+aEq KILLED nIT&Run COUNTY REPORTING DISTRICT BEAT MISDEMFANOIi 666 0 CONTRA COSTA 71 , COLLISION OCCURRED ON. MO DAY YEAR TIME 124001 NCIC q OFFICER I.D. Z WILLOW PASS RD 6/28/2008 1711 9320 018346 O MILEPOST INFORMATION'. DAYOF WEEK TOW AWAY PHOTOGRAPHS BY: X NONE < SATURDAY X YES NO 0 X AT INTERSECTION WITH: STATE HWY REL OR: N.BROADWAY AVE YES X No PARTY DRIVER'S LICENSE NUMBER STATE CLASS AIRBAG SAFETY EQUIP. VEIL YEAR MAKE I MODEL/COLOR LICENSE NUMBER STATE ). C3225212 CA C M G 2001 F01ZDCROWN VI WI-II 1074173 CA I DRIVER NAME(FIRST.MIDDLE.LAST) ON DUTY EMER EN Y ] I LE X KENNETH HUTTON OWNER'S NAME SAME AS DRIVER PEDES- STREET ADDRESS CONTRA COSTA SHERIFF TRIAN 1980 MUIR RD OWNER'S ADDRESS SAMEASDRIVER PARKED CITY I STATE I ZIP 1980MUIRRD MARTINEZ CA 94553 VEHICLE _ MARTINEZ :.yl C,�.., "94553 DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER X DRIVER OTHER BI SEXHAIR EYES HEIGHT WEIGHT BlRiHOATE RAGE DROVE FROM SCENE CL.. M BRN BLU 6-02 280 3/2/1967 ay Y� W PRIOR MECH.DEFECTS X NONE APP, REFER TO NARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER. li (925)646-2441 VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA INSURANCE CARRIER POLICY NUMBER LINK NONE MINOR SELF-INSURED 48 X Moo MAJOR ROLL-OVER DIR OF TRAVEL ON STREET OR HIGHWAY SPEED LIMIT CA DOT [ED `'. E WILLOW PA S RD 35 CAL-T CP PSC MCIMX PARTY. DNIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY EQUIP. VEH.YEAR MAKE I MODEL I COLOR LICENSE NUMBER STATE Z 68514192 CA C M G 2001 FORD WINDSTAR SIL 4NVT527 CA I(ORIVER NAME(FIRST,MIDDLE.LAST) X BALJIT SINGH I OWNER'S NAME X SAMEASDRIVER PEDES- STREET ADDRESS rRInN 317 ROUNDHILL DR OWNER'S ADDRESS X SAMEASDRIVER PARKED CITY/STATEIZIP VEHICLE BRENTWOOD CA 94513 DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER X DRIVER OTHER I BV SEX HAIR EYES HEIGHT WEIGHT BIRTHDATE RACE DROVE AWAY FROM SCENE C Mo Day Year `✓ M BLK BLI 5-07 165 5/23/1969 O PRIOR MECHANICAL DEFECTS X NONEAPP. REFER TO NARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: (925)354-4639 (925)634-2358 VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA INSURANCE CARRIER POLICY NUMBER UNK NONE X MINOR AAA LB-76-98-2 08 MOD MAJOR ROLL-OVER DIR OF TRAVEL ON STREET OR IT 3HWAY SPEED LIMITCA DOT E WILLOW Pi SS RD CAL-T TCP/PSC MCIMX Y ®� PARTYDRIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY EQUIP. VEH.YEAR MAKE I MODEL I COLOR LICENSE NUMBER STATE .I.' D5671590 CA U M G 1996 CHEV S-10 WHT 7P46723 CA 6RIVBR NAME(FIRST,MIDDLE,LAST) - _ dASIMIRO FRANCO ' OWNERS NAME _ X SAMEASDRIVER '@bhS:' STREET ADDRESS TRIAN 204 ALVARADO AVE OWNER'S ADDRESS p X SAMEASDRIVER PERIGEE CITY I STATE I ZIP PITTSBURG CA 94565 DISPOSITION OF VEHICLE ON ORDERS OF X OFFICER DRIVER OTHER BICY SEX HAIR EVE HEIGHT WEIGHT BIRTHDATE RACE EAST COUNTY TOW-(925)439-1141 OUST Mo Day Year M BLK SR 0-09 210 7/3/1948 H PRIOR MECHANCIAL DEFECTS X NONE APP. REFER TO NARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: (925)427-7386 NONE VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA INSURANCE CARRIER POLICY NUMBER UNK NONE MINOR UNITRAN 4501929 22 X MOD MAJOR ROLL-OVER OIROFTRAVEL ONSTREETOR IGHWAY SPEED LIMIT E WILLOW P SS RD CA DOT 3S CAL-T TCPIPSC MCIPA% •J- PREPARER'S NAME DISPATCH NOTIFIED RNWER' AME DATEREVIEWEO I 'F rf1C1K IR OIR346 YES NO X NIA \ ��h a��� �t STATE OF.CALIFGRNIA TRAFFIC COLLISION CODING CHP 555 CARS Page2(Rev. 1-03)OPI 061 Page 2 of 10 DATE OF COLLISION(MO. DAY YEAR) TIME(2100) NCICM OFFICER I.D. NUMBER 6/28/2008 1711 9320 018346 OWNER OWNER ADDRESS NOTIFIED PROPERTY DYES El NO DAMAGE DESCRIPTION OFDAMA SEATING POSITION SAFETY EQUIPMENT INATTENTION CODES OCCUPANTS L-AIR BAG DEPLOYED MIC BICYCLE-HELMET _ A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED DRIVER PASSENGER A-CELL PHONE HANDHELD B-UNKNOWN N-OTHER V-NO X-NO B-CELLPHONE HANDSFREE C-ELECTRONIC C-LAP BELT USED P-NOT REQUIRED W-YES Y-YES EQUIPMENT D-RADIO I CD D-LAP BELT NOT USED 1 2 3 1-DRIVER i E-SMOKING E-SHOULDER HARNESS USED i 2706-PASSENGER CHILD RESTRAINT EJECTED FROM VEHICLE F-EATING 4 5 6 F-SHOULDER HARNESS NOT USED 7-STA.WGN REAR D-IN VEHICLE USED G-CHILDREN G-LAPISHOULDER HARNESS USED 0-NOT EJECTED 8-RR.OCC TRK.OR AN R-IN VEHICLE NOT USED H-ANIMALS H-LAP/SHOULDER HARNESS NOT USED 1-FULLY EJECTED 9-POSITION LIN N S-IN VEHICLE USE UNKNOWN I- PERSONNEL HYGIENE J-PASSIVE RESTRAINT USED 2-PARTIALLY EJECTED 7 0-OTHER T- VEHICLE ER USE 3-UNKNOWN J- READING K-PASSIVE RESTRAINT NOT USED U-NNONE INN VEHICLEHICLE K-OTHER ITEMS MAR ED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY COLLISION FACTOR I TRAFFIC CONTROL DEVICES 1 2 3 SPECIAL INFORMATION 1 2 3 MOVEMENT PRECEDING LIST NUMBER(0)OF PARTY AT FAULT 1: COLLISION 1 VC SECTION VIOLATED: CITED ES 14, ONTR&ST0kTIONING JA HAZARDOUS MATERIAL X X A STOPPED 2350 NO B CONTROLS NOT FUNCTIONING' B CELL PHONE HANDHELD IN USE X B PROCEEDING STRAIGHT B OTHER IMPROPER DRIVING' IC CONTROLS OBSCURED C CELL PHONE HANDSFREE IN USE C RAN OFF ROAD X I D NO CONTROLS PRESENT/FACTOR' X X X D CELL PHONE NOT IN USE D MAKING RIGHT TURN C OTHER THAN DRIVER' TYPE OF COLLISION E SCHOOL BUS RELATED E MAKING LEFT TURN D UNKNOWN' A HEAD-ON F 75 FT MOTORTRUCK COMBO F MAKING U TURN B SIDESWIPE G 32 FT TRAILER COMBO G BACKING X C REAR END H H SLOWING/STOPPING WEATHER (MARK 1 T02 ITEMS) D BROADSIDE 11 11 PASSING OTHER VEHICLE X A CLEAR E HIT OBJECT J J CHANGING LANES B CLOUDY F OVERTURNED K K PARKING MANEUVER C RAININGG VEHICLE/PEDESTRIAN L L ENTERING TRAFFIC D SNOWING H OTHER': M MOTHER UNSAFE TURNING E FOG/VISIBILITY FT. N N XING INTO OPPOSING LANE F OTHER:' MOTOR VEHICLE INVOLVED WITH 1 O O PARKED G WIND A NON-COLLISION P P MERGING LIGHTING B PEDESTRIAN Q O TRAVELING WRONG WAY X A DAYLIGHT X C OTHER MOTOR VEHICLE OTHER ASSOCIATED FACTORS R OTHER': B DUSK-DAWN D MOTOR VEHICLE ON OTHER ROADWAY 1 2 3 (MARK 1 TO 2 ITEMS) C DARK-STREET LIGHTS E PARKED MOTOR VEHICLE A W SECTM NOUTED: CITED AYES DARK-NO STREET LIGHTS F TRAIN (L-J�NO ARK-STREET LIGHTS NOT G BICYCLE X B VC SECMN MOUTED: GRED YES FUNCTIONING' H ANIMAL: 24603(E) NO SOBRIETY-DRUG ROADWAY SURFACE W SECTION VIpUTEO: CITED PHYSICAL C YES 1 2 3 (MARK 1 TO 2 ITEMS) X A DRY 1 FIXED OBJECT: No B WET DT X X X A HAD NOT BEEN DRINKING C SNOWY-ICY J OTHER OBJECT: E VISION OBSCUREMENT: B HBD-UNDER INFLUENCE D SLIPPERY(MUDDY,OILY,ETCI) F INATTENTION': C HBD-NOT UNDER INFLUENCE' ROADWAY CONDITION(S) IG STOP&GO TRAFFIC O HBO-IMPAIRMENT UNKNOWN' (MARK 1 TO 2 ITEMS) PEDESTRIAN'S ACTIONS IN ENTERING I LEAVING RAMP E UNDER DRUG INFLUENCE' A HOLES,DEEP RUT' X A NO PEDESTRIANS INVOLVED I 1 PREVIOUS COLLISION F IMPAIRMENT-PHYSICAL' S LOOSE MATERIAL ON ROAD Y' B CROSSING IN CROSSWALK IJ UNFAMILIAR WITH ROAD G IMPAIRMENT NOT KNOWN C OBSTRUCTION ON ROADWAY AT INTERSECTION K DEFECTIVE VEH.EQUIP.: CITED H NOT APPLICABLE D CONSTRUCTION-REPAIR ZO E C CROSSING IN CROSSWALK-NOTa YES 1 SLEEPY/fA71GUED E REDUCED ROADWAY WIDTH AT INTERSECTION NO F FLOODED' D CROSSING-NOT IN CROSSWALK L UNINVOLVED VEHICLE G OTHER': E IN ROAD-INCLUDES SHOULDER X M OTHER': V-2 STOPLAMPS X H NO UNUSUAL CONDITIONS F NOT IN ROAD X N NONE APPARENT G APPROACHING/LEAVING SCHOOL BUS O RUNAWAY VEHICLE SKETCH FOR SKETCH 1 IAGRAM, SEE PAGE 4 MISCE ANEous Q KIT — INDICATE NORTH o­A _ STATE OF CALIFORNIA JN'JURED1 WITNESSESII PASSENGERS Page S QJ 10 • CHP'S55 ARS Ra e 3 Rev 1+03 OPI 061 DATE OF COLLISION(MO. DAY YEA ) TIME(2400) NCIC q OFFICER I.D. NUMBER 6/28/2008 1711 9320 018346 WITNESS PASSENGER AGE SEX EXTENT OF INJURY(-X'ONE) INJURED WAS('X'ONE) PARTY SEAT AIR SAFETY EJECTED ONLY ONLY NUMBER POS. BAG EQUIP. FATAL SEVERE OTHER VISIBLE COMPLAINT DRIVER PASS, PED. BICYCLIST OTHER INJURY INJURY IN OF PAIN ❑ ❑X 62 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 2 3 M G 0 NAME/D.O.B.I ADDRESS TELEPHONE GIAN SINGH (04/01/1946) 31 ROUNDHILL DR BRENTWOOD CA 94513 (925)634-2358 I (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES: ❑ VICTIM OF VIOLENT CRIME NOTIFIED ❑# U 69 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 2 6 P G 0 NAME/D.O.B.I ADDRESS TELEPHONE GURBACHAN SINGH (04/02/1939) 1879 CHAPARRAL DR PITTSBURG CA 94565 (925)232-3921 (INJURED ONLY)TRANSPORTED BY: TAKEN TO I I --,,21BE INJURIES: ❑ VICTIM OF VIOLENT CRIME NOTIFIED ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ NAME I D.O.B./ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY:j TAKEN TO: DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NOTIFIED ❑# ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ NAME ID.O.B./ADDRESS TELEPHONE (I.'IIJRED ONLY)TRANSPORTED BY TAKEN TO: DESCRIBE INJURIES: ElVICTIM OF VIOLENT CRIME NOTIFIED ❑" ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ NAME/D.D.S./ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED 8): TAKEN TO: DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NOTIFIED ❑" ❑ ❑ ❑ ❑ o ❑ ❑ 7ol ❑ I ❑ NAME/D.O.B./ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED B TAKEN TO: DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NOTIFIED PREPARER'S NAME I.D.NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YEAR T.COOK JR 018346 6/28/2008 STATE OF CALIFORNIA SKETCH DIAGRAM CHP 555 Pauc4(Rc%,.s- OPI042 PAGE 4 OF Id DATE OF INCID NT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 ILII 9320 AL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE= NoNE ) WILLOW PASS ROAD E/B N Painte� Solid Double Yellow Lines J Painted Solid _ White Line N.__Broadway_Ave. A— Shoulder _ Painted Solid White Line V-3 2 V-2 1 V-1 E #1 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE STATE OF CAL,FO"IA .FACTUAL DIAG AM CHP 555 Pae 4 Rev.8-97 PI 042 PAGE 5 OF 10 DATE OF INCIDEN TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 19320 018346 At-L M SUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE= N(3NF ) WILLOW PASS ROAD E/B N Painted Solid Double Yellow Lines Painted Solid White Line N. Broadway Ave. �— Shoulder Painted Solid White Line I E #1 I I A'LL VERIL C.S 1AACn PRiuR IQ CNP ARNvnL NO No SIWl of MSIM BIggf-N RAW PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK JR 018346 )6/28/2008 I STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL PAGE 6 OF 10 DATE OF INCID NT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 1711 9320 018346 1 FACTS 2 3 NOTIFICATION: I received a call from CHP dispatch of a property damage traffic collision 4 at 1711 hours. I responded from California Ave at Harbor St and arrived on scene at 1801 5 hours. 6 7 All times, speeds and measurements in this investigation are approximate. Measurements 8 were ta,I en by visual/estimation except where otherwise indicated. «, 10 SCENE: At the scene of this collision, Willow Pass Rd is a two-way eastbound/westbound 11 divided oadway located in the unincorporated county of Contra Costa. There is one 12 eastbo nd lane and one westbound lane. The eastbound and westbound lanes are 13 separat d by solid double yellow lines. The eastbound lane has a solid white line at the 14 south r adway edge and the westbound lane has a solid white line at the north roadway 15 edge. here is an asphalt shoulder at the north and south roadway edge of Willow Pass 16 Rd. Wi low Pass Rd at this location is primarily composed of asphalt. The roadway is flat 17 and str fight. The speed limit at this location is 25 mph. See Factual Diagram. 18 19 PART, S: 20 21 Partv#1 Hutton was located at the scene standing next to V-1. P-1 was identified by a 22 valid C flifornia driver license. P-1 was placed as the driver of V-1 by the following items: 23 P-1 stated that he was the driver of V-1 at the time of the collision 24 The seat of V-1 was adjusted to fit the stature of P-1 25 26 Vehicl # 1 Ford Party # 1's vehicle was located at the scene on the right hand shoulder 27 of Will w Pass Rd eastbound, facing in easterly direction. V-1 sustained minor damage to 28 the fro t push bar on the front bumper. No prior mechanical defects were claimed or noted. PREPARED BY I I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK J 018346 06/28/2008 I STATE OF CALIFORNIA NARRATIVE/ SUPPLEMENTAL PAGE 7 OF 10 DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 1711 9320 018346 1 Partv 2 (Singhl was located at the scene standing next to V-2. P-2 was identified by a 2 valid Cfornia driver license. P-2 was placed as the driver of V-2 by the following items: 3 -t-2 stated that he was the driver of V-2 at the time of the collision 4 -:)-2 was the registered owner of V-2 5 - he seat of V-2 was adjusted to fit the stature of P-2 6 7 Vehicle #2 (Ford) Party# 2's vehicle was located at the scene on the right hand shoulder 8 of Willow Pass Rd eastbound, in front of V-1, facing in an easterly direction. V-2 sustained --,)9 minor amage to the rear and front bumper. No prior mechanical defects were claimed or 10 noted. 11 12 Part3 Franco was located at the scene standing next to V-3. P-3 was identified by a 13 Mexica I.D. card, a driver license check which returned confirming P-3 was unlicensed 14 and m tching descriptors provided by CHP dispatch. P-3 was placed as the driver of V-1 15 by the ollowing items: 16 P-3 stated that he was the driver of V-3 at the time of the collision 17 P-3 was the registered owner of V-3 18 The seat of V-3 was adjusted to fit the stature of P-3 ` 19 20 VehicI6 #3 (Chevy) Party # 3's vehicle was located at the scene on the right hand 21 should Tr of North Broadway Ave northbound, facing in a northerly direction. V-3 sustained 22 moder to damage to the rear bumper. No prior mechanical defects were claimed or noted. 23 24 OTHE FACTUAL INFORMATION: 25 26 P-2 st ted V-2's brake lights were working prior to the collision. I checked if the brake 27 lights f V-2 were working at the scene of the collision while the vehicle was on. I observed 28 that th brake lights of V-2 did not light up when the brake pedal was applied. PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK J 018346 06/28/2008 STATE OF CALIFORNIA NARRATIVE/ SUPPLEMENTAL PAGE 8 OF 10 DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 1711 9320 018346 1 STATEMENT 2 3 Pa # Hutton related to me he was the driver of V-1 (Ford), traveling on Willow Pass 4 Rd east ound, at approximately 25-27 MPH. P-1 stated that there was a car length and a 5 half dist nce between his vehicle and V-2 as they traveled on Willow Pass Rd. P-1 related 6 to me t at V-2 then appeared to be stopped in the lane in front of him. P-1 stated that the 7 brake lights of V-2 were not on, as it was stopped in the lane. P-1 related to me that his 8 car was at a 5-10 feet gap from V-2 when he began "threshold braking P-1 stated that his ,9 vehicle hen skidded into V-2. P-1 related to me that his vehicle bumped V-2 with the push 10 bar. 11 12 Part # (Singh) related to me that he was the driver of V-2 (Ford), traveling on Willow 13 Pass R eastbound, at approximately 20 MPH. P-2 stated that he saw V-3 come to a stop 14 in front f his vehicle. P-2 related to me that he did not remember seeing a left turn signal 15 being g ven by V-3. P-2 stated that he then stopped his vehicle behind V-3. P-2 related to 16 me tha he saw V-1 coming behind his vehicle "a little fast". P-2 stated that he had his foot 17 on the rake when V-1 hit his vehicle from behind. P-2 related to me that his vehicle was 18 pushed forward into V-3's bumper. P-2 stated that his brake lights were working prior to 9 9 being it by V-1. 20 i 21 Partv#3 Franco related to me that he was the driver of V-3 (Chevy), traveling on Willow 22 Pass d eastbound, at a complete stop. P-3 stated that he was at a complete stop and was 23 prepari g to make a left turn onto North Broadway Ave. P-3 related to me that he had his 24 left tur signal on while waiting for cars to pass by in the opposite dire,Lsfo`Osxted that his 25 vehicle was then hit from behind by V-2. 26 27 28 PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK J 018346 06/28/2008 I ' 1 STATE OF CALIFORNIA NARRATIVE/iUPPLEMENTAL PAGE 9 OF 10 _ DATE OF INCI ENT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 1711 9320 018346 1 OPINIONS A D CONCLUSIONS: 2 3 SUMM RY: P-1 was driving V-1 (Ford) traveling on Willow Pass Rd eastbound, at 4 approximately 25 MPH. P-2 was driving V-2 (Ford) traveling on Willow Pass Rd 5 eastbOLind, at approximately 20 MPH. P-3 was driving V-3 (Chevy) traveling on Willow 6 Pass Rei, at a complete stop. 7 8 1 -3 VV driving V-3 in theleastbound lane then signaled and came to a complete stop to 9 make a' left turn onto N. Broadway Ave. P-2 driving V-2 in the eastbound lane saw V-3 10 come t a stop. P-2 driving V-2 then came to a complete stop behind V-3. P-1 was driving 11 V-1 in t e eastbound lane when V-2 came to a stop in front of V-1. P-1 then applied the i 12 brakes f V-1 but was unable to stop V-1 before impacting V-2's rear bumper. V-2 was 13 then p shed forward by V-1 into the rear of V-3 upon impact. V-1 and V-2 were moved to 14 the rig hand shoulder of Willow Pass Rd and V-3 moved to the right hand shoulder of N. 15 Broad ay Ave. prior to CHP arrival. 16 17 AREA F IMPACT: The #1 area of impact was determined to be 20 feet north of the south 18 roadw edge of Willow Pass Rd eastbound and 5 feet west of the west roadway edge of 19 N. Bro dway. The #2 area of impact was determined to be 18 feet north of the south 20 roadw y edge of Willow Pass Rd eastbound and 9 feet east of the west roadway edge of 21 N. Bro dway. 22 23 CAUS : The cause of this collision was determined to be due to a violation of 22350 CVC, 24 which tates in part that: 25 26 No per on shall drive a vehicle upon a highway at a speed greater than is reasonable or 27 pruden having due regard for weather, visibility, the traffic on and the surface and width of, 28 the hig iway, and in no event at a speed which endangers the safety of persons or property. PFEDARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK JR 018346 06/28/2008 STATE OF CALIFORNIA NARRATIVE/ .,UPPLEMENTAL PAGE IOOF 10 DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 06/28/2008 1711 9320 018346 1 P-1 cawed this accident by driving V-1 at a speed that was unsafe due to the traffic 2 conditions and visibility on Willow Pass Rd eastbound. Due to these circumstances P-1 3 caused V-1's front push bumper to collide into V-2's rear bumper causing V-2 to collide into 4 V-3's rear bumper. 5 6 A possible associated factor to this collision was that V-2 was not equipped with properly 7 workin stop lamps. This is a violation of Section 24603 (e) CVC which states in part every . 8 vehicle which is not in combination with any other vehicle shall at all times be equipped with 9 stop la ps mounted on the rear as follows: 10 11 Stop la ps on vehicles manufactured on or after January 1, 1979, shall emit a red light. All 12 stop la ps shall be plainly visible and understandable from a distance of 300 feet to the 13 rear bo�h during normal sunlight and at nighttime. 14 15 Summry, area of impact and cause were determined by statements and damage/location 16 of the involved vehicles. I 17 18 RECOMMEN ATiONS "�19 20 None j PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE T. COOK JR, 018346 06/28/2008 i 1 PROOF OF SERVICE 2 3 1 declare that: 4 I am employed in the County of Contra Costa, State of California. I am over the age of 18 5 years and not a party to the foregoing action. My business address is: JOHN A. PETTIS & ASSOCIATES, 3000 Danville Boulevard, Suite 373, Alamo, California 94507-1574. 6 On December 1, 2008, I served the following document(s): 7 8 FORMAL CLAIM 9 on the parties in said action by placing a true copy thereof in a sealed envelope addressed as follows: 10 11 Clerk of the Board of Supervisors Room 106, County Administration Building 12 651 Pine Street 13 Martinez, CA 94553 14 ❑ By Facsimile Machine (FAX). By personally transmitting a true copy thereof via 15 an electronic facsimile machine between the hours of 9:00 A.M. and 5:00 P.M. 16 ® By Mail. I am readily familiar with this office's business practice for collection 17 and processing of correspondence for mailing with the United States Postal Service and this document,with postage fully prepaid, will be deposited with the 18 United States Postal Service this date in the ordinary course of business. 19 ❑ By Personal Service. By personally delivering a true copy thereof to the office of 20 the addressee above. 21 I declare under penalty of perjury that the foregoing in true and correct. 22 Executed on December 1, 2008, at Alamo, Calomnia. 23 1 i 24 25 CARMELA R. MACALUSO 26 27 28 PROOF OF SERVICE 32 �2SO�r35a5.y� , ��Q N a 0.0 a4 7u-W �� cam. N cp �9! ,z i c�7 l o CD N G 4? G 7 � N % N LO co O ,,a O 9 i OCO CO C) s O N N y o LO . V � � c- �4 � Z t•" O � U a x O ,