HomeMy WebLinkAbout0850-72_Highland Haven Development Sewer Project - RDA_15.2TO:
FROM:
SUBJECT:
DATE:
CITY OF FONTANA
CALIFORNIA
BOB GRAHAM
CONSULTING RISK MANAGER
BOB WEDDLE, P.E.
CITY ENGINEER
CLAIM REPORT #92-75; SHARP, JOE W.
SEPTEMBER 29, 1992
This is to transmit the response to claim report 92-75.
As this involves a current construction site on a City Public Works project (Highland -Haven,
C.P. Construction) please advise as to the next step in the process.
enclosures
cc: Community Development Director
Deputy City Clerk
Redevelopment Coordinator (M.P.)
C Associate Engineer/Special Projects
c: \data\wp\weddle\j oesharc. mem
CITY OF FONTANA
CALIFORNIA
MEMORANDUM
TO:
FROM: JIM RANKIN
SENIOR PUBLIC WORKS INSPECTOR
BOB WEDDLE, P.E.
CITY ENGINEER
SUBJECT: CLAIM REPORT #92-75
SHARP, JOE W.
15836 TORREY AVENUE
On Saturday August 22, 1992, Henry Rameriz and I were spotting locations for house laterals
when at approximately 8:30 a.m. we were approached by a gentleman, Mr. Joe Sharp who was
claiming that on Friday August 21, 1992 "he was going to get his mail and upon returning from
the mailbox he stepped over the trench and the ground caved in" Mr. Sharp falling 5' into the
trench was then asked if he was O.K. by laborers Rudy Vadivia and Jose Cintora his response_
was "yes" I'm fine and he was then helped out of the trench by the workers. On Saturday,
August 22, 1992 when he was talking to Henry and I, he was saying how bad his back and left
hand were hurting. He said he was a Mentally Disabled Vietnam Veteran. On Monday,
August 24, 1992 Mike Pfister, C.P. Construction and I talked with Mr. Sharp and he said he's
sore and the doctor told him that he has no broken bones, just sore muscles. I told him if he
wants to file a claim, go to City Hall and file the appropriate paperwork.
I then asked Mr. Sharp why he was walking over the trench in the first place and why he didn't
find the foreman or the Inspector after the accident. His response was that he didn't think any
of the workers spoke English.
cc: Associate Engineer/Inspection
JR:yv
c: \data\wp\inspecti\clairepo. mem
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MEMORANDUM
Community Development Department
FROM: {rudy L. Lohse, Administrative Clerk II
SUBJECT: Ins. Claim Report 092-75 - SHARP, JOE W.
DATE: September 4, 1992
igz
,i
A claim has been filed against the City of Fontana involving your department.
Please prepare a report on this matter at your earliest convenience and forward
to the Clerk's office for processing.
Thank you for your cooperation regarding this matter.
cc: Ward-THK
Risk Management Division
Attachment: Claim
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GARY E. BOYLES
MAYOR
PATRICIA M. MURRAY
MAYOR PRO TEM
BEN L. ABERNATHY
COUNCIL MEMBER
DAVID R. ESHLEMAN
COUNCIL MEMBER
BILL FREEMAN
COUNCIL MEMBER
Mr. Joe Sharp
15836 Torrey Street
Fontana, CA 92336
City of Fontana
CALIFORNIA
September 9, 1992
RE: Claim 192-75
KATHY MONTOYA
CITY CLERK
DR. CHARLES A. KOEHLER
CITY TREASURER
JAY M. COREY
CITY MANAGER
Dear Mr. Sharp:
This will acknowledge receipt of your claim dated August 28, 1992 for alleged
personal injuries resulting from a fall into a trench at the above address.
Your claim has been forwarded to our Risk Management Division for appropriate
action. If you should have any questions regarding this matter, please call
350-7668.
Sinc rely,
Linda S. Nunn, CMC
Deputy City Clerk
LSN:tll
cc: Ward-THK,
Risk Management Department
8353 SIERRA AVENUE (P.O. BOX 518) • FONTANA, CALIFORNIA 92334-0518 • (714) 350.7800
SISTERCITY KAMLOOPS, B.C. CANADA
i
•CLAIM AGAINST THE CITY OF FONT.
CALIFORNIA
CITY CLERK'S DEPARTMENT
NOTE: Certain procedures governing the filing of claims for mone
are set forth in Title 1, Division 3.6, Part 3 (Sections 900, et
Government Code, State of California. This claim form has been pr
accordance with California Government Code, Section 910.4. When this
used, please submit to the City Clerk's Department, City Hall, 8353 Sierra
Avenue, (P.O. Box 518), Fontana, California, 92335.
II Original Filing I Amendment to previous claim
Name of Claimant: JnE 'ha 10
Post Office Address of Claimant: 1 5 4.0\eVQ_,`
Address to which notices regarding this claim are to be sei(t:'
4:)6,n tQ as a, v-42._
On (date of occurrence or transaction): 8�
At (place of occurrence or ;transaction): 1 S 17;(o�b\-\-e. (cc);T: N110 bo,0
General description of the indebtedness, obligation, injur , damage or 1.oss-
incurred so far as it'is known at the time of presenting this claim: C,Lo1
New cLnk k E--ha.na_ , 0,,''NL a e
No-e- t\i‘.e.a1c10,A cd-t-Q_Eti;n.
Resulting from (including, but not limited to, circumstances of the qccurrence
of transaction which gave rise to the claim asserted): C\ r\
0
(Ln �- a.l (� hc�-. C IN I frc �a0.e Irv\ 1 ko:A \ bg
The names of any City employees claimed to have caused the
2
EECEvED
damageorriumns
of the
njttA�rYY, dama or i
loss (if known) are as follows: '—T e. N1W2 o,,4 Ck,�k. b T0LhNQS �.rk
PtaA , \00In h� .111-h 5 t.viN by U,n),,key tM'
e at
Amount claimed as of date of this claim (incliuding the estimated amount of any
prospective injury, damage or loss, insofar as may be known at this time):
$
Computed as follows (set forth basis of computation 0? thL amount' claimed,
attach bills, invoices, statements, etc. if available) : 1\) 0 I n oo rs.
6 r t vve_. •
di SAN BERNARDINO COUNTY MEDICAL AUTER
EMERGENCY f3!PARTMENT -AFTERCARE INSTRUONS TO THE PATIENT
NOTE: The examination and treatment you have received in the Emergency Department has been provided on an emergency basis
only, and should not be a substitute for complete medical care. As instructed, be sure to seeyour own physician for follow-up care.
At this time, we will be happy to make you an appointment with one of our Primary Care physicians. It is important that you let
him check you and that you report to him, any new or remaining problems at the time, because it is impossible to recognize and
treat all elements of injury or illness in a single Emergency Department visit. Meanwhile, FOLLOW ONLY THE INSTRUCTIONS
CHECKED BELOW.
TREATMENT RENDERED:
❑ Sutured 0 Tetanus Booster
❑ X-ray
❑ EKG
❑ Lab Test
❑ Hypertet and Tetanus Booster
0 Medication
❑ Exam and Evaluation
MEDICATION: Follow label instructions for any prescription
given by the Emergency Physician.
IMPORTANT NOTICE: Your X-rays have been interpreted on
a temporary basis pending final reading by our radiologist. If
there is any change in interpretation, you will be notified.
FOR YOUR OWN SAFETY, YOU SHOULD FOLLOW ALL INSTRUCTIONS GIVEN BY THE EMERGENCY ROOM DOCTOR
WITHIN THE NEX14 3�1-4 S t---?-521-11-614448,
PLEASE CHECK WITH YOUR PHYSICIAFOR:
18 Exam and re-evaluation. F,Drt -et
Wound evaluation. e
❑ Removal of sutures.
❑ Further treatment of the condition which brought you here.
❑ You may retum to work/school. 0 Yes 0 No
0 You will need re-evaluation by your own doctor or
compensation doctor prior to returning to work or school.
OTHER SPECIFIC INSTRUCTIONS:
a-37345-
HEAD INJURY INSTRUCTIONS:
0 You have had a head injury, which at this time does not
require hospitalization. In a small number of cases however,
symptoms may appear which could mean a serious condition
and therefore should be checked by a doctor. These symptoms
are:
1. Continuing severe headaches.
2. Nausea and vomiting.
3. Excessive sleepiness or difficulty in awakening the patient
from sleep.
4. Unequal pupil size (black central portion of the eyes not
the same size).
5. Weakness, paralysis or numbness of the arm or leg on the
same side of the body.
6. Mental confusion.
If any or all of the above symptoms occur, contact your
doctor immediately, and if he is unavailable, return to the
Emergency Room of this hospital.
You should be awakened every 2-3 hours from sleep
during the first night of sleep after your head injury.
Avoid all sedatives, (sleeping pills, nerve pills), alcohol,
wine, beer, and narc • . Aspirin may be used.
Other Instructions: a.c.( 5 / RA 4
1_ rl5T i� II o
cb a bk N q s akitC el.
. rr Ly Picac.Tiot. roliAi
Wound Care (cuts, abrasions, burns,.etc.)
❑ Keep the dressings clean and dry.
❑ Elevate the wound to help relieve soreness and speed
wound healing.
❑ Despite the greatest care, any wound can be infected. If
your wound becomes red, swollen, shows pus or red
streaks, or feels more sore instead of less sore as days go
by, you must report to your doctor right away.
0 If dressings need to be changed: you should: -
❑ Change them 0 Call your doctor
Sprain and Fracture, Severe Bruises
❑ Keep injured part elevated above the level of your heart
for day(s).
❑ Ice packs also help prevent swelling, especially during the
first 48 hours. Place ice in plastic or rubber bag, cloth
cover.
❑ If you have an elastic bandage, rewrap if too tight or
loose.
❑ If you have a cast, keep it perfectly dry at all times.
0 Wait 48 hours for the cast to become strong before you
allow pressure or weight on any part of the cast.
❑ Wiggle toes or fingers to help prevent swelling in the cast
— this should be done often if it does not cause pain.
❑ If the part swells in any way or gets cold, blue, or numb,
LI� or if pain increases markedly, have it checked promptly.
0 Return for a cast check on:
THIS IS VERY IMPORTANT.
I have received the instructions checked above. I understand that I have had emergency treatment only, and that I may be released
before all of my medical problems are known or treated. I was given the above instructionor patients wit t) miyo ead injuries. I
will arra e for foil w-upvre as instructed above
7
Date
. Patient ID L 7 8
_ _ + -I'.
FP. u
Nurse's or Doctoi s Signature Patient's or Represd1 tative's Sign
Doctor:
• Nurse*
Was treated at:
•
4,
San Bernardino County Medical Center
780 E. Gilbert Street
San Bemardino, CAr9Z404:
11.14191-731 Rev. 12/81 Spanish Translation Received by Patient