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HomeMy WebLinkAboutMINUTES - 03191991 - 1.23 � CLAIM � ^ - BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA , Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 19^ 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government the action taken on your claim by the Board of Supervisors (Paragraph IV below)" given pursuant to Government Code Amount: �7D� x�O� .�O Section 933 and 9l6.4. Please note all "Harni��"���FD � ~'�, CLAIMANT: 8ODAC0L0FFI _ Anthony J. for minor Antonin J. BodacmI6ffi F E 8 w� 19 � 01 ATTORNEY: Date received MWINpL ^Q~ ADDRESS: 3824 Willow Pass Rd. , #2 BY DELIVERY TO CLERK ON February 19 , 1990 (hand Concord, C& 945I9-I027 delivered) BY MAIL POSTMARKED: .I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. February 26, 1991 RYIL BATCHELOR, Clerk DATED: epu 11. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 010.2, ( } 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 0I0.8). ( ) 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 Ill. 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 ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date Dated: MAR 19 1991 PHIL BATCHELOR, Clerk, B ", Deputy Clerk WARNING (Gov. code s��tio 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim' See Government Code Section 946,6. You may seek the advice of an attorney of your choice in connection with this matter' If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that l am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today l 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. Claim. to: BOARD OF SUPERVISORS OF CONTRA COSTA OCUM 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 ByAV/.'nY1/ f ��o�i=/ � Re er ed terk's �iling stamp RECEIVE® Against the County of-Contra Costa ) FEB 19 1991 —� to1 ;10 P.m. CLFRK BOARD OF SUPERVISORS Fill in name CONTRA COSTA CO. ) The undersigned claimant hereby makes claim against the County of Contra Costa or ' the above-named District in the sum of $ 100..6w and in support of this claim represents as followsgzK, 9 _.kifF�•�,,u�-�P1•6�/SHS 4lF&C.41, ---------------------------------------- T -- ------------------------------ 1. When did the damage or injury occur? `(Give exact date and hour) �m79,�� 2. Wheredi the/damage or injury occur? (Include city and county) F/LIt�FN/LE LL, eels,-VD 6. /6 "��G �a� �cAe�t� ��/!/cam -��•�%/� -----`OAIT;e Cf.+�ST•9�1�LliY ��G�Fo,E'_r/iR 3. How did the damage or injury occur? (Give full details; use extra paper if required) 1N �N .�TFin�T ,-z� ,�/�v�= ,�/yro�io ✓a/�,Joo��Gc�F/�/rte ------------------------------------------------------------- --- --------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 7_ !/SiiriG ©�. �.o o�yi�✓6 �p,�ccG T� �1�� �/yT®�✓/Q UO�>rf ,�OGvPG�OG DST/ �Di1l���/ rz� /��C�— 1/c--�7$ AS�EO pf�//S/��l 0/1/ a2 - ��- �/> �it/ILcG f�� )�i�.1/G v� ,"LCee ®f Tyr. AKebA ' �G�LG /1/�T�T.PvGG�i�G !�. «�/c"vw-o G 5. What are the names of county or district officers, servants or employees eauRing the damage or injury? ��E/SEG ES' ------------------------------------------------------------------- ------------- 6. What damage or injuries do you claim resulted? (Give full extent of in'uries or damages claimed. Attach two estimates for auto damage. Jr:" •�� e . �LLdGv_o5�F%S Y 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.)_Z BG tier ,fir/ee-e-' �l�/ZCA'G �D/ll�IJTE� ��ldle'.Ul' O/Y T/�E �SL's�.P1.UG �P�•Ul.¢GC 7 �F,Q�SD/Y�L //��✓�/2� 401.e T.f<� �E /�G �iPi�v/ �urq'�F.�ii�1G �ivGv/SN o,� .9 .doe ew.--ez 7-,oC 8. Names and addresses of witnesses, doctors and hospitals."�_ �Ae4cC=2 '004,0v/9 AieFiv .�/l'�'.s<i��L 9 gee" .v �C'4, e.�.Ye -be AoOV7 �ECTOQ.Ism SVA �T fi�1f.�Gr Nc!y s�iy�.SF.e —/�"li�•eT��YEL9�i9�_ , �� , c,�,Hitr, Qi�TirFdl�iO ------------------------------------------------------ 9. List 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.;):�4{-:, or by some 2erson on his behalf." Name and Address of 'Attorne LTi¢//Yt Q Clai 's gnature Address D /OaIAT /HT 4� T�--c ���.tiE� i ,/is �?7-3� ore ice" Telephone No. �iY. 7- �� �" I Telephone No. �/ t- �£ry - .`�-ado �---� 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 ($1090000 or by both such imprisonment and fine. /�'�OA-m �L'Cld�dCli� _ /��*�. � /�, /JZo o�L� / f 1- / �9 r, i ,,/ / ' / 1 r� r � � i� � � i � i i i r / � �j/ !' �/ /' /' / / / � /` / , ' �� r � % � sem. / / r � � � � / .- �, ' .. �� � / / / / , r i r , / � � i // /fir /� s�' r r / ��.� � % '� �Ii /' / i / / / _ dry ri • / � � �� / � i i �, i i PIP& % r ' i-� ,5 , � i •��/ / � �/ ice• ,• l MEW i // � � �: y // /-' / j. � , /, y /� i y / �- t � i � i � / r �. i = � � i - �� i /� i , / O ' �i i i i / � � / r_ / _ / i i i � � /� /' � / � � � �S� �� � I� � �' � � � i / � / - i ,/ � / , �� � i r / / � / � � j i �� � � /� � ��, �� � � � �� / O � � � , � / % /� / j i / / / / � �� ®� ;� �. �� - (� � Ali � � i � i � � , /� i �� �. � � �� �� � j �. �� /, i r � / �/ / ` . i / . �= � / -- , , /� / / / i � � � • i:, ,. . . �, / � � i. � ,- / r ,/ i i // / L i JG � i , /i � i��✓��I �� ��� �I � � �� �� � - /` � _ %r f / �i �/ � -i �� / � l � � ���� i i i ��, �, ./1 � � / /!/ i i CLAIM a3 BOARD OF SUPERVISORS.OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 19, 1991 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 Governr ERlE® Amount: $303.08 Section 913 and 915.4. Please note all "Warnings".((�� n n1 CLAIMANT: HARBARTH, Michael V. or Helen L. FEB NV 1JJ1 COUNTY COUNSEL ATTORNEY: Daniel Chizever MARTINEZ, CALIF. California State Automobile Date received ADDRESS: Association Inter—Insurance Bureau BY DELIVERY TO CLERK ON February 21, 1991 (via Risk P.O. Box 888 San Ramon, CA 94583-5888 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 26, 1991 PpHHIL BATCHELOR, Clerk BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Sup visors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: � �. Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)' ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (V ) 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: MAR 19 i991 PHIL BATCHELOR, Clerk, ByZ Deputy Clerk WARNING (Gov. code sect n 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: J— DO—01 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim For Damages In accordance with Section 910 of the California Government Code,this is to formally place you on notice of our subrogated claim for the loss described below. SNP RECEIVED Date: January 8, , 1991 CITY OF ORINDA FEB 2 11991 San Ramon, , California 26 ORINDA WAY CLERK BOARD OF SUPERVI q q/ ORINDA CA 94563 CONTRA COSTA CO Claim is hereby made and filed against the City of Ori nda Police Department as follows: Insured/Claimant's: HARBARTH, Michael V. or Helen L. California State Automobile Association Inter-Insurance Bureau Address of Claimant: (Send notices to this address) PO BOX 888, SAN RAMON, CA 94583-5888 Reference File 11-076670-9 Date of Occurrence: 10-26-90 Place of Occurrence: Camino Pablo, Orinda, Ca. Nature and Amount of Damages Automobile accident — repairs pending Items Making up said Amount: Pending Name of Public Employee(s) causing said Damage(if known): Roger Wayne Wilson Facts & Details: Our driver stopped at stop sign, preceeded within lane divided by solid white line. Your driver crossed solid line colliding with our vehicle's left front area. RECEIVED JAN 10 1991 CITY OF ORINDA California State Automobile Association CITY MANAGERICLERK. Inter-In su rance Bureau By: . F1688(Rev 11.87) "DANIEL CHIZEVER CALIF. STATE AUTO ASSOC P.0. FOX 888. SAN RAMON CA. 9458.3 3BOSTRC3M ' S AlJTO BODY BAR # AA151265 2-7347-49 SAN R 11ON VALLEY ELVD. SAN Fel-MON CA. 94583 (415) X31-1778 i T I MATE ## Mi 4c by JAMES DAVIS Date,' i31--E4-1991 Time,' 14: 14 413 F�I.ATt� CT. Remarks e7 Adjusted DANVILLE CA 94526 License '1SAJSY-JAppraise; Home :83 -8 i 86 Ser # : 1 MEE+-'8 r V l GA62^8 i 059 Claimant Wcx•-k 1966-1195 Rate Code: InsLtred 66 MERCURY SAELE In/Out Mi : Policy # Style : :Pt. : Deductibl i sca,f;R:f Claim # # DESCRIPTION EST PRICE LABOR 1 FAINT 1 REFINISH COVER FRONT REFINISH 2.3 ; NEN ASSEMBLY ARK LAMP OTR LEFT f 36.2 r 03.6 3 NEN FILLER PANEL, FRONT BUMPER LEFT 8, % %f 0.2 ; 4 R&I BUMPER ASSY, FRONT R&I 0.5 ; ; 5 CLEAR COAT 6 MITCHELL REFINISH GUIDE/ 3-16 41.33 +TBS -R 49.603 ESTIMATE SUMMARY Labor Descriptive Items i14� 44) , .L r BODY 1.3 a 44.00 57.23 ; FAINT MATER 49.603 MECH 0.0 @ 44.f3f3 0-v.-0 BODY MATER y0.0%43 UNIBODY 0.0 a 44.1 3 0.E0 ; SUEQ_ET 0.f%43 HAZARD WA Q-1.0 @ 2.EAD s%f.0303 TOWING 9.1.5ND DETAIL 0.cli @ 03.0%00%0 0-L43 ; USED 0.0%303 COLOR/SAN 0.s:f @ f3.W 03.1:43 OTHER FARTS 03.f%4%f 0.0 @ 0.00%f 0-k4%f ; OTHER LABOR 0.0143 or Firs. Items, 73.B r' Labor 2032.40%0 SLd3total 296.27 ax al 1-250, Grand Total $33033.f38 }}}}}}}{}}}}}}}}}}} Part Prices Subject to Invoice f}}}ff}f}}}}}}f}f}}}} AUTHORIZED AND ACCEPTED: You are hereby authorized to make the above specified repairs. I understand that payment in full will be due upon release of vehicle, including additional supplemental damage charges, and hereby grant you and/or your employees permission to operate the car, truck or vehicle herein described on street, highways or elsewhere for the purpose o1 testing and/or inspection. An express mechanic's lien is herebyy acknowledged on above car, truck or vehicle to secure the amount of repairs thereto. You will not be held responsible for.loss or damsge to vehicle or articles left in vehicle in case or fire, theft, accident or any other cause beyond your control}}} OLD PARTS ARE JUNKED UNLESS INSTRUCTED }} ESTIMATE authorized by date Thank you far coming to our shop for your repairs. TRAFFIC COLLISION REPORT PAD. / OP 9 _ SPICIALCOkoITIOPw . .1 mum" Kra a" ^101CLaasrncr QCWuwottrNtrsu - CauRT Ro p.T ev/'tt✓✓ll J LV.d G T MwsRA Kra last Com" REPORTING OWTRICT tour '� Zoe oa Qmcl 1frlM e4O7A �I ._g. �m� c� Vim► ° 'u` WIRED am MCL DAY YEAR r"(,W=I MaC I oPgCaA t 0. x ir'f //��rj1.o �� ru b �7 Q _ _____�_��_....�,. L�,._��.._r..��__.».�.._��_ �..�..�_ OAVOPWEEJC TOW AWAr sY: .. LSPOST SIroRMAtIOPt nrTtwLn OF < SMTWT 0 srATZ ME Y ASL ❑AT wl FE I I Gl d LA ❑ 1 PARTY DVVS" umtIAA1sE11 "A' CLAN SAFETY V"VIAR M"Aim MIC"m tNwstA srAn 1 0 � - <!� Wow . ow" NAME(P11arr.looms.LAtrY�i C lc oa mam, pmwrfi06ittN OYINEAS NAW MAN '''' As A �t 0 gn^4� JAA + , T ems/ �aQ" PARKED I"ATWIZI+ AOORtM i SAYE"G WEN "jt IAEA -- �7 Q� MCR on "A ETES mm"I wowr MN m"'m EYCt OiPOSR10M OPYIMCtt OM 0110tH 0► �4/7ttf11 GiOls,(t!1 QMMOR p �► .� �•� �� �_�:T"I - ire�c. u VIER mcm __ _ Im,CMMSCALO CT! p01a1 A.,AIIBIr IIt�RTkflWA.W4p ❑ C"l'AgONLY ORSCAIst YtIECLt MMDt N DAMAGED AREA . -001-N&KCAPARA PW=l"UM"A DSL OP STAEET.-OR ••KOiMti'AY I NEED PCOICO _• '- - , PUC PARTY ollfYfR7[lCaNst Ntststll STAVE CLAN I*Arm VSK VIM MA"INGOW COLOR uClMUtRstsEA iTAn 64 OwVSA t wsrr.tsoDu.LAST --•.-.. .•.. . ".. ... .. __. .._ .._. . . "W& ADIDAS" - oWKGts MAttt �aAatt Al am" -_ PARKED tsrATRI ID F CONTI M ADDRESS �iAMt At DRIVER ❑ x '71:1�/fL.L+C'r c - �. -- - MCr- an ..IWA, pSTU KDotrt �oart � rsmo�►,rt � : It"m o1SPaMswMOFVINCLta"Dow"OP. r-ioA+cu tK Qar++ot Tc.s A40 O"= Noma PHow stmpa" � PRIOR rtatwaCAL ORPSCTI nowAPPAmwrEff um m kA*"rvt o esl Or VSNDMAOI N OAWAED AAu13 LYlMCLE1. . s NIWRAMCX�C�AME# POLICY PAAMIA `{ Now '®ISPKIA . }. -0-749-7041 - 4e:::)/ J kJY06 ❑MYdt ❑TOTAL , OWL at low sTRm On HOWWAYw veto a , PARTY DIRYtIt'sut:MatMtAltOt WA- CLAN SAFETY VExYEM MAMIMOMICOLOR mum 10.0994 PUC STAVE sauce. 3 . . . . . . . . . . . . . . . ow" NAME t AmsT,mocu.LAsr) AODRtss •- OWWM MAW ❑SANE As OMER TRAM PARKED CITY I STATE I b► OWw RS ADORASsGA ('1` ME As DRIVER YRMCu u OCT. SQ MMR ErtS NOOMr WoWff [--�NXZDATI YfM RAGE pfPOSRfON OP YEMCLI ON OROERS OP:- j"�OfPIC[K, J"Iomv" [30T%gK Cuwr QA now P"O" sUENRIsi P"OW PRIOR MICHNOCAL DEFECTS: MOMS APPARINro RIFERTO MARRATNE❑ 0 ( 1 { } Cw WDESCRIBEE ONLY DESCRIBE YtNCLE DAMAGE � M Dt W DAMAGED IA �... / VEMCLA TYPE ,NSURANCI CAARI/R POLICY NUMSEA I 0 M04 Hkvm I I MAJOR OTOTAI DIR.OP ONtTRtITOR"00*AY , TRAVEL LSMT PLC . CIM Q PREPM t WPATCH NOTIFED RMIW[R'tNAYI rATt R tviawto /.r�.l''Lss�� D�'�NO ❑ RIA ���Q rTATI0FIGAUF0W"• a f .. . "� - TR'AFFIC OLLISION CODINGgg�� ►.ar ro CATIOilG CAV vs" r7a NC1C rwrr b4 O rrriru ,,., OWN[wom"ll"afts" NonR[o $ROPERTY :_ . — 0- DAMAGE 0NoDAMAGE oucnrnoN or 0AMAoO ` SEATING POSITION SAFETY EQUIPMENT � EJECTED FROM VEHICLE OCCUPANTS L-AIR"0 DEPLOYED M/c�� mst ufff0-NOT EJECTED A-NONE IN VEHICLE Y-AIR BAG NOT DEPLOYED DRIVER 1:FULLY EJECTED S-UNKNOWN N'OTHER V.NO 2:PARTIALLY EJECTED C-LAP BELT USED, P-NOT REQUIRED W-YES i-UNKNOWN ,. t-DRIVER 0-LAP BUT NOT USED 2 `� 2 TO I•PASSENGERS E-SHOULDER HARNESS USED PASSENGER 4 5 6 7-STATION WAGON REAR F-SHOULDER HARNESS NOT USED Q-IN V RESTRAINT Ni X-N4 I-REAR OCC.TRK.OR VAN G-LAP 1 SHOULDER HARNESS USED O•IN VEHICLE USED Y-YES 0-POSITION UNKH0INN H•LAP/SHOULDER HARNESS NOT USED R.IN VEHICLE NOT USED •, 0-OTHER •PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN 7 K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(-I SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY COLLISION FACTOR TRAFFIC CONTROL DEVICES 1 2131 TYPE OF VEHICLE 1 2 3 MOVEMENT PRECEDING . UST NUMBER(0)OF PARTY AT FAULT COLLISION I, ,AYLNfr D: �� CONTROLS FUNCTIONING APASSENGER CAR I STATION WAGON ASTOPPED (>• No CONTROLS NOT FUNCTIONING• $PASSENGER CAR W I TRAILER PROCEEDING STRAIGHT r B OTHER IMPROPER DRIVING•: CONTROLS OBSCURED MOTORCYCLE/SCOOTER RAN OFF ROAD NQ CONTROLS PRESENT I FACTOR• D PICKUP OR PANEL TRUCK MAKING RIGHT TURN OTHER THAN DRIVER• TYPE OF COLLISION PICKUP 1 PANEL.TRUCK W/TRAILER MAKING LEFT TURN 0 UNKNOWN•_._ HEAD-ON F TRUCK OR TRUCK TRACTOR MAXING U TURN • E SIDESWIPE TRUCK I TRUCK TRACTOR W t TALR BACKING REAR END SCHOOL BUS SLOWING/STOPPING WEA ER( MARK t 21T ) BROADSIDE OTHER BUS I PASSING OTHER VEHICLE ACLEAR HIT OBJECT EMERGENCY VEHICLE J CHANGING LANES B CLOUOY OVERTURNED K NOWAY CONST.EQUIPMENT PARKING MANEUVER RAINING VEHICLE/PEDESTRIAN SICYCLE ENTERING TRAFFIC SNOV NG 01MR•: i OTHER VEHICLE OTHER UNSAFE TURNING iff FOG I VISISILITY FT. MOTOR VEHICLE INVOLVED WITH: PEDESTRIAN ENO INTO OPPOSING LANE OTHER•: ANON-SON MOPED PARKED WINO PEDESTRIAN MERGING LIGHTING OTHER MOTOR VEHICLE TRAVELING WRONG WAY DAYLIGHT MOTOR VEHICLE ON OTHER ROADWAY 1 Z 3 OTHER ASSOCIATED FACTOR(SI OTHER•: 8 DUSK-DAWN PARKED MOTOR VEHICLI - (MARK 1 TO 2 ITEMS) DARK-STREETLIGHTS TRAIN A I"oLAnOMO QYO D DARK•NO STREET LIGHTS BICYCLE Q No DARK-STREET LIGHTS NOT ANIMAL: c QTc stcltoM TiounoM: cmo FUNCTIONING• �Ta SOBRIETY-DRUG ROADWAY SURFACE FILED OBJECT: ano 1 2 3 PHYSICAL. JA DRY ' r. QTR - MARK t TO2tTEMS) WET OTHER OBJECT: Q HAO NOT BEEN DRINKING SNOWY-icY • HBO-UNDER INFLUENCE SLIPPERY(MUDDY,OILY;ETC.) VISION OBSCUREMENT: HBO-NOT UNDER INFLUENCE IF INATTENTION-- HBO-IMPAIRMENT UNKNOWN ROADWAY CONDITION(S) PEDESTRIANS INVOLVED IGSTOP i 6O TRAFFIC E UNDER DRUG INFLUENCE' (MARX t TO 2 ITEMS) - H ENTERING/LEAVING RAMP NO PEDESTRIAN INVOLVED IMPAIRMENT-PHYSICAL' PREVIOUS COLLISION IMPAIRMENT NOT KNOWN HOLES,DEEP RUT• CROSSING IN CROSSWALK UNFAMILIAR WITH ROAD B LOOSE MATERIAL ON ROADWAY• AT INTERSECTION K DEFECTIVE VEH.EQUIP.: Irmo NOT APPLICABLE OBSTRUCTION ON ROADWAY' CROSSING IN CROSSWALK-NOT QTtO . I SLEEPY/FATIGUED D CONSTRUCTION-REPAIR ZONE AT INTERSECTKNL Q►q SPECIAL INFORMATION E REDUCED ROADWAY WIDTH CROSSING-NOT IN CROSSWALK L UNwvoLYED VEHICLE AHAZAROOUS MATERIAL FLOODED- W ROAD-INCLUDES SHOULDER OTHER•: OTHER•: NOT M ROAD NONE APPARENT H NO UNUSUAL CONDITIONS APPROACHING I LEAVING SCHOOL BLS RUNAWAY VEHICLE US SKE A.R.',' �GG1T,t/.13G3c.i�✓i1 racAnNOIm: Hfl DOT LANE'S CR CRNR /�.A/-3LL) "C CH?�0 rmtI -- DA PD SO 0P�� v4 ✓/ GT O i HER 1 i J ' ' 'sTwT-t oP cwLt*dwMtw .j PACTUAL-DIAGRAM PASS OfT[o•/COLLL ito" +/� `tet T1.41 (24001 MCIG RV Y/�\[t+Y/R�[� d�YiCIt1R'/7.0. " • YO. i DAY f� 4 lR. j� Y— Y .�/ ^rte' ��/ SUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED ISCALE' S/Z y INOICwTt Mow TY ' t .t Q ,�r'ivKeri+ Lce�ti. �� Ar,dch /�.�.�Ti�. Gc-�vS Wlorc?vAtRP �L x' v� 2.� 4 pwAMM [Y Lp,NUY[[w 1 Yd. PAI Tw, Iw[VI[Mi w'f w4Y[ YO. Dwv Vw. 56 , rwea,rwrmoRi� CHP 555—Page 4 (Rev 11.85)OPI 042 •TATs OF CAuiORN1A ' NARRATIVES PLEMENTAL _ PAO. l - 1?AT14 OF ORIGINAL IMCIOCNTTIMI (SSM) "CIC NuMItR 0/►ICIw I.D. NYYwtR 39 z 1-may '53 ta SCJ O _ ONI ��R"OMI TT►I SUPPLUMCMTAL i'X% A►►LICAILI) [�J MARRATIVL COLLISION IMPORT ❑ ■A UIDAT[ ❑ KATAL ❑ MIT& RUN U►OATIC ❑ SU►►Lt MCNTAL ❑ OTH[R: ❑ HA:. MATCRIALS ❑ SCHOOL ■US ❑ OTHCR: CITY/COY"TY/JUO/CIAL DISTRICT R►T.DISTRICT/IIAT CITATION NYMIIR LOCATION/SUSJICT STATI MIGMS/AT M"ATtO ❑ YUS 01 NO 1. ' 2. //_ 3. 5 1•�ID /Lo�c�+ yo - O a 7. 9764 b� 10. IS .. JF 12. w.�' ,y. 13. t� L� 14 - N ----- --------- -- - - :_.�._ �"; r ,u:�A►ct A• c STWxr1 1 ,fiEc /0 L Iib1iS N 20. 21. 22AVJ4 t-.-. C'✓I A--j 4-I oa 23. 24. E4!0^4Y WY / WT Y 28. L6�•QA4wfA7&MOO L '• �� C v.�. Qat 27. �� Z., ,V r- T w IL- -4 b AfTe Z.)-- SU 770%.,W O 29.U N —1.— 31 A rwt►A Iw's NAMt I...."u rt.R YO. DAT Tt, Rt VII"t R's NArI r0. OAT Tw, CHP 556 (Rev 1284)OPI 042 Use previous editions until depleted. 85 ZM STA-rt Or CALtrORNIA �• NARRATIVE/SUPPLEMENTAL FAGS OATt Or ORIGINAL IN CI1 NT 11 TIMI 12&901 NCIC NUMSWR OrrICtR I.D. NUMRSR MO► DDAT f,y�+ •YR: ` // "' G / ��I" !�/ /� — +* "%"ONS a'%••ONt YV Pt IUPPLt Mt N'rAL ("R"AP-LICASLal NARRATIVE 'COLLISION REPORT ❑ BA UPOATE ❑ FATAL ❑ NIT el RUN LIPOATE ❑ SUPPLEMENTAL ❑ OTNER: ❑ HA2. MATERIALS ❑ SCHOOL Bu; ❑ OTHER: CITYICOUNTVIJUOICIAL OtsTRICT R►T.OttTRICTJStAT CITATION NUMStR LOCATION/SUDJt CT STATt NIONNAT RtLATtO ❑ its x0 1. 3. 4. .�•+TN f sd C tw7 7. - 10. j !1. � t�'/r.;3 '',t„t;f,j,�t jJ,��}•. �t'�ti y«I► G'� u /�� � AOZlih-7i6 T �C 14. l�- 2.►:::- STi�►'!•� Jam. t" d x' N t�"• 15. ,�/�iftlwr'� ",�'�Iv.MN•� �riJlt a,•:• ,`"`•. .�++p - �.//r'f/"M'!s 17. . — 20. ►' �y 21. ./ � 7.4 rV 4NO G p..,, 22. 25. W / r ,nime— 26.#4� Zd2.14 /L.13; L.,ja JC 27J,5VU-- ZJAJ 'ry G ZTrb .► /L4'- GGc 4&& 28. -' G.o�-: f-�.Z ,-j Z r,4 uY 3L7A•"!'.. i�/Jt� J �� 4,w, � � z. O Tier ►Rt PA •R'S NAM■ 1.0.NUNRSR MO. DAY YR. NSVISMSR'S NAM■ MO. DAT TR• CHP 556(Rev 12$4)OPI 042 Use previous editions until depleted. 05 357p 9-r;ri OI'CALIFORNIA NARRATIVE/SUPPLEMENTAL ►AO9 '- OATS or Ow101N AL INCIDi NTTIMI IS-01 NCIC NUNwiw OIII CiR 1.0. NUNRiR rwQ owr rrw„ ..x•.ONi Ni TT►i SU►KiNi NTAL (`•A••APPLICASLi) NARRATIVIL 4+ 19 COLLISION RRIORT ❑ •A UPDAT[ ❑ IATAI. ❑ IT a RUN UIOATZ 0 SUIILUMUNTAL ❑ OTH[R: ❑ HAZ.MAT:RIALe ❑ sCHOOL crus ❑ OTN9R: CITY/COUNTY/JUOIC►AL DISTRICT wIT.DISTwICT/ii AT CITATION NUTAwiR LOCATION/SUMMACT .• STATS NIOMrwr RRLw TiO ❑ Tte NO 1. j tia7ls� 01. 2. 3. 4. s. 7. wan .,its," f••�f"'. 9. 10 4P, 00, +LII` 17a, Zez Va 'a bow 20. • - G5�.1�17..r ry '" x- v' eVrTiVdiGJ' 21. 23. 26. 27. 28. /Qd P M` 40y ,± o z — 3 29. 30. 00, -wiJ,Awiw's x^Ne i3O.MYNSSw NO. DyAY' Yw, wiY/i wriw•s NANi 1.0. OAT TO. :HP 558(Rev 12-84)OPl 042 Use previous editions until depleted, 115 760 iTATC 0; CAL:/ORMIA NARRATIVE/SUPPLEMENTAL PAGE 7 DATR OF ORIGINAL IN�CjIOCNT+ ,,, TIMI (SSSS) NCIC NUMDiR OFFICtR I.D, MVMStR 4... � MOI /V DA7 '•Y•'OMR —X..DNt T7Ft SUFFLt Mt NTAI. t"X"AFFLICAtbtl NARRATIVE COLLISION REPORT El BA UPDATE ❑ FATAL ❑ HIT Q RUN UPDATE ❑ Su►►LEMENTAL ❑ OTHER: C3-.AZ. MATERIALS. ❑ SCHOOL BUS ❑ OTHER: CRT*/COUNT?J7u D}C/AL DISTRICT RFT.DISTRICT/IGAT CITATION MUMSER LOCATIONISUSJt CT 1TATt MIGNWA7 0416ATED ❑ TICS ❑ NO 2. N. 3, 4. 5. L ggema 6. 7. 8. ✓Alma- 13. N13. G 14, 15. 16, 17. 18, . 19• 20, 21, 22, 23. 24. 25. 26. 27. 28, 29. 30. 31, ►Rt Fwwt MA Mt LD.MVMttR YO. DA7 YR, wtvlt�S w'a nwYt MO. Owr rR, jam/ CHP 556(Rev 12.84)ON 042 Use previous editions until depleted. 36 0 26 10 0 R.4 4,f- 26 orindo woy orindo cafifornia 94563 415 ' 254.3900 TO: officer Lincoln #9090 DATE: 10/26/90 FROM: Officer R. Wilson #42972 SUBJECT: Vehicle Accident On 10/26/90 at approximately 1605 hours, I was on uniformed patrol in a marked Orinda 'Police Car . I was travelling S/B on Camino Pablo under highway 24. Traffic conditions at this time were heavy due to the evening commute. As I approached the entrance to the west Bart parking lot, I observed the vehicle in front of me merge from the number 2 lane to the number 3 lane crossing over the solid white line . At the same time, I looked to my right for merging traffic from the Bart lot onto Camino Pablo. At this time, I observed a gray Mercury Sable fail to stop at the stop sign continuing onto S/B Camino Pablo. As I saw the Mercury Sable, my vehicle had already crossed the dividing section at the entrance to the Bart Lot. Assuming that the driver of the Mercury Sable had seen me and slowed, I began to merge into the number 3 lane to effect a stop on the vehicle in front of me . Unknown to me, as I began to merge, the Mercury Sable continued out onto Camino Pablo swinging wide to her .left and impacting into the rear passenger side quarter panel of my patrol car with the front driver side bumper area of her vehicle. Both vehicles sustained minor body damage to the respective areas . The driver of the Mercury Sable and I pulled forward a few feet and stop our vehicles in the number 3 lane of S/B Camino Pablo. Sgt. Wagner responded and took the necessary information for the county vehicle accident form. I took photos of the damage to both vehicles. CHP officer Lincoln #9090 responded for the report. Officer Roger Wilson #42972 Orinda Police Dept . -10 90q0 � ORINDW 26 orinda way orinda colifornia 94563 415 •254-3900 TO: Officer Lincoln #9090 DATE: 10/26/90 FROM: Officer R. Wilson #42972 SUBJECT: Statements at T.C. After the driver of the Mercury Sable hit my patrol vehicle and then came to a rest, I went back to her vehicle and asked her If she was hurt. She stated.. "No" . I then stated, "There Is a stop sign there . " At that she stated, "I know, I 'm sorry. I 've got an appointment at 5:00 pm in Concord and have to pick my daughter up before I go. " When Sgt. T. Wagner arrived he asked her to state what happened. She stated in substance that she thought she stopped at the stop sign but wasn't sure and that she was running late for an appointment in Concord . She further stated that she never saw- my patrol car until after the impact. Officer R Wilson Orinda Police Dept. Claim For Damages In accordance with Section 910 of the California Government Code,this is to formally place you on notice of our subrogated claim for the loss described below. Date: January 8, _ 19 91 City of Orinda San Ramon, , California 26 Orinda Way Orinda, Ca 94563 Claim is hereby made and filed against the City of Orinda Police Department as follows: Insured/Claimant's: RARBARTH, Michael V. or Helen L. California State Automobile Association Inter-Insurance Bureau Address of Claimant: (Send notices to this address) PO BOX 888, SAN RAMON, CA 94583-5888 Reference File 11-076670-9 Date of Occurrence: 10-26-90 Place of Occurrence: Camino Pablo, Orinda, Ca. Nature and Amount of Damages Automobile Accident - Repairs pending Items Making up said Amount: Pending Name of Public Employee(s) causing said Damage(if known): Roger Wayne Wilson Facts & Details: Our driver stopped at stop sign, proceeded within lane divided by solid white line. Your driver crossed solid line colliding with our vehicle's left front area. California State Automobile Association Inter-Insce Bureau By: ag, 7�� F1688(Rev.11-87) DANIEL CHIZEVER Photo P� e California State Automobile Association IVSD VEHICLE HARDARTH, MICHAEL, ' ; OR HEL Ir s 11-0766709 10—'16-90 AT 03.-MERCU -86 4D SED UNK — Q NEGATIVE 1MELP87U1GA628759 COL 00500 ❑ POLAROID SRM 18595 1/-/-z h MR W:%, 2 A.M. Al.� SS . U MAKE OF C68- EAR LICENSE NO. . DATE t HOUR BY LOCATION z.: .'r C ti. s MAKE OF CAR-YEAR LICENSE NO. f` DATE �y-:HOUR •is r - ,s.;..LOCATION ... }',''.Y• j - - fCATION i. AWAKE OF CAR-YEAR . 31 .-. ..:.. LICENSE NO. -Y _ CLAIM + BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 19, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $30 2.50 Section 913 and 915.4. Please note all "Warning§CEIVED CLAIMANT: RICHARDS, Leonard Ray II FEB 216 1991 P.O. BOX 2170 ATTORNEY: North Highlands, CA 95660 COUNTY COUNSEL Date received MARTINEZ, CALIF. ADDRESS: BY DELIVERY TO CLERK ON February 19, 1991 (hand deliverec BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 26, 1991 PpHHIL BATCHELOR, Clerk BY: Deputy , II. FROM: County Counsel TO: Clerk of the Board of Supervisors lv ) 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: r ' , Dated: .� ' Z �`�� 8Y: I J. Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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: MAR 19 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sect ) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 3—a C�—q I BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LOST .PROPERTY CLAIM Return original application to: Clerk of the .Board % PO Box 911 Martinez, CA 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than- the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of' the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of. the Board of Supervisors at it's office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claici is against a district governed by the Board of Supervisors, rather than the county, the name of- the district should be filled in. D. If the claim is against more than one public entity,' separate claims must be-.filed against each public entity. E. Fraud - Section 7:2•of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, town, city district, ward, or village board of officer, authorized to allow or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is g6ilty of a felony. " RE: Claim By Reserved for Clerk's.'.filing stamps 4le-ONARb 9)5,NAA?P05- RECEIVED FRECE'VE,Df Is-A 9 I= Against the COUNTY OF CONTRA COSTA mo sup ma or DISTRICT- SWO OF SUPERVISORS (Fill in name) CONMACOSTACO. The undersigned claimant hereby makes claim against the 'County of Contra. Cos C, ta or the above-named District in the sum of $_s02, SW and in support of this claim re- . presents as follows: 1. When did the damage or injury occur? (Give exact date and hour) Iry T-W 4rf tJ FIX/D A Z/t5 q1 14OPWArl A�p 2_,115/7 1 e.;,(20 A en 2. Where did the damage or injury occur: Include city and county.) lklgli,r WA-5 1pJCA1fCf,9A'rZp 3. How did the dama;e or injury occur? (Give full--de-t-ails: use extra sheets if required.) pg5mkID�eOpeR.ry wAS NO-r' TRA A)5PORT�fj> TO wt-Ififf Z- 4. What particular act or omission on the Part of county or district officers, servants, or employees caused the injury or damage? ove,r x �LT/,43 �c Lt -02 0 ACK PAIJILL BucK 757 CN�r+� -- 3 . t f- C/9 S f CN'j OAINI Nt5 r1_Q-=. _.._._...--�:>_.._-__..______.___,.--e._ _.. ..• ,__., __,:,"______"___�-'_''".yc, j'izw5(yc oh Pr„r$¢ Plrvctc - PROPERTY/CLOTHING RECEIPT I °¢ CONTRA COSTA COUNTY REC. NO. 9 3 7 2�4 P t � I K C(c;S 2 MN A DATE: ��-t RACK#,t F .I MD . c060k MCDF Jjj�� TIME: 4�LE�0A.R 1.JQOK. PROP.BOX. -WFC ; .... . wcs �us /�`S's NAME: �� A� i l. c�t.3F1► :.C .. 'Y BOOKING NBR. ETHER C11A/V6E POIRS € 2y'a pZrVAI sfrc s° CASH: A{CQ 1N �GA oa ❑ SHIRT/BLOUSE ❑ DRESS r- .4 Tr— . zo.�.- ❑ COAT/JACKET. c RF ❑ SHORTS/PANTIES JEWELRY Lo6 �-t Ntr LJ E FCj1-Pi,4' poe(il Klg F J� 0�}. ❑ SOCKS/NYLONS I W AA S2�NG w t%L� ex ++ i! EATER/S�1lT....Q� ANILT{`�... BELT �� ❑ SHOES/BOOTS 50C(4c. SEG.t RIR C4 & T-SHIRTJBRA. WA fiT PURSE CR7tFIGf � '' �°0 KNIFE G M 4,01CAC 10 CAA y t:c" . p�fps ��PS Gn��Y kAtu� YCASAxE L A 5 taS 06s , t c3�� O M vor4, : BKG OFC:. X ,. G .LL ii fieri ff INMATE`SIGNATURE I have received all of my per: ` DATE: sonal_ property and clothing.. REL OFC: X :;, ,. ... INMATE SIGNATURE - CLAIM a3 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 19, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnir-uQ_X1\/F0 CLAIMANT: WHITE, Edwin L. FEB ;J 6 1991 1111 Ferry Street, #937 rG J ATTORNEY: Martinez, CA 94553 COUNTY COUNSEL Date received MARTINEZ;, CALIF. ADDRESS: BY DELIVERY TO CLERK ON February 21, 1991 (via Risk Mgmt. ) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 26, 1991 PpHHIL BATCHELOR, Clerk BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Su sors 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: l BY: 42I A*tA Deputy County Counsel U_ 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 ORD 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: MAR 19 1991 PHIL BATCHELOR, Clerk, By ZDeputy 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. 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: �� �L—9 BY: PHIL BATCHELOR rb Deputy Clerk CC: County Counsel County Administrator '1 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 Against the County of Contra Costa ) or ) FEB 2 1 1991 District) CLERK BOARD OF SUPERVISO 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 $ and in support of this claim represents as follows: . . ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ------------------------------------------------------------------------------------ 2. Where did the damage-or injur occur? (I elude city and county) occur? -------------------------------�-5---------------------------------------------------- 3. How did the damage or injury occur? (Givgg 11 details; use extra paperp�if� equired), Sae. 4�<e( ter, �l T ���-B�cs�+,.��"nA-Em y�se. 1 ►��r1'1ti,�4 �z 'O ' q w1`ti� .byr `� Y 1 w e.,t���l�l Asa 64P�rn l/al�l��p� h�lT�w .1�Y► �OLI�i"� JE�4ke_l E bae�e�� PC _ ? a-;- ?) zrn1�Im: --------------� - ---------------------------- °'=''------- --------- _ 4. What particular act or omission on the .part of county or district officers, on,cu.�SiRauSL servants or employees caused the injury or damage? N4 IC4*.a P/-TA-LOW . h o u�►.�S,f\o Ca o n-f�e �,e�,.k- rtrna QpCS�L n r'Zt ti R- s Grp �h e eaP�.t�i.n - �(�wrL. J1JV�r'ti F}(_l �e,) '1G r Jr (J r krat NErt `C�+ yQ��e`c:t�C f,� s� tc`W- prv,� 10'i ebtk V1 5. What are the names of county or district officers, servants or employees causing the damage or injury? "Tr1e ncXi,�e e�._hV cl i ��s << i� ave�I'h Q anatct a-t, y►n,�any i '� � 's c�n ------------------------------------------------------------ 5. What damdge -or injuries do you claim-resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. a `�a d- � 0; 8 wz by ------------ r�= vo SAA- , +r� - A v�ca4�f�v�14LZ-1 ----------------------- 7. --- - - - --}--- - - ---- --- ------ ------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) �,• '�` �loat� R --C4 of t:.n.l LA_L 4 ) O ryV9.) --------- ,.` � -- ----------------�- ��-- ""_- `�-�----- -------------- 8. Names andaddressesof witnesses doctors and hos ita1s: � P Yow� d ew✓' A�, n��,p §,iQo °s ptia t\lo b a e the- C3 cp o� rnvn� h a�[L -c64, 2�3-", B4 "y�c t:,+.( WV44_+�dgy Ug s,) '1�a" T d. -------------1------------------------------``-------------------------- 9. List the expenditures you made on account of this accident.or injury: DATE ITEM AMOUNT 1 ?34 1Y1�yc T_�,. Go Code SecConon/ ides: eJ aaim mu by the claimant SEND NOTICES T0: ( torney) dome e eha " Name and%AAJddress of Attorney C auw_ Cla'imant's Signature � 11 l l (2- rJ (Address) J 9'¢: Telephone No. Telephone No. N O 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 anP.ffin�•,Q�or by imprisonment in the state prison, by a fine of not exceeding ten thousandTdollars(�($1.0,000, or by both such imprisonment and fine. ��� ' O'N" . L' ' BODY SHOP 5 L ays R66Loaner Cart With Any Inwrance.. __ , "` �' � Report _ . . . 895 Howe Road,' rift H __ ... . ... _.._... _ Wartinez, Ca ift?rnia 94553 _ Written ....-_... _ :.._: (415) 228410 ....... rw....-_ l .. ...... ...._' ---:...,.,....... . �_.r.- - Follow-up . Date _ - By NAME `t t GG�; 'r'1 , YEAR MAKE may' JJ� MO[?EL r ( i; ADDRESS f ! / .f /3 LICENSE NO. !- Z e '5 ' MILEAGE r CITY r ✓Lr STATE ZIP PROD. DATE BODE CODE PAINT TRIM H.PHONE +f' / W.PHONE VIN.NO. i INS.CO. ADDRESS DATE OF LOSS CLAIM NO. CLAIMANT ❑ INSURED ❑ ADJUSTER PHONE L LIC. NO. FILE NO. D.D. i EQUIPMENT: 4 CYL❑ "e CYL❑ AUTO ❑ 4.SPD. ❑ PS ❑ CRUISE ❑ P. SEATS ❑ P ANTENNA ❑ ...... .....: --6CYL;❑' .CID. STD. . .: :,S SPD.,,, .❑._. PB..❑.. TILT ❑ P.LOCKS '❑ .. VINYL ROOF ❑ OTHER 9 SPD. ❑ AIC © P. WINDOW ❑ OTHER "Re- .Re DETAILS OF REPAIR ... .._..:,.:. Asw .Prime:. Bea.. Paid N :pa : "!",_tt=US�'A=REPAIR .S=STRAIGHTEN.,PJC-RECYCLEMELWU&3ECORE Hrs: Yaiue,. a firs.. sdietOEM i > .. :.: V" . m Parts ..- .... ... ._._.._..,,.._ems,_:_..�......_ ,. ..: t `f t .t 7 Lf f, ..f-... 9 10 < rr 12L,i' .i !°liz t a 4 -4 13 14 n 15 16 I 17 l ( C 18 - 19 20 21 w w 22 . m � 23 24 - • m` i 25 K v 26 , m 1 27 3 28 _ .. .. *Owner Requested Entry i TOTALS ► :�,. � ,r•1 I hereby authorize the above work and acknowledge receipt of copy. Signed X Date i Account AQDIT10NAl_80t74;R.EPAlR OPEtiA71!}Fi5 Rc:71UiRFC: .: SUrMMA3V: Codes — 'Crash'Rough-out"(Pre-repair) Decal/Overlay Removal Assembly �Ham, $ $ Rusted/Corroded Fasteners Joint:&Seam Body Repair Hrs.@$ _ Check Wiring for Shorts Seating/Caulking Additional Body Repair Hrs,@$ =$ — I Undercoating&Sealer Removal Rustproofing.Soundeadening,etc. Frame&Structural Hrs.@$ _$�— SUB TOTAL PaintingC r Hrs.@$ ADDITIONAL REFINISHING OPERATIONS REQUIRED: Additional Painting Hrs. $ Clear Coat Color,Sand&Buff Clean-up&Detail Hrs.@.$ _$ 2 Tone Tint&Blend for Color Match Mechanical&Electrical Hrs.@$ =$ Gravel Guard Hazardous Waste Disposal Alignment Operations Hrs.@$ _$ Luggage Comp, Finish Complete Mask-oft Sublet,Prices Subject to Invoice Amount. . . . . . . . . . . . . . . . . . . . . _$ SUB TOTAL Parts,Prices Subject to Invoice Amount . =$ ALIGNMENT OPERATIONS REQUIRED:.'' : Painting Materials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . =$'; Steering System -Front Assembly Body&Shop Materials. . . . . . . . . . . . . . . . . . . . . . . . . _$ 4 Wheel System Doors) Sales Tax _9b on$ _$ 4 Wheel Drive Deck Lid/Hatch _ _� Other Tax _%on$ . . . . . . . . . . . . . . . . . . . Headlights Other: Towing&Storage Charges. . . . . . . . . . . . . . . . . . . . . . . _$_ SUB TOTAL Rental day(s)Cs $ CLEAN-UP/DETAIL OPERATIONS NECESSITATED BY: EPA/Waste Disposal Charge . . . . . . . — The Collision The Repair Process GRAND TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . $ [f- Broken Glass interior&Upholstery Exterior Damage Report Fee: Vr " ` Engine Compartment Luggage Comp, Other SUB TOTAL 1989 I!D%E/A inc.Form No.1028 I!D!E!A inc,One I!D/E!A Way,Caldwell,ID 83605.6902•CALL TOLL FREE 1-800-635 9261 " INDEPENDENT AUTO BODY & PAINT Phone 81 MON MENT PLAZA {415) 6$73117 :y ASA HILL, CA 94523 ONE DAY SERVICE NAME � _�:DATE:. ADDRESS PHONE �•;.. INSURED BY ADJUSTER _ PHONE Labor Lobar Labor Labor Labor Lobo, Symbol FRONT S Mrs. Perls Symbol LEFT S Hr s. PorttFondor, ol RIGHT S Itis Pens B urnper Bumper Brief- F•nd•r-•,^�-Fri. �-� -._ •onFn. Bumper • N Irl rl Id •r1 e1 Shield Fro.System If Fonder Midg. Fender Mldg. Frame Heodlomp Hood lamp ~T ' Cross Member Headlamp Doar Haadksmp Door Stabiliser Sealed Boom Sealed Boom , Wheal Cawl Cawl Hub Cap Windshield -� Windshield m C Hub & Drum Door, Front Dov, Front Knuckle A = u P Knuckle Sup, Door Hage Dav Hinge 0 C. m L Lr. Cont, Arm•Sholt Dow Glass Dov Class Co W 1. y Vent Gloss '-Vent Glass Y'.,•.rWa.i m tD 2 =1 4,.s:I4 3 5 O A Up. Cont: Arm-Shalt Door Mldgs, Doa, Midg, j.- ti'+.,ti m f9, r Shock Door Handl• Daw Hand 14i rn ino Center Post °H N°0SpcGreer Post a . Tie Rod Dov Rear Door Rea ltf '„M vZ 0 C -+ Stqor Ing Goof Dov Gloss ”i'":;t=jF�+ ° w m Dov Glass' © y Steering Wheal Door Midg. Door Midg, ' o Co 2 Han Ring Rocker Panel Rocker PanelCL �.... Y ' O O Gravel Shield Rocker Midg. Rocker Mldg. y' "ij1 m r"Park. Light Floor Floor � Frame "O m 'n Fra - Frame_ S qt y M Rod.Grillo Dog Leg Dog Legon m ow Qwr, Pone I Over. Paul >s yr Qwr. Midg. '$ Quart. Midg. A > D Ln Ouew. Gloss Quar. Glass w v cmn ' Fender, Reor Fender, Rear Name Plate Fender Midg. Fender Mldg. Hewn Fender Pad Perder Pad Baffle, Side REAR MI$C. Baffle, Lower Bumpor Inst. Panel Boll Is, Upper Bumper Brkt. Froin Sees Lock plate. U. Bumper Gd. Front Seat Ad 1, Lock Plate Up. Grovet Shield [You Tr,m Hood Top Lower Panel � Heodf.ningHood Hinge Flaw Top Hood Midg. Trunk L, �n Tee 7L Wan Otnomeno Trunk L,ght Tube Rod. Sup. Trunk Handle wBoeryRod, Core 4/ Toil Light PointAnti Freese Toil Pipe Undercoat Rod. Holes Cos TankFan Blade frame AUTHORIZATION FOR REPAIRS Fon Belt Wheel aro horebV authorized to rnska the abovz. Water Pump Hub & Drum specified repairs. Motor Irks, As ie Signed Clutch Linkage Spring GROSS PARTS ... ...% DISCOUNT NET PARTS f/ . SALES TAX /ey ' MAKE. �� YEAR_ STY L M DEL MOTOR NO. TOTAL LABOR SERIAL NO, LIC, NO. MILEAGE / J GRAND TOTAL A•-Aliph N-New OH-Dwrh•ul S-Straight r ep r E -Exchange RC-Rachrom• -U-Used This satimeto is based an lowest possible cost consistent with quality work and as such, is eumentad M•►Mtei Subtest to Prlcc !" +r(p Items not covered by this estimate or hisidew will be addrtwnol. San Frandsco State University Center for Advanced Medical Technology 1600 Holloway Avenue 415/338-1696 San Francisco,California 94132 January 23, 1990 Edwin L. White 1111 Ferry Street, ;*937 Martinez, CA 94553 Dear Mr. White, You are welcome to audit the course - however it mus-- 5e a formal audit with full payment for the course. Please come to the first night of the class prepared to pay course fees. If you have any further questions do not hesitate to contact my office. Sincerely, William N. Bigler, Director Center for Advanced Medical Technology WNB: fb - - --California State Automobile-Association Inter-Insurance Bureau 022 983092 022 L983093-0-R DATE OF LOSS CLAIM INSUREDS NAME DATE r 01-31-91 02-096725-7 WHITE, EDWIN, L 02-0b-91 T_ I. POLICY—TYPE KIND OF LOSS SUFFIX - CLAIMAMrS NAME.-- PAY Z M AUTO COL 01P WHITE, EDWINJ; L $872. 24 �'$Cr �• _ ADJUSTER NO. D.O ac IN PAYMENT OF: Through T SuAly Pntllk Nabond Bank 1110. 18365 COLLISION REPAIR'Z3 San Francisco Main COI\a t2to °z3 One Embarcaaero Canter —i C San Francisco.CA 41111 2 Cr PAY *EIGHT HUNDREL 'EVEN I T Y THiO _'�+/:QOM. mR M 1n fN r BEST AUTO PAINTING o- To AND EDWIN WHITE AUTHORIZED Sr—WTU:T ~T►+e 1410 STRADELLA CT DANIEL SIFFERh1AN i. I OF WALNUT WALNUT CREEK CA 94596 I 1110 2 2913 309 211' 4 1 2 10000441:9 28119 26 26911' - STATE OF CALIPORMA • _ /•� /�// ' TRAFFIC COLLISION REPORT- Property Dal-nage Only _ Original to Offkar; (Avs folnoolmd n laE) SPECIAL CONNDIIIOANS IYTE RIW_ —CITYx AJ.Ati/T JUDICIAL DIBTFYCT NUMBER (,lfl7l= f.0U117J,7G.�,'_y�/ A G)A'JTA REPORnNG DISTRICT BEAT REPORTING OFFICER COLLIf10N OCC Rlf/00 _ �( QQ�1,7 /, MO. AY '�E A TIYB(2A00 , ` HCIC OFFICER 1.0.���.I'' Tl� cra�UC 7S J �.+g. CJJI/L(/ Tl✓I "Cr / / AT INTERSECTION WITH DAY OF WEEKTOW AWAY STAT[HIGHWAY RELATED Mon: FEET PALES OF S M T W F S ❑YEs IVO ❑Y[s PARTY DRIVER LI BE NUN�jg� STATE� C�S6 SAF Y[OUP. SHADE DAMAGED K CH A. � )� n 1 V ?vj �Q71�(�T /a� DRIVER NAY T. DDLE.LAST) , PITON IIYBE$)�] AREAal —. {• �qC h Yr �/ 'K ` Iv C NORTH PED. ETRE DD ESB �� CITY(STATE/LP PK ViH [i BIR HDAT[I INSURANC`ARRI,R , POLICY NUMBER C - _ $s BICYCLE g0.TRAV EL ON STREET OR HIGHWAY �q 11.,,,, 4.2 EEO LIFT.VPARTY _. - In 16Oyu y� �? OTHER iK YR Kf I YODEL I COL LICEl�SENUYSE STATE. VER.TYPE c_0NtiPARTY DavfR c N c �� TJ c se oArc ;[OUP.2 �t " J„i Z: .�. �;DRIVER NAME(,FJRST,MIDDLEAST) PHOT N hi �PJcvl,�} Lt 2v;� Lc,'/�i 76 L ^ Z 17,4 ( T PIED. STREET 1/9RESXT ,, � y � '� fTJ_V /V PKVEH B[) sIR/r`HD�ATE �� ItnurtI` cA, Ir.R POLICY NUMBER �! I �.�� J (CYCLE DIR.TRAVEL ON STREET OIIlII 11 AY SPEED LY t. - L, 7v /1r� U - 7S- i4A/i'4 e4t,'t 2.�f - '3� J 1 ( P I OTHER V YR MAK[I M DIL/COL R 1 �7/ LICENS NIIM r.R • TAT VFH.TYPE PARTY [' i�oti���� Gr /�c i3rz,�-� i�z r 1 z5 d [ 2 WIT. RIO j;AO1 L.E-X NAME AD0;Ir,76 P11pN[NUMB R PARTY N0. ❑ ❑ NAM[ ADURF 44 PI10N[NUYBER PARTY NO. PROP. +AME ADURES7 DAMAGED PROPERTY OWNER PRIMARY COLU S10H FACTOR InArF1C CONTROI.DEVICES j 2 TYPE OF VEHIICLE 2 MOVEMENT PRECEDING UST NUMBER(N)OF PAFi f Y AT FAULT _ COLLISION N JAVC SECTION VIOLAIED: _ ACON IPOLS FUNCTIONING -- A PASSENGER CAR/STATION WAGON Q STOPPED _ B CON f VOLS NOT FUNCTIOIIING F3 PASSENGER CAR W/TRAILER 1 113 PROCEEDING STRAIGHT N B OTHER IMPROPER DRIVING• (;CON IROLS OBSCURED C MOTORCYCLE/SCOOTER IC RAN OFF ROAD D NO CONTf10LS PRESENT/FAC TOR _ _ U PICKUP OR PANEL TRUCK D MAKING RIGHT TURN C OTITER THAN DRIVER• -_ TYPE OF COLLISION PICKUP 7-PANEL TRUCK W/TRAILER E MAKING LEFT TURN DUNKNOWNAl1EAD-ON TRUCK OR TRUCK TRACTOR F MAKING U TURN . • _ _ - F E FELL ASLEEP• _ B`'iIDESWIPE G TRUCK I TRUCK TRACTOR W/TRLR. ;G�-BACKING (NEAR END - F�SCHOOL BUS _ H SLOWING/STOPPING WEATHER(MARK 1 702ITEMS) L)DROADSIDE - T OTIIEII BU3 -_ I PASSING OTHER VEHICLE QGLEAA E Illi OBJECT j [L!EIIGEt7CY VEHICLE ,J CHANGING LANES BCLOUDY I' UVF:R1Uf1Iirn If,ItIGFIYIAY CONST.EQUIPMENTI(PARKING MANEUVER GRAINING GVEI11^.LE/PEDESTRIAN �-y PIC-!.^IE ENTERING TRAFFIC D SNOWING )101 HER�— - - —- i'dl 011!ER VEHICLE OTHER UNSAFE TURNING FOGIVISIBILITY FT. �. I.IOTURVEIIICLEINVOLVED'+VITH t� Pur-STRIAN _^- I�XINGINTOOPPOSINGLANE F OT'H'ER: A NOtl-COLLISION — — __ /._II MOPED - -- _ ()PARKED -- ----- - MERGING GWIND _ BPEDESTRIA11____ P LIGHIIIf1GC 01t1[R MOI?II vr:111CI.E_ --- 1 ONI!-R ASSOCIATED FAC1011(S) G 1RAVEUNG WRONG WAY Q DAYUGFIT U IL11,II Oft VF-IPCLF ON 0111EI1 lll(:I I_'AY - r(f.lAf1K 1 10 211 EMS) - —R OTHER B DUSK-DAWN [_Pl.1'Y.EL' -ii— VFII1CLE_ -- - r I�VC:�•�(110N V10I_A110N: C DARK-STREET LIGHTS F TRAIN 4�---- -_— —- _-- -- 15 DARK-NO STREETLIGHTS (-411ICY(;LE _ -- !i V!:''''lllillUlUlAllOt1: _ �II!t'".L: -- �• _ SOBRIETY-DRUG E DARK- SiFt[ET UGIITS NUI PHYSICAL FUNC110111NG .,ti,,,.,, l ((,HARK 1 TO 2ITEMS) --- "-' ` ROADWAY Silltl-ACE _... ..-_._.._._-..-_._... .... 1�1.. I � y,f�'�,f:::.i:•iFa�]./,r'�'. a ,s�t'Y..• �i +.-�-�.. H•�(; !' �;• -T.ty } 6 i HAD NOT FIVEN DIIINKING .`�. v:v . n:.. Q DRY `MG:' . .LYLA�,P'y....,. ;.. iy — - -- BWET ---- � ,., i i'I•'I;NI UIISC11RIrt.1N1 : U NRn UNDER INFLUENCE `SNOWY-ICY - - ---- - ----•- ------------------- -- --. C CHID-1`101 UNDER INFLUEUCE ------- - i wAI I!t111UN' t` DSLIPPE:IHY(MUDDY,OILY,EIC.) .._. .. :._-_.__._.—__._- - VHOD-IMPAIIIMI:IIT UNKNOW N' A GO ROADWAY C011nl IIUtI(S) I'rl)F>IPI/(t1' AC 110!( - - -'— _.__.-. [IINnI'll DRUG INN LUF.NCF_--- - ' ..._.....___.-__..._...._.....__......_.... ))I tl 11 tllfl(;/1I AVIIIG IlAhtl' ._.. .. ._ _'---' - --------- (MAf1K11U211LtA.') I'>,INlll.l)l^IIlIAf1111VULyID ..-----�---...---�--._..__...__...._-_- - .-IFII'--- -- _-- -- -- _ ) Allif HlNI-1'IHY TICAL" 1i11A1'AIItMf:Nl NUI KNOWN LS,D141'11111 1' _ - )�!:IIU;':I tl:;1:1 I:Ilrl".':LV P.I.K ) 1!111 A!:''!IAII Y11111 It(lAl)--- -- _ -[TAm___ Al 12111 WA.C11011 f l U01 APPUCAHI E OU.E MAILIIIAL ON i?OADWAY' �i tl 1''".TIMI_V{II --- ---lIS111UC11()NONIIOADWAY•ONSfRUGfIOII-Itfl`AIIIIUtIE AI!t1il':It':f:(:III!!{ .`;1'I:C:IALItIIC111MAIlUt _ _ .�_. -..._... ,,„„,.,, _ —T!'1 n 11A7AI111T)tlq MATrI11AL 'ate Report 701934 NAME L` �L DATE WORK PHONE HOME PHONE��^IS5 � =-���••�� ' ADORE L.I..L...._.,:.. �./ 11�f1� —ti. /�,�,� CITY STATE ZIP YEA Or �.'.E �rwyA MODEL CIVIC 1RTc/J&ge I.D.NO. PAINT CODEy ' D PROD.DATE TRIM MILEAGE LICENSE NO. DATE OF LOSS WRITTEN•BY. �m INS.CO. FILE NO. CLAIM NO. P.O.NO. rAlUSTER;:t �'.. LIC.NO. PHONE Deductible/Betterment . F..REPADETAILS0., . . ,. ,. ,. ..• . . PI` A;=Aftermarket':N=.New.,:. ::. PR .. . . AR LETTS:;: LABOR..: PAINT: `-SUB /MISC: ?- ecycle/Rechrome/Recore R=Rebuilt'. - ^yy I_"v.. : .. : .... ... 3 .-.: . L rrfi A C.: j .4 s a� Croy 5 x L f< I/ (n 2- a I �' 7 k+ A /L_OMZ S i 9 44i.x pm 11 x i )l 6- io 11 13 a 14. ......:....: .,.. ;. 15 /o NL- /0���•�-y C� �e- \ 16 17 4 / U• d u 18 1s 3 2O-P �.. 22 23. G n Ilk 24• t51 LL 25 Qr 27 t I hereby au r'l ta a d agowledge receipt of copy. TOTALS 0 G7 I t 9� PARTS Prices subject to invoice $ /�o• Signed X Date LABORhrS.@ 0� $ 3;f�T'Ftt3 W ShopS I' S $ A W `--� PAINT hrs.@ Y6 $ T PAINTING Paint Supplies $ d0+ R.L. ST AU Towing/Storage $ 1410 S•radella Court Sublet/Miscellaneous $ Walnut Creek,' CA 94596 EPA/Waste Disposal Charge $ $ Phone (415) 934-6400 SUB TOTAL $ TAX ........................ TOTAL $ My, -y-- s, =�1988 I/D/EIA inc.Form No.1002 I/D/E/A inc.,One IID/E/A Way.Caldwell,ID 83605-6902•CALL TOLL FREF -?[iy535-9261 � 5 � ��►.r� ��"�, tom, �=-+�r2 �,. ba�� ti+o•Qu,,v��Y�tivn� �`�h� ©�� Pk b-w�a.� � -��� t c �tV t• '�h Vim, t,tJvt: • `� .J� r¢ 15 h ti s y•r t-� �,�b 2 la-r�. a Com.<9 ,yrvt. �`� �5 ,p�.r�L4.c5 ` �""� �Q.Yt(�., �r u�Ae `�.. ^+w: �0 i✓"�' c�'7,- �� nom., c�e,.vz.-�t✓L (.� -�trr- mow`- � '. �,�"tind•�' -�'o�r� d� �'��' �� rm c.�- ��vlc�-. e-eAr jv u�lt r\ 'Lb i vw 2.-4{f Yee at C L V cS r � / all, fade "-ee,.w cv' c CQ-�12-kr-&-A-,Zt pc4lr- C-C--YI W14A ni, C/Savt b,e P!2' neA V4 -�qh le-CA 7:�' Contra Costa Covinwt Oso ASF a SPRING 1991 SCHEDULE o CENTER FOR ADVANCED MEDICAL TECHNOLOGY SAN FRANCISCO STATE UNIVERSITY 1600 Holloway Avenue • San Francisco, CA 94132 • M 415/338-1696 PUBLIC HEALTH MICROBIOLOGY C1Sc 752.01 (Sched.*10172) BIOSTATISTICS AND QUALITY CONTROL C1Sc 703.01 (Sched.*10032) Microbiology as it relates to infection, immunity, water and waste Statistical methods directly applicable to problems of the clinical purification, disease associated with food spoilage and the epidemiology of laboratory. Charting techniques, method evaluations, normal studies, microbial diseases. Prerequisite: medical microbiology or consent of the proficiency testing, standards. Regional quality control as well as federal instructor. and state regulations are discussed. Clinical Science senior or postgraduate Instructor: Borchardt Wednesday, Lecture, 7-9, TH 409, 2 unite status and basic math skills are required. Instructor: Kelly Monday, Lecture, 6-8, Sci 206, 2 unite MOLECULAR AND CELLULAR IMMUNOLOGY I C1Sc 760.01 (Sched.*10.183) QUALITY CONTROL WORKSHOP C1Sc 704.02 (Sched.*10054) The realm of immunology with emphasis on areas of current interest and advances.. Both theory and clinical applications will be included for such Laboratory procedures currently used in analysis of data for purposes of relevant topics as major histocompatibility locus, monoclonal antibodies, T- quality control in the clinic:el laboratory. Completion of or concurrent cell regulation, immunosuppression, autoimmunity and immunotherapy. enrollment in C1Sc 703 is required. Instructor: Blackwood Wednesday, Lecture, 7-9, TH 434, 2 unite Instructor: Kelly Monday, 8-10, Sci 206, 1 unit AUT+OIMMU.YE RESPONSES C1Sc 762.01 (Sched.*10194) LABORATORY ADMINISTRATION C1Se 705.01 (Sched.*10065) Possible mechanisms of autoimmunity, resulting pathological conditions, and An overview of theories and applications of managerial methods for the autoimmune diseases. Necessary immunological concepts, such as idiotypes, clinical or public health lab,including: 1) communications, motivation and histocompatibility antigens, self recognition, tolerance and immune complexes interpersonnel relations; 2) clinical management systems and leadership will be included. styles; 3) laboratory employee recruitment, selection and orientation; 4) Instructor: Blackwood Tuesday, Lecture, 7-9, TH 409, 2 unite productivity measurement, financial monagcment, budgeting and statistical regulations. The focus will be on introducing students to the skills and FUNDAMENTALS OF MEDICAL VIROLOGY C1Sc 780.01 (Sched.*10216) knowledge necessary to function as an employee in today's laboratory and to identify those areas necessary for effective supervision and management of a Basic principles of animal virology including taxonomy, structure, function, laboratory. multiplication, genetics, antiviral agents, vaccines and a survey of viruses Instructor: Venable/Stovall Monday, Lecture, 7-10, TH 409, 3 unite involved in human disease will be covered. Instructor: Chen Thursday, Lecture, 7-9, Sci 214, 2 units LABORATORY PERSONNEL EFFECTIVENESS C1Sc 722.01 (Schad. *10124) DIAGNOSTIC VIROLOGY C1Sc 788.01 (Sched.*10220) An in-depth discussion of current clinical laboratory personnel problems: labor relations; performance appraisals; disciplinary procedures, legal Introduction to diagnostic virology. Cell culture, isolation of viruses and restrictions and required documentation in evaluations, counseling, layoffs chlamydia. Identification by cytopathic effects, neutralization, and terminations; wage and salary classification systems; and competency immunofluorescence, enzyme immunoassay, nucleic acid hybridization, measures. Focus will be on identifying an effective laboratory personnel immunohi.stochemical techniques, polymerase chain reaction and electron relations program to enhance employee performance and productivity. JCAH microscopy. BY PERMISSION OF INSTRUCTOR (338-2381). requirements for competence-based performance appraisals will be stressed. Instructor: Chen Wednesday, Lecture/Lab, 6-10, Sci 214, 2 unite (Class will meet 2/9, 3/2, 4/6 and 5/11.) Instructor: Barros Saturday, Lecture, 9-5, Sci 245, 2 unite DIAGNOS.ric MYCOLOGY C1Sc 858.01 (Sched.*10231) This course will emphasize the identification of pathogenic fungi that my be CLINICAL LABORATORY COMPUTER APPLICATIONS C1Sc 728.01 (Sched.*10135) found in a clinical setting. Systematic, superficial, cutaneous Microcomputer applications in a scientific and clinical context. This course (dermatophytes), and opportunistic fungi will be discussed. The laboratory will focus upon the application and use of various types of computer software. methods for specimen collection, culturing, specialty testing and The type of software to be used and discussed include word processing, identification will be covered in depth. spreadsheets, data bases, telecommunications, graphics, and statistic and Instructor: Borchardt Monday,Lecture/Lab, 6-10, Sci 215, 2 units quality control programs. The emphasis of this course will be upon the creative use of these software packages. Computer system selection and S NAR IN CLINICAL IMMUNOLOGY_ C1Sc 884.01 (Sched.*10253) purchase will also be discussed. Previous knowledge of microcomputing is AIDS: IMMUNO PREVENTION AND TF�RAPY unnecessary. Immune approaches to thetreatment and prevention of HIV infection and AIDS Instructor: Jackson Tuesday, Lecture, Sci 206, 6-8Lab arranged individually, 3 unite w,i•il-be examined in student seminars. Topics for discussion include: HIV • subunit and anti-idiotype vaccines, value of vaccinating infected individuals, dealing with viral variation, treatment with IL-2 and INF-gamma, prevention via passive antibodies, adoptive transfer and soluble CD4. • ' ' ' Instructor: Blackwood Wednesday, 6-7, TH 409, 1 unit GY SEMINAR' IN CLINICAL VIROLOGY: C1Sc 886.01 (Sched.*10264) ANTIVIRAL DRUG DEVELOPMENT LABORATORY INSTRUMENTATION AND ELECTRONICS Clsc 708.02 (Sched.*10080) This seminar series will focus on recent advances in the development of Theoretical principles and practical aspects of medical laboratory antiviral drugs that might interrupt the viral life cycle, and thus inhibit instrumentation including electronic and optical characteristics, calibration its replication. Various antiviral agents will be examined with emphasis on procedures, and methods of determining precision and accuracy in test results. their suitability for use against selected viral pathogens. The mechanisms Completion of clinical science or biological science major or consent of involved in the control of the pathogenesis will also be discussed in specific instructor is required. cases. Instructor: Jackson Wednesday, Lecture, 6-8, TH 425, Instructor: Chen Thurs, 6-7, TH 425, 1 unit Thurs, Lab, 7-10, Sci 206, 3 units CLINICAL ENZYMOLOGY C]Sc 748.01 (Sched. *10161) ■ 1 Theories, principles and techniques involved in enzyme kinetics and their role in the detection and identification of disease states. Laboratory methods in isolation, purification and manipulation of reaction components. Prerequisite: course in biochemistry. MOLECULAR AND CYTOGENIC DIAGNOSTIC TECHNIQUES Clac 717.01 (Sched.*10102) Instructor: Chun/Eastman/Love Tuesday, 6-10, Lecture/Lab, Sci 207, 2 units Introduction to the principles and procedures of some sophisticated molecular and cytogenic techniques and the application of these techniques for the CLINICAL PHARMACOLOGY C1Sc 770.01 (Sched.*10205) diagnosis of certain human hereditary diseases. Instructor: Chiu Wednesday, 7-9, HH 667, 2 unite Instruction will 1) provide basic information on drug actions, interactions and reactions, 2) examine the practical applications and uses of drugs as evolved from animal and human studies, and 3) cover host determinant factors ERYTHROCYTE HEMATOLOGY C1Sc 730.01 (Sched.*10146) and select phermacokinetic parameters that influence clinical effects. Instructor: Nagata Thursday, Lecture, 7-9, TH 426, 2 unite A study of disease manifested in changes in erythrocyte morphology and/or quantitation and the laboratory diagnostic techniques employed for recognizing or monitoring the changes. The lectures will consider actual clinical case studies. • l ' • Instructor: Rogers Tuesday, Lecture, 6-8, TH 425, 2 unite ICS CLINICAL LABORATORY MEDICINE: AIDS C1Sc 736.01 (Sched.*10160) This aurae presents an interdisciplinary approach to the acquired immune CONTEMPORARY CLINICAL SCIENCE ISSUES C1Sc 710.01 (Sched.*10091) deficiency syndrome. The instructor and guest lecturers (outstanding Faculty-directed discussions of contempornry.cl..inicRI science pichlirntiooe. labor&tory scientists and clinicians from the Sen Ffahl isco Bay Area) will Includes s survey of clinical science literatureand discussion techniques. present the epidemiology, patho-physiology, immunology, virology, molecular Participants present and interpret new publications. Individuals have biology, parasitology, clinical chemiatry, hematology, prevention and other responsibility for reports from selected subdisciplines. May be repeated for aspects of this new disease, the topic of intensive international credit. investigation. A case study approach will be used throughout the course. Instructor: Blackwood Tuesday, 12-1, TH 434, I unit Emphasis in on clinical laboratory medicine and application of newly emerging knowledge. �k FLOW CYTOMETRY LAB C1Sc 718.01 (Sched.*10113) Instructor: Schmidt Monday, Lecture, 3-6, HH 716, 3 unite Students will use flow cytometers and computers to perform calibrations, analyze samples, fund explore experimental variables, e.g. specific labelling, electronic gating, detector parameters, etc. Instructor: Weber Saturdny, Lecture, 1-2, till 122 SUMMER 1991 9 Lab, 3-5, fill 122, 2 units * NUCLEIC ACID PROBE METHODSC1Sc 877.01 (Sched.*10242) BIOSTATISTICS AND QUALITY CONTROL C1Sc 703 Applications of modern nucleic acid technologies to clinical science programs. Nucleic acid isolation, detection, enzymatic digestion, mapping, (See course description in Laboratory Administration section. ) electrophoresis, labelling, PCR amplification, hybridization, blotting, Instructor: Kelly probes, current and future applications in diagnosis and therapeutics. Saturday/Sunday (July 6,7 & 13,14), 8:30 a.m.-4:30 p.m. , 2 units Instructor: Pancham Thursday, Lecture, 6-7, TH 409 INFECTIOUS DISEASE AND ROUNDS IN A TROPICAL COUNTRY C1Sc 754 Lab, 7-10, Sci 207, 2 unite Limited Enrollment - Inquire early! Contact Dr. Kenneth Borchardt at 338-2770. July 20-August 3 -- San Jose, Costo Rica 2 units *New or Revised Course See reverse for independent study, thesis and research courses. lilt 37n03H3S 1661 JNI Ud S I`- �vzao-z�9 ZCI y6 W0J!1e9 '00WUe-4 ues y �tl31IV*'I d ' anuan y heMolloH 0091 a 16,nfinr: �fBoloutloal IeoipaW paouenpyJo{ ►91u90 R�ISQt,S If �o,° _ :Is- Al►s►an►U� alelS oas►aUer_4 Ues CIO T Y v7 m L m r.. w U m to Lm m 4 U m a 7 m O O nO OO0 4J bon h [.. 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L O Cd .0 m 41 4 4 m U y t ,L 0 O L t0L. t m m p w+X M 8.0� O« ° to c. 0 - O o V my + C L. Z C OOU m � s m C m 0 fi 0 L U C CI CU t m 4 O O O O O O O O > 4 WOC L4 .O L 'aO mfi �� X U 4 N N O m m C 4 L N N N N N N yr O M amm O U m O.0mQaWn m L m nC ° UULiO ! 'OO 'r G X O Vm0 L, , ° G 4i a UO O °L. QGL 4) m CU CvC7v LUC m 0 m Uw . u L u L.m u O U m m 4 N O a O4OtiCU >. 7 d C Om m CU WU U m 0•. t0 7- C L m m O O O O mCL.Om' co L C Y'O C v m m d++ T 0 U eM rmC 7W Y O O 0 (O N M N N m m V p X m w L. dU30W + t` r n n !+ Op M F m 1F m n` . 0 C + + .F . mLOt ' .. INDEPENDENT 1 Units Da Time CLINICAL SCIENCE COOPERATIVE WORK EXPERIENCE C1Sc 890.01 (Sched.#10275) Bioststistics and Quality Control (Kelly) 2 M 6-8 Prerequisities: Classified Clinical Science Graduate Status. An appropriate Quality Control Workshop (Kelly) 1 M 8-10 work experience position. A report must be filed with the instructor and Anaerobic Microbiology (Borchardt) 2 M 7-9 Department before course completion will be recorded (CR/NCR only). 1 unit Sexually Transmitted Diseases (Borchardt) 2 W 7-9 Laboratory Administration (Venable/Stovall) 3 M 7-10 RESEARCH PROJECT C1Sc 895.03 Techniques in Cell Culture (Chen) 2 Th 6-10 Seminar Clinical Virology (Chen) 1 W 6-7 Independent and original laboratory or field investigation under supervision Modern Vaccines (Chen) 2 W 7-9 of a staff member. Prerequisite: 1 unit C1Sc 896 - requires completion of a Managing Laboratory Stress (Barron) 2 S 8-5 research proposal and a preliminary oral examination. Graded CR/NC only. Immunoelectrophoresis (Blackwood) 2 W 6-10 Hours to be arranged. In order to register, contact the Graduate Division for Molecular and Cellular Immunology I (Blackwood) 2 T 7-9 the schedule number (338-2233, Room 254, New Administration Building). 3 units Clinical Immunology Seminar (Blackwood) 1 T 6-7 Lab Instrumentation & Electronics (Jackson) 3 T/Th 6-7 DIRECTED READING C1Sc 896.01 (Sched.#10286) Lab Th 7-10 Clinical Lab Computer Programming (Jackson) 3 W 6-8 Supervised preparation of the research proposal for Research Project or Thesis Aging: Health and Disease (Schmidt) 3 M 3-6 research and completion of the preliminary oral examination. Prerequisite: Leukocyte Hematology (Rogers) 2 T 6-8 departmental approval; permission is required for concurrent enrollment in 895 Flow Cytometry (McHugh) 2 Th 6-8 or 897. May not be repeated. Contact Department for "GUIDELINES FOR Immunoassay Techniques (Chun) 2 M 6-9 PREPARATION OF RESEARCH PROPOSAL" before registration. Concurrent enrollment Toxicology (Staff) 2 T 6-10 or prior experience equivalent to Biology 700 is recommended. Hours to be Thrombosis and Hemostasis (Pancham) 2 Th 7-9 arranged. 1 unit RESEARCH C1Sc 897 Independent and original laboratory field investigation under supervision of a staff member. May be repeated for credit. Graded as CR/NC only. Joseph Lazaroni Memorial Bioanalyst Scholarship. Apply_Now for Spring 1991 C1Sc 897.01 1 unit (Sched. #10290) CISc 897.04 4 units (Sched. *10323) Awards. Candidates must be (1) enrolled at CAMT, (2) licensed technologists C1Sc 897.02 2 units (Sched. *10301) C1Sc 897.05 5 units (Sched. #10334) and (3) plan to become licensed Bioanalyst lab directors. C1Sc 897.03 3 units (Sched. #10312) C]Sc 897.06 6 units (Sched. •10346) MASTER'S THESIS C1SC 898.01 A Graduate Approved Program (GAP) and a Proposal for Culminating Experience CLINICAL LABORATORY PROFESSIONS CAREER RECRUITMENT PROJECT Requirement must be on file in the Graduate Division office before registration. Completion of the preliminary oral examination is required. Volunteers Needed SFSU/CAMT is coordinating a statewide project. If you are Graded as CR/NC only. In order to register', contact the Graduate Division for willing to host perspective medical technology students from your area to tour the schedule number (338-2233, Room 254, New Administration Building) 3 unite your lab (and your lab manager approves), send your name, facility address and phone number to: Mary Ellen Hermann, Recruitment Program Coordinator, CANT, SPECIAL STUDIES IN CLINICAL SCIENCE C1Sc 899 Sci 211, San Francisco State University, 1600 Holloway Ave, San Francisco, CA 94132. Prerequisites: Consent of the department and supervising instructor. A concise study outline must be approved before registration; a detailed written report of the work accomplished must be presented to the department before the instructor files the grade of Credit or No Credit. C1Sc 899.01 1 unit (Sched. #10356) C1Sc'899.02 2 units (Sched. #10360) Cl Sc 899.03 3 units (Sched. #10371) Dates to Remember January 15, 1991: One day workshop - Update on Anaerobic Microbiology at San NOTE: Undergraduates who wish to participate in special study with CAMT Francisco State University. Contact: Anaerobic Systems (408) 727-1309. faculty should see the department to register for C1Sc 699. C1Sc 699.01 1 unit (Sched. #09995) C1Sc 699.02, 2 units (Sched. #10006) April 21-23, 1991: CSMT Annual Meeting, Shattuck Hotel, Berkeley. Contact: CSMT (714) 824-4400 ext 7668. Free subscription to a weekly newspaper for Medical Technologists. Phone: 1-800-346-2889 to receive Advance for Medical Technologists: After you read WANT TO RECEIVE THE CAMT FALL/SPRING COURSE SCHEDULE MAILER? CALL THE CAMT your copy give it to the science teacher at your local high school. OFFICE AT (415) 338-1696 TO ADD YOUR NAME TO OUR MAILING LIST.