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Home My WebLink AboutReel_0065B "~',' 'i,;,~,:;'.;/~.""i.':'/'-' e,,!",,:)'''''' '"'~''1,,-'':1;-''' ':',,,:-,::-:",::,,.,,,',,"";"> tu~'~~~'.~;';.',..;~,;.i;;.';)',. " '~',:.:;""";<:;~.~"~,~..,;,.,,.\.,"..;.,..,,.,';~ i.' ',,~ .. 'J ;..:,;.;.F~!L~~i:;;~\:;_~;t,;.~;'.~J~;{:b~02:;t.f~")~fl{~~i~::~,~:;~:~'~i8ZLQ:LJj~:S:~-~~.Li-::.J1~~'.i'..(",,;:,:~2~\~tf INTERFACE, INC. P.O. Box 3340 Lacey, WA 98503 JEFFERSON COUNTY INSPECTION REPORT January 19, 1988 MUlti-Service Buildinq 01-01 Fire extinguishers need to be added in the Annex and on the third floor. Fire extinguisher signs, that can be seen from hallways or waiting areas, need to be added in the Health Department and the Community Action Office. A fire extinguisher mounting bracket needs to be reattached on the second floor. 01-02 Evacuation plans are posted. However, fire drills should be held periodically. 01-03 The certificate of inspection for the basement air compressor is out of date. This needs to be reinspected. 01-04 There are exposed wires in the panel box on the first floor foyer. 01-05 Breakers need to be marked for what they control in the breaker-boX of the second floor elevator landing. 01-06 The ais1eways in all offices need to be kept clear of obstructions. 01-07 Safety bulletin boards need to be placed on the second and third floors. 01-08 First-aid kit locations need to be marked on the second and third floors. Also, a list of first-aid certificated employees needs to be kept with the kits. 01-09 There are bare bulbs that should be covered in the basement, the Annex stairwell, the south side stairwell, and the entryway porch. 01-10 Non-slip surfaces need to be replaced on the outside (North) stairway. 01-11 Hospital radio equipment on the landing between the second and third floors of the south side stairway needs to be moved further into the corners. 01-12 ~he breakers in the Annex storage room need to be marked as to what they control. 01-13 Junk in the stairway leading to the Annex needs to be cleared out. 01-14 A permanent solution needs to be found for the throwing of cigarette butts onto the Hospital roof from the North, outside stairway landings. ',;"';,;'; ;,l:';"J"';~,";: '_',,}!,~, 'iiT. _,( ;^;() .'i~ ';' .';: .:,-.-~ ,'-., '" '." . -(!,' ;,;", "';';-'-,:::'-"\,-:: ";"/' ,",,' ~,:-~ j'" ::L2.~i,L~;~'~L.~:iL:;'2Z~;;.:_..;,;,;,<;';~'~:.:~~'<J.:2t,:.,:f.~;.:tioJ,J26:'_:L.L::.:,: "'::,',X.;: ;-i':"Lj1~2:.;Z~;;:"G.t~.~~t;';;~~~'~~~-;";;~:1-";',~1~;;:~:~~:~;;:;:r:~~,t ";':;(;' ".-.,\,-..,.-.,.,';:..,,-" ( ( Jefferson County Inspection January 19, 1988 page 2 Multi-Service Buildinq Parkinq Lot 01-15 There needs to be improved signing of the one-way street configurations in the lot. 01-16 NO parking areas and parking stall lines need to be repainted. 01-17 The railings on the stairway leading from the parking lot to the building entrance are loose. wYI t<j~ Will Wood Interface, Inc. -'">>,"i. '-'-'<',"",,! >, ''0',','','1'' ,__,,~, ; """"',';,-."" 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"-.... ....... ~ ..; "... .." ... ............. .: h., I! ~ ~ ~ ~.. ~M ~~ ~.. ~~ ~. :~ W., ~.. ~., ... ~ ~~ ~... ~"' ~ It ~.. ~~;:; _.._... _~ .. .. .'t,..=,,,,lJ.._n- ~ ., .....~~ .~r., .......1. .'14...., ....'I~ . _'II ., '.'" ..'IIl~"., ~I" .,,-- -- - -- ~;.-;,;,~S' -- ty,r;/~H-- -- . - . -- .. - . .." I ~ ;?111"7 ",'/r-~ /')7? , ") . t I i '> ~~.:, :;.~,~ '.~,: ,r" .., },~,~. 2.. : , ~" I~ ~. , " , ,",' ,':,', ",,'. ",: ,";,,, . '': '," ,'...:\ "" :', ',' '.' : , " :'''' -,:"" ",-' ;.', ': ',,', ,', " : ",','.', ,':'.. , "":< " i' ':,:', ,', , , ' , ",:'".... , ' .','..,:,:," ': ,', " ',:', i ,:'" . ":"",'';':, : .... :,'" ":', " ',' ,. , ,,' ';' ,,' , :, " " : , " ':' : '.'" ' c":" ,,' ":,... , , c ," ',' , '. "d , ' "', ' ,'..", " )( 1/yt'7+'8 .. PETITION FOR VACATION OF A JEFFERSON COUNTY ROAD a o Principal Petitioner: rlnthony ~. Stroeder Authorized Representative: Same Mailing Address: 1730.Hill street Port Townsend, Wa. 98368 Telephone: Home: ,85-0498 Business: 385-141+8 Instructions 1. The prinoipal petitioner shall contact the Jefferson County PUblic WorkS Department for legal description of right of way to be vacated. A fee of twenty-five dollars ($25.00) shall accompany the request. 2. The principal petitioner shall submit to the Jefferson County Public Works' Department a complete petition, accompanied by a bond in the penal sum of one hundred dollars ($100.00) to cover, county processing expenses. Checks or money order shall be made payable to the Jefferson County Department ,of 'Public Wo,rks, 3. The principal petitioner shall include with the petition a map suitable for reproduction that is no larger than 8 1/2 by 11 inches showing to a reasonable. scale: (a) the county road, or portion thereof,tobe vacat.d; .{b) the property location and' names of all peti tioners; (c) the 'property location "and names of all adjacent property owners who did not sign the petition, with an attached list of their addresses; and (d) the nearest constructed county road to the proposed vacation. (This information may be found in the Jefferson County Assessor's Office, Jefferson County Public Works Department 'and/or a local title company) Request To the Board of Commissioners of Jefferson County, Washington: We, the undersigned, being ten freeholders residing in Jefferson County,do hereby respectfully petition the Jefferson County Board Commissioners for vacation of the following described road in Jefferson County. (Include in the description the length and width of right of way to be vacated) :*as recorded in Vol. 2, Page 54-ofpla,ts, records of Jefferson County, Jeffersop County, State of Washington. Alleys in Blocks 13-14-15 & 16, Eisenbeis Bay View Addition. \/idth is 10 ft. and length is 300 ft. in Block 13 & 16. Length in Block 14 & 15 is approxmiatley 300 ft. Le th is a roximRtle 210 ft is 60 feet each A'~or t'h~t pOl"'t,;r'ln of Sor"Ii::! st,l'"pp'h:;, h,.,.t.wppn 'Rln~'LrR 1~ & 1t. _1 '1-&-1(" S~'lTT1P hrlrlitinn. portion. ^ T 1 Fyt=; _roOT OR'RD 'RF.D -- STREETS---COLORED PINK-~ State the reason for requesting the vacation: rpt'\ yo.".'tn,...'" p,..npp'I"'t..r to Cr'l1lni'v 'l'ny ,...011..'l fr +.0 bnt,tel'" develope the property. J I ~' I 't,.,:, r. t \; ~. L i ~ , ~, " ~, .' . . ;J, k ~' , " """ "'-': , , ,', , , ,,',' " , " ' ' , " " " , ' (") o JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS " ,,'..,',, .. , i..' PROJECT/WORK AUTHORIZATION AREA ')~f~ ~AREA CODE: PROJECT NAME /f'Ck?d .07C4'~/"''''' ~A', G; Sr',r",~derPROJECT NO:l A'v~1 00'0148 TYPE OF WORK t/dC4'k~/? ~/ C?,~tP/'A-~/? Cl ,c6/sI""" bY!'/S &~ ,?//e!.u.J A'.:rd:" S'<<a 8REAKOOWN OF WORK ITEM5: COST ESTIMATE: TOTAL: !, SUBMITTED /tP-/ BY: ~ &-p.?k';x. 1982 APPROVED: /t> -ZS 1982" BY: .kJ~ () Ro-<~ DIRECTOR OF"'PUBLIC WORKS ROUTE TO: c==J ASSISTANT DIRECTOR c==J ROAD SUPERINTENDENT c==l CONSTRUCTION ENGINEER INITIAL ~ ACCOUNTING o o ~AL BOARD OF COUNTY COMMISSIONERS ," ":"",, ,,,",, ~, ::. ' :.,: " ',",'" " , .', -.: ":' , ;"" ' ,:i:" '/' ,,",..:,:',:' "', '; ',';' : :, '.. :',. .',., .'...', '" . ...... .:, '"., " '.' "'" ,,: ':", " '. .,,:: ""':, ,,' ", '" ',' ,,": "" ",:" ' , .:" ',: ' .,' .' :,'-..':.: ,." ,: ",' "",' " :"" " ,,:, " '.... ,'''' ;':;', ".., ,'. .', .' " '...,.. " ,." , .,'". .",.' ..', " ":' ,-::',:, ," '" ,: , ' .:' ",",.. ' ',' ',,:,', ":', :.' ..... '.-:. .. 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'J {\ "~.~~.r' PUBLICATION NonCE PUBLISH TWO TIMES: October 28 and November 4. 1987 BILL: Jefferson County Public Works COUNTY ROAD VACATION PETlT10!\ VARIOUS ALLEYS AND A PORTIO!\ OF SOPHIA STREET 1!\ THE PLAT OF EISENBEIS BAY VIEW ADDITIO!\ Notice is herebY given that a public hearing will be held by the Jefferson County Board of Commissioners on November 9. 1987. at 10,30 a,m. in their chambers at the County courthouse in Port Townsend, Washington, for the purpose of taking testimony concerning vacation of the ten feet by approximatelY 300 foot alleys in Blocks 13 and 16, and the ten feet by approximatelY 380 feet alleys in Blocks 14 and 15, and that portion of the sixty feet in width by approXimatelY 210 feet in length portion of Sophia Street (excepting Fredericks Street. Elwood Street and Bayview Street) laying between Blocks 13 and 14. and 15 and 16, all in the plat of Eisenbeis Bayview Addition, as recorded in Vol. 2 page 54 of plats. records of Jefferson County. State of Washington. The area is approximatelY one-half mile south of the city limits of port Townsend and west of S.R, 20, " ',~"" ... , " P 'I} r , t '~..:' , I ( , ~I ".', , ..' , , .:... ... ., . ., . '.... ," .. ,', :,"'", " ", "','.':,' ,"'>".' ", :,c':'''::" ':',', :.-".,,', ' " , , --'" : ,,'" ': ',: '. " , ", ,:" , , , , ' ...' ': :! . ..'. :." .'.:...' :: . .' ,.,. , ", , ...',;. .,. : ,..,.' .', . . '. ..' .: ';'.',", '. ", , " ,; .",' " " "; .: " ", "':" c, ", ,.': __ ",': L., .. ,.' ".. ...,. " :. '.' .. . " .'. ..'. ':,.., ,',:, '., "... ,'" . , "," , ",,',,',,' , ' . " ,:' ',','" ' .:"">, ,.: ," .', ' ..,..,..'.,..,..:,'.', ,.,.. .'...;',,::;..., " ;,,:" ""''',", , ,," , ',/' .. ",-,. , , '... : , ': ,':' , "" ',",,' .": ';,'c '., . ,. ".,:. ... ..' :..." ".:"" , . ':,' ',,,, :, ,:, , ": ' ", '., ' PHONE CONVERSATION MEMO DATE: /TIME: AM. IO-;;l{r8'=l- .2: lfS ~ CALL MADE BY C';t.-t;6Ai FIRM PHONE No. ( ) GD ADDRESS CITY STATE Jtf.KED TO ~tJV S": POSITION ME::I::o~u:;t:(!:"to - - A, bEi/EUJPUcNT AS Pt3"R t?ouf'RE- flFJ./S'II/r '!irfJJ, /d/If_ ~' -Y /,<; IAJAAJrc--/\ O>v I/1/DI3-I,,--- Cl. r:.-V Jr. TIJbut71C..l/ SNJl/fI 13/JSIIJt7&SES ~1J1f /, 7<::: AliA ./do 1= f).'^ 00 ":forJN/IJ~" j)!J{([;'L:JJ -rJic-';", .I'M I?/:;.b 711dYr-- = ea-{/".#' )1/;'1 .f- t:!.cU-Cd-e'!/ >- , f ZIP REFER TO ["I FILE .6) SIGNATURE &'~ 44 " , ,', .:,' ",', ,:', ~:;\;Xl~ '/;>:::,: .',' .'".':' " :,:..:.' ", .:' :.', '..... "",.. ., '." " "-: . "::, ",: ,." , ,. ',,: ,', '. , ,.' ' " . ,.: ,'....: ", ...:.' ,. :.':, , ':' "., : ',','.', ,c',." ',':::' ,,:,,',.-,,',: ::' "i '.':':' .:': ',;' " '.',:,: :'. ,""" ',', :, ,:" ....',:. ,::....,i. ",>: ,,',",' ,',,',' 'c ',,', ',' .. " '., ......,.,1. ,........:..'.'......... ," ':: :, " '.,'.'" :." ,.'.,' '. , .-, ," , . ":, "."' i"... ',;".., -- ''', "" , ,,': --', ,"" I :', :" ..,' " ", ",' ,',.'" '" "," :",' ',: . ",I " ',:, ,- .', " , ":: ':: ;'", :",'""", '.' ' ','. .". .' '.'. '..,...'.,.,' " i.,..", .".' ,. ,,:,:.',: " , ' ',' ", ,', " ''''', , ..: ,,'. , '. ':, '-',': , . .", .',"; : , . ',: '. ., ',', ". ";, ':'., "',,"'.',\',',..'.'" :..<,'. : ...., ":,, '.' '.,... " "',', ' ' '" " ' , '" :" , ' , ,.,' . '.:.'...,' ", ' .' '.." ,,'..":' " ,', ,'..' :", :,.- ':' .. ,:"" " , " :",,: ':,..-' , ,': :, ,:', : , " ", ' ' " ' " ' ','" '" , :, ' , :,.,:" " " ,",' , " , ',' ", "',,:' .-",:',' ::: ,,. , "" ' " ' , " ,', : ...":"..' ",:"',,, " ",,: ":" . '.:.,' " ,'..,'... ", " "", 'I"~ " '", ',',: '.'-' , " ' . -">':i:> .,..,;~..:,~i\ .l",;,;"",; :/{;;.:"" :"~:'::'::iY<" :;:<<,~:., \;,,,.) DEPARTMENT OF PUBLIC WORKS 1820 Jefferson Street P.O, Box 1220 Port Townsend. WA 9B36B (206) 385.3505 Gary A. Rowe, Director Robert G. Nesbitt, RE.. County Engineer MEMORANDUM TO: Board of County Commissioners FROM: Gary Rowe DATE: November 16, 1987 SUB3ECT: Road Vacation- Tony Stroder >. '", . ' , Attached is a drawing showing various roads in and around the Glen.cove Industrial Park. The roads shown in Blue are existing roads. Those shown in Orange,are.roads identified as needed the circulation in this area,' This drawing is based on the adopted Highway 20 Corridor Policy. After review by this office we feel that the roads requested for vacation by Mr. Stroeder are not necessary for circulation in this area. n '--" ANTHONY E. STROEDER COUNTY ROAD VACATION PETITION RVO 148 REQUEST The request is to vacate the ten feet by approximately 300 feet alleys in Blocks 13 and 16, and the ten feet by approximately 380 feet alleys in Blocks 14 and 15, and that portion of the sixty feet in width by approximately 210 feet in length portion of Sophia Street (excepting Fredericks Street, Elwood Street, and Bayview Street) lying between Blocks 13 and 14, and 15 and 16, all in the Plat of Eisenbeis Bay View Addition. as recorded in Vol. 2, Page 54 of Plats, Records of Jefferson County, State of Washington. The area is approximately one half mile south of the city limits of Port Townsend, Washington, in Section 16, Township 30N, Range 1 West, W.M. The principal petitioner is requesting the road vacation to retl\rn the property to the County Tax rolls and to better develop the property. FINDINGS 1. A petition for vacation of a county road is made pursuant to the Jefferson County Road Vacation Ordinance and is subject to its requirements and criteria. 2. Notice of the proposed vacation was made to appropriate agencies and adjacent property owners. Response by agencies is shown under "AGENCY RESPONSES"; response by property owners under "TESTIMONY". 3. Review of the proposed vacation by the Jefferson County Planning Commission is scheduled for November 4, 1981. Notice of the meeting was made by mail to all petitioners and abutting property owners. 4. A public hearing was scheduled by the Jefferson County Board of Commissioners for Monday, November 9, 1981,at 10:30 a.m. in their chambers at the county courthouse in Port Townsend. Public notice of the hearing was made by publishing legal notices in the October 28 and November 4. 1981, editions of the port Townsend I,eader and posting the subject site with notices. AGENCY RESPONSES 1. The Jefferson County Public Works Department has no objection to the vacation. 2. The Jefferson County Assessor's Department stated that the assessed value of the vacation request is $6,400.00. Compensation for the vacated area, determined at a rate of 50% of the assessed value of the property would equal $3,200.00. 3. The Pacific Northwest Bell Telephone Company made no response to the request. 4. Jefferson County Sheriff's Office made no response to the request. 5. The puget Sound Power and Light Company has no objection to the request. 6. The Emergency Services Council made no response to the request. 1. Fire Protection District No.6 made no response to the request. ~<,_:,,:>,::,_"; , ""'__',:;'/", ",.,"F";'c'.,' o ..,:,;:,:.,:".".,."" . ',;;:C"IWEDII1L'<'( , VOL.)~':#~PM;E LS?-/f OF OFFICIAL !\(CORDS '.. ONt.,~'fYJ~ c:?f'71 ,JvU fEB 26 PI\ 11: lfO Q 31..'31.95 STATE OF WASHINGTON COUNTY OF JEFFERSON In the matter of x _\..)~:~~H.i' c. (j.'\bOUl?Y 'JEn'I:.i:~~,"I,'Y !\UDITOI, NO. 20-~~L7__7~ RESOLUTION Vacation of a Portion of Sophia Street in Eisenbeis Bayview Addition x x x WHEREAS, the Jefferson County Board of Commissioners has reviewed a road vacation petition submitted by Anthony stroeder; and WHEREAS, the Jefferson County Board of Commissioners held a public hearing on the road vacation petition on November 9, 1981; and WHEREAS, the Jefferson county Board of Commissioners considered testimony of ,the public, comments from applicable departments, agencies and offices, and recommendation from the Jefferson County Public Works Department and Jefferson County Planning Commission at the public hearing; and WHEREAS, the Jefferson County Board of commissioners determined at the public hearing that the public will benefit from the vacation of a portion of the road and such vacation complies with the Jefferson County Comprehensive plan and other applicable plans, policies ordinances; and WHEREAS, compensation required pursuant to RCW 36.81.120 Jefferson County Road,vacation Ordinance No. 3-85 has been met, NOW, THEREFORE BE IT RESOLVED that the following be vacated and abandoned pursuant to RCW 36.87.140 and Jefferson County Road Vacation Ordinance No. 3-85: the ten feet by approximately 300 feet alleys in Blocks 13 and 16, and the ten feet by apprOXimately 380 feet alleys in Blocks 14 and 15, and that portion of the sixty feet in width by approximately 210 feet in length portion of Sophia Street (excepting Fredericks Street, Elwood street, and Bayview street) lying between BlockS 13 and 14, and 15 and 16, all in the plat of Eisenbeis Bay View , Addition, as recorded in Vol. 2, page 54 of Plats. Records of Jefferson'>' County, State of Washington. ADOPTED THIS :.?2~AY OF_ --;;{l-,f.!r.. 1988. ---' BOARD OF COUNTY COMMISSIONERS . ..., ~~, , ,/~::~ tOM<.-;'.., . .,' .\ ,.--01 , ' I. .' <;"- ,~' ,', .1, ~. :' ,~(~,;. ': ,. ~:,,~'"11: .~/'::, I"" , \ . ,"" \ \. " ,,~ "'. 1"\ I,' ~ \.111 ~~, \\..~..,;".... /'.. r. toll.. ., .........f... ,. . ", ,',<.: >'-::,';;"" ,.: ...~~. c..' SEAL'; '".: ,q~O},.' ~Ct&':Lt-~_ B.G. Brown, Chairman Qd~LOz~.z#~#~-- - Carry/, . Dennison, Member /:i:r<~.a..-<--tL-~~ George C~ Brown, Member ~T:1:: ' ._ U~t:~ /'j) '7t!. ~ J~rdine C, Bra~ ~~ ~ Clerk of the~~ard YOt 253 '~.r 159 14. fM" rr 886 ..' ; , , ",;" ',:" ,,,,,' ',;' ",' ' ,; : "", ;,' .', "", , " ' '; , : :,:" ",.-, , , ; ''';', '" '" ,: ' ", ':'" ,,' "," ,"', ,'; ',' , ' ," ,;. "'.""',' ",' , ,. " : ,',' ,',' ',',' ""," "<'" ',',,': ' ,',' ' " ",,/ ," " ,<' ',' :', '" , , ,,", , o CI< /:::;i:SC.f!. . c) AP.PLICATION FOR PERMIT TO: Jefferson County Oepartment of Public Works Courthouse Port Townsend, WA 98368 The undersigned Anthony E. Str'oeder hereby applies for permission to Sketch: CLear rL,?-ht of' W"y j n Pi """h"j" q"y Vj"w Arkl St..1J.J 00 C> d-vE. -.... '-- Blll.. /<-{ :'10.: :: - Vl- - - - - 8)..1(. 13 . , I FREDR';CI(. r~ ST. BLK IS' , , 1 " =~= = ~= , .3, L\L.. - <:l:.-, , , =~:~,,:, , 5,. = between F'I 1~lnnr-f A''''n .::.":-,,.., : On County Road "". " B,,'f u;eiN SOf>hLa S1" /6 Q~" II:~", C:.. and agrees to perform work' in accordance with all rules and regulations applicable as on this document and Subject to inspection and approval by JEFFERSON COUNTY DEPARTMENT OF purtc 140RKS. L~, , ,,' "TiE ~,'~ '", '" APPlican~~ f n3c:> ~eA:t~ Address 6J~;:;{ J~ ler.-, qg"Q.if &~~~@W[E[ID t, !" '3~~---O"-f.'l g- Phone Number fO/7)n Oate ( APPROVED 8Y:----I2r~ ;{.L t?/{ DATE; /0 -7 - ~7 , f 1 f, Page 1 (please see reverse) , " "', "",;'.:; ,',' ':': ,', i',:" ": ,'" " ,,' , ,:",.-":,',, ' '".- , ' :::'" " , , :' ;" ", ' ,", ',:, , ::':"" :,,;; ',:, '," ",:," "" .', ': ", "" ,",' '.. , ' " " ',',,', ,;" " :, ",; ,;;,' ',' "," ',: ,,:,:' '" ", "'," ',;,': :", , '.',' ",,' ,", ,,':.:. ;',,"'." >, ":.; :' ,'," ", '.,', " :' " ',,""i ,', "" " '" " "", ....', . ,'.: ;. ' ',. "": " ,U . , ,,':";.',' .,' ','" ". ,',' '.' :, ' .;" ',' , " ,'" ' , ','" '. '.' " ,;' , ,,,,;,"', : '; : '. :., " " , ,:; ,; ',,,; ,,' " , ,"~" " , IIIlIII .,. "~" 'r ;~" ,"" . ", '. " ' . .;' ~':"":""'::".";\ '.::. ,:,':,: '.-":<. ,:...:;;..~:;;..""~,~.:<-~};~,~:'::,:' ,"'. ,,',. ~>..--.>:,'..:--.: ,;.:. ,"-','/" :.:,':,~. ::,:< :'-''-"'.'';'':'" :.~,'::,'- :':"'.>"':'-::',:;':"':<;,: "":.,',."':",:~,:'"",~:,,,,:,,,',_,,:,',.~, !"_,',:,~,:'i,'"',',,,,":,',:,;,,:,',,," ".,' :",~'.',,:,. ',,,,',:i'"'h''''' __,', ,','.,',,':, ;;i::r;:~,~'?,h:,'L..:.\,j:,t'1,,:'M,:z~r,tKy,;':~~ ,'"'' __ ,:",,'--,> ',;....~.;;:-..."""".~_"'_~~~~~~ _ ,,.;'., ':""," '..'.' ",: . .""",",'., , -',"":.,':","',':';':' ::.-,:":', ,,::<;,::<,,;,'-' ;': ,}..::,-, >.:::",,~: i",:'....-.-',--'.',.,.'.',:"..:. ,.'" -'. :......,--",', :' ::.:';":::",' ';::,"': ,,":~,/::~::,' :',>:""'~ . ", ,,' .... :',~c_,~:"~",.:~~/: (""') \.'IW-~' c' Public Works Pees: (see attached) /00./0 Planning Dept. Fees: Assessor's Dept. Pees: COllpensaUon: Other: ~ TOTAL EXPIlHSBS: LESS IlEPOSIT: 3,200.()() a.9" /00.00 REFUND : oAMODIIT IlUE: 3, :2."S.QG> ',illite of PIHng PJnll1 lIesoluUon: Resolutions to: Anenor_ IICC Pllll1nlng- P08t1ng Notice to IICC_____ ~I.. ,'" " ", " " '. .. .' ..' ,: .. ',..' . ' . ',,:, '" ': ".. ,:' ,:" .','. :', ' ,:',""'" ': ;',: ,', ": "',, ',' '" ", '''':'''',,'' , '.. '.", ',' " ",.. ", '. ':',' ':" " "', : " ,', ',.', '" . ,'" ","., .. . "', .' "'," ' , ','" (j "<1"~ (") ROAD VACATIOIf COST IlREAKlii:IwH , VACATION RPA NO. l?//o'11./3 PETITIONERS NAME ~~ ~~ ADDRESS /"1 ~ IhvL ?r. PHONE - 0fI9'il LABOR: Xilmer:~hours @ 'SImon: 5 h~@ Breskin:~hours @ Additional: 1&.3/ thr.e /fJ.3'- 1M..: 6. 8''1 thr . = TOTAL i?c2. &2- IOTAL ,----,----:..51. '0 TOTAL /5":KY Mailing Costs: 11 e1 ..:J~ "Publication Costs: P-i-,UR~ Fe..-..~...~,:, , Compensation: Other: GJWro TOTAL ~ ~ roo . n (" ~ ~ - /r.ro.~ 3, ;J. bO.c)v> tJ,(fD - 3r&S. O~ flks 11~ F t ~ ~7. " ,.,';"', '::,:" " ",', ,.':' "" .',/ ", :...' ...... ,'.:', '.,,:: ': ::',; " '>',., "':" i . ..} . ",,:, ,,' ,;' "', ' ' ,: ,::', "" : ".: ", :,:',.' , :, ',: ':,' ':' " " ,.' ''':' ,,' ,": ':,'." ,:' '. " ":, .... ,., .,' .' ..' ...... ...,,' '.. .'," '., ". "" """', '.', ' ",' " .,' " " ,'. ..'.,. Ii .... ". ... ..... '.' ,'. ',' " ""'.' ,.,:,; '.' '.... '. '.', '.' .' ",' . '.,',. . ..':.:" ""',: "...: "', """'." . '. "'.., "'", , . '.:'>"'.. >,,' ',' ", ":.., . ,,' ,'.':', " . " .' .. .. , , ''','', ,': '. " .... ,',' , " . ""> I f i' '. ~, " :: ,:' '., II ill I ~ I .', ,}' ~ i " , " , c:', , " , ",,", " , , ' ' " "" ", , ", " , ' ,,' '" ,,',, ,-, ',:' ',.-:" ',,; :'" :"",''',,'',;, :;':."", ',' ,,," , -r dr, 20 -: /)~',!Cll ',"" , "'",, , "Y :" STATE OF WASHINGTON COUNTY OF JEFFERSON In the matter of A License to Use and Maintain County Road Right of Way x x x x LICENSE NO. 1-2-89 This agreement is between JEFFERSON COUNTY, acting by the Board of County Commissioners, hereinafter referred to as the "COUNTY", and JOHN J. DUGAN, hereinafter referred to as DUGAN. WHEREAS, DUGAN is the owner of Lot 15 of Hiller's Waterfront Tracts, as recorded in Volume 3, Page 31 of Plats, records of the Jefferson County Auditor, and WHEREAS, DUGAN has a wood pile and parking area located upon the COUNTY right of way of Oak Bay Road, County Road No. 56990, and Hiller Drive, County Road No. 51430, Section 7, Township 29 North, Range 1 East, W.M., more descriptively shown as attached Exhibit "A" which by this reference is incorporated herein, and WHEREAS, DUGAN acknowledges that the wood pile and parking area are on COUNTY rights of way and recognizes that the COUNTY requires protection of its interest in the rights of way; NOW THEREFORE, IT IS AGREED: (1) LICENSE. DUGAN shall have a license to use, operate and maintain the wood pi 1e and parking area on that portion of the right of way of Oak Bay Road, County Road No. 56990, and Hiller Drive, County Road No. 51430, lying southerly of the extended North line of Lot 15 of Hiller's Waterfront Tracts as recorded in Vol. 3, Page 31 of Plats, northerly of a line thirty (30) feet north of and parallel with the South line of said lot, easterly of line being concentric with and twenty (20) feet easterly of the center line of said Oak Bay Road, and westerly of the platted centerline of said Hiller Drive, as shown on attached Exhibit "A" for the purpose of a wood pile and parking area and for those purposes only. The license area will be staked by Jefferson County. ( 2) COSTS AND EXPENSES. DUGAN shall pay all costs and expenses related to the use, operation and maintenance of the wood pile and parking area. (3) INDEMNIFICATION. DUGAN shall be responsible for the safe and proper maintenance ~f the wood pile and parking area. DUGAN shall, further, defend and hold the COUNTY harmless from all liability or expense of litigation in connection with any item of actual or alleged injury or damage related to DUGAN'S use and maintenance of the wood pile and parking area. 1 v;~ 272M,; 596 , ':, ,', ""'," ,,' '.' , ',', ",' ,: """"\:' : " ",,', , ':', ' , , , ,':.., '", ", ',:,' " . ,'," .' ": :>."" " ':" : '" " " '" " ',," ' ',', , " ',,: ",' , ",', ,,"","", ',' ,," " ", , " ", " ,",', :.-' ,.""" i "-:,' ':'" , , , "" ":' ,:.', ':',':, ',', " ',',', ' ,,' " ': ' :', :,' ',"" ',' .". .'.' " ,'; ""'" ',"",' ,'"'",,':.',, ',"" ': ': ,", ',,.', '..,,',.' :,. I ;',: ,', ",: ",' " ,',:." :" """,' :',,', ' :' ':' ",,, , '<' "", " '" .',.:"'" , "',' ,; " , "',,. ,'" ''''', " '," :' , , ""'; ", :.... " " "," ' ", ''': '" '" ,', , ",' ',., " " ;,i, , ", ','. "" ::"",' ': " , ''':, " ,,,' "', " ,,'" ': ',' ",.' ':', ,', ,;"",' , " ,:', " ,':,- ',,," '.'. ;'" i " ':",' "', ':' " "" ",", ", " '.',', """, .,", ,",',,: ".'" " ,',: "',' , ,,' " ' , , ~ I' I 1:1" 1,: V 1, r~, ~; , , )' .~ , ~ (, " ~: ~;, II' ~. ..,..,. ,,, .' " . ',' " , , ',.', ',', ' ToT, Zd ':' " "': ,', , .' , , "" " 0.( ~ ,) 3:19720 IiFC('r;'-'t[) IN" VOL~2._?"GE.dd'~ ..$,1/.,." ;;;;~J1!f:t~ ~ ,_:;,/i , LJj fES -c ~PM3:5'8 tV~ STATE OF WASHINGTON COUNTY OF JEFFERSON In the matter of x A License to Use and x Maintain County Road x Right of Way x ,__ -'j.'l!?"( !:.. {3f.!10URr L'emE NO. '.~"W~~;;'''' fir ,. II This agreement is between JEFFERSON COUNTY, acting by the Board of County CommiSSioners. hereinafter referred to as the "COUNTY", and POPE RESOURCES, hereinafter referred to as "POPE RESOURCES". WHEREAS, POPE RESOURCES is the Owner of a portion of Government Lots 3 and 4, Section 35, Township 28 North, Range 1 East, also referred to as the unrecorded plat of Bridgeview Estate Tracts per survey recorded in Volume 9, Page 221, records of the Jefferson County Auditor, and WHEREAS, POPE RESOURCES is proposing to construct between Lots 4 and 5 of said Bridgeview Estate Tracts a well with a 100 foot protective radius which encroaches upon the COUNTY right of way of Paradise Bay Road, County Road No. 503609. Section 35, Township 28 North, Range 1 East, W.M., more descriptively shown as attached Exhibit "A" which by this reference is incorporated herein, and WHEREAS, POPE RESOURCES acknowledges that the well protective radius area will encroach upon COUNTY rights of way and recognizes that the COUNTY requires protection of its interest in the rights of way; NOW THEREFORE, IT IS AGREED: (1) LICENSE. POPE RESOURCES shall have a license to use, operate and maintain the well protective radius on the right of way of Paradise Bay Road, County Road No. 503609. as shown on attached Exhibit "A" for the purpose of a well protective radius and for that purpose only. , (2) COSTS AND EXPENSES. POPE RESOURCES shall pay all costs and expenses related to the use, operation and maintenance of the well and well protective radius. POPE RESOURCES shall also maintain the well protective area, excluding the travelled portion of the roadway. (3) INDEMNIFICATION. POPE RESOURCES shall be responsible for the safe and proper maintenance of the well and well protective area. POPE RESOURCES shall, further, defend and hold the COUNTY harmless from all liability or expense of litigation in connection with any item of actual or alleged injury or damage related to POPE RESOURCES'S use and maintenance of the well and well protective radius. VOi. 272 :.;.,,583 .' .., ,,- ';'. '. "" " ':;'~,-.: ':":o' " ./ ....:. . .... "'/' ,:,:.',,, :':,:',' ", '" "".""" , ':"'o" :,',' ',,, ':<'" ,,: : '. , ',' c." ::", , ". '. ,c "::.., . ..' ' ", " " ',', " '" ".,"'" '. " !" " ..".:' , , " "..' ',,' ':' '>"",:'< "" ':\':"",: '.',::'" ",'" '.:,:' . .'." ..',.,;,,,' ......'. ,,,' '. ; "', .:' ': ,,: :. . ,".:. ....., ..:' :,.... :. , '. "': '. ",:........:..... ..........,: '. .' ,: '.' ." ""''''',: '., ,," :',' ,",' ,',":, .' :,' "..' ",': .', "" ".".. . .' . .' .... '. .... \C,!::., ::i,' . ....: ..' ' , '.. .:', . .... ".:! ""'~", "".:.'" < .' .... ,.... .' .: ....... ......, ..' ......., :,:,:. .::' ",' ",. . ,',' ", ',:' ""', " ';: '." .... .... :'.' ' c', .. ' " :" .... ...,....., .' , I,' ,: : , : :.' ," ,'" . IIJII ',' " ", ,; ',''', ' , ' :', " ' ,,-,, '" (4) TERMINATION. This license may be terminated by the COUNTY on ninety (90) days notice. On termination, POPE RESOURCES will remove any and all appurtenances from the right of way, and the right of way restored to a neat and orderly condition, subject to the approval of the COUNTY. All costs incurred in restoring the right of way to a neat and orderly condition shall be paid by POPE RESOURCES. (5) TRANSFER OF LICENSE. This license shall not be transferrable by POPE RESOURCES without the written consent of the COUNTY specifically referring to this document. (6) COUNTY APPROVAL FOR WORK TO BE PERFORMED. POPE RESOURCES shall perform no work within COUNTY right of way without first having presented their plans in writing to the Jefferson County Director of Public Works, and having received his approval. /~ DATED THIS DAY OF~~,1989. BOAiD OF COUNTY COMMISSIONERS AJ4-<7A' r!--, 4~ Chairman:::7 .-_._....~ /...~., ; _t~ ~~.l'..'... 'Jt..:..~. 'C:;. .if...... '''/,-;",,'' -\ "' /.\, ,,/ ,.;-.., :?l ., '.' " I I '" ~1..'~-' "~": (; 0;." . , . II ~ ~ :..,~v~: i..: {J"" ~: ~ IJ" . ..s .'!~.~ ~ i ..:... I '. Sf:..Ii; "" '/ , .' ~:. ; \'" ')::<1'.: "f..' '/ .;,. .1: ./;~\~ ~. '\'~~'// I ;. ......,.~,..~_"su~~.;:.;..~. ATTEST: ", -,:_- ~-tLr-<4->J Member a;.{fa~~/.?v~.' ~ ~t/ AP:~;~ry~_ ~~F. Raymorni '" / p~secuting Attorn~ APPLICAN\ \ ~^ 4t,'/?/t? ;;;,,/'. pope. eSOURCES SigNture 1J1r".t::-. ./lA_ J J__ Title ~/~ ~ZncldfkfMUd Lorna Delaney ,9. Deputy Clerk of the Board ~ /':/ l 2 VOl 272 ,>>.,,584 ~ " ": > '~:.:,:;:,':l; , . ,>;;'~)~ .- <!>' ~ ': 'j, , I, I"~ Ji l' ,,." I~ ,:,:' , ' ,:'.', lo, , ":' ,',' , :' ",') ,': ~..:;::',,: '" "i, , ," .',', , ',' , .,'i,' ',; ',i ,,' , : " " .'." "':" "',,' .i' " :', ~,,' ".' " ',' ." ',' "'. ,.' " " ..':..",,'.' :", ,','" .,'." " ", ,'" :," ,'" ,:, ::: . ,', ' ", ,'",.,.' "." ""', '. '. ....' .,:, ,: ,',':, .' ", ,,<' , ',' ,",'..' ,> ,,' :" " , '.' ,.', '"::''' ""'," ,/' ': "',':" " " " ".: .,' ",..', .,:';' "., ' .' , .', '", . ',', . 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I' G' r r 'iI.' ,to " ~ f }. i, , III " ,,' :,',' '" , '::", " ' , .., ';/ , ,': '"'"" , '" '" "e, ,':' :', , , ~ STATE OF WASHINGTON ~'/ o. / No, 4 4 0 6 2 we"'" G ~ POLICE TRAFFIC COLLISION REPORT rp..TRAFFICWAY JlOI.ICtCOM""""NINUM81~ I---:-3i1 I " &~RIVATE WAY I'll OAll or COIlI~IUN 011.' uf l..Ull.I~ION TIMI JICOUNTV !';'" /~ }'d; tf'O w. .~ '""." ,~" >< ,.. 'o~;S-1I .-J~/_~'....), L.L. ON Dl )!!fIN . rOlllOWN I NAMt~0I~1I1111CIlHIG~WAY M'''' 0' Ow Do' /'?n~Lc<;.-c::: ION~~-,'"p~,'.e'J::> 7~$JclI~Ciwm. SUlf('O~~ INONIN1Ul~ClION.2:2?" ~ ~,r.; /7"/ -Z"'""'~'~18trwUN ~ STIlUT. S- STIlUl / D'SlANC! & O~l~_'~ fllOM 111'III(NCI. (1I0SS5111((1 011 NI"'Il~I.M)ll J>OST I ACCIDENT /S:z ~';~S ;:, ~ M ~ Of ~ C2:t' A1v~:r M~~~E CO~lISI0NI"VOlVED ~vlllll'. J 0 u, 0 'I ""I~I'" .--.. -- ~ NO ~ILl(D NO INJUIlID~ ~ILlAC[ HIl & IlUN -..J"'D/IlD'''~ i.,o~~~,~Rs...rzJ 0 PIlOPl~ACEONl'l' 0 ~1l~UITIO O~~~I~';i - .0 oeJICI$'IlUC~INI;,M[O~oeJIC'SlIlUC~ANDOWN(Il-S~Y.s+t'!e ~~ .. ~h'......A II~DMI.t.Bt'" { ~/"r Or eyd"",&, O/~/..J ~~,','" ~~ s soo- UNIT NO. I UNlTNO.2 VEHICLE $9 D':;:;;/;?S:;'~ ;;::::-;:~//'_v' -^";::/&:: Olll"~ ~ST r:; S~DIlIL 5;:r- q,;3" ~6 9' STI!t(lAOOIltSS ~ -.... LZ. Cl!y _ ./ ./ S'AII ~_ 1lPCOOl 1 ~~I_NO .,.....~ 0 Ill' ~~ llPCOOf: /~/<''''''<::. .0.4 7"8.3..37' ~3iP R """,-"" _ 1'7 OIlIVII;'SUCIN~NO I SIAl( SUI NogAT(~~~' Hy. IIOIlIVlII'SlI (NS(NO ~~,t,'1 IYJl O,t,(()I'BlllII-i L.L-:D~..;:/..sZ:JP8/~G I~v'# r s-: 7 '2:? v l'O...o DAY .,.. I OCCUPAIION IFlIlMNMI(~~ONINO j..f>~J~IGH'l~HI E OCC.UPATION flllMNAMI& PHQN(NO ~ I\'IS W(IGHT"IGHI /;:2. Z S/....::Z::OG-.--r C.,?:"..".;1c.,,?" = R ............ = '-- 0 CHECK (.....) I V1HIC~1 AS:N IM~~C'U ~C~~~~~iiAL 0 CHECK (,I) I VIHIC~I AHNIMP:~~R-~Ci>::m~I1:Al .......... ._'O"Ill;'I;U % ~2 CODES" -+ 13 ~~~~~. '7 . :~~~:.'.., 1.-/ I 5 Ill(hON / 16 ;;':':::?IICYC,jl- CODES" -+ 3 ~~~~:. <III ~\~::..., 51.11010'" ,.......... :02? ....~P ~"..,....J //~;/:j;1 -.;- /5~/ IN~ ~~rl..OI .......... 7 " 0 A""\J~A"'~I 0 ~~~I 0 ~g~lI. 0 ~~~,~:: 0 \"8.....~. ~~~":~uo'" 0 _"-lIA"'~1 0 ~~pr.1 0 ~~~a 0 :~,~:: 0 \".~'...!.I'.......... [kfi';s1~~~;~ I S;;~AI Is;;;~c2'vl E v/975-r;;;%;:~ IS;z~~~rY/~~ V,j ~: " Vt~" ~ pICI7PIA~V _I~T:HJA T~AIUIIPl._ATlNO. I~TAI~ H VIHCOlC>>P Il~ ~...~ Il:.ATt ~A,lTIllP\A1tNO I STAn .:::=- xc-;"'.... ~A".7~I~",. I I c./z;.; y::'~.7v"::?.51tJ.4 1 - 1 - ~ n=- \lIHIClIIDtN11~IC"'10N NO f VIHICtt IOf.Nllf~CATI~~~ ~ ~ 72:3 75~t,S-;-5i9, uc.v,/io/,S-A ~o 8/19/ - -!'I ~ IlICI!.nIlIDOWNEII ~I ~~IIl!.' MIDOLl I PHONI NO I...... IlIGI!.nll~Clrlll lAST flll!.T MIDOlI ~~---:- ~ "2,,. .:::J?-/..JJ.=,,,) ?!/r,.;/.s~# 5>.JG 1-n;5--?3)'5 ~ M Vc~L G.<='c,~.-4 -;:~f'6: -,)'1 '~ ADDIIU!.()foWNIIl ADDI!ISSC>>OWNfll ..2.J 6. /os"?/ -"'D~6c';;; ~ _. o"",.tc-""-,,z- ~ /::// ~;p/.k "ep -/hL"c.,:.-C rs= ~:~::)~~UIlAN . J~~~J _ )?;: ~&t:PL6..s R Cb....R'~;;.IC~ OQ~~ ;:r:;;-~"v.s~ ~1 OMlAGCOAAIA, I~ I ~......;"'""?~: ~?3 . I ~C:IV.":.~G ~AMAGffIAREA.--= ,rr-.? .\0'" ~_ CIoIAIl,*," - ~ ~A..S?- CHAllet 1~6~f;'g~~ _k--7 101' -f ~ 1-- I~- I08"ci"o;.~~ s~ 0 ri~~llv' 0;;';::';:"'5 O~~V:~IlV D~:~'yN %EMA,INEO l-~~~II~ ~O~Ci"D;'~~ =:p ~ DIAGRAM OF COl ISION 11m ~UPPII"'(""A~ I NOICAn NOIITH DESCRIPTION OF COLLISION eUSE 5LJPPlIMlNTA( SHUllf N!CI!.!.A~ 35 c., P~v': ?,y/ -:"'~"""' "~'j L','f.fPW -~d;// ~ ''#.....5 ;:;~;;-c.-.J ....v.d'.....;:p~ ~ ==- E ' 7,'2,')d"-V~~~ ,.1 1 f~, 1 !: #~? ..::r;,.!>r:-_~~"'~G 4 C:)A-E,,:?7:- ...~2~ '~ " "I'/@J.E!P'! 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ItI~~1 011 ACoINtv UNIT O' rOlICl DI~P.'CHIOI POlICI "~lIlVIOI CAli Of 1l11'01;~lA~PIl;;(~e;t.(J _ ~A'~ .-1 X I7f? L'. -r ~.4.,,~.d ~~ ~.S? 8.:3f1 /;:Z~ I/~~H~ .v~;..?~~ ' ..0 !J~.Ef' I \ -I~:"W' ,-'=', llIlIAN~ IlUIlAJ. 1 ~ClI COUNTV (P rlTV NO f~C& AD31 '~fll_ r9:;i;~c ~ Plllfrx (Q TM'U~ ~ ? b IlAMP r'..CIIA..... DAtA INlfll Il~~ I )lIID.I~"!'g~,,;~INCSlllttIOIlIlOAOO6l'Ilt.~IIl'INC( IX 1 CL$ ICIl~t:;f7T~60 SPlCIA: COOIt-.tGl,(,1 ;-,.' 'r: , :- ' ~ I 'I o Pt:DES TRIAN " o PEDAL CYCLIST """'" ~ '::2! ~ ~ " PHONf NO "'" " ..... .,... ....... ...... ,,' , , :C-" '. .,.;...- , ' , :'" ,,', :" :, ,," :,:,.'," "-.-":,,<,, ',.' , ,'" ': , " ",' ',,," , " '" , \" .",,' " ,', ,: " " . :,' , . "" .",' " . ..: . .' .- , " ,,.', ...:,'.', ,", . '~" ~' , '.. ... ..;. , "", " - :,,,, '... . :. ,,', "> ': , ' ":, \' :-:" . "',. : :,,:";1 , ' " " ,', '. m ,,," . ' , ' ',' " ,,", ":. " '. i. ." .' ....., .., ..: .' ", ,,:, ' ' " - ' "", "" '. " " ':' " ":,',,,,', " " ~,\..' .'. .'. ",,, ,', ',.' '.. : ' :"',' " . ; .:' " ..; : .:::/' '."" ,,':, , , " ,:, ,. , , , ~. ~: ~ I::". l" ,. 1'" \ ii',;: -, \ y I ;. , ~; t; 't , ~,; d ; ,'.', " " '",..~, ,.." " ' """'" ,,' .: "', '. " ;', i .:. :',,", . " " .,,',' ':,,' ',".,;',;,: .'.', ',e, ','.:" .' . :,' . . ... '.' .........'.... . ...... . '. .......... .'. '.. ..' .,....:........ , :' :," ,', ; '. ,'.' ,..... ',', ...... \ .' ',:. :'., ''-:", ",i, " ' , ,,,"," .' .': ;e'" ,i ,", \:,., ";. ',,' '", ' , ': ..' .' ':, ',: . ....' '.' ..... ';..,', :."'.' . " '. , .: :, ,'. .' ::. . .... '" i . .> '. '.. ",::: '. .} , '.: " ,'. '-"('"'' " , ,.," '(' ....' .. '. , ' ' , ~ fi,) STATE OF WASHINGTON ~~.AFF:C:;Y: I 2 ~ POLICE rRAFFIC COLLISION REPORT 0 '.'VATE WAY ._DA1t.o.' CO~\I~I~^il.l.:.;;;r ... .OA'fl?fl;;qLLI IC!~__,. ~'Il T'ME COUNTY r;- r'2ll'{! 7J')l1x.."'""I'''r'i''T''II'U2o''2f~ '3"el:::-P{!l,~~ . LL C"o'!t ON DE DIN CIIYOIITOWN I NAM!&NOO'SIlIlEIOIIHIGtojWAY 7'5 ""IS 15.' Ow SO. C~ MAC.' Ul.A ION revT'e~ IN1UI~CTINCi WIIH STREnQII IlQAO INON IMfll!KCIION ----- !8HWHN ~R Ir:,Y STRUT ..~h'\O \, SIIlEET I OISI~NC1" ~f~}'ON fROM 'UHRINC!, CROS5S1llHIOII MAllf~' MIl( KJ:> ACC'OENl RAMP '0 I m~I;:S n ~ n 0 OF 'r.?l_L./ M~~:E COLlt~~~:~~LVfD.r.-"'I ~;{~~!::D~__.NO'NJUR(D----1- 0 ~lLt"Cf o HIT & RUN ....~'A~~~..~ N '1,~I~f:>D 1~~'~S'nil:nJ~~'if,R~OflRl'trt(NC( C>>'VEHICLES u.J 0 PROPf~AC(ON1Y 0 ~RlUlTID D~~~~~ - I/\. I L..r'A:' /041 '9 (II1J(DT~~AMlOfoeJE~~;:'(:iNAM~.C". /s (~'.D~f SptCIA! CODING USf ~ F- 0"''''"7- Pr,;'F AI I UNIT NO, I "'fAv'ICl ,ODU ,,~~;:~,2 S,~H'CJ.E 0 ~DEST.'AN 0 PE~-::;~;'ClI/1 ~-j '''''''DD'''' "'," 'DD"" A 1;;;1 ~"" ~'Co L\ ":':UI\1l'~"0,,,Sf'4';::oM'0 0", "." ,"coo 'HeN)"O I~ ,,- I-HVI'f~o, v.~ ,~533- 43<:'c R / C: ""'r':;F Af\L -"~C;::J:SI L; I F I itFc;"t'C:- ~ "","C'""'0 "." I '''~To':'''r' 15 '1~11:b:. "D(s'7.;:OM~/I I RUi2d";H~ ~ cecu""o, /",M ,..... '"0",'0 / I"" """"' ;"OH' ~ L- 0 CHECK("" H8r~I't~f S'ZtJI2.pr~~us,Ci>~a;~WAL o CHECK ',I) IVIHICL(M'Z~';.t-g~f~-~C~~~~'At t~ ~CODES ..... 3 ~i~~~' -,.. m~i::M L. 5 IJICIIClP< 6 ~...~W.II<;YC"'-- CODES" + 3 ~i~~~' .. RI~'R",'''' 1..6' !JlCTIO,. 16 ~...~i~.li'('l;~t ;;'27 ~ .ilh1"'\ ~~L~~flsOt S'SIf'" / 10\ O......BUI.....CI O~~CI Org~'IR R~i:."',~:: D~"'Sf> m'~~~tRO... O......a.n...,.CI Ot~('I/::J~g~lIR O~~~::: OfR~~Sf> lCi72' rCA7e~7"'" MOOpO""'" I"'~D'~'''' E ,"".. ,...., ,~""', H", J7"IO''',,,,,,,., I"'U"O"~" ~~ ~I;':~~~J~ I';;::-':~ 1"(:"'1 ".""~ ".,~ t'HCM' I" , v/ I 'T< ""~"'v T" ~ ~ VlHIClf IDENIlftCA110N, N;" l VEHICU IPfNllfl ""ION NO. / ::::x:- 1'""lOL.JfU/l'-I;g8'~o(qq,~); i 'I;: I I I I l/i I I I I 1 I I I 1 I h ~ IIrC;l~nRLDOWNIR ~',f ~IRST,. I. ~ MIDDLI I PHONE NO R(GoIr.nRlOOWNER 7 fiRST MIDDLE HONfNQ ==:t ' /Y\ '-'-PI' ~ ....,.J H.J wO Mmo. 14.' I '~'DD"""'~ ~ IY)ld;>.e. ~ .__"""O~/ -;--< C ''''''...,~~~COO<O~ oF' ~A R' "7 ,"'u..."coo<o.o'" 4 O~~%I~fA~~~7;:tl I';;:~A I N - I D';'~"'''a~~c. I OAM~GEDIZREA --::::' E ~l ) . r~6~~f:'g~~ CHARGE CHARy{ 1~6~f:'~~~ 2 ) . 2 1 . '.. .- ~IU,l DAMAG&JO PRIIIEN D,UMAJNED DORI\IIN OREMAINED IS1,DAMAGE Ilf-' _~.1.o.p.::-1!1 ~ o ... I sL.co:, ~Isa ri~~8V' <::Jt. ~ I rtl~~E~ BY' AWAY S I'~ ,o.O"O~. ..::;: c: DIAGRAM OF COLUSION' IUS.E?:>,~PP(tM(N AL , INOICAI( NORTH DE~'PTlON OF COLLISllj)N' lUSt SUPPUM(NTAt SHUT I' NfCE~lIYJ JS . 'l:::r-rrrTl-T-'~SHU"'f'l"""B "...ow ,-, e H'lf"l ~'le'-- '-----:.;::-v.:-t--'-t< Li.);<:-'~ -t. -l-"-+-1i\T;T/)'- -JT'1-i-t.. -i~T - :;~~- "- -_C~:\v-_t1-_4zt._V~. _t~&, ~ ~~ UI\ liJ ! 1(, I, :" _",u!., ,- <::(W,o-_S"'')~-Th_~J~S-~_L'-<>~ f0- E:: ++j-I., '+-1.'-+'-1.. +,LLi-i.uj-j.+-,I"i.'~k;' -~- Th.lL_OF~~-,!C%.~-:::-__~_vej.jI"r.e._-;;, c: =c,'''I-l-=-:''1'i''- L!.:--1..J~w-+-T1-- -,- l>.JveJle~ 'oS/.. R 1'''.A--o;:;c:;..&\ .k.M~,..._,_...::J ...JC::V'-t~; :i-"-+--:--.Il~--I,t ++=f=-"'l~ - --.:.--~'-~ ..0 JI.J~, .',. o_(-L.4~.__70_ :::iiiL r-- : ') . . . i" ~" ",I. J._W. . I~, ""____,,,..,___,_____, --1 t::."i."~. ',.]11.[-.-,"1:-'......,....' ..l.-;..h.-~,.~~;:.I. I..' -- ".. "'-.."'-------'--.'."'...-'."-'--"_.."0,,,__..__. _._ _ lIT iTTT+ ttT+i~ Ttli,T=r-~:~ -- '''-'---''--':~:_::'-',-',-=~-~'=_',':::~:::~:::-h" ""I E- ~CA~JPAA~DTSR~S~ &IT~NEJS~~E~,~~~0~",~'000.N.l~.~~,i,t'i, VOLVED ~ .C~?E~ I. ,.1.. ,I ,..:,..' ~t:, I'~j" ._~.. I ~..~, lie" ~ 1---:- '-"''''''' '. ... 'T' srx I...c! k"l.c.lL;sl"..n~II'O\" CIA'\ Insl~ I !JfCl UIIT" ~:::" 1S-~A--,3D~oA-'-' , r~~;';,,?~~ ,,:::,~~O ~"~;,~",,, ~"" OIWl'" L "^., " "' I 1" "" "'" ....Dtlmo; ---- .. ...-. - -r~!~~'..Of """l ~~r~VJ~t"'OM 0"'''''11 D~~~";I D~~;,tR 0 ~nr O~~:",p .0 ,..,......... NOUN (I I I ....OOPf..S .. ~~L~~hO~ . '- "..- tl:~vlI~ II()M DAMe 0 ~~" O~~;"R r7il~~ 0 ;t~~".. xl"''R?:O''~-;;'''~O/? 10~i:s.p j7J' l'O~:i?CHfT~!'?fJCIOi~or''z:-''';~''~''l/f (.f;~pp No. -" A nJ.. " '" POI.lC( COMP\.AI"-" NUMbER ',J COUNt.,NO~ rnyNO. "TC)~ ~>I '",//,;;6-;''' PIIHI... IEQ. rllfPOS1 7, 8 " ~ I~:HW' I <ll OUIIIIAN f1--' IIUIIA! 1~CflON hl1 13" DIAGIIAM 0.-.1A , . ,: ':,' ", ,,' ,:' ,', " '.', '",'. " '.' . ~ . . : .:, :....'.... .........'.... '.' " '.' ".' , , " .' '::,:'" : :' " ,'. ",' ' .". '.':' ..' '. : ,-, ' , '" ':'i :', ....' ." '. "'" " " "'" '," . ", ': ' ,:,> . :.... " ,,:: ,.;.. ',::' "', ,"" ,", ' :.:, "':' .', '.', ,':.-" ' ::' ',. :: .:: : . . .,' .. . ".. . , .::'" .'. ", ,,' ....:. '.', . . ...:........ . .' , . ',' , ','," , ': ':, . .. e,' ' " , . ;r , 1 .">':,' ,':', ",:'-, ' "" <" ',:'" ,',' , , , , , ,,' ',,'V-''', : :, ,: ,: " , ,";' ;,'",' , """,,' ' :, ,'i .", ~' ': ::; wsp l~ tIlEV. 1.&Ol : ~ STATE OF WASHINGTON ",0' I 0' I lr:-\ ~ POLICE TRAFFIC COLLISION REPORT ~'OAF"CWAY I \ 0 PRIVATE WAY ._DAll9fCOU~:...I";._ OA10~O~ll 'ON...::.;.' '-Tll.l~~ ~~"oull,lCOUN1Y COVNT'l'NO/_~11YNO. T ['f2T\'c"\ >l6IW' .,. '""\.,' t"i)'...:'" 't'!.lJ ?D" \I :R1"R0':l:.-..-J It" I I '7 ~N rial D'N A.._ CI1YOll10WN I N~l&NOOfSlllUIOIlHIC.HWAY f.:'fClSJINJM~~1 1~'I!OU1~~;TIn.E1Wot. "mO,ep.iio,("J;"lr'l'->p ION (~~"e ("I::II I ~O.5'JO INI(Il~ClINGW\lH,SlIlUtOIlIlOAO , jNONINHIISlC1ION -r HllflX' lQ rMllE~'./j. c-" .... _________ \IlETWEEN f'l..\.~a. Po smn & "'1""\ t.. - ~'" I1UI 7- ....) v '} OI:'JI~NC~O~~.ION fROM I/UEI/EN E. CI/O:'~!oTIIII~ N[~I/I!o~ Mill PO~l ~CC10{N' RAMP lOI""IIAM tl"T" ~ &.f..~R~'~~!o ~ M ~ (] OF I~r-; ~ ("), M~6~[ cm"~~,~::"o""'O ~\i~~~~;~0 'N'U"~ 0 '~"\AO' o ",""N ~'::i"i~", 'Nn' I~..I 'c~f l:;.g~,~'fiJ'i.:gtf'ROAD"'''''''''' 8" O'W.jIClfS ill 0 PllOPfIUYOAMAGEONlV 0 ~t~U(1EO O~V~\~~I 1/\' r-9' ~5.::T!!J \q it)::;e;~""I?~~""'M'~;;~"PnL ~^ ls j"~~f' "',,,"coo''''''", UNIT NO.1 UNIlNO.2 0 VEHiClE 0 PEDESTRIAN 0 P€DAlCVCLlST ~. ~ O"''''N'''&klZ f;;:"J"'=> ;~" ",,"'N"'''''' ".. M'iOO.' J~ t" ro;:::- ''''''AO''~1 E ('-1'"'- ON:-.lA 'Ol2.. 1 ,,,,,ADO"" Y ? ~ "" Q.,,/ ('~. '" t::~ c':fr;;;<1 7z.;~o;( ~ '''' "An "'c " 1'7 I ~r> t: O'."f?A';RLH ~'1tf1pl ~ 1;, . ~:"r~'!I:;' ~ ,"""C'N"NO ,IA" '''l7i''o~.'''(~' P [2ceCU","ON "'"/"F,oe"ON'NO "" 1""'0"'""'0"' E ce,,,A"ON "'"N,,",,,"ON'NO /I ,... ",,0><' ",0,,1-_ :2 - K~T\/z,,1l n. J,;~I~" R / I o CHECK 10'1 "&r"~,~, .. ~~~::'S~" ~'l.'~,r,~,,'^' 0 CHECK (0'1 ' VI""~'" AN ...~,'S~" ~fl.'~~,zi^' 'rOM ~ COOES~ .'3 ~~~;. -c., T. ;~\;:~",-, T' .,,'''ON I . ~:~,K"_ CODES ~ .T3 ,,,,,,, . ""...", IT"""oN . ~.~,K"" ..1" ;;;2~.JI'AI I .t.(,"'~O'~ ~' "." ,,,,,. 7 "5 o ......~U\...NCI 0 ri\:lI 0 ~g~l~ -~ ~~~,~:t 0 ~8."'!,I' ~~~"~~HO'" 0 _1lU1"'NCI 0 ~~~~l-AJ. ~H~,,~ 0 ~~~,~:: OI"R'lIN? "'I 'I .....tbo~,' I M"{5G"'NO'" '~'ORON'" ~ "'""'^' 1MAITjOOOG"'"'V) 17''''''''NO''' T'''' o"CON" ;; ~ ~n 1"C1";;;~L \ "t::A \ ,,^,"~NO I "A~ ~ "'" CO<O' r'N" ".NO/ I '^ "" ~^'''o I"^' ~ ~"E~ICltIDl.;.:..;.NIl.f..I~~'_ ........I~-1 .1, _J l "tHIClEIOlNTlfICA~ ~ t',;;?LUi"""\It-'I'1:'{' It-.'Q):l.fih' IF ! I I I 1/1 I I I I I I I I I I I"" i!!::: "o'''''oo'$i\r')o.~'' I>rS 'fuid-&. MID'''' \;'2:,;;''39<;<., ~ "o",,"OOWN", /" '"'' MIOO" 1 ".",,, NO P ':::t AOO""""O~I~ M ~IW/I ~ AO'""'''"0''"7 ~ lE= N,,""AOO~M~A ~AG'N' R N.....7' 'N'U AN"'O ""AG.N =9- L- o..A)f.!hLAAI'&' Ik\;~"NO 1~"0~ _ ~ ~...a'l~Rb'klA --:n " '. ' . I'l<~;'g~~: ,"..'" _ '"~ ' 'f-'E- ~ ,~'f,'~, "~::~~~:~i' --rf".....~N'O o "'V'N O"""NIO I,PT.~,,~::,~,~ r-='\llJJt;K~'t~;rl?rh')lj;il~'),'.,"" Q\we. i1J~~~."" A"^, $ 1'~.OO"io~-rI""; ~ O'AGRAM OF COlLlS'ON tU" 'u,"~" --.Nl5J,^n NO"" OESCO'P' ON OF COlLlS'ON ''''' ,,,,,,,"'N'" '""''' N'"''^''' ----!!. ,. l-;-,-rcJ, ;--r""bl.B....\"'I"^""~-"l "mow ~lf'-SIB-- _-I-l--1"'\;;Oi- 1'--nZJ-~--":::::::: ~ .t4..~ ,'"" '0 oJ .. I.i. _ _j__LL -.-;:e..I- - - 5',-1-- ,;J:g'j e.... ,-_vnIlX/',_vnlveS--;:; ,~~,O,_.J g~_ ;=i:'~1 ~,+ ~, ~._.,SoPr:'__.sli~ ;"... vlj)ll._V~'-/J'~,~- === F ~-r-: -~. :' ~~ i I .,-L- -A -- ~lt-::J2.Q'-:_O~ udl~).f:lf:t 3..__Si~'-~s-- -;;J ~__I ~r.I -lJ1) ,~.._rlk'j.;-_+<2A-~~,'-'e_. f<D.IM<.s,- .=r +516 ..l--: -\_~ "I \ .'-Y-ll l_LL~1'-"-no -, - tt-'Clotl..~"~_\ _TD' vel'LA~e~:-I.fO,-- =0I- I " ,I' I I, I!r"'""' _ ,.)(,- _WulJ _I!> . _ ~ _.~ [IQooI~~- I-J I t-Jl<<;'; :' : ,~,!-,--1+-,-: I-i i-' Il,,)ty,,~~~,-_I~ L..\~b_WI.je.,Ir.--, , " Oto.<:-~ .'ro .~~_ . OO\\I'CI:.. ~O _{)r - ---' ~~: ,I ,;'-1 'I i -\ f i -! ! j ~2.e. _,\)el-\,t.l<. ..1-A11.c~ TO D,M.~ ,BI,..lDi'P, ~' NAME. ADDRESS & INJURIES OF PERSONS INVOLVED OCCUPANTS I WITNESSES I,UJ: l~~~{~~~~~~1~:~: I ~'6or.. --.......... u . + ~Al~p~E~')!' \ ,Nil''' 0 / .'" ""'- ~",TI{~'. f ~r~rJJ?fI'O"" 0"'''8 O~~~U Oe~~'l. 0 ~~ O~'i.tw 10(1\ " ~~:;[O, \ .,.- :11110; -T -- r-.. I 'N'"'''' ~fr,;Ni ," 0'"' 0 r';" 0 ;";"",,,-'::" 0 ;:;'"" ~ X I<J.., (_~, ~ ~...L \'e;~~'W'SP I~n' \1li'"'. "1~;g,"Vi/l;;n 'AJV~ ~~9J? ".:iC:(2~i; ..,.,>' < i'~'>0',' ...,... ,..,'i> "ii./);'" ......'.' >' >. . .,.,..i.>,.;.,: ..',.. ...,.,.:!,...'..,... .....,...........i..,;.,.:. "'ic;' ;.c;.; ie. i,e:;:':-- .....,.... ....,>.. ..'. .'..,. ii. "i. ii ,.i<rii.,; ),); .'.....i...:.,.....!',...';.......).. ..... iii;, ,ii, ' " .;Cii'). ' '.....;"i 'i ..' .......,:/,,'.-,.,' i"',} ".'" .)\;\.ii.ii~'8ii1:~i!,/.u,. , .'..,./' , ':, " ... ">" .:,.; ,.' :,i' /,ii" ,;:;>'i;>";< .,' 'ii'.': ..,'.,'.. ..,... . .,.. .',.'" ...... " "'i; i, T... .,,;,''')i' .....,..":.:) ..','. . i,);i ,'. "'i, \ ",':,:,' .: ...',.'.'" ,.... ",,' iF>'i>' '.' "";.,,.,.','; .....'..'.,.".,.i'.".. .,...,..'....'i,', 20,<;':';2~ :.>".,: ."i" ii, . .,..i ,..'.,..',"",," ......,..,):i;'X '."'" "....'.. No, L1.dn~.,n 23\ .=:J , POLICE COMPV>1Nl NUM HI -lfi~><WA UI/BAN I/UR"-l. 1 ,,,",,,, r-;;] d , , ... ; ~, r 11: } ',"" i"I ~~ CopEsT 1 'N:'" ,,~,T~,I .,J. ~ .~,!=I- Sf)!; I '&'c>! ~l"TUS ,",0 ,",WI (I"'~' 1/15111 Ufe, ~"'I"~ -1 '1 T 1>1"''0\[ !.C~r'J~ !I~UM 0 ...MB 0 ~~f.I 0 "h~, ~ 0 ~~ I OI"R~'Ni,~ t ~. i. " ~ "'OO~ES~ E"."' .' "'001l1S5 t>j/l,MI "'N'lIt~r_ \ ~"" if, ;,,':" " t " ~ " " ,,', ,,' " -;- " ""'i":, I' !, \ 4' :. \ , , I r: ~t' , , ... , , ,','">",, ,,' , ";,< ':'". ',', ',' 1/ :' ,...' " ,:" ", " ,> "'"",' , ": " , ': " ,"',' ''', ,,':,, ','. ' '," ":': ,',-,'" , .', '",' "~'I> " ';, , " ", ,I ,',' ," "",'" " , ,'",,:' ":," ",', , ::'" ,"'.."" ,"', ',', ,-, '" "" ';, , " ',''.'", ,,': " ' ::, " , ,":' , .' ," ," , ',"" ,: ,i, .,' " , ~ " '.,:" :' , " I , , "~'I ,-:-:-;- '''' ", ,',:,' :' '" 1-5,(. fi)" . - T ; ri 1."....' , .. , ..,,' STATE OF WASHINGTON..o< , 0' I No. .4 I I 13 3 POLICE TRAFFIC COLLISION REPORT 00 TRAFFICWAY liOl'C.~COM.PLAINTNUMat:~ n , 0 'R'VATE WAY D"'lfO'COlU~IO~ DAY otC:Ol.(11 11M! fOUNT'" COUN;"','''? C1TYt-IO., I [ 11''';a A'~ ~. ,"J' "",'.oo :'~" ... '"' '14-10'" 1/ \jd~N I (:J , ' liON O. O'Nfl C"''''''OWN I NAM'~~"'''""O'~" ~',Cl'I,"::; I ,_,IRo;~~fC~ IDt't.M''''~' Ow iiiiori-,""T1o.u\ut_,,, 'ON -uJ UIJMS t.:JJ, h '-,,',','/...> -.... ""-~ 'N'....C"NG ~'H "'''' 0' "''''' INOH 'N"'~",>ON /~'. "'. \ "^ ~' " ,to- M""O" _. ,. 0 - - 1..""~/tI/~~J-oHCfl,/().l,,,' I " <'":) \0 I OI~I"'NCt&~.',~~IlOMIrHl,~.Cl!O!o:'511/f.('~~~tSIMIL!"op _ ... ~ACCIOfNT "IIMP,_ ~AMo...IA .&' f'I~;:' (; 60, /-, ;; 00 ~IOlt~v. /. ,1\ M2~~E 1 . I COlUSIONINVOlV(C SfVIIi!ITY. .- .- O~YL ,..., , II II ...."n'..ft\jIUt 11~IJIl'RO 1~1l!"~_,=!I'!S':!In!.r.~RIlOAtIOlIJllfUnNCt U ~.'. ~oS~,~3. CD '0 ~:::"'D"'~~~'''.-'- 0 ~~~:: o~im"N I ~"''',., lfi I CIS rClj:'S:'o/'O,/ ~ !'q o"'~';;;/tUA';''t;,'''~mzv 'hI ld. tlIW.t~"'~t> ...C"" COG'NG "'. ., UMT NO. I UNIT NO.2 0 VEHICLE 0 PEDESTRIAN 0 PEDAlCYCllST ~ :... D""~~(!~ I... ^;."" ~B~ D'''''.NAM....... "'" M'D~r / I") rc- ''''''i3'~'Z..1 P'; /J,. T h, """""'" 7 ~ Lk.. c", 616 IT ^ ~.~ ,4'1';;;z." 1r;K>_:~LJI ~ ," "... ",~ l7'~ m ~ D'1JJ';,eaL,e. 43Z,lCS wXJ~ !f'7;;5'7 v " "'N~NO T""" ''/1 ",OA'~,''''~. Do Z ~~ hi~~~""''"''"'"8S7 0 ~L /2; '5:,' ~ DeC",.",," !".MNAM.. 'MON, NO / /"" ""00<' "'GH'"-- D CHECK I~I ' ~.. 0 CHECK I~I ' V'H'", 'SON "":0'" '" NO'""" .:: ~':i~ ';!.',J~'~< . =_ "... To 'f;:"i1 -, .." '" . "".. 7'>",,",_ ,. ..... :;; ; ..r;;'1?;Eov ,0 r~i;;;,,;V'PJti;~~:;~\~ E .." 1"""'~"~~'~7i ':~,,~,t~:" 0 1~'DRt;;;:, ~: [.'e;;" lo,j3,:;J"'MJ7i7-,~Ai"k1:': .,-.. [' . 7 I'" [.......- r" '3rNK"'j;"""'L' 2 q X 7::r Ss I '"I 'Z.SII~ V'iffi""'N""'''~/: I ~ "GI.n"pX'QaM, ~~P4 &M 'MON'NO o 1 "G'", 'DOWN,/"" Z "D:Z;;~il' PA01hc. ~ .i -b. It .\'itt l ~ 'DD""7" E E N""....D""t.;:;r:c.co ""'G'N' R / 'N."."C' ,~.o.. ~ 1,~.J'l.a1b"", 11II',~.~.;t' II;:!"""'" -= ~ ~~~^':i.'.. ~ r; IRg:::.';~.:t: eH'" . 0'",,' 'I~ ' """ 'r~~'G' 0 :r"~H I'iiI""M"N'D . 0 D""N o "M..N'D .... I,VI ,,!.',o:,:-:i,:=::: - '.0. ~a:?o 0 lir.!J>" ...., 'IOl~~" .w.. s 1'll--.ro.oDn.~;r,,,,, ~ D'AG~'~;::& ".","""..~ i1W~;;~~?~1.,,:,'; ~ ~" "-~ ~~~ r. ~~~-,,A!.IJ. . , '__~ ......."---"----0 o.u;o:::o.H'LJ , ~ /.. _" _ '- -- /.J&pc;;e ..In>/,PEZJ ~~ I1AJ ~..A:.-~ ~' [" ";- . ':- ;J.'''::--:s.s:;~~\C t~ezeyh?,p"'/"?7IkJ 7;t'.;f-rai:;;if!~G J' ~ " - ~' .' ". .,-' ..' .6u~... ~6 4!7,At,d ~~ ~u!!:;e/._" '~..(b - . - , . '''\ ~'7JM~ ip~~aP?i!-...H.de;.~. . ~_'/, . "">- "'* ((e.;X: tZI,1J'~.c:',~"l" 'i.~' "t:.' . W~ .uJ./T.r.1~~J.hvi!!!!2? h' ~ NAME. ADDRESS & INJURIES NS INV~ED ' + CODES 11 _ 2 T 3 1.'1 5 6 P OCCUPANTS / WITNESSES \~ NoX::,' ~H~41,J', ''';::;;:G' ,"'us '''.,w. .!!!!,: I.~~' ...11 I "'CO ~\C;, AJatJ(;:, ,,' '~:P,~'O' NO' OM, D~~"D~~;O::~ Dill... ~N T ~"'!~~fP' t!~v;.l~"IOM oAM8 D~~('l O"~~IY' 0:::- o:-.~~\, .., N1, r r I ~~L~~l..o' S~f"'I"'f1V MOAMI O~~'I Dc~;". :r:." o~~~~. JO~~'1""~;u~17~h rOI5~""1 i$N-"I';;~q(l.l':;~$C;r; J? W$P l~ (~EV, 1.80) 9 .i.'," Ct fHW" ., ~l~:::~ F' ,""'- tJ 'll1~T ~ ~ I.g] MIODH I N"Mf "OOI1U~ ["M' 70 "ODDf~S "AM' .t,OOllI5S X/''''...Ul':...II...c.O''.ClII\ko\toIl.R...''''1( I ..:" ,,;:,'7, ."",,' ',I, '::," .. ': ,:. . . .....: i ': '.'- """,;:, ,'." " ,:, ,,',,.,,,',, .' ': ',' "'"",, :,"'",',"" "" ;",,' ,,:', i' ',,"", .' ,: ,: .......' . 'L " "",, ", :: ' ,': "'" "'" , " '. :."."'. . ',. "", :: .,: :,' " " ' ;,; ...... . . ; ,",' I i' ," - -'7 .. , ' " "" ~"'" ",: ,.' , ,,, "', ,". "..: ' , I' OIlIVll/'~ NAME .... SHllHDA, MICHAEL ~lll[!T AOOl/t~~ ~2 331 Freemont St. Lf:--E c~UILCENE, WA STAlE 983761PCOOf. I ;H65~3683 ~ flY ,- Oll'\lllr!.lICENy. NO I STAlt I" I A. I f BIRTH I NIII liCENSE NO SBAHIMJ596L5 WA M 'Ii'I is i 4'1 v ~ OCCUPATION I flllMNAME &PHONI NO, I EYISlwtIGH'II-t:IGHT E OCCUPATION Z enaineerl N.U,W.E.S/Keyport,WA l11azj l8:j511 R o CHECK (t") " ~~;c~;'i'!> 'ZN E.s~i~~ff ~ A~~rt"'l F21~?D;~!,' :~ ~'f~~~no~:~\~~:r}ad ;;-~~~~;:~.~"'c. " L..:.. D.....aul......cl 0 mCl 0 ~g~,~ !Xl ~:::.~:: 0 ;-'8',,~p [ 81 ~K~~~[II,I I ~~~IlP~OVA) ISIY2~I/.CONV'1 2 VIH-:-C-Ol~ T'cIN!>! PloATE NO. rTAl( I TIlAllUl PlAH NO. !,otAH burg KZE930 WA I f':l; v';'~7~''';'~'';"~o! 2 I 21B I 2 a3 I B 1 3 I 013 I 216 1 0 Ii'C'" IlIGISTIIUOOWNI,1I L.A::>T fiRST L=. sarre as driver #l [2 ADOIlE!,!> Of OWNEIl ru- NAME & AOOl1tSS ~ INSUIIANCI CO ~ ~~ 1':- Farrrers Insur. ~CUJ,sbo, WA L..- DAMAGED AR(A I d~".(.;L\."'GI ~lION . ., . I ~'DIV''':.'lG qA.MAGEb'~EA -::a1 r-'I~ I~~~~tl CHAIlGE CHAIIGr ~f~'g~~ VL J ~ ..:3 L .,,~, ~' I~ r~~,,~~~oU''''' O~<;'~~" m~~'," O"MAON" 1~"D_~' .~o~~~~' ~ E DIAGRAM Of COll.ISION: .. . .(Uiit~UP"LIM!N ~~,__J.NN008'~C""T!D~?RTH .DESC. RIP1ION Of COLUS10N: IUSE SUPP~EMEN'AL !>HtET If MCESSAIl'l" .._ -isl c~+=1='-m::r.r::r:T1:lt"r-~"/;)':eo;n v,*,J.:<.::).elfl was~~Ori1:l1e C<!.ll~:-vem:C1eJ:eu-; E _J..,..;-::. ]t-,. . ~-I--' :--H+-l__ji u. ~;.....,..-l-'~ '<';"A .x-oa. clw.i;iY-2,ILt:lte2lb.. __@J;~!ll'ea ..p:ayel!!!>::!~. rox ::::J /~"-J,_L.l 1 I I ,I Illl,\: , I r"',-,.... 306' at which tiIre it =ssed back over Ute - -I'~::~';;;~ -r--)'-r-i-t-iA ..J.::::tJ.-1-I,:,:r::+= ~;;/.b_,..mc!C,nlb':::lMe~~-g:;::~tJ:'iiC)<=-~anJareE.f.OftE.c :::J 17!5-'r!~b!,;:t3""!. .J'/,)t- -1---\--1- . .,-4--+ the.n/b,_sho].l1de:r.w"yJ(!.j,s"t<mceJ!I~-,,_,__,- nil r:::- Y,):' '- " . '-"."1 t-'''-r-t'- _Jlfter,striking__tbiSl_b~,it"ro1~ed_on~o,_ij:,~s,...i:q; p Ll~2f"l'tl-I.+'qi"'~,,_dnLmfl..j, "ldiL~t;~J~t~~~~~r~~~~~~th~tEz~~Jy~ -1.:::r::T:TJJI-..-;' ..1. ,.1rt--.. -,- j j.::+j ,no.ted .he..wes ,intoxica~d.. ....-..-,--.,.--.-.,-'--.- G . I : I \:: I I I I I -1"-.i .Y r'.- NAME, ADDRESS & INJURIES OF PERSONS INVOLVED + CODES I 1 -- I 2 I 3 4 5 6 - I OCCUPANTS / WITNESSES If~ ;g~~~~~~~:~LAs~m -.sEX'::f J;crbiA1US (~~~.. L~~,~'-12'lJ\~ lii~fll -fJfC:i ~'I~~~' ~AM~,,_ . ___.'_0 _0_ _ "_~..u . _m _ 4 _. ~'bONI ___._ ._ I I I ....oo"m \'l#l.'~~!.o' !'oCr"!l flY 0 AM8 0 t'~~(l 0 ~:-:~! ~ 0 ~~ 0 ;-:~''''\I' E:""::::m .._-~ .... .. ~;~~f.O' - -- ~r~YJ~IiIO"" OA""8 ~~~t., D~~~,u 0 er~ ol;t~'w ..:'1 L NAMf r:crN I I "'I ....Ol)"m . - - - :~~Di~l,->or - -..--. - ~H';~tr"J~H/'''''' 0 AMB 0 ~~(.l O~g~'I~ 0 ~~ 0 ;t~~"p X '~~~"~~;~I;tP~~M~~;N' b~~~t~ IJ~ ~~~.~,. rl~~g:::(HlPI1~~;::~VEO OiT2:2';8~ APfPP 1/ 2, ~:i,' ~ ",'-- ," , '. " , , " . " ' ' ",,' .',', -~~ ~ ;,' ,. f'-.C:o, i/:':;.':' ,..... ./.'< e'.,.'.';,..",.. .,..."..,......"...}.,'.'..... ...........,'.C ~ ~,.".:,"..,~,:._,',..~ STATE OF WASHINGTON ;;'~RAIFF'C;~yl ~ POLICE TRAFFIC COLLISION REPORT ~ o PRIVATE WAY OAT( QTi'PU.,'.SlOI'ol A'I' 9' ~.....t~l I N TIM! COUNTY ~ .~-1;~' r~8 \lJ"I~O;1;u';~I;r~'r.;u;~r"il~1I (1545 HOURI JEFFEPSOO ON DE DIN CIl'l'OI<TOWN 1 NAMI&NO Of 5fRII10ll HIGHWAV 25 Mm 1lO' OW Olo' C1imacum ION Cov1e Rd INTE_SECT1NG WITH. STIlEff all IIOAO NON INHIlSECTION 8t1W[fN Whitney RD STllUT & Maple St. STIlEIT I', Ol51ANCE &:O~E;TION HOM llHEIl!NCE. Cl105SS111HTOIl NEAIl!5T Mill POST 1 ACCIDENt I 200ydH :r1~:S ~ 0 t-, [] Of Maple St. Mt\3~E COIllS.O"lIN"Ol.VEO .s.~.:"lIlIT'l'; 1 0 U L 0 I ",,,n",, ~o~~~~~s [J] NO ~~~:~~( ~~~:(D_ 0 ~~~::~ 0 ~;E~~~N ~Nll~ICIM~ 1~" 08JEcrsrIlUC':INAMEOfOOJlCfSUIUCIC/l.NOOWNfRSNAMlJ - Is 1ST OAMAGE o VEHIQE "''' o PEDESTRIAN '" o PEDALCYClIST MI II WSPlS9(IlIV.l-8l)' No. A!:n7<l? POlICE COMPlAINT N tu;ll 7Tt. ICIT'l'NO. 'Z; I~'I 'T~;i9'~~ Pl/~HX IEQ MILi~t.1 I /0/. 20 Il........P 10'A 1lAM00TA INTUI l::;t~ X-llD I~ EIlSEOING!>T1nlTOIIRO...oOAIlIJ-t.Rf.NCE I~ CLS ,00OSSSTT!ErtOllllOAD SPlCIAL CODING US1. UNIT NO. 1 UNIT NO.2 DIlIVlR'SNAMl JOHN S IlEUAOOIlESS --ZjPCOOI ,~,~ 1 .." I ~, ~ or~' IlI11f~1I flllM NAMI & PHONI NO EYiS WlIGHT H:IGHT ,tl f" ~'\' o CHECK (,I) If ~:ttflfs 'ZN EMP\Bnr ~ A~(Hfll'At CODES" + I 3 ~~~~~. <G ~~\~i:""" 5 IJICIIO'" 6 ~:'i'~0<;;~(L1 ~ 0 AMW,A"'(I 0 ~~~'-' 0 ~g~lIl1 0 ~~~~:: 0 :t~'..,!.O' E ~ rM.A.l<. (uv.......l. HlV,1 I MODlLIOAlll.NOVAJ I'''VLIOP Il:::CONv.1 "u.,.... II ,07fl 7 VtH COLOIl U!;.tNSl IIAIt NU, I S A lUll t'\,A1~ NO I SIATt ~ r "H'~'''IN'''';'''UINUI I I I I I I I I I I I ~ o IlIGISTlIlIOOWNIIl IASf fl1l51 MIDDll PHONl NO CJ - :rJ ;v.-" I PHONE NO W AOOlll5S0l0WNEll N ~ 'NAMTT A ~t~ UI- IN:>U~AN!;.E t.U. v Au~N ~" & i (' .1 " l \ 1-: f ; f.' "~; : , '.', ':'.' '.' ".;'. ",' , ........ ... ..... '. '~. ,/ ....~cc... " ..:.... , :" :,' '. .... . . "'",",i: , " " , :,.",.',' :." '..',' ,''- .' ,'. ,':. '. .... .: . , i."';'" 'i' :,:' .... '.. '.' ......., '.. .. ........ ..... . ..' .. q", ," ..... .....,. .'. . . .... . .', ..... ..... .... .... ../i . ....' <' ..... . . ..' ....< ,\ ... .' ......... ..' .... . .' .' ..... ' "c,;'", "',. ;' .'." .. .. . . ...., , . :." ';"',,', .'", ' : ".' :"""," ": " ,'.. ',' "'" .... . ....'. ....: . , "'.,,:.... . .......<. ,; .. ',"" ":', ... " . ,,,,,:', , " , , , ",,' , . ' ' ' " " '. ,.,'S"," ','. , ' , ,:" iJ' IHWA 2. I~~::~ I ~" x'" ~ .J:~ I B ~ - :::1: - T" -" ::, ;' .! . ... . ,"." :,', .' ." i:,'. . '..., ,,' ': ,: ' '. " , :' ", . . ......... .... ..::. , i",,,,,.,, ".':' · "/:"7 " ..' , , ',,' ," ',":, :i,:.' . : '.', , ""', ,":, ' " . STATE OF WASHINGTON , ' ,c . ..:,' , " ...,....""..... .:, " , ,""::.", . ,',: ... ,: 'i.'" ','".: :,:1 /77 ~:"',. J 4' I lJ.I!flA~ rr--' IlUIlAL II 1I J 8' , p-- .'r ,) II ,- , . "OO.l!fU r:: ~::lm C"'~f .PDD,SS X ;;';."?J.'~k;~~4 &A' / 0/ TRAFFICWAY POllet COMPlAINI NUM/lUl <<'.' PRIVATE WAY~. , DAII 'COUl' N L -o;;.~,LL'~.. -T TlMI 'ffCOUNTY COUNrY~, ClTYNO. I ~ /;2.'J/' tiS ,w. ." '"",;''';'~''X :u, n ,u'''..,"~' 11..:r-~...c-__~ II" LL - ON 0' o'N ~""'OWN I N"'''NO 0"",",0' ",p"WA< 'cre.~ AO':.~'I "'"'' 1 '00" """"'''e ..?~M",,!;;i, ow...oio,n-/O<-<~___':;.'ONd,1.:> 'p...~",<"<.",,/rv'~ ,'V, '51 I <::~"'.f"o IN1fIlSlCT1f>/GWllti ST"[fTCIlQQ....O NON1"ITflt::.tCJ'ON,- .pR.I\f:-",.~ A..b J "{fIX fC-:- fILE POST ,'...._':1 - '''~-c ~/<,c:.""""". .-?-'h'14::>~#(,;", ..3. :s 3 2 OIS'....:Cf~~'f" NHIO....."Hf.l!fN f.CQO$SSll~UtOllNIA"fSTMIUPO' T ACCIDENT IlAMP 11....GUM~~... .NrH~;;' ;:'..; ;., ;; 0' ...-.e-d-6 p7o:;/ .3.33 Mt~~E_ 'O<"'>OHON.OI.'D 'm"" -L 0" 0"""" I ."".. ON'" j,':!!?!; /'," I~NI!'~"".,,,,,,, """'''''''''''''''''' lB~' ~OS::\,~~, [2] D::~~~;:.;'.;;:;~:'D oiF;~~;: m:\::f~ 1o;'3"~ I'~I ,,, (''''2''~'~~ 7 <:> o..e'''''''''~'O'''''''''''''''DOW"'''NAM''_ T "',....AG, '~e..'eoD..GU" o -Z:>...~q ~&?~e;...v Is _ UNIT NO, , UNIT NO, 2 0 VEH'CLE 0 pmESrR'AN 0 PEOAlCYClISr G=' . P<O,.,~~, W, "'" ,,"',. N""''"''''''.." em- .MiOO1j ...~c..-k. .s./6/~ c-/,.?M?k.s I\. . ':;;~''':s.;- pO/3' 8./::;,- "''''~'' f::n E~:Qv44~ u.;"'~ 9xn9 r"::::vc' ~ "', "" "'C' j"OOM' :< -I:;.?d~sc ij/o ~8T~;' T;'l i;1t~ ~ ID~'~'TUe,".N",\ 1"'''1''', ~D"'o';'."'~. Qo ~ CX:CtJP"TIQo\j , fJllMNA.l.lf&PI10NfNO ;l:P,b/wt.IGH1 HEIGHT E OCCUP"'ION /"IIl'N.ot.Ml&PMONfNO 1('Il~ W(I~T I't:IG..., .l( ~""./c:' O....vc:. ~9'" <:::'_/ R \. ,..=:.. o CHECKI"l 'Vf",,:I~::N~:<::'.'~'~.:'~1W" 0 CHECK("I 'V,", ""fM':6~,'i~'m'%''' .,.,. .COOES......13 ~i~~~' ."7 . ::\~~" 7' , ''''''~ll' . ~.~:f.~''''- CODES" +T, ~~;~:' ~ :~\~~" " 'mc" . ~'o~'c" :.:,,, .~-:7 ~ ~..,;~/..=,.,,, ,~~:~:I.o ,- ..." 1:5 'oy~ J.JA"] ...".." 0 1'l," 0 ~8.", 0 ::~;:: 0 1'8,.. :~::(i11"o. 0 _M.." 0 '0"" 0 ~g;", 0 ::~;;: 0 ~~,.. ; 51.?? T""C'/Z:.1 ;/1::r-::~ ''':;~::' ~ E " ".. I'" '~'"" I"'\' 'DA" NO,., /,,'""00"" , l :: rz,,":':'''','''' I'~'~~""N" '''n /,"""~A"NO ~ H ""'0<0' I''''"'''''' "0 ''''''I' I"" lk /St-uc I%<'//_6!c 0.14 _ I,~ ~ I \.1 I ;Jf 2'$0<2"7N;-6 ~,1 / S?:YS- ';::f'- I~ ""'''''O<N'''' ~ '\ r;r:: "P"'~",,, W, "''',./ M>D'" "'ONINO 0 "G""'fDOWN" ,..." "'" M'D"I{ I "">NEN' c.=:. ".t!:4c4 C"l/"""r./~4 L ~""'~ W\.I I';,,; ADD'''"" 0"'" ,;? Pc/.Z,r- 'DD'm 00 OWN" \. ' .-< ..530 9-C'a....Z':".s.-.;:::s /c~ 7c.-"",,;=- ~ \. ,..- N..... 'DD'm 00 '"'".,e",o '" '",., R '" , AN" AOT'N ~" C: t:.<.............c::::. \. nO"''''''D'''A T!J'<.:!I'''O~3'?''''''<'= ~ ~"'AG<~", -;; J.. CM"IlGf ~ ~ ~...-9.s CM...IlGf 1"-, " ;T[j'D".'" o"M"NfD oD","N 0 1 I,PI ~o"l:"l,= ,- , s&2<.. :~fi1,;" R".~..TO~ o~c;.,~.."" AW.. "M""D s 'll-....r-.~~.;';03.1' ~ O'AGRAM 0' COlLlS'ON. 1:::",j'~~'Ci:~~:;, N~'~'MII:'" OESCR'PlION 0' COLLlS'ON" "". 'UOO'''MEN'',..."" ..em".., l-l' ~ ;-cr// ~ ~..s ~.w 7:>.$rc..-=...y .e"t:> .........:::., R CF".)<.,;/7-'..::. ~_ 'C"~""G" .7l::>.,.7"':$ ~""<:A- ~ .P"',&;;"# ""C>.."r.:> -.J.n;-: ~--.,,~ ,;-#~ c:G;,..e'",,'c>: , ~ d.=-~..?-'o{. ;-/.......... ~~7.;>::::JY' To ..--~~ :.2;h~ - l>'T~ $~.e:....&. ~.. ~= ="........... -6'.....~~ I-., ~ ~ J ?,;;-~ ,a....".:"'~......a;; 'S:">CO....;:>~..Jc:;;. ~ ....~ J:>. o?b-015CC''tslZ~ ',e'; - -:,. ~ . -........ #'5t! C u.(!vC!:' NAME, ADDRESS & INJURIES OF PERSONS INVOLVED OCCUPANTS / WITNESSES ~~ .:E'~~~f~Zl'~M.\1:: ::;F' ~~!~~.I<O' :';P'" ""ATtJllfOJ ~~ ':/.~'v~~/~o' ~ 0 AMI 0 ~~GI 0 ~g~I'''' 0 t.::.v 0 ;<.~~\, 1'~~P'O' 'G'", ~"""o. T~-::;;<e"DI"l""'2:i'IDID.no'.."":~[....o'd!JlfJT DA", ~ ,.jf~ U.5P 8-1" I 7,:~.(' j/f~.(., "'ft-9-8~5f,:; w I/,.e /kfF POLICE TRAFFIC COLLISION REPORT No. 4 4 o 6 W~l~(llfV 1.8()) 2 4 I "'''ON ~ i ~ ~ ~ 3' ',~,~. J ~. t. l ,r' { ~ i r= r-: G '~ -::> .~......-, '""""--" <"- "'- C;;co.t.fr' Cb,,/Z.s c: ........., ""~~".".J.s + CODES I 1 I - I 2 1 3 , . Sf X -, "'Gf kT"'u~1 '.....\1" I ~".:' 1..:1t\ IlPt:S1I1 I J ~ ... 11'1' DAMIl OE'i~tl O~.:... 0:;:: T T T J' fJ.~~";.I~'~O"" 0...0,18 O~~tl 0*;... De::: ,,~,,1.~~:.9 , OM~~ D;-.~~~. ~ " , , ~~ ~ '.c, . " . '..... . ',,', , " ,',' ",,' " ...> " ',. :,', ' , "",."" " .. ", ,',,> ,', "," .' ",' ...... .....".... "," ", :,'",,'., ." ';, '.' :....'. ,'.. . , " ' :' ,..... .....,... '," ,;, ':,.' " ,:,' .'. . . ,'" " .... ',' . : " " , ;, '," .:, ,.' .'~ " ..- , ... i, , : , " ''','' , ~',,, , ,.', " .., , "', . "'. , .' .... .'. ..... ." .,' ," ,.' ,.:" ," , ' '. ,', ," ",,, :" ", ':', '.' ......'...'.:...,..' ....: "'," '",' '",',', ',," " ,,', ", , ' , " '" .", '.,' .': , . ..', . ":,.'......,.' '. ,....;. , .: .,.... :.; ':,", " , ;', '" ,:", " ',: .. , " , " ,',:" I.' ;: I' .' t- ~ ~" '! t f ~{: j;.:,; # ~" * .,' " " ::. ',' '.," ,::,", ' . ,', . ' , ..... W!.p_"'Il"~9 No. 6 6 4 ~ STATE OF WASHINGTON 'AOI I O' I f':'"1 ~ POLICE TRAFFIC COI.lISlQN REPORT ~ TRAFFICWAY II ( I 0 PRIVATE WAY DAIIOICOUI!.1 N OA;;ot:.frohl~lON-~ ._~ IiMl -nCOUN1'1 COYN'YNO lCI1YNO H~.l~ &~ '" ,~ "":" r~",)('" n ,;k,,/;;'" 1I..J""6;--","/a-.e'5:W / ~ I Ll. ON Dt ~IN CYOIITOWN NM'ol&NQ OHTlIU10ll HIGIo4WAV ~~CL!I I~~' ~ I PrnT_TOUHOR TlIIl CO Md' 0' OW DO' /MD,tO'::"c ON ~.4./'DC: ~ i ,-7 "-'. I ,. .,..-.... INTlII~ClINGWI'W101lIlOAO TNONINIUl!:olCllON PlIlflJll -ltQ -lMIL(~f -:>3 r; ,4/i/e IBlfWEIN - !lUIUI & - !Ill/HI I I 0 . I Z 1'/, Ol!> ...Net & D~l;ll fl'/OM IlIHlltNCI. CIIO!o!o!oIlUII OR NtAllI!.l MILl PO!.l T ACCIO[NT IlAMP IDIAGRAM l)A,I... II H~'~:!. ;; A ~ ';, Of M~~r2E I COltl~ION'N'ICk'l[D !:of'ol[lM1. ~ 0 ~l!f.~ 0 I "'OlI~'N 'N~IJII ~~ \ll.'1l0 1:~1!~!>L 11~~ir~I~RRO...oOllRUlI/INCt ...)J .;.o~:~,~~, ~ 1ii;~~~~;:gI~~:1 ---" 0 ~~~~~ O~\~l~:N ~;:::.""; ].. ",n. c" I"""CI~ ~i D I I~' 08,,,,,""">NAM10"'" "'..UC.ANOOWNl.'....'" l~ "'=AOI 'kc,^"OO'NG",1 - UNIT NO. I UNIT NO, 2 VEHIClE 0 PEDESTRIAN 0 PEOAlCYCLlST J' ~a ORI~::'" / LA!:o' J"A...- /,flll!:o! M" DIII'Illl'~NAM( LA!.T f"'iii"!;r I I /.t:A//V _n_:,,-tC, '/'?;?~..-.J/'4:-6 A',.Jp,-"~~-,,,\ ~./__;~6/"7::> - IS "~;:;;:'7 ~ ~/.,J ;:::bE IOS- ';2';;'" /~) 4'.4.."J:;JG: /--::&3 S':.3/ --:!< 16. cm _ _ !:o''''ll l'PCO~ J I ~ONI~ 0 IIY . /. ~T"'ll ____ IPCOOt I PHOl' I ,~ r;:;- GLlGe.y /./4 a~9",.r 1585"S37y R C/':?".Af:::.-" .(1# "7x,32':'- tJ'~s::t<:3/ ~ tb. "'"""N~NO_ I "A" I ~'_ .0A .~H.. I I!iffi'fI'T"CIN~NO ' 1~!1 ~11100"'IDc:.,B'1l1~. ; Y'A;P;,kJ/-,:",S//.:?3 ItJA' 07 1/ ~3'?S; V 14...v:D,&....{'~/) w/,B? 4/.4 vr.-I/' ,/?' 3<j- B o::~ -If'Il.....N........t&PI-lONlNO .J..>'J~~c;.H'l....:?I-lT E OCCU"'...llON/ flIlMN........I& PIiC)NI NO tJ2~Jl1~GI-lT~I-l,I::z.. 2 -t:t<:;,;.~:: rz;o.......>,,,,,,,C /~ ~Vr~I"'ol""::9 R :Y'/e/.4...".c- .5E// D ""..?l"iS-r.,..-=- o CHECK{,I) If8t~:l:~:~rz~':,i'8~twC~~~il"'L 0 CHECK(r') I:~~~'l~' 1II....l .~ ~ CODES....... 3 ~~~~~' I.. ~~!,~:.'''1 41 5 IJlClOON/ I 0 ~:?,IIC'~ CODES'" + 3 ~~~~~. I .. 5 IJI"<ON / 0 ~~?:cu:.u.. TO 21 ./ 'NA,ji,,,, ~N c;;;. 'N~:::'~I<O' ~O~.:>= ) c.=:: t!~"':~'IlO'" 0 A..eu,"NCI 0 rl'~C1 0 ~H;'lI. 0 :::,~:: ~1,.!>I' tt~'1~UO'" 0 _IlV\ANCI 0 ~~~tl 0 ~!::;"ll 0 :;:'~L: 0 ~~1,.!.I' - ITo ~9;o ...;:;;~ r~~2;::~ l""':;;;Z E ;93/ \" /:.?:,";;.:~ I';~;/ 1"'~;1J" ~ .....;.,c~OI/ IlICf't(Pl...INO -1~1"'1l ~1'1l"'ILlIIP\."'llNO IST...n H 'I1,",COI.OIl -'utEN!X~L...t[NO \-~1"'lE 1,.1 I!.T"'1 ~ .lSt:JG Wc.4~?1 w.41 - - ~ ;:z,/",G k>./k~& t.JhJ I - - I~ ~~'D1Nllf.e~IONNO ~ L ....1t-1lelILDlI'\j1lf~e...l. NN~/_ ..-~ I""~ j( Ii 6 .:z I -:23 b ,,,,,,,0,, /6,1./1/9 #'3 y"J,.3.iS 2- V ;fl.,2t?:? c;.< r-YiL r.>=;- "0"""00_" "''' ."" M'''''''....... NO 0 ,,"""00_" ''''' '~ M'O"'I I~"' NO ~ L:2... "/.7~G.: ~......,=- W /_'''A'/O/J ~/g.e.# 1?~3&: ~ :2 AO,""''''O_'' N A 1""'0_"/->"", ~~_'"'Z>E'-J C::-<:-,E,e::J;;> .!lJ L=. S"/?-.:"C: E ;-.)",,=':04.,.;"7> "".;f1 -':;;;;;'3.:::. x rz NAM"AO"'''':J~~~ AO::', R:;;~ ~ N if ~ p~4hAAI"'. ~~C1"6~'" ~ er ~AMAGl:p'...R>>. ---s5 ~' ,r-7 ""1. O'~"~" CHA'_...", TZ> 0'e.'7:> .c/,,_) CHA'OI 'C}.. ;], =- ~ (0/.',0:".:.<, I" OAM~ 10 ~""N o "MAON'O ""N o "MA'NCO . , ,~.'.O:." , "i' _ ,olonoy 1~I~ri~fB" ;?'!...t.->~/'? Oi~~~BY r;,";.;~,-::"Z S/5o!'?o I IOlonoy. ~ ~ DIAGRAM Of COlliSION {IUU~UPPlt"'IN'A\ \NOlC...UNOIlTH OE5CRIPTlONOfCOllISION !IAISLPPLEMtNl...lSMlOlfNtCIM...IIYI So C:. .. . , , ' I '.'f ~ (rrrrlr~l' ';'r~ i'<1E;/ ""'.Z A/~,~: ~.$/~"':' $,AJ~ -.$7.""' -:- 3 r;r- ',: tl"1 i "1'1-1 " ,. \' 1" p.;~....;.:::. .r74;?/ ..-/~. 8~;4/.s;r- -'--'7<Y,ZSc""",,-;i; =- \_:" ! ," "l 1 " - r i -i--1 Vt:"ff P", ;;""M /Vrfl~ t:1,...J ,'5'~ s~ .~: :3 E-' - ~. , :~+ii;';,).ki:k ~..a;,,:-~~~~~?':-21 ':"~~b:~ ..' \ It,:I\.:I=ttU~t:t. .:_~~# ~ -=~==..:/=::~~:~z.:~~t27~~ r,-' !:"i Ti I A ++. +1++"h-1-.' .. ..._m. m.'.. P'" ~ ~ ~~Jp~~~~~S~~~~~~~~E~~~~r~~~J.~ltOlVED ~;7,Of~~i Ll,d,~"II:,: I ,~,,; ;.:i.li,~ci ..fo:. NA.'IZ....T..-V ~..;kS ......J-1'~4".s , ,::!?'" 7!J~-S7S7"'" /J7/.. /. ....OOllf~.,-P7~ L".} .L';.,Jt::...<J~;.;::.:.' _ ,./~.~('\c-,z N"TUJ:J:.OI' _.J~_J..-= ~TrICJMO"'MB Ori~(.I O""~ll o':t~ ~:-"~'..s. r NAM! ~rK W,t.(.,AH:'.'. ,/00"......../"./. ~"'Je.:; -~ 'd.' Iv~l. _ "t'ltlllf~!> -7~' LA r ;'/ Po "., i--'. _ :.4.,{){')-e:-.:...cC ;'l""Ul,'OI .... _ (\,.0.) c;:; . - 1I(~'Il~nlo.y, D...Mb O~~" D~~Il11 o:r~ '"'W!I ~~'..\. .0 ..._1 N T A;r;:b"~7C-~;~~~.~i~~jl~~~'; ~/:;!J.~~~:-~}F~~17J?~~~~;;; 4 4 31 ~ POllCt COM""...IN! NV.....8111 l~\~iw... oUIlB...N UII"'L !>LeffON kJ ..' ......':' ",':',,'<,"',~ \. ",,,,, ',', , ..: ,:, " , ' , ',' :.': , ....: ".- :, 3: .' :.;' , ., "".,",.,',',:, ::~" ",," . : ,', ..:::::' '" '.:: ""/:,". ':P' ,,;'. ":, " ': '';'" '" ':", '," '".' """.: " '. .,m, ':", ',: ,',''' " ',,: :,. ';.. ", ":','::' '. . . ..'.' ..... . "'. '. .' , . L~ .. ,.... 0:, ,,' ',' ,':', .,.'.... .,.' ....".. .."..: ", ' ,: ..... "" ". , " .... ". .' ::" ..,........ . " '. :,'" ' "..' ',." ' ,'.' ""., :'.,' ..', .;' ", "'" "'. ,,'. ';.:' ':,:' " , " .... ," '. ,:': , . ", ' ':.' ," :". ',', . ,: "'.' " '", ," '. ' .... ......... ..... .,' '. ,,: " :. ',:," ,,' '. , I . ': ";"i', ' ,::.'. .' ,:,:' , "", 'i :, .' ':'" , . ': :. ", ,'. . .': ....... ...... .:;".' ," ":.".' ,'. , ~ {, ) ~ /", l' :;, }. . \. ' , " " " ,." "" j '"'' , , ' ' , ,'" ,: , ,'"" " , " , "',' "-,,, ,',: ;";' ~, '; 1111 , , ' , " '"' , " , :, , ," " ,,','.... . :: ': : .'., "'"'' r;: ;, 'f" ; " , :;l. ".,,,..,,, STATE OF WASHINGTON W$PIW(lHII, 1.601 ""Gf \ Of \ ~TRAFFICWAY o PRIVATE WAY I;lATf ,m <;:OUl$! N ". CAY C?t COU!$ION _ ';_ H TIM! COUNTy [ "~: dl-~ W~.~..~~ 'UIS'iv'r~t\j'I..;SI;'lI (~~~~UI1) I ~_._. b~ \ ON Of D'N CUY011 lOWN I NAMf&NO Ol$IIlHIOIlHIGHWAV ":J..8 MU' /Q' Ow Do' ... ION =, ~"" \ e" lNllR$EC1ING WllH, STlIlO DlIlIQAO 1tj"'ON IN'lll~CIION I 3 IBfTWHN~~ 51Ilm&~E~l\)..sTI/EH \ t$IANCf & D~!; "ON fROM IlUU1W~E. CRD$$ $H1H I 011 NtAlIlST Milt POSI I ACCIDENT :l.S n~';:S 0 i., 0 [] Of - ..." /~ _I Mt~~E COUIS10NINVOWED .~~VlllilY: .......Ib.. 0 u. 0 &6, I >f.J~'~~~~HS - ~O~f~,~3s rn ~:'~~~~:f~~~:fO-.- 0 ~J~~T:: o~i~gt~ 9 ""~~~'~~"":"'~:"u.:"'oo:;:~'~;, /$ "(Jr' UNlT NO, 1 UNIT NO.2 POLICE TRAFFIC COLLISION REPORT A An'" ~ , POuef COMPlAINT N~Ul -, '4 !. "1 ~ No, CCNNTYjlo rITNO. rocr I """M~ I "IRounO:~T~ICO!X /,,1 -; I I '1VIS-O - ~ PREfIX fY. ,MILfPOST ruw.p r'AGIlAM Or.ol.TA IN li~jR I X.IlD I~ 1~~S~;;:~oc.'ll.~RROAtlOUIWI[NCl IX I ClS 100~Sq~i~~o SPlC!Ar1:001,..GU!.( I~HWA "'-'=>J URBAN r- u.'" MellON b 2-,6c8 .I" ~ D~~';;:~ ;:~ ~ ,':RSI D~~l: \ ~ I ~ S~lSS ~ ~n ../ ~ J ~ ellY SIAlt llPCODi PMONf NO 0 liT ,-, .0 M-" "''''~I \.. ~....". 1.0.,~ .._, R t::: ~::;;~~;p '=~.,,-. I \::~ I ~ ~fi~~";:::: ~ "V'''''O[N><NO ~ ~:; '!~MNA.M!&PHONfNO \ '\J:;:'. ~:s 1'NI'GHl .....'GHI ~ OCCUFAIIDN I flllMNAME & PHONf NO - 0 CHECK (f"') "~~,~~:~~Zm8t:ti~,I t 6,",OlOl<{.YC't CODES.... + 3 ~~iX~' I.. :~i'.;::"'! 5 IJICTlON 0 ~;~yo,;'C'1 L~-'~N ~':'N'V"",' 0 .~:: 0 tg;,,, ~ ::~,~:: ':':'8'N.. 0 ~"'N" 0 ~~~" 0 tgl". 0 ::~::I 0 ~~,~ [~ "";:;:;.:;,' I MOO'\,;:::VA' "'~':':~:' r r '~~"'H'V., IMOPE"oAnNO'Aj m, O'"c~vJ '::::0< I ;':~~~~Fc;\ I'~~~ I"A"""^"NOA"A" 7v,,,,~o. I" 'w "A" I 'n..'NO ISlA! ~ \11""(1 I tOlNTlftCATION NO ,. I _ ~ \_. "_. r VU11Clf IDENTlfICAH N NO i'i ~iR'C.I~IR'?~t.'\<,"It:..I"::)!1 ~,xi3 I I I I I I I I I I I I I I I I ~ QtGI~rtl.![DOWNIII LAST flllST MIDOLE PHONE NO Il[ ISmnDOWNUI l~l fillS! MIDDlE I"H~NO t::: <::: -- A"'" ""-"'0""'" 0 I f-- ~ ADD"""" OWN" ~ A"""'''.OWN'' ~ C NAME&AODllfSSOFINSUIlANCECO OIIAGENI ..... R A IN5U ANCECOORArJU~ ~ :.... ~f:e~ =>-""" C",_ _, o~~%'ZnA 1\i~7~"'81'''G I~" l \ ~\ ~ OAMAGfDA.I!fA --:;:; 1$ 2 ) . I Rri~::f:'g~~,' IC"'AIlGf ~CL CHAliCE 2 ) .-2:!. F': i,k-'""'I ,~.',D:,::--l, "'"0:::: I~ ~~:N o "MA<N'o 0 D''''N o "MA<N'o I'" I,k-t ~~,',~:~l,1=;;; IV 'L[iO'DnD~ $\SbC:>I6(l,:'I,":~" ~,. O~~":\."" AW^, $ 1'~[i'.:nD-::'I"': ~ ItrlF~E;~tf fJli::"~1r~;~;'~ ~\~~~~~~~~~~_~~s~i~J__~~== ~ t..= j,= 'l,-~, -~f,'_.'",,~' -"1"....~,'. '..~".,. =jJ:rr' n~\tt~';,= ~~'Li~;f~~~~~::~~:=l:tt:.~~:... ~ -= -i_'lL :---1-+,1,..11'+' ~e;--Lel"'T'__S\De"oE~\e;',~E~._O~___, ~ ~ ~':: i~~!J::~~~t~~!i~i~~::~..~~~:'f.l;j.~~~~,~f,~~, e "l....Mf ._ __ _.' ::'>60,..1 I "DC'lQf~~ rt1',H~~F.,of I ~t~f"'J~ fROM 0 "MB 0 rl~(.' 0 HIL~, R 0 ~m 0 :i.%'~r E ::::", ~~~I,O' ""r.5l'Jr"OMDAM' o~:"D~~:,,, o;:~ 0"'''" .. C ..........f ~..O'-"j I I _ loN)Qm :~~~'i~I..O' :~~r~\"N'''O'''' D,/IYoII Or,:~(I O~:':~,,~ D~::r 0 :::~~"p ~VI~IlC."TI"\I,,,",\ff.'CI/N . __ III"tl~~ Ac.U.C., 0.... ..,,' rC~'rr O'!'~""c.HIOI :"1!lCI "~Il"vtto (lA'1 Of Illf'OlIl .I ~~ D""f ~"-J\ ~ 'ON ~ ",,,,,, I \~P I'~~:? I\"'-IL\,,-li'~((,:g IZI'l S' DII/IVU/ ~ NAME o VEHIQE "''' o PEDESTRIAN '1Ji1~T o PfDALCVCL1S T MIU~ll g 1:= I ~1IlH1ADDRISS liP COOt IPHONtNO I STAT! WI: OAnOFBlllTH .., I ,.. I" -" II'H IWE'GHTII-lIGH1:::::: ~, '{ jQ2e ~ ~ ~" I , i ",:'" '",""" ,:",,' "",," .:... ...... .. """,,' " '", ",' ',,' ..........' . ... .. , , .,:, :,': .,,: .. .,'. ..... ..:'.. ; ..... ,i .,.. ::--;- , -:' , ,'" ':"<"" ' ""'" " "";, ;:,:' ':. " :",:".' ' , '. ;,""",,':, ,,' ," >:,,: '.,,' . ,'; . '. '...... , ," :,",,', .... , , "'-,' ., ::" , , " , ',," ':, " , " ,',,' ",', ;':,"': ':' ,', ':", " ',', .' :,., .:::.' ,,':' ", :,: " :' . '. ,.<,:": . ...,',:, ... . .. ..' ,',: ,.:-. , " ", ,'", ',,' " " ,,: :':: ,,' :.' , .' ': ',' .- .',' " .' ':. .-: " . . ... . ...... . .,. ---:-, ..." .... ., .......... .. .'. . . .:....... ... . '''', ",,' :' ..":' :.. .. .:,'. ~. . ", ",', :" ~' ," ...: , ,,) ';',,:, ",' , ',- " y( r fr "" {:-. " ~" t \ t < .' ," " "",',..,..,' ::', :,'" '"",,,,' , " ":.' , , ".', '.'., '" " ' :'; ",',;> p' ' " ' , ,: ",:', ' ,," ::,"," , , , -L\ ~ STATE OF WASHINGTON "0' I 001 (~~ POLICE TRAFFIC COLLISION REPORT ~ TRAFFICWAY II 0 PRIVATE WAY I DAllOfCOlJISI.u.~ -'I~ _oA'(9'~Q.I.~1 Iqf'.l TIME IICOUNTY [ ~:t I;;.; lii'- 1\IJ~'l;ij;'i'Uli'IXr:U"~f';"l~;:;' oqOO/I~l1) ll~e.FFEI?Sl:N 'I J8N Of DIN CllY 011 TOWN NAME&NOOfSIl1UTORHIGHWAY ~ M"" O' Ow IilI"O' (/)UI C,E",,c- ONLo"~~E J""aPI!P. " '(I IN1HSECIING INIIH. STREEt 011110....0 I:~:~::I(:::: D SlllffT & J..~.J..,f:.; SHIEH - /" 0151V &~(C~,l,,<,,:, '110M NEfll/Wet, C110SS:;Hlt!1 011 MAli.,,! MI~1 P....s ACCIOENT f:1 y~ M~'~~S ;; t, ~ ~ Of J-Jr.....y .It>/ Mt~~E COUI:~~ll~~OlVfO ~~V~i~~;~..tL.-NO 'NJUII[O~ 0 JIl~AC;[ OHll&I1UN ....~'~U'~~..s QfV[HICLES 0 0 Pl10PUlIYOAMAGEONlY 0 tlll~UlT(D M~l~'~'L1 "q. oeJ!:cl SIIIUCl( (NAME Of oeJECl STIlUCk ANDOWNfll'S NAME) I EST. OJVl.',AGE I NAP-.J:"7'P.E.T - C"uH?Y RoAN- $,....,.."'".1: UNIT NO. I UNIT NO.2 flll:501 MIOO,E OIlIVllI':50 NAME OR'VE~':50 NANlE :5oTRHTAOORESS 21PCOO( PHONE NO , ~~r;:r~~ \ po- AtlO~f~S ~N'Mf , , Al'll1lIH~5 X 1>~~t!;"OII'~~~MI&::;_ ~ WSPIS9lQ(V.l.&ol No, A A n to. ., ~ " :, 1~f:HW' v.... RURAl ....~ ~ POlICE COMPLAINT NUMflf~ COVNIV ii, I CITY NO. 00<</"1-'3'1-"" I:;;';iz 3'0 PREfIX rQ IMII.E~ .6Q IlAMP rlAGIlAM C1ATA IN.v, I:;'!i'u, f X-Rt> 'CA~ ''!f::!R HORROAOORR!.rcottNCI. ~ I ClS ICA(j:lIlS:IlO/0J SPECIAL COOING ~f. > . o VEHIQE "''' o PEDESTRIAN '" o PEDAlCVCltST MIOD.( 22l Lci= 1-71 8- ='T =t- I ~ --" .A ""- SlATE ZIPC I I , . , "', ,', . '" " " ',,' '., ' ," '.',' , ,',,::,.', '".' ": :, '. ,,", ,',',:/,..:.',,: '\ , ' "<'.' ,:" '.., , .. ',,' '. ' , '" .,'" ,"','< ' ,/:': , :" '. ':' ',' ',';' , "" ' "" ,.'.' ,'. "", ,', :':', ,,' """',,, - " '; ;" , """ > :",: "" '.' ''','':,' :"", " ":."',,, "'.",,',, .,''''.,'':" '" "',, ",.' ,,' ',,", , " "', :", " ,":, ,;:,,', ",,'.,: .. " , .0 I OAlf Of 011111-1 .., I '" I" I EYES WlIG....ljtC:IGHl __ :'.~.-i. . , ,~ ' ' , , , . " ,,;,,""C '" "C, " " ',;' "",'", ,'.' I ' " " """""'. -:-:c ~ STATE OF WASHINGTON "01 I O. I r:J ~ POLICE TRAFFIC COLLISION REPORT 0 TRAFFICWAY I L-f 0 PRIVATE WAY F1\ ~1i~~"f~'IW-;'?"l~:,;.!;"Oi~~;!~~;':f~II '~~~~OU" II'3:::t'ir..".., ~ ;Kf'N DE DIN CIl10~IOWN I _~";"'E&NO OfSl~!HOl/H!GHWA1 :2. M"" 0' Ow Oilo. \-\~~ ION I<.lu,<l-~ p,," INf[ItSECTIr~G WlIH ST~HI OR 510AD lNON INUl/MClION ~ IBHWUN:I'iOf'\c:l.Ad..6 fdSTllHl & ~ , DISTANC! & ~=:r;lION '~O.....ItE'IIIINCE. C~osssrll(tTO'l' N!AltfST.....llf PelS '-'00 ~~~~S _ f!, 00. n n Of:r/~ (ld. COLLI~~::~~OLV(o ~h"'~~~:;O_NO, INJUllfO_ D ~1~AGf CYVEHICLfS OJ [2l Pl/OPlIH10AMAGf ONlY 0 rJStULTtO "cr OBJECT SlllUCK INAME Of OflJECT SIllUC.. ANOOWNt~'S NAMl) WSPI~lll[V 1.80) No, n I o 9 4 o ~L1CE COMPLAINT NUMBfR I ?i~~~A liB UlIflAN8 RURA./. !' ~, :;. ~ t 4k, '~, I: ~, I, :"' r , ~ OlllVElI S NAME LASl 'IIIST MlDDtt ~ ( - \ ',lc.o '" :-'\Anf".\ HAL 'r:.. -", SllllE1AOOllfSS d STlIUfAOD~1!.S L2: C", / / I b NW f},,3' _f[:. ,"ONINO 0 m, ,,-- S'iA-q1 t. wA "7~1J7 782-6'12.'( R l:::::: :;; ~~:.;.~ (Q 130 H I ~A I;; o~i~~' ij~ ~ O"'''''''IN" NO '2IA~:"7X~N~=ONI NO 3'7'3 <l'f't7W~ ~ acCU""ON T"M "~'''HO","O L.....;;;::.;. 0 CHECK(l") I'St~,'td<i~'Zm.e~~~fSrc.?~~~iTAL 0 CHECK(r') I VfHICLEASANfM~l~~f~-S,C2~~~AI ~ CODES...... 3 ,..'u~. J I. I/I~ru.'..rc"f 5 I/Iel,,,," I 0 "'Ol()~.C,' CODES" + 3 I"JV~' .. ~l~ll/",..r 5 UlellC" 0 MQ10Io'l:'Cll 2E" ftlSS:"Sl.A'< fl.;]':; .::z;, ..... _ ,.".. ~ ,,.,, ,..". ..".. I/O... 0 .....~U\..N(I 0 ~~Cl 0 ~g~rIP 0 ~::;~:: 0 ;-'8,'..}P 0 _WL.....CI 0 ~WCl 0 rg~ru 0 =~~,~:: 0 ;-1/1',,~p 8e:.. I^"'NA~M' I Mp7~"NO'" /''''' ':0' ,CO", , ~." T^"" ",oOG',C"lY" IMO""OA","O'" 1"'"1'0"<0 ,,' 0: .",7.:.. 1u'T",z;, 11:. ....~.- I".' ! ""'''. r "- T' I.' - I"" ~ f;2;:r;%'~~;~~c':~2.!'2..1/12ICiOI51(61/14~'>ISL ""'~'''~"''''~AMI"~OI I I I I : I I I I I I ~ p;:: "G"::;::'"" "". "'" MOOD" '''0","0 0 "G'"""OW"" "'" "'" MOOD" "UNONO p '2 AOO"""O"",, ~, 'm"O~"" 8ll e ~ N~t & AOO~fSS OF INSURANCE CO OIl AGlNT S R N INSUIIANCE CO-Ol(AGEN ..J?l 1":- C.~: L ~C.L ~"loy8.5. - ~E., wolf _, OAMAGfOAl1tA 1~~~;'''''''J't ,~ ", lo'~I~"~~G I ~...a~~bl~EA --::;: rr.-I.M ' ~ I *of~'~'~':':1 C""Of ~ CH"O' 1 ~ ;'':':f~'~~ K-I ' ~ ::::: 1-1'1.---~;~~::;o~:':J'I~:::;~:i{tEt'~MA:L'O I~:" o~';,':,'" m~~~" DorM""'O I :"DAMAG'l'~o~~::;~':i k; DIAGRAM OF COlllSIO~~_...:. L~._J\L.,u"UM<N ^' !":C^'!.~.o" ESCR'PTlON OF COLlIS'ON, 'US! ''''''''M'"''" ''In" ""''''''' ....' "~n:",ri1><ib..1 "'0l4'"t'~""'f'Ti "~> -kg,l-l~;=}<.l:<;~~~-=---I-- ..... . . II I .\l~. ,--~ - - -~~'~ :'--STcrs~-~ C -t'=r+-!--I-H-~f1+H rr+~+-h- - ~~,~~~..:_~ ~:~===S ~-~=tl=fr~~l~F~tf~#= =~~~===-=====-=______,_,___; EM j -~rj ;;~jij JJlltl-! J..: :,--"-,~~:'-- , -=:~~=::==~-.:..-..:=::~~-:==_~~::::=~~~:.:-.,=:.-"- -=~ R: : 'I ~-i . r ~A~E:A~~~E~~~~~i~';;R~~~~ I~:OLVED -, - --- .': ~::::'I'I'I-- I -~ I ~._~- ~'~~'-6-S ' I - OCCUPANTS / WITNESSES \<g: :g~I~~~,'~,\;'I1: "'ii, ~i AGi Is;;",;,1 '':.~" 1 ":.:-1 ;',~\, ,,,.;IiMe;' ~~~! ~Nl I NATullfor -. ~6~':' ~ ~A,!~b~E~Of _0< "0 -" .. -.. '#}Jt~fso' .. --.~. ~~~~f1fOM O......B 0 ~~~I D ~~~Ir" D~;;' 0 ~~~.\r Y' -, '" ~I~', O"ICj~ ~ ~l "RA'~.. I jflADC,lf" fGtNC1 U''''W .. T"oll" OI!.PAICHtC,j fltlilCl AlIlIlVtqoA\f Off.!....I'O~1 I APP~1 I OAH 'l- I/t, I I ---",... - IO~~~ (),~, .1'1' I __ I \, \~J.J-l!'.roo I /i 1M.! : t; f" "':"'" ",,' . ,., ,'. .... '-'. ",,:, .' ',,' '":,,,,,,~,- ':'. . .:,' " ,. '.',:, ,: .......'.. :.'.... .".' ,:,' " , " , "', ", i,," ' " , ,:', " ' " 'C' ';' ',' ,," C :, '.', ;'. ",' ....... .... . :i:/, '., . '., '. , ',,'," ...."'.',,:,,,,", , ,':' " "':",,' " ":':',,", "':"",'i': ......,.... ' ".' '.".' ?':' ",:C" ;, '., ..... '" '.' :'" :: ",'. ;' . ........... .....r " ..",,' ': ,:-;.: ~' '.' "':' ..' ....: ....~. ;51 ..'. " ." ....:'. '.' .. .... '. '\ . " : . ..... .... . . .. . " ~ . '. .., .' ". "... ; ...:,' . , : .....,....... '" " i' ':. ,":" ,', , ',",c,,' ...... '., ii" . '," UNlTNO.1 SI~[H ACCIOfNT MILEAGE COD! O ""ll~'" HII "~UN I HJND>1fDl"~ o ~~~,m Is fS1,DAMAGt UNIT NO. 2 COI,JNTY iO~ I CllYp,jO. ''C.I :.~""" 19:;~::Ocoor PlIlFij(T~ IMIUPC/SJ I C. C::, RAMP rIAG~tM.fA IN"'TIlf 11~~r.ll:'l1or~~TtNGSTIlf['0I1I!OAOOIlRl~UllNCl 1)\ I CLS ICJlOSS9:t?~~O $PlCIAL COOING Lf>t 1 ~C"ON ~ ....... I> OIlJV[~'SNAMl D VEHtQE "'" o PEDESTRIAN ~1~SI o PEDALCYQrST MIODLE ~ ~ I.; I liPCObl I PHONE NO I :;,"'u I [1I OAffOf fllll.IH ~ I '" I" ['rtS1WEIGHTIH:IGHT -=: ;~ , ;~' IRO... '0 " "'O'l"'r~., ENA'" 10 _ "'ODPf~~ N........' "'~[)...,ss !>C!'lr"'f1"" UM 0 "'.....e 0 ~'i~1I 0 ~~~, ~ 0 :~:.r O:-8.1NS~ . -, ~r~"'J~ '110..... 0 ",....B 1 1 o ~~'Cl O~~~lf. 0 ~:.'" 1 o ~~~~p "'I I '." ,,: " , " '",',.", ,,:"; "",,',, r1 @:. STATE OF WASHINGTON ;;" I or J No. 0 I 0 9 4 w'"I"'''v",,, M ~ POLICE TRAFFIC COLLISION REPORT r.LJ TRA;;FICWAY POltCfCOMPlAINtNUMBEIl . 17 0 PRIVATE WAY Q~O'C;9l.L,I~!~-:~_i~ "'Ur.'-~~~ tON T;.:,-JI tiME IICOUN1Y LZ ~i IJ'71i9IW'i"'~';"T;;;I;;''':;': Ikll'U'//70"IIJEFF€-1'.50,v 11/ ~N DE DIN CIIYOIlTOWN N.&..M!&NO OfSTlltlTOllHIGI-iWAY f 2 M'''' 0' OW ~or C"eNT-=-'7/?, ON rJ!:7V7<=n ,-fc!l 'Nl(1l5[ClINGWlIH-:!ifl![['OIl~AD I~NINnll!tEC110N"~T 5TR~n & 'St.2. /O~Hl 1 OI~I;NCE & D~;':i<?!" fllO:!, Ilff[IlENCLCIl055 STIlHT 011 MARES1 MILE POST I ACCIDENT }r? ffi~1~:5 0 ~ ~ ;; OFE/}t:'-(t:/'HGlVNT M~~~E OUl~~~:~~OlVEO rn ~:,v~~~:;O_NO INJUIlED_ 0 ~~~AC.E 0 HIT & RUN I tf,J~'~~~~..~ Of VEHIClfS u..J ~ P/.'OPERT'(OAMAGfONL'( 0 5/ESUlTED 0 ~~~,t~ ~ CBlfCT SIIIUCl( INAMf 01 DB)fC1 S1RV5i ANDOINNfR"S NAMCj I fST DAMAGE ( /t?(C" AhIJAJl.:- rtJ/t:- - t/AJ) '7<f,;(} 7Z.?, ('0. I -CJ- UNIT NO. I UNIT NO, 2 I/' O~'lVI~/J..;;/ !\p/Vr:t".s m;I;'~;v ORIV15/"SNAMI. S'RIfIAPDRl~S / SlRHIAOORISS f";;''Z. 7-'>60 CC=,A,J"Tt'-7Z /f1J L..=: IC"~ I / STATE lIPC..::Df...... I PHONE NO 0 Cur IF) )/~<:-"'N'z-- 'vA- ej'?376 7.3:;1.'13[50 R Lt "'j!t::-":'Z';;'n>>1 ,~~~ .tJ, I W~ I;;; ~iI1rl;;:r ~ ''''''''''N''NO ~OCCUPATION . ,fIRMNAMI&PHONE 0, f'(IS jWfIGHTjHEIGHI E OCCUPAtiON IfIRMNAMf&PHONtNO Z. (0'1.5 7/.:uc17(J'>l} , J C::C F [3Ctj I/bO 15'-09' R J o CHECK (...) j, Vi~H1C~:~~ ~':':Ult:t:~H ~"'A~Si';f~'Al 0 CHECK (.....) I VEHIC~f AS"'N u.'r~6~~ff sr-l'mrr'MtilIAL ~CODES + 3 ~i~~~' I ,.. ~~~~~'''1 4 5 IJtClOON / 6 ~~:~.lPC'C'1 CODES'" + 3 ~~i~~' I .. ~mi~"" I 5 fJICl'O" z.. INJU~' E!, ' '" 0 .....e'''.....'' 0 ti~(l 0 C'lip,,~ ~ v::.",~:: 0 :-'8:"~P W";'i~~~~'~o'" 0 _bU'......, 0 t.Z.tt 0 ~!lPl!R 0 :;::;c:: 0 ~'1:"? """',OOOO"'H'V, I MOO'"O''',NO'', "",,'0' ,CO", , '!.' HnAO I........'~~',CH'V,' 1 "'O""IO''',NO'', I''""' O','L~"' ~;;Z Fj."Hf:~ 1':!.~'If..~ 1".TRCJf:::'"^"N;I~:.: 7V'H'~0' ILI""N...n..'~''''~ I" 1"K...,L.......A1fN 1"'Af -28 Ll..-f)]OnOo#I0R9G1C WIT- - 1'1 \- ~ 5'" .:r;'A7A";Cc'7H~II3'1C'1 q:J"1 7181/1 '1 ~ 71'&'/0 f "'H'~'''~N''''~'''O~NUI I I 1 I 1 I 1 1 I I I ~ ;z: "."''''0:'' A "'~ '"'' Mroo" I 'HON' NO 0 "."",WOWN" v,,, '"'' M'DO" I 'H~' NO, t- '~ '00""""0","," 'Z. 0""""0,,,"," !lJ E rz N~f /I AODilfS,S Of '~ANCf CO, OIlAGENI / ./ R .AMI & A IN"U AN.... ......... A N ~ . llome"...)h"./rA P'/Jd:, Z;;:"JS<!,vjl V I I QC" .......... t I~ I N I ~.~ ...~~'::.' I ~~~~'ZO, 15 lPAM~fT:~fA I "",~~!i'g&11 CHAIlG{ CHARGE I H ::;:!:,'ri~1oi ~""'J\AGfp AREA . ~ f" / 1~:=JO.jj"O~~ ESI, DAMAGE IE..~~~[~N D"EMAINEO . 0 ~:'~~N DRfMAINEP II(s~l;;:~~ I'ltJo:~_~o~~ ~ Ll s/5()O ID'l~V;;f'PB,( D~~~~8v . 6 .t. ~ lDlIAtGR]A~.9~ C9I:-lf'IO~N IUSEl50.}l;;ck~~IL, No~~~tUbWtH DES~CRI':~F COLLISION (lJSESUPPlEMENT"'1 !oHf{Tlf NECf:;SARVI 1 -, <'~Vft,,1 cf?-'''r- "-j--t -/::1:- 1-@-4= o-xYeb'~L~= 4/A,5c;;;-::!,&:v7~::c~__ ,ft " - --J-/-11- ,-r- r. --r---'-C~-z:4)3.~~-___-'?6_____,,___~ ,~ .: + IJ ~-r:--%z Kl!.'--oY__/..t::c::z:;1__ __ , -tt+--' -++-t-+-j--j--1 LL -I-r-I,g; .~$7:L.-r""-~_81:L/Y--~_t2~__-/F;ft.#J~-<t:>.<;==--_ -"- -tf- --~TI+'- i.L}::?Ir-'-p;;: A./~~_-{&"',,~ cek/__-"2""C._.___~ ~" Irf-+-H-.i-t-I--i-+~r j-,' - I -~~~~~~2f;>k.~~~~&~~~~:-=:'=~ "I 1 T1i~j-!!.~i:t:g,1t!;:j31tt:;:;o --:- -- . ~~,-:,,_:~ ;-~~-:,~~; ~-h( / OCCUPANTS / WITNESSES ~'3': l~~~}~~~~:~I..~m ID~l-'-;Gf- '.TU;P";j"J"I~~,r-' ~'ti~~I.i[-s,;.I.iJrcy ~~~r; fLJ IN":",',,, -- . - -..-. .- 'Ok' '-._.._.__.,-~",_.. --. f1o,:~,:,.,fO' - _ -1"'C'.~"'Numr",wu. M I I " I ..rl'M II. AMB 0 tWO 0 ""~ ~ o~:r 0 :~~~..,. ~::::""- - -. -'-"---'~~~"o, '_..__...~~'I~"D"O.MI, OI;,~~"O;g;,,:o~t~ 0",.." r( ~~f ~'I I I II "/'I~"n' - -. .~-- ...-.-, ~Llt~ho' .----.-- ~!r~f/J~ UMOAYB O~~~" O~'" D~t:r D;:'~~.." . l!fj"'(~IIC."~.:J"":~IP!o ~'~Jl4I..~., lJl~O'.f OIlTC.I'~C~ U'", '''' 1"oIlCl ol!o~,,)S"lPU~ICf "'"""VJ'~O'.,lt 0' "fPOIII "''lJ,&)''''' Y DAH X' ,.,- _'/Y -"""_ ",,1;0 ""cs" "",1",\ /':>1''1' /:.:kJ/ ~ I 'c: ,e.::, - G,f .J(.. V Nl./ '.OOl<tlS '.ooI1IlS -/..s" :, :CJl , 'C ~, ' . _ " ':!! . " ,'''' ",", " ,','" ,,,'" , '- " \- ~~ f~, f' !" r ,~~, t 1~ r " , l .r .. I',' f I, Ii ;\' I; , , "':" ':,::,: .,' ':, '.' C " "':"'."':>" '," :" ','. .',' ""',, ',: "', ',", ,',. .".,..'" " " ...' , ,,"', '. "'".' , ' , ...:' ,', :,' :" .. ,,", .,';," '"',,,' ' , ,';' ',,' ": , " ,,", "" " '.,':' ,'.' "" " "': " ' r" , " .,'..' ,"" ".'.,' '." ;- " " , , ' ", '~... : " ' ' ,'.. " " ,'", ",",,' ,', <.,' " ' ,,' ,. ,,:,i , ' :,." """..:', ,,,.", " ., . , , " .,', ..; ". , - " ",' " , ,,',' , ' ,',', I .. .. : ..... .....:--. .'. '.., . ..: . " ..' . ';c, , , ", ,';' ~~~ , " I@i:HW.19}- URBAN ILl U'''' I stClIDN COVNT'tj" CITY NO. lCT't.r:i'I" OX1'9j;:;"O ....,ox I'a 1"""001' (), 75 RAMP rIAGI/% '.....11 iNti} I"'~~c'" I~Nrfl/~~~I~.S1Rftl.~RrlOAD~ RfHR[NCf I') I ClS ICII~/E~ll.~, _ SPECIAl. COPING USE zr o VEHIOE U<I' ~ o PfDALCVCLlST .1_'j M'uu" d I'"ON' NO 7!. DAIf Of 81JHM -.::; ~ I ,.. I" .. m, r"OH' ,..oH' L o PEDESTRIAN flj;!::" SIA f lIPC"O( I ...If I Sf" . ...o101lC.CU ~""I1. '7'" ~' , '.. ...' " ,.:: 'I~ ,..,'.,...<":.. '. '.,', :','" ", , , ' '" 'I, : ' .','" ", ' "\., ",:.,"', ;': ..... '.' . .', ....:..',.' .... " ' ...," ':'. '. '".", :: .......... .. ...... .... . --.---.,. . . .' ...e ....:: . . .., ':. .......... .... ....... <: ....< . , '".'1 ': ",' .:. , .,', ,,:' " ',' .' '., . :<. , , , : ,,,,,, f ~\~~' ':.'" ~\ ~. t' t \~-;' '~, ~ I " , ).,' t } \ ;;" ":0 ~ l " ~ I j > 'i' 'J: I , f ~ ,. \ ~,' '. > -' . " .....,'......' " , .. .. , ' ',',,', . ",: ; " ~ ;' ~~[ 0 C~~l" ~~ 0 ~r.:.'..~. APP'~~, /~ 1;; 'f? " ,:,," ,,: .' "",: '.' ,,' ':"",,', ",,:.:' .',',,: '. '. ", ':,:'" " " ''''.-\'", ":: ',"','. , ,,'" . ,.i, , " ',,'- ." :', ,"',.',' .:.',' "",' ',,' , ' ,'-, ," ,:. ..:,,:':' , " ."" - .,' ", ,,', . .' .' "i' ", , ,:-" "",', " ,',', '.,',"', .", , . ,,': : :,',:' ,,' '.' ":-:-'. , " '<,.: ::: '.',,"/' : ':", "~:',,' , ,,' ,," ,,' ,: .:. '.,' :", ': , , W~I~lllf'l,1.101 0," rr ~Ij} STATE OF WASHINGTON PAGE I Of 1 '00 TRAFFICWAY o PRIVATE WAY 0,1,11 0' O~Ll":~ i u"', vt l;;OLL'~lur _ I TIM! IICOiJNTY [ f'l.-fu. XK ~.,~ '"",)('~" "':~' 'OA'.?l,""U ::rd~,J. ON DE DIN CITV011 IOWN _, 1_ ~l"NO ~STIl:[10.l1rl~HW"'Y "1M"" Mi, ow-YlO' O#t.01A&'lA'bN ~ VAL IN1[Il!.lC1INGWITH STllHTOIlQOAO II'IONINTlI1!.lCTlON /.... ~ _A'l.l!l.~ ~ A. IB[TWt:(~...r"..Af"~.. t 2. O'SlANCl.. ~17!_1,~ . H10:M I1Hlll[N~l. CllOSSSUlt!T 011 MAillS' M"l POST ACCIDlNT . 5 R~'::' ~ F, !-, ;; 0' tJAi:: ~...&,AA M~'6~E COLU~~~::~Ol\f[O"..., ;i~~:i;D_NO INJUIlEO_ 0 ~~\"'Gl 0 ;:~[~UN H.J'::~O~"!O ~VIMIC'I!I III Y.J PIIOPlIIT'fD........-.GfONL'f 0 Ilf!lUIYfO OVfMIClI - B OlIJ(Cl!1TIIUCl(INIoHoIOfoe~T~OWNIIl'$NAMII 1, ~ UNIT NO. I UNIT NO.2 ~ DII'VI~'$ij}; LL;TA-,t,/fC' t:\:~l ^.I 1-1. M'OUL[ DlIl'o'llI'$NAMI rc- $11I1UAOOlIlS::;,A 7,,)ttLl-l~ ~. $Tllll1ADOIlI$$ ~ CIlY J") ST...n llPjf~ : Ii. PHONE NO _ .....A. ~ IT IT. .,.-,.v.l1!l~4 -uM- .ll~' (j .3.ir="Z'f'1 ~ L DIl'VIIl'$IIC.N!.(. NO I $IATl I. U .='....H~f IIIIH I i'I,vt l'CfN$[NO I A" I $lYI D"'lOfBIII M ~ c.. -&//t LtI'<"II iirtlll-JtJl?. 1 '>>1 '2.- it :j.'z. v 1/ I NO ~, " ..;: .z ~~J~;c:tfiH:;"'M ~~~rg~ ~ OCCU'AnoN I"'MN""'. 'MON' NO / "" I""~' '''0'' _ o CHECK (I") I VlHIC~'.$ :-~~'8~ S,C'i::~"'fll'''''l 0 CHECK (I"') I VfMIC~f....S....N EM~O"'f1 m:rmHfll'....L '~7 ~COOES'" + 13 ~i~~~' f 1 A :w:::....HLJ 5 lJICllOO< 6 ~:?IOC.tll.- CODES ~ + 3 ti~~~. A mt,;:,'.., / 5 IJlCIIO.. . 16 ~~?IIO;.CII 10":'; Z Au,,= ON ~~g oue t.I?CJCE~:" ,6- ... 0 ......"I....CI 0 ~~CI 0 ~gPll. 0 ~:~I~:l 'Iii!'l ;'8'..!or m'::?t"w.o", 0 _auI....ct O. ..~(I 0 ~8~,1I 0 :~,~;: r ;'.~'..!>/' F,:' ~ """70';2;'" I MOO')e'~/"}r' "';ti,.7w" E"" I-"ooo<>"c"'/, ""'''"OA'',NQ'', I",u"f',e~" ;;;. e. me ta) ""ZY 1;6~".'~ ""':::::'0 \'"'' ~ "" "><0' I" '7 ,ill' I'" ~ ~ An r::::i ['g T"" "':;;;'''/2-'' 1 0 ~ q .t 1I. t!. I l) I "1 l """"'''N''''''''ON7 ~ ~ IIIG'S IIfOO_1 . LAS' flllSI M'OOil I'MONtNO 0 IItG'~IlIl[OOWNWN711 lA!ol flll$T Mloon E p C ~~ 2. AD'''''''' OWN" ~ -"'7N" ~ R '/ IN U AN AGEN 6 ? 7 No. ~ ~ 0 c, ~ '~A .I~~:~ $tCllV" POLICE TRAFFIC COLLISION REPORT !f'OLlCf COM~INI N~,!,,~II.;::,' COVNl~ NO f..t:, CITY NO. . " '.' '1i<"} ':"M.31'~:'~19#5';;'" PII(fI)( fQ rLtP<X>;,.,. Bo RA,MP . rlAGIlAM p,t.,TA IN I;'~ IIX.IID 1:.m/l!.l<;IINGSnlttlOIlIl'".JAD~RlfflUNCf 1)\ I CL$ 1'1l~~~(~II;o .sPfCl I COOING t.6l o VEHICLE o PEDESTRIAN o PEDAlCYCLlST J "''' " ""~. / ~ SAil . ,~ y r.:::- NAMl" ....DDII~ KUIl....NCf CO OIl AGtNT '-- O.&.MACID NiE. I rl.::!l~::':c.'1 1,:!~Al10N S.55/Z&:J/ ) Vr :'o,.~., 1'R~:f:'g:t.,' C..UG( C.....IIG( Ia. I\i:lrTi"" ~ (S10.........Gf 10 ~~~yN OIlIMAINEO 0 ~:'~lyN DIlEM....'NED "0'" s~,...^_...!1;:, 1~w,:-f8v ~ ~Ut... D~~~ev ' r=: O'AGRAMOF c::::__ V~~:~:I NO~ OESC.~~~;~~_ ~=';;"~= ....... ~ -~ - . ====-. I/,+~;&~ .",v t2.tL~.. 7?1 ~h--. ^" = E- - - - - - 7---::~~~ ~~Z~~~B _ ~ ......, ~ IDnJ ~,(U'?T2-1h .. .. '...--b1 E' :::: : -:'~~ ------~' ,... . -.. , - p . , '.J" - -- ~, I~ I>?"a-~ :RJiF"dA.vAn?<?~ ,wn::zJ __;,uA-?Z7,;''''''l' 1. H"';- ..~ 's'/'&~",(/~?'7~;f;n:?~#/~j!-'~II. /~"~?::J~~b,. r.-i-. .. - -..:.. ;_J ...-: ... 7f ~'lU1.?'?!. t!s~ tF." S( r-1/,f!I?J'7<$i!:) 1.9"!i',f''''..ot~ NAME, ADDRESS & INJURIES OF PERSONS INVOLVED + CODES 1 I - r 2 13 I. S 6 P OCCUPANTS I WITNESSES ~UJ: ~~~~~~~~;~L.~~:~ .s(I-1 "GI ,...'usl,....II'Ol I"v",~ I t"I~j~~ IIIUTR fJ'C~ ~~c~.. N..o,lt ~~ ~ I I .pollm "''''T~~t O. ;:,l~f'~~' 0 Al,\e, 0 N~(' 0 "";". 0 ~~ 0 Wi'..!>/' r::- :::;,~~ - ~~;I~O' ~~\lJ~"/o"" O".y.f1 D~~('I DHg~",. O:~ D~.~'~~. 1101 C"-I NON I I .OOIlI~S ~~1'i~lso' S}.~\lII'" X ,..\I[~"GA"...c,O"ICIIl ~N."-"I.Il..... !tlIl.OGIO' I'.....E"'C' I UN';' 9j. -rOl'CtO'l.P,t.':'M(tJl POI'CI ...1I1I"/tO " " J "~O """J~""I ''',,,,;; I d.7/.~ I t:rZ1,s 'ii..'-- . ,.....'...... . m. ~-::, . ...., , if?' ...}.<.../.'.....,... ? i!;j/:.!!(i< ,:.i" ,.i< ... i.C: >c..,iX'.......".i].', i.' ""i" ." ",., '.'ii.,.;;ii' i./,i.,.. 2 </)'.'i . · ::, i'-.i': !ii' .,.i...'...... ...,....,..,........ ,.'.'...'...'...,.. 'L'T,i ,.'... ',...,..... ...,......'... 'i., . ii' . i ~"""',.Ir,G()O.&.llEA" ~ LV ",O'-:-:-],-=- 11~ H)'.ci"o~~ =::i 'I',"~ , .i' .. , ' . .',', ': ~ ~ J , II f' ..' :i, "~ 'I) i: ;~, ,t t, f ., ~ r f t f :J'lo' ~. ~ Ie ,. I ~ } ',...'., :;,' '. '.":,' . . ,,'" , ,: .:. ,..',',", ',' ,', No. ,.' ,," : : "," .' .. '~5Pl~9<(~fY 1.&0) ::";:;'.!'\ '.',,',':, ~ , :" :,,', :, , ' '" @r STATE OF WASHINGTON '"01 \ 0'1 1'71 ~ POLICE TRAFFIC COLLISION REPORT ~RA'''CWAY I I 0 'R'VATE WAY OA'tOICOUI!~;..il, ,,-..~....u.~,y~'.~~~qLl!>IVN - ,. t~1I !IMf IICOUNTY IT IL:fti'lQ)I'.!''"''!;''r~''iX';;'II'UI~~c;' II ~. E'F'ffi'so.1 , ...-'II 0('>1 J25..l DIN A"\ CITYOIiIOWN 1 ~[&NO OfSIIiUIOIiHI(iHWAY K;TC1J,.I~ ~ I MmO' OW 6l:.0, LJ().lrp.>J:> ION (0"<""" (",;1 __ IN1UI::' CliNG WIIH, ::'IIUII Oli !lOAO 'INeN IMlli~CTION l,nW"N 0<\60 IS P.o. "'''' ;n', , ^ 'I 01::' ANCI '~~I~~ fliOM WEfHl1NCf, CIlO::'::'::'TIiUI O~ NlAI/E::.r Mill ~O::'T VJ ~.c::~~~::' ~ 0 ~;; OF ~G 1',0. COLLI~IONINYOLYEO [\lll/IIY.=. ~~, l~ D U l ~O~:~1~35 []J 2.KFI~~~=~~E~~:[O- 0 ~~~~~:~ I.q oatyo~erAMEP:j~'~UC~ANp:;(~1 PDr_ )eA UNIT NO. I F- o~l\IInN~Rp..;:t.~,~ ~\J~I\T ~ ''''''AOTytjg l-tAut PI RO ~ "" CJl), I fA.,p "CVA <;\"*3% 17'i6-312'l ~ '" E O~IYEIi'^C!_r~NO I ~TA1f I'" I"~~."~~ FIiI",IH I l\lll'-;:,llCIN::.f,NO lKA,JC\''' I I "'uRL.. ~ h 11'2-1 t3 G7 V ~ occu,::,::,- FI~M NAM[ & PHONl NO. _ I ~?;t.IG;1 ~ OCCUPATION filiM NAMI & PHONE NO / '-- 0 CHECK lV') It ~';}I't~;~~ 'Z~~~,rg~f1 ~(,;:r~B:~i.i'AL 0 CHECK (v) I VfHIC~1 AS-AN WFl'gYf( ~"Aiif}i~IIiIAl ~J CODES'" I: I~O"~~ 4 ~m~:;'" Lf I 5 IJIC11~ b ~B:~.~''.:,L.... CODES'" + 3 ::~~I{~' 4 ~~~~:~NI A 5 UleTlON ~ l"o.IU"~'" 'N~~~~NJt / o ....../lu,""CI 0 ~~<:t 0 ~~I.tl~ R ~:::,~:: 0 1".8.\...!>I' ~l':?t~~"o'" 0 o"MIlUL""'CI 0 ~~V 0 Eg~lI~ 0 ~j:."~:: 0 \'l.~~? , ~ .IMAfl;~D'CHE\I'1 MODSTwNO\lA) ISTW~..'hY~ E \lHYlA" l"",,",qlJV""-'E."Ht\l.I./tWJOH1DA~T.NO\lAI I:>'YI.&( O~,.............v.l I~r- ~ '~\~O:..,. '''N';~ '~I"^,,"~ r"~ ~ ""00<0' I" N "7 I AI"" ^', ~ r;-r-\I i[H'C~ItN!I'ICATIONNO, I ....L. I I I..... l YfHIClllD!Nllfl All NNI./, / ~ "~ It"iRI6d)i'1:<PI.:slb'~lbl I 1'1:,;)111(, I: I I V I I I 1 1 1 I I I I I n E ~f(iI::'TEIiIOOWNI~A~ ~f!Ii::"DlI:I'"t^MIOOLE 17G:,S"212C' ~ Ii(Glsnl![OOWN[~. /AST fill::" MIODlE H NlNO ~ ~ AOO",""OWNS-A"",,-.as ffit)"f"l ~ A O''''''OW7 FtJ . ~ NA.Ml&ADO~fi\OfIN~UIiANCICO OIlAGENl R NAMl&ADl)'rl>OtIN~U~AN fCO,OIlAt:>tN r3il ~ t"-efV\1 ,., / 1--; . L- OAMACfhA/lEA 1~~':';7:.."G I I~A I I D'DI~"&l''''Q ~A.M~(i(,OI~EA. f--:;:; I!> 2 ) . .H6~~f;'~~: ICHA~GE CH"~c,;t I R ~~CTION" 12 t-: (3.~';':';o~'I~r;;zbl~f~?$" ~~~ d:"ww,.~" m:';~~N O.EM^,NfO ;'~';:::~; '~.~,;.:';o~.~ t:: DIAGRAM OF COlLlSIMN' (u!.t ~UPPlfMtNlAl _~JNDtC.ATl NORTH DESCRIPTlf)N OF COLLISION" IUSE 5UFPLEMfNTAl SHHllf NlCfS::'AIlYI . I ~ . --'-'"TTT":1'J:T]iJ:""'"""":t!j '~ nlel-r~I--.N.l'8'-G--I-o.O-o-lr-----i.:::::: ~ ~j:tp~~t'i~:-fjJ-t~~~J:t'f-f~~I..j=r:::-3tril~;- .t.--:J:l;~')>~~R" W\ojL"~~ ~ I" I I I' , I I, ,'" ~-Y<Op,.DW::t--,_Rvh'-' r.:<_I/I(}':>~" ,A(',("JJ(}"".r~ t= S\p:,t,+-H +; ..\I+++i'++~+-l-I-' -=,\{i;:d,';;,-~L.~,~:=~_~~~~":~=:'_-== p- E:: \6i tI:>' ,i,CD ~,VOS: +-1"++!-++ .'_',,____,,_____''__u_____...._"__"'", ~ L ,-U:tl(. +'W, , '-,!-i, i -'-I .J-L' J-i.....:...": ..,L _.." ' ,__, .. '. ..:~ ",~:::'-'-','.. -:-, .:::,_,_,~~',:'=, :=~:'~::..=-~' __I j fni ~Jl'j'j'l++++l+'H-i i ' f-' NAME, ADDRESS & INJURIES OF PERSONS INVOLVED' OCCUPANTS / WITNESSES V~~ ~g~~i~~~~~A"~n: ~'60Nt :-::l~~(.O' Hut; NO :~ AI~ ~~ r .0' 1',1" NO ~'ATuC'r or It~)UC"1 s A A n l. -z I POllCt COMPlAINT NU!p.bE~ COUN'Yj~ )CllYNO. , : STC'fET ACCIDENT MilEAGE CODE 1l~}~$h/I.{J(';Uut. Y03'J6 PIltflX r'" rILt~' tj, -50 RAMP rIAG~AM DATA , IN iii 11 x.R"'I~N ::sYilI[ R1[ IiIlOAD000RlfEli[NC( 11/r I cu IC~O$y 2.'S3b $PECIAl COOING USt f!+ p o I.m & ~UN ~~'~~~~H~ o ~~E~~j:i JSf~(if UNIT NO.2 o VEHiClE "'" o PEDESTRIAN 0 PEDAlCYCLtST I ~ '''' MI.O" /rg /f ~ ZIP COOl 11'71'00. I_ I TAn l:>ill. YI OAnOf811llH p /1~'lo""IYI ~ Ens IWEICHTIH:IGHI ~ 1M 6 ~u~~~~ .'.1 1,'1 H'DOU Olll\l["/'::'N~[ AooC'r.,~ E'" NO., - A"O~f!.~ ......Ml A(l('I1I!," / "\- / :,CODEs'l ..1 . I ,,:..I',,~,'. 'I',i, '~:~;" 5 I,;'. 8-. sue ":."'f AGr b'ATU511 NO' I 0(\'." (,.!>~ ~(ST~"I'f JfC! I ~.If!~ ~ I ~ u~iVFl;' M 0 AMB o r'l~tI D HlL~, " 0 C~:;' O:1il'..v I ~r,.?rVJ~ '110M 0 AMB o ~~~'l O~~J~"P 0 ~~ D~';,'...~p x Iro:;11~~'~C;~ ~ NAMt~a. IlY4~lwsp ::,' . '. , ,,','" ..' >i',. " :". ".'.. '.',' ......" .... . .'. ", . ", i" " ," :,' .' : ',' " , '" " " " : ",.... .,". .' .... ,..'... ......... '.. '. ," ,C,,', ""if " , ," , ,:"" '., ,', "."". ....,'. " ' ;,'.' '.,' . " '",..'", ',-' ""',' .: , ' '," , , " " , ,c, "",:" ,," ::, ':,," ;' " , , """ ': ..C, ........',..., .'" ; ." . : ", ,"", ;::"": " .". ,...' . \ ".' .' ..... \. , .' . ....'.."....... . .'.< ..... , :",',,",'::',::. , , ' ""':", """ ,,', ", c' ::'..,' :' , "',' ", :' :,,,' ,,"- , , ':...' ',.- , '" .', ':'.' .' , .',' "'. ."" I,<i . . :' '. '.. , , ;" ' , " , , " ,," i t" *~ L f. f' i, ;' ,\ ~ , ,.;' " :,,',' '" ,,' :', '",,'" " ' " 'i' STATE OF WASHINGTON WWI~llffV,l.llO) , , :, ","".' ',F; , ' : , : , " '" ',: , e' , !,;:.} r7 ;'''.'..' D~Rf"c:;!v loo,N,,~;COM, ,""'Nr~". A_~,.., ,~A,_. n"n ? ~ ~PRIVATEWAY -, "',:;'". ~ D~ lOfCO~~,I)ION A'f l'~.I...... 'i~1 IMf I IICOUNTY ,COVNTYNO,fl ICITYNO."., I 'rz~jj;.w .; X ""i"';'~""'T~":" ,/~.;cJ" II :::re.=/.:y6/~a-..J/~ I " a ON 01 DIN Cl')0Il10WN I N........t&NOO/'!lTlUlTOIlHIQMW...., 1....',Clj I......~~I l"IIl~JI~/;$I:;':"'_ .. / ."" ~; Ow );10. r/'/'_~" ,."." ION r ""'-,n-F/Z A ' fA I ','51 I 7 oJ" v ~ INJfll$lCTlNGWlTH: $TllfHOli>oroAO IPIIONINlfRSlCTION Pfi{"... I' IM~~IPO~ " _ / I BUWUN ~lI1UT... STIIHT I [..00" ~~ )J J D'S "'NCl~D~I;:I~l MIl(fl N I.CIlO~~~lIlH';::._N[""IlE~TMlllPO I ACCIDENT AM I"t....GIl...MOA_TA..". f '-Ig-~'::' (; j..{ 0 n 00 830 CG.../7?3:/2. /2D M~'6~' , COtLl~~~:~~O\""!D '~g'}~~~;~_NO INJ'JlllD~ 0 ~lLt."Gl OMIT&IlUN 11f.I"t.'bl,J~~"5 IN'to. I~I~& 1~'ttO$rs~~&~%~IlI!OA.OOIlIllWrlNCl ~J O....lMlcm ([I mPlIOPEIl1TOM\...GEONlT O~llsfUlllD O~~~t~f - lI\. I 'N9o//?'o I I~ OBJECT STIlUCIC IN.......l OF oeJ[CT ~l1lUCl NolD OWNlll'~ NAM[I I E~l DM\"'~...r? ~"tCI"'\ CODING U5E Lf 2",Rsecv ~//2'CF ~C' -+ /?ot&.- IS/t::'c.>= , UNIT NO.1 UNIT NO.2 0 VEHICLE 0 PEDESTRIAN 0 PEDAlCYCLlST/ i ~I '- o,,~;~/ ""T ~/. ",.;;'" ,;::~';242 """'N_'..or ".., ''/ 3 w ::;??;~- C6.J~~ JZD ""A'"'''' / r= L6....CITT ~/ ~l"'T( C1"lIPCODl~NfNO 0 IT ll',"'E ..I.....u.... /I.~'~ - /":/~-hJC(,;14 bJ4 78~ y.5.;2~P'8.5 -R ./ /!. C ?;;;~LE ~o/Po ~;; 1/ ~~:1~I~;o ~ I ~~lI...lN~[NO I 71 ~ I ~~...lD':TBI;~ ~o ro:::;- OCCUP...TION fIIlMNAMt"PMor~ENO ~~GHI~~GHl E OCCUPAIION I FlllMNAMl .. PHONl NO ./ IlTlS IWUGHT KIGHT I~ ..N""~ ,,-..J0..06 '5 -R ./ I ~ 0 CHECK (.....) I VfHIC~f~'S ~~o;.:~rn ~"'i'~6'i~1i'''''" 0 CHECK lr") . V'Hlm...s... P~o"''H o,"'i'~~tlll""l ~ODES ... J ri~~' 14 m~:.'''' '7 5 IJICI,C!N / 6 ~:~.IIt'C\6- CODES.... 3 ~ii~~' .W"m!,;:""'" I 5 IIICI,O'" ~O"....rc; IN ~~:.."''' ./ .. O.........JI.....CI 0 rx~CI 0 ~~;'I. 0 ::::,~:: 0 ;-aT..V t::'~~~IUO'" O",toJl......CI 0 ~<i~CI 0 2g;T(' 0 V1:."'~I: 0 ;'.~'..v NO'<' IT 1976 ~:::J 13~~~""J ~hl~ E MTtA V '~"'" I '-'COHIO",IlT.NOV"', r I v" T02e VI.......7 l~N~~~~ _1~1...11 I flIA.1l11l PI.....ll NO l~lA'1 HI VEMtOlOIl/ ll...."'''...l..'.'''.. I I 1. ....",.Nv. I ".A.. j./hTc? b'd38sl ~ I - - /' h ~~7L'g"~ONl e; 903 i/8.:2 f 17"OIN"" A"~NV", , ~ ~ IlIGI~l1ll(DOWNIIl lAST flll~T MIDDll I PHO.....E NO 1l....I$n'hDO~)" WI flll$T MIDDLf L..::::'~NV" ~ - ~~e; 1~/;",,6 0 S~~J --1;~ ./"'~~';::$.; , ~ .OO""000-:'S:..r'~6 F .v?;;;~rNfi?3 .' C /~~"'?C''-'-r ~ ~ N"^"'(.....DDlll~$Qf IN$UIlA"'ClCC: ~(NT ~ _ ~ __ . U ...N........... ...."IN ~ ~ ~ <5U;'2!; ..v/P#'.4 - /--6.$/ 'A'.!:.~ R ______ ____ LJ L- DAMAGtDAIl[.... L0'o~A:t.'.."c;'" I~""''''''' ~~.......AZtO'A.vEA b1 rrr ?-r .\op~. rR~~:'g:t.,' CHAR~ (MARGE 0'--- .\O",~, P 1- Y'::-JiO.O."O~5 ~...;j~i~~IlV 2---Z:/~o-,J I~T WAT OIlIMAINID S 10.0"O~5Sl ~ DIAGRAM OF COLLISION: ~hS~'~~~ti~il NDe;"'lUb~I'" DESCRI~ON OF COLLISION: IUSE ,S(WPl.fMfNT....l Slo4fET IF NfClW,'.....' _ '"_' _ ~ ?4S/Z;/~G .,. ~ -P/~"'G'h' p!/ /.#3 N""A?p,..... q.-.J C6-J/~~=iii r, 83":_" ~ d.....v ~_~..~>. ~o ~~~ =.I r-=- /-6""-'P 41-,"CS@VC6-'.,,:e-- YsP,c4'c.... ~c~~ .L?c-"""~, ~"'~/ E? ::111 p.-'c.-/Z /~6' -: ,.y......4/ /2;i <'-'."., #"e;;/C'. _ = -"h'...l""'~ ::;/ '. ~'.....J ~"';./~,$~:-;-':D. ~Z "~-::::"::Jil <:::! ~ a_.I7-/......"'.<"ey<:,/7,.....6-....-9"G'#,- 74"c7,,--' ..' ..., , '~~;j /~r-~,.rh"'e:-A/~'~.-'~~~,;:/. ~ -=- ~~ /~~ =/~w"'-'&"', .?"".#?'/j.~c=- . : I: ~T~...t!/G <.of' I, ..B'.R'..?::~ "l",;h _~E"...-)C.?'" C\, -='7h/~"""&" =:J ' 'I , I ' ..c,/ c"0",~...--l r"'-~ '';' ,.... NAME, ADDRESS & INJURIES OF PERSONS INVOlVED + CODES I 1 I - I 2 I 3 I . I 5 6 - OCCUPANTS I WITNESSES ~~ ~ti~~~~.::l'~IA~W - If I I "'Of kl.uusl ,....,;",.., u"',: "lJ .I.mg IIJf" ...~C~. I~' I ~""l1.~I~Of ,... By " .. NO i"....T~~f~OI 1~~\lJ~'1l0M 0"'''''' D~~" D"~~T(' D~:: O;-'~'..." ~I ~L~hO' .", 0 A""R 0 ~~CI 0 ~~~.,,...[ ~r~ 0 I;o.':.~,. I IIl...g~oO~.I""I"'Cy ~~I~ ~;1 r~se-J~"!OII ~1;.::~':~~.d:p;~~'T/ I .~ I:~ pP l,:fsVl"t.J..$T~ 1'5.J 1""'1.00HIIS I 201OOHRS I~;..c;. b-Oer/H~ /~ y~ ~(/ POLICE TRAFFIC COLLISION REPORT ~":'" = , DURBAN - 'OA' ~ClI~.., " , :J . "'COIt'Cll SAlt'" :..- ,;27 E r:::=> F- "'ODIII$$ EN.., Xl "'Dtlll", .~, "'OOlilIU X 1;g';'7if~;;~~ OAMI O~~CI D~:':~.O:;:." O~i.v , ,'I, ,,' ) .........,,: ' " . '. . ...... ...... , ",' " . " ... .. -,,", '. ',',,', ", : . .. , ... . >' ,'. '., .'" . . ........ .......:,. '",'" ", ',' " "" :'" ' r ,; " , : v, ,," II':,' ',I"~"~ "" . -'.:.:< ," ','..,; :", ' ,,: , ":",,.' . ' ...........' ....... '1.'" .," '''_' '. '" ,", , ,'" "i' '.>,.. "" ,',', ',,' '.' "',' ':',: ", ,:--' ,"'" :.:": . .' .1:.:.. : , :, . " " ",', .. '" ':'" " ':, ", :,,' " , :,,:': " , ":. '<', " ' " ,: ." ". .:.' .;.. .'. ........; . .,''',' , ,Ii." ".','" , ~. f' j, i' ~1~ ''':'' ~' ~ ~. '. i. t f' l\ ~; ':'. . ""''''''" ., . , :"; ,". , , ""'.:'.' . ',<,:,', . '.' / , ..... >.' , 'III '" ,,' " " ' '. .... ,'", " ',' :'. '..', .' . .......... .: ", ':', 8"'"'''.''' ~. .r ;., r:::; "'" "" ./ 1'.:5 0: WS$'I509(llfV.I.80) STATE OF WASHINGTON PAGE 1 Of \ gTRAFFICWAV o PRIVATE WAY ::t~~~~lt~$I~I~~ "'O~,OI~~.~:~O~~I'~ ~,;,. i~1I (U$_E~~OUIlI lICOUNrl'~ __ " \ IL.! ,-'+ ..Ill' ~,. ,1\11 It.., ~C II '..J'-I-r-c.-'",O,\j ..- ON D_t D'N CITYOIlIQWN I NAMf&NQ Of$TIlIEIOIlHICl-lWAY l., M"" 0' 12l'lI~' QU,L(CNe. ION I,,^,,,,, t...I<.. ilD INlU/5l:C1ING WITH $IIlUT all ~AC NON INlUl'SECfION ~ """EN $l1lcl , \ OIS~A~Cf & ~E~tION FI.'OM litrE ENCE. CIlOS!! SHIEH all NEAREST MIl.E FaST '-1 H"~~:S ;:, A ;, ;9. OF ~loJ COU1~~I::%~Ol\lEO' ~~~~~r;O~NO INJUIHOA 0 ~~~L;AC.E O'VEHICLES g] ~'PIlOPf.IlT'l'OAMAGEONlY 0 ~rlUlTfD 4 q OBJEctSfllUCK (NAME~ $TIlUCK ANDOWN(1l S NAMEI No. 4 4 ? I .of ~ POLICE TRAFFIC COLLISION REPORT POLICE COMPlAINT NUMIl(1l li":W' ~ 1l1lAN ~ RURAl. 1 "',e,ON CQlJNry NP rCtry NO. I~) fCTCI.S I~O~o.:'1 PIIVll IIIOU~tQ';.STlII:nCO(l( !:; ;;J) I lJ'v<."'..s Q PlltFU( It IMILEP05T~ 00 RAMP rl"'CIIAM o...TA INTtR 1.":'9!, 11(-110 I'Nl~jl~;~~_S Rt TOIlIlO...oOII illfUII:NCf I'NTU I Cl$ CR~Tc;R;;~ t'o/ SPlCI"l. COOING USE I ""'" .3 UNIT NO. 1 srllfEl& ~,...:N'\J G\~5TRm J ACCIDENT MllfAGf CODE I .",,'" o ~If & IIUN HU"'D~IDh.S o ~W~li~~ - 1 ESf. OAMAOE $ - UNIT NO. 2 o PEDALCYCLIST ~ -~ .=r :T ;:r --! T'll - ~ o VEHIOe ~" o PEDESTRIAN fIR~, S9 OIlI.,.ER'SNAME Se;Sla" L e~'!>T;..... '!>fIlHIAOONESS I r-:i'" e," U"'~ C'\M, nA'EPA AI ~ 1"';>0 ~n-w.. j,~ <7~~";'i I P"O~ ~ e,,, I~ OIlIVEIlSLlCEN::.ENO STATt I'!>U - OAfH>fllit.rfi-i I IVEIl'n'CEN5E NO ~ I S'>I,Y)J""OO'+c- W -J "" 7'1~' ie-'j v ~ OCCUPATION I FIIIMNAMI & PHONE NO E:15 'NEtCI1TIHE;C~~ E OCCUP....IION K I~.k, k.........l. uS Nr-o,\JV Hl ''-w')j<;'-j R _ L...- 0 CHECK (,I) I ~r~,~~t'i~'Z~,e~~~~C~~5i~WAL 0 CHECK fA' 1'~~Fc:~:~~'Z~~t'S~:t~~~~~~i'AL ~ CODES" + I J ~i~~~' 1 .. mw:t.1 '-f 5 IJIC"ON. 16 ~:~vllC'w. CODES ~ 3 ~i":'~~' .. ~~rl;:t'l 5 l.lC"ON 6 ~B:~lICvc<l ~ ~J\J~'...z. 'N':~' o ""'SU(""'CI 0 ~~C1 0 ~H~IIII 8J... ~~~,~:~ 0 ;-'8.''''~P ~~~,..o... 0 ......Wl.."'CI 0 ~~~('l 0 ~m'lIl1 0 :~~,~:( 0 ;-"~~$P ~ ,q~c- ~~~oo;OHE~.1 I m)OF~D;t)NO"'A) '!>TYlJlJ'CON~.) E vT9A~ I1MC*~:EV) INCOIp;jNOVA' 1~1;~I~"~~VI ~ ~ 'Ri:t 1LP'c;Jb n:JA I'''''''~'= IS~ 7 :;:~';J ['~'iDrJ IS~ I"''''''::~J L:'" ~ r;;;;;;;;;' VEHICLEIOENTI',CATIONM) r Vf!1ICLfIOINIlfICATIONN y , ~ 1'-< Ii i p,~G:1 PI , 4: brl7 ~F' lA-I 11'(15'r-18 ,0(,1 ----' ,.,[xJ.><-i.A-l.N~xJxJx.I.xI.>c.'~.>oob-<.~ ~ IIfGI'!>IfIlES;~ V-ST ~ fIIlSTCR'V""MIOOLE rHO:::- 0 RlclsnIlEOM~'~~AST M~~,J';:E I~~~~ ~ lr-.. AOORE'!>SOfOWNfll... W AOORESSOfOWNEIl l..y)1 I i.j'1 !::;) S'A,vt.<.. t% (:l:: Iv"" ~ '3" a T(.l L.L R'~ t..,v <J"'; R... I$J',.) f-W PF NAME & AOOIIESSOf IN5UIIANCfCO_ OIIAGENT IN U ANCECO,OI!A~~N ["'(Jr. lJ2 S7ol>"'-'::' ~""\ 1:)~Mw;V W..... R A~\')<,j\liA I )'0'lH-l' 1 ," OAM~~b'AAfA 1I!i1 A I N I n'~'!.::''''G OAM...c~b'All~ ~ 1$ 2 '\0". CHARCiE CHAliCE I ~~~~m~~ 2 m~..... [_.!:II V1!l1---r _...._~, . ~~~YN OllfMAlNEO DRIVfN DIIEMA1NEO Imo'"""'ill,V[u___~:k~ ~(i080"0~ S l~~OflY: Ga~I;...,,--~j O~~V:~eY' ",WAY s~",,~l ~o.O"~I-::: ,~J?"r2(!..~M_9:fSOllF~C?N: __. ,J~t~J'_?(~~~~~NO~~~Illl"b~TH ~rCRI!".T~~o~~g.U?I~,~,: _~~ES~~~t~.f~!"'l~~~~NE,C~~II_~_ ___'__. ~ I- -I~,~,I, r.;:,.-Q I. TL~-"-'-I-I-!-,~,~- _\,eij.,:_L."/:?Ra.>L<:i0 S.". K_~ _...llQ/{_,.. 2--0:;-- p~ l!!::' ..'ti--i"-++"i-t-~~'1"t-I'-ST~ . B\.> "f- ="A'ZE~tfLI~,,,: (1'p.._~uA,nVe~wB"'s:,,~ .._,j:"I'L'I.c,\b" f- L \7e!4~-~" If-''C- .. .1..-s:~IO_'~- t:J ji~~7'lt~i~~-t::--t'f= ~~. -:~ =((rv~~o~~ icAOW_^i~~':Vfe7;~~?::_ _~~,%ItfJ;~~ h;i) f' _l".~_~e...+ ,~r-.j-t'fTL" '''', ..T--"~l\J~~..,I\"j;;;e1,;8f1v~<Jf"},V~f'Lff,!-",CO,~~~f-W "C .F4 " Pr rTf"''''+--I-r"I." ..." --, ,_c ~__C V "l\:)" ~rr:,..oJ__,J1J~,_,.....,._,,_._, , " ,', " " ,f3i>.,l~.:-, .e~,'!._2..." """o\-S.".tJ..tJ-OLUJfl~O.._,__. -,w:r~..;L~",ROrHi f'H f"/'+"I++-I'- .... ..--."'...,,-..."..... . "..-.-.,''......,.-, ~ r NAME, ADDRESS & INJURIE~uca~J;~~9~~H~~VOLVEO ~.~C:)O~S" I_~ 1_ 1 - 1_ 2 .1.3 " _~. ...5. 1 6 W r-- OCCUPANTS I WITNESSES fOll.AOOITIONAl NAMESl s,tf ACf' ~TATU~I '~~"I~~,~'I ~,''':,l~~ IItslll EJ[cll\~~~~v NAM' ;)fl'Jf'-f . 1...,: ,.s....J r'",j'r~ -pc,,<;:, - IL't'1 ,;;l, ~ 1 I 'of I "O('lPf!lS ";-7 'r ~.Q.)'iDA._~'-_.~~~ ~T~~.l.JF~J"~ 5fMVIlY MOAMI! Or,:~(IO~h~.It~":t 0:<'1:"~. t NAM' (V\ I<tl. i..J' W' I I ' ~.. ~"Fl ~ N\ 1 C::) 021 I 2. , - 10 "oolli~s --;i'-d: 'c;: .~~.~q_. &~~,.,(,\,..uj ~!~~!.~'~ ~~r~V~~HIUMO''''''8 O~WCIO"II' o~gy 0..01 _~ "'AM[ _ ,_ ._._ ~-r _ "'_. NO'" _,. .:AW I COPl,. ",.. 'U'l~. I ADDIt'S' itfjL'4~lso' 'i~r~f"-~y ItUM 0 AM8 0 r,:~,.1 0 ~:;~"" 0 ~~ 0 ~n'...". llf~~AC.I~~Vj ":"',~'Il:" ,~r.rm,"H;'1:!ti,!:lc'PArf'LPf~,~J APPIIOvlOflY OAlf X I ~.....,rr'~n. ~L '; ....~.'," 'Y0 I,,,,,",, I ""'"" 1/2f<!'f'li'K19't:.:'i .~i"., ~~ 0( '..., ,.V',"", . .'. '. ", ')" ". . '......:,.),{.<,./., ;",'." 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" ,.' , .,"........,.. ~ ," >.:, .,:' . , ".." '. , '. ,,' WSP'-Wtllh'I.801 ~ 51 ATE OF W ASHING10N MOl \ O' t ~ ~ POLICE TRAFFIC COLLISION REPORT 0" TRAFfiCWAY If 0 PR'VATE WAY II ~tt~~j~~4 w~ ;;o~ri~,tF~~r~'~~i':1~11IU\\2~~Ulll Ir3if1:t~'(),..) , ON Of DIN CIty 011 TOWN I NAME&NOO~STIlH10IlHIGHW.AV ~.I Mm ii, Ow filo. C\...':'MN.NM ION~~<t.UA-<IL.,(l.d INTEIlSECTING WITH STIlEET OIlIlOAO INON INTtllSECHON \ lenWHN Ce.(\16:e- ~ STllut & x."'c.. 4I STIlEff 3) DISTANCE & O~CTI9~ fllOM IlHEIIENCE.CIIO~~ STIlEfT 011 MAIIESl MaE POST I ACCIDENT ~CO ~~I~~S 0 ~ ~ (] Of H.p 26"'7 Mg6~rE COUI~~~:~~I"EO ~:;:~~~~;b_NO INJUlltO_ 0 ~VlAGt OH1T&IlUN I H.J~L~~t..~ OIVEHICUS rn '!K'PIlOPlllnDAMAGEON1Y 0 IltSULTED O~Tt~lt~E ~'1 O&JECTSHlllCIC.INAMEOf06JECTSHIUCIC.ANOO.....NEIlSNAMlJ 15 EST,OAMACE UNIT NO, 1 UNIT NO.2 No, n I " ~ POllCt COMPlAlIH NUM&", v - ... -., ~ FHWA I~~~:= COUNTY j'~1ClTY NO. ""'t1-;;\ l'OO9;?:5b I ~C" Ml:UlX-lfQ IMILt:PO$2. 7~ IlAMP rlAGRAM o.-.T" INTEIl I::J?:; 11I..II:D INltIlSlC!I~_STIIHIOIlIlOADOIl:ll:f.ftIltNCl . r~- I ClS CROS93(::_(-~AD SPf.CW,I[OOING l..6t o VEHIQE "''' o PEDESTRIAN MI:>l o PEOAlCYClIST M' , Olllvtll'SNAME =-..- OIlI'''IIlSL;i-W\LA~ e..\~C"\TfIIlS' ::r~St='.I"l~Dll ~'IlEETAODlIlS~ ro;:;- \ "2..\c.. F,lt.. ST. ~ "'t:>+ .Tt;j...>I\SE't'\cl"A~A 9B3'&:8 l~6S:9tBI ~ '" "A" "'COOl L ~L;:C\(~~~~ ZCJ 1 ~S I ~~ I':; L~oi tJDYllii ~ Illvtnll ENStNO I :>lAlt ~x rz ~~':v<i-rPTl';:;:~~ S~f-~L liij~177~6~1 ~ OCCUPAtiON rlllMNAME & PHONE NO L..::. 0 CHECK (,I) I "fHIC~i~~'ZNIMI>~'1j~a~c~~~~~i.IAL 0 CHECK(,tl If~~C~:'iI~'Z~J...p\6~[r~cf~~E~Al ~Z I ~C:D;~ ~. ,~~:~:. . :~\;:~" 4 I ""'''~ 6 t.'l:~.~"" fj!COOES .. + 3 ~~~~~. .. ~~~ll~~"" 5 UICT,O'" 16 ~:?~lOC'C'1 - Nt>J.:J5 ' tb 0 ......6Vl.."''' 0 ~~C.l 0 ~g~TIR 0 ~::',~iI 0 ;"8\",~p RO'" 0 .......llUl.."'CI 0 t~~tl 0 ~!.}~"R 0 :~:.",~:: 0 t'R~'..? FI "7b r~rDC"'"' 1 MQ'~;;yNOV" 1 '''p;.50N;, ~ V,'"" IC"V, 1""01""" NOV', I""'" v, ~m: ~ (2;;;d.:kI;:;m~ 1'l:A I "^'"'MllNO d;'~ ~ VI"CO'O' 1 """".'"NO I SA I" "NO I"" @ !'i'T;::::::; VEMICl lotNTlfIC~T~ONNO, \ l YtHlntl0lNTlflCATIONN =-- !"2'MI14:YiR,BI21t'::181}IP.t I I I I! t I I 1 I I I I I ! I I ' 1 I I C-;~"'j ~ IlfC.L~;~ ~~AIl-1ff~ MIDDlE I PHONE NO 0 III ls,nllEOOWN!1l lAST flllSl MIDDlE H NENO. ---: '2. 'DD":~~ As 'C>t-~ I ~ AOo<I""OWNlR ~ r= N~='''~COf%';;' TOwllSbod, ~ R 'N>U,^NClCOQRAGIN ..:!: ~ TWi..'.............' ,...I,A IUN I ~,.. ...~.. t H I I ___ OAMAGEO A,lllA -"\6~'I"'G' ...... " , . Dls..el''''G ~AMAGEp AlItA . ~ r=' tJ' :TDP;::j. ~':'~fJ'g~: CHAIlGf CHAIlGE ~~f;'~~"i ~~' ~ _ ' u..uu !> t~T DAMAGI 0 ~~':.l.r JJ.lltMAINED DDIl'VEN o RtMAINED If ST. DAMAGE I 4.___._4!>~ ~oeDn~ $~Q-f\~ ~l<3.'X~D(lY, R:\\s GA.#AC..~ D~~~~BY. AWAY S . 1060no... I~.J r= DIAGRAM OF CO. LlISION: "'. ....,IUSfSUP~rl~~lN Al IN~SATf~'!!?~TH DESCRIPTION OF COlliSION: (USE SUPPlfMENTAl. SHffT If NECESSARYl ~l 16 ...--~-., --r 'r' _._-I~'~~Hf.,J\l['1~+r-l~1l0W --K.t.~ --c::-t-6 ,- ~ ---l - -ft--i~,'"Z>:-ic;I;.-:-:1I1k-j-i~~-n TIT .\!i~'x~~&- ~~~~~~--'-~l"-~""'lf_- ~ 'H__ ~_:Rc!___ ___ ..~__ .6._~~l&_-=:J r:::' +H-H-i--l. ._~-f-+-t-I-+".l-=-l-1-+-H+ _f1_S'r'~___'~_\:._,"",,_....1 LS.:<:I..,.~__ ::P1 L::. -;-r-+iT+',r!---n-!- H-H,--t'T1- __~_. - ,_.=::J ~ ~tfrt}f1 j ~=-j:~tLtifjJ::~=- -:-====,~~-=:-:-~===~~:==~~==--_:=:=_::~----,:~,-- ~ , +H'! .1LtE! ~~~R~tt~t~!~~~tl~'~~-~~ 1~~~LV~::::~-=~==:-COOE;~..:~-;--~~:~;-.=3:=~:4:-=~--:~ b -- OCCUPANTS I WITNESSES W~ ~g6;{~ci'~Z~~As:m -ID":'r-;:Gf-1sTATU~I''''.;-6'''I'~~~-1 ~II~~~ OES;; UfCT ~T,~~. ~ ~oONt TII II ~A1\t.~fE.!,f l~tr~M 0 AMB 0 ~'iI['1 0 "~~, R 0 :t:t 0 ilr~~\P ~Ul~ _._ I I 1 :-'AT~~!.,or ~rt5'l""J~ ~1l0M 0 "....B 0 ~-.:t1 0 ~~~". 0 cnr 0 ~~'...,~ AO "'\J'~ 1 I -.... ._-. ... . "". i~1~~I$Ot .. -- $~~YM 0 A~li 0 r~-.:q 0 (g~, I 0 ~:r 0 ~R'~'~~~ re.AOc.f o~ IAC.ENC~ w." (" rOIlC{D'~I>"'lCHwl POII(t AIIII'lIlblD~'YJI '~'O1l1 I"'~ D."II ,t'N., ''"70 1:30>c 'j:J::~ ;=:;. I 1,!:t9., 11/7188 (~ J" ~ '6] -. PHONE NO DAlfOfBllITH NO l o..~ I v, lYlS W'[IGHT H:IGHT "'A>,If ADt'Il($!; ~ :::~I~$ C......./.I AC"Dllf$S X rp;;~~)'''::N'''M1)~~ ^ ~ ......: ..... .' '. ... .... ..e............. , :' "., ',,', .,' :' ',,, ... , " " , ,:"':, "." '," .' ........ "" .', " :. .' , ',' .:, ' , ", , .'.- ". ........:... ...... "'<' '.', .. .' ;,' .': .," :" ," ::'.........., ... , " '" ' , , ""'. 1"',',..-, I':' : ,\" .', ',,. td t . ". . .. I .... I ,..., ; , ". .... f' I-- ~ 2: ~ ::!' -= '."r;7 '.J . f ;,-' ~' t ; t '.Ji',. ~; ,11. j, ! i . . i' f" f' "f-" I j; " " , . .. \,'>, ..." . ",,'" ' ,,\:\'" ''>,'': " ,'" .' ..... .> ,,,,.c.,>,,., :,/,', rr) 8 ST~~~::>~F~~~~IN~~O~~N ~"RAFF~C::/, ~'~;COM~'N::"/'; 7 n,w"~,,,v,,,,,,,~ .,>i,',:. I ~ 0 .R'VAlE WAY '. .' If ",:': _q~.tP.fC;QlL''!oI.o~./ 1;_ .r"__DAy.QF.J....Q!LI5}~_~._ .-; II llMI IlcOUNT1 COVNT'l"N01 ~'ClTYNO. ~~HWA -',':.<,:,,"", @: 1<#iJ.' C'" j'~ w"I"'(l..l!l,ltl.IMD'i~Ul\lll' :;A' IUSf1.00HQUll'1 ~~o"" I DURBAN :':/:<"!:~ :~,:::j 01 lOb 'B''T Ii! ,,,><,, 2. 12.0 "....,-. ouo"'::c:',:' .3 ON 01 DIN CllYOIlTaWN NAMI&NO O'5'IlUI0ll'HIGMW~Y~. fOClS N.>~\?-:> IXillOUUOflSTllUIVJLJI;. IYC~ ':::-:";~':',',',:': ::>:::;,: 2. ."" ~ Ow DO' Pf.l-.UO)..Ol-' ONPARADISGBAY,,,, '7-.3 1;:5'0,:0,60 f4..;'...... INft~SEClINCWlTH~ETOllROAD :~::::~: LJ<. STIlI[T & lt1JT5tJl.J JZ.IAHT PIlUI:{ (G. M,.,~T7..&J ~ '\~:;:: ~ DIS1ANCE & o~~ ION IIIOM IunI/INCI. CIIO~~SIIIHT 011 NEAIIlS1 MilE roST I ACCIDENT Il........P ID1A RAMOAIA ':':::2" I CD __ V4 M~l~:S ~ A :-, ~ OF .M P 2. M~\5~E I :,:';,; COl\I~~:~:~~~VIODJ ~~~~;~;O~NO,INJUREDJ:L 0 !.p.:,",~ACI O~ll&IlUN I H.J':.'~~~~~"~ INlt" I~~I Xc~f ~t~2.!~t(~~~~~~()ll:((lHRH..c( _e! OV(HIClES 8..PROPfRTYOAMACEON~'" 0 IlISULTlD OeTE~,tt;i IX:' ~'os"'~o - 4Cj 06JD~'ie..rNB[;:/~~STIlUC~ANDOWN[R"SNAM(t Is QC,ro SP{CI.....-tODINC;USE UNIT NO.1 UNIT NO.2 0 VEHICLE :- DlllVtll'5N~I?~ (!)-IR~S7/)..A!; 7L' DII~~1 LAS1 STRUT ADDIlIS!> STRUT AOD~S L.3; c,,72. s;rARK ~~ ,,,cnot 'HON'NO 0 '" \. "A" EDer:ut!!e~ow WA I STAlE I.Ell '-~~.~~!,!// ~ "",,,c,",,),, GART(5C/..CJ(dd-<~/ /.VA 11= ~I *' 1~4 v \. _ 82. OCCUPATlf.)N fIIlMNAME&PHON[NO I (nsi,cHT H:IC~T ~ OCCUPA,llON IfIIlM~&PHONENO / 1- 0 CHECK(,..) IF5i~I~~I~~'Z:l:~pl~~lf~A::itiHfriAL 0 CHECK(,..) lf~IC~I~~'ZNlMP\~~(i~N6TU'rilIAl [CODES.... + 13 ~:i~", I.. mw:t" 3 ~ IJICT,Q>> 0 ~B;~.l/C~<;'I_ CODES" + 3 c~~~~. I \. ~mi:.'''l 7 5 IJICIIO" 2. IN~U~~h>Of ,,.tl~~f!.Of '\. / m'..~"'J~'~o'" 0 "'.....6Ul"'.." 0 ~~(I 0 ~H~T1~ P'W'l ~~::,,~:: 0 \"8.1"y ~r:?t,,~'IlO.y. 0 ......1IU1/l"<;! 0 '<.1 0 ~SP"1l 0 ::::,~:: 0 i"w~'''!.I' , Vl=i~ I:;:UB~" I MOO..,,.",NO"> 1"":2000"" ~ VlH n.. I""" 'OOOO"C"lV/ (\."O""NOVA' I"'" O',C""V, ~o: rr V HCOI.OIl IlIC~N5EPL.TfNO, I STArt \TRA,llfRPLATfNO TS1A,1I H V1HCO\.Oll T"l..tN:>tt'~A,lt'r' ~A '\. I",Allt"t\ATENQ 1~IA1t _" ~ 131..UG" 1 Go SI A6""A.. I WAr 1 - - ~ / \., I --';0 "'3;;C~7N;";CA~~'Yi'3113131E'IPI310IbIO;II~ l V'H';,"'0~N"'7AO'0~N;{ I I I I I~ I I I I 1 ~ . :rc '~-=,~O;,~ ""RCPer Z'oo," ';;37-")'-11/ ~ "O"''',"OWN''j 'A" "'" M'O"\. HON'NO ~ 132. AODR~~SOIOWNfll AOORf~Q1-0W7'"' ,&.{ll 72 'f:,'/ARK..RD Pr.I-,UDI-Ol-o-J A)A ~ / \. ~ ~NAMt&AODIlE5S0IN5UIIANC!CO OltACfN1 NAMCl""'Y IN:>UIIANI..[I;.U.UIOA""tr '\.. 321 C PI:: In 00 R / " -I ,0""'":0"", ~I~~::~N """0' ~ ~.A",1;~~A, c::;; F lJ;~~'~~' r:=-I~ fi~t~;~/OCSO,v 0 :"wW:~" 0 ~~~'.N D".AONm ~'t;J.o~~'~O~::F fi'C'" DIAGRA1M.B OF COl~~t~~lm(U5iT5~?~~~ -JNOJ~.11J1l~~fM DESCRIPTION OF COLLISION: (U5t SUPPl(MfNl~ SHEff If N!C(!>SARY, _~ ~ C -1-1-+..- .--'-4-( ,_Lj_-I-I ,.J__0.p, lJE'H,*,J..-I..A'(i,_-s.Jl3..ot-l~A"'j:CJ3i"c,,(-PJ::J-""H~- ;:Ji E -+-f ,. 4-.1-1..."- --, -L..J-r-t-::: -t<~nl'- _Cl..'(!;,1O_'S.Nol.LCJ:>w::omo::wS,Jr ~GA'J-=,_'S~lhJ,_ - '~~.; -+- i _L1_~__. r::-t-l-.q;--Hl-~.=F-:'f- -1'\-lC vaH._.HIT'..nI6~KCW,1:H(Zft/l3- ~ --1--1-1-_1, ::.:[-.J, . +'1-'.-j-r~~:- -1 "tt=1- ,-sU::C.OP_THC..BClAJ::>""'t:."(,,, !:,j ;-Y~i~J~~m,~::~~=~~~,~~~~~:~~~~ 1- OCCUPANTS I WITNESSES tfUJ: ~~;~~~~~~~lA,~g~ -S(j(':fAGlb'TANSII....'ri.. L~~~,~'..l ~Il";.{~ 1l'[~"R-1(JiCT ~Tr~~~ """'Mf ~OONE 1 I I ""popm . - . . .- .. .,. ~""T~~I!.OF ~~r~"'~~ tllUM 0 ""M8 0 ~~u 0 ~g~. 0 O:f~ 0 \1a\"'~p E;;;'", ..... ~;~I,O' ., ~troSl'W.o.'OAM' D:~~"~;~;:': O:;~ m~~,,, .. C NO I I I I I A[lO"f~S ~~TJi~r5or --. .- ~tr~"'J~'I/O"'O"Ma O(;:~ll ~~~"Il D~r::' D~1'."p IN ""''''1. ~ , . 8AD~'" """IN(~ II ".." l.' I~O\lCl DI51'A1tHEtJI PO~C.'''2'''~'''IO D,AIIII'OF/Qf~~ ~JY DAn . '==-- ~"'"""bl~ \jt.SO I [;'~'.AD" I ,.oo.."'s I .c;.OOH~ I~ ~.~ I 1'1' 'Bq , o PEDESTRIAN "" o Pf:DAlCVClISTi."\ .'00' -/ 8 7~ ~ ---ZWcoul fAit I SEll ...r, DAn Of 811ltH ,:::;,,_, /\""1'''1'' ..:..' Ens IMIGHT ....IGHT I -= O AAQIOIfC'<;U ~..tlT' 'i~ _, '1 '~ .,' ':,,' ',' ", , :, " , ',;" n,," ",' '",' " '", , ',',:"'.' ., ' , "", " ",' :,',', ' '",:" 'c" ' ' , '. "': "",' '\ -'-:'. ..".: .... ..' :' ....,..... ", ' ", ,,' , ", ' . " , " ' ,"" ':,' :: ' " ' :... '" ,',: ',::" :' '..: :::'" " "':: " . ..",' ',,' ',"" ':':', ..,:',' .- ,,' " , . " ,',i ":"" ' ".''' 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WSPI~9(lHV 1.801 STATE OF WASHINGTON PAGE I Of I ~ TRAFFICWAY o PRIVATE WAY D"I~91.COll~,,_, N , qM.9':~Q{ll~ION ;,11 t'ME IICOUN'i rr;-l ni' r (i, ltf;~ w~ i~O~ !'~I~:i";O r~.~iii" ~"II (IS4~~OU~1 11.:r~J..sw ~ litN Of OltJ ~YOR10WN 1 ~ft!.NO OISI/l~Ol!HIGHW"'Y .3 M"" 0' OW J!ia. c:h.HA.<."M ION t..-Ih.:,c!.... 1'>12. lNltll~[ClING WUM STREB 011 ~AD NON INlf/lSICflON _ J 8[fWH~()^dMes 5111[(1 & o\::E.rV\LA'1 SUm I'" OIS ANtl"r-;fC ION HIOM I/lflli!lNCL C/lO!>!JSlllU OR NIARfSTMIUPOS,,,", , I ACCIDENT 700 1il~~:s n ~ ~ [] oFTA.ot-JdM.6 ~ M~~~E COUl~~I~:~~Q(VEO ~~:fK~~::6_NO INJUlIIO_ 0 ~~~tACil 0 ~:~&f~UN I HJ":.'MJ~':..~ orVIHIClES rn '!i'P/lOPf/lfYOAMAGfONlV 0 11f5UlnD OVIHICl[ 9 ClI!J[C15TIlUCI(I~lO!06JfCI5TIlUCIl.ANDOWNln"lAMll 115TOAMAG! ~'i:.T - ....Ac...Cc. k,llJ BtJ.L - $ - UNIT NO.1 UNIT NO.2 No, n I n Q A 3 POLlC~ TRAffiC COLLISION REPORT POUCICOMPlAINmUMIlI~ I~::~ l~c"'" d CO<JN7~ Ic,m.o fCTt;, -?3~1 ~ IX ROU~S;QOC: MIrX IW, MILE POST '2..(.."1 I 11"",,,,1' 101... IIAM DAT... IN,... II~~ I UO INnll~~ffi'J,!RU OIlI!OADORJlII(IltNCl lA: I Cl$ oo(r~i;~~ $PlClAI. COOING t.l;E o VEHICLE "'" o PEDESTRIAN " o PEDAlCVClIST MI"'1X1 8 ~ '- '''''Koe,'Ci-r s k~dE\ \ A \ t~,3'" F-> ""~'l"''AM CST / Pa8a><. \3~ ~ "'\-\A~Ln:..~ I 'J'A' Cj8~3'9 13as::;'sZ3 ~~OBERRA3\ONF :;"1 M 181'~';~q IBi~li;;~s/l' !.TIlI(fADDRI:i:i o ClIV R I IV!R':iUC(N:iINO V llPCODI I' MON[ NO IAn I '" I D...n Of IlII1TH ~_o MO ! Dn IU --:.,c I (VE5 MIGHT '"lIGHT ..::: rz OCCUPATION fiRM NAM~ L..=:. 0 CHECKet") 1'~~ICllA:i'Z~'t.i'8~r~A::-S;Hrll''''l 9 CODES'" -I' 3 ~~i~~' I 4 m\~:;"'l 4 5 IJICI'O>oII 10 ~:~yllCyt'l ( ~~l~~hu, . AJF)1I'lfJ L.....=.. ~~~~~.~o... 0 """Ul"..,CI 0 ~~,tl 0 ~~~l' 0 ~:::,,~:: 0 ;<8'..,~p ~ ~::/4 ~~~~;;IV'l I MGA\~ts 15T2DRV-1 Li. 'BRa IIF.s~lt j"WA I ".,,,,,,,, NO I'"'' rr=- VEHICLE IDENTlflC....TION NO ~ . '31"'1i'P1'1 IgI.<\'!/ 1'/21"11"111"): ! I I I I ~ ~IGI~llS~ :c- ~'6 MIDDlE I PHONE NO '2 ADOIlI:i:iOEOWNE!l ~ OCCUPATION I flllM NAME & PHON[ Ne, o CHECK (v) . \lIHIC~f'iSA~pl'8~8Sfi>~"fliAl I ~~D;I:O:. + I , ~~:'~~",: .~\;::~.. 0 1:1:"~'>OO~ ~~::; ~:::~: E IMAllt ([)QD(;ioE \;.HIII_) I MOOll10AIlT.NOIIAl I:)TYlf I~OH..cQt\lV_1 7 V[HCOLO~ Ilh..t",~...v.,t"'V_ I :i'ATE Il AENO, 1::""1 f VEHIClE IDENTlIICAII N I I I I I I I I I I I I I I ~ ~ ~ '7" ':5 .. ~ o IlEGI:inll!OOWNEIl I I '''HUN! NO ~ AuOIlE:iS OE OWNEII E ~ NAM~:irINSUIlA"lCI'.:'I~G(NT R NAM A IN V AN..I...... .....-AutN -":-2 '---- DAMAGED AIIIA I Q.'LI:"~! l;:~AI' N " , , I t1'0IS""':'~G I O...&.';.G~b'Z1EA ~ ~' ~1 ,ITOP a I~~'!;lo)~: CH"IlGE CHARGE 11-oI6~f:'g~a; u2 ,ITOP;j' '-" , uii'i;inoi.. ~1[:iI.OAMAG( ID,~a~w''''...(,'oN 1JR!:-"AI~ 10""0 DOIlIVEN DIlIMAINED I EST,OAMAGE I' loecino.; 5h ~ IsralAL.If5t~BV' \Sll\s - 0......;.'''8V. ,,"WAY $ .- _. 1-- r= DIAGRAM OF COLl.ISION: (U:il :iUFP~EM[NTAl _JNOI~~TJIl?';Z'H DESCRIPTION OF COlliSION: (USE 5UPl'lEMINTAl SHm Ir NiCESSAIlVI I -2: .. TT-"-'f- - 'T -~-n""',.'<a""""r:I' OW '-K-.... -~--'~k~-:M: --l::6--<-=e. - ~'-i' 'H - +-, : '<~"r~~7-l;--~-r~-"\}'~:;::r--Lt,.,>_~$C:I8tl!~c'Ic.i.~='JS'" -..E.'i. ~--Q E' - -',' 'hI" I--~ T"'i-.r, I I 6.1"V~-~--S'^-~:;;a--i~--.t- _~.Ld~_,__,.1 'i--H--jqIp ~~____"._.._. __~.._...__ ___'______~ ~ [~;Ftr~T~ttn~~r~--[:-~~=---~~~~-s:~=~:==~ "- NAME, ADDRESS & INJURIES OF PERSONS INVOlVED + CODES I 1 2 I 3 I 4 ~ ~~ 3 OCCUPANTS I WITNESSES W~: ~~~~~~6~~~tlA~W ID'::f';cT' I~T;T~-S .~;.. ~t~" I "~I,';.{~ t"I'~T~M lJ'tCT I.:-:~~~. _ _ ~'".. .. __ _,_ . _. ~ONt ._ . M__ I I I I ~A~~~!.or ~C!N1vf!Y M 0 ".0.1/\ 0 ~~Cl O""~l ~ O~:.r 0 ;<"'i~v HU'~ I I ". ~r't~/.o' ., -- -- ~~r,s:jVJrfPOMOA""f1 O~~~IO~:'-:~"p o:r:r O;<..~~,~ ..0 ~......... "0 ,... f.jAfUl1rOF ',,"JUII,!!> "[lD"r~!o L: ",", 10_ .ON'I'.~ f>I"'''1 "Dllllr~s X~GI*~~~i\:::~ I tcr"?'V~~' M O".....e O~~~u O~1i~'I~ O!;;:.r o ~~~M le~':Joollr..-rCor;..c~o I'~;"~\l\ l~crif~p"l(Ht(;1 j'9~aPI~A1_~r'l'l>Ol1T, I~-'")I ~AIf 1.-, I..~~ I ~ l I "",.~ I ,,,,,.,, 1/!71891~ /9 B"1 ,," ",. ' ' , ,," .": " ,," :." . '<.. ",," " ' ", "" " ," .::: ':< ": ,"" ',' :,':, ' , ' \" "",, " ",," . , .' ',: .',' '., ',' " ".: 'c, ''',:,' :." .',' ."" "." ":".""" '" . I,;" : -:,,, ,,"" d ',",... ,'" , ,,": .: :"" ,," ","'", " , ' " ,,,, :' '"~I,:: I"~"~, .' '. , , ,,1: , " , :"'", "", .. '," , ,,' ,', ' '"..'" .- , :.. I , J II - ',,', ... "''-'_':.1,,' C>"r' ~ CO"~ .,." ~, >;~.":' , ,,",\ '1,1 :.- : ~; ~'- ,. ,.<: '';j :~i';'~;"';~~;':_';":':':'~";~"'~"''''v,~~,~' ':-"-.::.~::.::_~:.'. ',. 'j'~ l(, 10 ...... .." Washington State Department of Transportation OHice of Districl Adminislrator 5720 Capitol BI.....d.. KT.11 Tumwaler, Washington P.O. Box 9327 Olympia. Washington 98504-9327 Duane Barentson, Secretary January 27, 1989 Mr. Scott Kilmer Planning Engineer Jefferson County Dept. of Public Works P. O. Box 1220 Port Townsend, Washington 98368 SR 101 - Signs, Gardiner Rd. SR 104 - Beacon, 8eaver Valley Rd. Dear Mr. Kilmer: We have received your letter requesting a beacon on the stop sign at SR 104 and Beaver Valley Road and bicycle route signs on SR 101 at Old Gardi ner Road. We will be looking into both matters within the next month or so. I'll let you know what we decide. If you have any questions, please feel free to give me a call at 753-7220. Sincerely, dJ,~ C. D. HORNBUCKLE District Traffic Engineer CDHjcap WJW RECEIVED fEB G 1989 JEFFERSON CUUNTY PUBLIC WORKS nF.PT <, ", ,':.> ,< ~ :':: : ' . " , , , , , ,'. , " '" ._~.- .' ....." ..... '" ,', , , '.... :, , OBANCORP MORTGAGE CO. REAL. ESTATE PORTP'OUO MANAGEMENT P.O. BOX 8347 PORTLAND. OREGDN 97208 December 29, 1988 Frederick H. Stahlhut wachtelweg 11 6230 Frankfurt/Main 80 West Germany Re: loan Number 41351790 propP.rty addrp-ss: 281 F"irbreese Drive Port 'Ibwnsend, WA 98368 Dear Mr. Stahlhut: We spoke with'Mr. 'Stahlhut at 545-9150 who infonred us that the insurance coverage for 'a legal description of 50 Fairbreeze Drive is the sarna address.as 281 Fairbreese Drive which is the property address we carry on. the above mentioned loan. For our records it is necessary that the insurance coverage evidence be the sarna as the property address of the rrortgaged property. If there has been a change by the county as to the rrailing address, rray we have a signed statanent fran the county indicating this? Your prorrq;>t cooperation in this rratter'wil1 be greatly appreciated. p'" M.B,Cluff ~, Assumptions. Departnent 'Ielephone 1 'BOO-547 0917 extension 3360 MBC: lTC l;~ S'-"V/ .'l-tc""(""",,,,' tJZ-<r-o..:.L<~? j-tu" J.-vv,' tr'b~.~ iJ</./.)-<, ~J~L.I ~.'-o -Zl. /.>-'-.~ -<- ~ ~~-Z;;~.......-! ~ 2-<. S' &......,:11'" i/~ .2So) T<I-l-<. ~y...../ L9~. (K-L-~ tI-0 "l- 30 .g"u......J-...L'fjpjj-.'", (kr:L._tP-<:) ~ -"~ d- 'f--tJ- ...o..._~ tf'::'T"!'"]:::C~:''' d- ~,-,,-t- YZ<u ~,,(- )~ ""'~&...<~ .....:., S'o 1?:'~C:....uyJ EJ-'.-v. ' (3 ,.;;J-i<--<'~'-'?J'''''''' '-fA?' -;J.. ~~-L:J- d/'vo-.-l \,.\, ~9....-t"L~ ;<.lj J--. /''is-l TOL.L. FREE 1 (800)547-0817" 113031848..5400 ~f~~~~f0g~~~~~:~?~j}~r.':':~T':'" ' ~, , , .':,' .'.,"" ::'.,',:,',-.: " ".'",," ":"', .' ':,: ',.'" ..... ';:- ,",":" : ,". " "," ,:,:":'::,:' " :' : ",:, '" ""',, "", ,',,:" ',":" :"':' ", ,,', ' " ","'":"'.'.' , "':, ,", " '> i' " ,"". "" ',: ", : ",,.' . ',', ". :' ",' '~" ",: ,,' ",', ,', ,. ' " ",: , . ",:, ',' "" "" " :: " ,:",' ',',', ,'" : " ': :,," " ' ,',' "" ' ' ':', "', :' ", ," ':":' ':, :" . ,,,,,', ' ",::.",::" :', I,: "."" ,," ,'. "'""" """,' ".,:,'''"",,,,'''' . "" ' ,,' .', '," :"' : ',', '"., , "", ::: ,,:, ': ': ", " ' , ' , ':.' '." ' ' ',',' ' , " ',' '" ", ,,' ,''', ",,", ' ,,:: ,,' .' " , .;,,' ,'. "",:: -:' , ' , , '" ""'" ,"'" '. '" "" ''''''''': ,',',,:,: , ",' .' ' , '" ,:',' "/', , :' '>:':: ':,' ,,',, ' " " :, ' ': ',," " " " -.'". ' , ,,' ,':: "', " ' " , " , ," ." :.. .,.:., .. ,,":.',,'.... ",' '. , ",<:":":',:' ", ',,' ': ,: " , ' ~ T ()3,2,t-1.o3 (,(,pi.ed \!y permi..,sion of a:~I'I; '" /11'P l~ng inBerf'; and 1..ht~ All UI01', PUS$ i 1~188 iSRue of t~'e ITE J0Ul.tl~1. " " ,.':, '... " ' " ' , ' "",:",' ,',', ' , " TI~t~ foll,l,wing article is rnt~t.it.ut..~ (If Tt'i:'1nSpnl~1,.a1.:ioll. P. BhesR!lla, fl'om the August. .---.--..-.- -.' -- ..-.-.---.---.-.-- U'.:J1.' more iufurm::l\.i.on on ITE contact: Institute c,f 'rr~n5P0rtation Engineers 525 School ~t.reet.. I S.yl., Su.ite 410 W;:i:.:.dllngtnn, D,G. 20024.,2729 , ,', The Need for Adequate Intersection Sight Distance In Roadway Design , "', ....' """, ""',, ,"",: ',,:'" '.- }",: ':' c', ,.',.,.",\, ,','" ", ,,'" ,:'.; '".':>i" ,: ' " ' ': ',' '" " ".'\. ,,', , ' " , '" .':,' .',.-, , ,,;':' .', ,", '." .':' " ,. '" :', ";: ,: ',: , , .,' ,',',', " ,,' " ::,: ",,' , ;:'. '" ',":' ,'; ,"': ,', :,' ,";':'".'" " ,:!': . """.,-, ',' ." , ,"'.',,. ".,'" ,'.,' ", .,.',' ,"'. ',..' , " "..,',. "".':', ,: " , " " , " ,," ;', ,'" ,'" " ,;", . .', .', "'" :",",'.:' '. ". ",',' , :', ,." ',' ,. " " ,'" ',', "", ''''" " ,-'.,," "':, :: ,,,,,', '>, " " ",. , ' .:" ", " " .' ')i'; ," ,. .; '.;" . '" ' :. ' .'. .:' :. .' ",:':,' ,,' .." ,',','" ".' , \,: .""', .'" ",..,." ,,' '" '. " ,", , '''''', ."., . " ' , " " '.','., ':;' , ,,:,,', , , ,: ,,', , ~, '$ BY RUSSI P. BHESANIA M"lreOVl;r. land planners. in preparing subdivision plans, attempt to maximize the number of lots and often pay no at- tention to visibility at an int~rsection of subdivh>ion internal streets with perim- eter streetS. These practices result in op- erational problems and citizen com- plaints. The operating agencies are faced with problems that arc difficult to solve once the roadway has becn designed or the subdh'lsion built. . Mrit,5"rists'on'side 'stiiets or,drivew~y~ ,wi\h inadequate visibility llften ask tr~f~, ,fi~,engineers to lowe~ t~e, speed limit, or- in~~an nas~ing beacons, s,top signs,_traf- ',:66 sigllals', etc. These demands are ma'de because motorists on the .side street do not trust that a uriver on the main street will have sufficient time to safely come to a stop if they accidentally enter the main roadway at an i~appropriate time. Responding favorably to these 'requests'::' is'difficult, a~ipe~d 1imit~ c,annot be}C?"'<:',' e~,ed . for spot, problems:, .lnd', stop' signs .'/ cannot be phl._~e~ to giye preferential ,:,right-of-~ay to the side-street motorist~.. ' Signals can be installed only if they are, warrnnted and if their costs can be jus- tilied. Aashing beacons generallY have only temporary benefits~ they become less effective over time, as drivers be-' Cl1me accustomed to seeing them at a pnrticular intersection. Thus. the traffic engineering department often ends up imaalling "cross romJ" warning signs. perhaps with advisory speed limits. Hllw~vcr, motorist compliunce with these signs is poor. Even if the signs re- sulted in motorists lowering their operw ating lipeeds. the design of the roadway The design of roadway improvements or new facilities normally focuses much attention on the selection of design speed, which controls the horizontal and vertical alignment. Design speed is one of the main criteria used to attempt to achieve unifonn speeds with minimum variations and to realize consistent and safe operations on roadways. Design speed establishes maximum degree of curvature or minimum radius for hori- zontal curves and suitable length of ver- tical curves to provide safe stopping sight distance in the, case of emergencies. In establishing the length of vertical curves. the eye height is assumed to be 3.5 feet and the object height (1 inches. After these main controls arc deter- mined. the design of the roadway often procecds with little or no altentiun given to visibility at intersections of streets and driveways. especially when visibility' is influenced hy the vertical alignment. Some dCliigners helieve that providing stopping sight distance is adequate. This, howevcr. is i\ misconception. as the major roadway !lhould be designed in a manner that docs not require motorists using it to SlOp. change lanes. or reduce speeds. if fe:.\sihh.'. Others believe that the height (If;l vchicle t4.25 ft). which is much greuter than () il1l..hes, adequately emnpcnsales for intersection visibility. Although Ihe ohject hdght of 4.15 ft re- sults in a 52(:~ increase in stopping sight distance when comp.l.red with sight disw tunce bl\sed on the standnrll 6-inch ob- ject height. the increase usuully will not provide for adequate intersection sight distance. I l: { ",:: .. c. :': "',:' ,,:,: " .:. would be considered to be poor. as the signs would result in inconsistent nod nonuniform operating speeds. Thus it is important that adequate sight distance be provided at intersec- tions of streets and driveways with major roadways. Proper sight distance would improve safety and result in better op- erating conditions and an improved pub- Hc perception of our profession. De- tailed sight distance requirements for intersections are described the 1984 edi- tion of A Policy on Geometric Design of Highways and Streets, by the American Association of State Highwny and Trans- portation Officials. The standards set forth in thnt publication should be nd- hered to wherever pussible. To guide the design of vertical alignment and the plat- ting of subdivisions. this article will sum- mnrize the requirements applicable in most cases. Intersection sight distance depends upon the type of control. roadway ge- ometry, feasible movcments, and type of vehicle. The type of control includes yield. stop, signal, or no control. The type of movements include left-turn. straight through. and right-turn maneu. vcrs. Roadway geometric- featU1es in- clude width. gralles. and presence or nb- scnce of medians. Motorists on through-streets arc given preferential right-of-way; vehicles on mi. nor roadways are required to stop. Mo- torists entering the through-street from driveways also normally come to a stop prior to gaining accesS to the street. At the intersection of two through-streets, traffic signals or four-way stop signs may ITE JOURNAL' AUGUST \988 ' 43 '" '. " " '".'." " '", ",' >,/ .,",,",,, ',' ' , I ~I I.' t \ ! , , " ',. .", ' , :; "',' " " ",'"", '" "'" ;'"j , " ' , ': ' ~ ,': ," ,.'.' " , , ' , , ., ", f .JEFF~ cxx..a-.ITY FlU: r?K 6"/6.2oY DEPAR'noE:NT OF PUBLIC ~ , ACTI ON REQUEST I'=-:'/~ ~" REQlESTED BY. '-;1k",~,--, ~/tz DATE- ADORESB . r:2-=:L.I C<:':'J ~..= ;:;,(~, ././,1' /' ~/ P't-<<:WE NO. - 7..3 "2.- "T..;J./CJ J (:(L,"l(a,<,,<-~~ I tJA ALT, PH, NO, '7 ~ G- )/.,) 7Y IZI I NATURE OF REQl.E:ST- IN PER:Sa'i 0 BY PH:"'.J'oI.E 0 BY LE'1TER TAKEN BY. PERTAINING n:>\B.OFF1CE:' 0 ENG/S~Y IZI ROAD MAINT, Q EQUIP, ....'NT, 0 SOL'D w~(/ 1/ REQUEST FOR.~' ./...t"'<- (:./.<..v'7 -r -<2<".-<< .P' .A """'{J /"~ /, J, ~/.TC" K Rc:-, L.OCATICI'<. ROAD NANE c:.J [:'.u . ROAO N~R .zJ'/t.-.;::;.O'? M,P, ' .../J I ,......( , PRQ.JEcT - PROJECT TITLE RAO..JECT N~ER" DESCRIPTla'lI.. {~ I."~ C{#p.r/de:1 S;';,{..t1 6 R4r.L-L- , I,J~ J&~q75 , ATTACH MAP at SKETot , REFER TO.. y,:;.,&-6 ~1. c xJ(1 f-<~ / 1<:, RESPO"'tD BY.. ( RESPO"'ISE .. ,1. ; " Ro -'H) ;.s. vel~7 /l)A--1:?}:).OlAl . (AJn"",L ,"", ,AleeD EN9"Ne~i~ \'N,Q I'H'if "" A fH~t"lj ~c"T" -5e,... I.AlJ . SI'/-aIAL() NtJ.,.. C~;D 5"PA-t .ri-r ;-1... , Lv .-,) r-;'/, I . REVIEWED BY- DATE. CXJNTACTED REQt.ESTER 0 IN PERSOt'II 0 BY PHONE 0 BY LETTER <:xJNTACTED BY- RECXlM.ENDAT lao. .J: /'u,/I Iff,. /4. oJ;;' II f/(.',-~,7 UCJ-6/ /..1/Z' r;ltiS ,K'/.n{! ltJ(!tl S PREPAM: ESTI....n, FOR. . ;1 AOt1rE TO, INITIAL b 0 DIREC'I'CR 0 CONSTRUCTICN ENG. 0 ACax.NTAHT -- tr - - ~~' 0 A!lS18T~ DIR, - 0 ~ING ENGINEER _ 0 - 0 ROAD lIl..FOIV I SOR - 0 ADMIN, ASSISTANT - 0 - "9,'" ~. '}' '.' . ~ ':. ...... .... ." '" .' '. . -'. .' '.' -;, ~. '. ........ ." '., .:', ..... .'..... ....... " t ,:.t: ::'" .' ,,", ",:'", , ...." ,', ...' , ',' " ", i , ' ,',,', """":"" ,,:', ',': ~ ; ':::: '" ".: . ..' ....... :.. .... ..... .. , 0';:" . .' .' .... ...... .. '. .' (, ,....:.: ." .........:...,.. " .:..: ';'" .'" ..,". ;', . ....", :'::" ;.", :.' : . '. . .' , ",.,".. .', " , ' , \,', ";"'" ..' : :.;", "::,','" " ., ;. ., ",,' ,'" ""',' ': "',",..,," ": ',,",",' ,',' ,,:': '., ",',' ,,:,' ":,, ,': ' ':,', ':' ..'" ':" "..... ..'," .:; ..:,'....' .. .: "/:,' ", ' . , .'. ' ,',:" , ,,':. ,":: ' ~ . .' . ".,; , '., ".::"" ",:' "',, ":" ",' , r ',: . :- . '.. '",:: .,...,.,'.'. , , ..,,:',:-' ',.' , " ::, I "", ' , " ,,", ,', " ',.' "'" , , '" ,:.:' " " ':..~: ~.: ,'...., . " ,,: ~l ' .,' . '.. < " , , " ' ,"" '" " . ' , :,. '.. I ~ ".~j: ", , , , , '" " , .. " ,',.'" ,,), F.u- fo!. i/-.2r-'1'! ,,' tibS b.l!,.312 '.25 :,:' ,; , ,," , /'" APPLICATION TO OPEN RIGHT OF WAY Application is hereby made for a permit to open right of way, Please des- cribe right of way. (Attach drawing or map) f(o"\'..A:!.:":UA/).-,.-,,,,;,/u'b--,. , / - P ~ I 'lL-<L->; .,,h-,, , '''--' I; ~ CI "" " < <24 /l I~ 6-'YL lof.l RiiL t"k /0 ,~T: trl.~,~ / (.I (} (1"-//0/1. I ,J+ 1;; j;)A'~<.J ,jI.}.., IS' w/d~ .~ , /;/ Applicant agrees to perform the work in strict compliance and conditions set out herein, and any special provisions ~ Appl i cant Namen'7o 1L~P/M p /t, J..... ~ rl...-v..- , Address IOn A"..,/ C}CJ "" ;(/ad..tl"-Ao"'~ G()t".L 98.~.9 q Signature ~ 0 /l .1"4< / ) ('~) /;~ ~/ _____.> D with the te rms attached hereto. a... in.IS -= O.;l!.,::r ~ Da te 1/-2-P-8-$' f,' Ii t. ***llilli*** SUbject to the terms and conditions below, permission is hereby granted to applicant to open ri~ht of way, Applicable provisions are denoted by an (X), tk!T Applicant is authorized to, construct a private access road to his or ~ property in accordance wi~h applicable standards for private roads, llnac X1Xf<g:b:t( xo:<< xn~ xw t 11 x Ii If x lIS if II t If II XII 1'I lIx I t ale if lIx byx ~lll!x t:c:un;qx:E:a:g>1J1teerl(. The permit does not prevent other lot owners from uSing the access road, In the event u~ers of the road wish to have the road maintained by the county, the users shall improve the street to minimum county road standards, or may form a road improvement district per RCW 36,88 to pay for the costs for improvements, I Right of way will be surveyed and staked by a licensed land surveyor at the expense of the applicant, L-r Applicant shall construct a roadway to county road 'standards, The rfght of way will be located and staked by the County Engineer, After con- struction to county road standards, the new road will be maintained by the county ~' *Note: Applicant shall pay the county one half the mill value of timber removed from right of way in order to offset costs to the county for future improvements, f ", r: RECOMMENDED FOR APPROVAL BY ~~~ I' APPROVED BY ~~' I Cha~~a~~;~ County Co~missioners DATE ~.j ,?)"'''- /9R'r?- DATE".:27 ~/9'n Form 170 f :,t , . , , '.',' " ,- , :,', ' " , .", ,,, , ".' 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'1'; t' ~, '/' l .' :'; , ",' " , "', '",'" "',' C"y' , -'1/- (' ":jp'?;,~(; .'f ~~ .~~'.. ~ ( JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS 1820 Jefferson Street P,O, Box 1220 Port Townsend, WA 98368 (206) 385,9160 Gary A. Rowe, P.E., Director Robert G. Nesbitt. P.E., County Engineer December 6. 1988 Ger<lld M<lthewG P.O. Box 626 Chimacum, WA 98325 RE: Stevens Street Vacation Petition, 1985 Deer Mr. Mathews: Jefferson County requests that you send to the Public Works Department a written declaration of your intentions insofar as the above referenced petition is concerned. Although the vacation of Stevens Street was approved by the Board of County CommiSSioners, the required fees were never paid and the reolution which would have completed the vacation was not signed. This has left the process pending sincc June, 1985. The Public Works Department has received application to open the right of way of Btevens Street for use. however a written statement of intent from you is required so that We mQY proceed. Thank you for your immediate attention to this matte~. Sincerely, ~~~ Scott' Kilmer Planning Engineer xc: A 10.20 100% Recycled Paper :, 'i', '," ',C '" "",, , " ,", ,',,' .' .. "",', ,', ," ",' ,',:: ", ''', 'c' "'" ':i.-i', ", ; ,'",: :,,' " ": :;"" ,; :':',' ", ,,:l, ': ,."y' " ,',' '",,', , " 'j> <', ',' ,,', '" '-',">. . .' , ,:,', . " ""', .',:'<, ,',,' , ,',".::" ,', ',' " ,: ' ."" ".", " " ", '.' ",.,,: ',':' ',', " "" .',," """", ',', ',' :, "", ,: , ",' , ',."<':> ,,: ',"," "..',:: "",.' ','<:", '."","" ;<,' ': "" " ..,.' '" .",',' "", ';", ' ,'. " ,'., ,',' ,", :, '; , "',,' ',: ';, ,,' ,","'" i' '.' '" ' ,,'" ".:,,' '" '" :', ::" :;'" "',''- ",'; ,', ,: " " ' , "', " " ' , , ' , :' ",:~", " ,', ' " " : '," ", ",., ,',: ",:,' ','i,'" ' . 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(' I I =r -- I"'''''N (v\llL """ ~1Io\Q~ /Il,u.~...ur I \0 =-- l,/ '1 OI:.I"'NCl &O~1!IONfIlOMlIH(lI[NCf.CIO'O~~~'IO'H'OIO' N[A,lI[~fMtlfKl~' / ACCIDENT IO'AMP I DIAGRAM OAIA ~ ~ . ,,, ~~I:~~ O.~ n n O~ ^^.i i P.() M~l6~rE . CO~IONINVOlVED ~fVElIIIY ~ ,,~O--~ 0 l ....'U~'N IN'[I'l-r~JX-RDTgi~Slt~.~RlHOllllOAOOlllll.fUn;M:l ;J.,I," ,;,1'.,;,'"..,' c:.0~t~,~3, OJ R-~:~~~~[;;:;~;'~ 0 ~;~~~,~: o~i~~;"" ~~'"' (X' I CI$ ICR"'''t.:ct9-1i b 0?4C1 ~.'I1UCI( 1/AMf OF OaJlel ~'"UC" AND OWN(I1'~ '-IA....E:- ~GE ~I'iCIAt CODING US! -. KOt:...~ /ll'}tj'l.(' :- ~-- \ L'c' $ ~ UNITNO,l UNfrNO.2 OVEHIOE OPfDESTRIAN OPEDM.~'~ C,YC/"ST !~ i. ~ D"''''M'AcK~' L';;WD It """'NO"" "'" '" n 1.2 R"\ """AD t;;;\t..~ 1\tl401~ ''''''AOO''" / ~\J E~ CoO, fbrrr"T'T\ 'o:!::::n lM:l'''o;'~u 'HON~ ~ or, "A" '''COOl '7NO I ~ D"'~;":~, .~ :~I R2- I tM\. M ;r~~"lh,* ~ """".....NO I "All I "0T,':"'F' f5 ! 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'3 ~';';,~~' I" m~i:"'" U 5 fJIO,C)N I 6 ~;~.I>\;.ClI_ CODES.... 3 c " 5~ICTIO" 10 ;ll ;~:;:~::. l'J~l:::"" ~~" 0 1!i;", 0 ::~~:: 0 ~8\.," ~.' 7:~.""" ~~:,~' .Q~!i;", 0 ::~::: ~:~:::: "5 , "(L\7tj l~;'CH"J MOOS(?D~AJ "":;;~"" rr~ T'....=CH'" 17"""0'"' '"""'ON', I:; I IT "Ii.,,; r;;:;;;;.;:" "'k" [-'"'M~ ["" 7 ".,- I'~"_"_ )['" ,_,,~ ["'" "" r~ V(HICL( IO(NrIFlC~O/lj NO. __ __ _ f VIMICU fO(Nm,CAII NO / ~ I '31~"9J:L...IY'NII'1'''''.b~3:4i I i III 1111111111."" ~"G"""~N". u'" ","'" MIDO" 'HONONO 0 "G"""oo","" '''7' '''''' MIDD" '"",,,,'NO ::J L 1-,,$\)/1. 1(,J,j 0 _ / I--. i ~ ADDp~5WN;' I I.JA{)~ l-U:\ ~3~C, ~ .00"=-0"7 W r:r- NAM" AD;';0~N':;;':::S '" AGIN' R M[ ""7 '"'UOANClCO AGlN 4 L.= p.l'JrlDAAIA loE,;J:~::''o' '~~fl '" 'i}j I '>;',,,:.r':G I D~~EA :m F' f::}.'i ,lTOP;;j. 11-i~~~f~"g~"; CHAlle., lA1JJ.,.. CHAlljft 11-I~'f.':f~'R~~ I,t:' ';;j', ~Im OAMA...f 1001O'1V(N 0 OOIlIV[N 0 (~, DAMAd[ II 'TOP F=J;i ,;;<;rio.; 'I.' C;'"Q) 1F.5 fu~\~" A'1\"C;,D... J61c;,'i.'~., ,,,^' "MAlNED. " , ';;OnO",' t:::J t; DIAGRAM Of COLLIS,I~N:. 'U'.t SUPPllMINlAl JNOISt.ll NOIO"11 ~E~CRIPt'ON OF CO~LlSION: (use ~UPPlCM[N''''L ~HEET tf NfC(~S"'IlVI , ~ " 'l~"i' i'-IT'::;-"''''-'''''!''{'''~''''-'''rl ~ 'Vel-\I\' \ .$\t"'nDI'--~-'-"RD'-'-'~e i'::~-----'--.J In i..: 1(..0..0 "'ii'''l'''''r'l ,r '0 ''''-')\O''.~ /1,...,,-- ,.)/---,5 ,l~';,,,,,-t'... ',L'''~''_'''L" lA<'~,,_ ,1"'RoLill-_ ~ ;:: .".. ...,' ...:~TI'. fJ:,~~%ij~'~~~~;"~:~~~: c' ... "oL~' : <:p': ;:T 'I-! ' ~;;<:p ~ '. r' , ". '-';-': :-fSl~DT4'>lb,.x;'; ~".. ~.r?i" i: ;';~ f' NAME. ADDRESS I> INJURIES OF PERSONS INVOl VED 1- OCCUPANTS / 'WITNESSES ~~ ~~~~i,Ecr~Zi'~l",~W '^", '~~..... J<c/J. p.: . ~;1f''' _ "'Drwf~~. l'~' 3'11 I~~ ~';~~r<o' ~-"h.:1e.. EN,,", 7 :f;:~:;f 0' ) ...... "'DD"f~', " '~I < ~!r~V~~FII{J1o" D..I,Oa O~~'tl or~;IfP 0 cr;~ o:t~~" oA(, "'"' "N'O"" '1 II I T "C'I'lIfV, I ~~H~~lsor' t~r~"~~-'~ OAM8 0 ~~'~'l O::'~;It~v,.. 0 :t'~'..~~ ~l:""o~~''''~, a.. 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" ' . r, ' , " "'. ,,' ',:':", , .,',' C""',','., ,i" ~".::[",; . 'i ~:' /.- , \'-;,~,:'::4" .~ I ~ ,';~ "', i //-'" :1 : '. , ",' IIIIIIII ,,' ' , ".'... ..'" ". ., ,";", " " , !.. ,',' , ' " ....ori , ' " '," ;",. ,', " ' ," " " ." , ,'" ii" ~ STATE OF WASHINGTON [2' ~ POLICE TRAFFIC COLLISION REPORT OA,'JorCOL.1I10N. , A1 >1;.9(\11.0"1 , . -1 1!M[ IICOUN'1 IT - i2 : oOs' l 8~' w;^'i ~O~ : 11I1!:; ft'; r~l! ,J7.1 ~~,' (~5~ ~~~OUl1l II J ON Dl DIN enYOl/fOWN I NAMf&Nom51I1l(101l1"UOHWAY 9 M'''S OS (;jw ~O, p~Y'i- ION T" ,,-" IN'[~!.[ClING WIlli STIIUT OIlI?QAD NON INTlII!.EClION ....- 8ETWHN Rhody Dr. SIIlHt & SR20 3( 0'51"'''1([ &;':C1IONIIOM IlUIIlINCl. CI!OSS!,TIIEll 011 NEAIIEST MIl! 1'05 o . 5 t17r'~~S;; iJ f, :; Of SR20 COlll~~,~:~~L"[o ~g'~~:~;O_NO lNJUJHD_ 0 ~1l\AG[ ......- QlVIHIClE$ []J J;=,-PIIOPlIITY OAMACI ONLY 0 ~llsllJlTIO cr OIlJ!C! SI;UX' (NANlI Of oeJEC' SIIlUCIt ANOOWN{I!-S NAME I WSPI~(IlI",l.eol No. PAG( 1 0'1 @ TRAFFICWAY o PRIVATE WAY A "" . ^ _ _ ""~. COM~^,N' N""'I'... , ? ~..,. r-m COU~'I"" IC'"'''' I 1",',0:::' P lli1 I~:: fCT!; J3Masl Pk(H IlOO~;1~4'; I MC11~ -;n Ptllfl.K ItO, MILE POST - 1 I O.'~ 0 ~ !lAMP DIAGRAM o.-.TA $TRUT I ACCIDENT MilEAGE COD< M"I~'N ...mt>lltOI..~ INUR 11'Ni'~CIIID IN[IIY.ClI~~~~RRQAl)OllIll.HIl[NC1 II~ I Cl$ CII~STIIE(lO<- R ::L/) $Pt:CIAI COOING U$E OHIT&IIUN I o ~\~,~~( Is [$T DAMAGE UNIT NO. 1 UNIT NO.2 OIlIV(Il'$NAMI o VEHIOE <A" o PEDESTRIAN "Il~T o PEDAlCVClIST MiDDlI S ...1I11111l$NM'I( lA$T ~ CROFT, KEVIN GLEN I ~ 1). S $1JmlAODlIt$$ ro;:- 556 Fl anl er RrJ ~ CI'~ $IAI[ llFCOOE IPl'IONINO 0 CITY r-- Nordland, WA 98358 385-4821 R ~ D~;~$~'~~$ENO lw~TAlE T ~~ b9~TEJi~IIl(H6i ~ IV nUCEN$!NO ~OCCUPAIION flllMNAME &PHOM NO I [yt$IWEIGHI HEIGl'll E OCCUPATION T'IIMNAME & PHONE NO 2 nechanic Al~83-7906 Iblul180 60r R o CHECK (V') I A~~;:r~'Al 0 CHECK(y) 1;~~rt~EA$~N!MP\'flm~A::tf;\ii~IAl [1 CODES" + 3 ~i~~~' \. 'IY 4 5 111(11""" 1 I 0 ~.?:'i."'t;'C'1 - CODES" + 3 ~i~~~' . :m~:,,,.T S IIICIION 10 ;;'2:~,I/(.'CII "lIS stated none 'N~u~~hO' 0,", 0 .....BUl..NCI 0 ~~,(l 0 ~!I~". 0 ~i:;',i:t 0 ;'8"'~p ~~m1~INOM O.....,IIU1....'1 0 ~~~l 0 ~H~ll. 0 ~i~:;: 0 i"~~...!.I' IT 86 MA~~~E"I IIDE';;;~M)IIAII;~ofl.1J7d-..EIIH'(AII lMAJ.l (,HEIII I MOOUlDAflI.NOVAJ rmI2DfI..CONV'1 ~ , IIEHC.:Ofl lIClN$(PlAHNO I$IA1( 11IIAIlEIIPlATENO 1 ""A t 711tl"lCOlOII 1 lIC[N$(PLATE NO, I~A" All A(NO AE beJ.ge 04682H WA I I 5 "3 v;;c;'~'~';';'~~ol 5; 5 I EI7 : G 10 11 17 i 6' 0 12 1 9 r "H';""~NH";A"oINOI I I I I I I I I I I I ~ fTC: '<G,sn"oo~" <AS< "'" M"D" I'HON'No "O"""DOWN" ,"", '"'' M'DD" I'HON'NO d -.n "T~~ T""nin~ 1683-7906 0 1 l~ ADOIU$:,QfOWNlfI W ADOllE :'OFOWNEIl uTI c: 464 Taylor Cutoff Rd Sequim, WA 98382 ~ -LJ E NIW!&ADDIIE$$QfrN$UIlANCECO o.>AGtNT R NIWE&ADDIlE$$QfIN$UIIANCECO A...tN 3i1 '~, .-..C/ ..!oj O~~G,(bAAI" I af~fg, 1~~At'ON ~.. ....., DAM~t%'~(A--=- "'-[~ n ,\oP~ ~~ ?::tll Cl-tAIlGE CH"IIGf 2 .\oP~"'::::: - 'hl'.;'on~' ~' " VAO' I~ r~~tBR~;";;,linq 0 ~~~l" m~~'," o "MA<N'D I '~;'~'n~' =:E E C!}tf;RA~loF.f$'~\ol_S~~':r --P'o .- {u:. IW~.'n.EM~~\.!__rD~~"llJII~~IH .?!-527~.I~T,I_S>!::IEF+c:9.tuS'O.!'l.:.._~~.~.":~~~.~_______ ~ C 11 '; 'j +'H j+-~'"~I- ~~t~~eh:l~~rV~~t~nriu~~~S~e~.tnV~iCl~~~~ ~ " I!' 0 D.e<<.' . , Y I,::;:;' I Ill:' I : lost c:Ontroi:vcliicIe-crosse(fIi-ito-S-I~&dSide i- r=t=~~~~,_'!_+,L:~o:~ooo.l_~,;_,~-;~~~-r!~d~~~;~~:~~~~~~~:~~~~:~~::1~~~=:-=--- ~ E CD !"~~~ ~.;,;..~-lr1-';-'1 '1'+-1:-'1' p/O noted~~ :~r~,s:~tobesrroo~:~:~~~_---:':-~~= ~ ": ..:;-1 ~i-J~:~}:r:~IrI~jE~;:LjRJ:t I:VOlVE~_m_---:'~=~~::D::-~~ ':~'1-:2::= 1=:='4"~--5' I:; 3 OCCUPANTS I WITNESSES W:~: ~~~~i~~~~~~l,,$::~; -$fX:'r~C.E-I~'ATU'~ I....~..l ~t,r ~'..iJ~~ 11l1'sill.1 "f:;icll~W:. :::60Nl 1-- ~:1:t.~1..C11 ~~1;~"f1~ lIuM 0 .MB 0 r..:~n 0 "I':" ~ 0 ~i:t 0 ;t.'l.~,\.. .;<."" I ~"T\1.~r.o1 ~~mVJ~fIlOM 0,.,.,08 O~~Cl OC:.J~'III 0 ~r:.r O~~'w oiwj ,,:6" T -, ';;.,~~~Ir~o' -- $~r~VJ~ ruM 0 AMIl f3J I "'~,' (", rOl'CtO'~I''''c.>1E-tiri'O,'c.1 .11111<1""'1'0"'1 or W1POlll_1 "li':2" O~.llO,,, I Olj.l,<a" 12-8-881 ....';.?: ..,' iii,,;,". ..... ......:i:j .>)iF!, . i:?i'",.I. . .,'..' .'. ii.i '.' . ..' .'. "/'i'Ie." ."..... .Ii,... " .:i';:YJ Ii .}'II) ."...'. .,......,.,.;(.' ...... ."/,_::\/.)'IH >. "\:'.< ,.......I<'..'.: ;'" ,../.<A.(:/: i........."'............'.:C.....,i..,,, ',: '"",ii/.: .,. :.... Ii. :: ';" ,... " ,p [ I PHONE NO :. At( I" I DA1(Of8illlH .:....... ~ I '" I" .-" I EYl$jWEIGH'1 HEIGH! =- ~' \~~~ ilDDIIfS~ I'<"MI '" ;'" "Ol'lllf~; "II,....! "'t'!,lj'~" ".I(E~tt,,""'~c.OTl '(!" \0 N"~'E .. II"N~ 1'1lA",c.r 0"11.(:;11", X ,rt lIaynes, 03p. 'Dt I JCSD o;o..~'..,. 0"11 i , ., i I, I ~ ' 'i. j,<' ~ t ! '~ ~ . ",'.' ,', ,"'. "..' ,.(' :,'::' ",.,,'. .' ", :,.",;, .', ", ' " ":' " :. ,'. ',' ,: ": ... : " , lirr?" ,',' '. ....) ........'.. . ../....... :'\": .. . . "::' . ", ,'-', :'.'''. i, :,' ",,''' "", :'", "':,',' ,,:" , ,.' ,'" " , , '..':.' '." . .. .... ..,,' . , ..'. '. ..' ," .': '. , '" ::' ., ..... .' . ...... " .. , , , '",' o ,l , " .' .' ...... " ", / I" i:. .:/ ~ -q< ~S:7 '", ; :, 'i ' -;-:: " ,\' , ' " .". ......'. l~ '.... I ~ 'I I "" 1- !; r f i1: I "' :~- I, , fi ~ f r., f, f ',,', , """", '" ' ( " ..' " ' ,": :, '~", " '.-, " .-" , ' , "'" , .; 1 :j 1 ~,": STATE OF WASHIr>,:GTON "c< / 0' / rt ~ POLICE TRAFFIC COLLISION REPORT J:gj cw 1/ ',."..." O:~~:TE::Y OAII 0' (OUI~'U'" OAY vI <.OLLI~ION _ , H TIM! COUNTY [ lz'<-j ~ ~. .~ '"" .., ,~" 00' ..1<11 /~/S'., .J6,c.PC'R.scw I ~ ON Of J9IN CllvOIlTOWN NAM(&NOo;~TlltlIO~\I~HW"Y Vi ".... 0' Ow oo,Ch'/YJ/.JI'L'~ ON Rht:>r!u Lk'/i/E: IN IllYCIINGWlII-I 51"'111011 JiQAO NONINtf"'~ON 9~_ rmwm-J {~fl/7E/Z.. SHI(O & /..1l:f.tr I OI~IANCf & 561~I'ON '1l0M IlHIIlf.NCl CIlO~SSIIlIII7rtAII[SI MIl! POST /', ACCIDENT . 2- 'H"~';:' fOlo 0 iil 0' r .b/'fEt': ,!/,:a/~<_ 2~ M~'6~' (O\ll~~T~:~~OlVf.O m ~~~~;:;D_NO INJURIO---L 0 ~~~AGI r 0 ~TI~II~UN NJ~'~~~"S (JVIHICL(S L!..J 0 PllOPfIl'YOAMAC;IONLY 05llSULTIO OVIHlCU a oe:)(CrSrIiUC~fOr06J(,CISTIlUCo;"""'O~[IlSf'"l.6.M11 I IS,?AGt I r-c"'.JFP /--'0'" - T S- I' P UNIT NO, 1 UNIT NO.2 $0" 4~EC 21::A,/O ORlvtnNMH o VEHICLE "'" W$P.A,Il.l$9 No, 8 5 3 4 2 POilCI COMI\AI,..I NUMBIII In',.A' ~ I ~ ~~::~ lLJ ~CIIOt>; 7C f? CLS 1 A';!/'IJ'" I P~HI_ I ,IlOUl( 011 SIInI C .-<' I ;J I I Cf5:2 00 PII"U( ra rILl POSI ~. 0)7 IlAMP r'A"""""'" o,..lA lNIlII II~tj IXIIO Iroll R?'5.!~' $TIIUIORROAOQiRV[lItNC[ - IIX I CL$ (1l0$~~IR[(Tcl3is-o ~PlCIAI COOING U$l o PEDESTRIAN 0 PfDAlCVCUST J '1";" I ' ,/ M ~ STlll.ITAOD/I(SS A 12 "",q /732' :;. ""OD< '.ON".O 0 '" "." "" ""'/ 1 r; DIlI\lI,llS<;:C~::'O A~'/l.Y' A#$'A?P~ 3;?[;.~~ 7 IlIlnIlC[NS{NO I SlAT[ I S{X I ~0"'IlOf8IRlM ~ ~ /noss;;o>;- h'L09{&1?,c 0.19 In l2 ';3' d:; v .y ,'" .. / r:; oc~ Ifl~M E&PMONlNO ~ I,&MI S~;I ~ OCCUP..IION IfIIlMN........1 & PHONI NO /11'f[S IWlIGl-lT ",GMI ~ LZ 0 CHECK("") i'1'>.:-;.t:;\lI~.':~'-~~'-iL~'D'AL DCHECK(r"') l'~,"/ w II/IN A ~'J:'Ai .~... .,. "'l\,J" "'S"'~l~"::.~e,~1l Of "''''OIMIII + ""jUD, vtMICIf AS"'~~:.l.?"'F1 Of ANOI III :::>11 f2 ~~u~;l:: ;-;;;~~ ~:o . ~"~ h:l ~/H ~~ ~:~,,~.t1L- ~~U~;f~V~ "13 e'.~~ . ~"~,,... ~~nCl'O~ 6 ~~~.~'ClI ['7 ~ D~"""'OIt""O '"'iil" .......&...,..~" 0 mel 0 ~8~".. 0 ~;~.~~ 0 ;'8....~, .'....'V1DUOM 0 _au'."Cl 0 rl~U ..e: ~l;~"D 0 :;~:;: 0 ;:'~'_ ~ ~"~~ ..~~/~." a;;;;;;'" ""'PA~" E K~-;:;. r" .-~, .'" 17'"'''''''' I"'" '. ~ 5 I/'i;o..~ li~N${"I."'T1NV ~lATI ..ITR"ILlIlI'lAlfNO SIAIl H Vl"'COI.OII rU'-'N"'~L""''''''' A:> A II. ............... 1"....1 1'" J2//C,{,/ 1719 I vB WA'I - - I / I I G.5 ~1~MI6lot;J:gIOWO L (J 9 8 0 :Lf. I~ VIMICLI,otNllfICAllvnNv, :/ I ; ~ fi'/ IIIGI$nIlIDOWNIIl,.--LAST fillS' M10DLI. PHCNlNC RIGI:SIlIIIDOWNIII LAS'/ f,RS' MIODU 'l1UNfNO t71 l.L ~c=- A /6/<" - 0 / fLJ ~ "0""""0_" ..s:9.??'r ~. " OWN"/ ~ r/ NAM1.ADDIlI$~()'2~l.S:o~?N~t:p~/'e R "...........""'.7IN"U..AN'-fW .. N r7I ';- omAGIO AIlIA I d;'~.Mr":t~....NO' _ ~ -:""j '/0. 1 ri'o,~":'~1 I OA,MA.C.i.[OIARtA '":;:to 12, t!:~~\0,.. I ~~"f~'~.):t' CHAROf //, '/ '" CMARGI 6~e~'~.:t: ~' ,1'01''' / ........ ~ ISI ..AM"C,! 0 DIlIVIN DAMA~NjP DOIIIV[N OIl!MAINID liST O...........GI I' ........ ~ r::::..c - _IO~ S Z~/ I~ ri~},w .c5,,//S:;::;&;U lo1~~~ IlY ..W"... Is loaono"'. r f6; DIAGRAM OF COLLISION. :~~~,~~P~i~~~~~:~, .ND~,~~'b~I" DES~";:;;SIO~t./;;;Pit:;:;~(I:f;g;.~4: . -.oeIVe-, ~ fZL,t- ~a ~"-C. RhOd( DR./VC; N~//R";:> ;/0 .....v~~- ~ , L " '"S . G~.cVe= ~ ~e LEFT. LEFT }>J .~~ :~. ::, r~(;~$~d ,:to' I"?,,~ .~::(..... .'.= 21 ~,1i~,':' .. IL ~~~~p~~~~~5.;~~~~~~n~~~~~~~.~!~VOlVED "~.O~~~. ..~iJ,~.1 ~~: I <,U"~i I"~,, ::dA 'l.......l ( ~~NI r I 1 ADtl.m\ ~"'~~tor " ~H~~"'J~''''u' OAM8 O~~" 0::0:.:;". O~~ OM''''.... [L ..", ( ;;0"" I I "'1.Ol'llll~!' ~""~~I.OI ( ~~""lV'1I0M 0".10111 O~~tl O~~"D 0 ~~ 0...01 1/1 ~.MI ~ 1 ~,',,- ...OORIS\ ( i~L~~I\or ( -~.. W-:::;:"JWIJlVM 0 ,l,M8 0 ~~~I 0 ~~~". o:~ 0 ii.~\. .t;"'I:'~'C,AI'''c.OIIICI'' '>N"\l1 & RA"'~ IIIAD"lo" AC.INCY UI'olI1 0' rOl'u DISPA'CMIO/ ~~ull'lIlol OA'I 0' ~rJOOR' "PPlJ~~ ';;11 ",q. X //?7 ;:;; /., '~ usP 19:;;: /.f.~.f: II,.!..? I/Z.3d 1/1lI!\~ 1 It' , ~ ~/ DClI\lUSN........l ~'''UIAOO''ISS ":. '. ". ...' .......>'.< ': '. .-- .....>, .'. " ' " ' " ",.... " "',','." .0, , ", '.', '. ,'.,<' . . ." .. " " ',:':' ':- , " '. ,", ,,:" ',' ,:...>' , ." .....,.... ".," . '" .... :> ".,','.' ": ." " ,,', "" ':,,' ",', ,,', " " ":,' ,:Y,: "',." " , :",- '::, , " " , .' ,,' " '. ". .,.." ," ' " ' ' " ' ,', , , .. .'., . .' .' ",:' "" .i ". . '.;' .:' ...... '''. .. . .', ....: > ,......,.......<,; . :,. . : ' ....... ,," , : ,"", ' , ",' " , '" ",: .~: ' .\ :"., , ',:' ", '::, , ,:',' ~c, " ','''.' " , '. .:' .' :.0', ': . ........, " ",''c. ',' " \; ',: . .' ..' ...:'" .~ [2J {' " , ",' , ',: ,"..'" " ;' , , ""I" 8""" .,\ !.,. ~ ~ . '1 ['I ..".... , ':, ,,', '" ,; , " [~ .'ACt I OIl ~TRAFFICWAY o PWIVATE WAY OMiOfCO~ll~IO~~"", OA"Otl;.Olll~ION t ~nTIMl rOON',. COU7'l z,. I'CI1,.NO IT "'" 0,,_,..,. '" "'r ,"n"o '~," oo" ... /'">1, H'1J!!' - '_' ,~ \ /',.L.,.5 7i J<. (. /,C." _..i~AY',-~r.~/_J / ON~ D'N ..5Y"0"'0WN I NA.ME&NO OfSTRUTOIlI-i'CHW....,. P.. ~""E:"' bw .Ii?~C/~...,~<-,-,..r" ION/~A~/t "J4J...u"",e INIIR~EC1ING WITH STRUT 011 ~...o INON INHRSlCl10N _ IBltWflN r ~~.e. SlRm & t5!::.eP -'-~ STIlUl 1',1 OISlANCI&Or:~' N'1l0MIlI~tIlEN:.,C"Osss'lml II NI....RESTMlllPOSl I ACCIDENT I.' /&/:r Q'~~~S &: ~ n n Of .....??//~ ...i?o~;;'- fl... M~~~E COLll!o,ONINVOLV(C !olvER,TY, ,J 0 ~~L ~ I "'"I~'" ~o~~~,~R~ za '0 ~~~~~:f ~~:fO-+- 0 ~~~~~~~ 5 ~~~~~ ~=D''') 1'(;:) OBJ[el~'l/I.iC~(NAM[0'OllJ[C'5'l/UC~~MII~NAMfl I (~T OAN-ACE 1 ( C4/;P - 7/%:-<'--C IS - UNIT NO.1 UNIT NO.2 VEHICLE 0 PEDESTRIAN 0 PEDAlCYCllST w' I~ OIlIVCI7SNAMC 1.A~' '_ (lI,sr ~ 0'0'110 lC Ol/lVCl/SNAMI U'.~f ))l/ I C I Wc,J'VL/..Jc:;. .J2;:/':~'0'/ ,r-?P,.I,l, 5c.f6):,5~';::' /L/k";)'" ~~""7(:::.'5 I S'l/HTADDI![~S -d TaU'AODlIl5~ ;:ry ~ C' r// c ~ M /70.,$' '7'/' /p&-/<.-S:- 80/5 /",.5 6 ...J,hJ, "D.5('J.:Q i'::!.< ~ CIT' ~. ~TA'l 111' coo+: ~"'ONENO 0 ITf STAll ~~':'~ pMONE....... ~k/~.!c"',.-e:. .11.1/1' %337' .JS,$:;:-';?/7:? R ~..y...)r:<s w;1J 7.'?q;:::,o 7?.I.1?3.:3/~ ",/1-. Dl/IV[I!~uCIN~NO _ . -.J 5TAl{ I ~cll.1 "'OA III I'" I IV('~II fN!.!NO An , "":' AIlOllllll'M bo '-=- tJE,,..j,:;)L,_T?-.7?;J'St:'.T 1.!-.:4- l,.,.plt;:.. J"" 7/ V 5cv!'~53'7.3'/2D tJ/I j/?7 /"":2 fi;W -' ~ OCC~~'ON 1'llIMNAMEYOiONlNO ,/ Ll'ft.S ~.':-I1II-l.ICi~1 e ~?~..<'_ flll~':p~~ ......l..gt~ '~~T~!CHT ..::l.. I,.;l 5..4..(?C~7'T c::'#..-A?...::C"~.,~ /~..:s ~r~.s~ R """'C?Z'V~::/t' /;;~o...:? .......Av;.1-;;..~-T~r~'IC~ o CHECK (t'l I ....(0iIc7f A!>~N1;:~b~1I ~"'~~~~'II'Al 0 CHECK (I"'l I' ~:ci('i.~'Z~U;:"P~'b~(( ~"~.mi'..:'f'i1'AI ';r ~CODES"'" 3 ~~~. h . m'~::"T",:<::, I .5 IJlC"o-. 116 ~:~.li('(L\- CODES .. ~ J ~~~~t. 7 . :~\~::..., I S UICTlO... j 6 ~~~.lICfC'1 IQ ;17 ..3-C...-:~~r?#c:..:s ""..- /'Y~.-J:> IE //e--A ,:>~~/..re:S _.....r '"'D/27""__4f.'C.S:$ ::3 o ......"..........CI 0 ~~CI 0 ~O'.'I. 0 ~~::.~:: . R;.~i.9 "0'" '"'g._M.....CI 0 ~~~CI 0 (0';". 0 :;::,~:: 0 ;;'~i.9 --...;.-i 'IMA~lCOOD?tJ.'''IV) IMOOlllOAI".NO......) I~Tnl(2R.cON...) j'MMI .11(....) I~AlIT.~.....1 'f,.~.I.' J7 [1/"/,1." 1 /' //.". AJC);.# 1 df<'D/C E /:?,!;? r""'Z"7;> 1 -3-=-:;;<::; I ~;;y'';Y '0" I .....eO'QlI IlICE",~plAII 0 15T...n ITlIA'lt~Pl.AllNO IS'AII H \fiOiCOtpa Ilh..t~...I.A'lNl,.I .I~.:r~' .,rt'r"II-l"I1..'lNU I:".A'W .:s Va/OUA Ltp.2/oP511 4/4 I - - I t---Jh7c:;' Ib 7/.P-7-L. 1 V41 - V ' .:;. I=;:< r:;?2 ;",/'''''??5'''';; 7 ~ / ~ I 8' c:; 3 f 1/"/'"i)7,i 3 7 ,r/ ,:z..J /1# 0 3 ~.BI=; I'i":n" lIlGISnllfDOWNfll LAST ~51 MIODlE I PHONI NO HGI5nlllOOWNIlI LAST fl1l51 MIODI.E I PHUNENO _~ ~/J6..~.-I~ k'd.d ,l.. 13z.:;,;v7~ ~ Cc,,~.z.-;::;;-'s./ ((~.s;..AJtG C<" p~P7yc, II~ ADOllt!.H:tOWNElI ~ /' A0D511~()f.OWNtll /' 11;' L::::::/?CJ .s 7/. ,/%~ -...Yd?:>/c..oe;.c" ?# ~ ./'/C-:? "", ~~'['~;c~L..J -~/7CC_ ~ ~ NA.M(I"'ODIIE!>~~IN~UlIANClCO OQACfNT IN U AN...t...l,.I ........~~tN . J r~ d?"-;-;;,,-rL.~" ~J___c:..,(4..'../ R /'/~""/ .3 /kcc ~"-;<</7c",-;=- , ~ J>_~'~.\lDAA~ I l~:l/~N~~;, .~~,;; ~rx:e7.'~~...1 ~~~p'A:R[A. ~ [;' 'CJ,'TO';::1' ~.L. .. "-,., ~ C....IIGI 0'''1.00,0(;1 ITOPJ' , ........ , 0' ,"roo O"~A'"ro 0 'M" o "MA<"'O I '" .AM~ L....... '1=1 - lo.one.. ~VCJ Ai~~IlY R/~.s I~~",:.,ollv B~~~ r I~..c'" 19-\'0.0"0"'. ~ ~ DIAGRAM OF- COLlIStON' lU~! ~U'PlU"("'I"'l NO,eAT( NOQ'M DESCRIPTlnN OF COLLISION' (U!o( $UPpl!MJ:NTAl S...UT If NlCf!o5AlI'f) ~' , SHIft If Nl:fSSA.~1 Il'f AlIlIOW '-'.oJ' ",.::? _ -c@l V~,/ 017/ /_,$ ........J A' 'V.,Zv.r-4.v41/ F1ii ~/".. /7"~ ~-"i'..fp;:Z ~<<;y /2<::>, p I'C [3hlVgA, ..~-y .Pi>, ~ <:I "~"';;:"..:A. i!-";/'>~ So",/~ a-~ ~-t:' b>1 C_ _ _ _............ _ ;;:; _ _ _ t-/?-U~ /~, ./ ,5 P t::> ~ 'VC".'Y ~/ P/?<'"'/.?~.;D C>);-- /....l r7a-7- t-:J;J O <7'/-"-:"-' ""'("-7" .....~C'4.....5/......? ~:c.::-/~~-fC?,7V f.::.-l ~ ' .s'7;r...?~ ~':::;d -,/ /oN fi"'-''''' /&6"'--",c , .}:I Vc.v/. .y / ?7/~.-J ~/;r- /"#0::::. $C"6.J' ...-JC'-,~(r.-/ --' ~4 =-4: t;4U&i/ R7" S P '?I"'rit/ ).'",:./I#'.9- /I"'"... 7~ ./?",<>,i') L/=ff ~/ NAME, ADDRESS & INJURIES OF PERSONS INVOLVED . CODES 1 1 I - 1 2 13 I. 5 6 OCCUPANTS / WITNESSES 1,~ ~~~~~~~~~I...~"1~: SEll I AC( b"..TUS! ....."6.., ,W,.: ci:Julomlf UCt ~',~~. N.'o\~V"''''..J ~_ ,_~c.".1/~.~ J. ~~~~.::>..;2"~"/. /Ji"...1r7 2. I "'-:" ~:,I~",~ I "0'- ",oollm1l!/ -1"2'="'~~Rs&'~...) /"~. ./../~f:)/rft'd, 1'1 .~t'S!:::>~AbC:: tt~lo'l~'''UM 0 "'Me o(.~ 0 Pl. 0",.. ~.u..." ~ "l"'MI ~~.W"":7? s;..?,J~#~~_ J _ _/ ::r",lr,;re.s".s~,~'<~ t;7 -;7 '0;-" .", / "'''- I 0' "'DDII(~~~l~ -Ji.ag .... /Y'~z::.LO~ I 1"''-1' .",vr~,..Jc!" OAM8 Dc... Oco,,.,, 0 VI" g-..",~. "" NAMf i'41"~~th AI ,Z,.d"....J~S_ _ ~~~~o~5-0/?.5- II:: v ~ 1'O..tl "h. ..'. "0' 4POlll55 "7~J =1" ~....-;;1"......., 'i.:54.-J -/':?..... ....-".......""'""~!) ''''JUII,,'' ~~"..J~ ~Cf"'Il" 0...1,\11 Dc.. Dco"" VI" .;B1',.....v , I'...V~I~""I"'G?~ ..._~.y,I' UN' 'IlAO"l 011 j"'''I''''' U"lll O' rOlI~~~"'/"IC PO.'et "1I11,;,.v~OI 0""1 0' 1I1~'J APPlIO::1ID),fl ) I OATI rvy X liPP ~--I -n-;'V~.tX'-4 1,4I-~~1 II.<.'.!:J? 9-':~ 1.lI.'Lp /~? r.40?S'81 //U/rfMI. J/J "J j'1f 1; " STATE OF WASHINGTON , , ' , '" POLICE TRAFFIC COLLISION REPORT No, ( ~ 4 ? a :3 9 "~, ...... .... ,..)~ .'.... .. ~ .' '" ;;', 1~:ooWA UlleA,.. RURAL :.le ION ',,, 'CT~ ~~ I I' I~ rQQ/500 "fT1X r r"""'~/.9r ~ aAMp r,.c.aAMDoATA IN. 11~!":.I...ao ,~"'!.I.!.!l~'T1!~l'~17t.1 OUOAOOllRlHalNCt ~ ,1.;r'1 ClS ,CaO!lHTR((TQ~j~o ./ 5PlCIAl e OINC USl ," "" I .. t f; i ~. "')\.' '1.i' I \fie' " ~ ~. , $ t " f: \ ~" t t ~~, :~' ~ " '/ , , ~. j ~ " ' " , ' ,'" ':' ,","" ..' , ....... .' . '..' ..... " , , , , , ,",' ',: ",",' ,...: . ..,'.. ." :,', , ," ,'," ',' .- :, ....., . , , , '''- ,,' ,: "::' '.':.:, .',' ...... ... , ," ",',",' " :," ',- ",,' ,,' " ," ',:" , :" ','" ..' ..,:......... .... . ,:", ". . ,", ", : , ,':,:: .:' , , , "'.' ,", ". ',':", , " .-',:., '" ': ': ,,',,,:,,,, <...'. .,.'....' :". " . '" " . " , " .'", ' ',," , ,', ,', '. , , '. ' :; '. ' " " '.' ,", ",' ". ':' , , " I:::":::'; """ -':. - , ,- ,', , ,', " ',. , ~> ' ' '.. .' " ...... , ", '. ' '.' 421'1i::JI , . , '.'., ' ....:; . .... ........ .. . ..' "'" .;' . > ..... '., '. .... ," ',;-. ;" ':':: . : ::', : ' .' ,:", , '" ". ,,' '. ..... ". '; ..... .. ': ':", , ," ,," ''', ", ,',. ....'. ,'" . ""::.:.:" :.' . ,', . '.' '" ':',,' "":.," . '. '. '" ',,":" . '." ': " . "':, " " . :'. .', " " " :.'" .', ':' .' ,:. ': '.', ,,:: ," . '. ... ': '" .. i.":;} ";;,!u ' '.',: .' '. /'..'. ,iY:':': :, . ,j ;::., ,..,'::.:".....'.'. .,.;...,..:. .'.' ".....:;,.,'.. ..A I t: u,. . ,""... "".. ,,,.. V''<I "GI '- O. <- POLICE TRAFFIC COLLISION REPORT [g TRAFF'CWAY o PRIVATE WAY ~ OF COUlSON ~A'I' ''-'-'':1l5_'......... _ _ . I R IIM( COUNT'" li-?~'n ..... 'X:..':~n''''u' n ,vtlpiOr -:S-EI-~~ ~--. ,- ON 01 D'N () CIlYOlllO.....N I N.l.Mf..,..OOlSlIlEtTOIIHIGHW....... FClClS - l/lh"" /iil; Ow Ilil'o, t'r.~' n..... v..N OLD ~i)~ ~ '~fCTINGWlI'" $TIlHTOllllO....O /).. INONINTtllstCTlON [ PI/HIJ( L)M1)&M.l~f-IJ,IBITWtEN - STlltET, - STIIEff 0'511,""1" O';E~ ION fllOM IlHUltNC . CIlO~ STRUT 011 NtAlltST Milot POlO' T ACCIDENT - --H :'::5 ;; F, ~ ;; Of _ Mt~~E COlLl~~~~~~OWED ~ :J~~::;O_NO JNJU/lfO---L 0 ~I~\~E 0...,' & IlUN I ;i;;~":"$ ()I....(t-4IClES ~ 0 PllOpflllV DAMAGt ONLY 0 JlfSULT!O O~~~,t~ I OBJECT SIIlUC,l(IN-'MfOfoeJfC~UCr; ANOOWNfll'SNAMfl --f S fST~AGE " INo PO~ICt COMP\AINT NUMfltR COVNTYNO. ClfYNO. AOMU~I '~tHIIIl(:;;/:;-C/Dl fO. MI~t PO:iiT 0,3/ R,A.MP r.Al.>Il,A.M ClATA I""I!./t;:;i~ II RO Ir~.t!~:.tC!I~..:;~11UTORIlOA00ll'Ilt.ffllfl''''t / ,INTU C~S CIl~SST"f~O~fIO~,,:? ( SPECIAl COOING USf UNIT NO. I "RSI UNIT NO.2 Olllllfll'SNAMf o VEH ICLE "'" o PEDESTRIAN ..... o PEOALCYClIST M'Crx. SfllEUAOOIlESS ./ ;- ,_ITl' - o " R I :iiTATf I ~lll "'0 Alt~...~1 H U ~ Mrr~IClN!.i:-""O /' I Ens 1~IGHflH:lGHT : IOCCUPATION AIlMNAME& PHONE NO SA:/ ""~ PI'1OI fNO. OA l &IRTti Me) DA" ". - I :ii ATt ~, I HtS 'NE.1G+1TIHf.IGHT~ OCCUPATtON fiRM NAMl & pt.lQ,..,t NO. o CHECK{....1 I ~~I't~.~~'Z~..:.tl~twC~~6it.WAl 0 C1llCCKI....l IIIEtiIClfA:iiAN(M~ci~:1~~~f~WiAI. 9 CODES" + 3 c~:;~. A :~\~:.'... I s IltCI,OO< 6 ~:~"IPC'C';, I iES" + I 3 ~~~'i~' .. mw::'" s IlICI,O'" 6 ~~';.,IPC'w, '"' ~NAJ~ u- 0..... 0 ......BUl...NeI D ~~Ct 0 ~!};". 0 ~:~,~:: rwl'i......... 0 .......8l.A....." 0 C~l'..l 0 ~8~fll 0 ::~~:: 0 ;<.<l'..SI' vtH "fAR jMAI;ElOOQGf.CI-lt....I MOOfLlOPollT.NQVAl 1S.:~~'fC7 ~ IMA,I( (U<.Il.II.>t.l.....t....l IMOOEI.IOAIlT.NO....Al I~" t ,.caW_l ,[ "" co."" "Cl"",,,,"NO "." l":;rr7 ".,~ 7 "" CO<O' I" 1 "'" I "."" """ "C, I ".n C IIhilClt 100NT'fl ATION NO, I~ . o IlEGI5TtllEO O....NER ~A5T FIRST MIDOlt I Pl-IONt NO, ~ 'jitioIH!.S ~ OWN(1l rrr- \/EliICLE IOf.NTIF'CA110N NO. 0/ . r- REGISTtlltO OWNfIl L- 13 AODlltSS Of OWNER fIRST/.....IODlE .." :/ E R 'G'"' ~.-. I ! i,(' ~ NAME & ADOllESS Of IN:iiUIlANCj,Il'b OQ -'GIN' (t. , L...- O....a~EO AREA I db7~"';;""'G I;;;.,A I ~ D~~~I~fA -= r 1 1 . I R6~~;"g..::t~ ICHUCE CHAllGE ~";z 1 I . J3 .k--r .~_'_O!_:~, E$I.OAMAGE I~o OIlIIlEN OIlEMA,INEO oOlllllEN 0 I I.v .TO'~. = ''tl-.. [to.D"O~ "WA" AWAY llEMAINEO I'k. UHO-';'OM.:.:I' J<l s 0 lwr"Op,y. 0 :~v:~ ev S . L lDG~eC~LD~'S.c~ ~U,'~~~c~:;'l;i,. "'~;&;'I,<;:'" De~~~4;clrON' ,.\{"'w.UMli";::'";"'''i l, l _ ~ ~-z..:3".5., Pt~dDO~ ~Ai)Jf, IOIW"""""A I..>>AJi; - L G> frl:~~'ffJ~~~' #oZ.I, p.,.'"1Ud~E.'.tJ~t.[;'Df/~<+3 WL 14 '2. " ( I I l - 3 ~ "YYIM41~ EP'2 '_IlL' <3&r-S'(Iz,. F f~ 'Z- 'Z-"1 , l I ~ --.. [ 10 gS- /}w)./) ~(), rr.~AX~;1dJ /l)/)J)E ~ t$} t5e71-oal,IVG' ,_, .~,... ?J1r-:304-11.p II~ "Z. 'Z...., l 1 \ " 5()~-:Z11Ji~ ' ,."'fU.()'~~ . /.JD.u~.. I i;i-i-ht-r-fi'h-:" :^lI-P~iolAn>~~lraL ')C I] NAME. ADDRESS & INJURIES OF PERSONS INVOLVED · CODES 1 - 23. 5 to OCCUPANTS I WITNESSES tF'gi~~~cr~~~~tA~Hm -Sf~ I '..Gt 'AlU$ '.....~M ,~:,: 't:/ ItSIt UCT ....',c.r" 'ffff,-".", ~-m .s.. .!:-.eun"s .. . . f:o,,;'::,'"~O,r- -"!~07" ~ /'40 ., ?_ I." 1_ ;OO-.iJ ID ~,4...:(1 '~'''Jll~,l?*- -AJOJJc, ~~lIl~fllO' 0........ O~~u 0",1;".!'ii;j:;~ 0;<8',.."", [1"&1') ICIl-IE"LLe ~." r..l~"l''l-' o#-L 11</, .,. I... "7 1 ,- ~ 1A,~Ul ~~.l'-AfM4t' '.0 , ;D:U~ ~~lIl~' OM OAAoOB O~~\.l Dcg~". ':f:r O~~'...v <<I I'W U9' ~~,~ ~^.,..-.. 11 . i~?~" ~. ~77,.y 't: /u '2'- '2.. ' 1 I ..'- AooelSS /-'1....."'" .-_UJ"'7M ~ l..Jf)t\)~ ~ E'-I;V.~ DaM' O~~"Oeg;'I' VI" xl::;:;"~:'I:~;:"Il"N. -"d le~~~ooIlJAVI~C~]I~~l~P~'::(~~zl PO\tYrF;i 0('21.57;~APPROIIID'" I',. ~'. I, i ," . '" :,.:' " ,:':' ,', " ' ." ","", '. ," " .... ..... .... . '.. .,", .... : .'. . . ....: ,'. ...... .. " ", . , :"'..... ..'.." ..... , " :,: ,'.' .':'. , "", .' ,,' ' '(. :: .. :"" ~ ~ . .' ....'. '.' ,':::: ' . . .' ','. .' .'.,' '. ' '. . " , '. , . """,,,,' ',' " --oi] FHWA ~ I~~~ SlCll i ] , .... I J J '" h "," ~ t5 ..J o i.~'..~" pAn , I I' .:," '.,' ," . .'... I t f'.: Ai i; f' ;~:. i, l " f I' " ~ I, , " ( r t ~" t r h, \ i \ I ~ ! ""''':,'' - - S - UNIT NO.1 UNIT NO.2 VEHICLE 0 PEDESTRIAN 0 PEDALCVCltST !lq OiMnNM\~;::U~1 :::;rM,J::.. /J#IZ.'L~,&' O~'Y[i'~:Ve-';~cr~ /J.,I;~/J y;1-I1LVl7€Z !llliUl "OOI!I~~ II/fIT ADDI!(~!. ~ ro:- ::5/'-1 M~/J~, /c>-6s/S:3 1'i L.:b '" ~(=vL()~~ cU. Zq;CJZ<~Y;;-)~~ ~ '" h-rN.d.a~_/A. ~;Z:'t)..t$T:?:b--/~ 7 Li""~~;'?.6-;1.;LZ l&'.~?i ~";'?-~ ;;';;;";;,'M138/1C:~ 'I;;; I;;; iA"f/zz.. ~ 'z. ~ "'MNAM'''HON'~ ~~j5-.~,;'iE ~ ocZ:;;ee "'S;;;';';~'A.sr#-S> 2l1i~s; ~ ~ 0 CHECI< (JI') I V(HIClE ....S:'" fM~'S~I~~!:(i''''l 0 CHECK (,II I V""UC~f.S"'N tMl'LbVH ~Ci'~~f~"'l '! ~ CODES.....,. 3 '''IJUh . f1l~""""'-a" 5 11""00. I 6 r;::~.i'cYC\1 CODES'" + 3 ""J",h <II .l~'i",'" "? 5 IJtClIO," 16 ~~~.IlC'C'1 1 '2. (,,,, ~.~"... RJ"!-TA) I~",;::i~:-,'" A";~~JO~ \'~"'" I 0... ... rx ......e"'l.....el 0 ri~~l 0 eg'1I1 0 ::::,~:: 0 ;<8.'...~P m~r1~1~0... 0 ......&.I~.....el 0 ~~~~l 0 ~g,". llit :;~,~:: 0 \".1~501' Y~~-I~~tp~CMEYI I MOOt~;;:;~YA) I~T~/J:3NY)/ ~ VMY75 r"~5;W' I~Z;~NOYAJ 17J(1..2~~~ ~ ~ VA';;. ~a~"'M.I'''':':'''"o "K7I ~ "H'f:U. 1"2!~30/1 j'~~ I "=:'~~~;\r" ~ ~ ~rH"'S''j''05 If.:::r ~ b:3 S 9 7 Lf" i t?'3"'-;"':; S \~, \ ~ ~ 1l!C;I~nllEOOW""!Il)t::>l ~lll!>l MIOO~f ''''ON(NO 0 II Gf)"lll00WNEIl lAST flll~T M:Ol.( ~ _,NO, ~ ~ ::2 ..\.A-n:tE' w tr.~ .C,{})J,MJ/, '3.",_,Lt1 13 ADOllt~~ Of OWNfll "'OD"~!> or OW....EII l/~ :z. ~ n-.~; ~a4, q~bf ...:f:J ~NAM'ftO~::~~~1k~~ M- R' ~;;;N' A It ~ O~~r~t... l"rit;r~...ft""'c. IC::~"O" C~c:..lT"" ~ 8~~i:~~AI ~""""'AGlpIAALA.. ~ , F.': - ~ ,~. 1'R;'~~f;'~:;i C"AQC( C"AIlG! lIO'O'''''OAACoI _k-- 910l'........L:..= '\l- {io~'"o..~~r~~Il!i~~eY 119R~""""fO I 0 ~c;.~~ev r- ~~~~.... OIlEM...I....(O r~~~'~ ,ciiCino.~~ ~ ~ DIAGRAMOFCOLLISION~.6 ~~ P ....DsyifpP./''''1 OE5CRIPTlONOF COlLtSION: 1U!.(~uPPU:MlN1AlSHmlfNfC(!oSAIlY, ~ C ') (e..s~~ . . ;~ ()~:o~::;r~ rJA) Ow ~ r;: ~.... ~ [)a.HOlF# \- PlLLLIlJ/ ().(<T ~ SitJP -kAJ L=:J <G:l::I-""!! ==-- -=- --=:: ~ ;:..~...J --...-z... 'TZ> tfb ~&Ih- ~S,S I~FOT10P. r--ii1 r fW) )JOt ()~b 1tP7>#AC!li bf:- VE'ri 1ILZ. L::::I L. lX<'A-!$Gr"'~M~ ~ (_ \JeJ.I.>l1z.AP1t.U;rb~ /SJ<IUJet)lvroRr-, ~ ---- \ ,C& \ ~r ~ 01 V~#- I A-S '<ll- f e<.rre;esfj rrS g t:' NAME, ADDRESS & INlORIESOF PERSONS INVOLVED + CODES l.' I - I 2 3 I.' 5 I 6 - OCCUPANTS I WITNESSES W~ ~~;i~cr~~;~~l,;n; ro(X -I ~ca lATU~1 '\\11"1.""',: e~~'~ RUlR (lfC' 1'~'lerw NAM' .II'~A--=;er ~J7X~04 A l:t:"-;3'J'.r--2'~79' "V l.un"7 I /_ I I. "'DOllI!.!. ~ ':;'~; -"::l::l ~/'IL,tI/h""' 17: h;. '- 'M:;;1~- !.Cr.:r.\/~... 0 ...Me 0 ~~~l I ~~~.. :;~ 0 ;<8'.."" [NAM' ~ '}1UX:~" 'HUN .,,1 U. I I 1 ,I )0 ...oom!. ... -I I~~JI_ A~.. _'\ ~!U~fO~ ,,(,.)JJPlF t!""~~~'1I0MOA,..,e O~~~ClDe~~"1 "'V Oi'.~'''M 40 NAM' JA-t29;!-e2./.vc:------;r:; ?11/~' ;;cf:51'bnI!f'M""'/) +-I.Ull "7 "2 I FoI I 1_- "'ODII'~!. ';'--L .::: -;'~.~:r ~~~"~/!.o' ;;;::;/1-' ~~T;:;lVe~I"U"'2''''MIl 0 ~~~l O~g~lU ..,.. 0 ;',~'..\O X I....VI~~;GOHltlll!.N...~I&h~. lb~~;l~ o~7~1 rO(~tO ~tWl~IC/z~tlll~v~ dDAT~;J ;-c 'JO'i .... .,.... .'....7\:;;.. .:--~_ ...... ." '.\ " ----" <) ..'..'.. ..i\ ,....i,.., . ..t,':' ...;.q ,i. {,>. ,.,',.,.,/,.,,'.-; 'C"," ............,..> "...,..;.'C/. , ':,.,"'" .....'..... ,;/'ii'i .' '\i'; :, i ;. i; '..'; ,,/{'.... '.i.. ''''< i./i.' . ....,'..'........ ;,i .'....},. '.+.'....,.,..... ..,}i/'/'I .. -2.:..;J . J....Z:.. ..'..,....' ./.,< .:>,.., ", 'i'\ '........,... 'j " .:22'.: i.'i ,,' -{../) G-::' ,:. StATE OF WASHINGTON "G' I O' z.. ~ ~ ~ PV'I TRAFFICWAY " . :..../ POLICE TRAFFIC COLLISION REPORT LA! ~___ 0 PR'VAlE WAY O...ItOICO.ll!>ION :. "'YNl:O(li~IO"..1 .r~:t;~ R:.:JI'OUN1Y":--/,/___ I . IT 11 -i'OJ tk 1-' .,"'~'" ,~" "'~'II,ul4-~ II :::Tl=~AJ f ON Of 0..... ^ Cl1vOP10W.... I N.........I&NO Of !>llIltl 011 HIGHWAY 1/<fMm il, ow 6;:;0. rr. 7Z'&;:),.b'S~N OM~a'pr~, INlEll!.fCTING WIT... STIlEET 011 WOAD _ ~~N INTUISl:CIION I ~>:1tLLL~JW(fN 5111[(1.. - S1Q((1 1'/1 Ols,.......Ct&O,:!.I; ION 1l0MIlUfll N .CllO!>S!>lIlH10i N[...llIS' Mill.....,!> I ACCIDENT I I - H~'~~S f=, ~ M ;; OF - M~~~[ COlU~~~::v;'wtO ~;EIt~~:;O_NO I....JUllfO--1- 0 :l,\AG( 0 IoIIT" tUN I ~~'~~o~..~ C)fY(><'Cl(S ~ 0 PQOPf1l1Y PAM,t,Gf ONlY 0 Il{SUll!O O~E~I~~l ....-- . 08J(CT 5'llUC~ INAM( 01 OBJECT 5TllUC~ 0'I.I'II00....."'11'5 """"""'(1 151 O........AG! W!>PI~IR(V,I.aol No, I 9 8 I .!I 2 POI.ICl COMPlAI....' NUMIl(Il -~ JM........ -I~i~~:: MellON 7(; 1""-0 I ~7J~'1 "" I'~~/'~/'" PIlEflX . rQ r"'ll(PC>>T (;) I '3 I RAMP rl...GIl........DIl.TA IN _I ~ I I X. I) 1~~ Ill!>f_~!I~ ~!Il{(.l_~ll RQADOlllllWtlNCE J< IINTfR I Cl5 (IlO$STlllr~~~ ~ J 5""CIAI CODING USE ~ / lj ,. "2.. "', " '.:, :' ..;' , , :'" ." ': '. ',.," ....'. :,:'.' ',' ",,', ' '," ' ':." , ., ' ': ," ,", '::,. " . :'.' , " ':', " ",:"," " ' , , ' '.., :"',.' " , 'i : , ":,, , ,'" ,:, '," , , , :,' ," , :' ',' ..",' , ..... : . ,'", ,'. ",", I 0: ",," ": ,:.', - , " ~ ~. r'<- I h ~ 'h ~ ! I~'" t , 1, \. f, v.- I ., ~; ~ . , .' ~~m\l~~ IliUM 0 "'....b 0 ~~"I 0 ~~~'r~ 0 ~~~r 0 :"r.~',<V I'E'"'L~~~;;:'J' 1/~,rvc?;~'I;;~~~r7 tv 12.-~l ~ '- , " '," .".' " ; ,',,")'; ....,. .' . .' " """" ' "" '," ' "" :"'; ,'" ; . '.' .' ,"'.'.' , '" .'. . '.',' ::<\ : ',,"",' '. ", '. ...... .... ....... ':, '",....., .' ...:' : : :'. ,:'. . . ::", ..... ." ,", ',., , ':"'.' " '." ",,''-' , :, " , , "." ,', ", , ':' ",: , . '.'. ,.: ..:.::..:.:.. ". ,~ . ,', "': '., ,'. ;'.,'; , .,' I ~ STATE OF WASHINGTON ~"CI I 0' I No,. .d ? lOw:,,,,;,.,,, , ~ POLICE TRAFFIC COlliSION REPORT TRAFFICWAY """"COM""'N1NU"'", ,. ",.. (')0 PRIVATE WAY It3I',.t,r:()I':';'I~''f.it-,.. ,OAVOICO.Ltll N_ .;;~;J 11M! COUf><TV COIJNT1NO/"/ l'IlYNO [l''J,oo,j-;,.., .r !oU..:..,:~,rUI~;l>lo!~W'\:I~I":XIII/~;' ~~_f"'2.~ ~.., \.;::::11 , ,e5N DE DIN ".,...,...,CIlYV"IO'AN ,'_ I. N~l&NOOf~IHElOl/~; fCTC1~ I ~~I~LHJ\ ROIJIfOll 'wtll~ODl J ,,>US 0- Ow 00' - 'I>, ON ~.)-.=-co-~. /',,1 ,-jl Cf3J5D lNlli"~('f!r.GWlHi ~fJll{lOl/ro...;) , INoNlI~n tCtl~N . '!o.. PIIUI,lC 1'0 MtLfPO$T - I "'WIIN ,,"."'. "'.J "&; /3, <;fa I', ~lAYCt"Or;;?'MIiONfIlOMIIHf"fNCt,CI/O::'~~ll/H101l NtAllt~ MIL(I'O~1 f ACCIDENT RAMP rOIAGIIAMl:l4TA ;.tuo fi~'~~S ;, 0 ;., ;, or ,~...~ L2~...,- /,.L/ M~~~?[ . OUI~IONINVOLVEO.....!. lVll/Ill'..JIIIt'J .--" 0 UL O1-4T&/I N "'"I~'''' IN 'l:::tt~J~'IlO INr~?E_~'~~!lKf'OIlROAOOIlRU(IllNCl ~O~~.Lu~3s ILJ ~~~~~~:r~~:fD~ 0 ~:~~~~~ o~~~mU otJ"'O~'OI~~ I'VI CIS CR~$~f31l~S"o I~ 06~lsrRUC~(NM"tO'oe:JfC :'TQUC~ANDOWNEi'~;<AMf) ~ l 1.3(o'jl, "1__tSlOAMAGt SPfClAl CODING USt 1"7' >J,^_I_ ~"..:~ 'A";'\ ,UI (..(ilk UNIT NO.1 UNIT NO.2 0 VEHICLE $ OliIVIl/'S~~~~__~ J 1llib_ _ MIO~h'^I~ OlllVtll'SNAMt LAST o SllIrr,;::s~ ~ ~W/~ /n/ Aa .... /y/'U~ STIIWADDllfSS E c" "'"' -, "'." I A'~"'" I:'",ON'-"O 0 "" ~ ~j /A~_~ ~Aa ~A~~~R L ornF!:.I/~I.~......N""Nu 1- SIA:l I :>1)( 'liA lOftlllllH I IVtll;,UUN5!:NO r -, o I Ida. I 'F,,,"q ;~~ V B ~PA.l'ON '1 fill tM',ll&PHONtNO 1.l.."I!. IMIC.tHIHtIGHT E 7,"1';( "';_~J.J,..o1 I,Q" I J,y/ R o CHECK (,...) . \lfHIC~1 AS 'Z~.a~~~N ~r~~b'~;"ri'Al [I ~~D;,\~ " 3 ~~:::o -, I, :,\,;~".u '''''''ON IT. ::'~:1;'~ o A",~...~.....tl "K ~~'~I 0 ~~~TIC 0 :;~~~l 0 :-B.\..M ~o ;,jq:;'~I~~['OODGr'~f,) ~~(OAIl.T::::' IS:;~;::NVI \li~ti{:~ ~H.::. P~"'HNO j!>TAll" 111l""l.tll~...J'CNO ISl"l}'" ~~)I~ ' h /n. I c-'7,v,,-- ,f '" },- ;;;::;- 'Il'CUj':lN"'~';:~:;~ LJ r:.: .....'.~57;LlI,o?l" /; ,VI.TI n- I1IGl!:.~OWNlli LASI flll!>l MIOOI( - .2 ADDI1t55 Of O'M>lrll 'Z ADm/ISS Cf OWNEIl E . r- N:'~U~I1ANCfCO QIlAG~a^ .~: '7~?- 307t;; r lk? NAMta.AUjJllt.).:. IN U ANl.[ 'lJl. AulN L...- o~Aa:bj~~ --)I~..y"..H. U~ l.~ , . I n'~'s"''':'~G I DAMAGtDlZRfA I~ 1 .\or . CI1AIlGE CH....j;lGf I H ~f~'~~": 1 .\op. (]";;no~ silk"""' IBri-it JQ"M"NIO I O~';.':',"" m:;~': O"MA>NE. I~".~.G' 't;J';;riq- [ --- DIAG.RAM, O,F COLL,lSla,' N: iUSI ::.uppaMfN Al tNOICAH NOIIIH jE CRlPT10N OF COLLISION: IUSE SUPPLfMENTAL !oHHT If NECESSAIlVl ,[- T", .' -r"T'-I-"I,-'-":'-T-'[-.~iTlftll'C:~R'tli."l 61~1l110W - -','--' "--I'~:f_----l,~'-.._---_._----z,.'--';-;'l:;----._'-~ "-":"./..r.","T'.~,' ,_1-[." '0 'ii," ,.-0"..... ~U'!::l2:..<.GVl.,_"" .a:I.7rS~.....I\d_.",,",,~,J<\"_(I\,'" [t-I.,:"..i."J.,-'.~,-i.!: \f-'bL,'A\.~_!?p_c...._a~~- _ - ftiJ_tao.~z .U-<1T7cJ:>L-AS_ '-; '~1,I;.; .J;..t,'.k,:Y-;-, -,'--;; ';,+-p: ~. /A'J70"h_ - ~L"5WA ( _1'i:H~._. f-=Ci~'Tj~~ .0~1" 1-t' J.Oo~~~"'i?.~~~~=CD",""",-;~-rO~';7:: [~~.;o~ - '~~~%:;2~~~~~:S~~',= ~~-~~~ '-'I' , -7' 'd7Zt::-'/....r.s_~~...</_Ut:7'L~jj;~ , ,. . "', ?~' ".__up .__u....,_.. _',_,. , NAME, ADD ESS & INJURIES OF PERSONS INVOLVED + CODES 1,1 I _ 2 3 . 5 6 OCCUPANTS / WITNESSES W~H~~;~~~~~Ll~lA~n: "sf-~-IAGf-ll';Ti!~1 '~~~ ~~.: ~\~J5~ ~r'si; ",;re! ~'M. ~ONl I I I ~:l'd.~,f~OJ ..crNf"'J~'1l0MDAMB O~b''' O~:~~.~ o~,r::' D:1~'..~/> r:~" I :-t"'\t~I~(Ir ttr..sJ"'J~'1I0"'" O........f1 D~~I.' D;~;I1~ 0 cr: 0 :t~'.,..r "UN ,. IJATUpror 'NJUI/'I~ o PEDESTRIAN '" o PWAlCYClIST M' , LII'COOt I STAlt NO01UOO:.t117~' OCCUPATION IflRM NAMr & PHONE NO o CHECK (,I) "vr"'C~f~~AN..:w.~lt:~t1~I.i'~~~~'AI CODES'" "I- J ~i~~~' 4 :~~;~~''''! 5 fJ!CIION IN~u~~h""f ~~~"iW'wo"" 0 ......p.JI.."'c, 0 ~~;:tt 0 ~g~lFlI 0 :~::,~:: 0 ;:'~"'y E VtHltAII IMAl\(DODG'Ht\l) IMODlLIOAIU.NQVA, -f"5fTlll II. \I) ~ 'o'IH COlOR I ~I N L 1'\1 I s.,""n Ill/AILlII Pl.A ~ NO. I !oTATI f VltllCU IOtM,rICAIION I'll IF I I I I I I I I I : I I I I I I o IltGISoltlltDOWNEIl l~' FIIlST MIDOI.f I PHONlNO rns, WEIGHT HlIGHt . M010"CY(U ~"'fIY L ADOJ/(5~ ~"'M' "l'l~lI/l ~ ~ '-1"....,1 ...---, >5J::;::7~ .,,, , "" . '.' , " ."", , "", :":: ,. , ........ ..'.. , , , '.,,' ,: ", ,'" "';" /. " , ,. , . /,..', , ' " ',: " "' '" ' <: .. ,:.' ':.' . .' ,"'" ,... , ., ", ",', ' " . " , ".' .....' , ,", '\" ,,,'.' . .", .... .. . '.' , ' \ " "'; ", ':': ' , , , , ' L ~ I~..~. I I OUItIlAN f'---J "'" :..!.CIION ... " " f'" ".:~ , ,',' I,' ''': : , ,', .' ...::: ], l" , I-J . ~ '. 7J r...- -". - ';:'::1- $" '; ,~. 1018 ~ ~ ~ " '" " " ':J ~ J 0 I , , """ '.' ( " t, 'I;, j,. , " \' ,~ ';1 \ \ I 1- 'F' r Ii t~ ~~;< '::-,:, :l~l """,' ,,' :':: '., ...... .. ......,. , . ' ",,' . :... .,'c': " " "", ::" , , , w~P."I1.I~9 No, 4 3 9 8 <-1 .. '" ,[ ~ STATE OF WASHINGTON 'AC< \ 0' I ~2 ~ POLICE TRAffiC COLLISION REPORT ~.AfflCWAY I ~ 0 PRIVATE WAY :::"ltOf(OlLl~IQN - DAY ICOlll~ION ...1 TIMl IlCOVNTY COl./l'</~~"P_ I ClIy f..IO IT r J Ie> ~ " .~ "" .."~,, ", 5< 1I''724~' II "~~c.J < '" I o 01 DIN C.TVQlITQWN AAM~"NO O'~"I!IIOI/HIG"WAV IClCL:!o "'~'!~'Y:)I ~"ll' IIOV:';~/,~CCO'" ~.." ~ M"" iX..~ OW ~O, Ltt. />rN:;.""^ ON ~J\\)C" VA/I"" & /~, I '1"1/';.,)' INTIII!.IClINGWIIH ~11I((I0I1~AD NQN1Nllll5olCllQN I PIlI"'>; tQ """((PO!.' iI, 'II" _ ~. 8ITWt(N J=f..,.b C r !iUIUT .. SVt h>:-~ J !.lRHT ...., tP 13/ DI!.'....NCI .. ~1~'ON fllOM IlHIIUN I. CIIO!.!.!.IIl1(l 0lI NI"'IlI!.1 MI~1 PQ!. ACCIDENT IIAM j"IAGIlAM o.o.lA ~ t ~~'~~!. ~ A :-, ;; 0' _. _I Mt~~E COll!>lONINVCl'o'EO !.tVlllllv. ~ __ \ I 0 l o Mil & IlUN ""IU'N IN'I"I~'I"'g I~RO IN 11:.1. Ilt.;(jSlln.llORIlOAOOilRi'IRINCI _ ~O~~~~Rs OJ O~:~~~~:(:~:lO-I- 0 ~~~~~~~ Oe'I~I~~1 =~ !)t I CIS ClImSST~J;1lO9C> Ib Oe~ISIII~~(N""f\O'OOJ(C1STRnMlOOW"::R'SNffll _ liST O"""~G~ !lPlCIAtCOO'NGUSI I T !'(:)we;, tvl& _ ,.I.x,cl tD....l-€/\ $ 7.,5D UNIT NO. I UNIT NO,' 0 VEHICLE 0 PEDESTRIAN Ol/IIIII/.SN........I lAST fll/ST B l3 "'" '=+ .. " I; .'. o ~ f'O~ICf COMPl.AINI NU""BUl , ,: ,',:,' ~ J I I ~iHWA U"BAN RUIIM I :.I.C1ION 3" o PEOALCVCLlST M""',/" /1 I= Ol/JV(IISN~~;S' Ct:~;e- ;~I g: ::::"A""'~ss ~~I!a.J Lf.co~D ~N;iI; 0 ':~"AOO"" E OI'"'"SIICIS~IIV'A<'''-''' L..v:\ 1~~132~ ~~~~~~~ ~ IIvtl/'SUCIN:.I.NO fbCI.EUI'\"l:"'lIAltl- t"v~ r '8' :2 ,<"3 v ':;) ~-'" "~AM'~~~~~",~~.vI=-I;~I~:~IS3' ~ OCCU'AnON I"'MNAM"'HONlNO / o CHECK(t"') F~~,~mr:"NIMP\O"'IINo..';;~OI"(1I 0 CHECK I"') 1'~:C~IASANlM~~ i~A::g-N:I~AI ,.,... R CODES"'" 3 c:::.~. L.. <II ~~i~:.'N' U 5 IJIClION -,- 6 ~:?~OCI&.- CODES.... + 3 ~i~~:' 1 .. ~~~~A' $ UCIION 16 ~';?ylIl;'CII ~ ~ IN~l~~:SUI Ci..~',~ ~~~~~1..0' / ~~~1..-~~'eo'" 0 A""UlANCl Ol.~~Cl 0 ~g~lIu 0 :~::: 0 :"z....!." ~~~-;~HO'" 0 _MANCI ~ mCl 0 ~g~,,~ 0 :~~,: 0 :"B.'..~ " YOjctSs MA"cll~7" I MOORJ"NO'" ";"~ON" ~ ""A' I" '~~',cH7 1"''''''0'''00''' 1" I . ,CON', ~~ IT .'BC~ I ';:-p/':::~;' 1 'CA "A":.:::' 1"::- 7 YOH cex'" I"C'"~ '7" I ' A" ""~" NO I "A , r3 '2:cb"'Z'c;.:'cNO.:::l '-I . M 'i=( F , II I r.,.." I '-I 7 I~ YOH'c"''''Nn''cA''~7 . , . .J:: ltlGllonlllDOWNl1l lAST FlltSl "- _ MIOOII PHQNlNO.... _ 0 IlIGlSnltlDOWNllI / LAST fll/Sl MIDOl.( I'MON' NO _ SA",'€..- Ii-$ IRIV(.f . ~ r;-t;~ / "-=- '~ AOO"""O","" _ N AO...,,"O"1' (,f'1 ~_ 11'.;, D::.,~~r- E / -+J ~NMI'a.;~IlISloC$'NlISUltANC'COOlt"'O[NI N . A..,... IN:'UI<ANo..!COUk"AGtN --n) C ~iln"'E- ~- M -.' 't " R / -, i= CD~AG:DAI1tA. C~:I/~ 'J ';>.4~ .." CK ROI ~-, ~AMAGlplAltIA. ~ IS ~ II I.Vl . t10~~. - I lo."cin~~ f 10 fE~ ;::JltlMAlN(D O~~:~.I...N OIlIMA'N(D 11\i-..(iO.O-"O~~:::::ii: __ S . AWA.Y BY " US \Z)...v,.)V- h ~~~.,.o BY S, , r:= DIAGRAM OF COLLISION: IUU $U"L["" ,....L NDICAn NOI1TH DESCRIPTION OF COLXSION IUS( $UI'PlfMlNTA.L SHl(lIF NIC!~IlY) ~ .. " I, ,,",,,,,,,,c,"',"'r-l ,.mow ~W\ ~\ D.. ~ X ~ 1'10 I'\-. - "., ",,' V, " I , ~ n \)l D ,. ,1\ r~. j/J<.\\tV ~ Kl'I''''fl- \\""l4:, ' ,1'" , 1 0 ~\\ ~ l~ OFt" - E _ i~ .:....:-~:)~ t~ ~1'h~~~&.~I~OI'l,,~5" o~~~~~ ,,- ~ ct> ," - 'i,,)li K' ul\l)(ItT e~,~ \ ~'RH 1:121"0'''<:.. - =>>l- F' '-~ -' 1 ',Q>M.oolL~' it> q- I,.) J'll... 11r'<\:l Of -I - rwl1- CDlj-O:b., ,.,.-.,: :;t::I/ ~~ ~""''<'" VAII.R{ (1..0. -, " ,-- C.,,\~ !: ,.t 'ifth~IL' -.... -- -,. , i." i'iill i NAME, ADORE S & INJURIES OF PERSONS INVOlVED . CODES I 1 - 2 3 I 4 OCCUPANTS I WITNESSES \~ ~~~~~~:~A~n; . soe.1 "CI' b.TATUS '~~.. :~,: clt:'J~ Illls,. "., ~f.J< 1'1:l\."t-'2. :::1:'''~5~~~' I- I,C',.,L "J., I .... "DDIlI~\ ~~ ~"'ffiJ,,,,,,, -. ~~,~~~I..o' "NO,--e.. ~m"J~FlloMDA"I-B-CK..~~~ D"'l~~O:;:t O~~..,. r=;;;'m ":~~IO'" -- ~r.sl'I~"OMDAM' D~"O~:" D:;:~ D'~~'"'" '" ....(l(lltl\\ '1' ~~D~~fsor l ~ INI"nly ~I o A".,' ~~' O~g~lI' 'if" Ol~~'..\. X r'~ 'C;OO'G::'."~,'L 'e~ At0~p I ~rs' r~;&iCHIOI ~~l;r0112Z~'j;f ,~~ '. . ,', '" ' ",:" " " ',.>' ", "",': >,':, ",." , ....... ..... .. '. .' .;. ',' . ...... .' . .": ..; :, .".' .' . .;"., . :..":. ','.',',,- '. '" .' '.',:,.,:: ' """,;, '.. ...... . .':; ..' \ ... .'. . .... .... .' '.' . ",.',,:., '",', " ,', ,',' ,,',' : .' . . ......'. ., .... , I;' :: "," , ,":,. : " ,<.' ': ,,' , . ......' '.' I ..' . . .'. . . . .' ,._:.....J ,,' "" , , '",' ' " ,: ":':--,.' ::' ,:,:-, ,.,' , " , ,:' ...... ", . ....... . ." .' :'.' "', , ',','" ":', ".' '" ,'.;', ' ;.: ", "', .,: " .....! . " .,' '. ...., .... ,;:. '., .' " " ';" , .." , , " '-' .' ..,; l!P,0LJt /IPI'iU!'[ -$lAI~J. I WJOAnDo:.yBIII~. ~ IlYES WfLGH'I....IOHI -== Si F;; ~ ~ . SI.e, .=J IJICiluII,y ,- ;A'~J::p :,:(: ",,', , :.', , .. .' '.,', :, , ,: " , " "TI ,"'-' " ,. , ":'\' '.'. , '':- . ,",:: " ,::' , , :'" ", " ", "" , ,,' : , ' ',":"" " ' " " , "!" . , , .' , " "', "", " 'c' ", ~ STATE OF WASHINGTON "0' I 0' I ~ ~ POLICE TRAFFIC COLLISION REPORT I1:5!.TRAFFlCWAY I :L- 0 PRIVATE WAY -t,li;f7"lj';& I~~ '~J~ ;T~!: ~~:~:SrR' !~"I- ~~~' rOUT~eJ'So...) [[ 7 ON Of DIN C,lYORIQWN I NAMf&NO O'~1IHE10RHIGHWAY Mm~' Ow !jl.o, O-I'MAf... ON CA$. €!A,,- INTf;;:~lING WITH ~lIIHl QllllQAO INONINHIl$lCllON . C>e~)U" VI\f\.t.,J IBfTWHN - STIlEIT & - STlllEl 311 Clsr~CE~O~l71IONHIOMPUEJilN;, CIlOSSSff<UTOII NIAlllS1MIL(POST I ACCIO[NT ., ~H~~~S ~O Of g.Q..l\ner- $~1~" M~~~rE COILISIONINYOl\llD SlVEII,TY... (7) I IOU (,..\ OMII&lIUN I .......t:>RtCT..S 101Al NO OJ NO ~llll~~~O INJUl1fD--1-- ~~~~LAC< ....,'U,.. .. OYfl"tlClH. 0 PIlOPElITYDAMAGfONlV 0 I!fSUITfO O~lf~&~ ~ OeJtCIT~~;~rlllcr~~;:jIlSDlf\<H Is :e7AGE UNIT NO. I UNIT NO.2 !wilDOn 0111"'[11 S NAME o VEHtQE ..." ;J o PEDESTRIAN 0 PEDAlCVCllST ~ '''" M' IX / -::t / -;;:,. Ilh.u",f VNE NO '.:;. SIAlE I !>li'1 OA,Tf Of al~TM ---,;: / I NO ' DJ" I'll ___ (l'1.S WlIGHT HEIGHT..:::: '!3" O~:?lIC'C'1 I'~ W$P 159 (llfV '.80J No. A "t I Q I 0 POLICE COMPlAINT NLf.',flEW (JJ, flfWA . I ii~~:: I ~CII..., COjTY ';1- CttY NO /i........ '0 _~a~ JIlE I ROO5-0~~trq 0 PNHIX lO, MILE PO$T I 0 I ? 0 IlAMP DIAC;IlArYo DATA 'N.n I: 1_.aD IN 1.~~~~~lmJkljUTOIlJlOAOOll'~fElllNa; ~ IIM11l ClS cR~s~;q.rlti5-0 >nCLAL CODING USl ~';': ~ , :: , ;: ,~Ji , O~'(VW-HIRA\h(Asr !>lIlf{1 AOD"t~!> ~ c", II n ~ L.e i <""AIoi"TbrJ ~ tvl gf~t IPM~ rr-t: DIlIVIII'!>LlCEJ5~~ eN rvrr- STAT~ 51.)( I O"':H~f~I"iHYR ~ o IVll;>'S LlCIN!>E NO 5\(../015(....'-/ MTIM j;1*hLc:;:"'V 8~ OCCU~ I~;::~&PHONENO I~:I: I~HTI~~ ~ OCCUPATION IflIlMNAME&P~ENO / L....- 0 CHECK (.') I v fl &Ci>~~U;iIAL 0 CHECK ((') If ~~JC~f AS...N fMP~'S~1f &"';'ZOT\.:E~AL <; CODES.....,. 13 ~i~~~' ~:.i --' 5 IJtC'+ON 6 ;:,,p,:?,lICfc:.l/... C~~ES ~ + 13 ~~~~~' 4 :~~lr~~"..l /I 5 IJtClIO... ~ ~.'",'",J.~u,:,:~.f:~~... I\JOt--X.- INJUl;>II'S..... / ~ 0 ......W,....." OJ..:.":i:~tl 0 (g~lf~ 0 ~~,,"1I 0 \"8....~P ~t~~J~I~Q... D.......8..1lA....Ct 0 ~~~~ 0 ~lj~,tI1 0 ~~::,~:: 0 ~'l't..... VElq:] , IMAllg;iJCHEV, MOOR}l1f.NOV"" I~TYLE(~~VI ~ VIH'IAI;> ,.....,.,. 1...............I.CMEVj X..lOILIOARToNOV..., 11 I1DIl. ONV) :~rr [IVo..~ 1''''~~~~0S3 '~A "A"":':-"O I"A"_ ~ V'HCc>m IU"N"'~. '/ I'A A" nA'NO I'''' i~~,,, ~ VEHICLtlOENTlflCAHONNO .J. l VIH1CLfIDlNflfICAII....NN.... / I"",II="~ 15 N ! R'~Il1'; '-j:b:S;I' ! I, : IF I I I ! 1/1 I Iii I I I I I I r---,; ~ I1fGISltR;;;,wL~IOT("e flllST ~fr' MIDOLf IPHol'lJf~ 0 RtGI5Tll1tOOWNII/ 7~t fIRST MIDDLE HuNENO r-- ~ ADO"" "'';W;;'L. I I (-AM&'-. fiN ~O 1<1o"~S10IJ{j ~ A,",,,,,, ow/' ~ E: NAMf & "'~Dl1f!>~ C;S leSUIlANCE co OI1A ENI I R ""~.. A"'7'" IN~U..AN...;t co 011 AGIN ~ . L.. ..PAMAGIDAAEA 'AI ~ H) It~ ~I(]oi~.~oj, ~i~ I~A}~~:L 2"Mc,~ I;;~~'~" m:;~'vN O"MACNm l7=orl'~:~~';~'~ C DIAGRAM OF COllISION: IUSE ~UPFIIMENIAl INf!CATE NOI/TH DESCRIPTluN OF COllISION (LI!iof SUPPLEMENTAL SHUT If NfCES5AI1Yl ~L- ,. ".':"T-r:--:' 'T~~:;;d\l\);""NlCl...tVlr-J'~ ~bil'l\-I-SW-~ -~--- ._R;;Ti1.O:-~-<;--=r Li -:Tl~~-rtl ,~\,-!., r-Lj . T,!J\ ,-- - lL -_C'Ak-a.l -~~ II) -_= p-;-:: -~":"'1 ~:':-i-\L!:~lR..4,ch~k, e~~'[O \JW;-'kb~~f~~ '-~/).~ij-=-~=~ C::~::l ~~; : ,q:j.t~;;~::J1~~~1'-~~ Wl\~f~::=i:~~_:=\l_e~:l~~__~t>~._~;~~::_~.. ~ L";.i .,/'f!j"ili :"',, ....._ " .~ i -. .-t1 ;R ' ; t -;-~- ~~tb 1T1' _.,,-, "._.u ,_.m, =,,: ,,- :.:.: ~ - ~~~Jp~~~~~S~~~~~s~E1~~~~~~~...~1~VOLVED ~~s7~OF:~,- TA~U~ I......;" ~~: I ~I~J\; i[~~ fJ~CT ~~i, --.J N AMI ~r-.) 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". . ...., '.' ...... i, . ;' .... .... .,' "'. . ' . .' ,'.', .... <,,' ,...,... ..... ",' ", ,"", ' :". ' "",:' ; ..... ............ '," " ' ", " , ,:; ..... " : n"\,.jA1f~f o &,yp o CITY TIlH! ADDllt~5 ~' , 1-: I- ~, {{ :i~;; <1', ~ i,;, . ~~ ~ k " '. \ t {o.' , :to' , Ii l' ,", :' . . : ~. ,~, . , ',: ' .......... , . \. ....:.:;.- , ;'" ", . ,: h" Id " ',': ',', .' . ':' '" ,", ,,' "'" "'C' '" ' , ", STATE OF WASHINGTON ,,""', "";,, ",''' " " '"", ,', ,,' ",',,,, :'.", ,," "" ',:.: " ':.'"", .,' ".':, : ':.. :~ ALL REPORTED ACCIDENTS ABSTRACT OF MOTOR VEHICLE TRAFFIC COLLISIONS (RURALfj)R PERIOD OF 01/01-09/30,1968 "GEOF TOTAL PERSONS PEDeSTRIANS PEOAlCYCLlSTS ~~.Nc~&rs~o,:: TOTAL I,l,TAL CONDITION OF DRrVER IHTOTAl. IN FATAL CASUAL TV I(tLLED INJURED KILLED INJURED KILLED INJURED ACCIDENTS Ar.c. SOBRIeTY . ACCIDENTS Ace. :~~:-,' 0 , 0 U 0 0 HEAD ON 2 0 HAD BEEN DRINKING .}'.. 1"(>' 0 5 0 0 0 0 REAR.END ,. ,'.~,">: '.'-~' '>"':::"26 1 ABILITY IMPAIRED 10TOI4.,(,O 7 0 0 0 1 ANGLE ~.._,- Ib '0 HAD BEEN DRINKING 111T0111_, 0 .3 0 0 0 0 SIDESWIPE-MEETING "10 0 ABILITY NOT IMPAIRED :.-,f41'{;; 20 TO 2. 0 17 0 0 0 1 SIDESWIPE_PASSING 1 0 HAD BEEN DRINKING 25T0304: 3 .. 0 0 0 0 AL.LOTHERS 22 0 SOBRIETY UNKNOWN .. 15"1;0 35 TO 0&.4 1 27 0 1 0 0 NOT STATED 0 0 HAD NOT BEEN 22." It! 0 45T064:_'~' 0 13 0 0 0 0 .'. DRINKING ..: 55 TO 64 0 11 0 I 0 0 TOTALS 77 1 ORINI(ING NOT es TO 74 ""~ 0 ',10 0 0 0 0 STATED 7 ;~::,O 75 & OLDER 0 7 0 0 0 0 BACKING 3 0 "'." ,'" '.., :::.'; NOT STATED 0 : . 0 0 0 0 TOTAL DRIVERS, :, 29' i:,. TOTALS :, I a, 0 2 0 2 TIME MON. lhr\l THURS FRIDAY SATURDAY SUNDAY OF~~~~~~~~~~g ~~~g~~~~iI~;., '; " IN TOTAL IN fATAl HOUR ALL. FATAL ALL FATAL ALL FATAL ALL FATAL ACCIDENTS ACCIllf.NTS REPORTING O,MIDNlGHT , ~ 2 , ,.g 2 0 , 0 UNDER INFLUENCE OF ALCOHOL H . , UlIl 2 ' '''' 1 3 0 2 0 UNOER INFLUENCE OF DRUG . '.:,;,:1' 0 , ,," 2 0 0 0 0 0 1 0 EXCEEDING STATED SPEED lIMIT la .".' 0 , "3,00 2 0 ':1 0 0 0 0 0 EXCEEDING REASONABLE SAFE SPEED 'n,. ;_~.,90 0 . ,," 3 0 0 0 2 0 0 0 2 0 ., .,'11:00 . 0 '''2 0 0 0 2 0 " '.':;,0 0 . .., 1 0 0 0 1 0 1 0 ... ." 0 0 :'~ .7:00 5 0 0 0 1 0 1 0 0 0 ,., a 0 2 0 1 0 2 0 010 NOT YIELD TO VEHICLE 12 "" ,0 . ..., 7 0 1 0 2 0 ' 2 0 010 NOT YIELD TO PEDESTRIAN OR BICYCLIST ,.,0 0 " "., 6 0 , 0 5 0 1 0 IMPROPER PASSING 10 " ,1 " 11:00 '6 0 '0 0 2 0 , 0 FOllOWING TOO CLOSELY :" ,,,:"15 0 " 1:!'00 a 0 0 0 2 0 3 0 OVER CENTER liNE 5 ". 0 " 13,00 a 0 1 0 . 0 1 0 FAILING TO SIGNAL OR IM~OPER SIGNAL'" ':.:. n::o... 0 .. ..., 5 0 5 C 3 0 2 0 IMPROPER TURNING 2 . ,,;,,:-; 0 ", ,11i.00 5 0 ,. 0 2 0 ,,2 0 IMPROPER U TURN .- ":::0 0 C- " "., 13 ' 0 7 i' 1 2 0 2 0 DISREGARDING STOP AND GO LIGHT 0 '0 ", 17.110 ,,' :7 0 3 0 2 0 4 iO DISREGARDING STOP SIGN OR FlASHING RED 7 ," 0 " '"., , 0 , 0 3 0 2 ,0 DISRtGAROING WARNING SIGNAL 2 0 '" 1D.00 . 0 3 0 .. 0 ' ~ i......:. g APPARENTLY ASLEEP "'15 0 20 20., 7 0 2 0 3 1 IMPROPER PARKING LOCATION 0 .. , 0 1'1.'.~.:noo 6 0 2 0 3 0 1 0 Of>ERATING DEFECTIVE EOUIPMENT ,"9 " '0 J " 11,(10 2 0 3 1 5 0 1 0 INATTENTION 25 0 , n,:~~,n'oo ,. ,6 0 0 0 '0 0 1 0 ALL.DTHER VIOlATIONS , . 1 .,' 0 . :!41r10TSTATlO '. 52 ""'",,'" .' TOTALS H2'>' 5 TOTALS "126 0 H 2 1 '3 0 * FIGURES REFLECT INVESTIGATED ACCIOENTS ONLY f>REPAREO BV: RECORDS SECTION WASHINGTON STATE PATROL ....','...";>"">>.1.' " .. . : :":, .',. '. . ,,' ", ," ::': ..,,:. .> ......, . ," ,'" ' .', ""'''', " .. ", "",' ,;.. .' ..... " ". ,'" ":.. , .'. . ... : ".',.' ". ........ .....\. '. :".., . . '" ','" ,""" ' ' " '",.' ' ,.'" , .. ':'. '. :",. ... '.,." ..' . .' .....' . TYPEOF ., MOTOR VEHIClE ACCIDENT. . ~~ ~;~:~UN:N;OlL. PEDESTRIAN C) M,V.INTRANSPORT ~ M V. ON OTHER ROAD ~ :~:~e:Y~:~IN ~ PEDALCVCLlST Ui ANIMAL ~ ~;~~RO~~;;T TOTALS r , INTERST A Tf SYSTEM OTHER FULL CONTROL ~ U.S. ROUTE NO. ~ STATE ROUTE NO g COUNTY ROAD .... C1TY$TREET OTHER TRAFFIC WAYS TOTALS ~ ( i: r ~. . , .\\;. ~': j., l ! I ( ~' t "::""',: .... i" NUMBER OF ACCIDENTS TOTAL.' , 35 o 2 73 o '4 " 2 " 33 119 o 26a o u 93 ., 116 C 12 2bd FATAL NON FATAL 1 o o 1 o o o o o 1 o 3 o o 1 1 o o 1 3 COUNTY Ji:FFERSDN I" o 2 ~2~~~lY, : ~~15 I ;~.' lJfJtto 1~ .',.. 5 2~ o 0 2 40 2 S9 o 0 0 '1 0 5 o 0 0 o 0 2 29 0 b 60 1 81 o CI U 146 It 162 3~ '. 3 o 2 , sa " 119 o o .. 21 52 o 2 119 o o ,a 25 6' o 9 I.. o o 1 2 o ~i '. , . NUMBER OF PERSONS T'l'PE OF INJURY NON. . INJURY,,,: 31 o 3 ',,','161 . 0 " . 'c 2 2. 97 o '327 .. o o 73 3' 71 o . 182 1 o o 6 o o ' o o 3 13 o 23 o o 10 5 8 o o 23 o o "IH 76 , ,.127 C ",;~ 19 7 ~ :';, " , .~ 3~ ,,\;'. 2~ 3 ...., 2 o 0 1 1 2 1 50 18 G 0 106 S3 o o 39 20 .3 C , ' . , lOb o 2~ i .' , 9 20 o ,0 " , . ,,' ' "',' ,,::', ", .". , .... '... ..... , ,,' ;,':. ".', : ,.'" ','. '," , ,...... ......../ ." ..... . \ > ,".' '.. .... ,:' , , .': '" ,;,' " ';, .'. ';.;' ............ " , . . .', '. ,... .'. ." ',,' ,ii', ....; .' ;' ..... ..,..,....., ". ,:' .... :'. '. ':" ,,,,' 'i ". ./: '.. 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I~ 0 ,., 0 "'I I ~ g, /; ",I ;:: ~Si w ~~ :r I~ ~ ~ : '" ~I 0 ~ ~~ w' I~ ",' ~I ~ z, Z I~ ~I " " 0 0 0 0 " 12 i N ". ~ N N ~ ~ 0 ",' ~ 0 ~ ~ ;i:, 0 ., z 1 5l ~, ::; ~ a- Ig a-, ~I a- ~ I "'w , _u ~I I ~~ J~ ~~ a- a- ~ '" ;g; 0 ~ -' a- a- <; ., 0 ., '" a- a- 0' N ~j ~ ~ I := a- a- n 0 " n n ! 0'" a- a- d 0 0 " 0 " 0 i '" '" >- ~ '" ~ I ,.>- ~ ~~ u 1: ~~ ~ "'''' " " 0 0 " ~ :=~ ~ ~ ~' g g ~I ~ ~ '" ~I N N N N ~ I ~ ~ '" ~ ~I a- a- a- '" . =,tTj:~, '" .-...~. .-":=::-_I.~cr~.).:-=~'~..;:::r!_ :,Ti:...l...i._ -_.........~ '",.'.. ',' , , ". ' '." '.' '.>'.' '" " .' .' , ' ";c' , . " ." ~ RECEIVED JAN 18 1989 JEFFERSON COUNTY PUBLIC WORKS I1FPT DAVID M. BENDELL ATTORNEY AT LAW 1001 HIGHWAY 101 EAST SEQUIM, WASHINGTON 98382 (206)683-5788 January 14, 1989 l Department of Public Works Jefferson County P.O. Box 1220 Port Townsend, Wa. 98368 ATTN: E.D. Simon Dear Eileen: Find the attached executed documents relative to the Rondelay Meadows Subdivison Water System. If you have any questions please contact me at the above address and number. Very Truly Yours, David Bendell " " :.'. ",",", '",;;. "" " ", ," ;' , , '-':':".',' " "" , .', ,',;:: '" "," ,: ',,' ':, ',,' ", '", ,.'>:, " ,.,.,..' ", '" . ," , .,':' :, ,.",' . ".' ',' ,',-.. ';", " ,', "',, , <, " ',' ,.,' : ,', :-, " "'::, ", ,: , " ,'," '.., ,,' , ' ':' '.'.... , ." ,', ,"', ':' ",: '. " ...:',: "., .',:'. " C', "~ " "', , '.', '. '.",: ..': ' ,.' . ,", . '...,'..,'." ,: . '. , : . ',', ',' . ',\ ..',', .; ." ,,:,,!, ': .', ..,', .::. . :" " . . ',' ",' ,;:' ,:': ,", ,....., ..:,' ..' '." !'. ",'., " :," ", ,'. , ',"', " ",> , ,', .,' ' ': , ',:' .' : " ,,,,' '" " ,,', IlII ').;~::.<~->' T; ;":>' /,- ""'/'>:':' ,',,"::c >0' ',~ ," ", ". ~' ~~':_~;:: ,\' ;.':! " -i..:~,; ';~'", ;.,;,>:~::;';'}': -", .,i" ,j1:il~~;{~S,2L:j;'~':2~~"Q.ii;:0j;l~;i~:iQ;}i,i:ii~Sd~~~" ; '~'; "~':,; ,., ',:......" ,,""': :).'i, ~:; J:- ' :'::i:,~': . . APPLICATION FOR FRANCHISE 2 3 4 TO: THE BOARD OF COUNTY CONNISSIONERS OF JEFFERSON COUNTY, WASHINGTON BY: HELEN DENT, ATLAS DEVELOPHENT CORPORATION FOR: RONDELAY NEADOW~ WATER SYSTEM 5 6 Application to the Count~. Commissionc.-rs 01' Jefferson 7 County, Washington. for a franchise to operate undmaintain the 8 Rondelay Meadows Water System consis~ing Ofi easments, licenses, 9 pipes, pumps, drainfieldsand OthCl items, upon, under. over, 10 across and long the rights of way of the county roads of 11 Jefferson County, Washington, more particularly described as 12 13 14 15 16 17 18 19 follows: Those county roads lying within the Plat of rondelay Meadows as recorded in Volume 6 page 17 of plats', records of Jefferson Count). . None of the road""llY over which this franchise is requested is located within the limits 01' <<ny incorporated city or town_ The App1 icant herebl' requcsts tht thc BOARD OF COUNTY 20 COHNISSIONERS fix a timc and place for hcaring this application 21 and cause the Auditor of said County to give public notice 22 thereof in ttlC mariner provided by law, and ltlUl \apon such 23 hearing tile Board make and eJ\tcr u prop~r order granting to this 24 Applicun~. its S\ICCCSsars ltnd Rssigns, the frunchise rights 25/ herein I\ppl icd for. 26 27 " J, 28 i.l--"""~,~,,,,~..~ DATED thi" 27'rlJ_dll), of~_l~ . Da.'id /If. ~l1del( ! ...~l~~Altoi,;j~T"iJfl.nw~'JP::~ --- '- e ~~kv APPICANT-ATLAS DEVELOPMENT CORPORATION 2 3 4 5 6 7 8 9 10 11 12 13 14 IS 16 17 18 19 20 Ie,',':, ',',"":,,"',<:' "",.... ,',::.:,', '.. ":""'" ",,':, :, ",i' ""'~:::" ::' '"',, ,,:, ".." .,. .".."y,:", ",' , ,,"',"',"""'" ":'!iii', ,(' --......- """ " " , ' ,'., " , ' ,,, ~ . . " " , GENERAL I'ROVISIONS AI'I'LlCABLE TO ALL I'EIlMITS This permit is subject 10 all applicable provisions of the Revised Codes of Washinglon, except that an}' prm'ision in thi!". agrecmelll not eom.istenl with such resolution shall be controlling. A bond ill the amount of $ is requircd for the protection of the COUI1I>' as set forth in the Lernls of the bond. During the progress of the work such barriers shall be erected and maintained as may be necessary or as mil)' be directed for tilt' protection of tlje traveling public; the barriers shall be properly lighted at night. P ~'. In accepting this permit the petitioner. his successors and assigns, agrees to protect Jefferson County and save it harmless from all claims. actions and damages of ever)' kind and dCf>Cription which may accrue 10 or be suffered by any person or persons, corporation or properly b}' rt:ason of Ihe perfor- mance of an)' such work, characler of maleri:ils used or manner of in!ltalJalion, lIlailllenance and operation or b)' the improper occupancy of right of way or public place or public slruclure, and in ca!>e an)' suit or action is broughl agaiml said Jefferson COUnt}' for damagc!l arising OUI of or b}' reason of any of the above causes, the pelitioner, his successors or assigns, will upon notice 10 him or Ihem of commencement of such aClion, defend Ihe samc al his or their own sole CDSI and expense and will satisfy an}' judgmcnt after Ihe said sui I or aClion shall have finall}' been determined if advcr.!oe to the Jef- ferson County. , r {~:; Except as herein authorized, no excavalion shall be made or ohstacle placed within the limits of a COUnly road in such a manner as to interfere with the tra\'cl O\'er said road. Except as herein authorized, no cxca\'ation shall be made or obstacle placed within four (41 feet of the edge of the pa\'emelll. If the work done under Ihis permit interferes in any way with the drainage of the coullly road.lhe grantee shall Wholly and at his own expense makc such provision as Ihe engineer may direct to take care of said drainage_ On comrletion of said work herein contemplated all rubbish and debris shall be immedialely remO\'ed and Ihe roadwa)' and roadside shall be left neal and pre!>entable and satisfactory to the engineer. All of the work herein eomemplalcd shall be done under the !>upervision and to the satisfaction of the Count)' Engineer and the em ire expcme of said supervi~ion shall be borne by the party or parties to .....hom Ihis permit i!> issued. The Departmenl af Ilublic Works hereby reser\'es the right to order the change of localion or the remoral of any StrUclure or Structure!> authorized by this permit al any time. said change or remavalto be made althe sole expense of the party or patties to whom this permit is issued. or their successors and a!osigns, All such change!>, reconslruction or relocation by the grantces shall be done in such manner as will cause the least interference wilh any of Ihe Coun- ty work and the Count)' of Jefferson shall in no wise be held liable for any damage to lhe grantec by reason of any such wark by the County of Jeffer- son, it agents or repre~entatives, or by the exercise of any rights by the CounlY Upon road!.. streets, public places or structures in Question. This permit or privilege shall not be deemed or held to be an exclu!>ive one and shall not prohibitlhe Count). from granting other permits or franchi!.e rights of like or other nature to other public or private utililies, nor shall it prevent Ihe COUnty from using any of its roads, Slreets, or public place!>, or af- feCI its right to full !>upcrvision and control over all or any pat! of Ihem. none of which i!> hereby surrendered. The Department of Public Works may revo!.;e, amend or cancel this permit or any of Ihe provisions thereof at any time by giving wrillen notice to the permillee_ The permillee shall immediatel)' remme all facilities from the righl of way. Any facilities remaining uran Ihe right of way 30 days after wril- ten notice of cancellution !>hall be removed by the County at Ihe expense of me pcrmillee. The party or parties to whom this permit is issued !>hall maintain at his or their sole expcllSe the Mructurc or object for which this permil is granted in a condition satisfactory to Ihe Department of Public Works. SPECIAL PROVISIONS: 1, SLgns shall not be placed so they block exLstLng sLgns or Lnter- fere wLth vehLcular traffLc. . In accepling this permit the grantee, his successors and assigns. agree thai any damagc or injury done to the property of the grantee,or any expense Incurred by him through the operation of a COlllraclor, wor!';ing for Ihe County or any County employee shall he Btlhe sole expense of the grantee. his successors and assigns. -\(, Ctnd conditions as herein set forth. * >,0;- Dated Ihi~ da)' or , Ihe undersigned, herchy accepls this permil subject to the: terms -\( , 19 ~ \ I" ~; ~I'Phr;;a1ll ,': .", :: .... . " '.".' '. . i',', .' ;:: ,","":..' ::' ,.: :' :' " " " /. '. ." ..... '.' "'" . "''',: " ",:'" , ",": /'. ., ,', ",' . ," '.' '"'' ':.' :, ' "..' " ':', . '., '",' ':,:..,' " .' '. .' ." ........... ..... ........ ....:... ...... . ,'. :,: ,'" :,,' .. '...',: .' :,' ." ". "',' ,.,,'. ',,,:-:' ,;",-" ' ..', ., ,':, .:, '" . '.' ,',', , < ' ;. ': ' : , , .', .''-'' .."" ": :. " '....... ..... ..... ',., '" . . .....' ",.'. ',' , " ,,' , ,": ,'. . .' . ....'.., :;.....' '. "", '. '" '. " '.' .. ': . , , , " ''',,' i " .i i , I ~ I, ~ ,: ; .- '" ,:, " ;", '. ",.',,'. .- ,,','" , ,,' " . , :: " '., ' " "'>'. '. " ..,,'..... " ''- "',,"',: , .,:,::' :.' ':" . " ': ',," '., ',' ......'. ' ",..,' ,"', .', ',: .,;' ",' ,': ":'" ~'.": ; , . .', ,;,:" :,',: ,.' ",Ii.:; ".,.', " " ,", '.-:, -::-:-::-. ::" ":,.,,.. , "" " :," , ",,' '.'<":' ' ", ' , , ," , ' ,,' ,'" '" ':", , ," :,' '," " c ,': " !"':,~ W5fl~{IW,I.l:IOl , ~ STATE OF WASHINGTON "0' 1 0' 1 ~ ~ POLICE TRAFFIC COLLISION REPORT QQI TRAFfiCWAY I' 0 PRIVATE WAY D~!tClfc..OlLI5IU!'l::L-~' __~o.,..,,:...'..~91~N,. ..l\ "ME -"COUNTY' [0:2' : (jq' i gg (' ,." i,"":"" 1"""1 "l"XlI i'7b'600"OU", II JEFFERSON ) 0"1 DE DIN CllYQlllOWN T N.........1&NO 01 511lHl011 HIGHWAY 1 MIL[$ 0 $ (XIW Xl OF port 'I'c7.-msend IOW"oiscoveTV Rd INl[ii$ECliNG WITH $111[1t OIlIlOAO INON IN1[II$[C1ION ISlTWUN Cape George:;lIlllT ,Nelson Land...:i.-n9 3/ OI!>1ANCl & D~~lION HIOM RUEIl!NCl, CIIOl>$!ollllll 011 N(AII!!.! MI~lliO$l T ACCIDENT b 600 ~~I~~$ ;; t-, rx. ;; OF M.P.. #1 Mhl6~E cmUl'ION INVOLVEO ~611l~~~n NO INJUIHO 0 $~llLLAG[ 0 HI1 & IlUN I KJ~O~%~"$ 6.0~f~~R$ I!J Xl PIIOp(~AGEON'V - 0 ~lf~UlT[O O~'l~\t~i I .0 OBJECT $lI1UCK tN........E OF oeJECT lOTIIWe... ANOOWN11I'$ NAME) --1 1$1. OAMAGE -, Fir Tree- Jeff. CO. public WOD<S Dept. Ilnone UNIT NO.1 UNIT NO.2 fl~:'T Mlom~ O~I"tll.~NAMt No. ~ ,..... hi~~:: ,,""ON POliCE COMPiAlNT NUMbER COUNTY NO TITY NO. fC1C~$ 'AVM~)\ I '~T6n;/SO~ "EfIJl( -\EO MI1.t~l 0. 7-9 RAMP lblA'GRAM OAI" INnl I ~~ ')l.RO 'N'!~~5;!-I~:~Rt~ROADOlI wuctNC1 1)( I CIS CIlOS$STRm:p~1 ~ClAl fODING IX.l [] '," .,:: o VEHIOE "'''' o PEDESTRIAN fill!. o P1DAlCYCLlST MID l J B 72. OIlI'l,IlSNIl,MI ",': Ha<lARD BRICE EVERETl' !.lllt{lADtllll!.!:> r==? 932 PIERCE ST, ~ "" "'." ,"'00< -\ '"ON< "0 0 "" PORT 'ID'lNSEND WA 98368 I 385-0927 R t::. "~~';;~090Z I W';:" \ ~ \ori'5~"i;1! ~ ,y",,,""""O ~ QCCUPA1ION I ~(Il"'" NAME & PHONE NO )EYlS-rwtIGHTfHlIGHl E OCCUPATION 2 STUDENT 1Ft. 'lU'INSEND HIGl I3ro 11251509 R o CHECK("') 1~:t~~~':.:'g~::~~~I""L 0 CHECK(....) IFvfHIC~;~'::'NLMP\'g~tEOFA~~(~AL ~ CODES'" + 3 ~i~~~' 4 m'I~::N4 oS 1Jl(,,~l -16 r.?:~~II<~m - ~ODES .. +-\ 3 ~i~~~' 4 m~~~NI 5 lJlCIION 2. ~JJ1Jlllt:> stated none m''''':1'''. 0 ...""",, 0 ~:" 0 ~Y~,,, 0 ::~,;:: 0 ~I.~ . 0 ~~,."" 0 ,~~" 0 tY;", 0 ::~,;:: 0 ~.~I.~ "BEt' ......~;;:';t~H'Y' \ ;","0,., I"'';~'"CON''' E MA<HOOOG','"",' \""OHIOA"'NO'" r"'H O':'CONY,' ,~ ~ ";:; ~;"~' NO: ~~' 1 "."" M""O T"" 7 "" '0<0' TOC'" '"U I ' " " ~., N pl' , """'" "",'" '0<",,,,,."0" NO I""'''' 'O,""",A"O" NO, ":::5 JT121SIV11121E121GI01413171511121< 1 I I I I I I I I I I I I I I m::- ,,",,"'OOW"" "''' '"'' .,oon 1"ONlNO 0 "o",,"OOW"""" "'" M'O'''' r'"o :;: .~_"WILLIAM & GWEN sane ~ . O",,"'OWN" sane as driver # 1 E . ~ "AM" '00"''''' ,"'u,."c"o '" AOI"' "'" U AN<m>""''''''" L:: PEM:P- SEA~.:~ '"'" R '" .., <N 0...."'''0'''.. Ta';"...", 1"'':;-"'" --;;J; ", , ~.,., I 0....,;.'1'.... ':Ji !';'::,:v-r :,,,...; 1>I:r.::f:'~~;1 ,".",. ,".", I~:y,:f:'~",,~ . :",-4. ~I'\I"_J;;;;;"O~' ';'OAMAO' l:in~~&.,&Cisoo 'ID'VING o~~'~., m~~," o"..,N(O \~'IO""Ao'l'~;:no~"p rc DIAGRAM OF COLLISION tug_:>_l:'PP~~MlNlr.\a NDIC.....H NO~l... DESCRIPTION OF COLUSION (u:>f SUPPLlMlN1AL :>MHT If N~Cf:>!.""'lIYl ~ L:: "rl I]::.lJ~~l~~ - ~~;'~IdE31Jqb!L~iB,,0UN);U::N-':-DIsm~m'.3EH~!.~j P.:' +-1 ~--k"\<~~J,-;j:inJl",,:"Fpk:! -+ 6> ~~-w-~~w:-w~g:;~~ ~.: A'ffiJ~~ C t -1--\_i,,++.J-L:.\-L..L 1 ~\+"'i/.1)~d('l{?l JiiiM:._"RIJN1>X:-:w~:::,~-:h=-I5G-iNmLL-::GWE;J1S,jvEi.i:~~~ -r-1-1""'-r+~ -H-i-++-1++U~~!~\:"; _VEHICLE"SLID",BRC.ru:6IDE _OFVlO1\nyJ>UN E1\S1..Bl!!,ll:;!er:Jil r:.. 'L:'<;lJl,:\... ,~" "SHcmDER._TMVELED_IJO;IN"DI'IC!l J\ND_ROLLED_OVER,_,,~ C 1.~,,_Lll'_..Ld-~liljJl-~J1,tL ~~,~~R~;,~~~~~~IDE'_~~:~":_~:-,,= I I I' J \ 1'1 ll'f I +H I I .. ". -I \ ";' "~~~E:~~DiRJs1tJ~RIE~;FP~R~O~~I~~OLVED-- ,,-" -",-, :c::E~-I-\ "- '''2' ""~-" ~ ' ~-6.t:l _ OCCUPANTS I WITNESSES lf~ ~~~~~~cr~~;~A!.:m .-t;l.;f';'G'i'"\sij,ru5 ,\v,t"' ~)t.r -'~I~J~~ llf'~;R 'iJii:, :;"',~~~ ~N I I I :tf,~\t~r~or ~~M 0 AM!! 0 ~~~tl 0 "H~, 9 0 ~~~ 0 ~~~'...!., Nb'-'Nl I T '.'_ ~"'IN~J.of __..d.._"_ ~ra""J~F~O/o,' 0.....11 O~~u O~g~'(~ 0 t~~ O;-~r:.'.....P .-0 N~N T :;.;'jL~~150' ..~ -- ~b,,/J~ .uM 0 A'v'f1 0 ~~'l 0 ~g~~,. 0 ~~~ 0 j'~(~1,..~r DEP. r~~o"T~;;D I '~~~1' r17',l~':::'"" "'~7;~':'T225~B9" ~ ~','g-<j '07,;--:,\" ,::':'" .'" '.".' ",.,"', ;'.', ".,{ "';.',:';' i;:'. "'.>i>i/<. "'.;';' ... ,.",;:,,:); ;: ." i;><.'i.'\)/)<:ii,...i:: .ii:: : x""! " "'i,;:) .; ('i;' ";i.SiC. ..'....'... ./.!;;.:,"I' ,1, .'...',."?,..,"..,...;." ,.',.....,..i>>i,. "ie .:", .,',',',,>,'" / .'.'...,. ',J, tU .,.,.i,iii";;c....,. ...,...'...,. :...,......;.:.;; ':'i, (,; :.,.i..i:,.,..i.:;......'.?{J.}.. '........',;:,,:.,'; ;;/.i:'. F ':<X';' i.:'...;.........;,.., .'i.i..i.i.........:J'/ 'i' !.lIlllTAODlll!.!. SlAU llPe E PHONlNO. ~ AlE '" IKJ Dr;:~ BIN\~lI -::E IlI1M N",^,,~ & PHONE NO EVE!. WEIc;.Hl ~IGtH f ;L :~ . MOTOa.;1CU ~"fn~ ~ .,,}' "':3' ,-'" '0_ ;::::::;; o IS ~ -=9 r f. )', I. ,I \ .....[ltwr~!. E"".' :10 -.- ,.O("l~l"<' "~I .....[\[\~I!.!) X r~;;O'~~~9;;;;~: ::1'.0:<) ~.L ," ",'", -,-' ,'" " ",:': '" "'", -.., , .':.... '/:"'-.' '"',,, ''', :" ',' " :--'" ", ' '.: .,;,.; '" ',,', ',::, ',' ",': " ,", ,.',: ....... . ....-... ...... . , ,,,', ' ,'. ,:-.',", ,': ;', " ", " -" ....... '......"."......... :," . ,",' ,'. ", ',','. ,;: "', " " ' , ",',', "; ',,':.' ,.' ,..' , .,,".'. ..".." ..' ,,'..:. '.' ".' ,:" . '" , " -:- " ", " ,,' , " . , ~,' l '':' " ~ ,," ",'" " ' ' " ", '" "':' ".",: .' ,:.' , ',"," .- , 0,", ' , 0000: , o ,,' 0 , ' ' ' " "'" ..,>""",0 W~P,~ (II(\,', 1,80) l"'",\\~. ':>' ., c; c; R .'0' O' " - , , o' ': : , :", 0',,0,.,.1 :'00 '" ~ J J , I * . 1 '\ x I"R6"'r;,';:.~' "';:;i-n. , '", "':'.., ,,",',', ' ,"" ' '0 , , '" '." ',' ":",','", " ";",,',,: ': " ',"" .: ",,' . '0' ',',' ,;' , "",,' ':,: "':"'" 0 , '.,.. :,0:, ", :: ',' .':',:" 'i' '" ,'."'<' '," ,',:"", ':, ','," " , ," ",,', " ",",' ',' '.. o ',: . ", , ' ',' , , ..' , PAGt 1 01 \ 8JRAFflCWAY o PRIVATE WAY .oAHp'COlLl~I. N. ", OAYOfto"l~ ~-_:;-J TIM! lI'OUN1Y 7T~, I CJlY NO. r ! I ~1 \lJ~ !~O~ M\ ;"I~ '"yl1,' I~I, [XII (~~Ullt II :l""efRF.s,o,..} ~ I ON DE DIN ^ CIT'tOQ"TOWN "'.......1&NQOtSIRfE1QRHIC,HWAY f,':::' I:'~S 1~'-!.::'ll..trl'lltOIJql~~S/'j"7"0 aoo", 4 M"" 0' ~ ijio. Vorrr-'ih~n ON A,Rtb^,(',,," ^rF -, r 'J I I '.J ( INn ,fCIINGWlIH SlR([TQRIlOAD NONINnll'SECTION PllLflX IEO IMllEPOSt O. .;;2 d __ ___ BnwHN"1'1.l2.41tt\ RO STIl((1..1\.\e~Ttlt M S111Hl I I , I DISIANC["~rTIONfIlOMlltf.(Il(N ,CPOSSSTIIHIOIl NtARt~TMllIP,-,Sl I .ACCIDENT IlAMP IOIAGIlAMOATA 10 lD~~'~~~ n b.. ~ 0 Of "\\..1.--r')lot,. RD M~6~rE I COLLI~ION.NVOlVlOrn ~~",,~{I;D~NO,'NJU'HO..ta:: 0 ~~'L\AG( OI-lII&IlUN I o<.J~'~~~;;t..~ INlllf IJ~tfl X-IlO Itl ~~~S!.I!!:l'~Il.UT IlRQADORRlHIllNCl ~~ 7"' ~0~~~,~3~ '6l!.'PIlOPlIlI'l'DAMAOIONL'l' 0 ~lllUlTfO O~~~,t~[ _ I~_I Cl~ 1Cll:~S%9'~53 ~ '1 OIlJI\)I;;':~10'oeJfClS1RUC"'ANDO~MIlS'r;:1 I, f~( SJ'tClAJ.<rOINGL.r>1 UNIT NO, 1 UNIT NO, 2 0 VEHIOE 0 PEDESTRIAN 0 PfOAlCYCLlST -Z.i.J ~ DIlIVIIl~NAMC(\ ;~^\ ~~I,'1~'~ M:'; DIlWlll'~NAMl LASI fill I 7 .~ (6"::;" """ .0'"1'1 \ ....llaJ Dda t<.o """ ADD"" / ; ~ c", 1j,"r'l1~ ~ q~J~ i;:~~1 ~ '" "AH ,wwO /1'HON'NO ~ t::: OIlIV(Il-~lIC(N!olNO I. STAll I III A ~1I1 IH I IVIIl'SlIC:IN~(NO I ....I[.vxx I DAH_~IIIIl'H ~ Co(',eI'-l3Y'1'1110b ~M 3: 122: ~ v /I ~ lOA' I" ~ ~ L::;: I'''R-;~:HO;;''. S~/~ ~li~~I~S ~ OCCU""ON I'''MNAM'''NON'NO / 1 "" W"OH' ~'OH'.:= ~ 0 CHECK(~~';;:'~Z.~l'S~]Ff~tr~~Il'AL 0 CHECK(~) I VIHIC~f~';,',.~WP\'S~~":i'::m'Hf~AL r.... 9 CODES .. ~ 13 ~ ~~;~~:'''''' 4 5 IJI(T,oo-. b ~B:?O(:Y~ CODES" + 3 ( .~~ 4 '7 I 5 1.11(110'" 6 ~:~yOl;YCII 10 17 :l :!;.;;~~~oo. ~ ~~.u..." Iil-~~" 0 t~;". 0 ::~;:: 0 t8'." ~. '~:'_w..." ~~:." 0 tH;", 0 ::::,: 0 ~~\,,, ~ , "lH\'Q7iSIMA'''Cb;:'' I SO~.:r<OVA' "';;.'~ON" E~ 1""""0000"C7 1 """'"OA",NO<A, I""" '", v" 5 [ v -c;: "/'~~"~~S I"w ~ TA"""-=" 1 "A:' 7 V'H CO>O' rN 7 I'"'' ".. NO I "A" ~ ri"i'::"" VUllCLE IDENTifiCATION NO t VEHIC1l.! lDl1NTlFIC1A110l'>1' N'Y1 ~ I"'~ 1\l11d.,ql(.l'i(IAI3~ 131':'>,ICIOI' /1 I I I I I I I I I I I -.oJ ~ IIfGI~nll[OO~[:~ LA:!.ls:\~.I:~\ MIDOlE rt-1ON~ 0 IlEGIS,UIlWOWNE7 lAST fl~ST MIDDlI H 1"10 ~ W \"1 ~ ADD'~q~_"r00LL\.,()()D 1<6 ~'iW lM'l '1\A'L ~ AD'"'''''7 ...LJ E NAM[&t;:~~NCICO' Oil "GENT R 'AMI&A7Ef>'f>OfINS,U AN E A N ~. - DAMA:;fOAAIA I QD~~;:;~.;.t?1 l~A~ n'DI~.81''''C; I ~AMAGEp'~EA. :::21 rr- ,n_.\op~.l.ti~~f~'g~: CHAIlGf. CH...!f-.A ~f;'~~ rr-1 .,o,.~~ - t: '~oi'0'no~1~ ~~~~IS.Ji~~lIv. ~11l;MAINc.I"N rIi~~~~8V O~~~('l'N DQIMAlNEO I ;~I DAMAGll'~o.:_"~' ::E~', , t; DIAGRAM OF COlliSION' . . (U!.l:S,UPPl[MENlAl NDIC"':.~.NOIlIH DE~RIPTIONOFCOLLtSION' IU!l(SUPPlEMENTAlSHHTlfNECES';,AIlYI .-1:1-.. 16 "1-;- r..T-rT-T-'-'TT"""'"i1.....U' ""'OW,. '.\J.i:"W '-'Sis--Al--" --~'1'l'-HI()l..-'-- l'j'-t-!J-i -]-1-. -j-i-4-T+-.j- r~T - d G .~C---.. f\,~~~ -----' p~ r;r . .1.;. --n-L'I-'i-j--t-H . _+_.___.J.:D,.o,:l._____ ~~ ___....__.,.,=1~,_1._"- I~ .\'.\illtd'.J.,t\-"~ T,j'.I-T-l--t'1--.' '-1++ ~~~:,~=_~~~i.?~~:=W~ ~----==B- E' ::~j:~:-~~tt'I!-',~~;.~::~tJ'P1~-;=ftH=t .....-, -.,=:--:~::--,~::::: ,~:~_~~~:~::===:=:~-:.: t3- i. 1 " I: -~ ,.,.. I ,'1.: _. . I I ' , . " "~, "i'll ;0 -1 i i ; 'I~" ~ I't I i trlH' -1' 'NAME, ADDRESS & INJURIES OF PERSONS INVOLVED OCCUPANTS I WITNESSES l,~ ~6~~ri~ZZ~I...~.W~~ " \..,h P"OM '.: . ~ ' ~. . ~:~~(.~I "- ",'6"Nt ) "J.TUf,!~OI .'1>'" \ ~~~n~~f~O' - ~ ~~r~"'~~ f>Io O.MII 0 ~~~' I 0 ~g.'!t~ ~~~ lb~~~r~~p li'f'i~ 1~:~i(QC~IOI61~~7i'cl oJAh!;;' J~~~ - 9)'"'' Ij' '" ! .,... " f":'"' "" ..' 11- I 'n_" eL STATE OF WASHINGTON No. n ? POLICE TRAFFIC COLLISION REPORT !'OLlcr COMPLAINT NUMII(1l rJ IBEHW.... =::.J OUIlII.l.N U,At SlCII ; k'j ? f t (: t --n ",AMf , '-," .Or>lIf"~ ' EN'.' 10 .OO"'''~ "'......1 "t'Il)lIf~" ~CO?E5.1..l 1..7,""~,I,~,1-4,I,S .e,p 5fl( I ACf t..iATUsl'..n IO:>t., (....~llIlsTIl.l.rJfCl ~.,,,... I I SCf"l'''foV M 0 .Mll 0 rl~~1 0 ~~~, ~ 0 ~;~~ 0 \"il"'~. I ~~r,?V~~ fllOM 0 A""8 0 ~~~t 0 ~~:~,u 0 ~~ 0:-:::.,.. I 0;0:;',..., O~~ J'9 .~ , ...... . ", ' ." , " ",'" , , "" , " .... .. "::, ': ":,'," "" '" . :. '. ,.'0,"" ': ,," :' ' ' " " , " 0" ,," '.:.,:..'<''' ,: ,', ,", 0, "" ,', "" : "',': ',,, " :, '.." ''',:' '/". ',".' i....:. .:,' , , ",,'.' ',.:" 7, : .' """',' ,.' :. '.' ': .' ',:, 0,,' , ,:':: ,.', .,. ...; " ,:', , ..... , ',:, ,'::' " " ',':, '0: , '0,', , " ..... "" " .' ',,' ..: ,:., :' "'" ,: ~:r. ~ ~.\ 1- , ' . . ..~ ...... "', "'" 0" , ',''> ., ~ ~: 'f , ~, 1''' , \. t I ~, " t t. t ;, I ,F Jl - ,"' .. . , '. ~~1!{00j =l :.I';:j rOof" PRODUCER CORROON & BLACK, INC. P.O. Box C-34201 Seattle, WA 98124 (206) 443-2300 INSURED SUl1MIT COMMUNICATIONS, INC. and as per attached 3633 - 136th Pl ace S. E., Sui te 107 Bell evue, WA 98006 H . ...111 '. , , , ' . . , '", , " IJ:dIIII 'h"i'J~'~' ATr; (MMJDDNY) 12/27/88 ',,' ~ " , ;' , ','.: : .', THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL.Y AND CONFERS NO RiGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEP-lD OR ALTER THE COVERAGE AFFORDED BY T1~E POLICIES BELOW. ',' COMPANIES AFFORDING COVERAGE f~~~~NY A Transcontinental Insurance Co. : :. f~-M~~NY B American Casualty Insurance Co. f~-M~~NY C f~#~~NY D f~i4-~~NY E TYPE OF INSURANCE THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. CO LTR POLICY NUMBER GENERAL LIABILITY A ~ COMMERCIAL GENERAL LIABILITY CCP 702387907 b_CLAIMS MADE WOCCUAAENCE ~ OWNEA'S&CONTRACTOASPAOTECTlVE I-x- STOI'-G'O AUTOMOBILE LIABILITY - ANY AUTO B L ALL OWNED AUTOS .2L SCHEOULED AUTOS 2L 2L f1L I- SUA 902387906 HIRED AUTOS NON.OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY R"OTHfR THAN UMBRELLA FORM WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY OTHER POUCYHfECTIVE DATE (MMiOOffY) PO~ICY EXPIRATION OArE(MM/OOfYi) ALL LIMITS IN THOUSANDS 12/31/88 GENERAL AGGREGATE PRODUCTS.COMP/OPS AGGREGATE PERSONAL & AOVERTiSING INJURY EACHOCCURRHJCE FIRE OAr~AGE (ANY ONE FIRE) MEDICAL EXPENSE (ANY ONE PERSON) L,ooo_ $ ',000_ $ 1.,000_ $ ',,000_ $ 0_ $ 12/31/89 12/31/88 cs, $'!l0 12/31/89 SODILY INJURY (PERPEIlSON) $ ll{)OILY INJLJRY tC~~OENT1 $ PIlOPEflW DAMAGE $ EACH 1$ AGGREGATE OCCURRENCE $ STATUTORY -tf:t .t:~!iff~':'Q\lJ!t~~~$,JA':;$~' $ (EACI1 ACCIDENT} 1$ lQISEASl:,POI,.ICYLIMIT) $ lOISEASE.EACHEMPI,.OYEE) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/AESTRICTIONS/SPECIAL ITEMS Jefferson County County Courthouse Port Townsend J WA 98368 ,,' . , ','" . ,', ':.,:',:' '..:' .:..,,'... '. '. .. ;'. ,,' .,:", , . .:' '''''''' , .:':: "",:'..:, ".", . ,,,"'::' : " ....... ....... ..;-. . .... .. '.. ..: .i .,.'. ..... ..... ..... .". .' ..' '.\ ':"" " :::',',' , ,,' " . ',,'" , . ': ,... '. : "'.'., .' .' .'.'. ' '.' .... " .", . :, ., '. ":",. ,. '., ' ','. . . . ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX. PIRATlON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBL.IGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHOA'ZEDAEP?:j~ ~ , '. .................. , .',,'.' ....: " :," ,',.' . : ,", '''. . '. . '. ...:. . ... .'. . .. . ..Ii .. ...... :.. ....... ."'. ..,. ..: ,.',.. ...., ..:. '. ,,' , ,',,' '. " '.,,". ',' . " .':' ,", ,', .,' '. .' " , ... ',.'.' . .... '< ';:', .'< ,,'.-, , ',' ','" ",": " ,:' . '.,: ",' " ' ..: . -,,: :~: - ".' .,,': , '.',' :' ',"', ' ..7 ' . . ' ".> . .':"'. -:;-' /f' 2 '7 \'3 V~71j ';~ -J/-j -/ ,~~ ~ () ~. ;r" ..._J~ IA CD v .... 2,0 V. CClUtftV "'..,D."'-&.. ~ ..... ~ 1'1 Q~ ~ l..O~u~ ,,~ } Gu~~ (\~l 110. ~V I . ,~~ '~..-..-..~. _' \ ---?' "4.. ~""fl"'"",,,, -1- ~ otI"C,",DIA ...."., {{ ......~. ~. COtl.J'geWe.R "0." ~ ,f\; . ~ } ~ ,"'.t. ~ ~ ~~ f' r ~o~o....,;" s , I' ...~~. l .. '\o~ ~ ___ -r-,.......-,J b. ...... L_e'... - i-- ~"'''''D Ro , ~I\ ~ 17.,1?~ ";~~" , ' I ~'d'.l-e"...e!.'5 Av ~ ~ Lao.~T . , ~'C" ~t>. j ~~ OLO Fc."T Taw~ ~~ ~ \ WAY(- . \ ~1!lkl!.V"1) . ,; ... ~~~1.::.r ~ . I L:. \.,1; \; ~ - i " r' ...~ ~ ~~V \. D/... I ~ t\. ' --, ~f:ooo " , '" '.: " "',~., .:~.-:" . .' " , , ' .>' '.. <:,,<'> ".....' , '.', '".< ". i .... " " ,,', " :' ',' , ,:,:" ,'.," "':"'>", ,.,',.'" . , '.,' '" " . .... i.,.,'," .' .. :""', ' ,',':, ,,',I':' '" ,", " " ': .; " ',' ",' ': , , , ,,' ,,', ' .",' '" ',,:,',,"', ,,' , ,'.., . ',,. ..' "", ,":' ",' ",' ',,.,,:'." ",' ',,', ':: ''-:::' ","" ',,''',., ' ", '. "" . , .'..,'. '.:", , , '.;:' ':,"','..::,." ',. :"",' .: '. ',':, .. "", " '.' " ",',' ,': ,'",,'.. ,I'. " '. ", .. "" ," ., :, ,"; er,:' · .'(',' '. .' ' " ,'. " '':,' ':. ( , . " . " " ,.' " '.'. .,', ">': .. ",::C", ' .' "" ',' :":'" ;",',',' ',." ,'.,': "., '." ' ... . ".' '.' '. . ,,: ". ',"':' ,', ... '. ":"'.,' . ".. '., '. " i '. ,', ,"''''', , " , , ? _.. _.. " r ~ ~~ ~~. f' !' ' ff DI SNAGSTEAD , ~ ""p.2." I ~\ '\ I ~~ r ~ 11,1 " } " t I ,.., ~~ : ~ I lil .... , . "'" " , . : : .).;:;, ,,' ':,' " ,:' , : II I J ( I , J " " . . EXHIBIT "A" . . ~ ::,: : "..... -4f-'-r 5 id ~;J~.~- II ri~..... i ~ ~. '!- I i ~ cp 7 8 9 --- T : fg ir m ~t ~ t ., .. I~ ~ '!~ "-~4 I . CPoIa. CI ~ CJ I ""'I!. l. ~ , ;:' ".' '::.:'\_/.;"':'::",:"" 't';,. """";>:'" "'_ ",':' ,,, " ',,:":' " ,,' ::' ,:':,,' ' ':"; :;""", ',;" "" ': \'r,'" ' '~~:~~,;"""";;,,'";,'.,'',:~,~,;,,;j,;';C'A,_,..:-,''';''''':",~",;:: ,;;.,,,,,..:.._,~~:~,~";......:.:.;";.~,,;,,;.;"''''~.;;;;'';''''''''''','',',,'',;"''''f"I.',,,~;,~~,,; Slale of Washlnglon Deparlmenl of Revenue Audll Procedures & Admlnlstratlon Olympia, Washington 98504-0090 600 122 582 Certificate of Payment of State Excise Taxes by Public Works Contractor Contractor: TOLLSHARK CONSTRUCTION 1132 VAN TROJEN ROAD CHIMACUM WA 98325 PWC 72974 We hereby certify that taxes, increases and penalties due or to become due from the above named contractor under Chapter 180, Laws of 1935, as amended, with respect to the following public works contract: 3EFFERSON COUNTY BRINNON WATER SYSTEM INSTALLATION together with all other taxes, increases and penalties due from such contractor, have been paid in full or that they are, in the Department's opinion, readily collectible without recourse to the state's lien on the retained percentage. This certificate is issued pursuant to the provisions of Chapter 60.28 Revised Code of Washington for the, sole purpose of informing the state, county or municipal officer charged with the duty of disbursing or authorizing the payment of public funds to said contractor that the Department of Revenue hereby releases the state's lien on the retained percentage provided by this Chapter for ex- cise taxes due from said contractor, This certificate does not release said contractor from liability for additional tax which may be later determined to be due with respect to the above mentioned contract or other activities. Date at Olympia, Washington, 8/.;)// of g , RECE~VED r, U G ,j, 1988 STATE OF WASHINGTON j'JEPARTME,NT 0)' REVENUE ~v$n,t~ SUE MORRIS Certifving Officer JEF'::ER"'Ol\l COUNTY . ~ E S OFr-ICE f~OUTlNG: While C(}py-Disbursing Officer, Cunary Copr,-COnlnJ('lur. E{\jq:!t;tER~~XJJ (X'l211 (3:;5) - Pink CU['Iy-Filc. Goldenrod Cupy-Special FIle. -Qo. <<'0 7~C> l1,[b'IT''IT'IbOO @!r 'IT'OO~~~/J0iJO'IT''IT'~11 :;a I11LUILUtHoJ' -;:\".::':'; ~:':f. t~....~-_..:~ .._.;.~.: o,o,n:: 6/15/88 IJOD.NQ. ATTIENTION Breakin Carter ." 8rinnon Water System Project ThllshaIi< Constroctlon /1132 vi" 'Il'olc" Rond & Custom WoodwOIt/ ChlmocUln, W^ 90325 Co. Dopt. oFPublio Works JeFFerson Co. Courthouse Port Tcwnsend,WA9B36B o Shop drawings o Copy of leller o Prints o Charige order o Plans ~ o Samples the following items: Cl Specifications ~Attached 0, Under separate cover via COPIES DAT~ NO, DESCRIPTiON 3 6/'15 Certificate of Sub~tantiEll Completion .. ... cheCked below: )(]( For approval 0', For your use OAs requested. o For revtew and comment o FOR BIDS DUE o Approved as submitted o Approved as noted o Returned for corrections o o Resubmit..:....--copies for approval o Submit_copies for distribution o Return_corrected prints 19_0 PRINTS RETURNED AFTER LOAN TO US REMARKS ~.~ ()' COPY TO SIGNED: ~~ " ene/olur.. .r. nor .. nClt.d, kindly nCltlfy u. .t Clnc.. z o ~ t- a: o ~..~ ..:>= "'u t-:::> u. a: ot- t-'" ZZ wo ::EU t- a: ..: "- w o ~ 21~~ " <:i -., ~A~ ll~ .;t ~~ ~ "-l !:!~\ ~~ 'w ....... I~ a: w _ " N " - ;0 ~ :: ~ a: a: ::> o :J: ~\ c:o ....... 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QJ~ ....,+->~ QJ'~ ........::;;:: ....u or- co ~ OU'> ww..... co co ..... ~ ..... ..... ,. '., ". .' .' ... . . '. ~ . i51 s .f '., ":"" .. .\ " . :. .' .. ".. l1li ....><. ..................<}J/ iii........... · J....... · .'. .'. ......... '. ...... ........... ........... . ....>.iii<i<ii.i............".....i .....,?ii.../", - ,,~. . '-,. '-" . -. . "0.,.. -.,.-,," ./~" r~ ~ ',- -.. ......r!Jir". , "T'.' r. . -' - ......:... '." f' . ""'~.'" .0:..",;,...'>, '.j ~...../ JJ /~. . '!r".- , ,!'- 'P-:R __'0 .~. . i . : .~'.. ~,'r.-,,: ,""';-" ~ /'"'. r -/-J' . -: ..:. J'-:- '_. 0' .!',:.. . , ~ ~".,... ~!"'~ __:';# .~..J1'1" ,_..... -.:--. -~.~ --:rr:-_..-..... .N'" ._._.."l" {"r.:..:.:,,~.';' ,""-/~r ...~...'..-; .......-l::U"'........-,,;,T,f~' "~,J -.r.....-_~.}THe..!':..~;,.:;J,.......""',:~~:;.;r,.~J..,,._..r .....~._~.J.' '. "''j:-~~~ ~iJ.. ~~ rr:'ii~~~ NON-FERROUS, ~~...., , . ........ H. ~~ NON-SHRINK GROUT J'c~ .,.. IIIIIII!I c c........, '-".~.~ G.ryP. ..1-_.. ~<. ~."" ., .'" -''':.' .;-. ~- -:::: - ';" : ,- - -: - - -: _:.-" ,;!i:.?, ~:1.- -'?-1 ::;;- '- PBOOUCT NAME ",~e NO'-Fe,ro." No.-S,"" Gro" r.t., ..'. 2. MANUFACTURED BY The Burke Company ;J:::'" ~~ ~..~...~" '''", 3_ POODUCT OESe",pnON r;7;' ~: B..,o U,.. ~_"'~"''';' r... 'X. Burke Non-Ferrous, Non-Shrjnk Grout is a ready-to. use, high strength grout. It is effective at f.()J .;:.v:~ consistencies from extremely fluid to'p/astic and need not be confined in order to develop full ~~1 ~'~..'~ ~~ ~~...~...' '.,,:,".. Applications include support of structural bUilding members, such as precast wall panels, ~.... beams, Columns, and heavy machinery or equipment bases." ~::.. COmposition ;,..,.. ~ "'." Port,,,o oem,,, w"" "mo-"'e..oo e'''''''e "',' '"0 0'"'"''' '''000 ,,,., ~~~ ,.:./ "",,"e. ~. ~ B',,,,,,. """ ,rtrt .",,,, "". wm ""0'''", 0' '''''em,,, o,,~ "'rt",.,o wOO" , _ r r: ~~ unique controlled expansion. ~ ,;; · Co,", ",00 " '"' 00'''''0'0, "om ""Ort '0 """0 '. ..; I ~ · Can be pumped into inaccessible areas. ~ . f: · :~''''oo" 'e~ ';m"" '0 """,,' oo,~.., 0' mort,,_ wm '0' '"" 0' i;~ .... .i' · Low water/cement ratio results in early strength with exceptional bearing f::~7iI t..; ~ contact. ~~ '.. :~..;; · For large pours, Increase yield with addition of up to 25% by weight of clean. .:.-.: ..' ~~, well graded aggregate. ~ ,. " :.i-:~;i~ ~~.:. Packaging ~._-!" ,,~.. ". . 50 lb. (22.5 kg), Order No. (324) 57-120, on 00 lb. (45 kg), Order No. (324) 57'100, 7,:'':' mu/ti'wall bag with moisture resistanlliner. rl ~L~ ):. '1:1 :. ~ ~~ ~~ ~. ~.. ~-=! ~ "~'~ :f.~';~;~::-f!, ';;-?-~, ,-, -' .:_:~ n~. .: 2';..c "<" . '. .,'. '.:'.:, '. . .... ".. .'. '. ;." ..... ...'- .. .... .' '. .... " :.... ..':.' .' .......... .' . . .... :." ,',..i' '" ..." .,....., '.' .:.. ..':.' '" ..... :....... ..'.. '. . .... ....... .:.....,. "':". :,.. · ":':. .,.,,' ';'i . . ". ..,".. .. ...... .',.. .... '. .... ...:..., ..' "::-:. '.' ". .' '.' . . ..' ...,:, . ...." .' '. '''.;' : ,'" .. . ....,... ..' .... ..... .' ':':,". ..... ,:: .... .... .'. .,.. .... ...... ." .......... ................. . :. ", ....:..'.:.. .....,.. .... :.........:.;,....... '.' ..... .... .'. ....:..,.... ..: <.: <', '>. ::: . .: '. '. . .. :;:... . " ..;., .- c,' ,".. '" ....:,'. :, ;. .. .' ..' ....... '......... ..... ...... .... .' ..', . ...... . ... :.;'".. :::C' '.'. ,''',:.. <. -: . '. '..,' ;._.. ~:. -.' ': '. .. ' .'. '. . , : . '" .,,:-,: .' - " ,," . . . :," ,\:;" .. - , " . i ". -' .' , .: _ ,', ," i .. .... . . I:; . ,.:;-2 #i .-;. >1. ~;;. ?:;, ",... r;1'? -~ ~ 'ilw. . ~ .',,,- i';:;' ,,' " . . :(.. .' l'-~ ., "" t.... ...:.~ r...'~' ,~. .' Freight Class NMFC Ilem No. 42140 Class 55 4. TECHNICAL DATA - LABORATORY TEST RESULTS Data derived from laboratory tests. Actual results will vary with field conditions. Mix Consistency Minimum Flow (Plastic) CRD,C226 at 5 drops 100 flow Index +0.08% +0.08% +0.08% MOderate Flow (Pourable) CRD,C226 at 5 drops 124 flow index High Fluidity (PUnlpable) CRD'C611 26 second flow cone Flow Test . ExpanSion 3 days 14 days 28 days +0.04% +0.04% +0.08% 0.00% +0.02% +0.04% CompresSive Strength 1 day 3 days 7 days 28 days 5,400 psi 8,120 psi 9,330 psi 12,340 psi 4,410 psi 7,570 psi 8,490 psi 11,270 psi 2,870 psi 6,420 psi 8,340 psi 9,760 psi :.. ".' ....:.' ','.' . .' ,.. '. r 5. SPECIFICATIONS Complies with Corps of Engineers specification CRD-C 621-83 (formerly CRD-C 588-78) and ASTM C-827-78. 6. APPLICATION INSTRUCTIONS Surface Preparation Clean all surfaces OT grease, oil, dirt and loose material, down to sound concrete. Roughen adjacent concrete surfaces where possible. Wet area thoroughlyatleast4 hours priortogrout- ing. Remove excess water before placement. Forms must be strong, securely anchored, shored and sealed to prevent grout leakage. Mix CO/lsistency 50 Ibs.(22.5kg) grout Clean Water Minimum Flow (Plastic) 2-3/4 qts. .39 cu. ft. Moderate Flow (Pourable) 3-1/8 qts. .405 cu. ft. High Fluidity (Pumpablel 4 qts. .415 cu. ft. Yield DO NOT DRY OR DAMP PACK. USE BURKE DAMP PACK GROUT. WATER QUANTITIES ARE ONLY A GUIDE. For best results add drygroutto water; not water to dry grout. Temperature, mixing method, and batch size will determine the actual amount of water required to place grout correctly. Use the minimum amount of water needed for place- ment. Use amechanical mixer for apprOXimately 5 minutes to ensure a uniform mixture, and place. Mix as close to the grouting area as possible. Mix only enough grout that can be placed In 15 minutes. Working time is approximately 30 minutes at21.C (70.F). Placement G'rout must be placed continuously and from one side avoiding the entrapment of air pockets. ) Sufficient vent holes should be provided. Remove voids through rodding and vibrating. When grouting areas of more than 3 " in depth, add up to 25% by weight washed pea gravel that is 3/8" or less in size. Then mix and place as outlined. Should pea gravel not be available, any placement above 3" should be done in pours 24 hours apart. After placement, keep exposed surfaces damp, Protect from excessive heat and cold. Keep from drying out for up to 3 days, or apply a resin based curing compound, such as Burke Res-X. Burke Non-Ferrous, Non-Shrink Grout Is a cementitious product. Follow ACI recommen- dations for forming and placement. After initial mixing, do not retemper. Caution! Skin may be sensitive to cement. Wearing rubber gloves is recommended. Avoid Con- tact with eyes or prolonged contact with skin. If eye contact occurs, flush immediately with water. KEEP OUT OF THE REACH OF CHILDREN. 7. SUGGESTED SHORT FORM ARCHITECTURAL SPECIFICATION Non-Shrink Grout shall be Burke Non-Ferrous, Non-Shrink Grout as manufactured by The Burke Company, San Mateo California, Non-Ferrous, Non-Shrink Grout shall comply with U.S. Corps of Engineers CRD-C 621-828 "Specification for Nonshrink Grout". 6. WARRANTY Burke products will perform according to specifications only if directions are followed. Burke is not responsible for improper use, application, or storage of its products or for use of its prod- ucts In unsafe weather or with unsafe engineering or working conditions. Burke prOducts are supplied sUbjectto Burke's standard terms and conditions of sale or rental, which limit Burke's responsibility forthe product. Any warranty of the product is limited to Burke's or the manufac- :,\ turer's standard warranty unless otherwise specifically provided by Burke In writing. '. y BPB 300/9 B/B6 ) '"'''.,''' ' ..',,;!:,. "'~~:C'i'" ,. -'~~- >, .L' ;;) ;"/ ~~~-t::~'i,~;D,:;j~f,~~tij~~~k;~j~~"{if,ihij;:~}~:(~~~:;~~~f_~~~';~'(~Ir:1,,:~~~;~:~~;j;~~~t~7~~;:~'I~:;~;';~'f~~\;~;~~~::~J;.~;iW':i;;.l;~k02~~S;,:i3ii,:'1i~i:X~~<\ , ~- ;'-'-,,^ PREcrSION 621 GENERAL INFORMATION Basic Description PRECISION 621 GROUT is a specially formu- lated. stringently prepared. ready-to- use! . hea"y duty. non-corrosive, non- staLnLng, non-shrink, high strength grout. PRECISION 621 GROUT is ,design!,d for use at a~y consistency - dry pack to flowable." ' Features -; non-shrink - frOlll tbe time of place ment, very slight expausion, but posi- tive, and no intermediate or latent shrinkage. . ready-to-use with only the addition of water . free of bleeding frOlll plastic to dry pack consistencies . free of shrinkage or settlement from flowable to dry pack consistencies . a special Don-staining formula permit- ting use in e%terior and interior appli cations; appearance s~ilar to concrete and mortar . DOD corrosive contains nO chlorides which could aggrevate corrosion of steel high strengths at fluid consistency . pumpsble ) ~ .... l.Uab~,an Websen Technical Products (Canada) Ltd. 8605 Kerr Street Vancouver, British Columbia V5S 3E8 Office: (604) 43()..1455 Toll Free; Boo-663-4525 Telex: 04356660 Uses PRECISION 621 GROUT is fer use at any consistency from dry pack to flowable for precision grouting in industrial and cons truc t ion app 1 ica t ions where .shrinkage must be eliminated. PRECISION 621 GROUT is' an ideal 'pr~duct to .use in the follow':' ing applications: 1. Grouting heavy equipment. machinery bases, etc. 2. Non-shrink grouting of concrete beams, columns and precast walls. 3. Grouting under structural columns., precast tie-joints. 4. Re-pointing mortar joints, structural cracks, and other repairs to concrete structures. 5. Seating anchor bolts tensioned cables. atld post- 6. Anchoring pests for meters, railings and imbedded in concrete. signs t other parking fixtures ra Ie;" ~ If';> ~ 'l.. H l'r:: If"':, ~ t!;; ~~ Lb U V!f 't~ l1:Jl JUt. 11 1988 .JEFFERSOjl] COUNT',' ENGINEERS OFFICE After removing forms and wet~ rags, coat exposed grout with WEBSEN ACRYSEAL or WEBSEN ALL RESIN CLEAR. 3. PRECISION 621 GROUT should be pro- tected from extreme temperatures up to 72 hours after placement. See LIMITATIONS. CONSISTENCY METRIC MEASURE Bags/m' m'/Bag PRECISION 621 GROUT produces the following yields: U. S. MEASURE Baes/vd' Ft'/Bag Plowable J'lastic Ilry Pack 74 78 82 .0135 .0128 .0122 H,lintensDce No specia~ maintenance is required. TECHNICAL SERVICES 57 60 63 0.47 0.45 0.43 To assist in the selection of materials and the preparation of spe'cifications, please contact WEBSEN. For product installation assistance, please contact WEBSEN to ar- range for a r~I'resentative to be on site. TYPICAL PROPERTIES IPROPERTy TEST HErnOD FLOWABLE PLASTIC I DRY PACK I I I I I COMPRESSIVE !;'!'RENGTH CRD-C621 I I I MPa Ob/in') and I I I CAN3-A23.2 I I I 3 days 21 (3050) 34 (4930) I 41 ( 5945) I I 7 days 36 (5220) 44 (6400) I 59 ( 8550) I I 28 days 49 (7105) 61 (8800) I 69 (10000) I I I I A complete churt of properties are available in Websen's QUIK CHEK - GROUTING - 1. I wczb ~czn 1."....0..,,' ') ] ~ '" f/o' ~.....,~.."".... ~ "(;r, '{~:', ;' " ,~,' " "" ",\",~"-', ,-".- ,', '-".'. ,<,e' . ':'.;, ; ~l " "-><-(.,", .:.',;', ,,~ "', ", -"\ , .' ~:,~,:',:~';r,~~;"',>~~m.,.~;':.>"2!''';;~S~;tl;,"j;~",,'"l~~7'1i'I";'"":;;!,~d,:,~~:;;~,,:L;",,:;,~ ~;~"': ,,;', ..;..'".. ','... .;. ;.,>,;'. /C,? ;"...'::":::) n :01 FIELD';' NOTE RECORD (SKETC't;;., GRID) CONTRACT NO. 1Zco '7 00 BOOK NO, - PAGE NO.-===- - STATION .:::Jt,.i"fi=~O.J CO. ~0t0S rAC-lL.l'r{ MILE OR LINE CIS ---- GROUP --- CODE NO~ WORK STARTED~-z..\ 'l36 WORK COMPLETED e[ "2Jo) B8 STAKED BV I ,h", ,'C; 7-l' 'M <2 W B (I,fu NI nIT i-"> C> - I ~ I Ir, .) ;>l' ;;r ........ '- -.. r--.. ........ r-.. ...... r-.. ....... :--"'1 ........ r-- ...... t-- .. 1--_ : /, ,- J!.Y '- ); INSPECTOR (Slgni,"l'" ITEM REF~ENCE ITEM QUANTITY POSTEO OR CARRIED INVOICE OR BILL He. PO, EST. .. PO CF LADING HO, SOURCE COMPUTED BY DOT FOR... .U.fl311 eFRONT) REVISED 1 Ifill P J017. CHECKED BY '. , " , " . ," ... ":, ., " , ',,:,: ,,'. .. . . ,'" .'.'. ..".' " . ;;.' ' .', ,\ ".,'; ,..; "." ...."'.:. "..,'. . ",'0', ....',...:...... . ,. ',": ' . ," , ," ' ':'i' ,:' '. :.' .: ,.:"; " '. .'(,"":'.' ....".".. :>' : . ' "... , . ,'" .'..,.' . ' , ".. :.. ': ','.;: '<;' . .'::'" ".; :....,' '.' '''.'' .', , . .', . '.." : ",'. ' ,', "'.. .... '., " .., ,.... "..' .'..'.. . ''L';'"'' . ..,,::.' , . . , ,', ',>.;, ,".' c ,,:: ,...,,, " ..' "~ i.." ... , , > . ," ".' . ..,'"....'.:. . I o o ..... YlI='~ INSPECTOR'S OAll Y REPORT Book ~ Page ~ Contract No. PPJO TBO HighUlilr== Date :PJ/z~/'88 P. E. ~ Ne.f:8ll1 Section (Title) L:ouAJ7Y 4J'/2/2€c17&1 fi:bdry _ Day 71NRS/'>W Weather A. M. ~ CCDUO;/ P. M. ;:r.- ".5UI'II'Iy" 72-0 Contractor's Representative(s) and Title MIIC€ n4Ncls _ ~~ Location and Type of Work (',(..c"'1'r,J UP TlJt.J(tH 1/[> W,NOo~f #..1 r Number and Classification of Contractor's Men and Equipment Status (In use and/or d. "dl'"" foc "'\'"'. ,<c.) ~~ \ \ . --~ \ Diary (Report of day's operations. orders given and received. discussions with con- tracto~ visitors from Headquarters. District or FHWA. unusual conditions. recommend- ations and statement for monthly estimate) :I "?61 wln-l 7Ih; n"-en-W -MIKe ~s ANQ i4:V1ta<JGD 'T"Jfe; E..Rr}.Ta:;T. 77f-G CoN71e4r..rc.e IS C.fAmNNIJ(j -uP ) W4Sfhl../c, WiNDows / AlII/) 'TZ> uC,-;'nJ9 vI'" 77ft;; uJ"VNY..i J ~-'M1E'S. ~ ii, ..:r M&I W~f/..( I11EC- 111~ ANQ fJ/\ctJSSEO T1-Ie: P~CT. mc:-L.. M eR:b1V) Ar-/LEO A130ur TlZSn^,,:; ~ Tj'EotJT APf74CA-7lorl. '.:r lJ6CVS~&-o 7?-hs W, n-{ 77Ie lVl2.~~ >4N1) {'.PJNCL()DEO '77-f,:rr &Je Co()a)'DR.ILt.~ SOIl1E n::sr &t'..ES 7b / IIJS~~ 7Jfc c$Rl')()T. ' ( EAJT E)t1&b,,,. "" S ) .:r .l:>tRR::.n=n ~ PiU2l='7?14N' oIl/MI../DCi'vl (...y SG'Z.c-c?l2tJ 0/NOOWS 7?J D,e/u... ~ U,.oPm J=i<--n-nG ~ A7lJD Cd8::.<::.. -nI-Ec s"',,Jr -qom"J - "MD"-/1 M% _ur _" ,;,,.v ~. ::22tg r Sc=rrv.$L'J W/Nf)ooJ - J?oop A7<.E7-J N€RoE' IZtc ~ _ W<9,S:__ 7)/l'Ll.ED ON' '77h;; UJuJee A2AYY1€ - nJJO~I./~ /0091, . 6rcDdr fl/I/ 0 1/ ~V f../,t:;.m) .. ;:r LePr 77+e CorVn<A~ (.<J WVG//.)(f Olli CI...8=W UP A1.Y) TOr.X1i-/ B 7Vr.x..ff- UP ON "nfr;;, IAJ~AJOovJ ~es. \ \ '" '"",, """ ~ ..""- "" ~ ~.~. r f' ,1\', DOT ~~~~s:~27~~: , '5:', l t .' , ~' (Signed) .:....--' Inspector ,'.... ,'. .. . '....'...: .. '''', ,,' .', ': . .." :'" ';, ,:: '.', .. .' ", '"... .' , ,.". ,,:' " '. ' '.' . ..,. ,"... '.. ....." ".. ' ,.'.. '", . '. .. ',; ,...... . .,.,'" "", '. ". ,::'.' ...,.: "., ..".,: '.;". .:,;,.',' , .,.i"".:.,;' ',' ...", .:. ". ". ',":' '. '",' ,', '.' ..'.. '. '.' .' .':' " .,..'. :":, > " .,... ,...,."... '.,...,. . .",' ,,' ..:', . ...,'... '. ".' , . ",. ..' ...', .', . .' '..':..:,..' ... ,:.', "'" ",',., '.' :"" .:' . ," .,' ,.' ,,' .: '.' .":' ';,',," " " I,.... .".'., . ", ':' " ,:,' ,:' . ," .' .'. . . ""'. ",'. "....":.:..,' ...,...,: . .,' ".., . ,;". ":, :" '. . ': ' .'" ",::". ..', . .. '. :. ".' .. '''. ..' i,,' '.., , ,",' .' "'..... . , . "... ",: ',' ,::. :', ','.",. '.'.. .:" '> ". .:;" ' '. . "., ,... ...' , ,,.':" .,..":..' '. " I, ,:' .,',.....' .. ,,<.' , '; .... ." '.' .', . ";" ...', '..: ,,', '.> '. '. , ,. '::", '. ;"'> '. ' , ", ......,:, ' . .c' . ..,. "" , ..... , ,.... .',-,,".... ~. ?,! , f ~. r ~: i', ~ .~; '~; ~ f y , ~' ~ ,,'.-.. ' '." ','. . '. , """.;"" ,',' . " ':. .' '. ".:"; "," o n '"".. ... :7.: ~_ "M' _"'T............... INSPECTOR'S DAILY REPORT Book --.f2..L Page ~ Date 8/2.0//88 P. E. RDl3€1lT !Jess".,... ;:::;'ClL/r,! Day WeD"'''S'''''H P. M. 5u",,,,'I E'oQ Contract No. 1'.= 7f30 Highway- Section (Title) CO()/Jw Cf:)-eft.~010NS W~ather A. M. 5I.JNAJ'/ Contractor's Representative(s) and Title MIJ<:€ f"kANC/S- hGMAtJ Location and Type of Work &l20ur WNJDnWS i!-I.-eAN-UP Number and Classification of Contractor's Men and Equipment Status (In use and/or deadlined for maintenance. etc.) 1- fVteeM~ M VLl..e-~ 1It1)(ER. 3- Ut-Bof2Eei: /hwo PUMP b-:" (iA-uo,J 13 uc..Cer.s ~/^,," /tA{)IJ",,~<; '1'1 Diary (Report of day's operation~ orders given and received, discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, recommend- ations and statement for monthly estimate) ~ 11l1lt'&~ BI2DK€ l::c<<.kV 7J'hr rJ1Co1l/1),Vy" 'J7Irq Co1JI>e4C.To€. .E.e'PlACl:7J 0A:S LiMes AND R€6AN DP,""RA-77A1ip Rr /300 HKS, 77+e Cf;rJ~AC.mR.. mNt~ G/1.0I.JnNQ '7'7+6 WINbwJ> ON 7Jf€ F'XnER./OR K'coF MtE'A - '7'7hs CoMPUZr.c:<; 77IF' qI20u77Mtf. m I K:e !7'<o<MIC/ S; - ;hJeeTr)4-tJ ,q;v D ::r c.o tJ Mn:7J "T7ht: 6?RoUrd) I/IJ I A/DQ-}JS ; EAST StOF E)(T'a<JDR- = (it) := (fiJ tiff "" JacoI:' At2eA exl'9?lOl?-- 1m JHf .JIff '4:1 1M 1M l2ec ,q'<!EA - II (2) we:;r S/O~ :7,</,/<_ EAl7>ZY' -k'J~ @ ::{, '" " " " '\ '\ 52- 7bTA't... WINOot.lJS DOT ~~~~S:~27~~~ '" '" '" ~)i,n''x (Signed) ~J " .~.:,-, .. ,'" - "'., :' " " '. '..' Inspector '.. ',.., :. '.' :': '..' --~ '...>. ':" ,.,'. " :" , " ' ...,." ,.,'. ..- , ", . :.....: .,' " ' ,0' ',',:. . " ',..'..... '.'.. ."- ',:" ,,!.'.' , :..,.. :.,' . "."", "".,,,: ,'. :,. " " ..,; :',' . ". ", .':' '.,'; ',:',; , , '.,"""'.'.., ", "...' ..",.', ..,. ,.', ,,'.' "..: ,,':' ,... ".' ",., ',...., '," 0."0.. . , ': .", . " . ..... .' :.. ..", ", . ,:. .. .,:' ,.'.'".... , '.' " ,', :'" :.: ., ,'.. '.' .,.. ". ..:..'..'> . , ':' "... ',". ':"'. .:.,... . . .,'... ,,'.. ..... :'. .".., , ':" :" ..'.' , """" :. '. . ".. ...... , ,.,', , ., ,.,. ..' . ,',. , ',' . " . " . '.. ,.'. ... '.' ".. '.,' "', .. i: .'.,... , : ,', '.. " .. ...' :" , " . " "';,'"" ....... ' YM'='~--- INSPECTOR'S DAILY REPORT Book ~ Page ~ Contract No. . Zco1/!fJ Highway - Date 8Iz~/8B P. E. r:o~ NESJ5/7T . Section (Title) (lrx)1J7"/ CoR/Z.ErJ/ext!<, fAC/r1rY Day "/tlesPA-Y Weather A. H. StJA/;fJy 5'0" P. H. 9.V,vNY 8$ Q Contractor's Representative(s) and Title MIKe: ~Att.5-~ Location and ;~e of Work ~~ ~:;o.JlY>uJs. \\ \ ~ \ o o , -. ': '. ,'. " " ': I!I , . , , " :' ," . . 7?IG -;rn2" 77I-e: -me 71-f7::;;. .. tk~ (Signed) . ,-c ,,-,- '. ' " . " .... " ": :. '. ,.' ". ...'.. '.:' '. .,' .,' . . >',: .."... '.' '.' . ,', · ,.' i', " .'. ' ",.,' ".: " . , . .,', ,. ,'.,'. .<: '.: <::";.',. ,', :'" "', . ...' ';':.," ':'. ':'" c' .', ,':' ,', . '..,...' , ",: ", ,i . ,.' .,' ...... " . '., " '.,'.. ,,' .,' :::: . ".' < ..., . .,",.;,., '..': . ...'. ,.' > .., ,'i' . . ,: ., ,'. ..."'\.;" '.,'. '.' . ,., ".,'" . , ,,"., " " " ',.' ..,...,.. ..,',..:. , .. " .,.. '. . ." ';.'... ." ,.... ',' :,':"'..' :'. " :..'. ." . . . '. '.., ...:...., ';" .. ..,.,... .:..'.'. ',..' . .."..>:: ,'.. " " . ..,,' . " ..:'.. ...",. .' ,..,..'. , '. ", ...'.: ",," . ....-:..:.. " .' '....,.'..' '.:'. ." .' ,.,.',,'." ....' ".: " .... ,: ..{:,. , . .', :'.',,:.:;, "'''. ':. '. '.':>,:'" DOT ~~~~S:~2:;~~~ Inspector '1\' ~ ~. \ k " ~ t r :" '. .'.'. .,' i,: :.,' .: .':' .ill h, ";" f " i' ~<t f' : ," " ;'{' . ..,'.. ;' :....':, . " '..:. , ..'.' " '" . o .... ,:~. '.,' ..:' ',. '. ...; . .' '. ". '.. . n '",,/ ..... ,Yl', \VuhInglonSlala "''''6fJI' -.montolT_ INSPECTOR'S DAILY REPORT Book ...f2l- Page 1.2- ~2.2/8B P.E. i~ tJe.iM-r- n urY Day /fA.l)NIJA^/ P.M. {;VNJJ,/ BeD PtAtK:€' ~NClS - ~'2iS! uJ I"-';;X;W> Contract No. 7Z100780 Highway .--- Date Section (Title) CovillTV' ~17oN~ Weather A. M. SV;J/lJ t/ Contractor's Representative(s) and Title Location and Type of Work ~~ '\ \ '" , Number and Classification of Contractor's Men and Equipment Status (In use and/or deadlined for maintenance, etc.) /-;C;),'2r=wt~ lIIul.LeX<. MIX~ ""N. 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'. ..'< o n ........rl ...... y.=.~ INSPECTOR'S DAILY REPORT Contract No. ~~~ Highway Section (Title) Weather A.M. MIS"- /SHowms I Contractor's Representative(s) and Title Location and Type of Work fib ~ Book --9-/- Page ~ Date &(;~/a3 P. E. ~ AiB:l3/rt Day -rtJESl::Av 5I"Jo P. M. gf'~ to?'''' lZtClC- 7OuGRoAi -cv)rJeL Number and Classification of Contractor's Men pnd Equipment Status (In use and/or deadlined for maintenance, etc.) )10 ~~ '. Diary (Report of day's operations, orders given and received. discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, recommend- ations and statement for monthly estimate) -Z'. ~ .tJm-l l2{C/C /bue!;r:Al 15<1 "{lEZ€P;,bIJB A.:r nCJ'oo. 7Jk:f c.oNmc'f't>e. /5 ICe0l7Aj'f .q' c$A!!ouT r..h1/lp ~ .4Px- ~Nn:H..s 11\1 BR.l;;m~: f';t\:JD ~ ~c.mA/'7 WILL. ~r,./tJ -7:0Nv= 11A0/2~NINt .::r. t:Y5cussro 77-1€ 'PUt':A>17 (J,.J /Ill &n .5 Wtift!S . vJ I n-I Xlde:. /cu ~ ?-I""I//P/oJ/Alt'y. ~ . ...v1.4NtJ~geS' PlIlt. {Br..J/Gf<:.P GI20U;-1} AlJO "7fI13: 6 ~ rtV . Iii:vJ In l:::"77I-o/) uJl-hCH RicX 7f)t.LGfioN ~ {J)ovc..D 7;)IS?7ell;tJre ~ 612O~ (?.f.)/Il.('/s'J1;;tlI'rtJ/ mtu)U~fIour '7'7ffq 11) 1^lIJOI.iJ ~e_ C44-S Ur.JMt& Tl> /lUD~ILlzG TJIe r;l<.ocJ7J~~ NDr f)JDlZI:::. -ro[W,l. DOT ~~~~S:~27~~~ (Signed) " ':..'..,' . '. . .,..'..'.. :..,.'. .' :'. ,.', " ........., ",' " ':." . ,':" ''', ',., .".... ", '.... .,,:..., .': ,', ,''' ','>'. .... ..','.' . 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E. _ KOBezr Nf3'SBir'r Section (Title) rr5'>r) IJrl c:::.e,t<.t2EC:r76N11iiCJtJro/y /VlONf:Y:tY Weather A.H. oJ€'Y2.CASr SDC> P.H. Ot/~r /?)o Contractor's Representative(s) and Title '/?ielL 7Ou.EfirJl../ -O~ Location and Type of Work 7:1!93U/ZR. Pf1-tA./r /T-*uMIE~ I Number and Classification of Contractor's Hen and Equipment Status (In use andlor dead lined for maintenance, etc.) / ;:::;;~ I - Ut1301ZEf<... Diary (Report of day's operations, orders given and received, discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, recommend- ations and statement for monthly estimate) '7rft:= c.orJrnAC7v~ I#Js ~IUBO I/Nf) ffocEs IN tHG WIAI/)oW CAS/A/1' .tWO IS -me 9IZDVT MPt.tCA-17cxJ. , ',,' ,.:.'. ' , .' .,' '. ", ....': " . . ',' .. ,',' .,', '. , .' ,':' .' '... ':,' . '.' :,' " ".,:.' . , " ."...'.'\. '.c ',::'. " ," .' " ..:,:. ,'. ...,',. '.' . '. \ .'\.. "- "- "- "- "- "- "- '" "- "- "- " :,: :. ,'. 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SUN,.)! 70 D Contractor's Representative(s) and Title MIKE fRAil/CIS - kteEn1-.J Location and Type of Work /lJ7?3RJoR. W,iJOot<JS - eo/V'oPt.en3 GA-Ut'J4N'j 7Jt?-ILL- t..CtNDOcJ fi2Arv1e5 Number and Classification of Contractor's Hen and Equipment Status (In use and/or deadlinedfor maintenance, etc.) /--~~~ I~~ 1- t..A13;;1ZB'0 (lA-<JoCtAKf 7liJlS "];fa ( L- Diary (Report of day's operations. orders given and received. discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, recommend- ations and statement for monthly estimate) "7l-f1!i CON'T/'?P<.Ttx? J.I.~ 1>;2,//11"0"'7"1-1-6 /AfJfJfJnoJ ~""S AMI;) /~ PI!I#MZ-/"'~ 7'D G,iWUT. -Z MFf vJ'11I Mia.- M~ ArtJo ~IAfe!) .me CAv~N~ nN/)dv6; 7J.IG /ff>PUCA'rl()N 017 cA ULJ4N~ S'lAoo7H' ANI) c..oAlJ/.sroli: J 'PIC/CIEQ uP /7f2 Pv:ws ( l7ao CopY) - JDI-IIJurJFJ-J..{UAlT. Ai?cJ.f/'n:crs c./z.z../ &3 nz.,.,/VI 1M@", . M~tU:J /H'JO i2EJ1eueD 7H&- WtA)I)/),d 5tHeouar. .::t: l.P:Pr 77ft:::-. , "- "'-... 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H. -::;r >tJNAJy 750 Contractor'S Representative(s) and Title flA/KJ? RzA.NC(3 _~ Location and Type of Work lA.h73Je./DR. WuVOl:u).s 7?-G-J1,ft"rIIH ..-4VD ~C4<Jc..t::. Number and Classification of Contractor's Hen and Equipment Status (In use and/or deadlined for maintenance. etc.) /- lV/2k~ 640De<' S J - fA-7SIJ/2.~ CA-UC-IC/^1 ~dMcrJr/ /?ZtX-S Diary (Report of day's operation~ orders given and received, discussions with con- tracto~ visitors from Headquarters. District or FHWA, unusual condition~ recommend- ations and statement for monthly estimate) /11~.' .~~ CoA.!l7IVUED 7(:) K'G'VIO/e; 6U) (AUU::,'N1 /WI) . . '1Ce -CAtJGK . " .W(!)I~/Af FJ 110 Uk:" ~. Q4Y IfIt::E . (AOU(~A/Cf '/:;/111,<:11 _IS. S/YIOD'T7-/ /-#:reQ 4Nf) A- U9fl'r: RlCrJU.JN Cot),/? 73C1c- ~tyoJ 0.<.1 -nIe-.::tt:J8 ~ Jcf(2). 1:Jt. ~ "",""S'/~" 'TW' c-.- """ '" ~ ~ '" "'- """- "'-.. . "'-.. "'-.. "'-.. """ "'-. .- DOT ~~~~s:~2;~~~ - ( {&1 di ).." A.... (JJII!'!" K'OI'/Y --r ~. y\ '-....J (Signed) .,..., . 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P:. ,(ie@2,1r:r ~. (Title)COo....rrt- L.e2.'2€07eu f+lc.lun-- u"lJJJ~?:; Day ~~DA"r Weather A. H. '5e.uu I- L< ~,"" r.ll. _ I-Ic7 Contractor's Representative(s) and Title .I"1//CF ~c..1 5 __ F=<z-~ Location .and Type of Work ~~ C&:ri,n- ('~T1BMS f:fyjGn-- G~!rr7/J (', 1 lle: c.Af.:Jl..It../A/er ...Lt.L1..IU D&L.:J=S : Number and Classification of Contractor's Hen and Equipment Status (In use and/or deadlined for maintenance, etc.) ~~ / ,c-c:re~.ffl./ / - ~.fr1Z.- /.F.YDD~<:; -~ ,?>-IN L-. -:?n~t- ~7Z. i 'll74ND r~ c::, Diary (Report of day's operations. orders given and received. discussions with con- tractor, visitors from Headquarters, District orFHWA, unusual conditions, recommend- ations and statement for monthly estimate) ~l:)isc:.oss:&",,!> ~ ~~ CF= A-11~ ~:UG. ~"1) IJ.I.. ~~~N~':,~e;c~ V~,n-~~~~~., """",.,,; ""''''-- ~ 'M ,.".,,;; - 8<-~ V 2~;' "''''''~ " -=~=~,~ 11L-~~~.::~",~",. PILL-Hen -7::J2...iu...f=:iJ . //..( ~ ..;sTI;').:: 0Z..f"r1"'7c;.~,,:,~V-. l2>e ~)fK:, C~eD. <9-f.5"1' IN IHG' ~FICI"l:l'1OU..J ~~~~ ~/~I~N1i~1?-\~ ~l~:U~ ~'~~, ~<~~~ n~~ <l-lP.\- H6e€ 7Q ""'" ~PC I;""" _ rtkJ<'I'.iU,6- ~ , IHiA.J\)f:Jl...")<; . CRJ '"'71-i1:': ~ -~ ~ 'P1.IX"-8E -n-tt:::', .~ /='1/~'r'7J-h J..J6- ~'5 It) tbE2.~! /.-J 6- 5 ~~. = DOT ~~~~S:~2;~g~ ~~. fu.hAQQ- (Signed) Inspector " '. '. . '. '''''. [ "," :, ...'., '," ,..',.", . '. ': ,"::"'::' .'. ....: ..!" :',..',.'.: , ,:,....,.' ,",:"'.. :':,'. /,'; ..." '. ':.:, ....:' .' ' ..'. '" ' '.',. ,<, . .... " ,':,' ,. " ',..'..',', .,.,., :".:'.' ' :.. ,:. ," " .., ,:' .,.... " ': " : ,'" '" :"" ..., ': ,'.'. ::,,' . .,....,.: .,." [',.'. ,,',', ""'[.,, '.. " '. .'.:' ,,', ,,' .:' [.,:' ,'. " "'.. ::.. ".' .,'. ',' . ;..',' ..,.. ,d....:.., '.', . '.' '., '.' '... . ,... . ....... i " , ,". " " ,.', ',' .'. .:.... :. .', ",,,', .";..., ," , ' '..,'. '.. .,,' '.', , ,.... ,,!: '.' ", .... '. ,.... 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H, ~,u. r Book -L Page 1- Date ~-3-~~ P.E. ~T JJ~-rr FA'c..1 un- Lo.:l'N~y L.L5ID p, H. 1-1 07 ------- Contractor's Representative(s) and Title --t:oca~ H//C.G Eb Number and Classification of Contractor's Hen and Equipment Status (In use and/or deadlined for maintenance, etc.) 'Z ".-pe-A/ LnDD~ S S~~t>i/<L6- VA'Kf ov-s "5/'<?&r-L. !C3=7..-S Diary (Report of day's operations, orders given and received, discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, recommend- ations and statement for monthly estimate) .'. ._.1" I}f;z:;"': c.lJ:1:J77CBf'~~ ~C7u5 ~~ 'r~"i'b12l>tr.,-- ( lC1-i~ ~~/~/{_ ~7) CAvuG/~ 6- rFi?crr~ ~ t.-&1 K../lJt? 'f J ) ~ ./ /t I' 4 < 0)./ """7Ht;:' t0FJS T <:::, / PIE' !J'F ~ F.4r// /'TY' A-~BuS ('m/"T7MU-b-l:J 71mf:17 Lu7-nd Cflt.)L/~)/J{~ JZ.P)-~~ r9-:U 7J-H:;" eB-'fS''T ~ ? l?~ -/J'EP79 u.:n:.u7::::)(~r-lA..Y:"5::, (',4/:;;Oc./..L/'/'-.fJJ!4-S 'e.~Ftc.e'D LA"'l;"t1-Jt>ACI o;::i C K.E:":>'I ~ R .0C'77C . ~o6TS /I..tG. - lZES~C'P:e/C.. EG ~~ I E::--'?CJJ<..T' 'PAsTl=:. A'\ -n-I-F:;' CAJD A;:. EPrLkl \;:::)'A Y lO 'SE:f7'L L9P 7'ttE wi .u1Jo<-d~ ~"'2ffT1'DJ..1S i+i2E MdI?CEE'i>r7"uG... R12t"rt.:7:UD '"T1+€' At.3'IC:=;; f)G I, -n )oJ \)B-<-.) +:'7?f't-j/J~ I .sT A-:IJ 1) Lt.Y1 L L, n~G' /N-:<'/hP ~ 7It6 Ol~:Slh'b /<:..., CGYlD:..E17:;'/). /7 l<.3'/P.z:>o-<....)' F7Z/.J7'?e5 CbY?PLB72=../') -eoT:S1 ()6 OUL-T" - As ~ It+6 6J.J D t"JF I'tfr;:, ~ Irmr:v'-r ' /") /,t:6 -=::jT1"~.TI:':"D . l\-l'A1' '"'i\-\-6 (Q."ee! 711 JJ (yo "'j/U)(' ~s C 1"It.-L-E'l) $-<-') "'r / .<J 7'tf€ ~Al" ; 1=' i r A-Tl inJ, ~ 7::-~~~~ ~ &;- -&n~i-"7~ ~'J ~~/~~~crt~/~~ i="l?~// e::; -m f:}LL&t.....:> 41 T2- 00-1 -l . ttt€ C=.r? ("J"tJ1 I'D FL&cJ i 1 rrc::. ""Tl-\f:' C-cJ-f 77iiC-. "Be-;\'D'il'7, ~"'j'\'1 DOT ~~~~s:~27~~~ ",' ,'.. '" : "" ". ATTACHMENT II COST BREAKDOWN BY SUBTASK Task 12 - Port Townsend Landfill Feasibilitv Study Subtask 12.01 - Landfill Development and Closure Alternatives Subtask 12.02 - Evaluate Leachate Management Alternatives Subtask 12.03 - Attend Meetings Subtask 12.04 - Prepare Draft Report Expenses on direct costs (10% of $15,000 R.W. Beck Subcontract) Task 12 total $ 3,900 3,000 3,911 5.300 $16,111 1.500 $17.611 JEFFERSON-PORT TOWNSENO REGIONAL COUNCIL UNIFORM NOTIFICATION FORM (WIRP) 1. PROJECT IDENTIFICATION NUMBER: 31-8-0Q -01 2. APPLICANT: Jefferson county Public Works 3. PROPOSED DATE OF SUBMITTAL: .9-12-88 ,! 4. PROJECT TITLE:, Port Townsend Community Center 5. CONTACT PERSON: 6. FUNDING: Name: Carter Breskin AMOUNT (Ag.nCy:OF~.C'EFDA No.') Phone: ( 206) 385-9160 Federal $ 484,01l FHA Address: P.O. Box 1220 State 350,000 DCD BLK Grant Port Townsend, I-IA 98368 Local 90,140 City of P.T. Other 50,000 PVT Contributions TOTAL $ 974,151 *Catalog Q'f Federal oo.est1e Assistance 7. DESCRIPTION: Renovate the existing Port Townsend Community Center by intern redesig!':\, rebuilding and re-wiring,plumbing, etc. . New handicapped resj:rooms' new entrances and an additional 1300 .square feet will be added. External building 'treatment will also be performed" '. - ';d. ;:z;.4./ ~-.-.. . /d~ : .J)t; ~;ftk;>/~ rr,--, :% #0 .aL,~} -'.;.) (:::.,t~ j,c. -0/ a- J,."~F kr",.;e,tp~) .;tit!. ~ r:;?f e..F'I-'~ . .'. : t1 .,,~ R' ,.:... 0, + '" 1 " .J - 11; J-o. b"o, ,wI,?'" ~ ~..P~ ~ ~ 'f. l-C'u-\ u:/",...'V" l , ,I. 0 " p;;. .--r- d /- ^ Jl.o<.ri; rli1 .01)"... I~\ ~, .........~ I " ' ' v ' M....""f\ - ,..~''''<:'- ....,..~ .....' '/ Ii (j' , U ,,,.. 1 ....V4"-:" /;)....1~-....... , ....... ' , ,JJ4..). -f J:u-""I~-')}'~ ,o..L 8. GEOGRAPHICAL AREA AFFECTED: (City, County. State. etc.) Port Townsend, Jefferson County, Washington g. DURATION OF PROJECT:' June 1989 - March 1990 CERTIFYING OFFICIAL: Name r,,,,,..., ~ Signature ' a ~. Title D;"rpct:or of P wpate 9-12-flfl '.'-,':', ",ie""':':"'" ::,:;:,;.:::::....'-::':':::,':,,::" ~;'"(~);'5l::.;{;:~:,; .",:,:.......::,..:::,,:::,,"..._,::.......::':,<,.:... "",-,.,:",:",;,:',.-::,:"::,,.:,,:::-,': "'>,:c:;-' .. , ,,',::,:,")//,':,'-,::-:,::',':',:;:,,:,'}.:,;/'::,:;:n.,,:'\,'::,':- ',~ ":-~.::'; 1",-. "," " ~\f~1iX~~~:~[};i~%i&lli~t~~:;'~~fttlr;f,;~;%.Qi:i~Ji:~,.~t';ii~~]ii611';'~~1~%t':?d~5;g~~;t:;,~~~~if~,}~~;;~i::,~~;~;;,l~(,~:;~~~~~:)ij'~~~' v~ti'" ..eO?\:,~ CHUCIo.: ClAfi:.~J put-elm STATE Of WASHINGTON Ninth &. Columbia Building, M5/GH-51 . Olympia, ~Vashington 98504-4151 . (200) 753-2;!UU DEPARTMENT OF COMMUNITY DEVELOPMENT October 28, 1988 The Honorable B. G. Brown Chairman, Jefferson County Board of commissioners Post Office BOX 1220 Port Townsend, Washington 98368 Dear commissioner Brown: We have received your 1989 CDBG application for Jefferson county. We received 29 applications and will be completing our rating and selection process during the next two months. The 1989 ranked list will be announced in December. We will notify you at that time of our rating decisions. Thank you for your interest and participation in the Washington state CDBG program. ~sin erely ~- <-- / ' k c--::zq Kat Lind~ Acting CDBG Program Manager KL:krc cc: Carter Breskin, Property Manager REClEm'JED OCT 3 1 1988 JEFFERtiOill COUNTY PUBLIC WORKS DEPT. s;',:-,.< .:..,:'-..,...;.:.:....;..:,....'.,.....',...; :t.USiii::~:;./;~,t~;,"'{;:,;I'~i,;.+;':":~,~:,~-;.:~'~ ,,', :;' :,:':"",,/,<,,.' ....:;- .,.... '.:..' '.,' .....','.:. :",':,,.-'_'..:,: ;,::i\';l:;,;il;;;~~';;;,J~;;i~;"~.~,:,)~,,':~iti,2,Zd;~~,~~:;.~.;:.~~"':i\:';:.<:,'..,;',';~",::,....,;":". ',' ,.- :;,:~",\-., ~ .: lJrIIFCl'!iM"NOT'i'F'icAT':iOl'tFORM" ,,,,",vvvV ~ (',HRP) 1. PROJECT IDENTIFICATION NUMBER: 31-S-0Q -01 JEFFERSON-PORT TOWNSEND REGIONAL COUNCIL 2. APPLICANT: Jefferson county Public works 3. PROPOSED DATE OF SUBMITTAL: .9-12-88 " 4. PROJECT TITLE.: , Port Townsend community Center 5. CONTACT PERSON: 6. FUNDING: Name: Carter Breskin AMOUltT (Aqency:O~~~FDA No.': Phone: ( 206) 385-9160 Federal S 484,011 FHA Address: P .0. Box 1220 State 350,000 DCD ELK Grant port Townsend, vIA 98368 Local 90,140 city of P.T. pther 50,000 PVT contributions TOTAL S 974,151 *C1.t&lcg 0" Federal OOIIe5t1c: A5S1saoce 7. DESCRIPTION: Renovate the existing port Townsend community Center by inter. redesigI:\, rebuilding and re-wiring ,'J?lurnbing, etc. . New handicapped res;troOmE new entrances and an additional 1300 ,square feet will be added. External bunding ',treatment,.., will also be per, formed. ,," . / -.I. '. "",.f,1__~ IZA (V f/ / i1 ~ Co ,- ;/" ,,- .r...;..;:c;r.. ...(;t""'r ,--~-" /JtJ-1i : ,~' -}15t."1 ,./'.p:- d'~ :::..... ?Jo '~~I ' ." r- , r . If ;(. I'~ "U I' ~.....,L....,... -_.. ' _ Q/ "t.. j..ta..._V:l""e "c.,":...~&5',~ I /~.~I.. ~,.,- (/":''1 4J ; : .'.- ' ..J- .___;; 1"'p"'" :1 -;, ...tv "" ~ ....-.'U.....JPr,..... ,/l'W'" · J.,--:-i.f- '-t:r.:.-...-a-t -~' rW-t2.,.L.:;;: I.J """/,"0 , ".....; ,..t- CN :...0 s-r1 ..[>.,.... )~ 4-' ~. ' /,~.[;..,.,.....~ ~~~ /r,...t- .... - J f . Ii ,<I' , (j ........L_,...L,.~'-':'" /~'.......~- " '-' $.h- P-~7-' ff~ ~-/-. 8. GEOGRAPHICAL AREA AFFECTED:, (City, County, State, etc.) port Townsend, Jefferson county, Washington 9. DURATION OF PROJECT~' June 1989 - March 1990 CERTIFYING OFFICIAL: Name r:~ r" ~ A"; Signature ~ a ~ Title [){'r",,..tcor nf. p.wpate <)-12-88 -, ..' ':' ,..";;W\'",,,,'.. , "", ,"','.".,.'," ',', .' ,..,~:- l&' .",..." ..""... . L -~:,;.......::r .,' . , . /~, :'\ : ').or:: " '.,' "',.", .' , ' "'''. ,......'........ ", , ......." '" ~ ' , -'", ',,} 'i" ' '. '- ' ., " ",,{ ~" , . . . '" 't , -;, .:...c , , I!,::',',.:-':;' ),: ' :' . .' . """ " " " .', . ""'''"", -==1 ., ::,..:. """.' . 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'.'.'..:'.... ,"" , .0' ",or . ,'" T ,- I '0 ,~ 'i: ~ I j>'-.t' "..,Ie ..!, .f :......-:;-;:-... ;..:~..;:..: '~''''''..':'''....~. _.\1: : I:: 10 'I : .. ~ r'!':: I . , I ': : ,6 ~, . ,0:: I : , I I I I I '0 ~ " .. ii / , "- .r, ; . ... - - . · 0 ...., "...,; .~.,,, .1 , I '\' " ..6 ..1 '" I I I I '0 I ~ ,. I ,,", - . f '.. ;;, ~" '{ ~ ~ ~.. '0 I '!e '?:y < u' ..' '.' . ~"'~~ i= I' it ~ , vr '1 ~ v ... r ,1 ^-~ I t s:- ~~ ~, I z: r( .-l . ~ 0 '- .' r .'.....t- Z toO I hJ CI 0 - ( r(j it" u lLJ V@) if) I a( ~' I' - ,',:.,,,.,,.,-,, ""',0~;;",' ",~j_":'?"..jt_}/:,'::~::?"! ,,');':;\::Jt;,<;~~ ';;i".\!,:::;,~;;::L'.;!:Sf0':J.;:H5' ,cf:;'.\!",~~:~t::gU ;:1'-;0.: "::',:""':'~:::"':';"_:" :::~;',"'<:?:'-'::',-:/i".':' 'c' '.~-.~. ,,'., ".,~ ~',_';'~~_.':',.,.,_".;.:;;;,":;';;':"""~'_: ;;:;.;-.; :.';2l;-;i1::::~:<'" ;;;~~';' PORT TOWNSEND COMMUNITY CENTER RENOVATION AND EXPANSION PROJECT BUILDING COMMITTEE: Gary Rowe, Commit'tee Chr. Director of Public Worka Jefferaon County Linda Clifton, Director Head Start Preachool David Goldamith, Director Jefferaon County Planning & Building Department Michael I1ildt, Executive Aaaiatant & Planner City of Port Townaend Doota Jonea, Director Senior Nutrition Program Repreaentative, ,Port Townaend Senior Center Aaaociation Maureen Linehan, Project Manager Olympic Area Agency on Aging Warren Steurer, Director Jefferaon County Parka and RecreatIon Dcpartmnnl; Ken Walter, Chr. Port Townaend Senior Center Aasociation Carter Breakin, Property Manager Jefferaon County Public Worka Departmen't Miller-Hull Parnerahi.p: Dave Miller, Norm Stronp, Architectural and Planning Servicea ~ :'~.;i "". ',C'" ,,' " ' , , ,'," " " " <., ", .",', ,..."',, <", I,. ," ','....';' '..,. ' ',''':' :', ',' ': ,".",,..... , :c' '" ," ' ",,' ,," ", " ...',,:, '",' ' . ", """.':.' , ,,:' "" " ,',',', ',<, ' " ' ,,' "'::,: ,": ,',' '.' ,,' ..',. " "';,." ", .,;,' :, ;., ", .' ,'.. "':, ," ,', ','", ::" ',.' " : .,',.. , ',,' :", ,,',:: ...: "'.' , ",',: :, ',' :,i' ',', ,:',.".'" " , " '", ::"," :,,' ,.. ':, .', ' ,', ,'.... " " ,'" ",' ',',' ,:. ' .. '" "; , '",',,'. .. ',' '.,"" .',', ", ," '. "., , , '" ',:' , ':;,,' " ' ."',' , ,: ':'", ,,:" '" "".. .: :.:, : ': .'".' ,; ',': ,', ,:... ,,', : ", '" ",.::" ":'> .' : ,,:, ',., '" , ' ',' .' , .. '" """" ":': ,,' ' " :' ": ; ';,,' ::: " I:' , ','" '" " ". ".... , ".'..., ", .. ,,' ':: ,...' :,', ,'.' , .. .. , , " ,,,' "~..,,"\'i"' (j THOMAS .J. .l\JAJHAN o .i\H01'IU~lJ lit l~uw '.)J'J. WAHUING'I'ON .s'I'III~I':-I' J'. O.1Jo.\: 191 .'01&'1' '.'UWlII'tlit:NH. \VAI:lUING"'ON !.IlJUGU ~"~" (:l06) tlUa....:J!J!J ~.~~~oI, December 14, 1988 ':l[.; Jefferson County Board of County Commissioners P.O. Box 1220, Port, Townsend, WA '.98368 ' RE: ,Seton, et al., v. CMC Real Estate Corporation Gentlemen: . I Understand that the County is about to pay CMC some amountlof money for its interest, if any, in the railroad right-of_way which ran through platted Railway Avenue. Before the County does so, I would like to make a sUggestion. "'./ If As yOU know, Gene Seton and other Plaintiffs, ,including DiscoverY.Timber, a jOint venture of which the Setons are p~incipals, have filed a qUiet title action aSking the " "'<," court to award them title to certain portions of the "",;,,~,., right-of_way.' Discovery Timber alleges that its ti tIe to ia portion of the corridor running along Platted Railway ., "'" Avenue is SUperior to that of the CMC. At this point, Discovery Timber is not Claiming title against the County, ::>'f':.:it!.': DiScovery Timber is in a posi tion to ask the court for 'i<.,;,',;': summary jUdgment granting it ti tIe to the right-of_way ,,',"'" "';vis-a-vis,CMC. If DiScovery Timber prevails, it is ..,,';O\'!:~..,wil1ing to 'convey its interest in that right-Of_way to the "'c,!,,,,~"',r:..' County for. highway purposes. Perhaps the County could "!~:~y:", save some money if it would allow Discovery Timber to ':'.'",; proceed in its summary jUdgment, 'rather than paYing CMC. and he concurs with my analysis. "i'."'iL:;;,I sP~kewith Mr., Raymond, '.;~F~~~,;};;~'::::::~i: \I,is e. ':t.;, TH1!!;/15.A~ .:;'I~~i~':J~:;',;"iJ.: TJ :dp ~,co John F. Raymond i~,: ,:', W. E. Seton .,:',i:,:~,:I1 ~ t ~\~. , \, 1... ,:-, \ )'.. " '", ,'" f'I: IJi'.C i 'I 'r .....~ " i) lc.lW !. ,J i..'_:.:] ..' 'flY" " ,,,,,",; '"H , .. ',';:, "" ::" ,;:~iJ~" ':::' ';; :< <,;; ~' '.:: ",' . i; ~: ',.." ,..: :):~~~: ""'C' ~ ~';>;/.: ''):...'", ~:->., , j,:--::,: ': ....... :c..' .~.' ,..,.,:--::......-1"\...,-,,,-,->"'.-' .:;::~i:',',':";.-:,"..:".,'i:.',:_..<:,'-; :::,",:""",,:,::,:,"',_:.;<'-':':','::',: .:;fu~'iliL1\0h:;.~t.'.ij;:!~Si,iC\~.;;~~:,ji; .-<;:.:.::..." ":.'.'.:.,: ",.f., .. ''-'',.:':';''- ';'~"';:;":~;~S('(:":;'!;N::!i':L~I;':;l~}:';!;;(,i';;;s~';:iii~i~:;~{;~~,;;;;';':;'';:'';';'~ ;,J:C;;";'~: '~i~;:'-;CJ:;J~:;t:;~ti1i'i~~:',: o JEFFERSON COUNTY ASSESSOR 07-Nov-88 SEGREGATION OF RAILRO~O CORRIDOR IN JEFFERSON COUNTY - 1988 ASSESSMENT YEAR RR 7AX PARCEL TAX DISTRICT NUM8ER NUMBER OHNER VALUE ;:;;:;:;;:;;:===========::========;:==:=;=========:;:;;====:.::==;;:;:;:======:=;====;======= taD ..-.....------.....-----..-------....-----------..---------.....--......----------------..---- lOa 000100000 PORT TOHNSENO PAPER MILL $221.080 --..-----------..........---..-...-.....--..---...--..-------..---...---..---..-----.............----....-- TOTAL $221.080 :1======:1=========================================:===========;=======~====;:;= 1\1 S01051022RRl REED GUNSTONE $1,700 001321000 RRl RICHARD GAS1FIELD m . RR2 GASTFIELO TO BLOEMKER $90 RR3 GASTFIELO TO OLSEN $SO RR4 GASTFIELO TO BLOEMKER \T5 ---..-.....--........---......-...-...............---..-..------..---.......--------.......-----..........--......-..... 1\1 000\11000 C.M.C. REAL ESlATE CORP. 143,340 -...--......-...-......---.....--....-..-..-..---..-......----..-...-..-....---..--......---..-...-...---...-..- TOTAL $45.370 =======;==c=:;:~===:;:======;;;.:;====;=======;==;========:;::==;======;====:::=======:: 151 9010B4012 RRl CHARLES GUNSTONE IS,635 . RR2 G.J. & H.V. COTTON $415 RR3 ARTHUR FREEMAN ~S05 RR4 DOUGLAS KURATA $SOS RR5 DOUGLAS KURATA \\,410 901\13010 RRl CHARLES GUNSTONE 113,905 901184003 RRl A.G. & 8.J. LARSON 15,S60 9011910\6 RRl REED &RENAE GUNSTONE 111.060 902011006 RRl CHARLES GUNSTONE \ 14.650 902012004 RR2 CHARLES GUNSTONE \4,985 964508802 8LK88 J .A. & Bmy MACLEOD $50 9645088048lK88 J.A. & BET7Y MACLEOD mD 964510002 8LK100 HARGRAVE GARRISON $150 902231004 HARGRAVE GARRISON ~35.030 S02241026 RRI CHARLES GUNSTONE $2.065 . RR2 FRED MARGGRAF. JR. $2.415 RR3 CHARLES GUNSTONE $385 RR4 ROBERT LOVING ~ 1, 68D RR6 OIXIE & ROBERT BROWN $1,680 902143045 RR5 ~A~G~V~'~R~m~ lu:m 902243046 HARGRAVE GARRISON H,15D 902242005 HARGRAVE GARRISON \11.550 . Wl W.R. & V.M. ABEll $2.4S0 002363007 RRl CHARLES GUNSTONE \5.685 . RR2 CHARLES GUNSTONE $7,735 -.......--...................--..-.......----..-......--...--..-........-......----.....---...--..-.........-...-....-..--.....- 151 000151000 C.M.C. REAL ESTATE CORP. $92.365 .....-........-...........--...--.....---...................---........-......-.........-..-..--..........---......----.......--.. TOT~L 1245.835 :::Is===========-===:=;;;:==::s:;:.:..::;=:;::I:I:===============I:==;==============:i$:;;==$';. 161 00\152015 RRl MARIE WORKMAN \frOm Mill) $1.575 001161004 RRl MARIE WORKMAN Irom C.M.C.) 14.84D 001161005 RRl MARIE WORKMAN Ircm Mill) \11,035 f~>~'i '001162015' IPlIBl.IC'R/W:~SAN1A BARBARA)'C,'l1?Ul',ll0'! t>V <0011620W 'PUBLIC':R/W': DENNY'5.2NO)~,':;S,:t,'.$2.630: ~)'vr 001163003>' \PU8l.1CR/W' PHILl.IPS B~~;.V;}.i;\10;9551l ______~~}~_~~~~I~~~~~------_-.:r~~~~:~~~~um~~l~~~t~~:Tift!.:~~~1~~L----- 161 000161000 C.M.C. REAL EsmE CORP. \44.5BO PORT TOWNSEND PAPER MILL 142,535 ...........-.............--.............-..-..--.............--......---.-....-....-.........-..........-.........-.....-......--......... TOTAL $115.390 c=&G;::==:~.I:=..==::===IloC.lI::I...a:.:.=.=.lI=;;.===:=a:=;:=a:===.aa::;:=::;t;::'lI::r==a:;.=.===& 751 002354007 RRl CHARLES GUN5TONE 14,600 RR2 CHARLES GUNSTONE t7 ,860 002284035 RRl BEN LEVINE $610 002332023 RR1/RR2 BEN LEVINE $6,275 ......-..---............-....-..-....-..--........--..............-....--.......---....---...--........-...............--........... 751 000751000 C.M.C. REAL EST~TE CORP. $64.900 ........-............---...............-..----.................--........-....---............-.....-.......--..-........-...........-.. TOTAL 184,245 n '~. HEW PARCEL HUMBER 901054007 001324024 001324026 001324065 001324023 9010B4003 901081015 901084013 901084014 901084008 901171001 901184001 901192002 902011002 96450B803 96450B803 964510002 902231004 902241003 902241004 902241023 902241005 902241012 902243039 9022p045 902243039 002363001 002363004 00115200B 001162001 001161002 0011~2016 001163003 001174022 c==::===c 002354006 002351002 00228303li 002332006 INITlAL 1988 ASSSESSMEHT TO PRIMARY (CORRIDOR USE) OWNERS. C.M.C, REAL ESTATE CORP.. $44B,305 (-12,415 for MorQQraf'. property) PORT TOWNSEND PAPER MILL. \263,615 ABSTRACTED VALUE FROM TRANSACTIONS. , FROM C.M.C. REAL ESTATE CORP.. $203.120 (IncTude.I2,415 for M.rQQral'. property) PORT TOWNSEND PAPER MILL. m.61O REMAINING 1988 ASSSESSMENT 10 PRIMAR~ (CORRIDOR USE) OWNERS. C.M.C. REAL ESTATE CORP.. U45,185 ""''';+ PORT'I~WNSE~D,,PAPER MILL. 1251,005 'fl, ~ ,~ ~., %:.;, ~l ~ ~'- ,t,~, , t; I': " t, ';'''' 1:.. ;;:;-;,:-c " , , , " " " , , ' , , I , .'. 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'" (,f- ~ .... .~ '3 ''';ll Sf' , ~' J 0", i=\i <t.... 11:'" ~ "'I 11:0 o~ Ult wit 1-""> ~J; 1115 wg ;iffi w~ ~~ :lE,.. u~ \ I o w a: ;:; 8 i ~ !1t ~ '" o ... ~ .. Ji!~ ... . "_"i,-',"" ,. ,.;',,", ~""'..r".",,i- ",." ~ { " . ~ .,..1'.".....". .,,.~, "' .~ \. S I to : t 0) i~ '? '. to ~: 0 ..~ N = ~ - ~~ '" ~ 01 l H Ii \L . . 't ! ~ ~ ~~ ~ , . ;\ . ! ~ ~ ~ ~ ~~ ~ \ : ~ . i! ~ Ii '" o Z LLJ :U) Z 3:. o l- I- a: o a.. t-! U) Z :t: ::> ~ IX) N 10 10, a: o >- LLJ > a: ::> U) c z ct, -I, ~ o a: a.. , ~, U) a: LLJ C Z ct uJ uJ ~ , t ~. , ~ Ii " ,! ,i !I .. ~ H II ~ I ~ '.... ~ I , ~ ! = . t I . .. "1'#'''11.'*,,....,, -==r <> -==r 'l ,~ '-"'--1-"" .. . ~ j ,1' l ~. I" ~ . I \ -\r --.:..., ... ... t, .. ~ :: ... . .~ ~ .. ~ ; t '. : . ..... -.. ~ \ ; ~ ~ ~ .; .. ! ~ I ! ~ ~ t . ~ .." . . ...",. : t ; ::: '00 I 5 : I , . . l\") ~ = a .. . . ! ...". ..... !\I ~ 1 . ~ . .. ~ '! S ~ .. ..., '-.. '....11 : - , .. 't 't'f I I 'I' I : I I ,,', I .~ .;;'1 .. ~,'p.. " ~ -".'''-'''''' " '." ... ~" ~\.' ' J~~~ ~ "'<"~ ...~ ~ ~ ~ ~ "- '- " " " " ..... ...... " \\ en CD ~ en 0) Z == ci Z '1.1J en z == o l- I- a: o a. . ~ , . ~ ~ ~ s . ! ! ~ ~ l , t .. If , ~.' i l ~ ' , . t . " 1: ~ : .::: :an, . ..,.' ~ t : .. ...,~I .... - ':":c~:': , -'-',:,; ~ -,;,,\~,<:\' r-;.'J " -" ";"'';';,'''''_::>> ";':';: '>:',J'-;":;-.,.:'::_:;'';;',;.:;:'; , ,/(~;,:-:\-:,'~: ' ;';:;"<~i ; ,/.,/. . ""'<\ (. ":~;~;~i1:~;d~));;.;;;.~,;;;.,,;B;;:;;;:~';b;.~~~;;-,;:~,2~,~,_~,::::'><,:,:Ii.'i;~ ::;'/::::,':":,~i:>:~:'>) i:::,' '.,' ':"',',;: ';'",:.,::: ':~.':;,:::: ;~./~~~h~:'~~B;,\~E~t;;~:~:':. -: ,'.<t,':" ,;~; ;"" "i.'.;' /;. "q~~tSi.ii~i,i.\l'i;:k;~~,}ifj~',;;;Si~~:i~;fj'::tid"~:iJii~~~~~~~~~'.. ~ Jefferson County BOARD OF COUNTY COMMISSIONERS , Port Townsend, Washington 98388 . Phon. (208) 38~.9100 LAIlRY W. DENNISON, DISTRICT 1 a.a. BROWN, DISTRICT 2 JEFFERSON COUNTY COURTHOUSE ""'TIOHAt-HISTORlC SITE pORTTOWHSENO, WASHINGTON GEORGE C. BROWN, DISTRICT 3 August 1, 1968 A.~. Hallin, Area Manager C.M..C. Real Esta.te corpo'ration P,O. Box 6205 Chicago, Illinois 60680-6205 Dear Mr, Hallin: Because of the complexity of the l.,oal and title issues involved in the liquidation of thet'ailroad cor~'idor through eastern Jefferson County, we, have chosen up to this point to abstain from taking a position as to the true ownershil? of the cort"idor (or portions thereof). Since the t"allruad \m.. historicully been assessed by the State of Washington for tax purposes (as an operating utility); the .:rei'fereon 'county ASSOSSOl' hoo d"c:ldorl to continue aElaeesing the railroad until being notified that he sh()uld do othel'wise., It is, however, the responsibility of county government to protect and uphold the public interest with regard to properties entrusted to the county through deed or plat dedication. specifically, we wish to call your attention to four plats located near the City of Port Town$end through which the railroa!3 corridot" passes. 'rheae are: 1. Santa Barbara Addition 2. Denny's 2nd Addition 3. Phillips' Bay View Addition 4. Irving'ton Addition please Note: 1. 'rhese plate are all antsid" exception of Irvington Addition, corridor. the oi ty they are 11mi ts. along the Wi th the S.R'. #20 2. '1'hosc plats Wel'e recorded l:lft,,,. 'the> x'clih"oad was built. The railro~d corridor was identified on each or t~ese plats as Railroad Avenue. 3. 'l'llere is no deed to the t"tlilroad fox' any of this pt"operty. The portion of Corridor crossing Santa Barbara, Denny's, and Phillip'o Addition were claimed by the original railroad through '101. 14. ilolo: n ;'~J7:l . .'~ . r,' ,: ,', .,,'..' ,..'.,,' . , ", ,',', . ." ' .." ': '" ,'.. ' , , " ',:, " '" ",., , ,',.1 "" '..' ,", ",., " ,:' ,", ',',", ", ..,,":, , .." ",,' , '''', " , " " " " ,,' , ;.. ,', , ,:": ':,,'::,:""', ", " " ',',' ":"," , , ','..',' . ,."," " ,,".' ,: '",' .... ,", ';':'" ':' "" ',' , ", , " < ", ':,.,.,, ,,' " " '..' " ",:' '" : . , , ," .',' , ., " " ,::" ..c" ....;":' : ,'" " :- , ,.:,;"", ',,' ,,," ,'," ,,:: ,:,' ,,' ,'.',', ,",,' '.' " ;,>, ", '., ,..',.,:', ",.' .' , :.,',.,' ", ','". " ' " :', ,'," ":: ", :: ,', , ",' , .. ::,' ,;,:,' ..' , '. ":, ,"',' " , ',> . t "<, ':: ,," , , ", :' '.:,. ..", :, " ',..,:" :' , : .';': "":'".."" ,,'.',' " , : ',.,' "" , " , , ", :;< ' ' :',:',...:,:;",:, " , ..', ;:;: .,"'",.,,' " ',: ii,;')j,) " :\':".,,"." '...,'.'". "..,.... " ,:',:, '. " I" ,', " ::" 11 i{ '. ; It r.: h , i, ; " ' I;,.", ,:: " ',:"'" ,'",', , ,'. ",', ',', ".. " "",',' .... '. " "',',:':",', ,', ,,' I.: '':'', "',',:, .;:, I:: ", "'., ," f":","::"'L'" , \..",1," , I":' :, ,:,'..,' ,",,','.. l"L':'" "L' '. - .,'- (IMPORTANT MESSAGE) FOR / ...}t.VI^VV DATE 1;)..-(1/ (/ T1M,F~~:~ M (:J/;./I 7(juJfo (Ov6n. -to I ) tJ I ,-;2 V - <iCJOO AREA COOE NUMBER iY;i;::",, .": , OF PHONE I TELEPHONED CAMETOSEEYOU WANTS TO SEE YOU ',' " RETURNED YOUR CAll EXTENSION PLEASE CAll , WILL CALL AGAIN ',' RUSH " SPECIALAITENTION /y:: II ", , MESSAGE ld'fR) ~C/~/U . S?417U( i SIGNED LITHO IN U.B.A. TOPS ~ FORM 3002S i~- -~;,: " , ,:' I, , ,'" ',,", ~:': ~ '",.,<1' '. .,.. . .' . : , . ,'," ,.', : :' ,rd , "",' ,,"~, , ',: '.. 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',;', ' , ., : , .' , , , , .. .- .JEFFERSON COt.I'4TY FILE .'..,.:, ' DEPAR"I"MENT OF PUBL ~ C WORKS ~ ACTION REQUEST REQUESTED BY- 10)>", 1\'\\ O"P,oFn ...L.-U DAn;- 1/ / I {"" ('f,6 - 17<... PH:JNE NO, - / I ADDRESB - ALT. PH. NO.. NATt.fiE OF REQl.EST.. ~ IN PERSa'II 0 BY fIttCHE 0 BY LETTER TAKEN BY. IW'\ PERrAINING TO- 0 OFFICE: 0 ENG/SURVEY 0 ROAD MAINT. 0 EQUIP. MAINT. 0 SOLID WASTE IlEQt.EST .FOR,- ~eJ7"",c;~ tEkJ"'L. 'T=1-I1=:' t=:CJ2..-L, t:JLJj ~ 6- Cct=.J 1i- ~!--IJJ~ ROAD NLNBER M.P. PROJEcT- PRO.JECT TITLE RRDJEt:r NLNBER. I ii';~f'~~~~'~~~ ",'( t= r ~~L- - ~" ,,~ "7<tJ.oP- ATTAOi NAP CR SKETOt REFER TO- K. ""B o:g RESPOIW BY. RESPONSE - BRTNNON SHOP' 7:..190 C~ 'S HoP V~ OUIL SHOP: .0/ If lJy,9!.5 I HADLOCK SHOP: 371 CHlMACUM RD. OUIL COMMUNITY CTR: '2..0:'2.0 \-l,(C',"v I./~-f to I - QJIL-, JEFFERSON CO. LANDFILL: '~1\ r^..~~ L"".J)!:)IJ .\,)~. REVIEWED BY.. -r:.'^- I 4; bATE- "\''7\g6 cx:HTACTED REQlESTER JID IN PERSa'II 0 BY PHONE 0 BY' LETTER CONTACTED BY- ~.' . REc:::cMIiENDAT I Qlf,.. PREPARE EST ""An: . f"Qf- fIOIlTE TO- INITIAL 0 DIRECTCR - 0 CXlNSTRUC'TICW ENG. _ 0 ACCDU'\lTANT -- 0 ASSISTNn' DIR. - 0 PLN*rIING ENGINEER _ 0 - '( 0 ROAD SLPERVI SOR - 0 ADMIN, ASSISTNfT - 0 - ~" 1< ~: . 1)1. ~ " , '.,' ,-:-.,: ' , " " , ,', " ", ',' , " .l ',,; ',"'.., , ! ' ..' .,", .-",'" " ",' , :,.'. .' " ,,:,'. ,:':. ,', .' '," , '-:" '. .." ".'" , ',"', '::" :" ' ,,', '" , ",:,.','"',, ,,' ,'",', " ,',',' ", .'...: ,,'.' ':, '," '< '.'",,'. .. >'", " '..', ':" ' , ." ' " , " .. ,'",,' " ,,'.' ','.'. ","," '. ,':' , '/', ;" ' >. ':,'", ',. " ..'.< ,,', ',', ',' '."" ,,:, ' '" ,,::',," ",' ,," ,': "',.,'" ' " ,',,',' ,"" ,','.,' .,.',', ',', ,', ,,' ',' "", ""..:: " . "".,. ,', ' " ,: , ',',' ',,' , ", ", ' ..',' ' :,', , ,."" .. ',,:.. ", ,',., ',', ',' " , "": ..,'.. , " ',,, ,),' ", , ",:, ,,', ': ':' :' ,',', : " ' " ','"."'. '," ,'., , ,','," ":', . " " ' " "',:, , < "".' ',' ,:,:" ',:,',' " , " ' ,,'.' ": ',: ',' ,',' ',., ".,,','."; '".;;, : \ ',':i' ' " , , " ' ", '" , : ' ' , '.. ,,' " ,:: , :< ,,' , . .- ..,' .., . ~ - ~ " ( t $ - i ! t ( ~ ! I2J ~ ~ ~- L i: ~ [:~': tLll: : [;:'! r-- [~~", ~ [:: j lO DI,,! (I';. i eJ B Q;:~,~ jl'C"'J ~~'l r;:; ~.. . ^ ;; " ~ ( en ffi :.0:: '" a:: llC o '" ~== t5 z2 ~ ::l~ "'~ 8~g~ z.....c;: 001;0 en I- <3 z: Biz ~ ...... z: tt;::;; ~ ....Ii: t- ~ Ii: ... 0 C 0.. " iL ~ ~ is ( i- ~ Ii! o In ~ ( ~ Ii: .. ~- ~ ~ ~ 1; << "'-.- , 0 ~ L ~ i- ~: '". ';. .......-.. .. \ I \ \ I I \ I I I ~ \ \ I i I I \ I \ I ~ \ I IE ! ~ C ...J ~ I <l: ~ Z " ~ ,; Ci 0; if a: ?--~ ~ 0 2 ! ~ ~ ~ ~ ~ s ~~ ( L, n "g.: . ~: on hf. c ,E~g on r:> !~i on I <Xl o. . '" r- G> I 'p C .~ 0 1 g \~i ..c: ... i U BE I I ~ o~ ~ m. ~ l t:H 5 ...:rJC"i 0 ... '. LOCATION ANNUAL VOLUME TANK SIZE FUEL TYPE Brinnon Shoo 500 gal 1000 gal leaded gas 200 County Shop Road, Brinnon Brinnon Shop 3000 gal 500 gal diesel 200 County Shop Road, Brinnon Quilcene Shop 4500 gal 550 gal leaded gas 81 Rogers Street, Quilcene Quilcene Shop 6000 gal 2000 gal diesel 81 Rogers Street, QUilcene Quil. Comm. Center 1500 gal 425 gal heating oil 20320 Highway 101, Quilcene Hadlock Shop 15000 gal 5000 gal leaded gas ,371 Chimacum Road, Hadlock Hadlock Shop 17000 gal 1000 gal unleaded gas 371 Chima cum Road, Hadlock Hadlock Shop 32000 gal 2500 gal diesel 371 Chimacum Road, Hadlock Hadlock Shop 3500 gal 3 X 550 gal heating oil 371 Chima cum Road, Hadlock Jeff. Co. Landfill 5500 gal 500 gal diesel 250 County Landfill Road, Port Townsend Courthouse, P.T. 8000 gal 1500 gal heating oil 1820 Jefferson Street, Port Townsend Recreation center 6000 gal 1700 gal heating fuel Lawrence and Tyler Street, Port Townsend . Hoh Shop 5500 gal 1400 gal diesel ,Mile Post 5.63 Upper Hoh Road, Forks Hoh Shop 4500 gal 1000 gal leaded gas MilePost 5.63 Upper Hoh Road, Forks Hoh Shop 3000 gal total 500 gal heating oil Mile Post 5.63 Upper Hoh Road, Forks Hoh Shop for both tanks 300 gal heating oil Mile Post 5.63 Upper Hoh Road, Forks Clearwater Shop 250 gal 500 gal diesel Mile Post 3.02 Clearwater Road, Clearwater Clearwater Shop 250 gal 500 gal leaded gas Mile Post 3.02 Clearwater Road, Clearwater Clearwater Shop 2000 gal 500 gal unleaded gas Mile Post 3.02 Clearwater Road, Clearwater Clearwater Shop 1000 gal 2 X 300 gal heating oil Mile Post 3.02 Clearwater Road, Clearwater ,: , ' ' :,' J " '::;"" "'",' ",' .'. .. , , , ", ',.' ," ...' K. WENDY HOLDEN Director 'r~.~ ....0 fib ,.. .., STATE OF WASHINGTON DEPARTMENT OF GENERAL ADMINISTRATION OffiCE Of STATE PROCUREMENT 216 General Administration Building, AX.22 . Olympia, Washington 98504-D622 . (2061 7t;1-0900 November 1, 1988 Mr. Tom Morello Department of Public Works Jefferson County port Townsend, Washington 98368 Dear Mr. Morello: SUBJECT: PARTICIPATION IN THE STATE'S BULK FUEL CONTRACTS In response to your inquiry, the state has established two contracts which cover bulk fuel requirements throughout the state. Contract 24-87 is fer large volume deliveries and Contract 25-87 is for small volume deliveries of less than 8500 gallons. Both contracts include three grades of gascline, diesel fuel 1 & 2 and heating fuel 1 & 2, and may be opened up to political subdivision participation upon request. Enclosed for your review are the terms and conditions portion of the small delivery volume contract 25-87 which shculd meet ycur requirements. If ycur political subdivision should wish to participate in this contract, please submit a purchase requisition or other comparable form to our office for processing. Identify by delivery locaticn the estimated annual volume and storage tank size for each type of fuel required, and a contact person and telephone number cf someone who may be contacted if there are fcllcw-up questicns. There will be a ncminal charge (between $40 and $95) as reimbursement fer a portion of the direct costs 'associated with adding your requirements to the contract. Once your bulk. fuel requirements are added, price adjustment information will be prcvided to you through the weekly publication and distribution of contract change notices. Your decision to include yonr organization I s fuel requirements with those of the state should result in significantly lower contract administration costs and lower fuel prices. If you have questions regarding participation in state bulk fuel contracts, you may contact - Judy Smith, Purchasing Agent fer Auburn Public Schcol District (206) 931-4970 or Conrad Muench, Equipment Superintendent with Thurstcn Ccunty Department of Public Works (206) 786-5496, who have participated in these contracts for several years; or you may give me a call. A;'" ~.' t', Sincerely, _ ~.,oI ~ ~ll;_~(;I> ~ert P~~" ~':;~:~, Buyer Purchasing and Ccntract Administration Phone: (206) 753-1040 RECEIVED NOV <1 i98B RP:mp JEFFERSON COUNTY PUBLIC WORKS DEPT. .....r::~3 ~ \ 'I I f ii, I, t :',1',", ":'" ,':' ";,,:,,,. ..",,' ...,."..,'.. "',' . .\: ,', ,'", ,-:' ',":. >: ',' "" ,: ,..':' ""'.' : ',: ',:-... .', ' ":.',.' .." :", . ' ," " " ' ' '." ,,',' " ,',,' " .',' ',', >,:<" : '". ,'" ",.'. ,", . ,',',"..", .", , ,...., " .'" ,', '.." ',.' ..', '., ": ..> ,: "'.:,' ',.', "."." :,,. ..",' ","." . '.. ,,':' :' '.':,','.',,', '" ""..,.,.,' , .'," ".:::', " ,",:: :,.., ",...,' , .. ' " ' " ,'.. :", .' , ..'. " , :," ': ,',' : ..' ," ", ." " ,:".. ,'" '...,' .' ',.',' " ,,' " ' " :' , ,.." ,":, " ,,' :, "..' ,.",,' ,",:, "'.. ",.' " '.. ...,'" ',:' ' .. ':' " '.... '",',.' ' ".' ",', . ~ ,..",' ',' ,,' ',', , ' . '" '" ,'..',', .'."", ",',,' " :,' ",.. .',., \ " ,', ,"., ,', '. " " .' " ' ,,:', " ','.:" .' :, ':,' ,,', , " ',.', ',',' , , ,:'.',..:"" , '.. \,::<: ", ,I: ':, '.. ' , '", " , " , ,,', , ,;,: ,',' '.",',' :"': , , ' " , ' ' ", ,,' '." , ,,',' ;:'" ,,'..' ',' " ':' ' ',,'.. , ,', " " ',,',' ',' ',' "',, "':", ',', " 'l I' , ::""" ":: ".".','."", ,'.' , ,:' ,," ',',.. STANDARD TEAMS AND COHOIlIONS INVITATION TO 810, REQUEST FOR QUOTATION. PURCHASE" FIELD ORDER CONTRACTS Tt-I: PURCHASE ORDER CONTRACT tNCLUOfS THE: FOlLOWfNG TERMS AND CONDITIONS AND INClUDES. BUT IS HOT L....ITED TO THE INVITATION TO 810. REOUEST FOR QUOTATIONS, SPECIfICAllONS, PLANS AND PUBLISHED RULES AND REOUlATtONS OF THE DEPARTMENT OF GENERAl. ADMHSTRATION STATE PURCHASING DIVISION AND THE LAWS Of THE STATE OF WASHINGTON, WHICH ARE HEREB'" INCORPORATED BY REFERENCE. C IJ CHANOI!I: Ne _"".Uon In an)' 01 thl t.rm., condolion., c1lhweI'"Y. price. qUIIII)'. quanlill.'. Of ~cihc.lion. 01 'hi, order ~I bti '"Iehu wl1houl 1II'f,IlIIn con,,,nl ollhe Dl!'lclOf of PWfChl.lng and Malariar Control (2) HANDLlNO: No chltg,. .1Il bti ,Uo_fl1 for h.n""n,, whiCh Inch,n;t... but I, nOlllnllled 10 picking, wrapping, big., COnl,in,r. Of ,..II, unl.., othlrwl" II. lId hlrlln (3) DELtVlR't: For any ..cllf;lllon to thl d.II'1'lt/'Y da,. .. ap.clliad on Ihil ordar, V.ndor thalt gl'l'l prior noU'h:lllon and obIlin writlln approval thar.lo lrOPllha Dlr.clor 0' Purche.lng and MIt.rla' Conlrol, With r.,plct to d.llv.ry und.r Ihll Dfd.r, I"". I. ollha ....nc. .nd Ih. ordlf I. .ub,lct 10 l.rmin.11on lor lail"r. ICI d.hver .. Ip.cl'lad TbIleclplanc. by lhe Pf,lrch.." or lal. performlne. with Of wllhoul objection or ra..",.tlon .h.1t nol w.i'l'lth. "ghllo el.im d.magllor lueh braach nor eonalllule a walvar 01 thl raquiramlnl. ror Ih. Ilmll)' p.rtorm.ne. 01 .ny obllg.hon ram.ining 10 be parform.d b)' V.ndor. (4) PAYMENT., CASH DISCOUNT, LATE PAYMeNT CHARGES: Involca. will not be prOc....d 'or plymlnl nor willlhl p.nod 01 comput.llOfllor Cuh d'lcounl commence until racaipt at . proC'arl)' complal.d invoica or invoiced IIaml "e r.cerv.d, whichav.r I. lalar. tt In Idjullmlnlln paym.nl i. n.e....ry due 10 d.mage 01 d,.pule, Il'Ito ell" dl.eounl period Ihall commence on Ih. d.t. f",.t .pproval lor p.ym.nll. 'ulhorind, Under Chlpl.' 88, L... 0' l~l, "purcht...r 1.11. 10 m.~. Ilm.ly paym..nl, vvndor may involel lor on. petc.nt p.r monlh on tha .mOf,lnl overdu.. Of . minimum of on. doll", P.)'menlah.1I nol be con.ider.d Ial.lI. ch.ck or w.r"nll' .ull.ble or m"I"c! within lhl time .paclflaCl, or 11 no I.rml Ira lII.cllled, llrittlin Ihirty d')'I. NorlN.lt)', paym.nlllo vendo" will be remi"ld by m.il The PurCh...r .hlll nOI honor draM.. nOI ICClpt good. on . .ighl d"ft b.II.. (5) SHIPPING 6HSTR~cnOH6: Un.... olherwi.a lpacill.d, .U goodl .,.10 b. .hippad prep.id, FOB De'lin.Uon. Wh.re Ihlpplflg .dOf.....lnd,c.le room numbere, II "",II bo up 10 11'1. V.ndor to make d.Uvery 10 th.llocllion .1 no .ddllionll cn.rge. Where .pe<:i1ic IUlhofl.lllion I. glinted 10 Ihip good. FOB .hipping pOlnl, V.ndOI .gr.ea 10 prepIY all .nipping chIll11", roul. ..In.truclac1 or IIlnelTuctione a,. not provided, rOule by enelpa.1 common carrier, Ind 10 bllllhe Pur<:hl'.'" I "pIIII. .Iem on Ihe ,"voice lor ..Id Ch,rgu. E.eh invoice fOf thipping ch,rgeaahell coni. in Ih. origin,1 Of. <:Ofl)' 01 lhl bill indiuling Ih.lthe p.ymenllor ehipping hI' b..n made II ,a .lso .gre.d Ihal the p"rChlllr reae"," the righl to ralu.e COO ahipmenl. un REJII!CTION: All good. or m.leri.l. purch'lId h".in If' .ubj.<:IIO .C'prOWll by lh. Purchaeer, Any fljeclion 01 good. or mll.rlll "eulling beeeun 01 noneonlormlly to thl I.,m. and .pacillc.llon. 01 Ihll oroar, ....h.ther held b)' the Purchl.er or returned, will be .t Vendor'l IIIk .nd 'Ilpen.. (7) ID~NnFICATtON: AIIlnvolc.., pecking lial., p.cklg.., .hipPlng nolice., inlfNc1ion IN.nuII., and other "",rill.n documlnl. ."ectlflg Ihie order .hall conll,n Ihe .pph<:lIble pur<:hl" Q(der numbl/, P,cking 11.1. .1'1.11 be .n<:lo.ed HI I.ch and ev.ry bOil or plck.ge thipped pur.u.nl 10 thi8 order, mdlClllng Ihe conllllls therem (8) INFRINGeMENTS: Vlndor agr..e 10 plollcl and live herml..a the Pur<:h...r Iglinll an claime, euila or proceeding. 10' p.lenl, tred.m.n., copynghl, or IlIn<:hlse in'ringement ari.ing Irom Ihe purchlle, inel.llalion, or II" 01 good. .nd mll.rial. ordered, .nd to ...ume .11 ..p.n.e. .nd dlm.g.1I ",..ng Irom eucn clllm&, SUI' I or prae.edlng, un NONWAIVER BY ACCEPTANCE OF VARIATION: No p,oVlllon ollhl. order, or the rigllllo receive ....on.ble parform,n<:e ollln)' ICI<:.lled IOf by I". IVlml ehall be d.em.d wllved bV . "",.iver bV Ihe Pur<:hner 01 I breach Ihereol II to .ny plrticuler Irannclion or o<:curence_ (10) WARRANnE6: Vendor .....rranl. th.1 .rticl.. .uppled under Ihi. order conlorm 10 .pecilic.lionl herein .nd .,e IrI lor the purpo,e for wtllch luch ooodl alf' ordln.rll)' employed, lacepl thai It I plnicular purpo.e i. .I.l.d, Ihe mlllflll mu.1 Ihen be f.1 lor thll plrticul.r purpo.e (11) ASSIGNMENTS: Thl provllion. or momee due undet !tile conlract .h.1l only be IlIlgn.bl. ....ilh prior ....rillen connnl ollhe Dlllclor 01 Purchlllng .nd M'ler..l Control (12) TAXES: Unle.. ofh.rwi" indl<:.led, Ihe Pur<:h.e" .grlealo P'Y III SlIle 01 W.ehinglon aal" or ulllea. No eh"o. by Vendor .hall be made lor I.dlr.' I.CI'8 I..el .nd the Purchl'" .gr.a. 10 'urnilh \landor, upon Ic<:aplanCI 01 .ni<:!e. .upplild under thie order, ....tlh .n eaemption cerh',cII.. (13) UENS. CLAIMS AND ENCUMBRANCES: Vendor w.rrlnl. .nd repre..nl. th.1 III tne good. Ind mll.nlle ordered hertlin Iftl free .nd clear 0' .lIllena, clltm. or Incumbrance. 01 .ny kind (14) fag( OF LOSS: Regerdl... of FOB poinl, V.ndor agree. to be" III f1.k. of loae, injury or deslruction 01 good. .nd m'lerille ordered herein which O<:CUI pnor to dehvery S4lch lOll, injury or de.lruCllon .h.1t nOI "lel.tI Vandor Irom In)' obllg.lton hereunder. (15) SAVE HARMLESS: Vendor .1'1111 prolecl, lhd.mhlly, Ind .ave Ihe Purchallr "armlell trom Ind ag.lnllan)' d.mlgl, coal or Ilablllly lor eny InIU,,1I 10 peHlona or propen)' ari.ing 'rom eCI. or omillione 01 \lendor, hi. employeea, egenla, or .lIb<:Ohlt.<:lore, ho..oever cauled. (6) PRICES: II price ie not .Ialed on 11'111 order,il ill Igreed thlllhe good. .hlll be billed allhe pri<:e 1111 quoled or peid, or Ihe p"v.,lIng m.i1t1l price, whichever lllo.el. (17) TERMlNAnOH: In Ihe ev.nl 01. brllch by Vlndor ol.ny ollhe provi.ion. 0' thie conulcl, the PurChaeer reservellhe r.ghl to c.nCII.nd terminllle t/'lil eonlre<:t lorwllh upon giving or.I or wrlllen notic. to V.ndor. Vendor ShIn be Iilble for d.meoea aullered by Ihe Purchller rllultrng Irom Vendor'a bre.ch 01 eonlll<:l. (18) OFF.SHORE ITEMS: In Iccord.nc. .ilh Chlpler 39,25 RCW, upon complelion 01 thl' order, V.ndor eh.lllurni.h a e.rtlhed el.t.m.nllllling torth Ihe nalure and .ource 01 oll-Ihore ".m. in IIICI.. 01 $2,600 which !\eve been u'IlIud In the performance 01 Ihie conlre<:l. (19) NONDISCRIMINATION AND AFFIRMATIVE ACTlOH:The Vendor lor". not to dllcriminal8 .g.inat .ny clienl, employee or .pphc.nllor employmenl or IfIrvlCtll becluse 01 r.c., <:re.d, color, n'lion.1 ongln, .ell, marlt.1 I,.lu', ege or the pre.en<:e 01 .n)' .enaory, menIal Dr ph)'IICI' h.ndlc.ep .rlh reo.rd 10, bul nOI IImlled to, the lollowrng employment upgredlng; demolion or lren.ler; r.<:rullm.nt or recruilment edverti.ing: lly-oII. or lermin.lion; rele. 01 ply or Olhel lorm. 01 comptln.lllon; lel.<:I,on lor treining; "ndltlon ol..rvi<:el. It il further under.lood Ih.1 Iny Vendor who i. In viola lion of thil el,ulI or an Ipphc.ble Allirmellve Action Progr.m ahln be bllred lorth....llh Irom IIc.ivlng I.ardl or .ny pu(<:h.ee order tlom Ihe SllIe unlee. a ..Ii,'.clory .hawing I. m.de th.1 dl.<:nmlnllory pr.Cllce. or noncompll.nce w.th epph<:.ble Anlfmlli'l'l Action Progr.ma have lermlnaled Ind Ihel a recurrence 01 .lIch Icll i. unlikely. (20) AHT"TAU$T: \I.ndor and Ihe Pur<:hller recognll" Ihe' in .Clull ecnnomic prlclice oVlrchlro.. "eulling 110m enli.truel vlOralionl Iff' in I.Cl bOlne b)' the Purch.llo, Thlralora, Vendor hereby .ellgn. 10 Ihe PurCh."r any .nd all cla.m. lor lueh overch.rgea. (21) O~FAULT: The Vendor cove,nanl' Ind aorelllhal in Ih. eVlnl eUI' i. inatituled by Ihe PurCh...r for eny del.ult on Ihe p.rl ollhe Vendor, .nd IhO V"naor I. Idjudgld by a court 01 compelenl Juriedlcllon to b. In de'lull, he eh.1I p.)' 10 Ihe Pur<:h..er III co.I., e.psn.e. ellpended or Incuffed by the Pu(<:h...r In connecllon there""llh, .nd r.l.on.bl. .Uorn.)". I.... The V.ndor Igrl.. Ih.llhe Supeflor Court ollhe SII.e 01 W..hrnglon eh.1I h.ve juri.dlction over .n)' .uch ,uIl, .nd Ihal venue .h.1I belllld In Thulllon Counly. ('2) BRANDS: When I ,p.cl.1 brlnd I. nemed rl.h.1I b. conltrued .olel)' lor 11'1. purpoee 01 indicating the .llnd.,d 01 qu.hty, petlarmance, or uee dllCflb.d Br.nd.ol.qu.t qUIIII)', pertormanc., and u.~ Ih.1l be cOhllderad, provided Vendor epecil'l. the brand In.1 modell.nd submit. ducripUvalll".lur., .hen ,vlil.bll An)' bId conllllnlno. tlrend wtuC/'l I. n~llqu.1 quelll)', p.flormlnce, or Ultl Ipecrlltld muel be ,.pree.nled.e In a""nlle Ind nol II en .qu.I, and I.ilufllo do.o .haU b. .ulllcl.nl ralllolllo dllrag.,d Ih. bid. (231 ACCEPTANCE: THIS ORDER EXPRES&.Y LllrAlTS ACCEPTANCE TO THE TERMS AND CONOrTtONS STATED HEREIN ALL ADDITiONAL OR DIFFERENt TERMS PRD ~~~~~~ VENDOR ARE OBJECTED TO AND HEREBY REJECTED, UNLESS OTHERWISE PROVIDED IN WRITING BY THE DIRECtOR OF PURCHASING ANO MATERIAL OEN PUfI 00II lA_v I I/B3) 011' ,. H~ ~ ~' ~ .lI;. , \ f .' , ~ r l' I', ," ,"..', "" "',' ,,'," ',,' ".,'< ',..'/" ,,' ':' '>" ,,', ". .",' ,', ',,', : ,':, , "., " ,:, " ',.., , , ..' ",.., ,',',,' : ': '" .:' '. ";' , " ".'" ',',' "'<, > ,.".' ,.' ,:' ,',',' ,', " ',.", ,,', ,',', '" ' ,', ,,' ',::, ',''', ",' , ,,' ,,'.' ,,',' '.:, , ' , ' , " '. ",'::: " ,> " "',::' ,""', ,,' ':;", ,:', ': ' "", ',,: ,,',', , ,:",:,,', ". "': :', '" ,: .'" : , · .....',,: .( , ,'..:, ;, '" :",'",.. " ',,', ,',. " '':' ':,.. "" :':,,", "", "', " , ',' ,." :';',. ',,' ',. ..'"",, .. ;:,',,' , ."" " ' , ',' ,'"..' ..'" .. ,,', '..' .".' , " ,... ' ' ":'" '.,"': ' "" '::,,' , , :,.; "" , ,,',:,~,~..'. , ',' '. ':' ',:, , : , ,:' '::' " , , , , , , ",:,', .. I I I .>. ..'. ',' ",' '\~ :;,', "', '" ">' ;' "'.,,,'.",,'.,.,. ',<' ".." , ' j,~ PART II SPECIAL PROVISIONS CONTRACT NO. 25-87 PAGE 1 1. CONTRACT PERIOD Contract period shall start on the 1st day of April, 1987, or date of award whichever is later, and unless terminated earlier will expire on the 31st day of March, 1988, unless renewal option is exercised prior to expiration. 2. RENEWAL Contract may be renewed annually in four (4) additional one-year contract periods, subject to mutual agreement, with the total contract period not to exceed five (5) years. 3. PRE-BID CONFERENCE: A Pre-Bid Conference will be held Monday, rebruary q, 198/ at 10:00 a.m. in Conference Rooms A, B & C at the Department of General Administration, State Purchasing Division, Room 216 General Administration Building, Olympia, WA 98504. The purpose of this meeting will be to address questions and provide clarifying information. All interested bidders are encouraged to attend this meeting. If required, a written bid addenda will be mailed to all bidders following the meeting. Interpreters for people with hearing impairments and braille or taped information for people with vision impairments will be made available provided we receive notice of this need not less than ten (10) working days prior to the conference date. 4. SCOPE: This bid is for the purchase of Bulk Fuels and Lubricants delivered to various locations throughout Washington State. Bulk Fuels shall be purchased in tank wagon quantities and requirements of 44 State Agencies and 15 Political Subdivisions are listed in Part IV, Attachment "A" Bid Catalog - Tank Wagon Bulk Fuels. Average city prices for four cities listed in the Oil Price Information Service (OPIS) weekly publication shall be used for contract pricing. For specific bulk fuel requirements at various delivery locations, bidders shall specify a firm fixed margin above or below the average prices listed for their price adjustment reference city. These margins shall be used for bid evaluation. There are a total of approximately 600 delivery locations. The estimated annual bulk fuel volume of this contract is approximately 8,750,000 gallons plus the requirements of any additional state agencies or political subdivisions added during the contract period. The volume of lubricants is unknown. The following bulk fuels shall be included in this bid as mandatory items: a. Regular Leaded Gasoline b. Regular Unleaded Gasoline c. Premium Unleaded Gasoline d. Diesel Fuel No.1 and No.2 e. Heating Fuel No.1 and No. 2 f. "Winter blend" No. 2 Diesel Fuel. Unless otherwise ordered, winter blend No.2 diesel fuel shall be a blend of 70% No.2 and 30% No.1 diesel fuelS. " ',' :', . " .' 1 1.' ~-' ,<,,;":':', '." ,..',;', ' '.':, , ," " ".. ..', ".'.... ,,' " ,', ,,',' "...,.' " '. :',.' " , , , '".', ",,' , ,;. ',,' .'" ,'. ";' ", .';' ,":, .'... ,.., """': ",', ',' ' " , ,.""", '", ' , ',' "," ,..' , ' .. " , ,,,.' ' ,', ,'," ", ": "":..,; , " ," ':'" ", " ','; ":, '." " / ,,"',,' ',,': ",": ", ",' , ,,' "... ":,' ',':' ", ',: :0', " ',:', , , ' ",' ,: ,,'. .. , ," , .. "," , , . ',,' , " '\, ,'.. ~: ":~\<: '.'-"";,' ",:',. -'>-:", ,'-' , .", :: ~ "< :,- '-','. ."'" ,'--;.. "::::""-':,:,, :'" ',:'''::,'',,,:'--',:' ','.,-,:-: 2::;~;~t~'~<!*;ii~~d~jtij2~&~d~~;~':"":':' , .' ',','" ~ '\. :',:'::::I'J' "'",:;.-,^;'; /'":~,,:,,, PART II SPECIAL PROVISIONS CONTRACT NO. 25-87 PAGE 3 5. The State PurChasing Division shall publish weekly contract change notices to document the effective date and approved averages prices for each of the four price adjustment reference cities _ Seattle, I Portland, Pasco and Spokane and to document other amendments or changes J ~ to the contract. If It appears that an error has OCcured In any OPIS pJ,k11 II'" publication, SPO shall contact the publisher for clarification. It (,h""C. i:. ~ understood and agreed that company n&nes and prices can be removed from and added to OPIS by the publisher without materially affecting the average price computation. 6. PRICING: PRICE ESCALATION A. Bulk Fuels: (Continued) 'Ii. Bulk fuel contract/invOice prices' will be allowed to increase or decrease during the contract period. The effective date of contract price changes shall be the Monday of the week and prices shall be firm through the following Sunday. OPIS PUblications are dated and most often received the Monday of each week. Once the reference city average prices are documented through the publication of a contract change notice, they shall become effective on Monday _ the date of the OPIS publication. Bid margins are then added to the average prices to determine bulk fuel contract/Invoice prices, exclusive of applicable taxes, for specific delivery location fuel requirements. B. Lubricants: Contract prices for lubricants (See Section 4 for product category list) shall be the Vendor's customer posted price less discount bid to the State on Part IV Attachment "c" Lubricant Olscounts. During the contract period, the Vendor may change their lubricant posted prices, but State discounts (on a cents per gallon, cents per pound or percentage basis) Shall be maintained. A copy of the Vendor's customer posted price list must be availble for SUbmission to the Buyer or purChaser upon request. A copy of old price lists must be maintained for a minimum of 2 years after contract expiration. The lubricant posted price shall be a price Included in a catalog, price list, schedule or other form that is regularly maintained by the Vendor. It must be available for inspection by customers and must state prices at which sales are made to a significant number of buyers constituting the general public. C. Approved price changes or other amendments to the contract shall be documented through the publication of a Contract Change Notice by the State Purchasing Division. D. Requests for price Increases to compensate for other increases in the cost of doing business, other than OPIS price changes will not be cons idered. E. No price increase shall be applied to a late delivery, if the increase resulted from the delivery not being made within the time frame established by this contract. ";::,'S,-:; ,,-,/\,,/ ";;;':";< /".' {>'""",:,,, ',:1" .' ~ >"i ,',':.\,',' ," ,!'-':.. "?'.:."':'-,:,~ , ' , ',~, ':'~';'?':,::;: :},' ': )~" {-~:: i ::,::':::-;~ :",P," '-",7', iY;',-'\> I". "'-"':'>!i; " ;'::,:: - ~;'::,::...>~::; :.' i ': 'I ;1 '''t- "C":;'i ..,......... .',. ..... . . ..... .... . .......... . ............ ...... .." . . '. . . . . ',:'., .: ." .' . .,: .' ".' ,:,"', ..' :'.:.,: c. ,. ".". '. ,'. . ..:.... ........ . . '.' '....,:. . . "'.:'. :.:: ..,.. ..... "...., . ..' '. . ':. ..' PART II SPECIAL PROVISIONS CONTRACT NO. 25-87 PAGE 7 27. INVOICING PROCEOURE: a. Joe venoor's oel Ivery receipt is to be signed by an agency representative at the time of delivery. In rare instances when the delivery driver is unable to locate an agency rep- resentative, he may write "no one available to sign" on the delivery receipt and sign it himself. b. The Vendor shall establish a separate account number for each delivery location. c. The Vendor may prepare and submit an invoice to the ordering agency for each delivery made or may consolidate invoices and Issue them periodically such as monthly. Vendor shall be responsible for the correctness of each invoice and incorrect invoices will be returned unpaid for correction and re-issue. Repetitious incorrect invoicing may be grounds for contract termination. 28. PAYMENT TERMS: Bidders are urged to offer prompt payment discounts, as lnOlcateO In Part IV Bid/Award Section 3 (less than 20 days will not be considered). In addition to being considered In bid evaluation, a prompt payment discount wi 11 resul t in the invoice automat ically bei ng selected for special handling to attempt to meet the term specified for entitlement to the discount. If no prompt payment is offered, the State's normal payment terms for this commodity is net thirty (30) days. 29. SUBCONTRACTING: Subcontracting of any portion of this contract must receIve prIor approval of the Buyer. 30. OSHA & WISHA REQUIREMENTS: Vendor agrees to comply with conditions of the Federal Occupational Safety and Health Act of 1972 (OSHA), and the Washington Industrial Safety and Health Act of 1973 (WISHA) and the standards and regulations issued thereunder and certifies all items furnished and purchased under this order will conform to and comply with said standards and regulations. Vendor further agrees to indemnify and hold harmless purchaser from all damages assessed pur- chaser as a result of Vendor's failure to comply with the acts and standards thereunder and for the failure of the items furnished under this order to so comply. 31. DEVIATIONS: Deviations from any part of this Invitation to Bid must be clearly noted and explained in complete detail on bidder's return bid documents. 32. CHANGES: No alteration in any of the terms, conditions, delivery, price, qua Ilty. quant I ties or spec if i c at ions of the resu 1t i ng contr'ac t wi 11 be effective without the consent and approval of the Buyer as documented by Contract Change Notice. i i " '.' ;,:'- .... '.' :.,....... "'c '" ., ",:,'. ,. .'.' .;. ....:. ":"'" ;~~(?[ .,: '. .' \' . :".' ,.>:< ,'. '. . i;i ''1f~ l . ,,' . '.;...;;:;:".' .' ,,:'. .. :... ,:: :.:,' .'. . '.:: ',' '.' .' . .'. "": . . .',' . ...< ",,'. ",:': ...,.... .,'.: "".' "',".. , , :: ........ ..... .....:....... '. ;,' .'" ..... ., , ......... ."<' .".' ,:' . ,..,..' ".....,..' .,' . ',': :,:.:, .:' ,'. ,: . ,.; : ". ,. ....... , .. . .... . :.' . .,. ,. ;.. ., .'. ".' ' .'., . . '. .:.' '. ., . .:.... : . ", .':. : " .' . . " . .:., .'< .': .: '. ',: .. ...... . . ...';'.., . .' '. . .. :,- ....:... ..... .... ," ;. . . .,.,.,. ,.' ':'.. .,'. ,.......,. .,': . ".' .. " . .. ::. :' . " ;'" .. D{i1:~i;:.';;::;;:~~.;~ ~:;':.':<:::::'l ;jo";"~.",, '"..."... ,....,-ci.'.,.\-, .. "'-"j,);",--"";,-.,, ',' ': ',', , ' ",..",,, "",.:.",~.i.&"", ,=..",.,;.";,,;.>-~..:".:.~,c ~-"'--~'~J';'';'',..::::.c.;C';': " ....:.~:.~,~t,;':i:i\1<; CONTRACT NO. 25-87 PART 11. TABLE I REPORT OF DELIVERED PRODUCTS VENDOR: DELIVERY LOCATION COUNTY: DELIVERY LOCATION AGENCY NAME & ADDRESS: REGULAR REGULAR PREMIUM OIESEl/ DIESEL/ LUBE OILS/ .ill!. LEADED UNLEAOED UNLEADED HEATING i/2 HEATING i/ 1 GREASES ~ --= ---= JANUARY -- -- FEBRUARY -- MARCH -- APRIL MAY JUNE JULY -- -- AUGUST -- -- SEPTEMBER OCTOBER -- -- NOVEMBER DECEMBER -- TOTALS ".,,"., ";"~";~ ~~u:,,;.;.!~?; ,,'-'~t,~I\'. ,'i"I"7"'/," ,;.'....,.,.",..,.>-..:"',,','-,., '~', r.!'~..,;"'" '-', '~':'-!:J'. ,'.'" ,',:,:;',;i;,;:,: ,..-- " ,,',:-' ,:..:::....,,::,<', ; "'':-:::<'-':',:>'>-- . : ':.~;: .':,:~:,\';' : :::-" "-, ..,,~;, ,; -;'-;,-:' ',<" !~. '.:: , .., " '; ;:--,'\,i,':-, , ~:-' ,,'", c """.'.:"".';':"_! '!;j> " ;:;J.: :::,:,'::: i:--:;';..,':"-':;;', i,~+';l't!:r::/:: CONTRACT BID NO. 25-87 ':'-""\"," ';:c,.-, '~:','>" PART IV, ATTACHMENT "C" LUBRICANT DISCOUNTS ;,:::i~""i'" 7:"'(';,"~'" ';"-";i,,':':, Bidders are to fill in below the bid discount off their customer posted price I ist that they are offering the State. Be sure to identify whether cents per gallon, cents per pound or percentage. Reference Part II, Sections 4, 5, & 6. LUBRICANTS BY GROUP A. LUBRICATING OILS B. LUBRICATING GREASES C. TRANSMISSION FLUIDS O. TORQUE FLUIDS E. HYORAULIC FLUIOS F. KEROSENE G. THINNERS H. SOLVENTS F IRM NAM~__________ BIO DISCOUNT % OR/ GAL. ______________% OR/LB. __________% OR/GAL. -_--.J. OR/GAL. ____________% OR/GAL. ----_----1- OR/GAL. % OR/GAL. % OR/GAL. ...,~ ;".::-:'" ,', ,.:', ;:"':c,'/',.,:,,-:,":::': :"':::.h>t,:,,:;;:};;':,;:t"~i~!: ":;':' ",' ",' ",.-,.. t~j,: .., " , ,:',,' ',," " ' .. ",....:. " " ' ' .' ".' . ", .... '-:.,., ,." .. . :. " ' , ,";.', ., . "'.',, ,'" " ," ..".'. '" ."( >'.' , ., >;:,.',' > . "," '. .', ...< '. '. ", _~I o di ?Jdd .. ~I:r/~ ::)1:-; ~ . ::11 - . ~1;:;1Cj - .'5"'1;29 ~v - 5" :??,q - .h;2,lq ::iflt;!- . ~c:I 9'7 - ?3h'1 a...p - .6:5(PQ - .5"1/.::<9 ~- 5t/-~q -.%'-J9 al!L. . :':-:lllf. - . t/& <J.q - ,5'tJ-t> ~/- .54&'-. .D.2. tJ#i- /:::/3- .1/.-71- 7t[!1 - . </7<1- .477 , I I I I I I I I Ii Ii I I I I I I I I , I i I I I .' . '".' ."', : .. ,,:,', " :. '. .,,' .",:.' '. '. ."..., ";.' " ....' , " .' . ':: .,'.".,.. , ':. ,,'.... '" ," ", ", " 'i:. " '. , ',:- ',..,',. '., :.:'.... .",.' , . ,', , .,' ' , :::. : .,: ." )' . \ ", l ~, t ., '" , :',' ',: ,.....'.. ',;, ".; " '::,:.. , .",'.','.',<..,,' ,. ,.,. ".'..' ",' ",' .. " , ',,' , ,':.' ' , .. : . '.: , .',', "....,'.' ',' ,..' ,.'. .H. . i .' ",'. ,',,' ,'.', ',. :,' '.'.', ,,", .'.:. .. .,.", .." ','.' , ,', . ..' , " , "..'., '" ", ...,...'..:, '.'.,.:<,:','.,.. " ','" ','" ',1",:,",'.';' ..:' , :', ..',' ': .. ':,,' ,. '.. ',' -.:. c. '." '" ,::, .., ....., :', '. ." "".' ,...., ...: ., .,..' : , .:,." .,;:: ". ""~ . .......;:. ,'..,.' " '. . , .,'... : . ' ...:" "", ," ,; :' "'. :";' ': ' , ..". .. .," " '. , ", "~' .....': " , ;, .' .. ,....' : ...'. ';, ',' " ".: ,,'\ . .., , .' '.,' ',:: . ,'. .." ;,'.....', >:. ,', .,' ',,', "'.".<:> '.. " ".' . , ': ," '," '.:-,,' , ' .' . , '.' . . ..... : ''';'' " ' : , - ~ i~Jj/",,/L/J n 11// ~a~~L__?:?3S- - ,'l50/S"" yt~ll ,?3hg - ,F53Y /l~- ,'-g?DP - &"',;;)7S- ~I-- ,YWg - - J?S"37 ~ ,%5-9 - / %"679 ,M,.'i!- .2"&:>.79 ~ '.Y7Z'S- ~ ,H5S' -- 2?f6~ {hit ,'Z'Z3S" - . t'73S . ,.....~~ ..-, . 'i'l5.s- - ;7 Y3S' Ce{..... ,;1F3S- - Y63S . , , I . ! .. .. " 1 " , II ". ..: . ''',;.' ,',...,, ":,',,",.' . "".,'..",-',",' ,,',' , '.(, .. .' ' ':.. '. '.' :. .,:.'" " .' " ;;: '.. .'.. ,: " '".: ::. .".<,< ,.1':<' '...,'; ..;,.' '. "," ..'. "', .',.'..", , ."'. '.,.. .. ':. ': : i:, ".:;: " ':.. ',' ,.,. " '..:., ':,:., " '. "i.. " ',,: ,,' . ';.... , .. ": :'" ,', ',.. .;," " , ',' :',' ',.:!, ",' '. '::' ", '-;', '.....':' '. " ,', .',... ..,' , ,., ,', ,:' :.., :, :, ,,". ' .,., " . '. .'.. . ...,' . .'...",', ."'".""., ' "".' ,'" " .,:' ; .,' . :", ':'!',' ,",:.",':' ..:, ,.', "'. ,: ...'. :.::'i, '..' '':, "',:," :, , . ',"" ..' .' . ,,' ,.:,:' '..'.., ',',., ., " , '.',. '. . "..,.. .. ,< .... ..'" ,',:,', ", ',,' ,,', ' '.', .', .. '..~',., .: "., ' '",,'.., " ,':, ,','. ,'.. '/: .', " , '.:' ',':.' , :',": .."..,.....' , "..,'.'.', '.' ",:' . :. /", ": ': >' , ,: .. ",' , - - , ~ . -",,' :' ,...,' :' _ :,: ~ ':'i -::-' , ' , .-,' _,'; '_::" ':,,' --.',:_. ' ' , ,,"'" , " ,," .. . " , ",' , ". , ' . '~i;~,'i.,.:",~;.~0,~.;,,_';i.,:,:~\;,.. "<:;"~:~i"\'i'J ,,"' ;,,_~ ~.,L~,,::,,":~~:~.~._.: ,," :..i"::.,,,,,~,,~~;}~;i;2'c.t;'" ' ___.--" ___:"". .~: "..... ... .., .. '.L._I_MI~nic.Uih.utjnn..J~ PROPOSAL TO, THE BOARD OF JEFFERSON COUNTY COMMISSIONERS P. O. BOX 1220 PORT TOWNSEND, WASHINGTON 98368 DATE: "DEe.. Ij) HONORABLE BOARD: 2,7 We, the undersigned propose to furnish in the approximate quantities and 01080L of the locations as shown on the attao amount shown below, for the calendar ~onr The prices bid do not includo state and federal fuel Ub~ tax (gas tax) and do not include state and local sales tax. The undersigned bidder will determine tho amount of the appropriate tax for each item at the time of delivory and shall collect eaoh tax as required by law. etroleum produotn to some or all for the totlll " , ., ~'. , The bid price includes all oosts related to delivery of petroleum products to the locations specified in the amount specified or quantities ordered. The undersigned bidder shall make all arrangements necessary with tho appropriate agency for delivery and billing. The undersigned bidder will adjust unit prices periodio- ally in accordance with prioe changes from its supplier. Th~ undersigned bidder agrees to notify all agencies or departments of any price changes to be passed onto the purchaser. TOTAL BID PRICE: (NOT INCLUDING TAX).3--?> '1'[ ~8,IOL{.'10 .. 8S- FIRM NAME: Lv ~.5.' LA....),..! Ol t SA L E -:Po () "Ro X I '-I 8 g F-DtZl{~ I WA Q~ r1.J.~ ",~"A(;<'<L SIGNATURE OF AUTHORIZED OFFICIAL /:)1'>7 IN ( ADDRESS q 8 33 { DATE: 1.2.-4-811 RECEIVED JEFFi!RSON COUNTY ENGINEERS OFFICE -C-' -',. . ,".'". " ,', '.". '. '"".,'.. .'.'.'. ":" .,:..: ;:.....,.. . ",.... ' :. , . - 111 . Wes'.holesafe Distributing, Inc. 19B8 PETROLEUM BID LOCATION UNIT I QUANTITY UNIT PRICE DESCRIPTION TOTAL COURTHOUSE UNLEADED GAS GA. 12.500 HEATING FUEL'2 GA. 10,000 PORT TOWNSEND PROPANE GA. 8,500 HADLOCK ROAD SHOP REGULAR GAS GA. 35,000 UNLEADED GAS GA. 8,000 DIESEl FUEl GA, 20,000 HEATING FUEL'2 GA.. 2.500 PROPANE GA. 10',000' QUILCENE ROAD :'SHOP REGULAR GAS GA. 1000 DIESEL FUEL GA. 1000 HEATING FUEL'2 GA. 500 PROPANE GA. 1.500 QRINNON ROAD SHOP REGULAR GAS GA. 3,800 DIESEl FUEL GA. 500 HEATING FUEL'2 GA. 1.000 HOH ROAD SHOP :;>,000 ~ REGULAR GAS GA. "" t#. 'E'......: . (' ,I...~ ,~~oo "1' v/" 'J'''' ~ J.l-&.5', ..E-,. I 0 do l.'SO C, '!:-S' . fa 8 I'. ". <D 8/ DIESEL FUEL GA. i..2or> . ~ HEATING FUEL '2 GA. 1,500 ~, ./ ~ , . ~, r ~; " . ......- ;..' i. . , '. '. ',' : :': :': .,. ", "" '. ,. , " :,......;, , ":.:; :......,,': ';'.;..>. ',' ',', ' , "...J.':'}," ..' , <', .", :: " ... ..." :, ,;' " ,;: :... ....':" :::,.,', :: . " ". ':: \' , , " ,.. ',.;" , '. " '.' ,',., .,.. :. . " , '., ',:', '.. :, ',;' :.....' '.- "" ...: ..,','.., '. :'... .", " ;,', , , '., '.", "" . .,."'..'.,.,,.,,',. ,'.'.,'.; , ....,.'., .".'.. ,", , , ", ", ' '. :.,',:: .." , ',:, " , '..: : " , ., ., :;., ':"..'., ' '" '> ,:. ,,',' ',' " , " : .;'.... .": " ',' , ':.'...:' ',', ',..' '". " " '. " .',.,: ,:' '." '.'..,. ,', '", ..' .' , ,':.' "'.. ,;, , ' " ' ',' .', " "'..:.,. '. " , ", " ". '.....,', ", ',' '" ..'.' , .". :', :: : .' -..- " , ~ ,', .. " " " ,0<".,,'.., , ' ' " . .' '. ':':, ..', ',,' " , ' '" .. '.... .'.. '..' .. ,,:,:~, '-,:f ' @ Wes' Wh,sale Distributing, Inc. '''' ,:,~/~~ 198e PETROLEUH BID :/' LOCATION DESCRIPTION UNIT QUANTITY u;m PRICE TOTAL CLEARWATER SHOP/ REGULAR GAS GA. 2,500 . -n5"~ .1,/ <67. SO ANNEX --"-'-;,.- DI ESEL FUEL GA. 500 .701- '~o,5o " COUNTY LANDFill DIESEL FUEL GA. 5,700 PORT TOWNSEND . SCHOOL HEATING FUEL 12 GA. 25,000 BRINNON SCHOOL REGULAR GAS GA. 3,000 HEATI NG FUEL ,12 GA. 1,000 PROPANE GA. 2,500 F.P.D. 13 PROPANE GA. 500 SHINE STATION PORT LUOLOW REGULAR GAS GA. 3,000 F .P.D. 13 DIESEL FUEL 12 GA. 1,500 .. HEATING FUEL 12 GA. 2,000 CAPE GEORGE F .P.O. 16 REGULAR GAS GA. 1,500 EFFERSON TRANSIT DIESEL FUEL GA. 35,000 (BIDDERS RETAIL ISTRIBUT!ON FACI- ITY IN PT.TOWNSEN )PROPANE GA. 22,000 HIHACUH SCHOOL REGULAR GAS GA. 14,250 UNLEAOEO GAS GA. 1,100 OIESEL FUEL GA. 19,500 PS300 HEAVY CRUO GA. 4,000 , \~ . i," , " ,'. "'. '<'.:'"":.,: : ~ ,1, ) ", :''':,'::'' '.'..... :':' , '. " '.: ',:,', ~ ", .,',. ",".", .".', ,', ."'.'"..'" .". ,"..,' , ",:' ! .':, "',,:':: " "^^', ' ':,:, \', ", ' ".. I '. ',', .. 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" I" I : '. :' , ':,1 ": l\- PHONE DIALOGUE" I (Name) -1LDr:\---1"~(712..G??-L.O ---r Talkedw;th ~ ~So::tL of~lJ. ~ :&1~~JJ.L<r o Party called Time _ \.:..3 <::) Oate ~!5_/_8_'P__..____ ______~___________'______._____'______._w..,_".___~_~_._,_ Action Needod __.,....' ~ _..,~--,-~~-,,-.,_.__. __>h ~"''' ,,,' .,', ' :;, 1-, ,:,',1:".... , ,) " , :' " "'",, : .:. . r:; '. IR;~ .. :,: ". ",'.. I, :}./"':r ; :,',., . '/"~jr~l'~'~'~ "; , ,'., .' .,." "..."." ", .', ' . .......:.,." , ,'.H', . . '".'>'i, '. "1, . ..:;~"L;,~"_,:__..;,"::;:"', '! " .." . ".,<;'C::}>' ',' .. , ,', .'" .,"., ,',":' " :.'. ' ,..... .', ..., .",. ..". ,,'., ,. .."',', ' , , , ,,: '.""'. ..' .,",' ,','. ....,... , .'...' ,',' , ",.,." :' ',.." '.".',,' , '" . , " " '.',' ,.'.. " :"..., ," ':.' '" '., ' ,.",..": ".., ", '. ' , " ." .. ','.. . : ' " ...,'". .'.' " . ,.. .:../' " ' , ' :" :,:, :', ..".'..,... .',' .'.. '. .."', " , , " ". ',', ,.,',,' , '.' ", '. " ....,.. ,', ,,",'... " ".... , . ", '.. '.... .... 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',.,'..'.... ,',..'\&~ ROUTING SLIP r:?~ I DATE '.:"",' ';:~ll ;;;:":'" ~N /~/g8 f f~ ~.Lo ;;;,~,,.,/,. ./ '-'- ["<'"s,"e 1 "~',"'"f_f4~"'- '-~(. ,_......t/~ L ',~ 'h..~.1 MAIL STOP PHONE .. ~ (.)cb J/..S3-/c.lVU jor Action ~ B .For Approval Per Your Request Per Our Conllersation ~ ~or Signature ' Read and R~furn Road & Roule 10 Files For YOur In'annalion For YOur Comments ~/WL ;a.,,,,, C~"'?:1 "','3/~tfh,I-;'/z /.'-:e. . au: t-Ul-~ ~d a.;vz. t.f!"'~ ......~~Ht"..~ I .,' ~ t(Z,,?;aX~~~ ~~A-&!Y:~ ~~f ...',....' 16.t::J,z r'"l"t..-'./'-<.v.d ,;:.') ~k~ (au. \ .. ~ ,:I /-"'1/'!'( ,J,' TO' ~do,. r<"~ &"'1~tPJ.A;'--. .f..:.I-~:S--::-e./ C)/~ (".,<.....il'..<:.I..~---::~~. ,....", f;; ~l . ,),.: ':1 -/,-;J , \...) '~",' 0~..(Y ~.;I...A...t. .td~e..r/':/..l~/~< t~~o- '.:"';'.P f"'!~/'.....~q.""/""""/",, ,: \ .11 . / f'; ; . oJ.,!" ,;;(, J i, '.',,<.-{ ('-!l..q ,~, i.J)~t~ U,..../l-';.:/..~.-:..:1.-4!. .....'.. .;('." {/ . [/, (' ii' '; '//,)..~ ..', '-::?/-j ;,;>,,' . /. "',,~,-, '/'?//'~' :' . ,,/. ;. ..'::........ ..J( ,., ,'" - "e."""'"'? . ...,r-~3 ---, ,. ,', ,.:,,' .::.' .' .; ..,,1': ,',.;" , '., ~~~(~;~ : ", ," ., , " ,. I'."., , ,,'; .'" ,,',i ',' ,,' , ' .:, :" :'.' ," ,'., . ' . ",' " :..', ',' ,'" ': " , " ,":- " ''': ,.'.: , ,. " " ". ' ',: ".. , "':' " ,', , " ,", '",.,',.,.".,., , '. , ". , ":, ' " ",', ',' :,' .... ": , , ..,. , ~: , ',', "., ;,i,r ," :",:-,.,,'::. ". ," , ...,,:' , . .', .. :' " " ":: : ..' ;', , , ,..,'.:.,,'. "...:" ,'; , .",,, , " '..',::... ' ",', , ".. '.., : :;, ,,'.. , ,:" ," ';, ", '.<:- ", ' : '."", , ,,',.... ':' '" .",}: . ,'..,. , " . ,,' '''', '" . , . ' \, ,'. ',': ...,. ':,.,: ,: " ,'." , " " :..,; " ", ,.. " ,'..'., " '." ., '.'.'.' : ',"'. "': ',: " :;," '.., . ":', " .. " , '.,' ", ' ,,; , '";:''':''' :.' :' ( , ,..; , , ",.",...,:'., , ":"':"J~{ ',:: " ,'!'::',: ,~J'""",'.,'"" " ',' . '1 ", -.J', .. a . ,~ " ", ' , '. , } ~;'1 . ."~I r 8 ~~:~~~~ ... '" ;'K" .'wOK" ,... ..'.. ",...,," '0, ",.N "'oI1ow... ."'e.... FOB, dU"n'llOft ehcwn btllow, P,IC" m,," ~ b..~ on O\W 1H11t., 1.lended and IOI,lIed Add ..1.. ,.. II . lep,ral, tlM. o.~ OU"anl.. Iahovld be ,~ in '0 flell.. tonl.d.r.hon, bloia mWII bl "',da on 'hi. form and.~ In tuI, ::' :', "'," :,', ' '," . ", " .., ,,' ::; :,' ., " ' "'<':,:, :, ' ' ',::' , ':.,.. .". " 1 :;,~ ."i'" ~~"':'~';~ "~,~" .,. ,'..' , '.'",'. ,'., : '.' .,.' ,'...,," ',' , ',', ,., , '.'..' , .;:," .. '... ,.,,',., " ,'.' , , " ",.',',.' ,', ' .., , i"': , " , . c. ',',.,' " ..:- , " " ,'. :. 1--,. ..., , . ' '.', " :', ' .. , '" , ','. .' .. ' . .. '.. " ..' .. : , '".,...' :', ". . .,.', ,! '" ~'i ','I l: , f \' :,: . ..,,' :i ; ; ,: ,', : '. ',' .- i., , I ~ I , I BIO OPEHIHO : ~ lEe 14 -2 PM MARK VOUR "'" DEPT. REOUISlTlOH NO. ENJ:~OPE ./ .;J.5-B?A~ I , DEPT; OF GENERAL ADItIINISTRATION STATE PURCHASING DIVISION Rm. 218, Oln.,al Admin. Bldg. Ol,mpll, WA 8lIS04 (VENDOR ""ME AHD AODRES~l '1 IIIfTUIIN > .ID TO " BUVER N"'1fusERT PAUL~, JRL:~ NgtIYEij OATE ISSUEO .___.-1~06.J.2.5}.-IO:'!q. _. ........ .1 ,a-i-a? I PRICES fOB TO: D!LIVER~ LOCATION LISTED BELOW l_ '-.J L _ . r u_. _.__ ~. n .lnAL ALL .....U.... AND CHANG.. - .....CIL .IDa WLL .. RI".CT.D ___ ___ IT..~~'<j __.~o~':'.oo~~Y.~OOE _ +__ OESCIlIPTIOH OUANTlTY I_~~ ~~~~'.'$' ,AM~U~T, _ "__ I In furtherance, of State Contract 25-87 (which had MWBE,~:tici at ion r, equ,i, me",nts I, of 0% MBE and P% WBE), the delivery location iden ified below equires bul fuel. I Your firm was I"warded a portion of this contract i'nd Sini you have expres , an interest in bidding on new fuel requirements ip this nera~area, we i invite you to p-id on this new requirement. Pleasr' speci a f rm ~ pe~ ' gallon margin itor each type of fuel listed below. Upon a rd t ese margins ill be i added to the prices listed for the price adjustme t refe nce ity specifi for your firm in the Contract Award SUllIllary. All of he te~ and conditions i the bid/contrabt shall apply and, if you are the uccess ul bi er, the 1 tion will be added ~o your contract through issuance 0 a con ract hange notic~ ' Premium I Dies~l/ Di ell , COUNTY: .:Je .(lfE,so/,\ unleaded unleaded R "lular Heating #2 Hea ing #l I I. , " I Est. Annual,V91ume: See, ,At:b-.e.~"'~ ~e3/1r'e'" ~t;s (Jr .,1. ..'. , Tank Size: I ..::re.{lfe~.)\ c.ou,.f;'1 ~/~e"i ~~ f,.",,,'c. ~I<s $~ $_ $LI$ , $ I (Vcl~~s ~ro in g:llop~ :nr margilSin 0) Jars/gallqn.) RE eEl VE 0 De/lve,;e.,. CO ~ta,.t afte". ;r40\U.'::1 I) "8C'f I i I I .~ ... ~-'" Ll___~~,~__I_ _p_ " Bid Margin: i :OEC 5 i 1!MlB JEFfERSON COUNty PUBLIC WORKSnFp.T. i '- .... .'un __J DO NOT RETURN VENDOR NOTICE: 'The Stale reserves the right 10 aceept or reject bids on 88ch item I.paralely or aa a whol., to ,ejacl any or all bid., ..ive inform.lilial and 10 conllct .. the bt.ll~ter..t. ,of the State may reQuire. Bids .r. subject to the standard terma and conditions n Ire printed on Ihe reverse side hereof. By signing below Ihe Vendor .Ulrma heV:lng reed the condilions nOled IIbove Ind on the reverse aide; Igreea therelo end hn .'ated hareon the price. It which he will furnish Il'ld dahve, el a'.'lon or loclllon nlmed ebove, Ihe Irtlcles.e specified. In tne 01 conflict emounla.hown in Ihe Unit Price column of Ihis form prevall",- ..~-~ GUARANTEESDELlVERVFOB DESTINATION ql~.f"RINTNA".E/nTLE ", TELEPHONE I V,lIdol' WII' AI\nw . WITHIN DAVS AFTER RE OODER AT I AO~~~~S_~.__._ _____.__ .m..... ."'. 'tb ___ _..__~. ..__ ... I SHIPMENT WILL BE SIGNATURE DATE' FFlOt.t ., . i DI' "l~~ r;, ~:,. I ..____~._;_.. . . ", , Net 30 '(~"'(jfH"UAOOfIIA.w"'fl.'J .1~ ....' , L . -~":,' ',." , I" . ....., '" ,'..', ',."..::' " .. .':, ':':.. , ., ",",'. ,< .,.'...'".' " " " ,', ..' .., '. ',' , I I I J .., .' ',' ", ...,.. -.J :. '.:" , I.' " '.'; , " . ... : " ;.,,'. ":,,', ...: . i." .. I . , ':::; '" . . ", ,,','.'.,' .. '.,' ':'" , '..' '.' '. '.' ,'., '.,' ',.",' " ",., '..... ' " " " .., ',' " , ': ' , , ,': .,.',. ,.... ,.,. , .:' " " ' ~,"" ..... ,. , .. ",. ", ,. " ,< ... ,i:..'. " ,',. r: , ----' '.. , " '.:. / ". .:' " " - " : /, ':, " ... ' , ':': .' ..,.' , : '. ,,'. < ,.'. " I ' ",..,.., ~ ',: " .:' ~ ,.". ,. ~ ~,c~, ."'_:::" 8 :" I .. ,... :: i '... , " . ' . ~ .. , , .'...' ':'.:':..:. , ,',:'.:,:, <' ,:', " , ; L , .: I, .',' . ' :,: .; I ',.'. ,.' . 1 , , > . ", ' ,'.' " ..','. ", , <.' :, , .. ,,'; ',...' "," ',' '.' .', .' ':, ' :.. ::,' ", " .,'..;', " ..." ',: , , " . ..; 'L'" ~,F;{:~f ,',:' ,..', 1-: ,,' ,; ..,:. "',", '1,: .': ".,.: ......: . . ' . , ' " '", ',,' , , " .. " , "l' ,:, , ,;' ..' ,I"'::":" .' :i , ~ .."..,.3 ;,,:".' "",',.' p.'? '. ... \~'f i)',\ .. J J -' J !ii . ".".,:.'l ;.;:j~:]~;f~~~~ ~g <> '.,.,. :',.","'", VI_ ~ 8 .... ~ >:'( .- ... c: C'GI ::> ... "" ~ . ... ~ ,'" '.;i"i/': .~ ..... N () 0 0<1 III .. -' 0 J -' () 0 J .. ..:..,:> ~g ~ 0 0 0 ~ I1l 0 11\ ~ ... ~ 0 ~ ... VI_ ~ 0 10 0 ..,'.':,'::.'..'.:. .... Is) ..0 t1. "0 .- ... ~ :::t- ..... f'\ L ,; c.. " " "" /'(\ .... VI :'..... 0 0 J .5 "'" . ... J 0 0 J -' () 0 f!' ,.. ... ~ ~ <l <::l 0 <:> 0 ~ ~ ~ Iti' ~ ..: .. 0 'E " v: '" 0 ..... ...J I1l ': "-I " => III ... 6 ii; >< '" 'I ., -' ,0. 0 -' ... : ...J ~ ",' ... => Q I1l '" ' GI () () 00 .", :z: C ~ 0;:) c g "' .... ::> ~ ... .... "" .. :0: .. >< .,'. I1l :z: "0 J J -' -' III "" eGl .' ~ ':',.'.'.'...' .... ::l"O .- ... '., . ~'~ I' g ...C: <.0 C>.::> ",.,'. C ." ...J "" '.... . "" <-> '=> ,', QI ';" GI " QI QI '" "" e e e e "" ::> ::> ::l ., ::l '0 '0 '0 '0 "'. .... ...,.,', :> :> :> :> . .'.,;'; z ,. "-I ';;; C ';;; .s -;;; s ';;; c "', ,;E :r " ::l QI .... ::> OJ ::l OJ ::> OJ 'i ....,'.,....:.>: <-> 'C: ... ell c: ... ell c: ... ell .' c: ... "" , .'l V> .'l '" .'l ;:;; .'l .;;; .... ~ ~ ~ ~ "" "" "" ... t: c: .:9... .; c: :s ,., .; c: :s .; c: ." .".' "':'.' ... !, '" ... '" ... '" ... .... ... .... '" uJ .... "" "-I' .... "" ... ..... .., I ~::J< ,.,,5,...2..) .'; '^ .' 1'" :..:," " ~ ;(rj'N:)vic); Fi::Ff' 3L ~ 'I ~1~' i CY >lPr)') :-}t '\F 1,)":1 .. '~."',... $lt " ~~,C\,,~~ ',.:" ~." ~ ~,~"'. ",. ~ VI ~ '... ,"; ~ ., 41'" 4C ..'. ~ ~ c:'t; '., ~ I"... ",~- .. - I ~l""l$-~ ;, .. C~';:t ~~ ". ! ... ,.., .~. ~ ... .. 8 u '^ .l/ .. :3 .~ "'" rlai J ~~ :0,. ,. .., :~ ~'tCl,,'^"IC 2l s;:"'I-! ~..];l3 ~ o~Vl!, '" " C' 0 ~ :K h~ ~'-i.: ~~ll'~o! it.!J.lf~~~ oil ~ ~ 3 I, .oJ.:J - ::o,c Q .~ ..... ~ '"., . . 0( ~q, (,3,.",," oO'E-c~ ~, ..u _C! . ...,. 't "-' ~ ',., ~ Ii" ~ ".s~O ., b ... ~~..::: ~G'; ~.; ~ k~ Ci. <!I : ., ,:' " " ",' .':, , , " ' "', ...., ,....'., :, , .'" "." , ,," ," ,"'" . . ,..' , " '. ,':,. , ,; '<,::, ',:. " ,i ':: "~" ... .. ' , ' ",'. ...,..". ',.,..... ' , " .' ,..' , ',' , I', -.. ~ ~ ... .~ ~ ~".1;~ ~~ ....\1\ ~ ~~~ III... ~,IJ " ~ ,~ ~,~ ~l" ~ ~ ~.- :I ~~O;t) G , , , " . , .. , .', I':>: - :' , , J J J () ~ i J ,~ ~J I ... J J .-. ~';""'-'^'7""""- c ''''', , '. . . .. . .'.. ',..", ,': , " , ", l J I J Payment will be made only after a properly completed invoice is received. If the purchaser fails to make timely payment, the vendor may invoice for a minimum of one dollar or one percent per month on the amount overdue. Payment shall not be considered late if a check or warrant is available or in the mail within forty days. Normally payment to vendors will be remitted by mail. The product purchased herein is subject to the approval of the purchaser. Rejection of the product resulting because of nonconformity to the terms and specifications of this proposal and contract will be at the risk and expense of the vendor. All invoices affecting this proposal and contract shall contain the applicable contract number. The vendor warrants that the product supplied under this contract conforms to all Federal, State and local regulations and is fit for the purpose for which it is intended. ~'. ! 'It,. :;:.. The vendor warrants and represents that the product supplied under this contract is free and clear of all liens or encumbrances of any kind. Regardless of the F.O.B. point, the vendor agrees to bear all risks of loss, injury or destruction of the product, supplied under this contract, which occurs prior to delivery. Such loss, injury or destruction shall not release the vendor from any obligation herein. The vendor shall protect, indemnify and save the purchaser harmless from and against any damage, cost or liability for any injuries to persons or property arising from acts or omissions of the vendor, his employees, agents, or subcontractors, however caused. ~ The vendor agrees not to discriminate against any client, employee or applicant for employment or services because of race, creed, color, national origin, sex, marital status, age or the presence of any sensory, mental or physical handicap with regard to, but not limited to the following: employment upgrading; demotion or transfer; recruitment or recruitment advertising; lay-offs or termination; rates of payor other forms of compensation; selection for training; rendition of service. It is further understood that any vendor who is in violation of this clause or an applicable Affirmative Action Program shall be barred forthwith from receiving awards of any contract to purchase from the County unless a satisfactory showing is made that discriminatory practices or noncompliance with applicable Affirmative Action Programs have terminated and that a recurrence of such acts is unlikely. In the event of a breach by the vendor of any of the provisions of this document, the purchaser reserves the right to cancel and terminate this contract forthwith upon giving oral or written notice to the vendor. The vendor shall be liable for damages 2 ~ l~ II ': .' '''~'~:' , ,'~" " , . ", " -" , : ,":', " " ',: ."".. '.:. ":, ': , ,;', '. .', ,'.'...>, " , ..., ",,' ',' ':" ',..." ",' ',' ::", ',.' ':, ' , .:~, ,..: :':. " "":.:: ' .' ", "',':,': ..,":, . ,;." , '. ..., '.. ,:, c,:" ;, ',.. :.'.', " '....",... , '',:::' ,., " :.',;" '""." "v,',. .... ' :. ..'. ,',. , '.", .;; .,' " ,., ,. ,,'.. , '" '..', ',' ,,"', .,'; '" . " ,: .,,' '" . .: , ' '" .>. ','. ,'" ' '.',. , .' ,: :', " , . " ", ,: '. .,'" '.,':, ,', ":, :. :", " ',' " '","",' ;'. ..,,'" ... " ,,' .. .. ' "', ,',: ',.' ", .' "',.", ' ",'.' " , , . :" ,," ",' " ,'... ,:,,, , ", :,' , :'. .... .':'.'., ':.' . "',.. .": .', '." ,', ,,' : ." " '., ,"', " ,,' " :.',': ' , , ',.,," , '. , " " : , ': " ~',,: ',.. ,". .. ,', ' ,', " ,,,, " '.",' , ,:': ',' '" ",' ,', ,::.;:....'..':,','.:'.'.. ,...' " ,,".' :.I " ~i l. l Ii ~.' fi: :.~" t. ~">' ,. ir' );,~ , ...,. ., , '...., , ,'. ,',.. ',' ...' '..', ,.'.,.. , .....," ,."", ..." suffered by the purchaser resulting from the vendor's breach of contract. The vendor covenants and agrees that in the event suit is instituted by the purchaser for any default on the part of the vendor, and the vendor is adjudged by a court of competent jurisdiction to be in default, the vendor shall pay to the purchaser all costs, expenses expended or incurred by the purchaser in connection therewith, and reasonable attorney's fees. The vendor agrees that the Superior Court of Washington shall have jurisdiction over any such suit, and that venue shall be laid in 3efferson County. The bidder, by signing this document, affirms having read the terms and conditions noted herein, agrees thereto and has stated hereon the orice at which the bidder will furnish and deliver at the given location the product as specified. The 3efferson County Board of County Commissioners reserves the right to reject any or all bids, to accept the bid deemed most advantageous to the County and to waive all informalities in the bidding. 18,000 gallons of liquid propane @ ----per gallon. $ State sales tax @____% Total $ Company Name: Address: . City, State: Telephone Number: Authorized Signature: Date: 3 .. ....,. ", " ',' :',.. ,,'.., .. ..' i." ::', '.. ' ',.." ':. "', ;'< ,,: .' ,'. ,'>.'>.i\: ': " ,', .,',. ',. ' ',,', " , :,:'<5 " ..', """ >., .' ..'.," ,... '",,::;: ':. :, ,.." :....,', :': '.. ',' " '.... i,; , ,'" .' ,,' .' ..""i,' '" ,'" .", , ".> ': ,., "'.... :,,:: .:......" . , " . ...,:,>.." ,'::' .:' ".. " '.:.' , , , " .., .'.'".. ,. " .. '.,' ,,'..,::,' '."::' .' "... :, ~.., " , , :', '" "', , , , ..'.:': , :..:, " , .. ,..,' :,' ,"'.: . '.,.",',. " ,.,' '.."..' ....". ....: ..,., '.', . :'. ',' '. "", .' '" ." " ','.,' .: " " , ;: , .: :. ':"'" " : ',":. ".'. .:: ". ,., : , , , , .: : ' , r ? ~, 1~, I;; t L - ,..' ',: '.." ,. , .., .. . . ' , . ' ".. .. , , , :..' .', " . '.','. , fib ~ __ Li"d), .L '-'U I ( V')," e"f-E: C.;;, 7c7..c:/~' " '~a(~ /', '.,..,..,1 DAVID A. JOHNSTON A.I.A. 299 OLD BLYN HIGHWAV SEDUIM, WASHINGTON 98382 (. -(206) 683..5564 .~ ..~:~.\.\'~': I;-;) ~~~:~- j;;:"'-'" _.~." "~ (CO}' .:('" . ..:~ '"<'~2~ 1'--:1 -'~''''''..' . I' -:-" -I j- :., _ . _.' :1 <.P::' ,:"',.:.. . .;. ~2~~, g.i~I~~F~ c' "'-<..."- , ,-"-..., ,-- January 29. 1988 Sheriff Mel Mefford Jefferson County Sheriffs Department P.O. Box 1220 Port Townsend, Washington 98368 Re: Jailbreak attempt Jefferson County Jail Dear Sheriff Mefford Enclosures included herein will refresh your memory on my responses to the above problem in January.12..8L Obviously at this 1ate date Palmer Constructors, Inc. will do nothing as they always have done nothing. If you want to tackle this problem yourself it is not too difficult. If the frames were full of cement grout as they were required to be, access to the anchor straps would be almost impossible to find and considerable time would be required to get to them. Therefore I suggest the following: Rent a heavy power electric drill with a 1"01' I 1/S" steel drill bit from Johnson Rentals 01' some other place. ( Also Johnson knows the rental agency in Bremerton that rents a small concrete grout pump. Ask him to verify the drill bit size). Drill a single hole in the center of the top of each window frame at the enerior of the building. File the hole smooth of burrs and sharp edges. Paint the raw metal with a rust inhibiting color matching paint. ( this will prevent a rusting condition after the cement is installed. Rent a high pressure cement grout pump from the Bremerton Rental ( I don't think Johnson has one) rents for about $ 0(0 01' $50.00 per day. The size you want can be carried &round like a fruit tree sprayer. M.i.J: a slurrey type cement grout ( my guess about 50% portland cement and 50% nne sand, Check with the pump supplier on this.) Pump each frame completely full until it backs out the fill hole. Strike off the excess with a wood shingle and clelU1 up. The hydraulics of this thing may put considerable pressure on the mastic type joints and cause some cement bleeding. I'd just plan on cleaning it up afterward. It's my opinion that the hole on the outside can just be left exposed on the outside aflcrward and can be dobbed -with a close matching paint if you want to. That's it. This should give you about 2500 to 0(000 p.sl. hard brittle concrete in about 2S days. however it -will be hard to touch in 20( hours, I -would suggest that prisoners be kept out of the cell until the cement has 201' 3 days set. I hope this will get things back on track lU1d I wont be reading any more of this kind of activity in the future. ~s tt;uly. .iJ r/ .r- ~~ ~ 'cr ;Ping, Ltr, Palmer. Ltr Sheriff JlU1Uary 12.1987 {2f!...~.. ~~~- .JDHNSTDNrASSDCIATEsrARCHITECT. ,', ", '. ,:' , ,,: "". " , '..".... ."" '.. , ,,:' , . , .,.. ,::': ,", ", ., " ...", "', , , :'" .... ':,'. "... I, ',' ',', '" ' "..' :' <".. .. ",.. .,." ",,: ..~...c'!i".'.".., ;,;.;..,',.. ',,'..'..', ,,' , " ' ': ' " ',,: . ,'," ,', ',,' ,';:,;,;:: :.", ..:'..... ", ',: :' ",.. ,,' " , "', :,':"" ".. , ..' ., ",.." ,:' ',' :,'. ::: ",,".' " ',,'.. ",,', '" '," " ,: ", .' , ,.,' ',," ',.. ..... ..' .,' ,,' .,..,'",' ,'. ",' '.',. ,.',. , .' "'<,.' :',;' ','<'. ' .,'," ',',.. ,,' , " .. '.,'" . : , '. ',' ..'.' .. . ,", :,'.,.,'..'. ' ,. , , "',, ",:", ;", ..:".., .. " .' " , ',:, ....', , ,.':' , ,,' .. ': ,"',; '. ,: . : '...' '.' ... ,:" ,..", , , '.... i' .. '. ,: , III , '" .r~ " " ", '" ' 1;,'>>, " ,'.. " ,,". , ." , , , , ." " , , " , " ' ',,., ".', " ,,' " : .",,' '.',,' "c " " .' ',. ' , ' . .....:,' ,: :' " , " ,.', ,:',:,,: , ,".. ' " .. ',.' ...,:' :'..':.....: ?avrnent will be made onlv after a orocerl\7 comoleted invoice is re~eived. If the purcha;er fails to 'make. timely payment, the vendor mav invoice for a minimum of one dollar or one percent oer month on the amount overdue. Payment shall not be considered iate if a check or warrant is available or in the mail within forty days. Normally payment to vendors will be remitted by mail. The product purchased herein is subject to the approval of the purchaser. Rejection of the product resulting because of nonconformity to the terms and specifications of this proposal and contract will be at the risk and expense of the vendor. All invoices affecting this ~roposal and cont~act shall con~ain the applicable contract number. The vendor war~ants that the product supplied under this contract conforms to all Federal, State and local regulations and is fit for the purpose for which it is intended. The vendor warrants and recresents that the oroduct succlied under this contract is free and clear of all liens or encumbrances of any kind. Regardless of the F.O.B. point, the vendor agrees to bear all risks of loss, injury or destruction of the product, supplied under this contrac~, which occurs prior to delivery. Such loss, injury or destruction shall not release the vendor from any obligation herein. The vendor shall protect, indemnify and save the purchaser harmless from and against any damage, cost or liability for any injuries to persons or property arising from acts or omissions of the vendor, his employees, agents, or subcontractors, however cau~ed. The vendor agrees not to discriminate against any client, employee or applicant for employment or services because of race, creed, color, national origin, sex, marital status, age or the presence of any sensory, mental or physical handicap with regard to, but not limited to the following: employment upgrading; demotion or transfer; recruitment or recruitment advertising; lay-offs or te~mination: rates of pay o~ othe~ for~s of compensation; selection for training: rendition of service. It is further understood that anv vendor who is in violation of this clause or an acclicable Affirmative Action Program shall be barred forthwith from receiving awards of any contract to purchase from the County unless a satisfactory showing is made that discriminatory practices or noncompliance with applicable Affirmative ,Action Programs have terminated and that a recurrence of such acts is unlikely. In the event of a breach by the vendor of any of the provisions of this document, the purchaser reserves the right to cancel and terminate this contract forthwith upon giving oral or written notice to the vendor. The vendor shall be liable for damages 2 :~, 1 i i ~: , , '.', , '.. " .., , , ' ' , "': ", ',' " , " :, . ',: ' ':.:, :.' .. .'( ',: ",,',:,,,," "::..:" ': : .' :,: ': ".,.. " " ".. , " ',. , ..:, , ,'. .' ,.' , ,.,' .,',' .., ". ' " ., , '. ': " , :': .,' ':' '/', ,"., ' .., :" " ,': ::"", ...", :, ,:' " "', """, ,. , , ,': ,:' " ",:'" ".',,", ' ..-' .'" ,", " , ::, '.. ': .: : . ..,... ',':'..."" ", ',.', ,.", ,'. ,.' ':,,' " ": ," ", .. ,. '. '. '. . , : .,' "',,' , " , , ", ' , ',' '" ' '" , , ' '. .:' . ,;.' . ' ',", ...'.' " .' c"> '", . ,",",: ' , , " ., , ",', "," " , :', .c"" , ,:, ",,: " " ',',::' ..',. . ' ,...':: ... c.,' " '.': '. " "',.' , , , , , ,', ".. ., ,', :: , :.'.",:, ': ':.: '",' '..'.. "'.:, , ", ~~ , : " . . . ' . ,:,: c:-: ,. '"...", ,.,".\ "., " ," .,,',:. '> ,::' .', , '.,," ,. " ".' .': '," , , , '.. .i .. ,.'.,:: .' " :, ..,..,'.: "i" ".',.' '';, , , :.... ",:,,' ';:, .. ',','.' ;:'... ,'.. .. , ',', . .',' ," "i: ,': :'. ',' ' " , '" , < ,," ",,' ,," ,,' ,'; ,> .,." ". ",', .. '",'.', ; :' .... :' , " " ':: .. .' '.' ':, , " . :' :' i. ,;' ~ '.."',.. ,:' ,,' . ,..,: ',' '; " ", ..',." ..'.. ' " ". ' r '-: " ,', " , " " , " ..", " .., ", " .":::"'.... :', , . :' , , ,:', ':.., " " ';',.. ",,' " '." ' , ,,." ':'; .' r, ';'" "... ,'. '. , r:, ,".' ".'."'.,,, ,'.,',. .,", " , " ,'., . ,'...',,: . , ,., ..:; , '..: (i,. .: ' . " ';, , '.' " '"., , ", :' , .,: " , , , " , :. . ,,' U,S. DEPARTMENT OF AGRICULTURE PREAPPLlCATiON FOR FEDERAL ASSISTANCE FEDERAL ASSISTANCE 2, ~~~~:s ,NU.B'R 3. ~~~lfbA' APPLI- liON CATION b OATf iDENTI. 19 89' "1" ":r F1ER OMU Approval No. 80-ROI90 II, NUMBER .../A b_ DATE ASSIGNED r.lI, mUMII dill 1. TYPE XitPREAPPlICATlON ~bTION DAPPlICATlON ","" "PI'~ 0 NOTIFICATION OF INTENT (Opt.) ,=" b,,,) 0 REPORT OF FEOERAL ACTION ,. "". Blo..! 4. LEGAL APPLICANT/RECIPIENT 5. FEDERAL EMPLOYER IDENTIFICATION NO. 91 - 60013220 If I~' I~( , . Appllc.ant Name b. OrglfllUlIOn UrIIl : c. Street/P.O. 80. (I, C~ I. Stale If'rom ltd.",' ClJI"lc,,1 6. PRO- GRAM a, NUMBER b.TlTLE I I 1.1 I I I e, County g, ZIP Code: h, ConIICI P.,son ,Nfl.... of ttl.plwII,^"o.J 5: 7. TITLE AND DESCRIPTION OF APPLICANT'S PROJECT Courthouse Building E Improvements. Re-roof courthouse with slate tiles 15 original roofing material; reinforce roof attic struc ure. Clean, repair, repaint exterior masonery. Re- air and repaint or replace exterior window woodwork. E 1 z ~ 10. AREA OF PROJECT IMPACT fN~"'~J Qf~"'t~ rollll"t~ 5r/Jft~ lIr.) Port Townsend, Jefferson County, \;ashington State 8. TYPE OF APPLICANT/RECIPIENT A-State H-C:ommuntf)' Aclton Ago<1Cy B-Intent,'e I_Htllhef EducatION! In.\ltu\JQn C-Substale J_ln(h.n Tnbe Ooslnct K-Qther (5~ri/y) D-Cou", ,--c., F_SchooIOllt.tet G-5p9cia1 Purpose DI.tnct EIII" ~pplVlm~l~ Itlf" II] 9. TYPE OF ASSISTANCE A-all-te Grllnl 0-1nlUl'f'lC8 a_Supplemental GI.nt E-other C-Loan :::~~~ ~:J::rl., OlTI 12. TYPE OF APPLICATION A-New C-R8Vl1lOfl E_Augmenl.bon B-flenewal [)..ConllnuallOn 13, PROPOSED FUNDING . FEOERAL S 360 000 b, APPLICANT c. STATE 11. ESTIMATED NUM. BER OF PERSONS BENEFITING 18,000 14. CONGRESSIONAL DISTRICTS OF: 15. TYPE OF CHANGE (F/J' 12rp, 1M A-Increase Dotl.,. F-Qlher (Sprrify): B_Deer8ne Dollars C-lncre." 0ur.,1On O-Oocrease Our.hon E--car.c:ell.lion EIlIt,/Jpproprwlt {flU" liJ b, PROJECT .00 .. APPLICANT .00 Second .00 16, PROJECT START DATE Y~/J' ",/JllfA- d~y 1B .00 18, ESTIMATED DATE TO BE SUBMITTED TO I. TOTAL S~OOO .00 FEDERAL AGENCY ~ 20. FEDERAL AGENCY TO RECEIVE AEOUEST f,."""'''. ell)'. S'/Jlr, ZIP,'ad.1 U.S. Department of Agriculture District 22. ! THE ~ ~~~\I~~E~T &:: THAT ~ ! Second 17. PROJECT DURATION 4 :~;~; ~:r,;;" o:mJ 19. EXISTING FEDERAL lOENTIFICATlON NUMBER N/A d LOCAL .. OTHER YnI. "'011'11 dol' ,. 89 1 25 21, REMARKS ADDED Dyes 1tJNo in I~:':=~;:;~~~~~r:e~~a,: ~:~'~~~~~~B ~~~~~~~;B~:~r;a~ws:~ ~~~~r&uanIIQlnstruc\lC)na !V/J"" COflsct. lhe oocumenl I\8s beer! duly .\I1hof. IpOIIW ~~~~\I=~O~~~~~= 111 N/A .......f'lCe.ifthe..81.tance.. appl'O\led. '21 '" Office II R,,,,,,,,, .-... o o o o o o c, CATE SIGNED }....,'_II.' .. 23, S ~~~~~.YING S; SENTATIVE ., TYPED NAME ANO TITLE George C. Brown, Chairman b. SIGNATURE A~/J-L ((/13:"" oj YnI, _n't d4, ~ (fL' 1. 89 26. ORGANIZATIONAL UNIT 27. ADMINISTRATIVE OFFICE 25. APPLICA. TION RECEIVED 19 28, FEDERAL APPLICATION IDENTIFICATION 24. AGENCY NAME ! 5 29. ADDRESS I 31. ACTION TAKEN 32. ;: 0., AWAROED ~ 0 b, REJECTED 30. FEDERAL GRANT IDENTIFICATION 34, STARTING DATE 36, ENDING DATE 19 37, AEMARKS ADDED Yn>' "'Ollt. dQY Yn" I'UlIOUAI ." o c, RETURNEO FOR AMENDMENT mOd. OEFERREO ~ 0 e. WITHORAWN FUNDING . FEDERAL S .00 33. ACTION DATE ~ 19 b, APPLICANT .00 35, CONTACT FOR ADDITIONAL c. STATE .00 TION (N~",t Gild Itltpll""t ,If,"'/w') d LOCAL .00 e, OTHER .00 I. TOTAL I .00 . In talllf1ll'bo\I. .ellon. .ny comme"ta'~ IrQm cl.."nghouH. ....r. con.ldctlod, II .gency r.sponae.. Dull i,JnGctr pl'OYIS1OflI 01 P." 1, OMB Cltcul.r A.a5, n tin bIN" or II belnllmada 1. INFORMA. YtG, "'1>11'" lID, i-- 3B. FEDERAL AGENCY A~95 ACTION CY.. fiG,No b, FEDERAL AGENCY A.a~ OFFICIAL (NtI""Glld'fll,pllQlf,Nol 424.101 FORM AD.b21 (REVISED 6~78) PAGE I STANDARD FORM 4201 PAGE} (10-,,) I'rtscrib,'d by OM/I, Cirtu/Qr A-102 A." ~, t' '.. i : "', ,\ ": ,( " . .." -;.. '.. ,"..'.' ..', ,,' ..'" . .;e/ ~ \ ': '. '. " .. ): f 1 I ~ ' " .. .'::' , , ',: I 23 :, ,,~' ,,' .. I11III ,..,..,.".,. ;~}.: .' :r. I " " . .., "', '" ',"', ,'. , , .. ',. .,,' . '... ' '".".. .', ,>> '.'., ,',' .,.,. ."..'. " " '..,.,' " ",:' ,,' , :'", " "....':, ',,' U.S. DEPARTMENT OF AGRICULTURE PREAPPLlCATION FOR FEDERAL ASSISTANCE 01.18 NO. 8O-R0187 PART II (Check one) Yes No 1. Does this assistance request require State. local, regional or other priority rating? 2. Doe~ this assistance require State or focal advisory, educational or health clearance? 3. Doe,S this assistance request require Clearinghouse r,eview1 4. Do~s t,his assistan~e request require State, local, regional or other planning approval? 5. Is the proposed project covered by an approved comprehensive plan? 6. Wif/ the assistance reQuested serve a federal installation? 7. Will the assistance requested be on Fed'era! land or Installation? , B. Will the assistance requested have an effect on the environment? 9, Will the assistance reQuested cause the displacement 01 individuals, families, businesses, or farms? 10. Is there other related assistance lor this project p',eviotls,- pending, or anticipated? 11. Is the project in a designated flood hazard area? x X X .. .X X X X X X X X . PART III-PROJECT BUDGET FEDERAL CATALOG NUMBER (.) TYPE OF ASSISTANCE LOAN, GRANT"ETC. (b) TOTAL (e) FIRST BUDGET PERIOD BALANCE OF PROJECT Ie. '1 (c) ld) 1. 10,423 2. 3. 4. 5. 360,000 Loan v ...; " , . , 6. Total Federal Contribution $ $360,000 7. State Contribution 8. Applicant Contribution 9. Other Contributions 10. Totals $ 360,000 PART IV-PROGRAM NARRATIVE STATEMENT (Attach por inltruclion) ,; FORM AD-621 (REVISUD 6-78) PAOE l ,,',,<: i,,'", ,,' " ';'.' i.\ ,':.::" " ", ,:;".(::;:::: , ,';.' ,', ..', " '...'. ;, ,,' {;co,,"'>";,...,' :.'" '.:,: ',.. ,.' : "..': " ", '.' " , "" , ", ' ..,," ,: ,.,:, , ' .. ',.', "', ,: " , '. i' . i : ':. . ": '':, ',", ': ,... .. ,.,::'..'" " ',,': ',': : . ' ,," .,.." ',,' .. :" : ' ",.., , ,..' , .' ,:,': '.' " ,', ':, :: ':" . ,:'::.'" :': , " ,:,.' ,', .. :' :"::,:,,,:.' ",,:' ',' ,..",.,:....: ' " " , " :. :,' ,', '",', " ,. '.,",',", ' '. ';: ':' " ,,:' " " , .'.,' , , , " ." '".. " . : ", .,":' <<: ',: . ,', ' ::", , . ,,' " .. ..." '., . ',~ J '1 I II '., ' .':>: " ,,' ,: " ..' , '.< , ".",.,... " ',' i ". ' ',/ .' ,,' SE'R\lICE ~.'," ,,'. , REQUEST ',:-, ' '" ,", . ':, " " ...' .. .. " ", ....:.. '. r- . I , ,> I ',.. : ':, . ,pi I TOTAL ----, ..----. DATE - ..---...- "j TIME , 4-28il8 0'100 ,. , SERVICEMAN \. J. .l)~ SIGNATURE '" , "" : , .' I :' I; 1.' " ~\ I; ~" ", ~', .,...., '.-', ' " ::', ,: If' . '.,'... '. ,,' .,'."..'",.":'" '.. ..' ,'... ':,:,', ',:,,' ", . ;:'t;::,::: ...'" ..' " ,',' . <'c~'.'.: :,. .' h.,.,'.."':.,,, I:' :!f,"". ' ", III :,. .,,',', '," ,". . ", , ' , " ,;;' ,.,. ",. .",., I ~ :." , , ,,'" , '" "', " I: ,:, , ~ "" .... " ~~~;:', "':,."... , '. ...' . i: , . "': .'.','. ',. ...,'. " :,. ':' ,,'''.,' ," " :' . ': , I:. "",. J ." : , .',.. , : ", ' '... , ,', .:.....'"':,, .. " " < ','. .' ,',1,,'. , -,' , , :'.'" ,. " \ - ,- "" - " Z< <c:J3.~t2 03 TELEX.WJEi8~~~~ER SR# Q4\ot'rz. COMPANVNAME _ SOl'\.\ C-.cur-...\-cY CUSTOMERNUMBE~D &&7Z\ II CUSTOIJIERP.O. NUMBEH STREETp'O,.BCX Il2.0/ C61..\.R.-n~ u.:>.E )3LDG. JOOLOC'''ON 8SrYlT.- OLD SflelZli+'S ere. IIP'AN3S0~R9rGO CITY\:,\. ~1.Jjt-!;.sI:;ND TSTATE Wf'>. -rZlP98s0g REQUES~A'k.~ s. 1.ct..A1Nc. A. AECElIJl:.ODA1E4(12.{tJSME 0'9\4- BY'lA1...5A IAPPOINbM,rO~lEg.S~Ot1..,- S/I/S~'Mf. f'rt1\ /HEPAlHSEAYICE 0 MAC 1:8 I~ r& . ~':'~~"'_" ..u., '''~I'1 ..., 1(4') D6L IVE12. 3 fEACH f)IS9LAi L-,( - 16 (JHo\~eS !)6Lt\!E:(2.. 2 ~ AC.M LI'--Z I:)w-:'NG'>., 1l...~Tr->(...L. A'6\J\JG. 5Pl-$)N.E-S u..((C IZ ,('.1.<-. OLD CABLE(sJ A~ m\ACH (S '?OS:; \ 6 LF- , I No ClL.'$ S~E:g.IF-F 's / ~E~ ?\'-<:>sC: cv;r"C-5. \ ",eeA. p~G-ttP<vY'- As NEG{)EO (see 'v=l"',r\ '. ',.. " '~-~'::/'-T~E" ~~~~EES~C6E~?NREKD ~NB'O\i'ft'~;-;; d 4-~Z8 -88 .. . - . '.. i) DEL\'-lG(<.ED St>n'<\I=o (2:)' ~NCGLLe-o ?ef- WWtrmE.(tS \2.SGll.l<-'S,. t3) ~PI or,"" I.'r,_ <=?', ,,- ,~k. 'i"t-\<'. 7<:; nn ~r./>' -, r'Z ,>,.., \2 A.' '7T\Lr, ~"'t 'd."..... ~Lf\ T8 (1,. eA>--'> -nf,-,,^INAL. ANC~ f\ll eMU::. \~'NAll>D ~,. W I -k-A -(Y\",c> .<f~. ^ r..LL LL "'Ala" a.';;"-.ll"' (.2,C,\LE-L (''''''^^. -r<.AM"'~tzf\' (.>1t-P:rS 1'I=(3)TI~tz<A1f.13q ~' 1.\1\,A.~"" Ct..AL<"'. I~ -- - A ~^ 8';\. IRc> 'lC, '\',L<ST.w 01" ,furlT ~r? \C\.,.\k:'d,,',~d,A..k<l0<fS.IRI-'l'5 ?k:,w.~e{J \"C~~\.35 -"'*\'3"'1 r..<; L-)( (SDL. ~"IZ.:rr'" --- '~L:',(,-2. YEsTG1'J flrLL r-t=.A(('<.\A?-{ Ie{ Cl.lJPING- 0:I:\). ~"'c:-rco N. T-O,I::-. '... ." :l;;:'.,>::TCC, P_A'~,",: #,:<::':'-': ..."c.;;..,......, ;ap.' \i' L"- IS .....'SPLAN 'i'%N~ -... ;,D,~!E; :E_jy,_~:~( c:o'of' ,~'~~~~:~,~,s} Z2 IOIC'lZ - 20 I '3 -z:- 5 lCO' 4..2.8 50753 T7C. 1.3 .\.1, 'S7G. 3 I 4:z" 5~7(;3 S Ie;. 2. '7 4-18 SO,52 S 1&0 D.5 ~.",.u"'\I"'\E:\~.;;.. A. CIh"1 """'-'l'o-""") '3<ZJ> fLOol2- cou(2."t f"IZ(;~11tC 42 A '~I"E. """'0. JA(.\:.".. :lit 'PR. \l1t.ML ;:rp<c~-l'E.I CI'I6'-1:. I ----n'~-----~,TIM~ --,---- DATE.,' . ~-8B ICoIS ':. I I ~I~~l~~~~ X~~4 TOTAL'" '1.Co CALL SERVice CHAROE CUSTOMeR INFORMATION COP\' T004 7/86 ACCEPTED SUBJECT TO TERMS AND CONDITIONS SET fonTH ON THE REVERSE SIDE HEREOF UNLESS OTHE:RWISE PROVIDED FOR IN A WRITTEN AGREEMENT DETW[EN urec {OR A SUBSIDIARY 011 AFFILIATE OF ureCI AND CUSTOMER. ~",*,l--.;i' ".. ' ..".. "...,. . '.:,: .,'., .."", .,. '.' . "I',;,'~ .. i', " : , ' " " . >:" " - .' .:', .:' .. ... .", ", .':, AS , , ", ',:. .. , " , .: '~'-"':;:',,- "," }-",'''-:,;,;':' ,;,;v"'.:,,,-.,, ,(::/'::", ),,: .':':,;--':>:::i < -, .-:," ~ :', ' :t~:, ::, ,':' "-,:,,',,.; ,,;,1...: .:,-,....'", ,';;.';';-' ".;:J':;:ii~~~~:T - ",' :~ ;'- COM;PY _E C . @o\-l.-';"'-C;~\A... ~U STRE '/ CITY:-lfTATE TIME 6Y , ',. ':'i: E/8?)70~ CU~'- JOB LOCATION , ---~-FIP REQUESTED BY I APPOINTMENT DATE , AECEIVED lJME ::' i i~ ,{, I l-:JuJJ ~ !y 'Jt : {' -r t ~:>,::::<.'" ,: .'.-:::::":','/,'::,:"";,::,,,'N; ,;:-\/:::;:;,,:'~::'>'" . ,;j')'"':-~i'.:; .. .;;~:G:/,?+,~{ ~~~M:ES~C 6E~?NAEKD ~~'~'~ I(~: Xt:'LT ,\, _: ()CJ (7.. n ~ . '" , . ~O~,... JI",-...PL_p .,.<:",'"' , , ,,' fh f TOTAL DATE -"'TIME7"_~--- . ... . - .. . ~~~l~5~~N \k... k,~W~ / CUSTOMeR INFORMATION COPY I. I ...." '" ',.. ,"', ',.,' ".', ,', '" :' .. ,.., , " ,'..., ' , /, '. ,', .', '". ",,' , ,'i. ,',," .",...,', , , L: . ",'.," ,,' ',:', ....: " ,:, I \~:~\~~i: ::,. f: j:',' I" I,' " ", . ,', \ "". :," ':.,' , L,< , I I,-t . - ... ': ':.<:', ~'aTY: I ,DATe'. '1~-T1ME I CUSTOMER SIGNATURE . .,'.. " '..",',' ..,. ',' '., , , '..' :' ' " ',' , . .. ': . ,,:':. '" ',:' t.' '..,. "., ..','> :.'," ,,',' ....' ...." , ,'.." ",' ",,': ',.' .".',. .' , : " , ,.' TELEX COMPUTER TELEX'PRODUCTS, INC. SR-# 7f('i>99 2... II CUS10MER P.O, NUMBER 'II PHONE NUMBER I REPAIR SERVICE 0 o .:. . ~DATE: ~M~:! :C"OD!=: ~<~:?"~,~5_:;': 17/.~ ! ,.~" 'lPr I ."- Iti7_~ "'"71 7'-11-5 F TOTAL .. i!... 0 72'^- DATE ':'r TIME PER CALL SERVICE OHARGr: A I lJ ,Ufn cK "/.1,_ .... '.. ' " .. .. (IiI ( ACCCPTl:D SLlOJECT TO TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE HEREOF UNLESS OTHERWISE PROVIDED FOR IN A WR'TTEr~ AGREEMCNT OETWEE:N UTCC (OR A SUBSIDIARY OR AFrlLIATE OF UTCCI AND CUSTOMER. " , -~l~: , : "':'::':",:,' " " ,,' :", '. . ,...,' , " .: ,'., .' ...' ':,. .. :, , i' , '.1: ---;- " ", ':. , ,',!, , ". :',,:', ..:, , " ' , ".:':' , ., : " : ,. ":0;,::; '~" . /7. 'n,._.~~ O'-P_,d.4:e..-r:- ?4/...... ~,..,..~ ~~~ "n'-~CJ,'~~ ~,:, ..a.-~~"",;-.~ e.G~ II.~._~~ u:,......' cd-~,,~,~~~~..u:! .~~-~,. ,._.,.~~~_.~~,-4~..a, ..__._...__.,.~~.~...,.."acv-~" ,----_..._----_._--...~..., ..' ,..~~",-;)~ ......c_....,:_._~--~2A'.~:>:.:~.. .4:?-U~ .. .--:- ,.. ,~" /Zu;uu.Lc:,.,.....".., --':----~..,.'-rc-/a~vk~." :.:...,~,..._.._...,.__../..._...,....._...., ......,. '.,0..,.., ..,', '....,"..' , , . : " ,:.,.', i . " .: " ..', , '..':., ",;,>'; , ,'..,', ','.,' ,'.,i" ' ,. ,.'. , -- n'nmnll J onLIIII r _lIUI..t'U'Il.VIII~ POBox 503. Wenalchee. WA 98801 (509) e8~-'542 4 PROGRAM CHANGE RECUEST Company: 9JfMO~ (lHt'A-SY ~/.&o Wth.~ Reference No.: Deper tmen t; Date ReQuested: (' A' - 9 -,f'J> 7- /,f'-$'? ~SR'P System: De.te Needed: Oeser ibe the reQuested changes below. -i2v ~ ~~ -:z:;., ~ ~- '777,L~ & ~L;j<-- W-~.J '.J}~vv f/J~~:,!-- J ~ ~ ;0 _!P~~'/ -<h.1:iY 6?~ ;;L~ -t-7fJh d~ ~ ~~ ~ " .L,. ~.J '..--.'.J" , Requested by: ~ ~~ DEPARTMENT HEAD SIgnature: Del. Signed: Approved by: ;;;6 M BRESZ rJu-t;; ~ DEPT PUBLIC WORKS Dale Signed: 7..../?-J>f . Signature Sampleo Enclo.ed? WN Diskettes Enclosed? Y N E.timete Reque.led? ~ ~ Y N " .'f ~, r " \ .."'" ','" ,.' '. ' " " :', ", :'...,..' ,<( ." '". :'".,". ,"...., , "..'.' , , .: ."',. .... "... ' i..,., .. "':, ,', ",' ",,, ' ',:,... " " " "". . ,: ,> "',' " ',.', .: ' ":..', ',,':', .. , ..,' '. '.... ' , . :.': ,..' :" , , .' .. '..... ' , ,,', :',,: ' ". ',;' , " :' .", '. ",. "".'., , "....,.' .' .. , ' " " , ',. .".. , :'," ,,' , '::' , ':.... ',,' " . '.' ':',: " , , .:, .. " ,': " :.. ',., ",' ,,' " ", ,,", ," ",,: .. .:\',.. '.",..'::....".::,< , , . ,'...,,' "..: ..:,:" '.: '. '.' .. .., '..' :" , " ',,' .. ' , :'...'. , ..' '.. " " .. ' ,., '", " ',: . ' , ' > " . , ,:, " . ':,.., ,:.., '...' .'..,.,. ,"'. ., ". ., ;: ',:'" ',' ,:' . .. : 'iI, "', ': ..,. .., ~ p- ,", ,:', " . " ,"., '.', ,,'..,,'.. ",:'," ..', " ,.' '.,. ",', ',,' '", '"",.".."". ", .,.,.'" .. '.' ..' . . " , , 1. l II POBox 503, Wenatchee, WA 98807 flrd(>"'W~r ~ ,;'p.i,rH/f: (509) 8B4-1542 ~~~I'I~_U.~'n..I~?'.'~_". '" """ "' __."" ...._ .,," .___ m. bined distr ibut ion data files for the assessor and treasurer. The current system instal led at Jefferson County uses separate distribution files for the assessor and treasurer. The new system is almost completely driven by user defined codes exter ior to the programs. This means that county personnel can more easily add and delete districts and tax codes. ~ 6. Three separate batch subsystems exis.t for posting the following: B. tax, and assessment payments (including refunds and NSF checks) b. cancel lations and supplements c. segregations AI I three systems are designed so different operators can enter data concurrently from either cash registers or computer terminals. The batches of transactions can be edited and posted e i the r 5 e par ate I y 0 r a sac omb j n e d bat c h . 7. A new "Outstanding Balance Transfer" sUbsystem has been added. This subsystem can be used to correct and/or close out out- standing balances by fund (e.g.. state school) 8. IDDU specifications for all of the data files will be provided so you can generate your own queries and reports by using Query/36. Because of the integration with the assessor's programs, a siQnifi- cant effort will be required in designing the interface to the existing assessor's system. In addition. conversion programs will have to be written and tested to translate your existing data to the new 1i Ie formats. The fund account ing system has been improved in the following ways: 1. The Data Fi Ie Uti I ity inquiries I isted below have been replaced by interactive programs. The new inquiries provide editing, decoding of computer codes and are more flexible for accessing information: a. bond principal and interest inqUiry b. fund name code inquiry c. fund code inquiry d. rem i t tan c e sin qui r y e . rev e n u e ma s t e r f i lei n qui r y f. revenue descriptions file Inquiry g. revenue detailed transactions file inquiry h. transfers inqui ry i. warrant principal and interest inquiry i. warrants outstanding inquiry k. bUdget account codes InqUiry - 2 - , \ " ,'..' ,- '" ,.. ..,'., ",.., -:' .. . ''-..,',,. .. ,',., :.... :":: <" ':' . ,'.,'...' '., , .,'.., ,,' ,.,". ..,,"...., ',', '."" h"" ',' '.. '>':..'., , ., " " '., ',,' " , " ., ,,'" ":,' ", ,'." ;'\'::",""t;:" :" .'..', ';-" ' " ,,' .':, ,.,. " " ',:' , ...' i, , " :.' ..' ,: ',' ':, '".. , ,...,., ""..., "....,' ..'.",:: ,":,', . ". ,,:: ..,'. " ", ".'..' .",;, . ".,., .." ...':. , ,.":,."", ,', '.':':,," ,',' '. " ,..,. . ...,..' ...,"'. ': . ,',,', .', ',' ''''.. "":', c." 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I'" ~~~ ~ ,f:oo,c...p..J:o.J:"'+,,-WNWNWW i::l \O\O\O\D\D\O.....,CONI.ON.t:'- '" wwwwWW\J1\DCOCX:lNJ:o i;~ - ooooooww:"':""~;"" .... ...._____ow.....J:o+"-w \t ~- s... ~ \.~ !:l~ 0 '" I:> ~ .., ~ " >< ~ ~\ S I., ~ I:> , " " V ~ .., ~ '" en :>' " ":">, .. ~;r ":; L }" ~. ~. t-" ~. \ ~, l, , ~; j ~., ~~ 1l.\' ~ .', : ~;M , " ,'...",. ,': "',,,' , '., , ": ., ' , , , . :', ~ ~- ,.; . ' , ',', , ,: , ,," .. , ': '. '" ',:' , ", , ','. BUSINESS RECORDS CORPORATION HARDWARE MAINTENANCE AGREEMENT : :' .',' '. ,."".,,.' .... " '...i ' ".,: .:,",..'. '" '...,.": .'."," .'. '.. ,. .,.'" ',:'.,...", ',' ...' :: ;, .\" ,"" ,'.,..' ,.'".> .,,' , " , ,.:. " i" ,," ";' """,,: ,,'.', .;'. ...,.. '....,'>. .',' ',' :", ,',.,'.'..'.' ":, ., .. : '..',. : ,: ", ': " ....,.. .. : .' , .:' . .', ":.' .. " .:" .', ,: '", " " : , ".'.,' "..',',.. '.'.. ','> ." , :::: ,,',. '.' ',', .' ,.,",. .,',,", .'.." " ' " '. " ..'", '.. :',',: .' ": ,:'.. ; ,..." ", " ':"" ..' ".,':., ,,', ,:.::, '", ' ," .' :", :-: "."".' '.'.'.' ,:.' ,',..' '..,'.,',' '"." ....",'.', " . :,..'; '" ,': ":, ' , , " , ','.', :' ':.:'", ....', ' , ":".,: , ',' , ,:' " " " ,:' "". , "', " ,,-,: ,: ,."',,,./ ' " .,..,: ;': '.' : ,,:;'., ,,' ';, , :.. : . "".:'. '. "",,:',..., THIS HARDWARE MAINTENANCE AGREEMENT (the "Agreement") is made and entered into this-----1L day of Dpc:pmhpr 19-.Ba- b,Y and between Business Records Corporation, a Texas corporation having a prrncipal place 01 business al 7800 Slemmons Freeway, Suile 640: Dallas, Texas 7S247 ("BRC"). and Jefferson County ,a ,having a principal prace of business at 1820 Jefferson St. Port Townsend, WA 98368 ("Customer"), In consideration of the mutual covenants herein contained, the panles hereby agree as follows: 1. Term and TermlnalJon. This Agreement shall become effective with regard to the computer equipment, hardware, perpherial equipmenl and other products described in Exhibit A attached herelo (the"Products") 0"_ --.In..nun ry 1 , 19--8.9.., (the "Commencement Date"), and shall cO~lInue annually Irom the Commencement Date, or this Agreement m~y be te~mmated by t~e ~anies as foll~ws: (i) immediately upon delivery of written n~lIce by BRC o! Its mlent 10 termmate, ,il C~stomer shall assign, delegate ~~~:~~~~,e (::,a~~f~t~~~ ~~~~~~,e~~a~r paa~/~~:fv~'r~h~r~e~b~~~i~~nt~ ut~~e~t~~~ party that Ihe other party is in breach of this Agreement and such breach ~~ntmue~ unremedie.d lor forty-fl~e (45) d,ays after the delivery of the notice; or (Ill) by enher party, If a party delivers wntten notice to the other party that an assignment has been made 01 the business of the olher party for the benefit of creditors. or a receiver, trustee in bankruptcy or similar oHicer shan be appointed to take charge of the property of the other party, or the other party is adjudged a bankrupt, p.ro~'ided such assignment. appointment or judgment is not remedied or reversed wllhm twenty (20) days of delrvery of the notice. 2, !n!P.ccllon. BRC shall have the right to inspect any Producls before ~RC's obligations under this Agreement with respect 10 any PrOducts shall begin, if such Products are not covered by an agreement that is in force. BRC may perform such adjustments and repairs as i,l deems reasonable and necessary 10 place any Products in good working condllion, If BRC determines in its sole discretion, that any Product cannot be placed in good working condition then BRC may exclude such Products from this Agreement. Customer shall pay BRC for performing such inspection services and for all labor, materials and adjustments required to place the Products in good working condilion, at BRC's then applicable rates for such services and materials. 3. Price and PM'menl. In consideration for Ihis Agreement, Customer shall pay BRC the sums described below: A. An amount equal to the aggregate of the initial maintenance lees on the Products as sel fonh in Exhibit A. :: Any lees or expenses invoiced to Customer by BRC pursuant to Section C. If Customer selects any of the options described in Exhibit B as an addilional service to be performed by BRC under tn,s Agreement, then fc~~t~~:~ri~~~1 i~a~~~i~i:~d,ltiOnal sum equal to the aggregate 01 the option ~~cjse~~~aiief.O~e~U~iri~ug~ti~end:,r~; ~~:~r ~~~~~i~~~u~~n~~h~~3~~~~~~:~~ thai BRC must pay as a result 01 its performance of this ^greemenl. E, ,The payments described in paragraphs 3.A through 3.0 shall be inVOIced to Customer and shall be due within twenty (20) days of the date such Invoice is delivered, IIBRC shall not receive a paymem Irom Customer by the date such payment Is duc, then Customer shall pay BRC Interest on " ": " .. . :." i' ,,', suc~. overdue payment al the. highest level 01 interest allowed by law. In addlllon, Customer agrees to mdemnity and hold BRC harmless lor all costs involved in collecting overdue payments from Customer, 4. ResPDnslbllllies 01 BRC. A, Subject to the pr~vislons of paragraphs 6 and e, BRC shall maintain all Products covered by thIS Agreement in good working condition. II Customer shall elecl to ship the Products to BRC then Customer shall pay aU costs 01 ~uch ~hipmenllo and from ~he BRC maintenance facility designated by BRC, including any expense for Insurance, and shaH bear aJI fisk of loss 01 or damage to the Products during such shipment. It Customer chooses 10 have BRC maintain the Products at Cuslomer's facilities, then Customer shall notify BRC 01 it~ re~uest during BRC's normal working hours by telephone or wrinen com~umcallon ~~d C,ustom.er shall pay the associated travel expenses deSCribed In Exhlbll C II applicable herelo. Notwithstanding the 'oregoing, ~n emp.'oyee or agent 01 BRC .shall make one on-site preventive maintenance In~pectlon 01 t~e Products durmg each 12-monlh periOd while this Agreement is In e~ect. without charge, lor the purpose 01 inspecting Ihe Products and providing routine maintenance 01 the Products ilthe PrOduct is serviced on sile. as part 0,1 the contract. ".t,he Product is depot repaIr, the preventive maintenance IS done at BRC faCility. B, Subject 10 the pr~visj.ons of parag~aphs 6 and e, BRC shall supply all parts necessary to marntaln Products In good working condition free 01 charge, AU parts.supplied by BRC shall be either new standard part~ or parts 01 reasonable qualrty, and shall be substituted and exchanged for the old parts which shan become the property 01 BRC. 5. Responsibilities 01 Customer, A. Customer shall provide BRC fuU access to the Products to perform any maintenance services required during the term of this Agreement. B, If maintenance is performed at Customer's facilities Customer shall ~rovide B~C :-vith adeq~ate working space incruding, but not limited to, heat, I,ght: ventdatton, electnc Current and outiefs, and adequate storage space, if requited by BRC, for spare pans for Products. Such working space and storage spac~ shall be within a reasonable distance from the Products, and shall be proVided to BRC by Customer at no charge, C. II BRC so requests, Customer shall record, In reasonable delail operating information .relati~g to Products, Such records shall be adeqUal~ ~alfu~c~iO~~~ operating history of Products, including any history of 6, EI~lu.ded Services, This ~greement does not require BRC to repair or replace (I) ribbons or other supplies which need repair or replacement as a result of normal wear and tear, (il) Products which have been repaired, altered or I~~nsported by persons other than those expressly approved in writing by BRC, (III) Produc~s from which the serial numbers have been removed, defaced or chang~d, (IV) Products damaged as a resulr 01 accident, disaster, theft, vandalism, neglect, abuse, use of any PrOduct for a purpose other than the purpose for which it is designed or use not in accordance wilh instructions furnishe.d by BRC" (v) P~oducts ~hiCh have been subjected to physical, mechamcal or electrical deSIgn alteration or any conversion by persons other than tho:;e expre:;:;!,' apprc'.'cd In writing b>' BRC, (vi) Products uscd c,' <lny person other than Customer's employees or persons under Customer's direct supe.rvision, or ~vjj). Equipment, that in BRC's reasonable opinion can not be repaired to a maintainable Condllton. 7, JlllC~lm!r. BRC DISCLAIMS ALL WARRANTiES WHETHER EXPRESS OR IMPLIED WITH REGARD TO ANY GOODS OR SERVICES PRDVIOEO BY BRC PURSUANT TO THIS AGREEMENT, INCLUDING ALL WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, e. ,CustDme~'s Remedies, II BRC shall breach thIs Agreement In any ma~ner, Cuslomer s exclUSive rfl~edy shall be the further adjustment, repaIr or mamtenance of lhe Products until the Products are In good working conditIon, Customer acknowledges that it has sole control over the Products Accordingly, BRC s,hall nol be Iiabl.e to Customer for damages In any way related to or connected wnh r~sults oblalned from or otherwise contributed to by the Products: BRC's liability lor any, losses or damages 01 any nafure except 'or personal inJury, whether direct, indlrecl or Incidental, arising Irom Its performance ....' :,,:':, " .., , '...,.... '," .,', ',' ,'.. J I 'I ! ,..', ;.;',,'... .:' "'.:' .. " I>>"'~>-"""~" e" " , " : " "s:, " " :' .." , , ..... . ' . ' " .' :,~"" ,', ':.""., ',:" ' ", ,', ' :.,', ,: ,:' '::,:' .' . , ' ,".",' ,". " ,,' ", ,: "..,.,:...'.'< '.'".,,' , .~~ :'" '.' ,:: '., .., .:',.. ,';,',., '.', , , :: ExhIbit A PRODUCTS ~ * DEPOT REPAIR Optech IIIP No. of Units Serial ~ Location Initial Maintenance Fee 5 $ 1,200.00 * Cost for repair of all above equipment at BRC-Addison facility. If on-site service is requested, customer will be billed for all travel related expenses. Jefferson County Board of Elections 1820 Jefferson St. Port Tow,lsend, 1M 98368 ,Janua ry I, 1989 to December 31, 1989 exhibit B OPTIONS OPTION A: ELECTIONSTANOBYSERVICE-$ 751l, rl,y plll< tr,vpl rpl,tpn'pxppn<p< Definition: On.Call Service to cover election tabulation, Specifications. including approximate dates for the above service. must be provided in writing to BRC at the time of contract initiation. This amount would be billed at the time of usuage, ..( ,,': ': ,:,:' .. '. ',,:',' , ",':'" ,',.: ...' " , " , " : "::: ;, ti '~' '.' "", , .. ",; " .'...'.'~..'.'..:. ,.... " ;', "" " :' :: " ",,' ::'.. ': " , " .,,' ':" '.. " , ',',' :,...: ' '. ".... ': :", ..:: ' " ':',: ,,' :, ,:>: ,,' " ""', ,,>:: ':, , ":' '" ' . :,.:' ,":.' .. '", , ',:, ' :' ',"; '.'/ ' ':, ",. , ',,' ,,', ..",: :.':",..'.. , " ,.' , " ',', ", " .',' ,." ',., .:" .. '. ,:: .... " Y"" ,." " .. ," ,'.. :" :.', '" , .. ' ':' : ':', ". ,> ' , ' '. ," , . : .. ' , ': ,', " " ~ ' ,',', ,'" , " -' , .'~ " '.. ",' " .' " "" , ", ';: : ' ,': ,," , "," .. ',-" , " .,' '. ',: ' ::'. . '.,. " '.. ..:' '... : :,' , " ,', " ".',' .," ,'."",,'... ,,>',',',:'. ',....'.:..' -- , :..,: , ,... >, ," .." '.. " ' i' : :,'."', .. :',: ',:' '" ,,': ' " ,::.. ," :. ' , "" '. ':.", '., , ,,', ," , , ,", '. .',..', .':,,' '. ',. ,,'.. , ", ",', .".' ':'; , , ,', '.., .'.. " , ,.' ,: ,.., .': ' ".' " ,,' , '."" '" ,',. .', ,'" ':' ','",:' ','; " , ""." '. " , ," ,', ".,:,,':, '.": ..' ':," ':..',:, ;' " ' , ,": ,:', :' ':" " :" " " " :' .:'.-': ,:.',' :' " ,',: ':",..,' .' ',. " , . ',., .: ' ': "{" , .., ',: " : ,: '..: . , : ':',. ',',., ',:, " , ," , , -- Exhlbll A PRODUCTS ~ Optech llIP No. 01 Units ~ Inhial Maintenance Fee Serial ~ 5 @ 240. ea. $ 1,200.00 · Cost for repair of all above equiruent at BRC-A&Hson facility. If on-site service is requested, custcxrer will be billed for all travel related expenses. Jefferson Coonty Coonty Auditor 1820 Jefferson Street Port T<>mserd WA 98368 O:tober, 1. 1988 to Septenber 30, 1989 Exhlbll B OPTION A: OPTIONS ELECTION STANDBY SERVICE - $ 750 a day plus travel related expenses Definition: On-Call Service 10 cover election tabulation. Specifications, Including approximate dates lor lI1e above service, must be provided In writing to BRC at the time 01 contract Initiation. This amount would be billed at the time 01 usuage. '~ \ i l .' .' ! l-. ..~~ ,,'..' ": :-:,' ,::'<; ':', "" .., ":', .,,'. " . ',',:, " , '.:, ", ','" . ,,' , "..,.' ':, ,', : ''.::' " , , ,,' " ",'" " .. ": . :' , " :" :c. , , ,,:'," , ,::', " , " ,:, , , ", "\ ': . , ~i ," !;- . 'i .~ '~. "4" ~' ( l!<: ;u,: ~w: if r..~i"f;' .,1... '. ~', , , J,... .. ."(j"':t,.,, ,,,,C.-,,,..,'>".'P,' ;.'_"'. ""_;o_,~,:~i_~~_:_--~~,,';'j"'Y~d'~'_=~;-~"~~' " ,;: --:';':<'-:::<:~'-;/::;:'-<"':":> ....,;.;-'-:':::::}:"",-:/.,.. :~.-:, : ,,:,'\ " \('~~:t:~,:,~;,::;S;~:G'2~~i:;:;:.;;.:.;.;:2:J.;........,.ll_.t=!!\U-- ~ L_.... -- -- ~- ....- -- ":e:"--i.-'-,,",',, "';-;~:,,:;.'):' {,;' -- -:i .1 I EIhlbll C TRAVEL CHARGES The following additional cllarges shall apply n Products are serviced at Customer's facility and those Products are not serviced on s~e as part of the Maintenance Ageemenl. ~; '( ~, ~M ~ , I ~ f j 1 ~ i' .., ' " '. '..:: .,", ,. .. .., ,..:' ""', ,. ',.",."..,' ."',:' .. . " ',.. ' , '~ c/' ~ .c?c;?, "7' j, ,:?~; ~.' ~' ~-4'/ ~.....:c ~ a ~~~~ ~~~ ~ TOLLS HARK CONSTRUCTION AND CUSTOM WOODWORK 1132 VAN TROJEN ROAD CHIMACUM, WA 98325 (206) 732-4080 ~-;;r~~ June 13, 198B Jefferson County Department of Public Works Jefferson County Courthouse Port Townsend, WA 9B368 Proposal The following description details repairs to the Jefferson County jail facility. Scope of work: 10 windows. 1. Window frame grouting: as per instructions from David Johnston. Pump hollow window frames full of cement grout. The cost of this work is $3680.00 plus tax. 2. Caulking repair: remove old caulk and re-caulk grouted windows. Caulking material is Res-crete R.D. 881, Type 1, grade C. (See attached spec. sheet.) The cost of this repair is $2012.50 plus tax. 3. Wall patching: patching of walls in cell blocks D and F as pers instructions. The cost of this work is $839.50 plus tax. This work can be completed within 30 days of acceptance. It is the intention of Tollshark Construction to pay prevailing wages on this job. BY: ~7aa~____ Richard F. Tolle~son, Owner This bid may be withdrawn if not accepted within 30 days. ACCEPTANCE: , ' , ", ..'. ,:' . ". " ',., '..'...,',: "., '.,. ... , ", .': ..', " '",:' "....,.,..'..'.. . '.', ..'. ,',,' '" " ", , , '..,'.. , .., :' ....:., ,..:' . .',.'... " ....:, " " " " ,', ", ''', .. '. ':' :""..., , ' ".".,....' ..: : ,.. .. .. '.. , , .. " ' "\,' , : ".....:.' .',. "..' ,:.: ',... ,.' " , '., ". .', , '" ',' ",', ": .", ...., :..',. :' ',,' '.:... '... .... ':. ' ..' '..::',, ,.'. .:, .'...... ' ".'.',...'.' ", .'.< :." , " ;\ "'.'.',':.,, .,.', "'.. : '., ....', " . . " :' , "'':-'" :.. . ,.... ',., ..' , '....' " ' ,', "":"",. ',,:", , :. ..;,,'.", " ','....:'. ',' '... ': , ,:. '/' .', '.', , :, .',. ..;., ..,,:. , , '..", .........', "..':..., " . ' "..', . ,,'..',.',' "'," ", '. ,': ,>'<.. .',.,:.:: ". i ',' " ' '", ":" :', '.. ,,' :": ",."',:,,. . ,"., ,'., ,,'" ,', .',' " , f, ;, ,.,. ,'",',','.,. ' ."..,.. "< ,".... ' "". ,.,' ;;;' ~,;, ',:; ;>:;: ." ...' \,.. , , , , .", ' ,:, '..',..' . ". ':... ", ,... ' " , RES-CRETE R.C. 881 EPOXY PASTE (Type I, Grade C) 1. PRODUCT NAME RES-CRETE R.C. 881 A two-component epoxy for bonding and patching on overhead or vertical surfaces. 2. MANUFACTURER PACIFIC RESIN FLOOR PRODUCTS,INC, 17601 Sampson Lane Huntington Beach, CA 92647 714/841-7100 3. PRODUCT DESCRIPTION Composition: Epoxyresin base with amido-aminetype hardener. Basic Uses: Designed for patching concrete on over- head and vertical walls without sagging. RES-CRETE R.C.-881 can also be used for grouting anchor bolts and dowels Into concrete, setting tile, blocks, etc, Color: Concrete Grey Sizes: Packaged in 1 gallon kits and full 10 gallon kits. Standards: A,S,T.M. C881 Type I, Grade 3. 4,' TECHNICAL DATA Consistency Potflfe Tensile strength Compressive strength Mixing ratio Bond strength Curetlme Shore D hardness Thixotropic paste 45 minutes at 77'F 2,218 P.S.1. in 24 hours 7,400 P.S.1. in 7 days 1 to 1 by volume 2,000 P.S.1. in 7 days 48 hours at n'F 90 5. INSTALLATION All surtaces to be bonded to must be free of dirt and oil. When applying RES-CRETE R.C. 881 there should be no standing water which would prevent the epoxy from being received by the concrete. RES-CRETE R.C. 881 should be applied by troweling. 6. AVAILABILITY AND COST RES-CRETE R.C. 881 is supplied through building material distributors. Major contractors are supplied direcUyfrom PACIFIC RESIN FLOOR PRODUCTS,INC. Prices vary with quantity and packaging.Ouotations are made on request. 7. PRODUCT WARRANTY All products proven to be defective in manufacturing will be replaced at no charge. Since the use of lhese products is beyond our control we cannot assume any risk or liability for results oblained, nor can we accept damages in excess of the purchase price of these products. 8. MAINTENANCE If RES-CRETE R,C,881 is damaged, the surface may be ground and recoated with RES-CRETE R.C. 881. 9, TECHNICAL SERVICES Technical assistance can be obtained by contacting: PACiFIC RESIN FLOOR PRODUCTS, INC, 17601 Sampson Lane Huntington Beach, CA 92647 714/841-7100 17601 Sampson Lane. Huntington Beach, CA 92647 . (714) 841.7100 . ' .".,. .'. , " '.~.'.. '. ' , ' t; 1 T ~' ;,;"- .. .. " ",' ' " ' " '.' ' ..'"..,: :',.. ,.' ,....""...,',.,','..<, ",." ,,', .".'..' CALL FOR BIDS Notice is hereby given that the Board of County Commissioners of 3efferson County, State of Washington, will receive sealed bids up until the hour of 10:30 a.m., Monday, July 25, 1988 , at the office of the County Commissioners, Courthouse, Port Townsend, WA 98368, to be opened and read at that date and time for grouting and caulking of windows at the 3efferson County Corrections facility located in Hadlock, WA. Bids shall be submitted in accordance' with the specifications on file at the office of the Director of Public Works, Courthouse, Port Townsend, Washington, where copies may be obtained. Each bid shall be accompanied by a surety bond, postal money order, cash, cashiers check or certified check payable to the Treasurer of 3efferson County in the sum of 5% of the bid amount, to be forfeited to Jefferson County by the successful bidder if he fails to enter into a contract and file an acceptable surety bond in the amount of 100% of the contract price within ten (10) days of the award. The Board of County Commissioners reserves the right to reject any and all bids, and to accept the bid deemed most advantageous to 3efferson County and to waive all informalities in the bidding. APPROVED THIS .#" a..., DAY OF ~ _ . 1988 Board ~ Commissioners r f '~., ~\, ~) B.G. Brown, Chairman ~'i' ", l ,>... r " ',' .:, , ,"'.,,','.' ' ,,: ,'" .. ",:.:' ,'.: ,'., . , ":..;" ,'.. " ' '. '., '.: ", '. ", ,", "" .," .";: , '... ", ';" ." " , :,' ":"', ')" ,,': '" , ::..,.", " '. ." '".:"': ' , ,..'., ,,' ,',. ,', ': " ,,' , ' , ' ", ",. ,,', ' " ,..,: '. ,,' .. ".' ,:', , , ":' ,'. , " ..... ' ,: , .. ,': ' , ,",' ',' , ,': .'" ': , , ".', ' ' ,', ,', ,','.'. ' ' . ,,',,' , ': ... ',.":'" " "': , " ,','" ' ..' , ..,.. ",'" " ,." . (, ' .":: ' ,,' " '. . ; "':" ';' . i .' ,',,' '" ", ',: , , , ':','-'. , ",' '" , ." :.,'".. ,': , :. ," ',':'" ,:.: ,',' :'. '. ., .: ;" :,.,;::, .': , ,:",>.', ;' "',' :".. '~,:' :. ::, ':':, , " , i...'... ," ','.. '" ',. ' ,: :: :.:,: ":,: , , , : "...:, '..,' .' " '..,' . . ... .. .. ,'.. '.' , ,':'" ,',' ,'., .' ,'," DATE OF BID OPENING Sealed bids will be received at the following location before the specified time: Office of County Commissioners Jefferson County Courthouse Port Townsend, Washington 98368 DESCRIPTION OF WORK The contemplated work to be performed under the contract consists of: filling of voids and caulking of window frames in fifty four (54) windows at the Jefferson County Correction Facility. CONSIDERATION OF BIDS Bidders are notified that all bids are likely to be rejected if the lowest responsive bid received exceeds the Engineer's estimate by an unreasonable amount. In the event all bids are rejected for this reason, this project may be deferred for readvertising for bids until a more competitive situation exists. DATE OF COMPLETION This project must be completed within thirty (30) days of award of contract. FUNDS County current expense funds are involved in this contract. WAGES Prevailing wage rates apply to this contract. Contractor will be required to submit certified payroll. 1. ,', ,:' ..', , ",:," , .. ,"" ',', " ,. .. : , , ',' " :, (" " .. ;,', " \" '..,,'" , .,... .. ,'",<:., ; .,',. ,,',' .,' :' .. :,' ',.:: ' .. ",' . ' " .':", ;', ',' " , '" ,': , " " "'.':'" ',':' ,'..' , ,': ':; ", .., ' ". '",., 'i,',' :.:, "., ':' ,,';, ':;. , , , ':.,' ,'" " ", ",.<<;" , ", ',' .' '" , , ,',:. ': :" . " ... :' , ,'; ."..",",""" " ":' " ' ' " '.. ' : .. , ',; , " ,',., ,., .." ,,' ,," , , , ,:,. , :'; ,,' '(., . " " , ;'.. ','.. . " . ',',' : : ., " ': ," ',.... ':':'., , '.,.," '". .'" '""., " " ".., " " ',' , ,:', ", , , ",,", ,;, " :. , . .." ",,:', ' " " ": ,,> " , , " , ' ' " ,:: " , ,..' ,'. . ',' " , ,.' ' ': ';< ': ,:" .", :: , " .. ",: :' ",,, " ,..;. ': , , ,,; :,' :: i.' r,; :;', .. ":' , ".'."",." i , \ l' '. . .'.. ' .......... . .... >' . .... .' '. .' '. . .., . . . '. ...... '.' . ....... .'. ....... .'. ....' .... . ...... ..... . >.. . ". ...... . .... .........< '.:.:'. cL'L'.-C:>z- 7.j6:3 \ ~_. a~,.." ~ - .- ..~, :-;t.. (,~ . /:'f JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS 1820 Jefferson Street P.O. Box 1220 Port Townsend, WA 98368 (206) 385-9160 Gary A. Rowe, RE., Director Robert G. Nesbitt, RE., County Engineer Mr. Rick Tollefson Tollshark Construction & Custom Woodwork 1132 Van Trojen Road Chimacum, WA 98325 Dear Rick, In view of the award of the bid to you for window grouting and caulking at the county corrections facility, I would like for you to cancel your recent invoice (in the amount of $502.08) for work done prior to the decision to include all 54 windows in the project. Please call and discuss the matter, so that we can resolve the issue to both the county's and Tollshark's satisfaction. Sincerely, tbrlbr M. Carter Breskin Property Manager PWA02 ERR02.70.03 100% Recycled Paper , < ,,:;;,"; . . ",;.' :.!:<:'::.'..... ,i'~;~r"'.';. 'i,,":,' :i " .:.:' ~ ::: .....:. . . ,'. """ ',/: .... . . . .. . ';. ......,.;' .i:.'" .: ~::;r;:";':.:::;;' : .., ."" '.: . ," ;, :".,.'."," ........'. .,. ,: ''c: :.'. '.,'., :,," '.", ::.::. . ;:'. '.". '.:': , : '.' '. '. ' , " '.. . ,,:. '" .:. '.'. " .".',; , ,:,: .', . ".,' ".... '''''., ". ". .' ,"'. .... ' '. ., ',. ''',' .: ,".' ", ", . , . " ,,'."., :. .; :.... '." .:'. . ,.,' '., >., " . .... ,,:;:,' :,;..'" 'S; ': '..,',: "".. /. , . '. ,,'. . .: '....'. '" '" ':., ".' "','. s; ., .' .... '. .' ". , . , '-'-'I j J ~ I J / . ,~~:} ,. , ' " ;i\;\~0d:;,'<i\'.'_:-'f,t,;:,:; i""'. ,,' -,' . '.:' . - . . -." '. ,. . . . ...., ,,' :OC'; :f~~~:/.::~j:::::;;~(:;,:;jiL::::';"':';~': ,;<' . ,'",.>.,;'. :".,,; :' i;i<~().:'-.~~::-' ,~<~}~,~~ ~ ,EAA' O,?.7CJ,03 R. W. BECK AND AsSOCIATES ENGINEERS AND CONSULTANTS PLANNING O(SIGN R^TfS [NVIRONMINT^t {CONOMICS M^N^G[M[NT FOURTH & BLANCHARD BUILDING 2121 fOURTH AVENUE SEAT1lE. WASHINGTON 91t121 TEL: 206.441-7500 GENERAL OffiCE sv.nI.E. WASHINGTON TelcphOOe:206.441.7S00 Tele~: 4990402 aECKSV. Sealtle.WATelec.opler: 206.441.49(02 July 25, 1988 mENO. AA_OOOO-BD-AC Ms. Carter Breskin Property Manager Jefferson County Public Works Post Office Box 1220 Port Townsend, WA 98368 Oear Ms. Breskin: Subject: Proposal for Engineering Services Jefferson Count Correctional Facilit In accordance with your request, we have prepared this letter describing our recommendations for engineering services associated with the County's correctional faci 1 ity. Our recommendations are the result of our July 30, 1988 site visit, discussions with you and other County staff, and review of the June 1983 drawings and specifications. Damage to the facility is localized in the north wing of the build- ing which is above an area of compacted backfill. Damage is characterized by fine cracking in the masonry walls and reinforced concrete floor, buckling of steel plates at the tilt-uP panel connections and possible deformations in roof, Suspected cause of the damage is related to settlement of the compacted backfill foundation. Specifications call for a dense, well compacted founda- tion which may not have been achieved during construction. While we do not consider the existing conditions to be an immediate safety hazard, we do think engineering evaluation and monitoring of the facility are warranted. Our approach to evaluating the existing facility for the County is to provide engineering services in phases. 8y performing the work in phases, critical Guestions can be answered first which may make subsequent phases un- necessary, thereby reducing expenditures by the County. We envision three phases as follows: Phase 1 _ Immediate inspection of the existing facility by a licensed structural engineer. Particul ar attention will be given to inspecting damaged wall connections and inspection of roof beam connections. Phase 2 _ Monitor on an ongoing basis deformation of the building including existing cracks. This phase would be a joint effort between the County and Beck. Beck woul d provide a 5.""'''. WA' ",."w,. co. ph,..nl.. A" O""ndn. rL' Cnlumh"'. N" "o'tnn. MA' ,"",,",,,,"h'. IN' MIM,,,,,,,I". MN' ,,,<mm,'n'o. CA' A,,"'n.TX' ""'W'"'' TN ~.... ..... '"'_..",' .. "" . > "'" . . "', '. . . .' .' ::' ....., . " " :. ......:. ":.' " .' '.. . , .... :. . ."", ..:. :.,..: ;'. ;':". .:.".' .:. .' .' ":..: . .":,, ;.', ...... '.'> '..;" .,' ,'" ..' .'.' , " ., .' " '".' ,,' . '.'. .,',,: ,'. " "'.' " '". '. .'. ,",. ..' " " ' " " 'c' ;.' '.' ,'.,. . . .'..... GRI EVANCE TO: GrrlC;Vo..V'CG c...o-r-cll' Ylu.k"y DATE: J /ft.1 ( /4- / '0 'l{ FROM: ;: WOL(J;;iL Ii /(~ t<> C;f'if.eJ(., -j'YIe- tkf-1~6t -n.~r fk.+r:q' '(\ v..-.s j fl tY)cltz 5 ,:[: 1'1 CL f,(::./ 1J, ~ ned"" ho..s f.\/t?ti~t::-- o.b Ie- ?t"/~"'IAI'\T~ 0 r Yn ~;fho...1e.. ,:::\~ r:-ct;r&lol qo-:. q "fh-c. CDi,&"I:..tIOI'. if to<:.. blA.,/d""'9, r.::,- Po '0" The.. eC-"" 'p}-"1 c;.\ I J 5 jv1C\ IPt; \ \(.,'/'J{ / " 5' 4V1ct -r('el"-~ q.c:rICM.5 6P 51;'t,6( i.1c'~''Der'? ,Je.. IMI. -~/lc& foY o-s e)l ,/:10 xes o-f 1h c:- .>i?tTi- 0 r C~-{,LY\-rl;' 0..\,\& ~~d\, -f'C<J:-j-<; ~o.vc.6a:.: b,o'-('1J~ JOO T1~""e D-.17i:-.."t, 0 VI , WU:l\\7 If fl'le:;; I "I f!., c: pc,-~r~lId. /,/JIll be.. lV1 f~c -f'/..At"..r'C.- jf' ,--(,) I'td"- t,oc.~ .$<::l\.....e.. C;..C.7'1 ~M -rc..,c:k.'f(M oJ;.ou:1-- l--t g':J: re.-o..v..e.s-f' -f'Ir'b--r I Be- pY'e.ssei"-1' v..l~eY1 ) . -('h , ? c:; (" i c::: U C<.V1C c:...- fs rev~ ~&. L?y G Y"iCltV~ VIe... c... :) Lo~d,'\'\ Ct.. 1oY') '. r:;e~ INMATE .... ,':DISPOSITION: REVIEWED BY: ~ IV ~~r-f ~/~. 7(lcr(tf 2nd LEVEL 01 SPos I TI ON: "/.' ,"",:'~.:" . i' . -.." --:-: .... . '.' .. {.:. .;';,. " .' .'.:: ::' '. . ". .." '" .". .".' ..,'. . :. .... "" ::! ":, '. .., " :'.:" .', ,.' ": .':..... . 'i . . . . ; :'.. .:...~'::;.. ....:..:'.i'~:'..:.... .' , ' .;':' ,:: , ,,,' . 'i' ." " . .' ,... . ......... .'. ,'. ",'. ..... <,' .' '.... .... ....... " .' ... " .. \," .....' .:.:.. ',..' ..., '. ',',:': .... . ,: <,,;" .......... .:.. ':,"',."' " .:' .: <,..', ;. ;.: ..... ,.'. '~'" .... '. . ...;. . . '." .',' . " "":":' . ...,.' .' .", . .'.' \.', . .' ". :. .'" ",':". ,,' ., . ....... ',.' .', . . ":,, . ' "', .:. ' ,\: '" _,,{ . ....: '. :~~\~~~.::: . " . .,'. , ','- J I I . .'..".- ..;.,."~...:.:,";,.="";"",:.,,,,~_,,~,.;.,,,,,~~__"~.....~..""._",-~_.::'..':",;...~.,,'",..;,.,~~.;'L,:,.,,~,,~,''''..:~''''';''';'M';''''~:~....... _,~,,~_~~':"';,~,c;;;.~_L:"'~" " ( ~\ \ GRI EVANCE J u../y 2-C> / '?:v TO: G\~ie--'~I..1t\<'c... CCJ\-d. vl~ttc r DATE: FROM: 76/1''1 FdJ~...s r WO",,{d<- I, Ice.. -to ~y/~C- the "cc--c.r -rJ-1~ :r C~;'\o1 Ivc.-kc..J... /'V\.To C<... Le../{ +t'0-1- the -rc.w1p<....h~o('~') Rt:c0--. 0.(- c.)C.c..ecf..~ S S 0 F. r c...J.^'1 I G'C.-/ee-J.... In ts . -tJl'j cdl, '~o''''' '.23 ~oV\....':) C.'-~1 /l'-VleQ.e-, o...4uc:t'sC le';'''F-rVl..rc.-'s l,-v,fh"'iA..--r- c::.....'^Y .50r-r c.f' c.col(."y cAbo/lid, \ ~ . :;~ %''''' 11;:;)-" v fJi~J.4 ./ -?:7 ",--;ff/ . INMATE ~ ~. '(7 ~-VL vl t,l r '? v- ! ~ {..; ~ !....a.... Cv v- ..:~) t-r[.C '~:"" ,~"'_~"-."_~' l"Jc......, "Z 'Q---,,__i.__ . '.- G....-l-....:--s..~ (:'e... .~.....-. .../ ,(~.t_.4. Ie t./l ,e~'(f t;,":1:.,..-1, ~ -' 2nd LEVEL DISPOSITION: REVIEWED BY: .' .... ~ " ',,'.. ....' . ._._' _______......_ ._____. ...._"7____4 ..~t-.._-_..___.""" ...------.-- --:--:-- .--:- ..L~:i\L.< " ;". . . ~_~./:'JC':' {'J?, "~;' 0 . '... , . .; --' J~~~~(~~l~l;~ .1!~FFE;~;;i)N COL':4TY PLANNING AND BUILDING DEJ'.\RT;\,lENT i'.! I. H,), 1:..!~11 ['ul"1 'lil\\ ll.....'llll. ',\";I:--tllll~l"ll :1....::.;.... Plallllll1J..! l~tlli) :JK:j.HI.111 Bllildill).,t (:!{)(il :}Si'i.SIl-1l .JJo;FFEIt:-:I):\: t'{IU:-;'n: CO!JHTII<)USI.: David litl!t{;...lllitl1. Din't'tol" MEMJRANIlL'M TO: Jefferson County Board of Ccmmissioners David GOldsmithP August 30, 1988~ FROM: DATE: SUBJECT: Third Floor Conference Roan This memorandum is a follow-up to Judge Majhan I S concern over the use of the third floor conference roc:m. Before..... look to solutions to solve the "sharing" problem, I """uld like to set the record straight on the conflicts Judge Majhan raises. Wednesday Night Meetings: Between the Planning Conmission and Shoreline Conmissions, the conference room is used at least one evening per wee.'< and usually twice. Add in the PUn and other night time users and one can easily see the room is constantly in use. The evening in question was a prolonged public hearing which lasted beyond 11:00 p.m. at night. The room was picked up before being closed for the night. but it was not arranged to a courtroom configuration. To correct this problem, Carter arranged for Bob and Pat to check' the room each morning to ensure a court room configuration. To my knowledge there has not been a problem since. /.. ;I.... if Y b " Trial, Noon Recess: The second incidente referred to in Judge Majhan's letter concerns the use of the conference roan by the employees guild to hold a noon meeting. A member of Judge Majhan' s staff was a part of the guild group and was Sj;:ecifically asked by other guild members if it was OK to use the roc:m while the court was in recess. The ans<;er was yes and the meeting canmenced. Schedule Conflict, 10:00 a.m. Thursday, August 25, 1988: The third conflict Judge Majhan alluded to was with the Safety Conmittee who had scheduled the room one mcnth in advance. To our knowledge neither Judge Majhan nor his staff either checked to see if the room had been scheduled nor did they schedule the room. 1- f,:" ~, .:. .."... ,,: ",...' ..', '... "., ,'. "'..:.,,'... ., ':.' ',','. ',",", :..,' ," ,,' '.. .', ..,. ., " . " . ",' ",'. ',..,' ,'.. " .':.' ,.'" '...': ...;" ,'.":' .", ' ' ',". ".' ." ,: >'...,' ,,;' .' ",'" .'. " ",:<> >' . ,:'...., ,. ',. ...... ',' :.' ..".' : : , ":,,, ,"'.. ' " " ',,' .' ", :' ,::,', ':, ,:" .. .' " :' "",', .. ,.'.,.;:", " ",; ,:,' . ., ..'. ,:> '" ,:.".,,,' " . ;,:' ',""'" ,',' ,," " ' , ." ' . :. ,... . : :.' : ..' '. . . ,,', .. ..,., '.'. . , ", .." \ ,." ,'''', ::;"." '. ,':',,' .". ,.':'", '::', ",' .':' " :, :.',",,' ,', ,: . .. " .. ; .. " " .. ," .'.. ", .. '. '. " ..., ", ',' ..' '.,.' ..'. "..,.. '.'..,' . ': . ."":, ,:, .' ;.' , . .. . .,' .., ," ','. ',.- '" ",:,' , , ". .' ',' ,,: . ' ..' '..'.. ' " ,,' ,', '.. " ,.,,', '.:',::. .." '..'..'.. . '.<' . ' . " ',' . ,> ,,' ',', ,. . '. ". '. : '. :, , . . , ,... .' '::, . .. , ..., ...,'. . , .: . ..,. :. '. .' . ,..., , , t .' . ',,,, '. ' : ': ',.. " ',' ':'.' ." '" . , < , ' , "; '. " ;., f , J I I I " ",,":,i' ;,...,,;':X:',;' "' " ,'I' ,'"c._._...,,__ ,,'~:~~.:'.., ".:;~~.:::.;<~~,".;~<,:":;"~~,,,~:.,,;~~~<.L,L:~;.,,,.~~;;,,~;;' MEMORANDUM OF TRANSMITTAL FROM: BUCK &: GORDON, P.S. WATERFRONT 1'l.ACE SUITE 902 1011 WESTERN AVENUE SEATl-LF., WA 9HI04 (206) SH2-H540 TO: carter Bruskin Jefferson County public works Facilities Division P.O. BOX 1220 port Townsend, WA 98368 Gunstone/Tax lot #5 ~, ~~, Webb's Forestry Servi~es ~ 1019 Swanson Drive, Centrelle, WA 96531 Area Code 206_736_3225 Otflce 136~1661 RE: W.M. WEBB, Consultant We transmit the tbllowing: Abstracted tax deed to Jefferson County and abstracted deed from Jefferson County to correct erroneous tax foreclosure. o o o o For your information. For your signature and return to this office. Please file original, acknowledge receipt on copy, and return acknowledged copy in enclosed self-addressed envelope. Other: TRANSMITTED BY: Joel M. Gordon!mq DATE: Julv 8 , 1988 r~ECEJVED JUl 11 1'380 J[;r-FEHSON COUNTY IlNGINEEr.;:", OFt"jCE IIIIIIIIIIIiiiI ~. t ,;.", k' y -"f t I ~.> ~ . ," } '~ " ~, ~" >" :::\' , >-- ..,.. " ':' > . , ',,'.. ,,' '" ,.. , ,. ' "':",; .,',' < '., , ' ...,'".", ".. ' ',..'..' ',' .' .:. .' ," "', ,;.. . ,,'.',', ,:." '.. '( ,'. '.:i ,,". ; . ".;,,' ",' " >"" ,,'.,' ,,' ,'.,.. .: .".. >;',:..>' ,". ",.., ,'," '.'.' ,.' . ..., ' '.. ,,' ,':' ,', ..' :::' ,. " '..",.. ,,:. ':,: ..:,:.,'.,> ,.":: ,'..:: '::' " , ;~: ,:, ,,,,,,. ._OUll~';':;~i~'fi~?i:'~1 ' "'~'~:,: ;~'i [::: ;:;;~: ": :::";'-:f;t"~e~i?i'~.l':'~.":;'~::,:"i:.:.;;, ","'CD. .(c :,.ne "~~.. or :.;:": _ _ _ \" -'_ '::-:'q'.~'"' _ _ ." _~,~,~_:>'~:!,:,..,.\;"y - . .;".~~;j""" .' ~,~,,'-" ~:''->T;'-':.'\::::~~'" .: ~~. '}o'.e:-n!i~::i ~.C ~":e:'1: ~: ;_'.~ :';:'"~: 'P't~: nf -. :.;~!'t: e:n: ~~; ~. ~_;:.E~EC . ;~~c~a;~i~~~&~E~~r~~~v~~ ~nc E~ c.~ec~ 1.C .::"~f:.-:'E I.'. Ttle eeea c~ven tD correct errOLeOUE tax foreclosure by JefferEon CDunt~ of lands above descrlbed end wtlct vt time "0 ~~rPD:OEure WEre teld b~ the Vnitee Stt~eE DE v milltary , - ::-eEE:"\"Dt~ c:: T\~:rst:.nnt 1.C tr.e order c: ~i:e Pres icent, o:-_~ the Unite: St!:.teE uns'er"ciete of SeT'ter:;be:o 2Enc t lODe. ' . .~... ':"r:.ie c:o:n.'e~..t.r,ce :E exect:.tec 'LiT"OfJ req1.ieE~ c.f ['rfll,t.ee enc ir: ,,'~!;. T".t:rEt.'lnce c: Go resolution c.: 'the Boore c.: C;OU{1tr COnLl:"\1eE~cHere. :". c: ~effE:rEc:J CCHaJt~. rec:c1rcec. ir: .~'olune Ol~ r-sie .,,::-~:,~~~ of tr.e Froceed lllge of sEd d l>oard of couirt.;; Co!:',r: 1 s s i oriers-:-- -, ~ ~ ',I , " ",' , " ' ." :, :. , . ,:',,'. ". ,',..,.,. ',. :. :',..' " ,':,' " " ' , ' , '.'''',' ", '., ' ':: ". .' ", ,.', ,'..' " ,; "",.:, ":'" ' , " ' ,'" ," " ,": .,.', . !' ,,', , ,,' ,', ':.' ,.' :: " ' ;":' .. " : ,,' ...' '.", . " " ' ,:,",', ...: '.' ...' ''-: ':'," "., ", . ,,', ';.", . ',,:' '.' " , ',., ,', ," ..., ,".'. .,..','.,. :.,.., ,.' ,',', ','. ". ,,' '. " ',. ,',.':' ;.". ,',,:, '.'." ':.. " " ".'!:i> ' . ,," ,:', . ' ., ' .., :'" ',: ' "',',:. " ' , , , ." , '\" , . ,'. .., '. ' ' " ." . ,,'., ''':".' . ,,' '", ' .' ''', '" ;," ,:'"', ,.' :,', " ' . ~i< '. '. '\ '," ,," ",,: ',,:',." ,. '" ::',," ,:', , "",...,,".'."",,: , " IIIlIIII .... i; ~ .2 ... .. ~ u q: o CO ..,: '! o.!r; ... i; ~ - u '" q: ..: .., III c: .2 VI c: => \!) ,oz~ ,oz., li 't> c: l) -J ~ '" III en ... u ... q: ... ... 0 :- C> C\I >, ..., 't\ .., 'lI ~ I.. " ~ Ir) :::i , \ \ , , , , , , - - -;,,=r:;',l,-.. 4, c::t \ri ::i " '''' .....':1 ".... .....'" ...-ii: '1.." <>'" 't~ e.:;------ ''''''Z'''' '0 '''; , '\ , oJ .. '0 , ~ c:::) -,:,\ to., ~ ~ ~ ~, ~ ~ ::; -.., ~ \Q ~~n h ~ . ,,~" ~ ..... ~~ ~....' t .... ~ k ~ ~ ~ ~... ';- \l ~ . ~ .1: ~~~ -0 ... ~ ~ ~ $ "" \" .. ~ Ct) a., l. l: ~ ~ \l ~ \ 'tS ;;; 'ti' ""-J .. ~ .. :r ~S + ~ <\J ,.. l\J '-.J ~ .~ ... t ~.~ ~ ~ ~ ~ ",,'" .. "I'\i ,<> ~~ .. . I ~ ~ It ~ ~ t\ IrS ::. .; ~~ (f h', .'b \I'j c " :::; l:I .' , '" ~ ,,;;' '/ ,~.:. '" 0\ ..... ~, ~ ,u ~ ::s ~~' ',. ::s l\j b ::;:. h: II '~ ~ ~ ~ " .~...'~ ~ ~ .. 0 ~ ~ ~ .. .. , ~. -....! .~ l:S /..... \:) ...."" , <\i , .;~~.....~. .. ") C) ~ ~ ~\.S , oJ ~ I.. ...'.:!:,.,1-#>'. ,--:::. , ~ ~ ~ .~ ;;; , "'>i.~:"IJ~.~ ..... "- J) , ~ ~ ") ~.... ..,.,...... ..' , ~ 0" '. , ...... .....':'.... , ~~ /r=~' , ") '., , ~ , , ~ , , , ~ , , , , , - - - -. ,1'r -.. -'~~ - --,~.. --~--"-""""'1 "..'^-' ,"'p ..,P ,,' , " " '^' ;', , : ' , ' ,'.. " ," ' , ", ". ,,:',, ",:." '",:", , '.:~" ' '. ",. ",:,'. .',',',. ..'. ", " ',., ,': '\." >: ''',<' .".". '. .'" .' . " '..."'.:. ,.'.'. ".,.,:: '". '" , ... , '. ,..',..., ,.., ~..>/, .JEFFERSON COUNTY DEPARTMENT I'lF PUBLIC WORKS COURTHOUSE. PORT -rOWNSEND. WASHINGTON 98368 . PHONE 38S~3505 ,", ,I _..~~3.:.~__ PAl;;E DATE _~_ _,_.~ /1'- TJ "'T--"C'F~ C rC--'l"! -.. -.-( -"'''1'---'- pi L.t.:..__ .,We.B. : ,_-::,/.. .......".11-. .~._,__..II .. ----. --,~ -- ...... \ I I I ~",.:.-... '''- " .._.' , i "I ., , '\.1 , I -~.--';::': I ". ,......~ I ~., ; [ "'I I -_......., . ,," i IE ~ o~. """! 1 ----, ,....y --. , ~"'" \ I '"-'"'"'b:::::::,ls 39+ ,3<> ,,; ,_zw'-~-'1L-;, "-1 I,' j \,' '1/ "I I ~"" ,-I t I i ~ !"''-' ,,/<laP) 101 I I ABCiATj 'Z00a> I , ' (.-.:...,. .".,,_,~I~L_...:!l:.t:Coh~~:c~~I.:-~~~:n..::~r;.~"~~ '~~..:r-.,....-_.~:i--II L, ._:_~ f... .....;i .1 I I I' !T>J+"c '.' .1'/ 1 r"".,,-'I--"-,I-'~"f' . ,..,.' r'"-I'"=i",~~='ni ._~ ......1 1 n.. I ! Ii'. I .! ! (II "LD'r;",s,,; "1 R.'-"'i-ro' 1:1> c1"'S/"'T0i-""'L I'n "1_nn,I_I,~ ,. ! i .' _nl:c--~nl-_ni : i I I I I I ! : i ,., I I I I Ii! I I '! ,I r' -nr" rn .,. I .....r--r' ...,. i ......'..i In 'I n!: 'l'u"'I"-' i " I I I [i I : I. ',.,.;-,.. ..-, ! I i Ii' I I i I ~ I i I i r ! ~ L... i. I.__,!.. i ! j : '. , " .' """,,:0 ";''':',,:;,,',. ';:' " ", ,>',~' ,"','" ," '. '. .'" ,,"'. .. .. ,,' ,: ,,', ~ .. .:: '. '",' ":, ' . ,'::>: :":, .,' ',' ''':'.' '>,: ' ,':' '. , ' ':, , :,' '.. ': ';',,', '. "".'. .. : ' , ' '.:',-", ,:' i ',.', . .;. ,,' :':',"." "" " . , ,'" ".:, . " ". '" ',..',.," ,:' '. ,'.'. .",.:. :',"'<. ..,.' . , , ' .. ,..,":" ,,' . ' ." : ", '" ",,' " , , ';,'... :::...: "".,. .' ",:.,' . " .' ,," " " ':,," .' ':," ' ': ,,' . '.c'''::'::: : -: ,'". , " " ,:' ,,,' .' ..' .,:. .' ,.:.., ":, ""., "', '''' , , '.' .; , '" ;'.' /' "::'" " ',. ,,' " ,,' , , '". , ' ,', " I~ ;- L t p' t I'" ~ .fl;, { l 1 , ~' I: , :'~. ~;. " t. ~.' ,: Ii j ':" ',', ,,, ii' .....'>...' O/7R7Cr<!.. ~ z'/AJ"oE" ;7#/s Glt'~s 7'7<( ## //,)<:"77' Or eCJ~_ <</E',#,h/c;c ,4/#/f/Y CA~c:7S aICE.J- .LoW"E-<' .".'" ,4//G'h<'<"'1'Z -7 ~/ce.o /T oN' ~6'"'NY.Lo"': /.::o~ LoAlG~ t-</e?M2 , : ''', .,:' , , .',.. ',,; t ' , '.,' , ", " . ' , " ':' ",:,.', , ',' .",' ......... ,.,', , '.,." ',."." , "', ' .' ".. '.J '.., ..'... " : '" :', .,.. : '. '.,', .,..,. ,,", ..,","',. '. '..',., I', "..', .... "," '.',."..',. . 6. ~e... 02, 57? ",,' ,..., FLOORING PROPOSAL ~,v-,CT Bog PENiNSULA FLOOR COVERINGS 1433-8 Sims Way PORT TOWNSEND, WASHINGTON 98368 (206) 385-0945 2644 proPeA~T;~d ~.R~r~1 AI Street -.::;EFFa?SuN COiJIJrl f!.,HLlc M".kr 7- 1- 3~' .Job Name C-,JmtT/LlNITy' IlCTI~N Job Location , CIW. Slate elnd Zip COde Phone Iln5t811atlon Date Insteller Proposal Made By Job Phone 33>'- 9/60 -'., ~,- ~' TE,~r::r~-13'~' T'I J'TT r-'] ! ~ ~r~]~~ ~ -;----" ~~~F- h-= - (; ~:!.r--~ T.!:I-r!-r2 13_.!.'!.---21-.!6--.!1--I~I-~'?:t-~:;!l?t..=2.! -P _:;!3_.....?.. ~T-~-=-27 "_JIB ~9_~O~1 -~-:;! , ~/C'" C'r ""Qf N.!l:L.Ua-q 'Ov.,v rt/,(2NITCI,((; :L1f""nOVlWG 0 D COVI; A c 0 "--r--'j-- T-I-r-'---I 1-'r,,1 '~J-I"-I-l-.:r:-I'-ILI T--'1 'I~- - ---- ...... '_ot.t>-X-1~oi" -ft't'/f.lf"jropc; ~-T"ier7f/.L+7Y"'YJfa::t.f4> 84-0 ['-'-' -- ""-G"-Yru....r ~-~~t~ I ",r'~",,,N:1 U)(""'_juYP7:>'! C{ct<{ _oJ\:? ('Ot/T~/LY.=1~~~~~T~ ~ A r_€A, .,~s~~q~f1ftill~l,~IJl~ju.l;r~~f~C.=~~f1= . \'If,iN S ne~l- IZ:/J 7RF$ I-'/~ 1.IT}-l!tlc:~J'1 L !J ....ca~c)"Gl<1i /Ifl''''e~ r 1'ts'<J =dTo~. ~~~~1wtt~ff}tff~O .~ ~~= dHItttl~-lmHttEl_.tffHE~+ . -l< ROOM MFR, PA TTERN .~o:z., !?At<'IIt:7T LINet91I<Et<. JOB PROPOSAL PADDING ' . ADHESIVE MOLDING COLOR SIZE SO. YOS. PRICE/YO AMOUNT ~>1Y": ~A" ~,-;r;3 ~6'1 IO,.!)o 36;:1.2.00 4/-"'0 "100' - "1-: CoVe.6.o4 E IN; 'J'It-u:o I, lao 6 CoV<'l!l4r.o INr "4a..FO, {'/l/?k7/f.,/S"TA<.L TI.w- C.:>VIA/::; CAP rf_ v//"Ut' --I-- 'I':K~ 13$'"'''''' L!I~ MATERIALS SUB-TOTAW' Sg I'l 00 LABOR SALES TAX '15 3 ~, 8 TOTAf{,::I.1~ ni DEPOSIT BALANCE ACCEPTANCE: I hereby accopt tho propoeal outlinod above and authorize work, to commence on the date specified. CERTIFICATION: Thie is to certify that the sbove describod work has, been completed to my satisfaction. Customer __Date Customer ___ Oeto : ,: ;' ',: " " '.: ' ;... ": ',.,",," ' , ',....' .. ,.,.,',"".' .' ',...'.' " ''':' , "," " ., ';," '..',..' ", , " ",.' , '. ,,' " .-: '. ,',.' >' ',' ',:,; .,,' :" CUSTOMER COPY ,'" ". " ' "..,' :"'" ,';:' " .' ..., " ' ".; ",,', '.' ",' ,.., , ".,',." " : , ,', ',.' . . ',:, '.',':, ".' . ""',,' ' " , ..',' '" ','.., ',,' ' ,...,' " , ", '. ' ."'",, " ",.; ,. , ': I ;, ". ',,', .' ",', ;,' :, , ," ..:, ,'.' '. " ., , " , . , .' .,.,' ',' ,,' ,,', '., ,', " , ".. '.. " , " , ",,', , ': , ,,'., ' ~i > '::4:::J:\;~;h,..,:::';,~ ,', <;>",- ~:: '~>;';.- ,;>',.;-, ,; ;:1.1':<, :,,: , ""ie"" :'~-';',;:/:,,::"i:::"::: ~--- ~-- ToJlshark (OnSfrUdl%n 1132 Van Trolen lIoad & (uslom Woodwork (hlmac:um. WJ\ 98325 206-132-4080 lIel!:ll=TOLLS((2t1NO Carter Breskin Facilities Manager Jefferson County Dept. of Public Works Jefferson County Courthouse Port Townsend, WA 98368 August 26, 1988 Project No.: ROO 780 Jefferson County Jail Window Caulking and Grouting Dear Carter: The date of substantial completion on the above mentioned project is August 25, 1988. We request issuance of a Certificate of Substantial Completion as soon as possible. Yours very truly, ~~~ ~ichard F. Tollefson Owner RFT/li RECIEIVE[') IiUG 29 1938 JEFFERSON COUN1"V ENGINEERS OFFICE k"j""'"';' ""ii';" L,"" . .'.' '....ce....... ..' .' .."" ". ",'- -, ',' ." . -"':.~ .... ,,:-. :."......-... ..... :....".'--> ..... ....... '-":""'--'-'---"-""-:- ;;i.....'.c,),;--.'....'.:....,..-.....:,.-..'.;,- ',' .;:....',:,....."'.',.,.::.,'......;.--:...'..'.'..,..,-...'...,:.::-."-,';.,:....:.;.,'.; ,;".':,',,',::_.;:,_.i,~'.i..-,,:,._".: ;:,.:',',::'-,:',',-':i.:'}':",:.'.":' .':<i".:":",\;,,, ,:,<.,/,:;,::-_::.}:_;::,,:.:~),," (,:;k~::,~<li,i:~,;:.~:,,'!~dl~~,i:~;tL~,i.,~'~~".';;'.~:,~~2~,~~~.i.::~;.J~~;:j~~ jLiLl~i~"L0L'-;;"~:'\:2~..ii2:'~:~:2;iJL1~-)::';','i ,/.i-~",.': :; , @) SAFECO" LOSS CONTROLS FOR MANAGEMENT SAFECO INSURANCE COMPANIES HOME OFFICE: SAFECO PlAZA SEATTLE, WASHINGTON 98185 Brinnon Senior Center/Brinnon Motel July 28; 1988 Dale vi Sl.lrvey Insured Policy Number 31503 Highway 101, Brinnon, WA Localion PROPERTY B8-l: At the time of my survey, it could not be verified that the hood and duct in the kitchen area in the area of the building occupied by the Brinnon Senior Center was being cleaned on a regular basis. If allowed to accumulate on the inner walls of the duct and hood over the cooking equipment, combustible grease can greatly contribute to the spread of fire should one develop in or be drawn into the hood and duct system. For these reasons, it is recommended that the hood and duct be placed on a cleaning contract with a licensed cleaning contractor. The hood and duct should be cleaned at frequent intervals prior to surfaces becoming heavily contaminated with grease or oily sludge. A recommended cleaning schedule interval would be on a yearly basis. NFPA-96, 1987 Edition, standard for the Installation of Equipment for the Removal of Smoke and Grease-Laden Vapors from Commercial Cooking Equipment, Section 8-3.1. mlm/LC/3/4 As an insuro.. SAFECO has an ob\lio~". ir.tcrast in your success in preventing accidonts and providir'19 safe working conditions and safe pfemises, for that ronson. we are glad 10 provide you will1lhc bonnf;t of our experience and expertise in the form of our opinion. However, you should keop in mind that we cannot and do not in any way undertako 10 a$surfle your basic logal obligalions to your emplovees or oUlors on your premisos. That remains vour basic responsibility. Reference Abbreviations: OSHA _ Occupational SafelY & Hoallh Administration NrPA _ Nalional Fife Protection ASl>ociallon ANSI _ Amefic3n NatIonal Standards Institute NBC - NatIonal BUilding Code 01 Canada NFC - Nallonl1l Fire Code of Canada CPSC - Consumor Product SalolV Commission DOT _ Departmont of Transpoflation (Malar Carrier SofOly Rogulalions) ",,:/", E;, " " . ",'" " .' " " ~, .1,: ,.,.,... " .,.'," " ':;;' ',;" . , '... " " ",', , .. , '..:, "...'., r . ",.,..' ",.'... ".' r-:- " ,',' .'. .'. I,. " :,'. "" .,',. '.',.. , ' '.... ',: ' , , :',"':' " " ".' ,,',: ,', ,.:,.,., ':'. " ..., ," .,.., " " " ,,\ '..'..' ,',. ':', ' ." .' " , ' , ' ,,' ;, ',','., " ,,' , " ,'.', " . " ;,. ,". ." .. " ' Ii ,..' . .'.',.. ,," '. '., ""'. ' >' '.'i, ".,','. .., " . .. " ,,' . , " ' , .'., '. '. .' '... <"" , :', '." , , .' ,,':, ", .,' ,,', ' ,.,'." , , ' . " ' :." :': ' " , . ,'. ",',:.' , ,". , ,::;,',..... ':, ..,'," " . "", ':/.' :', ,'. . .'...,'.' ' ",.' '.', .,.",' ," ,:. " , ' .. ' , " ' : ",' .. .,' ,',,' : ' ' ..., .. .,> ,.:".' " ',.;.," ,.:.'" ',', , "" , , ,;:r;}:':::',':,:', ,." ":, . .. .' 1.\":;: ".,;,,':. '. '..; ".' , ",.' .',' ,. .' ;" '.,;."':::;" , ,''',., : ,." '.: '. r, , '. .'" " ,'..'. '..' Ii" ",:; ; :, ... " . , , . I :,' , I:, '. , . . I':', ".', , ..",.'"..". L' "';:' ,: '",' , " ,:, " , ,:, ',' , ..' , , ',<', '. ",', I,'. . , , ;,'.'L Ii . ,': , ..' ',' , I: ; !.- i , i ';,' , i ; ,L'," " " : \, , , .. " " " CI!fc 6', ZOo 0'-' f' v t\ f. ~;fj We- ~r~hd:cU1u:t !c;: ALPJNE FI~ ~ SAfElY E(:iXJ\?, "'?,O,bol< 305 MT, \JER-tolClt-lj WA, 9 n13 ~~~ed t~:!Z.~. '.: cIt(XIy ""(P#~~ (J~~ M...- t.l.1V1uc.. a...t ULu.- ".f 1$ 0 ~ ....ea.. , 'lo ~ ,juM'6-/.t...A:JuJt"6 s .c. .;.. \-CC\.S '1 Cff "SJ). ))av-U 0 Cl/)v av...#-- - . '. ~14cUa-~~ ~wdJ, ~ ' ,:.::~,.., .,..- ." r "71" ',' ',... ;', ,,'. ',' ",' ,. " ;,' '. ";' . I "'., , '. ',.,,',. '.',:'<i\,'; I " ,::'.:n! . .,', :, '.. ,\,"',.',. .' ,,':" .~,> . , .. ,'. ',: .. '.' :,', ',', . '. ',:', , , .- '. , ,:' , " ' '" ,.,," ",. '. '.... ,> , ,: '. ,.,"",,' " : ',', > ,,',.,,'.. ,', '., :.. ," '." '''', " ',' ': ,:' , ",. .'.' ,..i.,.:,...',...., ,',' ',", ,,';; , .' ' " ". ',: , ',,', ',', .' ,.,,',.,.'."'" " , """; " . '., ;", , , :' .' " , " .' " " ,.,'..'. '. . ',:' .",' ~:, ". ! ,',,' ", :::, : ,", ':', '. ': ,"" .... ,', , . '" ..,',', '.' . " " ;' , :"- . .,' '., ..". . '..', ". ", ',"'..' " ',," >.." " " , ',"', , , ',.',' ',' ",. ',' '; , ' '. .:' ' , ' ' '.',,' "., ,',' '," . ,. .' ..,... :,." . ',." .'..'., '.: " ' ,:' , , '" ,;' i,"', .." '.,' ,'"., ,,' :':".'::" , . I, '." .: '. ---1 ' " ..' ': , "':" ", :" ",.. , ,'; " '"'."..;,, .", I ' ' .~,:):: , .', ,';,', "" . '.:. .. .-1'.." , II1II ,: ':':: " '. . .. It. > ,"".,." ,,' ,:, "',, .. . , " " .' : " '. " " ,', '. ',' :.. : ".,:., ,',' i . ,", '!r'lIilnl\llA~ .J. l\lA,nllAN .:\ HI) l'ul~11 llJ' 1..IJ'W OJI_. \\',\l"oIIINtI'J'UI'O STlIl":WI' 1'. O,lIo;\: ,J!)I "11'1' 'J'II\\'N~I';NII. \\'ASI"I'o'tl'nJN IJIJIJ(.11 (~Ufi) all::;..l:!'.)'.) Augus'- 11, 1988 Mr. William H. Sv""sson 8415 5th N.E., Apl,. 301 Seat'-le, WA 9811~ RE: Svensson - SI ',gman Pal"king Lot Lease I Dear Mr. Svensson: As you know, Jefferson County has leased its building in the 1000 bloek of Water Street to John Clise for a store. Ever sinee, the County has been after the Skogmans to allow Mr. Clise access through your lots to the back of the County's building. At first, the County wanted permission to allow the garbage truck to cross the lots so that Mr. Clise could keep a dumpster behind his store. That request appeared reasonable under the circumstances. Next, the Skogmans were approached by the County to allow an employee to cross the lots so that she might park her car next to the dumpster. Arguably, the dumpster and that parking plaee were on County property; it would be impossible '-0 tell without a survey. Now, the County is claiming a right of transit through your parking lots to allow delivery trucks access to the rear door of Mr. Clise's business. The Skogmans, while they want to be cooperative with the County, are vehemently opposed to delivery trueks using the parking lot. First, there is the ma'-ter of traffie congestion. Because of the size of these delivery trucks, '-hey would have to either back into or baek out of the parking lots. That creates a danger to traffic on Tyler Street as well as a hazard to cars parked in the lot. Further, the delivery trueks will block the hotel guests' cars or block the parking places from the hotel guests. Either situation 19 unsatisfaetory to the Skogmans. Although the County suggested limiting aceess to the store to certain periodv, sueh restrictions on aecess would be impractical, if nnt impossible, to enforce. The SI<ogmans belil/e that it would be better for you and the County to doal direetly with each other. After all, the Skogmans are (Idly tenants. In your negotiations with the County, pleao0 keep in mind that the Skogmans are leasing those lot" from you at a good price for a particu- lar reason. If t'i'1 County is allowed unfettered aecess to t "",, '.:, " . :' ':' : " .':;" , "i ,.",.,', "i " ,:::,i, ,",' ,.'," ,.; ,: :;.: ,'.' ':, -: ,':: .. :.' "', ,',':i ,:'., '..' , . ': ::.;",' ,,; '," """,, ,: . ,:" ':', ',';'" ,,, :,: ';" '" ,:,' ,; ,', ':", ':",. ",' " ::> .'" :,' :>:', ." ," .', .' ' ,,; ',' " ,:., . . , .' , ", ,"., ,',,' " ,! " .."'...:: .::, ',' '.',,' " ,.."'",',d,,.'.., '". ,: ':: ,"', .',:: ','>' , , ' ,'.;' , "', '. .' ,:,". ': :,.i, ,', ", ",.,' " ' ,,', .', :,:', ,."" '," ,',,' " "", ", .." i,.. ',' " ,. '" , ,.',,:', T, ~ ',:.,' '.:' ;' , ' . ", <' ': :', '" ' ,..' " ,i:", , ~I " ; '." ," .':' . ' " , ,.",'.., ,'..,' '. ,',. '" : "'"..,' '. " .' :,' ':' , " ,i:, ,'" '. '" ".: ,...," ,; . ,'.', , '" " . , :', " , . ',."",,' ,,', ' " ",' " ' ,,',,' :"..; , ",' " '",' "',' 'ii ':, ::-:'. , '" . ,:,' , ;', ,,' ,,' '.' ,',' :, ",'/ To: William M. Svensson August 11, 1988 Page Two the rear of its bi' ',ldi n(l through your lots, the Sl{ogmans would consider th;', a violation of your lease and would expect the rent t, be substantially reduced. Sincerely, ~/~- - ~~~':'" MAJHAN TJM:dp cc: Mr. and Mrs. ',es Skogman Jefferson COllllty Commissioners Jefferson County Prosecuting Attorney Jefferson Connty Dept. of Publie Works ", ::, , '. ' , . .. , i ," ".:',' .' ~ "'\ . ,,' .: f , i,. ",. " "'. ?:",' ;,,'. ,; " ';'i '" , " .... ". '. :'; , ":".",< :. ,'" '. ," ; '",'.',. i""".,."., ,) , ,',' "',. , i',' .'.' '.' '" ',' .' ,', " ','., ;" :,.' i,","," i', ,;," ' .',:. " ,':,,.;' ;', ",'" .' ",' :.., .','.:,': , ", ,.;.'"", '..... '. ',,', : ", ' , " "" " "" ' ',.,...."".,. '.. " " .' "",' , ' '" ': . ',."" '" '., . "" .. '" ,.:. , , ",.'.. "', ~ ,; , ",:~ 'j ';'''''j :,:.:,::.:-',::0- ";/,-,.."",,,.,,: Memorex Telex k~?t~02~8'lhCasl 33rd Place Bellevue, WA 96004 Telephone: (206) 827.9600 MEMOREX TELE~ Memore~ Telex 11000 NE 331d Place suite 21 0 Bellevue, WA 98004 ielepnone: (206) 827-9600 Thomas F. Zuvela Senior Systems Consultant August 15, 1988 MS. Carter Breskin Jefferson County Bldg. P. o. BOX 1220 Dept. of public works port Townsend, WA 98368 Dear Carter: Again, it was a pleasure to meet with you the other day, and I thank yoU for taking the time to review your telecom- munications needs and concerns with us. It soundS like we are finally making the proper improvements. AS part of the follow~UP to that meeting, please find at- tached the proper paperwork to implement the additions you requested including new telephones, SMDR output, and remote maintenance for the Multi-Service Building. Sincerely, J~~'~~' Thomas F. zuvela Senior systems consultant TFZ/pjp ~ ',~\ ! ~' " " " " ... " , , , ' , ,'" ' ,,'. '. ,.', ' ".,.' '".""..<., ."", ',." ','.,' ,',' ., ..."" ". ,', , ',.,.. ": ',. .' .."," '. ,,' :', ",.' ' , .. , , .," ..': . " ',' , '. ,.' .," , ',',' ,:. " ."", . ,',',.. :', . ': " ;" 'J , "" ",':.', ",' ",''-' , " .' :-', t, ,~_ ~~o'ripU.\eCriU POBox 503, Wenetchee, WA 98807 (509) 884-1542 FAX 509 884-8982 ~ JUly 29, 1988 Elaine Arey Jefferson Co Central Services POBox 1220 Port Townsend, WA 98368 Re: District Court Applications from JALAN Dear Elaine: The cost for the District Court Programs varie~ with the model of the System/36 upon which the programs are to be operated. Speci f ically: Models 5364 and 5363 Models 5362 and 5360 $12.500.00 18,000.00 In each case, an additional 1400.00 per day plus expenses must be paid for training. Five days of training is usually required. I believe that your best solution would be the following scenario: 1. Purchase a System/3S Model 5363 wi th increased capaci ty for the Sheriff's Department 2. Move the exi st ing System/36 Model 5364 currently used by the Sheriff's Department to the District Court. 3. Buy the Oistrict Court software to run on the System/36 Model 5364. The cos,t of several options is outlined in the following paraqraphs and table: Option 1: Instllll District Court on main ~vstem/36 Model 5360 o i s t r I c t Co u r t Pro grams 5 days of training & expenses Video displays and printers $18,000.00 3,000.00 est ? ~ IE.' iF'- r;',:; Q \\ (. r.:;,,' It\'- U~ &7:. ~"'";.? ~:';l'" \J L:w ~ r.UL 1 1988 Jr:.F;::LZr-,~r:::::'~;l~j C~)\JNTY ENGINEEI~S OFFiCE ,':'- .:, '" ". "",", ',' '''. ,:.' ,,",, " , , ,', '... , , , ,". ,.', "'- ., ',.'n, "'; ", ", > '" ,''', ", ' .' :,," ",:, " ". ':'.:':' , .': '" ' " '.' ,:" :,.-' , "', ' . :' ,'i " " , ' .', ".,' .,'" '" , :,' ;' " ' ,', ,':' , " ;, ',,' ,. :"i', '.'," .' ,": " , ",' ",,' ", ' '.. ;,,':: ';, ",,' : ",.., ,",', ,: ,'" ',:':, ':' '. '" "" ." . ,;' , .''', ''', "., ".,," " ....:: " : ' ,..-"" " " ..' ." . "'" ',' , " : ','. ,,' " '.: ." ',: ,: , , " . .',:; ",.' .;., ,.' .',. ", ,:,:,;".' . ,'. , , ' . : ,,,.,' . '"'' " ".. ,'.. ,. ',,; '\" "':,:,' " :", : " ,:" ,',: ' , " , . ,'; '.'...' :" " , " ','- , , " :-- ,'",' "" ' , ,'., ., '..,,',' .' '. .. :" . ;" .' .',: :.. .. ' , ","' ,.',.'.,:'". , " ~ .' i " ;.", " -,.'"".':",,, ':',,',':.:\ I"~"~ i,,;,:,:;:',<, -', , .,~' i"''';'. '" ", '"'.--,, <"',,I'}_,:' ~'.'!':,:';:. ~,)::, ,",: .' j: ';-- " ~, ..: '," ';, ',' ,,'.:'..':,' ,'i "". 1:::',:";:,;" , ".. ;, ,: .:;' ~ ,',', ','" , """,':', -'~";<- , ',~: " , .' ::' :: ' " ;: ! ;,'>, ',',<';,:.'(',::: <:/,., , ,',",:, i',:\,'; r',',; ",... ,\. ,!I .., /, , ',' . " , ,,':. ',' ',.'".','..:' "';, '; ,'." ,'..'. ',' .;' ..' ',' . ," ,.,' .,.., ".','",. ,.",.' ',;: '.' , .. ',.,. ." " ,> ' " . ;, ,," ,.'.i, ,..'".' ..,' " i...", '.'. ,: '>.. "', ',.:,' '. '. '..' , " .: ,<-, ,<:";:: ,~? '7. -/"~,? ASSESSOR'S OFFICE August 30, 1988 RE: 1989 HARDWARE/SOFTWARE NEEDS - ASSESSOR'S OFFICE SYSTEM 36: I 1. No new software programs. Completion of eXisting software development for the land appraisal program, the historical record program, and misc. appraisal << property programs. Additionally, there are still some errors, changes, and minor enhancements to existing software. 2. Windowing ability. Several speci f ic items have been previously identified (i.e. ability to window master names file from the real property master). 3. No new hardware needs, but it is a priority that we maintain easy access to a high volume printer. It should be noted that the 5225 printer in its current location (Treasurer) is constantly used by the offices of the Assessor, Auditor and Treasurer (along with the system terminal which controls it). At peak periods, this use often runs through evenings and weekends. P.C. : 1. In our preliminary budget, we will request an additional P.C. for 1989. This will be a low-end lap-top such as a Toshiba 1200 ($2,500) or comparable. The lap-top should havE;' a 20 mb hard disk << a 3 1/2' floppy. Software will be Word Perfect and Lotus 123. 2. We will also request a digitizer for 1989 for the existing P.C.. This digitizer should be at least 20" x 20" comparable to the SummaSketch ($2,000 - $3,000). 3. A plotter (i.e. H.P. DraftPro) and hardware enhancements (i.e. 2nd 19" monitor) may be proposed at a later date (mid to late 89) should we go to a full CAD mapping station. 4'. For 1989 we are requesting AutoCad software ($2,000). AutoCad add- on software (i.e. COGO, mapping) ($1,000 - $1,500) may be requested at a later date. AutoCad (and the digitizer) will initially be used by our cartographer (already trained in AutoCad) to run out legal descriptions, compute areas (replacing the now defunct digital planimeter), and begin the preliminary work for setting up the methods and standards for automated mapping. ~'7?L ?aack Westerman III ~ , , .. " '.',,' ,: ,,"'.>:, , ' "::', ' ..; ',',.' ..' '.. ': ...' :', ',::': ,..... :",,' .": , ..:: '" " ,':'.... , , ,.",..,. , ,': ' :: '. , '," ,i ',:' , ", , .. . ',. ," .,.'..' ". .", . ". " ,/' ':, " ' ':, '.., ';, " ".:, ,,, :".' '",' '", , ' " ". '.' .,' ,," ',':, ,:' '.', ,'".,", "'. <: ", ,,: ' , ,', ' .,:" "":5' ',; ,; ,,' ',.' , ....., ",..., ',." ,. ,'.., .".,:: " " , : .' ."" ' ': ' , '. :"'" ',,' ':" " :' ';" ' ,,' , ',,' '..': '. '. " .,' , :,' . "," . ,', ,.' . . ,','...' , , ': , ,', ," , i . """, '): '. " .'.' .. :,' "'.- :,' "', ' , ,'" '! " '.',. . ,.'..,' ,','", ..., .',' :. ,;: , , ',. "',,':",^'"'' '~,~ f ~l. f l; ~',. i; I',' ; , ' " ",'..,,', " ' '.' " . ,,' , ", .,.." , ',.'.',' '", ..' '''... ' ",' .."','.. :";.. , .: ", ':', ' " " ' .,' " .:' ,,>, '.' " , '. ,,' .. " ' ,'" ," : " "''-'' ',,' , ',".' . ' ',' .",.., " .' " , ," " , ':"" ",', ,.,,,... '....:" ',:.-.,,,',',,, , . ,,':,'.' L.(;: .4:.:'/;:' " .. Gardiner Community Center Advisory Board 1761 Old Gardiner Rd. Gardiner, WA 98382 September ,11, 1988 Jefferson County Commissioners The Court House Port Townsend, WA 98368 Re. Appointment of new members to the Gardiner Community Center Advisory Board. Gentlemen. The terms of Board members Mr. Einar Forsman, Mr. J1lII Burllle, and Mrs, Helen Robison, expire in October, 1988 at the,olose of our meeting'10/4/88. The following persons have agreed to serve three highly recommended by the present Board. Danny Rice Vernon Kelm 1861 Old Gardiner Rd. 411 Sunshine Dr. Gardiner Gardiner Sequ1lll, WA 98382 sequ1lll, WA 98382 Phone. 797-7115 Phone. 797-7095 year terms, and they are Marjorie Pearson 1010 Fairmount Rd. Discovery Bay Port Townsend, WA 98368 phone, 385-5137 It is the Board's recommendation that the above appointments be made. Installation of the new Board members would be made at our November 1 meeting, Election of the '88-'89 officers will also occur at this meetinb' Very truly yours, el~~ E. V. Forsman President co. Helen Robison, Secretary . '<"'",', ,.',,',,,, -:-:...,"" ,.' I, ' :, '", '," ,', " ,,', .': . ',', ,', "."', ,',.," ".,'; " '" ,:. ., ,'. ',.'. ' " ,:: ''', "", .,' ',," ":',':," '.': ',... ' '.' ':, '.',.'''' ,"y:,.,, , ' .. ..,' '.' " .\:::,,'.,,1 , :':. " '" '.',.'" " '.. " ... :. ,:, "", " : .' , ' , , ~: " :,' , ',". ',', .",: , " ,.:,', ," . ',: , " :-' ."",', :, ", " " .' "':".' ,:, i, ',' ,,,.' , ",.",: ',:, ".' ..,' ,."" .''', ." .;C' , ',' .'" ',',.",' ", " ,,';' ' ,'.'''''' '. ,:' '",' .' ' :. ,.,': ,: ' ,', ' ".' ,." ..', "",, .,' '. ".,,' " ' ' '..,' , , " ' , ;",... ,,' ,'.' <',. :'" " "" ", ,c," : .':' ':, . ' " '" , , ,,", '" ... :' :,:' "" "', ",>"",:,:" '"" "):,:'( , .. ," "'" ",." :. ," '., . ',' ,',,' '. ,',' .. " ,.' '. ,',: .' ",'. ,'" '.',., ,:: .".. , ., , J I J ",.. , " " ", . ". \::,',: .--:";" '. ~' , . ,:"", ' , ,:~;'. .',.,.." ,'. .', '..., -;- :' DATE 8/17/88 I H~3URAHCE SHOI.A,I I t--~I:?i .', , ", " ,,',.'," ; ',' , ',.,;. ",. - ,',.. '. '.', ",/'C(02d:':?'(:Z!, ,''',:',',' /,',vo 7-/0 \," ',;' !':',: ::", !,' , , , ' .' ADD I T I OHAL I t~SURED" .,':- , , , ,- : r ,.., ' I ,.,', ,. . ' ". ." ..., ,I ." '. , ' : ,"', ' .' , , OI,IHER t1CCLAHAHAH COI-4STR PROPERTY GEHERAL LIABILITY COVERAGE COMPAH'!' t1ARYLAI-4D CASUAL 1',' POL I C',' HUI'lBER PA51389464 EFFECTIVE DATES 6/30/88 TO 6/JO/Sq THE DESCRIBED EHCLOSURE PROTECTS YOUR IHTEREST IH THE ABOVE PROPERTY IH ACCORDAHCE I,JITH THE POLICY PROVISIOI-4S. PLEASE Am) I SE IF AH',' CORRECT I OHS ARE l,jECESSARY. B , ',,' " , ".,." ,,'. f,' EI-KLOSED ADDITIOHAL IHSURED EHDORSEMEHT L CITY OF PORT TOWHSEHD C/O DIRECTOR OF PUBLIC OWRKS JEFFERSOH COUHTY COURTHOUSE 1820 JEFFERSOH STREET n POrt-Tc-WV'~ LUI'1, 0i3l-6 b RaDII I ~1 TO: REDMOND GENERAL INSURANCE AGENCY. INC. !:', P. O. Bo~ 847, Rndmond, Wllshinglon 98073.0847 - Tel.: 206.885-2263 l', .1 iV. " '" " ",'" ,,-: '" ,,', , ' , ',', ":,, , ". ,. .,', ,', ,. :',,' , , , , . ,',"" .," : ,'" .' ,'.' , ',' :::', ''':'. ", "'.' ',<...,': " " ',' ." '. ,,:". , , ,'" '." '. '.,"'.',.,"',' , . "',' ',' : ,,', ' "..,,' ,: "'..' ",', ,'".', .. "", "" ":" ' ',' ',.. '., "'," "'.; '..', , " ... ",: ", '. ' ',':':" ... '.' ','" ",,' "," : ", . , " ,,'..... :",', ',,':" " ' ..' , ',,' , '.' ': : ,,', ".' '.. :,'::",' ".. " " " "",' " . '. , ',' , '" .".,",:', :: :., ',: : ""', ",::, '. ',.,., , .' , , ." , .,.'.';, ' ",' .'" ,', , .' ',' ' ' " '" i: , ",':.., ,'..' '", .. . ' ,': ",,', ':" ",: '" . ':.. '," ','i ;:. . 'I <1221 .".' " '. ..' " "," -:' " ' "" ". >/ .' ,. . ' ' :.< ., '" '.', ,'- ,'".,',.. .",',,'..:, ", '," "'., ' ,,',,', '" :, ",' ," " ,',' ' , ,,:' ',:' ".' ,,' .. , ,'",':-', .. ,,: '," ,',.',:'. ."" , " ',', ", ','<: , '. ",: , , ': '" '".""':..."',:,'::" " ", ,",',,' <:',', '.,',..:-.':. ,'.' ';, ',,',,',' , ',',' '.,. ':, ,,",,, " ",',", ' "',,> ,',",' . " " ,:: . ",;,' .,", "" : ,', ""., ," '. "... " '::'" :' ,.,', . , " ' ','. '. , ':' , ; ',' '':,.. , ," ':,' ,', ',:,..,.,. ,.;",,' " ' " ,'. '., ' , "',." '., '"",' '.':. '. ".:, , " I. ,...,.', ",' , ',' I. ,: """:':L It'i~~ ,:;~., .,. ',:, '':' '.;, " ,l"., , .'; .., I: ","', I," ',' 1\ "..:' ..,' \: ",',;,." I;, "" 1''---:' ii', ~.. 7' ~ t' . \: ~( I ,. , " " ~.. . ~ ~, ~ '....,' ,',' . "":" 1 ~ I: ,,' :'" :" ,,'.' , .', ,', <i:~ I ...~ '",'<"GJ'" . , : ':,,,,".' ,:.', ':" "~'"/ , " " ..' .',", >;:;;',"'"" :,";,','--'-'> '0",,".-', ;'^; ",-,';"!, '--,-::.,:<,..;,' """;,:;, ~~~lW~~;<'';lj,.<,.;io1''::,:;U~;'i!.VA\'',~~..stt'''>I.;;_i.:2..:..~:,;;';;::r,;:~:~~!,;~;~~~D.;....~:~'~~",~~,~,~,~.~~~:1-1:L..~;!.~;~~1i!:;i;:."l4~i~~\{'Wff0:;;&,;' INSURED: dba: MCCLANAHAN CONSTR. CO. POLICY NUMBER: -. )3PAO IltJ] R.. COMMERCIAL GENERAL LIABILITY POLICY TERM: 6-30-88/89 -- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT'CAREFU~LY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) ThiS endorsement modifies insurance provided under the following: AGENT: REDMOND GENERAL 42-02055077 COMMERCIAL GENERAL LIABILITY COVERAGE PART. Ef f: 7 - 21- 8 8 SCHEDULE Name of Person or Organization: CITY OF PORT TOWNSEND C/O Director of public works JEFFERSON COUNTY COURTHOUSE 1820 JEFFERSON STREET LOCATION OF COVERED . OPERATIONS RENOVATION PROJECT FOR A SENIOR CENTER IN BRINNON (If no entry appears above. information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule. but only with respect 10 liablllty arising out of "your work" for th3t insured by or for you. RATES ADVANCE 'PREMIUM BASIS PER 6100. PREMIUM PREMISES/OPERATIONS PROD~CTS/COMPLETED OPERATIONS COST 6 .027 . eAT AUDIT COST e .061 TOTAl.. eA1' AUDIT ADVANCED PR;;MrU/f ..., CGl IIlb/lc 8-2-88 CG 20 10 11 85 ~Opy"gl1t, Insurance ?ervlces OJlice, Incoo 1984 .... ~t f; I 7'~ "", t. f- ~ I :1,' fl .,' ...'... " '.,.., " ',' " .'.,. ' ." , , ',' . " , , .:', ,:: '.. ,'. '. '-: ',' , ' '.",.',' ..... c /:',r' ,-,'J :'<-,J '. .,,' t ~ PO 80x 503, Wenatchee, WA 98807 f."EfHVd1H.'tf'J.:rYlri' (509) 884-1542 r--\lUI'It'U ~U\lllfW~ June 30, 1988 Dear Customer: As you ar~ proba'bly aware, IBM publicly announced the AS/oilOO computer which is a replacement machine for their System/36 and System/3S computers. At the same time, IBM affirmed its intentions to fully support the System/36 Model 5363 as a new product until early in the 1990's. In fact, IBM el.o disclosed tha ability to double both the main memory and disk storage capacity for the 5363 relative to the previous 5363 maximum configuration. This latter announcement assures a longer machine life cycle for cur rent 5363 owners. Bee a use 0 f 0 u r bus i n e s s rei a t ion s hip wit h IBM (a n Authorized Application Specialist), Compu-Tech has been given an expedited delivery position for the new AS/oilOO computer. It is estimated that we will receive our machine i n I ate J u J Y 0 rea r I y Au 9 u Eo t. We wi I Ita m i 9 rat e 0 u r current programs to the AS/400, but we intend to make some signi ficant enhancements to our software in order to take 1ul I advantage of ttle capabi r ities of the new product. AI though we are very exei ted about the AS/40Q, we wi r I keep our e xi. tin 9 S Y . t er;> / 3 6 andw i I I f u I I Y . up po r tour S y s t em/ 3 6 ? c u s t orne r $~s:1.[~}rg~:.,8::s,~:.;:L(::J,:,~<::,~~::c.,S>,~~?f!l},,~,~~~~"t.~:~:./,;~,~~~~J, ~,J~e...;~~ b7--?/"o ~ If you have any questions or want additional information on the AS/400, please feel free to cal,. COMPU-TECH, INC. , '....,',' ,.,'.' " '...'.. ""... .' ',' ., , ,,' ...., '. '," ,....,., " " ' 'i: ,,'" ", ;'" ,.'.' ..' '.".. '. ',' '". " . ,,' .,'.. .,', '. ..." "" .i ," ,'. ,'..' '. '.' ,'.,.." '.:,:.,. ,". "',' , , '.',.'.. '..., '. .. .', "., .' ..." , ", ..'. ".' ," ", ,:,' '. ,.,', " .' .,:,:'.t' " <: ..., , ..",.. '.,'.; ",\: '''', , .',." ,," ,..', "". ..,' i .,.' ,.' .,.,',' '. ," ... .'..,: ' '.. " ',: ': ,'....', , " , . , ' ','" : .. ':' '. ,',..,"... ,"", i" . ..." ,,'>, .~, '.'.i "".", .i.. ..' ,: . '." " . 'i. ,,' ,,' .,,":", " ;',...':. ',' '," '., ',.'.., "," .:.... " " ..".' ". ,'<. ,'. " ,""..' '," '",' ':" ' ',.' , " ':., " , . ' , '.: . ." ..,'.", , ,.' . ".',.. ',.' ',.' ,'.', . " " " " .,." ,.:.' .'.'.,',. , . ,.., ." 'i, ,'" " ..' , : .. " ", ':. ' .', ': " ',. .', " ' '" '" ,,' " '.'.. ' , ,: :., :"',, ,,', ..:,'" , ." ~ I ~, , " , , , . " " '. , .'.. ", ".. ,." ," " , ",' " :, " '.. , ,,' , !I ;:, " ' r/, --PCp/C/o c.-/;'-'.c:' ,-::~'",,:.i ~ >-'-;)" .:;:J,~,'" .,. VOUCHER COUNTY OF JEFFERSON PORT TOWNSEND, WASHINGTON 983GB 32967 WARRANT NO. PURCHASED BY OFF ICE OF COUNTY CORRECTION CENTER CONSTRUCTI N\MOUNT AUTHORIZED =/F~ \<i' ~. DATE OCT 1985 13969 65.10 ACCOUNT TO BE CHAHCEO TO PC&D Inc General Contractors OR, f. ,~ ~i Ii' ADOR ESS ST, COUNTY OFFICE USE QNL Y CERTIFICATION I, the undersigned do hereby cenify under penally of perjury. that the malerials have been furnished, the services rendered or Ihe labor per. formed as described herein, and Ihal the claim is a just, due and unpaid obligation ag;:ullst Jefferson County. and that I am authorized to authentj. c:aleand certify said claim. CITY STA TE TERMS NOTICE-TO SECURE PAYMENT THIS FORM MUST BE MADE OUT IN TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUOITOR, COURT HOUSE. Signed (Iitlel BV DATE QUANTITY DESCRIPTION UNIT PRICE AMOUNT Project 81-15 Total complete and stored to date State Sales tax on above 7,8% ~"m,,' ~~ive Disbursement to date "rA"i'n..o ni s"nrOAment to Voucher Disbursement this Period 10% Retention for Escrow Current Pavment Due 61,475.01 4,795.05 66 270.06 49 275.27 16,994,79 1 576.51 15,418.28 VENDOR lOR SELLERS) SIGNATURE NOT REOUIRED Relu," All c~\ ~ ;"';;1 '"\ ALLOWED BOARD OF COUNTY COMMISSIONERS DATE COMMISSIONER DIST. COMMISSIONER DrST. CHAIRMAN OF BOARD I I III I I I I I I II I I ~ I ~ o .. "'I ~ ~, } ", :, ~:-:"", ;'...., ,.' :' " ,c., ',. ,""'.... " :' ,.'",' '... '.' , ,', ';,:: '..: " ,.,..'. :,,' '.' .,.', ',': : .. " ":', . ": \ " ,,', . ", ,." ".: ''.;'' ":, " " '",'; , ,..,'!, ," ", '." ; ,... ' .. ,'...,.' '". ',','. .,"" " . " ',: ,.., ,.,' i:', .' " ",' ::,' " ".',', ' " ':', ' , '-c:', " ..,,'. ','" .'," "'" :,,', " .. "',, : ", ",', .'.; , ",.' ".,., '., .' " ',.'.'., C' " "'" ,'," ,'" . 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JS, ~EI.fe .,....,........,..,......."."..""",.",.....,...."....,...,.~~~.,."..r,;;~'~€~~..."~'G'.i~..4"5',..{) I .>1 it 5240 SHORC'I/EADO..'..S ROAD FREEL,l,'m WASH!IJGTON 9S249 I'OCRESS CORRESPOrWC"ICE TO: PO BOX 250<9 LAKE CITY STATION SEATTLE \'!ASHINGTON 95125 " '.,: . :-;-.-; , ',' '~,,,' , ' .'."" .;, ': ':" , '.' '.-. '. '. .: " " ;", ,', '"", ,..., "; ,',..., .>:: '. ," "".' '''. i, '): " ,:.'.,' ",,::'.i '.: " " , ,.' '. '. , " ",':','" :'.', ' ' :'. . , ,... ." .. :.. .' ,", .'.,. " ". ,'.. .,," .'." " , '. " )'; ,:.". ,',. '. .'.,.,' .,>' ',',< ',',..',"',.:..' ".. '.".. '>.: '.... ,.' "':,' " , ;, ' ':, '" " ,", ' ,',' ... ,'..,:....":: .'.. ",:. :,: , "': ,." '" ."" '." ,. " '". '. ,,'. '.,', ' , ,,"'. :, '.:'." :."., -: " ' " ., .. , .:'" . , ' ' ..' :":,',.. " ''', ' ", , .',/" ,,, ',.' '::.' '.' " " ': ".",,', ,,':''',' ,.,'" '.', ' , ~ : ,.' " ,'.. , ' , " :" ,., ;"" ,," ,:".,.,: ; .'" " :'!: " ": ':, " .: ' , ,/ ,,' :, ',., " " , " '." ,::, "', ',' ': , .: .,., "::, . , , ;',,, " '.' .< :,,: ': " ,,': ' ',' . " ", : , " '. '" "-', ".....,.,,' " ", .. , .' ',' ~~~A~ _ ~;O/o{J PURCHASED BY OFFICE OF COUNTY TO PC & D ADDRESS CITY TERMS " , " , ." . ',.', ", ' , ,',' ,,: , '" '..'..': ' ,:' ';'.., '*~t./{)/pO VOUCHER COUNTY OF JEFFERSON PORT TOWNSEND. WASHINGTON 983GB ',: .. .,'.. ",;..'.. ',,', '. ' " :.., , " 35902 WARRANT NO, CORRECTION CENTER CONSTRUCTION AMOUNT AUTHORIZED DA11 MARCH 3, 1986 13960 65.10 ACCOUNT TO ~E CHARCED OR, ST. COUNTY OFFICE USE ONL Y CERTIFICATION I, the undersigned do hereby certify under penalty 01 perjury. Ihal the materials have been furnished, the services rendered or the labor per- formed <15 described herein, and Ih.11 the claim is 3 just. due and unpaid Obligation against Jefferson County. and thaI I am authorized to authentj. cate and certify said claim. STATE Signed (title) NOTICE-TO SECURr PAYMENT THIS FORM MUST BE MADE OUT IN TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUDITOR, COURT HOUSE. UNIT PRICE DATE :., l Rl1urn All Copieli 10 Auditor. i ;'* ,If' f I H I~ ;) co "< " '~ ~; ~. ',', ".' , ", , " " ',' ....,. , By QUANTITY DESCRIPTION AMOUNT Final payment to Date including additions and deductions on the change order plus retention 6,965.50 VENDOR (OR SELLERS) SIGNATURE NOT REOUIRED ALLOWED BOARO OF COUNTY COMM1SS10NE~~~T /l-:l:--?tff3/ptJ? COMMISSIONER orST. / ,.,..;7_ ~ I ~ ~fl~~ -v.~) ~/L1 LV~1s COMMISSIONER DIST. - CHAIRMAN OF e..o ~ mm I ~ rr ;1 ',:'" "'. "'," :'..',.. ,:.!", .:..' ::,i" ':.'.," " :~. ,', ,", .,,',' ",' '.,., " ,"'., '.." " ',' ,..' " :", , , . '.,: '.' ,,'~ ' " ,'.; " ,,', .,'..,,: '. '.'" < ' .,' " :'.;, '... " ',',', ,. " .,. ',.' '::,' ,', ,:i 'c. :':, ':;",:." '" ';., ,', ,;........, '.,.' .: >', ;'.:, ,.'",' ..' , ".' ',", ":" ,', ;\~i ': ' " ,,:' '" ..'...,'. '. ", '..,' ' " .., ", '..'" .'.' 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I!! flico ~~~~~~ E .. ). ~ '" '0 ~::':' :; 9- c: o~ :;'.0 ~ ~ "&1 ;;: ;;t-ll?j 3-0[:-:- " Ii =, q 3" _ Q ... f'~. 0 q", _"T f;; ~~~::!fS .. 2 ';: 0 .~Q ~.!f[::: :;: ~ l:T 8 irr f~ .... n g' a ~8~"'E ... t'" ~ i(~~ ts ~ ~ ,~ s , -. :!l ~ ... 2- rf?- ie -'f.3 ~~~~~ 0 " i!:o- ii ,- <: .., ... Q !3J. o . 0 .. .. 0 "'~ 51~ .. >- n a : ":J1f ~ ~ 0 ~ .. If ~ s : ~~!'J8'" !i- n :l! :I- + ~ 8 n ;g~ " " 0 '" -0 t! 8c~tiii a E 2!2 -0 ~3 6 c: <0 .. e- qi;! 0 ~ ~: tl !2C1 $}~ ... ",. ~ Q zq .' . '" " . ;;j!2:"C 9~ Cj~ 0 fi ~ .w~ 0 Z ~ ;;j~!2 In' ~ '"""," Z ~[ 0<0 ~ So' , "'-n ;;j ii ~ r r .. : ".. 0 0 U. w... , ....0 ... 5' ~ ! <:' 0 g ~ w .... , , /-;;-'< e: <n "'''' ;;, . " ~ <n<n ~ ~ . ~?,. 2: ~ E i' '" '(.o)~(..r)i>?V}'V> ~ 0- " it ~~ "'''' '" '" ~ a ... ;! ~~ '" ~?..~..~w~ ."" !'> <0 OOOOD!;! , o' '" Q '" ~ <0 l:.OQ:lc:.nO:lQ:l '" .... " <n 8~~~ ~ ;;;. '" '" O)Q~OoO:l '" Coo !, 0 a.. '" :n ~~~~:o~ ~ ~ i!l ~ <n cCJ-tO:l.....t..:ICO 0:> '" !3J. E ~ ~ ". Q I 0 C:::H:::) 0:. 0:. ob.. f\:I "" '" !3J. ... '" 0 ~ ~ .. SO ~ '" , ':., , " . " " ,,' " '," , '\ ( S c ), ) e' " I " I'; r ( ( -" ( f l !- !" L C (J f.! " ;, c 'r ), " C ;, " , 1I L 1 r, ", , : ~ ,; _~ . l . \ . ) ,I !'r:(CJ~. (;1 I//\/'!/~,C[HS JEFFERSQ'1 COli~1Y JAIL JEFfU&!~ C(t'NTV JO:.r.'SJOWHU'iT & ASSOCIAiES 51512 fPilOJECil IO'~".[R) l/li1CHJTECTI lJOBN:t':&ERJ u Cr.~:'T TO M~E tS4,6S4.S1 '2 lESS RErr~;IO'\l (1M'i"J 11llll~G t>D.: llATEFRQ:o.: OOlE10: 4 SEPT. 10. 1985 OCT. 31, 1985 *,JCII',;lLTlESSR::r $54,654.51 '4 TAl D'l '1 ~ 7.8~)'; 15,1'43. rs _STDTJ:l!. 169,6'31.56 *'5 LESS p;mo:n:rs 1$51,9"',,4.16) "'.AlP! cm.'TRACT: CKA.';G:::ORDfRS: Ifr.5Si'. ~~ $4,a.4.51 liS TOTA;. S69,697.~6 '7 BILllt\5 Il~O~f\'T $7,743. 4i11 N:J:C(J\'TRACT: f,64,654.51 .r.'ll~ COVTRACTtllfI ,.... It.... flU It UII 'H" lilt I U II" UIIIIIUII.. II flU 'H"" HUU' flUH fllfH" III flU' II"..H",III. ...H...... UIf f DESCRIPTIDII SCHEDU..tD 'JA:'Lt: P:::JW:T BIl;.R~.tE TO RETIlI~Il~!"' CO"'.ET: CQI";P..ETE r.~~ PREV1D~S tllfll!:U~i\~II- PERIOD..lllu CO~:>:,[TE PllLl~S ~IJ~;{ n~ PL~CE P::~:::Et.'TPSE iO ~~rr~ =====:::=====::::================================::==============::==============::::==..=::=.::===,,:=::======::.==::===.===z:=:;:=:;:=:;:=:;:=:;:==:.:= GEP.'El!A:. C~.'DITlO~:S t3,lW.f'l tJ.N1..r~ Ii'. ~l ~. rot f3.r:~. rl- If'~. r,: U.\'~ Ii'-, r~ SITE ~~~i{ ,z,ru.r~ 'z.ru.r~ I~. r3 ~. rot 12. r~i'. (If' In.~;( IM'l H.r~ CO.'.C~TE t3,enr3 '3,BU.r~ fl". r~ ~" r" S3,EU.q~ InrJ: 1~.rJ n.~~ ~,~SO~ilY II,en.i'I~ U,f:(!.~e. I~. 1.':3 ~.f;( I:. ~f'~. III Ir~.r" f~.r~ tU: rEHlLS tl. 6$1.. i';'I tl,65r.~~ ,~. r~ f.rJ: U,~5l>.ri'l 1r.1. r~ l'l.r~ t~. (~ CJlR~Er,'TRY t2,8~1. 1"1'< 12, en. r0 f~. r~. ~.rt: 12.flt'.rl I('~.r,; Ir.r~ tl.rl Tfl:~:O:~:" , Jl:DISTURE PROTECTlO~ '2,r~~.rl- 1?,r~i'I.r~ I~.tl r.ro:: t2.r~? 'Ii'! 11:';'I.r,: t;'l.r;o Il.r? DOORS I ~RD~'IlRE tb,722.N 56, 722.r~ ,~. Vi'! ~.I'': n.nE.lll IU,l'; tl.r('i Il':.r,'. Flt-;IS'1:S '16,~"'1.rz: U~,5l'ii.i'(! ''''.1:';'1 r.u tl~, Slr. l'i'I H'j1.r,: 'i'I.r~ Il.r1. "'ISC, SPECHt.T1ES '2,'W.tl '2,0~1.1.'0 t~. 'Ii Q'. ~,; IZ.U~.~~ lr~. 1;( Sl.el! fl!. r~ E&:JIP~v.'T ':lN~.~ sl,rl~.?~ 'l.??' '1,1:'% 'l,rn.f?: H'e.V'; S~.l.'~ Il,.rl, FUR~JSHltl5S '8se.r~ 'B~.e" ,~. r~ ~.r%. S~51., l.'~ l?l'.P% 'l,f;0 fU'l. S~ECIR:" COI\STRiX:TJO'... Sl,r..~.r~ II,rn..rJ ,~. r2 r,p,: 'l,('nr~ 12'21.('': S~. ra 11. r~ f':tCI".A~ICA:' $1,3u.el fl,J'l!l.t'l ,~. 1(\ l.ry. Il.J~l. 02 H'~.\?1> '?e~ n,r~ t:LECTR!CA:" '3,6!B.r~ 'J,6.?B.illo ''''.''11 P.f;( tJ, E~e. "l' IN.~'; HI.?? I~.rl. "4'\~GE~~T FEE 'lil, S(I~.V'~ Sl?,~"'.eQl sl.e~ ~.r" "...~~:'I.N Ir.:'-:.ri '?eJ Il.r~ =====---========--.:...-=========--===========:;:=============.=============:;:==.======.=======,,================ TOTALS t6(\,5S\?r~ t6~,550.el: tP.re ,~('. 551':. Q'l, S~.. rz; '1.lI0 .CHA:,iGEORDERS.IIUtlflfl.,HI.lllf....,IIIIIIII.ltll..I"Ulftlll.IIIf'tI"lflllllIIIIIIfIIUU'ltllf'llIl'tlll'ltlltlllltllttltflllllllllll' DESCR1PTIO~ SCl-'EDlUD Wl:.L:E PREV!O:JS tJIIIICU'l;;~~j PE~WDUIIIII TOHL tD:o'PlETE PEI;CEr;-:- fl:l:'l:l'JCE TO IiETIlH;tl[;: ~ BIlllM3 ~~~;{ I.'> PUlet PE:1::E~lP5E TO Nl7E CC~;li..ETE CO:>:P.ETE r. r~ ======---=--============::===="'======--==========z:==:;:====::==='"=============================== flWlS!lECToUTlETSFoRpt.;8 t2,rB4.rl> ':?lP6J,16 '2r.B4 l.r,: ,.:, r8~. rl l~:'-:. P% 1~.1n SM'~ CREDJTFOREXISTIt.'GSlJES I'J,422.N) ffJ,422.001 t1.rr l.r': (t3. 4,~. ii'll'} al:.~% t~.~~ S~. rJ OiCLOSU~~ l.l lRNDRY S'32,"f~. ''3.:1.'11- SJ.r~ r.p,; 19?~. r~ :~~.r" u.rz '~.~0 PAH>TP'${S& TO:JCF;.:P '2.J15.l!l ,~, 315.1.'~ U.P:~ 0."'; S2,m;.U In.~'iC t~. 0:l 'l,.(,~ DELETE SA.'iITARY NllP;U~ DISP ff472.r31 IS472."2'I 1<1.('"i'I r.e" IIH2.f'l-1 In..v:): Sl,P;' u.r~ FIVlCH,C;IlGE FOR TElE;lHD.';E USE 1'856.5'3) II1.e0 1'~-b.S:;. l~.!.e,; ltSSE..SSI H'r.p,: se.r:~ 'U'~ j:lODITJO'-'A:" P:lH.111:;:lTERIRl. 'J,S3;.1~ t~.r:~ '3,535.1r: m.r:t 13,536.10 lnA': ,~. rJ t~"elo ========--========================================.=======,,:::===:===========--====== TOTALS S4,l~4.51 SJ,4r.4.16 '2,7U-.J5 14,1f:4.5J S0.elo u.re fG~Il"':J TOTA~SI'IIIIII'IIIII"II'IIIIIIIIIIIIIIII'"IItIlI'lItflllllfl"I'ltI11111111111111111.1111.1111"111111..111...1....1111'1...111111111 rAI~ CO-\'T~qcT + CH:l','GE ORDERS S641654.51 151,9::4.16 12,7U.J5 IS4,E54.S1 '~..r~ '~.rr, .11I111+lIIIIIIIIIIIIIIIIIf+lIl"II'lfllllll..,I+lII.IIIIII..+lII'1111111111'1'111111"'1'1"1111'11"11111111111'11'111111111IlInlll.111111I11I 5240 SHOREMEAOOWS ROAD FREELAi'D \'l/\SHII,GTOlj 982,HJ r,ODRESS COfiRESPOUDEIWE 10: PO 80>: 258,19 LAI<E CITY Sl AT 101, SEATTLE Wr',SHIIW101, 9[:125 k. ;~.: . ,'.' ,'..',..i: ,', :' '. ' ',.. .."..,. 't: ':" ,,-,',,: t , , ',','., '.,. ".. ,,: ',', ,'.: { ,'" I ': ,.... " '. ";"..< . ,'.. '" f ,.....', . ,'. ',' ,..". ", " '. .,", ,1 . . ~" ': " "i' . ' " ,.' ,,' ,', ,,':',' :',' , ' l ;,'. . ,: '..' , .' " . '.. ",' " , ,'.', ' .' ',' : '. , , ',: . ' ': " . ...,', , ,: .', '" ' . " , , " .':',..., "'. '.-,' ;, :", ,', '''',' '. , . " : , " " ", ' .' " " .' ."..', ' ',' "> , "',: ,'," :':", ,,'" , " ,',",' ,'...' " :. '. ",'."., , ' , :,.,: , ,'.,,' ,', '.: . .i.';' ' ' " """" " ' ", " ,,". ',:," " ;. "', ,.' ,.'. .",'.. .',.'.' , ":,<, , ,.' "" , . , , . " .. ',' , .,' .' . ,,;"", ";, " " ' , . ",,' ,: ,,'; " '... ,,:,;: , .. ":, C ','. "., ',...' i,,,, '. ",,' ',' ' , . .,' " " . , ,... ..... ',' ,': ," " ,'c . i." .,", : ' i .' . ,: " . ." ." . ' ,.,:", - ,,~ , .., , "..". , "'.",,, ., ...., '" . ,".". .': , ':' , '",- ,'," l \: 'i . ~. ~ I ,.' ',.' , " " ", , , ,'.', '".",' '.,' .,' , ',',', ,.<lCE .....r{DER AlA DOCUMENT G70l Distribution to: OWNER ARCHITECT CONTRACTOR fiELD OTHER IXI ~ o o PROJECT: (name. address) Jefferson County Jail Hadlock, \o,'ashington CHANGE ORDER NUM8ER: 8 TO (Contractor): r PC&D lNC P.O. Box 25849 Lake City Station L Seattle, WA 98125 INITIATION DATE: February 11, 1986 "I ARCHITECT'S PROJECT NO: 81-15 CONTRACT FOR: General Construction ~ CONTRACT DATE, June (3, 1985 You are directed to make the following changes in this Contract: Paint materials re-supplied to replace empty cans of material, stated to be full by original contractor. TOTAL ANOUNT THIS CHANGE ORDER: ADD $ 3,536.10 Not valid until signed by bOlh the Owner ,and ArchileCI. Sisnalure of the Contraclor indicalc~ his agreement herewith, including any adju51mcnl in the ConlraCl Sum or Conlrilcl Time. The original (Contract Sum) (Cilt<ID<lXlE:t<Ii.M:KKmxm>6oGll was..................,........ $ 60,550.00 Nel change by previously authorized Change Orders................. .... ..... ..... .... $ ( 1,402.28 ) The (Contract Sum) (fill""""Ioc.fJ>I9I""""mmli1=> prior to this Change Order was ....,..... $ 59,147.72 The (Contract Sum) C'(}uQ~}'jX'Ka:o:f%lKl) will be (increased) (decreased) (unchanged) by this Change Order. . .... . . . ... . .. . . . .... . . . . .... .. .. , . ... . . . . , . . . . .. . .. .... $ The new (Contract Sum) tXt(~"tm.1X~l'l:'H~Rh1ittill including this Change Order will be . .. $ The Conlract Time will be ~"",Jeoo:=,t) (unchanged) by The Date of Substantial Completion as of the date of this Change Order lherc{ore is 3,536.10 62,683.82 ( JOHNSTON/HUNT & ASSOCIATES ARCHITECT 1]]2 East Front Street Address Authorized: JEFFERSON COUNTY 1~1~E~efferson Street Address :;;;;l:dL~68 DATE "?.-2.y-6'~ PC&D INC ~~~~RAi6~R25849 Lk Citv Stat. Address '~ ltf" BV' . , I~ BV~, r1??o-.-- DATE o? -I' t. DAlE ~ AlA. DOCUMENT C701 CHANGE ORDlR . ',I'Rll 1978 EDITION . AlA" . CD 1978 THE AMERICAN INSTlTUH or ARCHllECTS, 173S NEW YORK AVE.. N,W., WASHINGTON, D.C, 2000(. G701 - 1978 , ," .' " ;... ~' '" ,'-',.":' ,,", '.. : ".>;', ,,'.' ',' " , " ','" ,,:,' : ":" ; "', " , :",' ,'. '. ,~, '.', ' " ',.' " . ", '.,. ',' ' " .' .,,' '.,.' ,..,. :, . .. " ..," :', " .".' , ." ,'".'.:',," '," ','., " ' ,,',. ,':i"',"'., :- :'.' ".' "',....", " , ",' " '..,,'....:' , " ..".: ,'" ' ',' ,,"'!, ' ,,' c" ',,-' ""..' ,,',' ',',:! ,,' ' . ',.,' " "':,' ", ,." ,,".... " '",.,',.' ',' .,': '" ;"'.'.' .,', '. '... '..., i 'i \ ',' ",' :,', :" ,',' ,', ,'",' "', ,': ., ' ',",; '., '.. :.:' ", ':' ,',' ',' " , : , ..' ,: ':: .' "'., ".." , , ,.,,'.','" ,:, ' . "'" ' , .:,,:' .... , ',', ", '., '." .,,'...< '.',' . ,.' .' '.' ",,', ' " ' ,,' , '," ': " .. .," '" .... :,::; . ':' :,' . '. " '..", \i: , , ..',', ~.. ) Days. ,,", .'''' ".' ::: '," ,', '.' ..'..',' '..., ',,' .. " .. 'ie' . - . -,i . Distribution 10: .vER OWNER ro ARCHITECT IKJ AlA DOCUMENT C701 CONTRACTOR 1SJ flElO 0 OTHER 0 '" ' " . 'f" .' , , ! !<~.' " PROJECT: Jefferson County Jail (name, address) Hadlock) Washington CHANGE ORDER NUM8ER: 7 REVISED TO (Contractor): INITIATION DATE: February II, 1986 r PC&D, INC. P.(). Box 25849 Lake City Station Ljeattle, WA 98125 -.J CONTRACT DATE. You are directed to make the (ollowing changes in Ihis Conlracl: "I ARCHITECT'S PROJECT NO: 81-15 CONTRACT fOR: General Construction June 3, 1985 Credit to the Owner for Puget Power Bills from June 12, 1985 through August 16, 1985 as outlined below: Billing Period 5/17/85 through 6/18/85 = 32 days 1,324.50 ~ 32 = $41.39 per day 6/12/85 through 6/18/85 = 6 days 6 x $41.39 = Billing Period through 7/18/85 = Billing Period through 8/16/85 = $ 248.34 1,026.11 696.25 TOTAL CREDIT THIS CHANGE ORDER = $ 1,970.70 (DEDUCT) NOI valid until signed by both the Owner o1nd Architect. S;gnalu<c of Iho Coo'''''o< ;nd;ealos h;s agroomont horewHh, ;oelud;ng any adjuSlmool 10 Iho Conlrae' Sum or Con!raet Tlmo, The original (Contract Sum) (G<tt.H~:I{~A~~:Gc~t) was.. ... ... . . . " . " " .. . .. .. .. $ Nel change by previously authorized Change Orders. .. .. . . ... . . . ... . . . .. . . '" . . . . . " " $ The (Contracl Sum) {~>:~R~RJt,:;t\h~U:lXl>."i~ prior to this Change Order was .......... $ The (Contract Sum) ~r~K>i=j(',,~) will be (~J (decreased) t<mEba<t!:HcI! by this Change Ordor , , . , , ". . ". "" "" " . . , . " , """ , ". , , , , , . . , , , , , , , , ". $ The new (Contract Sum) (KroKDaJilJccdJM,)..ciml:l~ including Ihis Change Order will be . " $ Tho Contract Time will be Cim:lOll"odbitl""'=oIJx(unchaoged) by The Dale of Substanlial Completion as of rhe dale of this Change Order therefore is 60,550.00 568.42 61,118.42 1,970.70 59,147.72 ( -0- ) Days. :1 JOHNSTON/HUNT & ASSOCIATES ARCHITECT 1112 East Front Street Address PC&D INC ~~~~RA~6~R25849 Lk City Stat. Addrt:'~s ~ .~, T.TA OR." /Z^ J 1-" ';} /. L '/.1 J OATE Authorized: JEFFERSON COUNTY 9.W~OR Jefferson Street Address ..Port Townsend. WA 98368 _~4-< .c(~ DATE ::? .2.Y-8G ":&:''"'~; 8~ ~-dJ.,~ ~ -/1"- AlA DOCUMENT G70T . CHANCE ORDER . ArRIl ,778 EDIlION . A/Aft . It> 1978 THE AMERICAN INSTITUTE or ^RCfHHCTS, 1735 Nl\V YORK Ave, N,\'\'., \'\'ASltlNGTON, D.C. 20006 G701-1978 t .,:: '., . " .. ." , ,.,..",. ..:-::-.: ',' .".,. ,.' ", ", . '. ,':,'" ".:, ',:,.. ::'.... ',: ,', "".,: ,', "." .' ':,'., " ... , . :., :.".. '>: " '.,' "",i'" ,,>': ",.'.,.,'......'" "', ' ,: '" .':',,'. ,: '., .,: " . ': ',,'. ,',' ..',.,', ,:'. ",. ,':", '..",' " . ,".c'. ".' ":':.. ::,>',;' . " . "., ".' ' , :... '. ','. ': ::', ,',' ',', ".",,: ,", :< ',' '.",', .", " ,.,' ,', f,:""", ,',; ,y , .' " ',,::, ,,' ", ," ',' " ': ' ",<..' ,.' . ..,",. d, '. " ',"'.,.. ,'",' :., .... '.:' " . " " ,,': '. ", ',' , . ',: ,,"". '" :' ,i ~\"." .;. "'..."',', ',' ',", ' "" ,,' , " .', : " ";, . ,.' :,. ' :,;' ,.: " "':, ' '. . " '",. ' '.. " " :'.' .,', ., ,.,.,. " ,'" ".., ,,:' ",:" '...', ",,,..., ..,. ", : ":,,, . ;;' '; " . .', .;\ " . ",.' , : . ".,,', . : ' ,.., ',: '. ' , ""," "" .', " ~"'~- ,,' :, :':/ ~:, " : " r ~ I ~ {. I ~; ~ '" ':'" . "" ',,' " , ,. ,"I", '" "... ''; ,"'. .,. ,:' : " '. : ,,; ','.', ; , ',' '.:, . . :, ,,':" ,:j , , , ~\:; '1 {" " ,t. t " j ~,' \, ~,' ",~ i r "-:, ..';> '., .~~ .._,.' ~,. " "., '\ , '., , . ~ f" /" ;PC.o / tt7 i1 PURCHASED BY OFFICE OF COUNTY TO ADDRESS CITY TERMS ....... . ' , : , ' ", ,', . ' ',' , . " . ,," , '. VOUCHER COUNTY OF JEFFERSON PORT TOWNSEND, WASHINGTON 98368 30963 WARRANT NO. CORRECTION CENTER CONSTRUCTION :;:;1='49 DATE AUGUST 1985 AMOUNT AUTHORIZED /1f1300 65.10 I O"'l tor IOU..'.... ~'i PC&D OR, POBox 25849 Lake City Station Seattle STATE lia 98120; ST. COUNTY OFFICE USE ONL V CERTIFICATION I, the undersigned do hereby ceni!y under penally 01 perjury, lhal lhe materials h(jve been furnished, the services rendeled or the lahar per- formed as described herein, and thaI the claim is a JUS1, due ill1d unpaid obligation against Jefferson County, anci Ih;.ll I am authorized to aUlhenti. cate and certify said claim, Signed (title I NOTICE-TO SECURE PAYMENT THIS FORM MUST BE MADE OUT IN TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUDITOR, COURT HOUSE, DESCRIPTION UNIT PRICE AMOUNT Return All COPi~50J to Auditor, ~. <: I ~ ,'" " , '::-: " , >,',.'" , , . '" , .:,,' ~:-',"""""',"""'" ,--:) ,"", ',',,'., ",' ,,'. ,',;, , " "., " ", ,:, '.' ':'.'",.' " .<':" ',,; . "..,",'". "", '.': "" ',' ,', , ': '. , " ". ' " .,'.'" , ' ',',' ,..." " "', " ":':,,, ":' ,,> ,,', , , :'.' ,. :', .",.'" " ,:' ""i. " ',,' , ,',,, ',' .', '" '" " ,,' "" ":, '" ....'" ':' ,,>'" " , '" , "'. .'. ."",,', ,.... , .;..' ,," ,', ' " , " " , ". . ,'.' , , ' ... .".. ,.. .'. ,i ", ,. " '.....,', ...... ,...,,: ,'." '..,' , ,," ....'..,', "~,":". .,', :. ,..' " '.'. ,"'.." '..'.' ',', ". '.",.. ','.',':. '" : '. '",. , ,,' ,,', .....'.'...." ,....," " ,.,'", ':', ' '. ',." ,', . ,,', ' .. ", " '.'.' :'.,', "'. :' ,'.,,':,' ,', " ,:', : " '" " ,,' ." ,.,,' ,,' '. , , ' ,:,/' .: ,",:,' ,,' .. , , '.,. " ,', ", ~7' " By DATE QUANTITY Pro;ect 81-15 Total complete & Stored to Date State Sales Tax on above 7.8% Cumulative Disbursement to Date 45,709.90 3,565.37 49,275.27 10% Retention this Period TOTAL Current Payment Due 4 570.99 44,704.28 VENDOR (OR SELLERS) SIGNATURE NOT REQUIRED ALLOWED BOARD OF COUNTY COMMISSIONERS DATE COMMISSIONER DIST. COMMISSIONER DIST. CHAIRMAN OF BOARD ~ I Uv lm i - i II <I 51 - I I iil ;: a [E'~ E Z u u.~O ~~:S~E[.g 8 I I -. .. ~ if; < ~,g~~ ~€~ I.~.' .s!:8.S-5eu ", ,. .. , ,. . '." ..',,' ,. I': r : :;'. "" , , ", , ,: '..".. 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LU .... ::? >- ~ 5j:;=~ ~ g ~ .D e-S-s]o~ ~ '~62 ~86 5: ~ ~ iHin! c: '::';; E-s ... C,I .. U '5 CeG.l.,:g-s I- ... ~~ ~5'~ ~ z et: ~ 8 >- z ....._ ~ E 0._ CD <l:: EgS:5.sed " : ,.,.. Y,: , ',.' ,",: ,,' ;:,.,. ;"; '. " " , , ...,.., J I I =: .......' '''':' ., - ">.;,:-',-,>),;-,,, \'(:':f'-' . . :~(..~,.! """ ';".,-: ~', ;:S~~:;-'Kj;~t~j: :~~):~iF}~:; '; i'/;,\~,-';' ';e,.',,'-:" ",j,;.: ,';tOO, ,~..': 'i h:.":- '. :",~>..-, R. W. BECK AND AsSOCIATES ENGINEERS AND CONSULTANTS PLANNING DESICN RATES ENVIRONMENTAL ECONOMICS MANACEMENT fOURTH & BLANCHARD BUILDINC 2121 fOUll:TH AVENUE SEATTLE,. WASHINGTON 9ltl21 1El:206-4.11-7500 GENERAL OfFICE SEATTLE. WASHINGTON Telephone: 206.441-7500 T~It!I\: 4990402 BECKSfA SClIlllll,WATelecopier: 206.441-4962 fiLE NO. AA-OOOO-BD-AC August 4, 1988 Ms. Carter Breskin Property Manager Jefferson County Public Works Post Office Box 1220 Port Townsend, WA 98368 Dear Carter: Proposal for Engineering Services Inspection and Monitoring Jefferson County Prison In accordance with your request, we have prepared a Professional Services Agreement (PSA) for engineering services associated with the County's correct i onal facil ity. The PSA is based on my July 25, 1 988 1 etter to you which included our proposed scope and cost services. Subject: Two copies of the PSA have been enclosed containing a scope of ser- vices for the work to be performed, payment provisions and standard and spe- cial contract provisions. With the exception of the Special Provisions (Part IV) the contract form is similar to previous agreements between the County and Beck. These provisions are ones we normally use when the scope of our in- volvement is limited and damage or safety consequences may potentially exist. If the County concurs with the agreement, please return one executed copy of the PSA to us. Receipt of the signed PSA can serve as our notice to proceed unless you prefer otherwise. We look forward to working with and being of service to the County on this project. If you have any questions regarding the agreement, please contact me or Steve Benson at 206/441-7500. Very truly yours, R. Wj1~K AND ASSOCIATES /-/~Ii M~u- Donald R. Melnick Partner and Manager Construction Services Office SAB/DRM/vla (1528Y) Enclosures Sllm!le, \\fA' Dt'nvt!(, CO. F'h(H.nill, AZ .OII.lnclo, rL. Columhu~, NE 'Ilo~ton, MA. Incliiln'lpolis, IN. MinnOil!Klhs, MN. Silcraml'nlo, CA. Allstln, TX. Nil~hvillo, TN 3 ~. t:.; t' 1 " y .~ I t ~ ~,L " ",. " ",' : .. .. , , " ,'.', " '.,. .',..'. ." .' " . : ' .. - ' . ,.: , eoe,e <!)z, 3d i, J,-!:/a~L~!y-- JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS \ t'~ 4' ,~ " ,- .. \r Gary A. Rowe, RE., Director Robert G. Nesbitt, RE.. County Engineer 1820 Jefferson Street P.O, Box 1220 Port Townsend, WA 98368 (206) 385-9160 MEMORANDUM TO: Carter Breskin, Facilities Manager FROM: Patrick D. Whiteman & K. Bob Henderson DATE: July 13, 1986 SUBJECT: Courthouse Smoke and Fire Alarm Systems Regarding the smoke and fire alarm system here at the courthouse facility, the alarm is not connected to any outside agency such as the fire department, police, sheriff etc. This is in my opinion a very qrave safety-liability situation. I recommend that the alarm be hooked up to the fire station and that the whole setup be put on a ongoing maintenance contract to assure proper working status. Respectfully / @-~ h5J, U)k~ Patrick D. Whiteman, Chief Custodian and Acting Safety Committee President K; Bob Henderson, Safety Coordinator 100% Recycled Paper '...... '.. .,:..., -,'.,.,.".,: ',",',,' ".. i" ',' "i'.' '",':''; .-:: '".' ,: " ",' '. :',,:: ," ..,,'::.', ,,',"', ,,, ...,',' , "':, "'i" , ' , .,' :,'" '.. ,'".."..:', . 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'.. ,',.,..': '.'.",',.' ,,', .' , ", , ' ,',', '.,,; '.', :': '" :;' , ,'" ' , , ' .', ': " .,'". .', '.,., ", ',' ,..., .., " , .. .,",':',., < '.', ",., ,.: .....',..., ..,'. '. . .' 'i , ;" ", ".." . '.. ',' , ... " :'::, .' ,'" '... ',,' '",',' ,,' , ,;;, "",:': . .. . ," . ": ....' '. '" \ ! t " " . .. .' " '., " .'" h' ",', -" , '., '..... " . {J- Exhibit A Page 3 E. Estimated Cost of Services The following cost estimate includes the cost of all Beck labor and expenses associ ated with the structural inspect i on and monitori ng program. The structural inspection assumes two engineers wi 11 be provided for one day including travel time. Phase I Estimate Labor (2.4 labor factor) $3,160 Expenses 100 Subtotal $3;2liO Phase II Labor (2.4 labor factor) $4,650 Expenses 200 Subtotal $4,850 Total Estimated Cost $8,110 ( 1 528Y) ~ ';';f :' \ 1 I ~' ., ~> f r t '" ..,., .' ,,:.' .'" ,N':' ',' " :"..,,\'., " ,,"', , .,'. , ' ., ' ' ' ". ': ,'..': " ,:':, ..,',. ',', , ',,;' '.., ': " ", ,: "':" ' .,',:' ''-' '., :' ',', i:' ,,:.-i. ':::, "",.., " ",",,' ", " " " :.',:., ,:',', " ,:-',:: '" ' ',,",': '.' ,', .., '. ,", .. ",., .,,":'. . .', ,:' " ," ,': .': . "",' " .': .' ,::' ' .. .. ' ' '., '\', , C:' ,,:, " " ,",. -' , C, , , " " ,:.,:'. :', ' " :,', ': .' '.,' ". ."',, " " '.,., '. .',. ", ": ,.'. ': . .,'", ".,'.",', " .:' ,", ',' .: "", ' ;', ",'".-,C, '..., . ''C' ," '., " . '.':. .' ..", ' ," .,',; . " '" . ,',. '.' '.. ,.,' .. .,.' . <, ,," " " " :,', ",'" " : :'" ,.','. ':, .. ',', :': ,:/ ,;.': :. "', " " ., '.', ".' ',' , . , " , .,,' ..",' "',' ". i ..... '" . . ", ' , ,,,,-",:' '., .', ,'d. '''', .; ,.""\,, ,', ""'" ,''- , "..."..'...,,' '.,.,', ' .'., , ".,.' , " " ..,..'.,.. .' " ':'" .~ " -:- , .: ...: ",', , , , .' ,"" '.,'......:,. .: l ,,', , '" ,',', , ' ,',' '," ' AA-1926-IA l-AZ August 4, 1988 Professional Services Agreement Inspection and Monitoring of Jefferson County Prison [, PART IV - SPECIAL PROVISIONS A. LIABILITY FOR STRUCTURAL INSPECTIONS AND MONITORING 1. Scope - In performing the structural inspection and monitoring, the Consulting Engineer will base its analyses and opinions on generally-accepted engineering practices. The Client understands, however, that for the compen- sation herein provided, the Consulting Engineer cannot expose itself to lia- bilities disproportionate to the nature and scope of Consulting Engineer's services or the compensation payable to it hereunder. Therefore, it is under- stood and agreed the Consulting Engineer's services are limited to analysis and preparation of the reports required by the Client and that under no cir- cumstances shall the Consulting Engineer be considered a guarantor of the safety, integrity or stability of the projects as to which said analysis and reports are made by the Consulting Engineer. ' 2. Indemnity - Nothwithstanding any provisions to the contrary con- tained hereln and as a specific exception to Paragraph III.F. of this Agree- ment, this provision shall describe the extent of Consulting Engineer's lia- bility related to the rendering of professional services under this Agree- ment. It is agreed that although the Consulting Engineer in the rendition of its services pursuant to the provisions hereof has the legal liability of an independent engineering consultant to render said services in accordance with generally-accepted engineering practices, such 1 i abil ity for all damage or liabilities of any kind or nature, including but not limited to damages to the property of the Cl ient or others and injury to or death of any persons, as a result of any act or omission of the Consulting Engineer, whether or not due to the Consulting Engineer's fault or negligence or breach of this Agreement, arising out of the physical failure or inadequate maintenance, surveillance or methods of operation of all or any element of the project for which the Con- sulting Engineer had an obligation to render opinions or recommendations re- garding safety, integrity or adequacy, shall in no event exceed the aggregate of the compensation paid to the Consulting Engineer under this Agreement, and the Client shall and hereby does agree to indemnify, defend and hold harmless the Consulting Engineer and its agents, employees, and consultants, from all claims, liabilities, losses and expenses in excess of such compensation. IV.B. LIABILITY Delete paragraph III.F.4 and substitute the following paragraph: 4. For amounts in excess of any proceeds of the insurance required to be maintained by the Consulting Engineer under the provisions of this Agree- ment, the Cl ient shall indemnify the Consulting Engineer, its partners, of- ficers, employees' and subcontractors against all reasonable expenses or lia- bility of any kind arising out of any claim for loss of life, bOdily or per- sonal injury, property damage or other loss from any cause related to the fur- nishing of the professional services covered by this Agreement but only to the extent that such expenses or 1 i abil i ty exceed the Consul t i ng Engi neer' s pro rata share (based on comparative fault) of the common liability. - END OF PART IV - ;C-', ,." ,','.', , ;"",' ':' .,' .,' '" ';', "" " ;.. " ':,: '. :. , " , ",:" .':' , ,'; '",:' , " " .. ~ i~, t ... i Ii k I' . ".'" " .' .. .' ' , , , '.. " " " ' ....,. ".,. , .'" .. '.' '" " . ,'" " , ", ,":,' ' '. : ' ,','," .' , "", ,... , ,<?,r-'"C,?,,=?CJ \ -"',,~~\ '- .~. '. . - l:~~;?~ r",." ll~~::q ~ J'~t~l;me~ .mH.'ERSON COUNTY PLANNING AND BUILDING DEPARTi\-lENT P,( I. BIIX l:.!:.!() 1'111'1 .1i.\\'IL....I.,IIL Wm.ld,lglllll !!."'i:lti..... Planning (:.!IHi) :~H;i.1I1.lll BuildillJ..! (:!lJli) :lHil.!lI.U .JEFFEIlS()~ ('c)lJ:\TY t"OUHTIIOUSE David Ooldsmilll. Din,'('lor MEMORANDUM TO: Jefferson County Board of Commissioners David GOldsmith~$ August 30, 1988Cf!!!;:/ FROM: DATE: stlBJ'ECT : Third Floor Conference Roan This memorandum is a follcw-up to Judge Majhan I S concern over the use of the third floor conference roan. Before we lock to solutions to solve the "sharing" problem, I w:>uld like to set the record straight on the conflicts Judge Majhan raises. Wednesday Night Meetings: Between the Planning Corrmission and Shoreline Corrmissions, the conference rocm is used at least one evening per week and usually twice. Add in the PUD and other night time users and one can easily see the room is constantly in use. The evening in question was a prolonged public hearing which lasted beyond 11:00 p.m. at night. The room was picked up before being closed for the night, but it was not arranged to a courtroom configuration. To correct this problem, Carter arranged for Bob and Pat to check the room each morning to ensure a court rocm configuration. To my knowledge there has not been a problem since. Trial, Noon Recess: The second incidente referred to in Judge Majhan's letter concerns the use of the conference roan by the employees guild to hold a noon meeting. A member of Judge Majhan I s staff was a part of the guild group and was specifically asked by other guild members if it was OK to use the room while the court was in recess. The answer was yes and the meeting canmenced. Schedule Conflict, 10:00 a.m. Thursday, August 25, 1988: The third conflict Judge Majhan alluded to was with the safety Corrmittee who had scheduled the room one mcnth in advance. To our knowledge neither Judge Majhan nor his staff either checked to see if the room had been scheduled nor did they schedule the room. \ "... "'.'" ',,', '. . " .'. ' '.', ."." '.., .'.. ',., ;<,:, ,... :".: :"" ;'. ".,:" '. , .... "; , , ' " ' ,". ,;', "'" . ','".: ;'" ',," ..' ,'...:.,:: ,:, :, .. . ' "" "'-:: ", ,::", '" '. <:, . ' 'i. ' .,', '/' ,: -:.. ,..' ':":' ,',"':" ,'" :",",.. , .',,'" ,':'" .', "".".:: ',,' "'..., "" ,,' ': , ,:,;:" ': ',,"'., :. ,,' ...,:' " ' ':, ,,' ' ' '.'. ", "'..', .:. .'.:.." .,.. ' ,: ",: ','..,," :;, "..:: , :'.,,,, ..', .:, ",', ., ',:'., ", '" , '. '; ..',.' ,,', ,: .' ' ".". ,',','., . ",', ..., " ,., ,,,' ''', ":'''''''' .. )',', :..' .',"";.','.,...'".., :' , ,,'. . .."",',....'.. ,'" ','.",' '...'."," ,', ,.,'". ", , :" " , " ". ,.'",' , , , " : ' ' , ..... ". : ' , ..' ': " ',.'.; ,,'. ''':;:', ',' ':,' ' ',;" ': .. , ", . ',,. . ,.'-:', : ", :'; :", ,,':' ", ',:'," ...,' "":', , " .',: :.. ':' ", '..,..:' :, ,'" ':' . ", ",', .': "', .,' :", :. .,:' , ,..' .,'. '.,: ' : ','" " ,', ";', : .::.': " ' >.' .' , . " ' " , -':'" .," ,:.,' ,..,'.., .: :', ,,' '" ,: ,': ", ", .. " , , , ,,: ": J I I , , 'I \ i I' I " '.. .... , , , "... ,'" "", . . ',",. " ': " , ,,"', :. ,. .,'.',. ",:. The Honorable B. G. Brown August 24, 1988 Page Two Benefit Summarv paae ~ fq since this project included administration and totalled at least $642,382, this must be reflected in the report. I have "roughed" it in. Also, provide an estimate of the ethnicity of senior center users and how you determined who the beneficiaries are, lines 7 and 8. Financial Summarv Paae According to my records, acquisition cost of the land and building was $429,273.83, rather than $192,193.62 as reported. Please check your records. Balances of each line item should be listed as $0.00. contract and Subcontract Activitv A note was made on this page that this report was mailed on April 22, 1988. That report went to someone else in the department. In that report all contracts should have been listedr including the CPAr McClanahan Construction and John McClane Construction. If it included all contractors, make a copy of it and submit along with the corrected Closeout Report. ' I am returning the entire report along with a blank form for your staff to complete and resubmit. I would appreciate the corrected copy by September 16. If you have any questions, please call me at (206) 586-1243 before September 2. Thank you for your prompt response. Sincerely, /?<.../ ' L- /1.-~J,,".>?/..A-hG L.- /nt? cU7I><!C-.v Charmaine Mortensen Community Development specialist CM:krc Enclosure " ,< , ..",.., , " . , ' : ' ' ,,', '",. ' ' ','" , .' ;.... , ,,', ".." ,,', ".' , . ,'." , "" ',.'." , ,,'.,' . " " ,'.,' .' , ,." .." . '" ...' , , ", .'. .".."., " ,."', "., "... ' . "., ' , ' . ' " ~'" " ' , :. '. 'i:' ",..' ': ," ,:,':' .: ' ',' . ',,'... ",' , , , ,.,. .' '. ,", " ,',i,' " ',.' .' ,: "., "i'" "i' .".'. '" ',,', '\ ;', . . ,."i' " .'..,' ", '.' ": .." ,',' . . , ".,.. ',' ' ': ", .; ',' ,,' , ,'" .", ," , :' " .". .' "." ,,,',,,' ': " , ':' '" . .,.' ,: ,:" ,',:. ", ",.',. " ;..' ' ';, ',: '.. ",: " " , .:',', ,.' '...,' ." " " ',"" '. . ',',." " :,," ,,', ,','.. " " , ,',' "',:' ..' " .,' " '. ' , ":, ,.'>. ," " " '" " ; '\, .' .' , , .,,' , . ", . '., ,: '..,. , , ',I' " ''''',,'.:, ," . "'"., . :""" .' :., " ' :':, .: " , .....,.. .. , " I11III ~':;i';'.' , '::'-';"":".';i :i;~:~~!;, :~~:~\ f t.~Y~~~i': 0- ~ ;S "" OJ ~.rg \D ~f ~g In ~j ---I U"> lj) ~ ~ "" '" o .... ... "tl ~ @ <.> ~ Q) +' ~.a .~ 15 "b8 ";1-< In ~z; B~ ~'A ! ~ 6 I '.... ~~ ~ i:E I-< '" +' <.> '" Cl ~ 0< '.... ~ ~~ '.... ... Cl I5'l I ~ I q ... ~ ~~ ~I i "g~ ~~ .......,-4 t:l"" >~ ..... ~~ ... ~; I ~ I""';"':': ~.,.-':}t,,;, ,;"" '::".:.'.'.:.\:'''''. " ',: ;. :;l~i! i..~:',.:,.:,.;;....., :;. . "~~~\':~'i::;;,;~~'f;;~ ~ :;:;j?,.:ttl:;,~(;<i~;;g;: "',' ,:::;,:'~>'},;;:',;:';::,><i:~; """,?";,!:,.,,,,.:,,... " 1" 't ~ :, ...,,'- ;,;;",',:;;::,,; III .0, Q) ........0 .... ~~~~ a .... J asi " .... .... ~ ~~ Q)~ ~.t; -. " ... i " Q) ... ~:;r 1.. .... A ~~'~5 'd ~! z ... !tlt ~ ~;,; ... ilJt 'O!< ~~ ... " Q) Q) .... ! .~ ~ ....." 0.... 'O! 'a1 ~ ~ ~ III ~ Q) I '... "" J, ~ ...' Iii"d Q).~ ~ ~~ :l, sl:l'a1 i ~~'l).s~~~ on .~ "" J, .. ~~ Iii"d Q) ~ ~ 'O!::l'a1:\.sl:llil ~~~.s~~~ $5 5] .. :E~~ ,!:l~ ...~'Ol ".... ... Q) Q) Q) ... c c is&l.al ..: ~ :6 ~ ~ ~t ~~ ~I I~ ~~~ a",8 ~~8 jii :oo~<:> c 8 0.... '...... ~~!'l >...oSl .... " ~~i 8 .:g j ~ '8 'e ~ ~ ~ ~ ::0: cO ]; .. .....~ &.0 ~!OllJ21 ,;,J~~~ z <:""." " ", -...... I I ! I, I "' I c 8 .. J N .; t; '" ~ I 0 > ~ ~ l- e; ,f ~ e a '" uI 0 !;< 0 < c c ~ ~ z '" III 0 : :z 1;- <s II: ::> !: ti d z 8 '" ::> !<!. ~ z ~ ::> '" , , !Z '" .. s < 0 I- ~ ~ "' ~,3 '" .. irlz i= z ~l~ '" < ~d tl ;: ,. c5 ~ '"> <:l: d ~~ a:: .. t 00 l- I! zz ;z <<0 " ""c.J z '" zz CD ;: ~ ii;z =' ::>z C/O ~ g a: ~:5 0 < w w 0 ~e!l1 - u.,G.z '" ..:. .~ O/: <:l: '" g 8 ~ ~z t- w Z I- 0 '" w::> c.J "'. a ~ "':><:l: < ~~ ~ ::> 1 c ~ ~u ~ '" " '" c.J ~ ffi ] u ::> :e! ~ .fi '~ ~ !Z ~ ! ~ r, P. fI\ 8 ~a;H~ ":NM~ "' In~i 3 '~ihl~ ~ IE oJ.... M_ - ~n :; '; ~ 5l!5 ~ S ~ 8 '" w ~ Z :; I- w ~ '" '" , .. " I z ~ ~ I '. z .. I II: " U i ~ ... .' BRINNON SENIOR CENTER PROJECTED BUDGI,'r fOR 1988 1m' ff~'m~wl~~'~,~ .p\\ .. ';f~~,'::,~:.:tUJ) '-..".'(: .JUL - 51988":-' :' , J~FFEHSOifCOUN1Y \iOAIID OF COMMISSIONERS .Iune 6. 1088 HSVENUBS IHlN'l'^L / NO'rEL ~EN'1'^L / APT UGN - 1987 l'GN - 1988 $ 810U 2290 1000 500 1~ $ 4725 1336 584 292 6938 EXPENSES SALARIES $ 5694 (6864) $ 4004 l"ICA 428 ( 516 ) 301 ES 285 ,( 344) 200 LI\BOR ,6 IND. 224 ( 270) 158 ^D~lI N SERVICES 772 450 MISC. START - UP 1759 1027 PHOTOCOPY 200 117 POSTAGE 200 117 SUBSCRIPTIONS 50 30 SUPPLIES - OFFICE 400 234 SUPPLIES _ 'OTHER 400 234 TELEPHONE 1000 584 TRAVEL / LOCAL 250 146 TRAVEL / OUT OF AREA 200 117 TRAINING ' 300 175 UTILI'rIES - GilRBAGE 500 ( 600) 330 - 12662 (14125) 8244 JANITORII\L' ,,2152 1257 FRINGE ." . 525 'j i16 PROGRAHS 2406 14G4 17745 (19208) 11211 * UTILITIES _ ELECTRIC ( 8 mo. ine.May) 1600 TOTAL FOR (7) MONTHS 12Bl1 " .* llilities added 6-24-88 '. ','.~ INSURANCE ? Yet to be determined. 'j .'1-. ~. i" I; rn .. ' Q) !~i~ ..... a .. ..... ~ I;~ .~ .... Q)~ :z :i j.t; ..., " Q) .. . . ..... 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't:M4:J ... .... ..... o :> co: .. ffi 0::1 u~ ~ ~- ~ "'0 < . :),0 :I o z _ :>1.1.1< Q~~ 3i:i u.w- 0"'- Ww ,.'" < z Ii '/5" . d! ~. f ,'f;' ",&61 =~I z ~:I: 0 Iii ;:: u~!!C ;;: ;is- ~ ~~ci ~ ~~m ~ =8.=-, ~ ""'.0 ~ i!c- g 0:== u ~~_o ~ ... Cl'~ -. "i ~ ~ ~ g~~ "w. ..2i~ ~~~ ~:q ~ ~ 1 !;i ! wO ..w <" Ola I .ll ~ I;, /r/.c?? , f~'. }I ! ; ::,:: ....". .' --:" . . '. '",' ", " . . . .:. . '" ,". . ',' .', ::. . .,. ."':, '. . .. ..,.. " "': '.:,' ,', .'::" ...':': "", '", .' :.," ":' ',: ':'" ':', ::.:" , ' . . ':". ,'. .' .,' .. "" . ,....,.........,.., ' ,c. ; ." ,,>.' .' . . . . '.. ,'. \. :' .' """': ',,'" ". ;. .,' .i.':' . c"': . .':" ';" ,.,., :', .'" . :'.... ,', :': .....:..' , '.:: ":": .' ,",,,'," " " ::, ..,'.......: ',' ; , ':" :,' ,," .',' .... '. " .' ,'.' '.:' . . .", ,. ,. " ' , '. ",:., .' .', " , , " ", .,' .' . ,'" :'.'<' ," " ", .',".. . ..... ' , '. ,'.'. ,'", ',': '.' '. :.: ',' , c' , ' . . . , ' '.' ,'.- . '" ',,: .':. " '. . '. " ~ ~ . !'~ ,:', ~' " .'",' . .'. ."",.< , :.;, .. "" "'''' " " .' . ;, ".",' , ",: ,,:','. ':,: ' .' " ':, ." .' . .' ',:' ,: ' ; "',' ,'.' ':: '. "',. ;" . . . , '/ , . '. ' , .: \., ), t }: ,'>..' '.,",. ,::. .: ;" ." :'. ,:' "" ',,: '" :- . .:" .. J I ~ . J . L-:::- . :';. I I I L ~ L ~ L ~ ., ". ..... .... . . .:" , ., . . , . , ':., ,;,:. . ". :'. .':". ,': .' " ",.', ,. ,,', ": " ':.' , . ',.', . ',' " , \ 'GJ ~~'(t.,,\';,r. l'Jt!" \.~,9li:~\;: / ~~~~W r~:~ JEFFERSON COUNTY DEPARTMENT OF PUBLIC WORKS 1820 Jefferson Slreel P.O. Box 1220 Port Townsend. WA 98368 (206) 385.9160 Gary A. Rowe, P.E., Director Robert G. Nesbitt, P.E., County Englnesr ADDENDUM III JEFFERSON COUNTY COURTHOUSE RENOVATION PHASE II. R0741 The bid opening date on the above-referenced project has been changed to September .l~ 1988, at 10:30am, in the offices of the Board of Jefferson County Commissioners. ,6?d&t<-<_</}.I) B.G. Brown, Chairman ACKNOWLEDGED RECEIPT: Representative Business Name Address Telephone 100% Recycled Papar i ',.' .. . . ",': ','" '.. . :'. ," '.'.'" '. '.' ; . '. ' " ,i:, , " ", , "..., ' ", " .,'.:' .. ,,'.... .',..", ":.,,: ", f. ,..,',', .- ",: " .:'...'.. :' ". .,.., ,i .' ":. ".,''''.' , ...',,' '., . '. " .,',' .:': ': ". ,.', '. ,,:, ': ",:"..".." ",:' ,', '. . :', :,', .' '. :'.... 'o':<<;," ,'. ,...., " , .. ,'?, , ," "..,,', ' .': :' .':' ",' ;'''. "::" " ", .' ..':' ." ....:: '. "" "':,' ,.": ' ", .'\ 'i::., " ',: "'" '...., .::,' '0' ...'" . ,.. " ," '''' '" '. ,."" ',. '.. "", 'f ..'. ..'.' .',,' .'.' ..' . . .' , ':'" " " , ' ", ", " ...., .,... .' \. ." "., ..,., " , ':""," . . , . ,;, :':':,.,.., ,..'.' " :::' "., :', ':: :' :',,::'. ," " ':, . '. ' ': 'o'.' :: '. , '>,,< ", '. ..: " , ,'. ,:. " " ." '.,""",,'/,' 'o'.' ,',. ',' ',': ,,"":' ';:...::,"., " ' , . ',."" ,'; . ",:' ""',, ,',' ," . ..... ". . .'.. "",' . " . :, " ... ~ K' t .' . ~ j:' t" /, ~' ( t,: }: ~ r ;. I .t F i \ 'I. \ i ,~< " ' i' ,'O' i I:. U .... .., .' <i.....i ,"" ..... .' :' ",.,.'. '...."..,.. ...... )', ~,,_.._-, . ., , - "eO 7-,/ , < .. CONFIDENTIAL .. " ". ", - NO. ITEM COST BASIS UNITS UNIT COST SUBTOTAL .. SITE WORK (<' Mobilization ea. S3.cco,CO 02)72 Minar Demolition tor Remodelino ea. $2.5OJ'co 0Z222 Excavatinn. Bocktillina & Compactlno ea. $1 ZXloo ':'. 02514 Portland Cement Concrete Pavino ea. $1.5OJ.00 .'. I 0272J Storm Sewaae System, Runoff eo. S5CXl,co Asbestos tile removal In hallway eo. SS.5OJ,co $ 14.2CXJ.00 CONCRETE 033)) Cost,ln-Ploce Concrete cu. yd. 21 $2CO'co $4.2CXJ'co 03346 Concrete Floor Flnishlnn sq. ft. 35CXl $2.25 $7.875'co 03732 Concrete Repair eo. S 1.5OJ,oo $13.575.00 MASONRY 04X0 Unit Masonry System sq. ft. 'Nl SS.oo $2m:J'co 04SXl Masonry Restoration & CleanlnQ misc. S5CXl,co $3.100.00 METALS OSEOJ Metal Fabrications - misc. S 1.5OJ.00 05521 Pipe & Tube RaiJinns lin. ft. 45 $25.00 w::o,co $2.100.00 WOOD 8< PLASTiC cxrol Carpentry Work - misc. $4.cco,CO 062Xl Finish Carpentry, $7.2CXJ'co 06410 Custom Casework - $10.5OJ,CO Interior panels metal and wood $2.5OJ'co $24.2CXJ.00 DOORS 8< WINDOWS 08210 Wood Doors eo. 13 $750'co $9.750'co Wood Doors entry pair 1 $6.5OJ.00 $6.5OJ'co 08610 Wood Windows - Repair eo. 16 $275.00 $4AOO'co 080C0 Glazlno S 1.5OJ,CO Metal secur~y door $1.1 oo,co I olazino tor security door S650,co 883J Mirrors sq. ft. 24 $7.20 $173'co Door hardware 13 $75,00 $975'co $25D48.oo FINISHES ~ Metal Furrlna & Lathina $3.cco,CO 07.nO Gypusm Plaster SS.cco,co a:r2tIJ Gypsum Board Systems. $1.750'co Elevator paint inn $3.cco,CO 09311 Ceramic Tile Finish. 12 x 12 Inch Ceramic Tile sq. ft. 3ffi $8.00 $2.840'co 6 x 8 inch Tile Bose sq. ft. 1~ sa,co $1.512.00 Comer sq. ft. Z2 $8'co $ 176,CO a;\686 Carpetina-w~h Cushlon- sq. yd. 4C6 $19.00 $8.854.OJ 0;>;(0 Painting- .,',. 'e. . :....,: "'" ) ,,' " .', ',' ,.'...,',..", . ' ,'. " ': . :,' ',::::,..,' " . ':".' , .,'..' .' . ': " ',.' . ," , ..",.,'., , : .. : ,', > '.".'i.. .,.... .,." :, " , , ',\ \, . "..,. '. . . i ':, ," " " :' ,.,..,... , " ' , '. " .-~ '.' .,'. . . ,". ." .,...,. ,', '. ", ' ': . ::.. ,', ',.', .',.... \'. '..;,:': ',.:','., ", ,:' , , '., ',":, \ . , ,:<" ::: , .> ",,'.' , ":. .,' ""', , .' ,'," ,....." '.:" '.. ,'.. , .. . .'.' ,.... ,'.' .' .. ,'" ," ". . .! '... ",' ,.' ..' , , ,,' ',' ". ,,' , " ." .'... .,.:,..,.. :. , '. ...., .,.. .', '., . , " " ' '. "" "", ", ": :','.. , '" : ' .,' .", ',: "N'" ',',.,.,..'...."... )"',"," '.,i ......., '.. ," ",.'''.". {'.".. ' .' .'.. .. "'.' .... " ",.,-' b, i..., - I ,.... ':, FINISHES (continued) ,) Walls. ceillnas. misc. sq. ft. 48125 $0,24 S 11 .550.00 Stain and wood finishing S2roJ.oo S40,182.oo SPECIALTIES 10100 Metal Toilet Compartments - eo. Door & Partition Sections eo. 8 5962.CO Hardware eo. 32 $917.CO "- Pilasters & Pilaster Supports eo. sSw.oo ,: Headrails eo. 53CX1CO Installation 51 .axJ.oo Computer room enclosure eo. S4.axJ.CO lC622 Fire ExtinQulshers- Halon Extlnaulshers eo. 2 5139.CO I Dry Chemical Extinaulshers eo. 2 SM.CO Brackets eo. 4 S88.oo Installallon 5200.CO lca:o Toilet & Bath Accessories, S 1.DEO.CO $9 .572.CO MECHANICAL ; 151<;0 Mechanical Identification SSCO.oo t:' 15200 Plplna Insulation SffiJ.oo ~j" 15410 Plumbina Piplna S4roJ.CO ~, 15430 Plumbina Speclallles ' ;;- I Floor Drains Per Unit 3 5244.CO 5732.00 Area Drain Per Unit 1 S366.CO 5366.CO Clean Outs PerUnll 4 $320.00 51280.CO 154<0 Plumblna Fixtures. FlXIures 8 S3thO.oo Valves 5 58CO.oo Trim 52272.00 Comer Supports 6 52.362.CO 15520 Steam & Steam Condensate Plplna 52roJ.CO 15525 Steam & Steam Condensate Specialties S l.axJ.CO 15850 Ventilation system S3.8CO.oo 15880 Radiant Steam Heat - Runtal Unlls VLX 21/21 ea. I S476.CO VLX 35/35 eo. 2 51256.CO VLX 56/56 eo. 4 S3A2O.oo 159>0 Testina. Adjustina & Balancina SSCO.oo S30.Cl54.CO j. I .~, ':", ",''' :'. ,,", " ,.,....,'.,..'.'.., .... ..,'.., ., ." :'. .,'.. .... . i', .'.. '.'i.' .... ".." . .',,:': . ".. ;:,.', ':o" ..: ' ' " ',:' , , '.' '.. "" ,"'. , ..,: .,' '. " , .,' .,.,. .... . .. . .. " .... '.' " ' ','., -.:.,:.. .. ,,: :","," .' " ,;.. '" " " "':' " , '. :" ' :: " :' . ',' , ' ;"...., . .'" , .' " :,' ::'; , " .', :.. , ...' " , ." ' , '" '. .'/' '. '. "" . , '.' : . ,:'" 'C , ..:" '. " . " . '" .... ,'. .,'.. .,... '" .'. .,..' : :. '\ ,:,.,:,- .'.... ' . "...: " .:' ". .,' ',,' ,'" ";: .' :':,. ,;"" ,','.,' ,'''.C..'''..','" :..':.\ " '" : . ',' ," . ,,:, . ..." ,.,' '., ,....,.,'.... '.., '; , ",' :", " :'" ,.'. . , , .' ',,:", " : ' , , '. ','; ,c. " ," "'. ,', "', " , ''',:' "'- " ':.' '" " , . ;...: 'r ~ I. ., " t :.:'. ; i' ~- ',..... , ': .. " , :, ,'. ' " " , ..', ;; .' ,: '.- , '" , . ;"_,~>r'"'__"'"''''' - . .' ELECTRICAL ltcOO Move wlrino to ductwav $4.s:xl.00 16111 Condutt In hoD S3.s:xl.00 16113 Underfloor ductlno S5.s:xl.00 16120 Wire and coble S3.s:xl.00 16130 Boxes $1.s:xl.00 16510 L10htlno fixtures l Pendant ea. f:6 $70.00 S3.92O.00 i~'; ; <,. 'r', Celllra ea. 1 S35.00 $35.00 Standard 2 S33.oo $66.00 ~ ii' ea. l: '~ Artemlde Surface ea. 2 $154.00 $308.00 KLP Pendant ea. 2 S70.oo $140.00 KLP Recessed ea. I 585.00 sas.oo Uthonla Surface (Exit) ea. 1 $70.00 $70.00 Halo Surface - Tamper Resist eo. 1 593.00 m.oo Installation $4.axJ.oo 16850 Electric heaters wijh fons ea. 4 $138.00 S552.oo , 527.7$.00 $189.800.00 $ 189 ro::J.oo Bond fee $4.555.20 Subtotal $194.355.20 Profit and Overheod $29.153.28 Subtotal $223,508.48 Continoency $2O.axJ.00 Subtotal $243,508.48 Tax $18.993.66 Total $262.502.14 '.' ~' .' ..'., C '," . '. ',... ',,' . ""'1,' ',,'. ,,: .'.,'.'., '.:, , : r ::' , :,:' '. ,"',,'.,'. .',' .., " , " "; " ,... ".. ,... ..; I '. f " : :" ''', "'..,, ,: " ,", 't, " . '.', ...., ,.... ',." ". ,.f .: ,. .. ..... .. .',': :'".,.,:, ,1 ' . "....' ,.,.. ... ,,' . . , '.:: ,~ , ,,' <' .,.. .' ."'.'.. ": f ~, :,' ""'.', '." ",:',1,:, '. ,'.,:, " ' \'. " ":,." "'.:' .', "" :',: ,'. "", :,.' '. \" ,,', , .. " ,. '.', >'., ,'..: .'" ... '. .... '. , . "... .',. .' ,',:' ...'..', "".:'". . . "" " :" :: " :. : ,', ", , ' :,: , ',<,.:" " : ,.. ...': "'...,., ..,. "., ,... ';,. ,", ~. " ,: '. ',' , '" ' ,c "', . .",' . ' " '.' ': ". . ." '::. f. ' '.',' , ", '.. ' " . ' ,":',' " i ,': ,,' " ',' " "'" :", /",,::. . ..' :,J "'..', . . '... ': .,'.,." ""H '. :< '. :'". .,...... '" ',' .', i . , '. '" , .'. . : ,< ,"',." " ' ",: ", ,.i.. , .-....,.-- :\ ':<" " " ~ ' .. :.Ill :U'!I: '/'..''1 =-:-1111: rll:J ....4:... rlh' .'J :f 1]:1 :~ PUBLIC UTILITY DISTRICT NO.1 OF GRAYS HARBOR COUNTY 2720 SUMNER AVENUE ABERDEEN, WASHINGTON 98520 9/29/88 I~~~:~,:; 3145 I SEE IMPORTANT INSTRUCTIONS 8ElOW ocr 4 1988 E:'.?l? ,0;:-;.",. ~-<; D >'~ ~~ ~J :.Jefforson County - Pub!!c Work" Oepl , i ' ..", .'.. ::~ >:': ";: I. ' I .:' J I,~ " 1 r ''o ,'. ',' '1 ' ...' "', ",'o.." " .", ", :'. :,: J '.',' ,,"...; 'o,' ".': :,' II" . I ".,..: .' DATE HOMEOWNER/AODRESS CONTRACTOR B Ilg~~~~UN~C~:ES~ JEFFERSON PUBLIC WORKS Clearwater Road Clearwater. WA 98575 :,::' CONTRACTOR A T ~URCHASE ORDER NUMBER 931450 CONTRACTOR C IIOPEN PURCHASE ORDER NUMBER '; , COAST ENERGY SAVERS. INC. P.O. Box 310 Cosmopolis. WA 98537 521 sq.f . 1521 sq. ft. 150 lin.ft. 193 sq.f . R-27 Ceiling Insul. w/add. vent. R-12 Floor Insul. w/vapor barrier & add. vent & 6 mil bl.gr. cover R-3 Water Pipe Insulation Insulated Windows (20) ,: BID AUTHORIZED I AMOUNT AMOUNT 980 98 490 49 Iw' ) .') ) 1945 79 972 90 3072 30 1152 61 5999 07 2616 00 CON. rR'lt~OR ESTIMATED COMPLETION DATE QUANTITY DESCRIPTION A l I I tl I 1 ~..,,,....L.. "',"" L , ' . , ' rTl 0 1.' THIS ORDER CONSTITUTES AN AGREEMENT TO FURNISH MATERIALS AND/OR TO INSTALL CONSERVATION MEASURES TO MEET BPA/PUD SPECIFICATIONS. I 2. CONTRACTOR/SI WILL BE PAID THE AUTHORIZED AMOUNTlSI LISTED ABOVE FOR EACH PUD APPROVED PROJECT " PROVIDING ALL THE ABOVE-DESCRIBED CONSERVATION MEASURES ARE INSTALLED. IF ALL CONSERVATION MEASURES ARE NOT INSTALLED THE AUTHORIZED AMOUNTS LISTED A BOVE MAY BE ADJUSTED AT A LATER DATE BY THE DISTRICT. 3, THE PUD WILL NOT BE RESPONSIBLE FOR COSTS EXCEEDING THE AUTHORIZED AMOUNT(S) LISTED ON THIS PURCHASE AUTHORIZATION ORDER. ADDITIONAL COSTS ARE THE RESPONSIBILITY OF THE CUSTOMER. 4. CONTRACTOR(S) REFER TO YOUR OPEN PURCHASE ORDER FOR INVOICE PROCEDURES. TERMS AND SPECIAL INSTRUCTIONS. 5. SUBSTITUTE MATERIALS OR SUPPLIES WILL NOT BE ACCEPTED UNLESS APPROVED BY THE DISTRICT. PREPARED BY -fJtiL~L ~J~EAVATION DEPARTMENT DAL DOVE I ;i;UbIlC U trlty Dls~t ~O)OI Grays Harbo County R~ ' ~~ ,A ONSERVATlON MANAGER / .7 J-;;~lANSEN CUSTOMERCcO~ .~ :: :i', ;" t ''o "', :, "'.')". ..' ,",': ", :.'o " , '. '", , " ',' , ':: ,::: " :..: :' :":,, " ':: :,' ,", .,. ,', .' " " "',', ":' ':. ,:.' ", . ' ", " " : .,' , '. ,." "... ,', ' .': ...'.... .' ..' , ~",," , :' -: 1 ,.','., '. ,..' , :..., ',' ,,:.:' i '. .' ,', ", '. " ." " ,,' , - ..'...." ..' ": . : .' , ' , - ,,::'C, ' ,:', ," "..' ',," '. ::. '. . ", <: , , ::". " . ': " ::"'''''.: "',,": .. :,- ,. .' .' , ' '. .....;. '" " , ' ; ".. I...;,,: ; ,.. "",' ". :. '" ',' . ".'" .:: . ..<. . :.." . .' '. ',: 'o' , .. < ,......: -j1 " , '" "',", ..., : .', .'; :,.. , ; :: \, I.. " J: ; l> \ ~ I K: "." .. '. :", ,': , , :' " ' ..,', ",.'11 ..:...':: " .) ::;'..:':..;, . [PUB~C U~~L~.~:B~::~R~CA~:~~~::~::';~N~~=::R :~UNT~ 1 ".-' - ..;~-~~"'"~.. ---~--.~~~" r TO JEFFERSON PUBLIC WORKS Attn: Carter Breskin P.O. Box 1220 Port Townsend, WA 98368 I SUB..JECT Residential Weatherization Program L ~ ~ r MESSAG'E OATE 7/25/88 Please read, sign and date all the pages of the enclosed forms and bid sheet. If you have any questions, please call. Thanks. REPLY ..N.C~ ~ QATE SIGN EO -' . "',.. "..... _.. r' . ~'~I_,lJiiill' Du'" '0'1'(1""00 . ,gg l, Sf"llll" 'a.~ . 1'.,O'.~""" 11"00'5_' "~"H'UC"O'.. TO "'C~'V'" . 'W..... .....u. .. ....~~.. ....... ~a..""", ~.... ......T. en... .......... ...... CeI....'" ......... ~'. .. '., , : '.' ,,:,:' '..' , ":, .... '"",, ,":',,,,,,.,,,.,, '."<:.:, ," ,". . ' , ,:::', '., ":"" ,.' ,.,... ....' , ,,', ',' ":', ',>:.' ,', 'i :,;:':,.. ': " " ;', :,:','" ",' ;", "" ,',' ",', ", '.' ,'..., ", ' " . .' """, .:,' "',,,,', ,: < ' ','.' "",," ,,: , .," ," ',' , ,,' ,;,:" .. , ' .'. "" ":: : ~ . ,', i .' " , ,\" " " :' ,"., , ,',' , , : :', ", " ,', ':,.., ' '" ' '" : .. ", '0' " """, ' ':" .',:'::, , ." ,:', ' " .' " ' .', .", < , " } : ,.", ,...','. """"'. " :,:":,' ';': .'," ,..' . ,,' ,:' ,.':'..,,' .' " ".,', ' ',:'... ,'."" :' I ,...' ::' " ", '. ",:", ":', . ,', ...:.. " ..' \, ',' ,', "', :". ,,', " ' " ! '.' :':,',' '.' . ." '."':, :," : "':'" ,:,,' " :':: ':,' ".. ,':'." , ",: " ...:,,'," :";.'. .,r:,. """'" .' ,,:" ,," :" " ' " ,",.' "',',:,',:, '. '.... ":'.',, ",.', .. ': : . :,' '" , , ..', " ,,' " ,',' " ""''';.:.. "', , ,,:' " ,",: ,',,'. ", "", ,: ,': ",' " :,::', "..', ,,' ":" " ! ,~: .~ \ . 'to, , : <, .. ,'..' : ~: I ;:; ,,. .',', IIlII PUBLIC UTILITY DISTRICT NO.1 OF GRAYS HARBOR COUNTY N2 . 1585 '7 BPA WEATHERIZATION PROGRAM BID SHEET Bid Date Homeowner' Address lcf.nalyais NIlL/:l.q~ . ~ Contractor's Contractor' Addre ~ / Phone ~b I: A. Ceiling area - Sq. ft. / "5".:11 add R - ..:L:l-- Sq. fL. add R-_ Sq. ft. add R ___ B, Ceiling ventilation - odd 'I net free w:ea.!!!lWed.J Upper portlOn7LLLOr,(,1' Lower portion C. Ceiling HV AC ducts-tape uninsulated duct joints D. Insulate ducts - Iin. ft. add R_ Comments TOTAL E. Floor area sq. ft, I -('> I add R F. Install 6 mil ground Cover G. Insulate water pipes -Iin. ft/$.'11. Add R H. Insulate Hydronic pipes - lin. ft._-Prld R~ I. Install vents - add'). net free area req~ /tj(l;,r..t-L.- J. Floor HV AC ducts - tape uninsulated duct joints K. Insulate ducts -Iin. ft. Add R Comments TOTAL BID AMOUNT ?5lJ.m TOTAL ?(Jf. ,,7) TAX 5.t'. -)/) /ldJ.tm /:J 4Y 1'7.:1 .<(9 Lf77j?jv- ll. 1%.~B ~ ;<;" 07) 1'7 -rr;- .a 'I,). ':;5 /91>5.1JV 1L/Z1.1Cj 1945. ?'f . Ill. L. Unfinished walls - sq. ft. _ add R Comments TOTAL IV. M. Windows + Type/sq. ft. Type/sq. ft. Mfg. name s). Comment sliding doors No. windows_Airspace_ 1\10. win ows---Airspace_ ;J 'i'>{1 oD ~,Q ~ J?fl ~07.:J.:'J,{l ~ '1I(1)/TlJ TOTAL .:l.!J :J. <.(1 J1D1;;J,:~o V. VI. VII. N. Weatherstrip doors No. of Iin. ft. O. Caulk windows No. of Iin ft. P. Clock thenno.-no._ mfg._ modeL- Q. Dehumidifier - no. Comments TOTAL TOTAL ITEMS I, VII SifT< ('I() L/ .N 41 .5!;.Yi.!j a CONTRACTOR'S FIRM BID: J. t.he undersigned, offer to provide t.he conservation measures as described above at the prices shown. which irclude!l aU labor, materials. etc., (Homeowner doing work himself must include materials only, not labor. I and in accordance with SPA Weatherization Specificat.ions. I agree that no work is to be done without. aut.horUation by Public Utility Dist.rict No.1 of Grays Harbor County. This bid is considered fir~~less written notice is given to the Dietrict within three working daya, although I may wit.hdraw this propose I irno}lyc.p,.dr.-L.~ days. ~~ A De,. aJ~.~lJt2L By _,_~L'-= iI~ I Title J HOMEOWNER ACCEPTANCE: I, the undersigned, heve contracted with the above contractor for the instaUation of aaid approved con.erv.. tion measures, r hereb)' accept this contractor for the inst.aUation of luch meBlurea and indemnJfy the Public Utility District No, 1 of GraYI Harbor County from any demands for damagt" of any kind which may arise from the installation of the conservation measures{.). I certify that 1 have received an indoor air quality brochure and understand that. aU materials and inst.aUationa must comply wit.h current BPA weat.heriution lpoc:ifjcatlons in order to 2f:ome eligib for rei bursement through the R,r"sidentiaJ Weatherization ProgTam, Si"n.dthis~llayof 19~. Ph.c:? ~ / ,. ~r~~ERy~cPUSTOMEFl SignatureX' ~"""_ !.../~''''/~UL.. ' PINK-CONTRACTOR '.:, ) fy,li . A' 'f; ~, l j ~" l ! " " i/ , . ~: I ." .,: '. '.,.: ,..,oo"....:" " oo ' i' .,'.' ,0" ,-- !:" :,', ". " ::, '" : '.' ',..'. -- -.," " , :,"', ',' :' ;' " :.' ',":.,:," , , ' , " , , ',' '.' .'... ...'.'. ',' ":.: ",", "": . " .,., : :' '. . ..', ". . .....,. , " ..'- . .,....... ':. ',: ", ' .' " ''::.',,:.: .' , ''',,'', : ...., :;:'; ":::, ':",.- . " ''';'.: ',.' , ".'" :' ,': -::-- . ',: , ' , '.. , . ,'..", , , , .' . .. GRAYS HARBOR COUNTY PUBLIC UTILITY DISTRICT P.O. BOX 480 ABERDEEN, WA 98520 OWNER'S NAME OWNER'S ADDRESS OCCUPANT'S NAME SERVICE ADDRESS Window H Size 1 :2 Jt..:2 II.. 2 Ix 'J 3~ ..J 4 I x,'l 5 1'\/.4 6 0..... i.; 7 V 4 8 J y...x.:-;,Y. 9 '}{ tf 101,' .)(. '/ 11 I . ~ 123",.<;1'.. 13 ~x, 4\ Yoz.. 14 :,,~Y... 15 'II_c;'1~ 16 Y...:~ ,~~ 17'Y..." 'A"'i 1 B .-:? X ,-=<, N~ 00808 ENERGY CONSERVATION OFFICE WINDOW BID FORM ANALYSIS NO. ~,~~" WORK PHONE ~~DE ~~tiIJE ZIP CODE WORK PHONE : .' _"',i, "1'" , HOME PHONE s:~~e = ~~~~ Manulac1urer existing WS' Caulk" Type Y/N YIN Leve' Fl.' Proposed Imp. 81d Amounl Finish Rem.rks C;t,../d " G- o' "_'r_c.> '. <. A...J~ " '~AJ;'" .' WJ"dD tV I_..JJ h_ I~. --;;; -- 19 IJIIJIIL Of- "If?/ AJU.... ~'-M_e..$ ""I;;;' ~ /_ b WINDOW SUBTOTAL 1:28:5()" '" TAX A~A A, WINDOW TOTAL ~1?~) WealherstrlDDlnD Total Ft' Bid wlTax WEATHERSTRIPPING Doors: (Itemize) 'Number of windows needing CAULKING Doors: (..) 001; 002; 003; 004; Threshold I Sween I JQ )ocr Bid wlTax 005; 0 OS"Number of windows; TOTAL BID INCL. TAX S I ~1..2.~ The conlractor hereby agrees 10 meet the minimum Slandar~~~i~t~~S~~~~t~o~~~eCifjOd In t~':w, Bonneville Power Administration Residential We.'herlzatlon Program at the prices quoled on '7 ~~ ,S.;Ch Item Is to -A bid separalely. II", If Contract (apared by 0J:tf~~ ~ !'L.~ Dele~de ~ (J{f Phone.~~ Excess costs above the ~PA ~x~u~sh ant al}'ount,are the respons~~;;reowner. ;' HomeoWna(SlgnaIUr8~ ~...c.4.",,-~(J..tU.(A~"'/ . Date WHITE - UUllf~ YELLOW - Cu.forner "HI( _ Cantrac:lo.- " .' " .'.;,.' .' , '... ,'. ' , ','.' ,: ':" , '.: . . ,.',,', ' ...., " '. " ':" ,': '.' ." . ",.". . " :':, ',.' " :' ,.'.', , .., '.,: '"., " ~'\""', . .', ... " :, " ' .: ,'," .', /'.. .....' , .' "... '.',; ", i '..... '" i' ':; , , , .--:- ': III "', .' '~' 1. , '~; ~ j , ", ~..:: :'J::>, ' . ......:;' '-;', '.: .: ...' ,.... , . ,."__'doo ..,. "". j1' 1. ,',", ' ,",. ", . " . .'." , I c~rti~y that the r~sidence to be v~atheri2ed has as ~ts pr~nc~pa~ me~hod o~ h~at~n9 permanen~~y instal~ed electric hea~, installed prior to Apri~ ~5, ~983 and does not have a non-e~ectr~c centra~ heat~ng system. I alao certify that the residence ia not B seasonal residence and ia occupied %or at least one-hundred eighty (180) days of each y~ar and is not a mobile home. I understand that the veather~2ation money distr~buted by Pub~~c Ut~~~ty D~str~ct No. ~ o~ Grays Harbor County ~s ~or reducing e~ectric~ty Use in e~~ctr~ca~~y heated homes. I,there~ore agree not to switch iTem electric heat to another heating SOurce. The undersigned understands that kiCkbacks, rebates or other non-program bene1its 1Tom contractors and/or suppliers are prohibited and may be subject to Federal Lav. I~ dry rot is ~ound to eX~st ~n the underf~oor area o~ the reaidence to be veatheri2ed a bUi~d~ng perm~t sha~~ be obtained ~rom the appropriate bUi~ding department, any such damsge shall be corrected and must pass the ~nspection o~ the appropr~ate bU~~ding department, The above-mentioned correct~ve action Is) sha~~ be taken before the installation 01 any underiloor insulation occurs. ~ I certi~y that I have rece~v~d an indoor a~r qua~~ty brOChure, a Privacy Act Notice, and have a~~ the in~ormation concern~ng th~ BPA/D~str~ct Res~dent~a~ Energy Suy-Sack Weather~2ation Program. I authori2~ Pub~~c Uti~~ty D~str~ct No. ~ o~ Grays Harbor County to make disbursement d~rect~y to the contractor upon ~nsta~~ation o~ ConserYat~Dn measures and D~atr~c* inspection approva~. >< ~,(J~a...._., /,;l l~L /~f;Y HOlfEOWNER'S SIGI/ATURE DATE ~ f, HOlfEOWlIER' S SIGNATURE ':'" ':'. <': "'" , " ' ~ " , ::: .. '.., : . ',' ".', '.....'. ....., ~___-- -~'..:" ',"'" .'.,c-, '. ,,'. ..,. . ,,' .;' ..'.. ..., .:..' '.. ',' ':, "..::,: '," " .' '.. .:-.: :: " " , . '.' . , . ,...,' '. ' '... ..'. . ..:"l :, . :,: ,':": ''': "".", ' '''.''..,' ';":'., :/"':',"':" '. ...' .,;' ,,, ....,t.. . ...,.,.' "'.' .'.,.... ,'.' : .' , ,:" " ':.;,. .. .,.., .'.. """,." '..,' , " ',... "...,.. .' "...>. '.' ~.'. ;'., .: "..'. .',.: " . ' . ' ..: ,', ,,': ". ';.> ,. ....'.. :"'.....'.,. ." "'. ..."..".: ...'" ,,:, ..;' , . . ' .,. . " . " .,......'.. ..... . ". ',........ '. " , .,': :..' '"'''''' ',,', '...' .. "," ":' '," " . ',: ,/:' .' "'" ': .:" '.' I',' .',,',..' '..;.....',' ",:..' """, .":, '-:', ", " , ,'. :,... .'.:.. .\ . ." '... ". '. .,...,' '. : .," ,,',,:. ...., , '," .. ' . ' " "", "."'.' :",' " ''',' , , ,', . '''. :.'" , . '" . " ..',.' .. '. .,. ' ,," :.. , ", ' ',,' . ," ", \ " .' . . ", '.,' ':', , " .:' ..'...,., .', " ,,' ":.' " , "..~ :' - '," : . . :~.', ': " 'C., IIIIIIIIIII ':"'.." , '" :: , .. , . " " '""",,:.' ~ ,,: INDOOR AIR QUALITY WAIVER Public Utility Dietrict No. I of Grays Harbor County (the District) DISCLAIMER 12 you choose to install storm windows, thermol windovs, caulking, veath~r- stripping and/or blown-in vall insulation (tightening m~asureB), air, iniil- tration into your home viII be reduced. Reduced air infiltration viII reduce the amount of energy required to heat your home. Hovever, the reduced air infiltration will permit a build-up ox pollutants, if present, in the air ox your home. THERE IS EVIDEIICE THAT EXPOSURE TO SUCH POLLUTAIITS, TIOIIS, HAY ADVERSELY AFFECT YOUR HEALTH. EVEN AT LOW COIICENTRA- Sources of pollutants and methods ~or controlling the po~lutantB in your home are described in the SPA brochure end booklet, both entitled, -Home Weather- i2stion & Indoor Air Pollutants-. The brochure and book~et prov~de the in~ormation necessary ior you to evaluate the e~~ectB of these pollutants en you Bnd other occupants oi your home as a result of installation of house- tightening measures a If you have any questions regarding the pollutants described in the brochure and booklet, or other pollutants possible present ~n your homel please refer to the brochure and booklet or call SPA or ~he District before you decide to install tightening meaSUres in your home and be~ore you sign this Waiver and Release of Present and Future Claims. If you choose to install storm Windows, thermal vindows1 caulking, weather- stripping and lor blovn-in vall insulation and receive payment ~rom the District under the Residential Weatherization Program, the District ie not liable, by virtue of providing services or payment for the purchase or installation of these veatherization materials, in any Buit or action involving a District customer or occupants of such customer's home. If you choose radon monitoring or to have an air-to-air heat exchanger installed in your home, the Distr~ct makes no warranty, express or implied, or representation oi any kind regarding the accuracy of the radon mon~toring results or the eifectiveness of the air-to-air heat exchanger in reducing radon or other pollutants in your home or the appropriateness %or any parti- cular purpose of the air-to-air heat exchanger and the District is not liable by virtue of providing radon monitoring or providing services or payment for the purchase Dr installation of an air-to-air heat eXChanger, in any suit or action involving a District customer or occupants o~ such customer's home. WAIVER AND RELEASE OR PRESENT AND FUTURE CLAIMS I have read the above disclaimer statement Bnd the booklet and brochure ~itled -Home Weather12ation and Indoor Air Pollutanta~ and understand each. In consideration oi receiving the benefits and payments (to me or to my contractor) under the Residential Weatherization Program, I agree that I viII not make any claim or demand against the District, and hereby release and discharge the District ~rom any and all claims, demands, liabilities, suits, causes o~ action, for any damage or injury arising, resulting or which in the ~uture may result, directly or ~ndirectly, %rom any reduction in air in~il- tration into my home Bnd any associated increase in the concentration or air pollutants in my home. DATE /d ~z.' /~/.7 "'OWNERS SIGIIATURE '~~^"").tL~.-zL- . ADDRESS TO BE WEATHERIZED , , , .. ...'., " ,..'..' , .. . '..""., " '...' " ,,'" , " . ,.' ..' ", ,.<.... . ' " '"", ,": ,'.. , , " " , ..' ',...'.,. , " '. ,< .,,'.' J ,. Weatherization Program Participant: This notice is provided to inform each homeowner 0% hea~th and safety insta~lation problems which cou~d occur as B result o~ the installation of weatherization measures under the Residential Weatherization Program. rn order to minimize the chance of any health and safety prOblems, we are Baking you to look at the attached diagrams and compare them vith the installation work performed on your residence. If, after you review this information, you have any reason to believe that you may have an installation problem related to work completed on your house, please ca~~ Pub~ic Uti~ity District #~ 0% Grays Harbor County at 532-4220 or 1-800-562-7762 to schedule a re-inspection o~ measure(s) in question. I~ our inspector determines ~hat the meaaure(s) in question appear to have been inata11ed improper~y, the Public Uti~ity District #1 o~ Grays Harbor County vil~ take appropriate action to see that corrections are made without cost to you. I~ you vish to have us reinspect your weatherization jOb, p1ease contact us within 30 days o~ our final insp'ect.ion. J JH~HWW~E~)...). / ' ~ ~~=_, r1h<~.(~p~.1 i /.:2 Jl:z2L./?' / ,pi DATE ~ ~,.. t i {, ).. "i," ~ ~' r:. \ I . " , " .' ."., ,..., ,.'. . ',. . ,'..'. . '. '." . ',::.' . ',. ': ,.,. ',' '; ',' ," " '...;,..: "., ' ,':. .', ,', :" '.',: .. ,.,'>,/, .,...'. ..........,< ,." .... ...... ,,' ": ..'"" ,',": ' ',. '.' , . "':" ::' ',: ': ' .. "',.' " " ", :"", ... ,,' , '.' ,;,' " '.' ":'::,: "", : ." ..... ...'i.<'" >r.., ;,. , " " ,,", , . : ':,.. ' " ." ' , ' '..,' ,: .' '," , :" '" '" . ',' " ,: " ' . ,,' :,' " , "', .'.' , ". " "'". ' .', " .. ' '" , "': " .'....'. . ., ,,: " '.., " ,,'.. ,,' ,',' ' ",: .' .' . ..' ,'" '.' . .' '.' . " , ,',..' '",,,;, .':,' "'" ',' :.', : ." ,,'..."', ' ' "'., .." ':',',,: : ,': ,,' . , : " .. ,,:", "', : " ,'..' .. '.' : ' . .... . ," .... '!,,: . ",. ':,,: ' .' ,'.,', " ".:',.',,', ' .:', "" ':'.'.' ,.". " " ' , ' ',',.' ,'" ',. '., '" " " ',;' '.' ,,',,' ": '. .,' ",' , "... ' ," '<:, ':.'. '. . " . ,'.' .'.' ;:' ,,>', ,'.. "-.:,,: .. , ,( , ' "',' " .'..', . " '.,'., ,.;' . ..'.' . .' 0.... " "' ., INDOOR AIR POLLUTION AND HOliE WEATHERIZATION ....pAfir II I. E:;;.;l'/(r(c- .J . () t/~tf IrY ~I /J'y) Acknovledgmen~ of Regeipt o~ Information Consumer Options for Haintaining Indoor Air Quality I have received the brochure and booklet provided by BPA on indoor air pollution and veather12ation. I plan to read this information before I decide how to veather!ze my home. If I decide to install house tightening measures in my home, I vil~ choose one of the three indoor air quality options after I have r&vi&v&d th& in~ormation provi~dhm~ NAME ')( ~v.J DATE /.-2. ~ /if'.f' /?' ------------------------------------------------------------------- I understand the information provided me on home veatheri2stion and indoor air pollutants. On the basis of that inf~rmation, I have chosen ~he option checked below: OPTION 1 W&ath&r~z& v~thout Radon Mon~tor~ng ) I wish ~o install house t~ghten~ng measures, radon monitoring. v~thout OPTION 2 Wea~her~ze, ~hen Monitor ~or Redon ( ) I wish to install weatherization measures, including house ~~ghten~ng measures, and then have my home mon- i~ored ~or radon. I~ my radon reading is above SPA'. Bction level I may choose ~o have an air-to-air hea~ exchanger instBl~ed in my home to compensate ~or the e~~ec~s o~ these house tighten~ng measures Dr pursue alternative radon reduct~on techniques. SPA vill help share the coat of this air-to-air heat exchanger or alternative radon reduction measures. OPTION 3 Monitor ~or Radon, then Weatherize ( ) I wish to have my home monitored for radon before I veatherize. I~ my radon reading is above SPA's action level, and I install house tightening measures under this Program, I may choose to have an air-to-air heat exchanger installed in my home to compensate for the effects of these house ~ightening measures or pursue alternative radon reduction teChniques. SPA will help share the cost of this air-to-air heat exchanger or alternative radon reduction measures. r 1 ;\to,' ".' ,.. ....' ".. "'.,,','..' . ..", ':'..' ..", '" ,..' '.:. .'. '.',':, ,';, .'... '. ..'..' ...., ':", ",:'. ' ','. " ....: . ....'., " . ,',", ': '. " " " , ,'., :. .,.,... ...,. ......., .",. .... " .... ...' .".. .<.,.' ....'.....' '... .. ::, '.." . .," ... \', " i. ',........ ", ,: . , , ",.:,: ." , ',. ~ ..:. "." '. : '. .. :.. : , ',:.' ".', ',' :", ',:',,""". .. "" ,,", , , , ..' '.'...' .>. . .'. ...'.. .' ." ,. ., .,,"... ..,'.'.., ' ,....',. i., .. .,',.. 'c';'", ", " ,": ','... ".: . " " :,,', ,,"oo :", ,," ,", .., . " , '.'., ::,' ",,' ::,:' , ..,' ..' .. ... .,,'. .".,' : . ',." '..... . ,..' ,',..: '" .. .. '.' ... ',:, ',' ,''':,' " ' ::'" ',' '"'' " , " " . ' .: "',",' ,...." ':, ". , .'" ". , ':", ., ,. .... .', , ..,' ,'" , ,", : ' .. : ,.... . " , .' ,'.~ ,',': ~ \, k ",: ,.' ': ." " \ 'f" . ; f " " ::.. .. .::., , ,\"'" ,', " :' .. ..., ';, "" ',. : '" , . . .. '..c. :;,l1li1 ... " "',<C -=.:. ':.' ',', , ,": ~ . - . " , , , " ," .' ,,>: ", ", I understand that: . if an air-to-air heat exchanger is installed, an attempt will be made to size it to the pre-weatherization air change rates.. . alternative radon reduction techniques may be more effective than air-to-air heat exchangers at reducing radon levels.. . there is uncertainty as to the effectiveness of radon reduction techniques because each home is difierent BS are lifestyles. . periodic follow-up monitoring Cof my home) is the best way to determine if radon reduction techniques are effecti ve. . additional monitoring would be at my own expense. I have been advised that the Bonneville Power Administration and the Public Utility District No. 1 of Grays Harbor County make no claims or warranties regarding the effectiveness or reliability of any radon reduction method. NAI1E ?< DATE ff~~) /7~~.J /02 ~ /9/A> t JI ~,i ;,; t -, ":', :':.' ",' ;',.'o" .....-,;"". : i ,", ,', " "" " , . ., ' '.',". '.,.. ":':':" '; :;. '. ',' :', ,'..,",.: ,'.;.' .',' .: '... ,.. ,"',' .'... ."', " '.' ..:' "';,":" '"',, ',', : ,': '.,",' ',: ..'.".'",,: ,",:, ,,',;, ',' c ':'" ':,' ...,.,.. :,.'. '.", ,:,'. .: : .. ',' '. " ..:;, :..' . ...,...,., ":', , "c..',. i,:" ':.' :: "',....:.,.",, .," " , ' , "..' ",:" ' ","'" .. ': , , ..' .' .:.< "'. ,,"'. " "" ..,.',',"..'.: ';', '.', ,.,':' .,' " '", ',:: c '" ",. ' ' ..".. .' :: " :',: . '. ". .;';ii, ,> :, :>, '...,,'.;. .' ...,. ,.'. ':,'< .. "c ' ": .. ,:,,' ',", " "',' >' , '.' . ", " ','.'.:'..' ,':', .,; '< '., .".,. '. . '. . ....,'.',...,. '. oo.,..... ',: , .' " .,' ,'. ',:, , ,',' .' ..' ,. '...., ,; :' '" , .: "'. \" t . ., \ " :< ,:' " ", ',,'" ,,' ,", " :'/:'," , :' ,'. ", ':', ,,'. " ',' .: . .',:: . ;'" ..,., " , :,>': ",,',:: , "':::.' , : : 1 l' .:7 ~, Ji i I' i ~' x >, t., t \ I I i:, i: ; . ", , :'.' ,,' , :"" ,"', ":i,' ,...',<;;,.5.- > ',' " ';'.,.,..,';.,:,"" ...' '.< J-; :.- ,." - /' r ' iiiC', ENSRGY BU'L-J<ACt\ ~itli2t!J:~E:r "1./ 'j/' .!J '/f{l~fl Li/!ii ,i ,T r / 0 II (,1) A.<~[l/:j: IIAl':r: V(,T~,!'. 1"''\ V~U;~LVtJvl::'.s ACCOUNT # -.5~-(j],:-~~,_ tj AD[;RESS '('JPI<//<J~_(C{ ADV I SOH 1","- .___.ii, CITY/STATE ('J0~{A/I.A./~ -' oJ AurlIT DA'n: {. -1"\ ~f1 Hol':E PHONE J\'"s - .3 ~-O S- ANALYSIS It IT I..{ 7/1 3 f.,l'i.: BUSI1'ENANT PHONE 7S:~, - .5 '2 \ ~ PAD # ...... .... .. .. .. .. .. .. .. .. .. .. .. .. ...... ~~.-. ~ t ~P. .. .. .. It .. It .. .. .. .... .. .. ........ .. .. .... .... .... .. .. .. .. .. .. .. .... .. .. .. .. .. .. .... .. .. .. .. .. .. , @+ MAJOR SO,FT. EST. KWH MAXIMUM LIN.FT. It MEASURE (R) INSTALLED SAVINGS. BUY-BACK .. .. " .. " .... .. .. It.... ........ ...... */* ~.. .. II' .. .... .. It, .......,"i.. .... *1*" .. __It,.,.",. It It .. It Ceil1n,' "2., c; 't 1i''I/ s <')('1 BID PAD Al':OlJNT (NOT TO EXCEED 50l( OF ACTUAL) ;....lf1b:v'r.. s .. .. .. *ef'p,,1t .. .....~.... It S . 'fY Ceilinn Ceilino Floor Wall s s s !1..f.S- ,.. S $ s $ $ $ 152- 1'2.. !f1 ~ tr If'l- r: --;C1 '! 77-, 'IcJ $ Wall W1ndow,hl,l\l'JJ 7-0 I f,2,.1,'f'Y '" 7C, '2- $ 307;). ? cJ W1ndows \ S $ $ ......................................~...........l..............,.............. AIR-TO-AIR HEAT EXCHANGER.. -0- Is $ Is s $ $ $ //5' 2.. ~ I ................................................................................ MINOR MEASURES ... TOTALS rlO) s $ s 7J,//.- 'U. I c.. '" '" $ '" '" '" Sqqt? /) '7 ................................................................................ ..:';:~'.,?;?'/'. 2{ f ~ cz.J "I" BUY-BACK AMOUNT $ .~ I' I~ seasonal residence, reduce KWH savings by 5ol(. BPA w1ll ~und up to 50l( o~ the actual cost not to exceed S850 ~or a non low- income residence. ... SPA %unds may not be transferred from major measures to minor measure~. HOMEOWNER BALANCE '" 3'3?J, ~( Particioation Aoreement Upon recommendation of the Res~dential Conser~ation Service Audit, I have s~lected and agreed to instal1 the conservation measures listed abov~ to me~t BPA/PUD spec1~1cBtions. I~ I 1mplement all selected conservat10n 1tems, I am ent1tled to the Purchase Author1zation amounts as l1sted. If all selected conservation measurec are not installed far whatever reason, the Purchace Author1zation amounts may be adjusted by the District at a later date. If I do any of the weatherizat10n work myself, I agree to complete the work no later than thirty (30) business days ~rom the date of mai11ng of a Purchase Author1zation Order. If I cannot perform the work with th1rty (30) days limit I shall 1mmediately so advise the District. The District shall then 1n 1tc sole discretion either void th~ Purchase Authorizntion Order or grunt an extencion of time. [lATE Lo?.~~.c:j.Y'..ff,J<.,.. HoMF.:ClW~IEf/ L~~.'<kL~ _. ._._..,_...' ",;, ',,:..:',:" ':~''C'' . ".: ," ,',:',' ''', ',' '. .' .'.' '.' , .' . ,,' " ,:",.",." :..', ':, ' , ,'> , ".,. . ':' ""," ''', ' , . :'. ' :' ,:", " ''; , , '" ',," ' : ...... .. 'i.". '... .. :'; ',"":,'. ' .,: '..., ..' ,..'...,' , . , . , '.'. ,.', ,i ',',' ',: ;" ' "'" .. ..\ .. .' .., , ,: ,',., . " " ,', '. ,.,. , " '.', ...., <, ..., ,,:' ,:. ':'. :. :' :' ' , ::' : '. . , " ,;h" , , , .', ' . .,' ..,. . .'...,'. ..'.,'.,..',.;'.. .' . . '.,.,'., '., " ' ' ,.' '. .i'.' '.'.,' : ,. '..' , '.. " ' '"..,.:,':: , '.:" .". ':." ,:,:, .,. ,'.:.: ': .".,'. ..'. :'" . ',''- ", ,; , " , . :', " '. ,,' " ., '..'..' ..'. " " ',: . :" ;'," ':,',' ",:: -,.,' .' . ~'':'.' ..',...., :-; .. . ..,..,....,.. " ',', .:,' ",::, " ' , , ", ",' ','"'",, . ,:' 'i :'" , .. BID SHEET PUBLIC UTILITY DISTRICT NO.1 OF GRAYS HARBOR COUNTY N~ BPA WEATHERIZATION PROGRAM 15857 l. J -' I CUI.; 0.., OAf. A. Ceiling area - Sq. ft. / "/:2/ add R - ..:L+- Sq. ft. add R-_ Sq. ft. addR-_ B. Ceiling ventilation - add'l net free a~ea~tWed~/ Upper portiOn 7L!J..Ll&-f' Lower portion C. Ceiling HV AC ducts-tape uninsulated duct joints D. Insulate ducts -lin. ft. add R_ Comments TOTAL E. Floor area - sq. ft. I -<- 'J I add R / .?- F. Install 6 mil ground cover I 0<; ;L I sq. ft. G. Insulate water pipes -lin. ft/$12 Add R ~ H. Insulate Hydronic pipes - lin. ft._-!ll'id R I. Install vents - add'!. net free area req: (l'jr",,;:re;:- J. Floor HVAC ducts - tape uninsulatedductjoints K. Insulate ducts - lin. ft. add R Comments TOTAL III. L. Unfinished walls - sq. ft. _ add R Comments I. II. TOTAL IV. M. Windows + sliding doors Type/sq. ft. No. windows_Airspace_ Type/sq. ft. 11/0. windows-Airspace_ Mfg, nam';\sl (! /l /f. /Y) (,... 0 Comment!(~1t'.j{l f1 J Or!U,rYl TOTAL V N. Weatherstrip doors No. of lin. ft. O. Caulk windows No. of lin ft. P. Clock thermo.-no._ mfg._ mode'- Q. Dehumidifier - no. Comments V. VI. VII. TOTAL TOTAL ITEMS I, VII I/<{>.nalysis NIlL/:;.ct.W . . '7 .:e-t,v Phone / C .5 -S&t,.' BID AMOUNT /h1.J./X) TAX C;g', Sf} TOTAL 'ioy",7) / hI} .(7f) 1'14V /'1:;.</9 ~ ;<; 1m f"l '" I)' ,!). '1.1. <;$ I YIJ5-IJ{) 14l.1. 11 /1'/5. ?f ') Q ,,;Z, n!..' ~ :'.q ./{{) ~D1.J.~ ~ :r 6IJ IJlJ ,:2, ,') .'J. ~() f1D 1.') 3,i) 5<:-.1,. <; ff/) L/ ~ '-I d 1 ..s.!BJj)"'2Z.. CONTRACTOR'S FIRM DID: I. the um.lersigned. offer to provide the conservation measures as described above at the prices shown. which includes all labor, motcrials, etc., (Homeowner doing work himself must include materials only, not labor.) and in accordance with BPA Weatherization Spccificntions. 1 agree thnt no work is to be done without authorization by Public Utility District No.1 of Oro)'s Harbor County. This bid is cOllsidered fir~.r~less written notice is given to tho District within three working days, although 1 may withdraw this propo,ol if :elC,'PlCdr.:ill'ij! day'. ~ ,~L Ooto 1d.,~IVJL Byd~~ 1lL-L. I Titlo ~} HOMEOWNER ACCEPTANCE: I. the undersigned, have contracted with the above cont.ractor for the jnstallation of said approved conserva. tion measures. I hereby accept this contractor for the installation of such measures and indemnify the Public Utility District No. ) of Oroys Borbor County from any demands for damago of any kind which may arise from the Installation of the conservation measures(s). 1 certify that I have received an indoor air quality brochure and understand that all materials and Installations mUflt comply with current BPA weatherization specifications in order to become eligible for reimbursement through the Ileflidentlal Weatherization Program. Signodthis_dayof .19_. ~ if ~';' , if, ~' , ~ 1 f' t, .~" . 1 1 " } \. r , " I; 1\ I ~ I: ~:' 'I,,:. I, " ,"....: " '. ":, ,," v,. GRAYS HARBOR COUNTY PUBLIC UTILITY DISTRICT P.O. BOX 480 ABERDEEN, WA 98520 OWNER'S NAME OWNER'S ADDRESS OCCUPANT'S NAME SERVICE ADDRESS Window Exlsllng WS' Caulk" Proposed # Size Type Y/N Y/N Level Ft.' Imp. 11:2",...,2 V" 2 />t LJ 3~ lJ 4/....'-1 5 IvLl 6 0"-'iT 7/v4 B I Y..... v~<;"y. 9 /v tf 10~'" l.j 11 Ii;. L/ 12 3 'L-:';/" 13 ~")/.. <"rot.. 14 ll~~ 15 \,-c:'1", 16 '!I_v fA 2l 17 Y...v 'A"! lB ~"'=?- 19 ENERGY CONSERVATION OFFICE WINDOW BID FORM ZIP CODE HOME PHONE ZIP CODE HOME PHONE Air Tbenml~ Safety Space Imp,FI1I11ll Glass Manufacturer Finish " . v V- ill/JilL cj- 'HV /I)u~ ~eHMe.$ /,7:;<5 ~{) N~ 00B08 ANALYSIS NO, N OF UNITS WORI< PHON E WORK PHONE Bid Amount Remarks Cd",'/d !,r:.- J' ..; ~...-.... . CIlLl./d h"., t")~.",.-", WOld 0 u.J ,., .-::;-/ L ~~ - WINDOW SUBTOTAL TAX WINDOW TOTAL WeatherstrloolnCl Total Ft' Bid w/Tax I,:t 2:50. :.. f) " " 't ~. 1~t:>1-'.~ WEATHERSTRIPPING Doors: (Itemize) 'Number of windows needing Threshold I Sweeo I I q ><:1 CAULKING Bid w/Tax Ooors: (....) 001:' 002: 003: 004; 005; 0 06"Number of windows: TOTAL BID INCL. TAX $ ~12 J~t The contractor hereby agrees 10 meet the minimum standar~~~I~t~ndSII~~~1ion specified In the Bonneville Power Administration Resldenlial Weatherization Program at the prIces quoted on , ~~~' ch lIem Is to b~ ~ld se~araleIY. . A ,i . A _ A .. ~:~~r~ 8 ~~~:::6:.fi:t-;1~ Excess costs above the BPA maximum ~ ant amount are the responsibility of the homeowner. Homeowner Signature Dale WHITE _ UUIIIV YELLOW - Cu.lomer PINK -. Canlr.clor , " ".' ,,' 'i"''.: ,: ":, '. ........,'.'.,' ...i, ': .. ' ;' '. ' ii, "....", ,":,: ' ',," ': , .'. ,..... .... ...., . ".,' ,. ,,: ''''. " ': ..: , '.. ... " " i,.... ,',"..', ""0,.,,..,.,.'......... .i' :.". " , , , ' .. , " ' ': . '," ," , ',' " ' ..., " ,:' , ,':"" ", " '."'~ " ., . , " " ':' " , , ,.' ' " ''o ,'i '.:: "," '.' ,"~ " ." '., ",;< , : : , 'i '.' ", , ..,.,'.,.,?;I :..; "';"" ::', .,' - " :":" ',"" " ,.;, ," :'.', ..,.; ,', ',.;, .,.. .',., ',;, . .'.." " ,"" , "",'::,," , , ,'..:".. .' " ,': . .:,: ,,.',, ",'. " ',',': :'\ .....'i. , :, ','" " "', ,:,':' :: : " , , .". .'.,., :i ", ''', , ' ": . > -.. ,,' ',,".' , "1 ......Z-__ .^ .,,; :~,-,i"';" <,;::/0;:':,:. ,.."...,.,-.;'::; ,,',- '.'.. · ;:!~;~;C;:,:;t!"J:T':::;}{t':;)'):'2i7.~~':;=.i)'5'.;'c~,,;iS:01".i~~":~1S~ii"g'~~'2~::!!.t;~:;":&:;!}~j,;,' ' ~ JEFFERSON TRANSIT AUTHORITY P.O, BoX 908, PorI Townsond, WA 9836B 20613854777 October 7, 1988 Mr. Gary Rowe, Director Jefferson County Dept. of Public Works P.O. Box 1220 Port Townsend, WA. 96368 Dear Gary) This is to inform you that the Jefferson Transit Authority, at their regular meeting of 10/5/86. declared surplus to Jefferson County one (1) smokeeater. This piece of equipment is now yours and is currently located at the Brinnon Senior Center. Please give me a call if yOll have any questions. ~ pe ter Badame Manager PB/ta RECEIVED OCT 11 1900 JEFFERSON COUNTY PUBLIC WORKS DEPT. iJ(;'\::<<, c'.>:;' ';",'",..; ",\:'::;:<1.; ',){'J..';~:?~, ~. .nJ,;~:ti:::I); ti~;~i >:.;~ ,< ....... "'.' , :::.':"':' :,' '.,..,., -,..';', ',..', .',',.',":':, ,..... ,':......,' .-:'....,.....::'.-',... ..:",_"'>',:'.:. :,:.~..:'.c:.-<'.:,::__'.."...,-:.. '.'. .. '.'''',:':',.:''-'',-:'., ....,,:.-,..:'..,; ,.'.::,,"-.:.;:';"".: :. ',.._' ";",.':: '" .:.- - ':.'<". ,'....:..:',...:. ':..._ .> ','. ,.....'.,..:...'.. ,'-i,: -' .,' " '.:: :.,...:-':". :,.,....,..:':. '. .._~.:.::'.,< '.: .:,::-'- ::.- }{i;~,~;~.'j}::;:;:iG~ff:,~t~i~~)~~hti':~Yth~t,):;~:~J":~~.-,i'i;,~;~~~:;,~j~:~{j::;;~:~j~~i,it;~:~;i';:,~id:~;~;~~,i~~U ~L""Z; "",V';i'" PEJCO FEDERAL ,,@Jr@cQbl1t 'illJJlj},ji@1Ol COUNTY COURTHOUSE - P. O. BOX 1220 PORT TOWNSEND, WA 98368 Phone, (206) 385,5575 August 15, 1988 PEJCO Federal Credit Union wo~\d like to rent the space currently being occupied by tlle PUD office, not including John Floyd's office. Our understanding is that PUD will be vacating the office on approx- imately October 1, 1988 and the credit union would like to occupy it at that time. We understand it is 465 square feet and rents for $5.15 per square foot, making the total cost $222.82 per month. At that time we would give up our current space. Also, we would like to know about possiblY updating the carpet as it is badly worn and to have the wiring checked as PUD indicates they sometimes have trouble with the fuses when using an electric heater. Thank you for your consideration of PEJCO renting this space, we hope to hear from you in the near future. PEJCO FEDERAL CREDIT UNION BOARD OF DIRECTORS Kathy Schwartz, Manager ~ ~)~r ../kLvJ~ , , , " , , '''', '.' ,'". .,..'... " : " ",": :,::: . . '''',< '" ",,", ' '~~, ~ '~'" , FINANCIAL ,SYSTEMS PRODUCTS CORP. 321 Minor;,Av'enue North - Seattle, WA ' 'i'~, ," .,.98109 ': :~(206) 623-4940 .0 "" " :': ,.l j " :, ~ ,:' ! I." ,: ',',' , Date /ohJA~ Name 7= ~~ rn~ ~_,/ A./--? /' /.. b~":::~ Telephone Mach. Make Model "","'?n~.s Serial II, '?'?/-="oo,"-":: Copy Count .",\ Addr. City ~/ U:::r_ <_~.<7 S ta te /.0"", Zip Analysis: Work Done: ."q,,,/,_c ..--;;,_ ,r::" ~P:: ..- r/..~~.. A.................. A7 .....,_._.,.., ~.<~---. .4', Parts Used: ;;;~J/"-A .> '::?::?-OOGJ /2.--~__ =.4/_"", > ::.>/- /':FO= .&- ~ /c:'"..._ ....-::.., - ' ,4-74/.- ""??.5-?- ",",00 ~___,c- ,/"~ Loa~er O,U t Model Serial II Repr._ STATUS OF SERVICE: Service Guarantee_ New Machine Warranty_____ Loan_____ Rent_____ Contract<~~ Customer Approval v!J1 U"W ~/../k';'" Representative ~~-,~ Travel Time -<;'- hrs. Labor Time ?.%hrs. ( " :' ':, . ;c. ',", ,', "" '.' ,," ,.' ," ' :' >'." .".' '. ....,". ''',:' ,',' ',". ' ,'. ", .,.' ',..','. ,'.. ..',. , . ", ", .'. ,'. ..'. " " : ,;" " , ,;'..' , . '. ...,:.." " " ";' " ':.", ".' ,; .. " ':."'. ,,', ", .: ", .' ".' .",' ,.... c."...' '" ' . " ' ",', " ":, .,:; .' , :', . " :,,'; "',. ',>,:;', '" ':": '<:"" " "':,' . : :. 0, . '" ;,..::, : -:-". ,., " ',',' ,: ,',....' ::'.., <, ..', .; .,."." . .'i " " ,,' , , ";," , " ":'.:, '> " " . ",:: ',.' '" '..:: " " ,.' '.' : ".', ".., :., ':.' ': "::"",' ,'" ", " " ".." ',',' ,', ',"i' '", 'c' ,,', ," '. ".0 ,"; :.,', ,'.... , ',; ',' ' . '.'.< , :' ':. : : " ,', ' , , ' ,"', '.', ,', '.' .'. . "', '" ",' :", ", .. ..:"."". '; , " ", ,'" . .' ", ',; ',' , " ',". ..,. .", ": ,,::, , ' :, ::" ,,:: ..." " " ." '., ',,\:' , '. " : , ,,"', , ,':, , ,I " " , ".. .' :, .0 , '. . '" " ,.'.'.... " ". ',' , . """':' ..., ',' ;:',':: .' i~:L--:"" ',~ ',' , ' .',',.' . '," ',' """,. '..: ,; ;, , , ' ,'. " ", '.....,.. +,.6T4r., ~Io. . 0..". ~ State of Washing Ion Deparlment 01 Revenue EXCISE TAX DIVISION Audit Procedures & Review Olympia, Washington 98504-OO90 c:;~-'6 Cr2, 7;;.'/~c..13. C::~".""~-<.'!.<(<'--""':';I:"J Certificate of Payment of State Excise Taxes by Publie Worl,s Contractor 600 122 582 Contractor: ..,TOLLSHARK CONST'a ,CUSTOM WOO 1132'\TAN TROJEN ROAD ,.,.; >~:L,iW.1'i' -T9TJu:u.;-Nn HA ........Qo-:>aCl CIt/lnl1(.W'~ /11/7, Q.f3,"'-S PWC 76485 We hereby certify that taxes, increases and penalties due or to become due from the above named contractor under Chapter 180, Laws of 1935, as amended, with respect to the following public works contract: ~'; ;':: , ~','. JEFFERSON'COUNTY GROUT a 'CAULK WINDOWS @ CORRECTION FACILITY together with all other taxes, increases and penalties due from such contractor, have been paid in full or that they are, in the Department's opinion, readily collectible without recourse to the state's lien on the retained percentage, This certificate is issued pursuant to the provisions of Chapter 60.28 Revised Code of Washington for the sole purpose of informing the state, county or municipal officer charged with the duty of disbursing or authorizing the payment of public funds to said contractor that the Department of Revenue hereby releases the state's lien 011 the retained percentage provided by this Chapter for ex- ,~ ~. cise taxes due from said contractor, This certificate does not release said contractor from liability for additional tax which may be later determined to be due with respect to the above mentioned contract or other activities. Date at Olympia, Washington, /~/t,/J p FORM REV 31 OO:!8 (3.85) STATE OF WASHINGTON " pDEPARTMENT OF REVENUE ..JS;7<"C(. ;/''/a-?t<~, SUE MORlN,l!ifuing Officer ROUTING: White Copy-Disbursing Officer, Contlry Copy-Conlractor, Pink Copy-File, Goldenrod Copy-Special File. "l!'B- ' ~- r '_i~: ' .'. ': . " ,'.',' " ,> ' .' ,', ' ..,. .',:,' " " ..' " ',.,. " .:,' .',.' ".',,' . ,..,..,..: ," " : '..' ". ", ',..." ,", ,'," " . . " .'" ,",' ,:,' ';, " :, " .:.' ' :,..., '. ',',.:' . . . ' ". " ,,: : " , "'. ", " , ,", ',:, ':: . '," "".' ",' .' :,,, . ': ::':,' ,': . ' :'...,",' :', '" ',",'.: '.':, ',' " . ' , , ,. :: ,: ','. '. , ' " '..,,' " ",' " :,' " , '. . ". . .,.' ,.,.,..."....'.< '/, ' ,. '''',' " : ; " '" : ."," .' '"." "'. ,:', '" :,0.' ... '. '..', :. .,. ,', :'. .. . .... ," .: ' " " ,.'.:, ,', '. ,'.. .' , , '.,.. ..': " . , '" ' , ...." ... " ...':." ::" :' ',' :' " '" . ., . ....... ..' '3 ,'....,'. . .. " ", . ", , ' ':, ", . , ': '., '" """, '.':, , , '.... '. ': '. ,", :: " "... ' '," :.' .. ... ..:' " '...." . " : : , t '.', .',' .' , ,i, ,i :'" . IlIlI I 0" t \:' l ~ I " ~'\ r r -':,." ,..".....,'"' , ";,',<', ' " e~~~.2. 7a. CJ ~ . " ,"'... : '...:' OCT 3 19& :Jefferson County Public: V\I"'~4I; "'Cpt. 9)""", >~'. ,\ : I", . : ..'!'I.?J......,.! Complete & mail entire set WITH APPROVAL FEE TO: Dcparuncnt of Labor & Industries ESAC Division He.7)O 925 Plum Street 01 mnla. Wn. 98504.0631 (206) 753-4019 (Type or print clearlY-nth Is Is your APPROVED FORMS TO BE RETURNED TO: lshark Construc~ion & cu,~,~,~,~.,~.'??,~,~~.?E,~..l ~2,~,wY~~.OEE?-L:~!.~~..:..._,........"w....,........_.,.,...1 , 1~~l!.A 983;J .-J Please aI/ow a minimum of 10 to 15 working days for processing from the date the DeparlmenJ received your documenl wIth the correct approval fee. CONTRACf AWARDING name PUBUCAGENCY Jeffernon County llddrcss Jefferson County Courthouse Affidavit of PREVAILING WAGES PAID (Public Works Contract) INSERT CARIlON ('AI'ER BEFORE COMJ>LETING mailing, label) Contract/BPW No. RMJ 781/1 -Bid due date ! Date contract awarded 7/25/38 i 7/27/88 -, ' County where work performed Jcffero::.on County ....Prime contractor 'follsharl-l Con~t'.cuctioll .....Was a statement of intent filed for tJll~oject1 Yes [X] No L.J ~ phone no. 1i::5'iite work comPletea- Dept. of Public work~L 385-9160 18/26/88 city stale ZIp Por~ Townnend, HA 98368 SEE INSTRUcrIONS ON REVERSE SIDE i2. APPRENTICES: Name, registration #'1 ! stage of progression & date of hire i I I I ! I ! I I i I I PLEASE ALLOW A MINIMUM OF 10 TO 15 WORKING DAYS FOR PROCESSING FROM THE DATE THE DEPARTMENT RECEIVED YOUR DOCUMENTS WITH THE CORRECT APPROVAL FEE. 3. RATE OF HOURLYJ>AY 4. RATE OF HOURLY FRINGE BENEFITS 1. CRAfT General Laboret' N/A $15.46 $3.43 Foreman N/A $15.96 $3.43 ! I hereby certify that the above information is correct and that all workers I employed on this Public Works Project were paid no less than the Prevailing Wage Rate as determined by the Industrial Statistician of the..Department of Labor and Industries. I understand g:~C:~~~~~~;:::;'~;t~Olatc Prevailing Wage Laws are subject to .Cf~~J>~'~~C~ <.,:.t~I:2!~~d ~NH~,,,,_,.,..wmm''''''^'''PIi;'''N''~#''''''''''^~'''''''''''N'''' '(iPe or rmt ompan;'~~ one Tollshark Construction 732-4080 .Adarcss""~"''''.''''''''''.''^'''''''''''''''''''''^'''''''''''^'''''''_.'''''''"'~""""''''''',''''''''''''W^"".,...................,.........""",........,.."".,.............. 1132 Van Troj:'" Rd. ~citY"""'''''''-'Y^'''''''''''''^'''''''''''''''^StatC~'z1p'''''1~C~trac~7~'''R;g'i;tr;ui~~N~ Chimacum, WA 98325 l TOLL5CC217NO Completo this form In triplicate and have each notarized STATEOFWASllINGTON County of (J.P ~fo'~- Signed or attested before. me on 'S"l a....-t- 1 I Cl g R ","H"~''''",_ '." ' 11 . / j"'~&rg~~M~~oi)o'~ry pUblic)9s;WlI1U ~ , y~,JP\.A ~,f ~'\...~r~SlOr~ /;~.>'~.: 0 , , U ~\ "".~,y'''nppolntinent expires '(/L."'" .;. lQ'1::>- ~ tei \\C6NiRACTORS, MAIL AN AJ>PRoviD COI'YTO THE ~ * ': ,c" - CONTRACT.AWARDING PUBLIcrAOENCY4 \<"t7oo;~d1-b6~'~ffidRVi;' of wages 10.87 S - P 0 1988 -":~':.~{.~,.~;", .. 'E 8 ""';,.--.!Z.r W.:\S~\~;;" L t 1 -...""~."~;,,,,,. ,""All r;.\ \(lr,/'I L='& J. Use",Onl APPROVED Department of Labor & Induslries By ~ 71la.., ~llls lal Stati,fV'pipn SEP 2~ '88 , '. "...,. ". :' :.,: " : ' , ,,,' " '.:, ':-., :; ';"".":,: "" " ' '" :.', ' ',": , ... " ,':,', " , :- .' ,,' :',.: ,"".' , ,: '. ,'. " ,',.,.., ", "'. '" '.,..,' " , ".,..'~ ' " , .. ", , : '",', ,'" ~' ", ",:' .' ", ,,' . ",'.." . " , ,. : '", .. '" ':" ': .,'''.,'., . . ',,:" .-, ' , , , " " ,:', . ",,' '.<>'. ., ", ':: '.""",'" : ':.."'. "".' .:' ': '. ,': :.' : ',' ,':: ',' :, " ',:' .,.,,', '. : ,::.,.,., .' 00 :' ,,' " ,"" ,,.'. ,", "'. :,' "" ".- " . ':, ",..'" "::,.,: ",.' " ,:':'. '," ":': ' ", ...""..,, . . , ".,"", : .' , ," '. ,:', " .,., :,:',.': " ::," , '. ,: : 'i , " .", ", '" ::,,' '. ", ',,: ' ': '; '" 00.' , ,', ",,: ,""..",' :"''-,: ',,' : ".,: ",. , , " ,,': ...': ' :".'.:,', ': .' '., :,,' , .' . :, . ..".'. , , .. ~ (k l t f J/,^ ii " " . I ~ ,~',1 ~ i" I I I: ; \ " t ! 1 ej, . " .', ' ,'.:, , . ''''''/ ,,'o' 'o' , ' , ~-e..-::: .0.2.70'.-03 o. jpSEPH A. DEAR --- Director ~) -t I~"~ ..."" OCl 3 Isea STATE OF WASHINGTON :Jefferson County Public Works Oopt. DEPARTMENT OF LABOR AND INDUSTRIES General Admini5frdlion Building . Olympld, WJshington 985().HJ6J I September 28, 1988 Jefferson County Jefferson County Courthouse Port Townsend, WA 98368 ACCOUNT 10: 409,627-00-7 Tollshark Construction & Custom Woodwork Contract No. R00780 Gentlemen: Please be advised that the Department of Labor and Industries does hereby release Jefferson County from any further liability pursuant to RCW 51.12.050 and RCW 51.12.070 as would otherwise incur in connection with a contract calling for grouting and caulking of windows at the Jefferson County Corrections Facil ity. This certificate does not release Toll shark Construction & Custom Woodwork from liability for additional contributions which later may be determined to be due with respect to the above mentioned contract or any other contracts said contractor may have performed. Very truly yours, \( ~'~ KaYe~ 0 ~~ Administrative Assistant c:J Contractor Compliance Unit Phone: (206) 753-4398 CCU1:23.jh30.1 cc to Tollshark Construction & Custom Woodwork 1132 Van Trojen Road Chimacum, WA 98325 ~.," " .'; ,'. ,,', ", :' ."'.., ',.' ' :" :.' " " .,'.' "",',',,;,"..,.. " . :,,', , ' " " " "", , '. ':," ,;-'.... ' ',' :' ..,,: ,. '"'"..',.,'.,'.'.,'.,''' C",..""" ", .,:' ", ""," ."" ,'. :', "...,'....,..." ''o, . ',.' ,:': ,/:" : ',' ,,: ':...' , .' ',', ' ' , " ',' ,',.,,' I,,':;, " '"., , ',.', ',:, . ,,' . '. ,.' . .. oo' , " . .:.. " , ' ,:. : " ':. ",.', ",', /,' ,.,,', ...."..' "" ''': . ".," : ",)" .....' : ','.., '..: ",','. " , " , " ,'. ., ,.,.' " " ',>> , , ,'" '...... '..:..."., ":,; """: "<.' ''''':'',.: ' , '. ",,', ":. , ' ," ,,:..' .i , ::, '" ,:':,' :.', ,.'..., ,,':,,' " '. .' '",:' ",<" .,... ,:,:,: ",:.. ',,' '.': ',,' '.,". .', ,', '.., , ,",,' ' ',' ' . " .,' ,', ' .' ',',' , ,.:,.' ""', .:', ',.' .,' '. '..,",'.. ,.:.: ..' ..' ',: ,.' :, , , ' ,,' '. ,,:,:': ' , ,q.' , , .... ,,,";,, ,," '. ", '. .' , . .',' '::,. ,: " : , ,." ,,' '. :" ", , , '.,' ,',,',: ' :,'. ',. , .,.'.. ,"':,' ,,," " : " :/ ...,' .,'. , .' " , :' ''''''' ',,' ,', ~' ".," :' .,.,.::' '.',>: ~;"'I ii: . :",i,.:. . ...". , , " '"., " " ,;":"" " ",'.',' , ,.':',,, ,'. ,:" ...' " :",',., 6'''''''' 09/28/88 : III , : ",:' '... "'" ,''',. , " ~' , .. OWNER'S NAME (91 ,C"" : ",'." ,.,. . ' WATER SUPPLY AND WASTE SECTION WATER FACILITIES INVENTORY AND REPORT FORM AREAS WITH CROSS HATCH SHADING MUST BE COMPLETED BEFORE BEING SENT TO PROCESSING. BASIN NO. (4) CLASS 151 17 3 ~~~~)@~~\0\~~~ ~ .',,' ..,. ::-,-", Jli'i~i!~If.!f~~ SYSTEM MANAGER'S NAME (81 .. JEFFERSON COUNTY COMMISSIONERS -0" ,,_....,.._,...,..,........._. "..._,..,.._..__... .....,..,.."..__ ,....... AHHM CITY o PREDOMINANTCHARACTERISTIC(15) l ,. ,5J.",.t'l5,Rl3.~H',(~6L..... ~ ~~--1~~~~;;:: -II' g :R~:~~,~,;:/~:::'AL ~ INDUSTRIAL ~ ~6~TN\,:EDERAL I AGRICUL rURAL FOOD SERVICE I o OTHER I AliNA . CATEGORY TYPE TREATMENT T I'~'j r ll" TT1'i'Trr i I i I':j II U I I) Ii) I + I". ~ :~!t5i~: !~:~I WATER RIGHT NO. "'1 ~ IllI :>-I~ ~ II< (23) (24) ~1,:::"'!Z''::!Cl OR ~, Iii: CI ~ ~I~:!l;: WELL PLANT :~I~'ffi!l?!~la: CLAIM NO. .. - - -- ~:l:l ~ ~ "8::: ffi DEPTH CAPACITY ~,9,~:~'!!g:z.~ 15~sU~f"~11 ~W'~':~~""_~=-#'-=~1~9.~~~~'.~~~~~:~ ~ ~!~,5;:~ iE~::li:;; i (FEET) (GPM) ~'5!fl'lli'~';t'a?IO ~ "'~ ". ..',,'.,.... Jxtr Tl., ~~L~ ~""""'-3 ;rt1i.!Tj .....-.-.,-.. rtLf II .,~.~~. " Il.qD+'...,.".."', #f:1 # ..~'~~:.= :"_-'-~ :f-TLmt ~-=~=.=_=, ,.',.,. ., "I',J"1'J'" 'r~)' . ,-..,,-- .,.. . .[.J...'1't.1']'1"'., .... 'o',' ,., ..' "... ......-,..", ." .. "'1' ..-.- ',.' "',' Ii:: " : Ii! ) I j ',1"'[ 11' it" . --,.--... - , "'''J'''rl'J'r' : I ',' .. "i ,- ", . '.' ,.-...,..,1......., "... ". .."I. ..., ,... ',,,.,, . '. I ' :, " : . I iJ! I ____ ',',. .'.' TIT!" IT: -"-": - Tf-FlJ1T --"7---"'-' o-GD.~:-: -~_.:. ....,.."........" ++H:++ I,~.....'.., +i:1H++ .:.::,==~::::'=:: . HHHH' '" ~. ~ . j 'if : ".., "'::,' " ,,':',..,.' .i e.:: '. :.,.: " ", " "', ' ,,'..', , ,,"",', , .' ::, ,". :,' ;'.' ,: . ',':', ' " ,', ,:'. ," .,' . .',' , ",' .." : ,:",.', ',., ,'.':' .....' , :',' ",' '.' ", .':, , 'I. " .' ,'o' ",:, ,",' '".' ":',,'," ,", ", , . , " ' ,', ,.:' :.,', ' , ,,' , ' ' '.,., '''. ',' .''. ',.:' ': ',' '::' '. ", ',' ": "" '.'\ ;' ',' , '" "'.", ", ", , .:,"e ' ..'.'...., '.' '.' , .' ," ," ,"'.., ' '. " " " , ", ..' '.,' , .. '. " 0,. MMNM '!It SL~7R~"""""" D(F'ARlt.'<NIOf 7~ , SOCI~~llH ~. (SEE INSTRUCTIONS ON BACK) ~ SYSTEM 10 NO. (2) 09340-0 .~,YST :~ HHHH I~ STREET ADDRESS .. NOTE: IF SPACE IS NEEDED FOR ADDITIONAL SOURCES, PLEASE ATTACH SEPARATE SHEET. . . V'HHM ~- " " , , €Ii + IF SYSTEM PURCHASES WATER, ENTER SELLER'S 10 NO, UNDER NAME OF SOURCE, ':: "', :oO NO. SER....ICES 413) METERED 0 STATE ZIP CODE ,."".,..,.. ,,,,..~T.".~~,~!!.()N,,f!.E.~~":~,I~(,:>I\~!).,..,,...........,...,,._ TOTAL CAPACITY --TYPE:' -," -_.'G'R.AVliYlTNcoiiE-RED."-_.'-"--~~----.._-_..--- GRAVITY COVERED PRESSURE o T~~UJ:~s~S .'..0'0/.-.. ---c)% ---c)% 100 % TOTAL LO~iION (26) D.O.E. TWP RG sec. CODE , , TOT AL PLANT CAPACITY 3( I GPM IF SYSTEM SELLS WATER TO OTHER PUBLIC WATER SUPPLIES, INDICATE NUMBER OF SUPPLIES BUYING _ C> '," .,:' ,. ", '" '.' '. ,,' " ,.; ,.. ',: ;e, ..", :'" , ' , "'" .." i ." '.' ,,': ,":.' , . :: , . .,.,. .i; ....',.... '> , .', .. "J" ;t }.: ~' ;,.:;: t " \ , t ~, , ....., '. ," ' , " . , ,', . ",: 0 , .', ,';' , , " . ", . .' , ..,,'. ,... '. ".. .'. .'. " " , r. N I~H~ :It ~7r~_""""1 DfPARTt.'{NT Of 7\SOCI~~~LTH WATER SUPPLY AND WASTE SECTION WATER FACILITIES INVENTORY AND REPORT FORM 09/28/88 AREAS WITH CROSS HATCH SHADING MUST BE COMPLETED BEFORE BEING SENT TO PROCESSING. COMPLETED BY. GJ' ~"~ !Ji,j.~''':'' . "'>Q. (SEE INSTRUCTIONS ON BACK) '0 _VSTEM10NO l21 BASINNO (4) CLASS (5) 19070-D 17 3 SYSTEM NAME e ~t~'h~~Y: MNIlR Q .YSTEM MANAGER S NAME (8) 'e . (8 OWNER'S NAME (9) 0g~~~r 1.~i!1l rl~%~1~STeM-~AM-E::;;t-~?~~7" INO. PERM.AC1IVft11~NO. TRANbITORYt12/" NO. SERVIces (131 ,"..j:~~~~::~~~:;~~~~~1;:;91$:t\~~~>;t\SW~}~! METERED (; ",..;.~,':~:c.;:""_,,,,,,'~'" ',',"" .,.,',. .':" ?~,ANIJ.~ p~ O.Wt:"E,~S; ~~L~~tJ:~~1~~t~\ iO,. MHHA '0 JEFFERSON COUNTY Cm111 I SS lONERS STREET-ADDREss'-......----. '".-- --"'--'-~"-'-~ ....---~--_.-- '---'---"-'--- JEFFERSON COUNTY COURTHOUSE <\;;,""'''' IF. TRANSITORY ,POPULATION. (141 Co'''') l,~,f;~~)l!,~PAXJ:OPULATION EACH MONTH, ,,~~:~~::,'<$;'_ AP,RlL '7Y: c;TY-----~.------ ---~---..-.-_..-..~,-_."_.-~~-.------." -~-STATE---,..-- ""-'. zIP-c-o[iE~~-'" "~..'- PORT TOWNSEND, WA 98368 .. "'..-~P:E;:;~~7~:~:::~:;:~~ISTlg,ll,5),_.'11 O::-~~~~ES,::~~::~:-- G~~ SCHOOL,'INSTITUTION 0 W~TUE~I~ltr;:,.~/PUD 'B>'~' , ~U:~~~:~~~OMMERCIAL I', ~ ~~~T~V:EDERALI AGAICUL rURAL FOOD SERVICE i OTHER I , .I1JISTRIBUTI.<?N..,fl~SE~VOI~,(.s) (17) _.,' TOTAL CAPACITY --',.'YPE;" - "ci'RAiirry"uN'6ovERE'O---'- GRAVITY COVERED PRESSURE o T'O~u6.:rs~S --'-'"--.0;';-.''' ----v% --0% """"1(j()""% o HHHH .'Q TOTAL CATEGORY TYPE TREATMENT 1201 (21) l2 (25) TTTl '1'1," ] ] '1 [ , , i.: I ii' I; '1-,1"'-:':- 126) I " i Ii ;~i.!gl !.I~I WATE~'~~:T NO ...1 ... III ,.. (2.3, PL"A'N'T "~'I'=="'z<,!g:,~c-;~.!I OR '" !1~i,~!~I~ ~'~:R:I~ ~ WEll - ...J _ ~ CLAIM NO. - -:: =::;.:::' _ _ ~ DEPTH CAPACITY ~'~L~:t~j~I,* iil ~ i: o:n ~ ~ (FEET) (GPM) ~n~;8'lili~:.i,~lo :!~4f ~.. _92 "'3"H#I=H: =-===~====~ ~I IDTlT. Imru .','. ,."...", ....,'.. , "II,]!_J''[ "I:+ "...i-t""Jic'; '--." 1_____ i,.__ 11LI1-J I' "jTJ"I".'J" 'j'j "1'''~J'''l'l'': -, ..-t'I~.~" - """"""'~'-.I~'" ,-. I, ,i . I! I: I I I --.. =-~=.-.::=:~-==~.::.~::~:~:::=:::,::...._., TIn IT - '.'"" rlTIIlT ..,;. ",~ .....-...",-.. .... ....-..,-.... ..,...-,......-,..-,.. '11"1'"'1''''' '1"'1' '.--.'-..' ..-"-. '1""r!_]'ri'li'''I'l'' ..~ .. "",c." ,c....'."..-.....c....--.- " NOTE: IF SPACE IS NEEDED FOR ADDITIONAL SOURCES, PLEASE ATTACH SEPARATE SHEET. lO"ti,ION . '. TWP sec. CODE RO ~~~i8~ ~_.~~.~~:~_.;i?~_A~~~~~~~~~~i1.~).".. -- m'__. I,' ,.' '.."" ..' ",' "'. "''''' " tit AnHa '0 ':' ' I'" , , " " ,.' ., ", , " I (.) ,-, . HllHR o TOTAL PLANT CAPACITY 3~j GPM IF SYSTEM SELLS WATER TO OTHER PUBLIC WATER SUPPLIES, INDICATE NUMBER OF SUPPLIES BUYING _ + IF SYSTEM PURCHASES WATER, ENTER SELLER'S ID NO. UNDER NAME OF SOURCE, (J " ,.' ..,.': ." .. c, ,,' ,c.... ,: :.'.,: .',. ' .' ,.." " , .,..'....,'" , .', " : .'.,... .,.. ,"..< .:" , '. "" '.., ':,' .,'" , ' ',.'..'c.\ ......,;,., ,", " " " " "':'.,' ,:""" ,.." '..'.. , ,'..'...... '" ',', ,', .,' ' ; ,i 'i:'. ,..,. ,', ..,',..,.. ','..'. ..,..' : .,..' ".', ',.::, ..'. .', ..,.:..,:. '..'.'.:. .'. ...:.. ::: " .' ,.,', :<" .'...", '. "". ',> .,' . .,.'. ,'.,." '., ." .,' '.... " .. ':, , ' ," ,':, :' .'" '<:,', :":, c" ,'" : :':,:, ,,:, '" ': ", ,.' ';:: :,', :,...,: ...,., ". ' ' ",;: ". .'. " ,.. : .,.. ,..,',.. .,.",', ',' . ., . ' " , ' . '" ,,' :' , . :,:",' " ,",', , ,'. """" . , ,,' ,'. :'i' ..j' ", '. . ..' . , ,'.. ,'. . '" ,.., '., ...,; , " : :: ,:,.j , , ' " ,0, :,' ,. ,': " "'" :'.. "'''':': :," ",,' " ': .c." : \,:' ". ". " .. 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f( .~' I; ), "" i' It Ii I~ " ~; . ; .~ \ . . " ,', " " :~: .. ': [ : .'. ',.,' ",.' --.J' ,I , '. ",' . " . . '...; : ~." , . ",: : I ,.- '. ~";'.< "J' " ."", 'i"""'<;;';'-~:;:'~';""<\" ,.,.,'; ';,~~"1ti;S~L;:~;;2L:i~~'j:..L:l\~'ii':'lE~lEi;~~~ii1U:~,;i:} ;':';".';'\:,:'::; :,':,:'.;:r.::' ,,\:~,;,,;";;,:. , ,".' ;_;\i:~:/ .' ~ . ,:-/:'--' " L,>-'::':' ~.".,' '.;:':~i..;:':-):;,:<,:,:':~;::;:i':'" ';~:iZ",~",::",,:'/<lzill;::~i2LL;"i::ttE~~ E 02,20.03 lULL M 'iUGARMAN "er.fe(olrv ,TATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES O/)'mpld, ~Vd.,hifJEton 985U4-Vf.J<l5 Dear Water System Manager: Enclosed is your file copy of the recently updated Water Facilities and Inventory Report FOrm (WFl). This WFI reflects the information we have on record for your water system. If changes become necessary prior to the next DSHS initiated update, make any changes on this file copy and, send to our DSHS Olympia Regional Office. Our address is on the back of the WF1. Approximately a month later you will receive another up-to-date WF1. Keep in mind the following when reviewing and making changes: _ All areas must be filled out according to the directions on the back of the WFl. _ All shaded areas must be completed. _ To make corrections, put a line through the ,incorrect information and clearly print the correct information in the appropriate space. _ Source location, item #27, must be completely filled out to include township, range and section to the quarter quarter section. For example: Township 10~, Range 9E, Section 23 SW 1/4 SE 1/4 (or 23Q). This information can be found on your legal property description, well log, etc. If you have any questions on completing this form, please contact your county environmental health department or myself at (206) 753-5090. Sincerely, -53CVl~I-(J e~r?;&/n-7:-L/~ Sandra Brentlinger cJ' Water Supply Technician Southwest Drinking Water Operations SB:clu RECEn!ED Enclosure OCT 2 G 1Sa8 JEFFERSON COUNTY PUBLIC WORKS DFPT. '..<!'. ~. I1,S. ELEVATOR '" m.mbf1r 01 'he CuOIC' COII)OI"ion I.mllf 01 c:ompen1u @ SERVICE REPAIR PROPOSAL/ORDER U.S.E.C. Proposal #87-1584 FROM U.S.E. BRANCH NO. 16 ADORESS 2920 N.E. Blakelev St. Seattle, WA. 98105 Contract No. Ref. 16 7165 TO JefFer~nn (I~,7c:.~~::Xa/~;'t~;p:r~r;;;I~~~ Address P.O. Box 1220 Port Townsend, WA. 98368 Oate October 23 , 1987 Shipping Address Jefferson Countv Crthse Attn: Carter Breskin Port Townsend, WA. 98368 UNITeD STATES ELEVATOR CORPORATION. (hereinafter called the company) proposes to furnish the labor and materials to accomplish the work listed below. Please note that this service does not Include the inspection or repair of any associated Items. We shall perform a Five Year Safety Test for your traction elevator. (See attached) All work is to be accomplished during the normal working hours of the elevator trade,and we shall have the uninterrupted use of the elevator while completing our work. Price firm for thirty (30) days. $798.00 plus Washington State Sales Tax. PRICE - lWXXNWl~l!>Clt . This proposal, Including the provisions printed on the back hereof and any spectflcations or other provisions attached hereto. when accepted by you and the Company, shall constitute the contract between us, and aT 1 prior representations or agreements not incorporated herein are superseded. Upon approval r pJease forward us two signed copies -- thank you. Accepted LEGAL NAME OF PURCHASER By ADDRESS By By TI tIe . Date TI tIe ELEVATOR CORPORATION Date If.s. ELEVATOR j.4 m.mbttf 01 1/.. CubIC Corpo",Jgn f.mllyol comp.m., Q SERVICE REPAIR PROPOSAL/ORDER U.S.E.C. Proposal #87-1584 FROM U.S.E. BRANCH NO. 16 ADDRESS 2920 N.E. Blakeley St. Seattle, WA. 98105 Contract No. Ref. 16-7165 TO Jefferson County Courthouse (J/t'Tt'inafur cu.Jkd tilt' purclIQu-r) Address P.O. Box 1220 Port Townsend, WA. Date October 23, 1987 Sh i pp i n9 Add ressJefferson County Crthse 98368 Attn: Carter Breskin Port Townsend, WA. 98368 UNITED STATES ELEVATOR CORPORATION, (hereinafter called the Company) proposes to furnish the labor and materials to accomplish the work listed below. Please note that this service does not Include the Inspection or repair of any associated items. We shall perform a Five Year Safety Test for your traction elevator. (See attached) All work is to be accomplished during the normal working hours of the elevator trade, and we shall have the uninterrupted use of the elevator while completing our work. Price firm for thirty (30) days. PRICE - X~)I1:11lX)(~ $798.00 plus Washington State Sales Tax. . This proposal, including the provisions printed on the back hereofand any specifications or other provisions attached hereto, when accepted by you and the Company, shall constitute the contract between us. and all prior representations or agreements not incorporated herein are superseded. Upon approval, please forward us two signed copies -- thank you. Accepted LEGAL NAME OF PURCHASER By ADDRESS By By TI t Ie ~ Oate TI tle ELEVATOR CORPORATION Date .. ' ~\ I: : (," t " 1.1. ~, r .:~ :.; I' " ~ r , I" I , ~ i 1 T' " !' ",l2i .... , ' ...' , , "'...' ."," ".., '" :,'..', "", ,_.,,, ....,..'.........-"";-...".""..." .. ..,'" . ' PENINSULA FLOOR COVERINL) ", : 14338 Sims Way . , . ,,' PORT TOWNSEND. WASHINGTON 98368 '; ,.,' (206) 385.0945 ',...'.,.... > ',,', ".. '. ,^M'7Q("y /'~ (",,,r-\- L l "'.. "" " I (5i"lossr / <:.+ ~i~~,r CARPET/ITEM Sfec-\.YY! C6(fZ'.+ clronir C(' CQfpe.+ 'S:to..'\y\ 9(Xlf ", ,,'... ""., ...._-. .._~ -- . q;~ , , ~~C\.SU<'~.(") C,C .C;fu~~p 1/' :4:ssesol J 1-"C eV"\"5 '1"'17} c.::,o 11.J.. '1' Co 1'71 rYJ. SPeCIAL INSTRUCTIONS I carMy thaI I !'Iavo rond conditions on ruVOfSO sldo and agrOlllo sarno. " ' " , "".;':' SION^TlJRE I hmuby Ol:knowlodOo HIO sallsfaclory complollon 01 lho ooovo dllscrlbod wO/k. I I DATE ,- -,-.-, :'.. ' .. ..,,' ..., : .' '," " '" ',', '" "" , " :.",'. "i,'i < ,:,,' .' '. ",:,,':'" .'.' ,,' :' '. .., . , .', , ,,; '. .'. . . . "." .... ",' .. ,I:' '," , .....:.,. :,:' : '. ':" '-, ,", .,: ,,', .', . ..'.....: .'.' .' :".:'" " I" .',' ,J., .'..'....',. '. " .' ,::.", , ' " ' .. ..,' " ',' .'.., . . ...,'..." " ',,' . ' ,,', ...,".,: '.., " , " '," '. : ". i, ~;t-~.v ~,...,.':'.. ./..!'-r- ~"1~' ". ..', .' f' {JI?tZA/~u:--x? " ". '",; '" ". " ."; ':.; "., ...,. , " '.. ,': '<, '" , : .' """. .", ..'., i ,'. ,.... ",' "" . . ':' " ."",:''', ',~" ,",',,'; , " ',. ',,: ,:'. ,.; ,", '.. , , . ' '.' , '.., ' cc;e"e.o2,,3<2 I @~~illmDm@ (' W@[R1m @[R1[ID~OO 7196 DArE OfH)O"~: -h'CHfoOULE.O ~~!/!~ICIAN ~ARPET 0 FURNITURE o OTHER ' SIZE sa. FT. PRICE TOTAL 3<OSCj 13q L/79 .b7 51009 3<tn' I 10.1107 ",690,:~'-f "" '" 1 ...., .,,'. ;.,".,,,.,,.. """" , , ... .. I ~ , I , \ ,. '" , .... ..I, '"'' , I" : ) , I I I I TAX I TOTAL 590IQt./. %ank%u TOTAL MATERIALS TOTAL LABOR ,"'!'f~;\Ir\ft<;l:-il!(/j__~; .vM~;.il#~~iG , , III , , " ': ,.., " ': ", ,"",' ':':,",::,- , .': ,',' .. '..,'., '" ':, , " , , . I ,.), ~ .; \' ,.'.' "'", ': .."', ',' ,', ,""'" .. I",' <.. ..' ,: ..', . . , ,:" ","; .: .,'.. i" ." , " ,'" : . ", :':::,':'> , " ." ",', ""'.":- >.:y.: .. .' " > :.. '.. , , ; , .. [" ' ", "; :":: " ,,,' :',' " , . .. '): ". ,'.,.. , ' " ,,: .'.: '" ,'. ,'1 "':'-:~ .,-', . .. " . 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