CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2075 JUL 21 1812:32
TO PERSON OR PROPERTY
HELLI
CITY CLERA
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurrence (Gov. Code $911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code §911.2). RETURN TO:
3. READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Moshi Saleh -
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP T HOME TELEPHONE NO. (626) 705-1160
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 6/30/2025 TIME:3:11 •AM IX PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks. 1439 W Persimmon St. Rialto. Back Fence
3. HOW DID DAMAGE OR INJURY OCCUR?
The qrass fire occurred on a vacant lot owned by the Cityet Rialte.
4. WERE POLICE AT THE SCENE? •YES • NO WERE PARAMEDICS AT THE SCENE? DYES ONO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
Excess weeds on the vacant lot. The lot was not maintained.
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $3,495.00 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates DAMAGES INCURRED TO DATE:
Hem/Date: Repair Estimate of back fence Amount: $3.495.00 Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: 3,495.00 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Weed Fence Replacement Amount: $3,495.00
Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $3,495.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: - Irene Aquila NAME:
ADDRESS: ADDRESS:
TELEPHONE: TELEPHONE: L)
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: | ) TELEPHONE: |1
DATE: TIME: • AM • PM DATE: TIME: • AM • PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions,: Indicate place of accident by "X" and by showing house numbers or distances to street corners If a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your yehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMZANT.
CURB
PARKWAY
7 SIDEWALK
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
Joshua Chae 7/21/25
TYPE OR PRINT NAME DATE
Manager
RELATIONSHIP TO CLAIMAN
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 Remit to Main Office Installation
Main Office: ALL COUNTES Date
930 N. Main St.
Temp
Riverside, GA 92501
951-780-9300 FENCE & SUPPLY
Air Quality
Orange County 714-619-0498 WOOD • VINYL • IRON - CHAINLINK Coachella Valley 760-834-6221 Lic. #717249 • Fully Insured & Bonded • Since 1978 7/9/25 Estimator Chris Barrett. Jr. Cell (951) 906-2029 - [email protected] No. 52333 Joshua Chao 74 Description ReDwoon
NAME Linear Ft. _
ADDRESS
FENCING SPECIFICATIONS
Rialto 2P 92377
CITY
HOME PHONE HONE CHAIN LINK ORNAMENTAL IRON
JOB ADDRESS City
EMAIL CUSTOMER REDWOOD Dot Ear
Ix6 - Butl
74' Galvanized
Line Post 0.D. Post Picket O.D...
2x4 (3) 2x4
Comer Fost 0.0. Rails Pickat O.C...
173495050
Gate Post D.D. . Walk Gates Post 0.0...
Post Gage 0.D... Unsa Gates. Scrol: Design ..
Make Ups... Gate Hardwane Wak date..... co..
Walk Gates. Post on 6' Center
Exclaces
E71
Drive/Slide. .. Post ort 8' Center D. Colors.
Stalr
• Pool tear oun a core Dil :30. Set
• Footing Removal /Removal • Generator - 13) Dirt Box
BID VALID FOR 10 BOY
Install 74 lINEAR FEET oF 6FF TALL REPLOOD
Comments..
Pots CAR w/ Galvanized posts
# Plants, BusHEs, folage, roots ett deared off fenceline by omers prior to install 0% dapcult rogeired on ecceptnace of quate. Contraets without deposits will not be ta CUSTOMER PAYMENT due day of completion. Pense walt the job with the forestor apon completo. ayronts hot received upon completion will be charged 306 per dng after 7 days mart paid. Cuetemer her 1. yore marrang to czesiels and lahor. Limited lifetime warranty on Ply Gom vinyl from manufacturer.
ACCEPTANCE: The undersigned accepts the conditions and terms as stated hereon and agrees that this proposal becomes a contract between the two parlies whose signatuses appest below.
Purchaser agrees to pay All Countles Fence & Supply 10% of total in case of contract cancellation. ACFAS assumes no responsibility of utility lines or underground at property even with Dig Alert.
We agree to fumish material, labor and installation complete as specified above. $3495 - 80
Complete - Inc Tax - Core Wall Release X
Accepted By X Work Satisfied X
White - Vort: Order Yellow - Office Pink - Customer's Estimnte/Solen Receigt Gobb's Printing, LLC - Form 102 Rov. B 20.21 +18883743661
* ergeon
CITY OF RIALTO
Quote #1994510 - Landscaping 2025 JUL 21 PM12: 33
KECE Y
"RDER ID ORDER AUDRESS
CITY CLERR
#1140174 1439 W Persimmon Ave, Rialto, CA 92377, USA
*!!.P** TOTAL LENGTH EXPIPES AT
A quilino Alonso Soto Ellis v 76 ft Jul 21, 2025, 6:59 AM A 76:0
•
Project Scope
A 76 ft Wooden Fences $3,450
Finish Height of 6'; Nail Up, finished side facing inwards, Side by Side, Dog Ear 1"x6" Redwood Con Common Pickets, 4'x4" PT Brown Tone Posts 3 PT Brown Tone 2"x4" Rails, Demo and Haul Away Build Specifications
Project Footnotes
• To avoid delays or added charges, please clear the work area by trimming back vegetation and removing obstacles at least 2 feet from the fence line on both sides before installation Total: $3,450
For as lowes $15745/month* vilh Learn more
© 2025 Ergeon Inc.
LICO:TS
• City of Corona, CA - Business License / Registration #03968149 • California CSLB License (C13-Fencing/C27-Artificial Grass/C8-Concrete) #1040925
CUSTOMER
Joshua S Chao
FORDS
1439 W Persimmon Ave, Rialto, CA 92377, USA
NFIRS-1 Basic
36185 ||CA 130 2025 || 25-157354
FDID State Month Day Year Station Number Exposure
B Location Type
Census tract:
Street Address
Intersection
In Front Of 2641 JIN-North || LINDEN LAVE-Avenue
Rear Of
Adjacent To Number Prefix Street or Highway Street Type Suffix Directions
US National Grid
Rialto City CA J|92377
Apt./Suite/Room City State Zip Code
Cross Street
BUL
El Dates and Times E2 Shifts and Alarms
Incident Type Alarm |06 |/ 30||2025 ||15:17|
143-Grass fire
Arrival /06|30|202515:23 Shift Alarms DistRict
Platoon ~
D Controlled 106 30||2025||15:46 L10
Aid Given Or Received Last Unit |06|| 30|| 2025 || 18:09| Cleared
1 Mutual Aid Received
2 Auto. Aid Received San Bernardino
3 Mutual Aid Given
4 Auto. Aid Given E3 Special Studies
5 Other Aid Given
None Their FDID Their
State ID# Value
Their Incident Number
FActions Taken G1 Resources 62 Estimated Dollar Losses and Values Apparatus or Personnel Module is used. Losses: None
11-Extinguishment by fire service personnel Apparatus Personnel non-fires.
Suppression 5 10
Primary Action Taken Property: $| 10,000.00
EMS | 1 2 Contents: $/2,000.00
Other o
Pre-Incident Values: Optional None
Resource counts include aid received
resources. Property: $ 5,000000.00
Contents: $ 100,000.00
Completed Modules H1 Casualties None H3 Hazardous Materials Release Mixed Use Property Deaths 1 - Natural Gas Not Mixed
2 - Fire Injuries
3 - Structure Fire 2 - Propane Gas 0 - Assembly Use
Fire 3 - Gasoline :0 - Education Us
4 - Civilian Fire Cas. Service 4 - Kerosene 33 - Medical Use 5 - Fire Service Cas. 5 - Diesel Fuel / Fuel Oil 40 - Residential Use 6 - EMS Civilian
7- HazMat 6 - Household Solvents
8 - Wildland Fire 7 - Motor Oil
9 - Apparatus 8 - Paint
10 - Personnel 0 - Other
H2 Detector None 59 - Office Use
11 - Arson
60 - Industrial Use
Required for Confined Fires 63 - Military Use
1 - Detector Alerted Occupants
2 - Detector Did Not Alert Them 65-Orrer Mixed Use
3 - Unknown
Property Use None 341 Clinic, Clinic-Type Infirmary 539 Household Goods, Sales, Repairs Structures 342 Doctor/Dentist Office 571 Gas or Service Station 131 Church, Place of Worship 361 Prison or Jail, Not Juvenile 579 Motor Vehicle/Boat Sales/Repairs 161 Restaurant or Cafeteria 419 1-oг 2-Family Dwelling Business Office 162 Bar/Tavern or Nightclub 429 MultiFamily Dwelling
213 Elementary School, Kindegarten 439 Rooming/Boarding House 215 High School, Junior High 449 Commerica. Hotel or Motel 241 College, Adult Education 459 Residential, Board and Care 311 Nursing Home 464 Dormitory/Barrack Non-Residential Parking Garage 331 Hospital 19 Food and Beverage Sale 891 Warehouse
Outside 938 Graded/Cared for Plot of Land Property Use:
124 Playground or Park 946 Lake, River, Stream
655 Crops or Orchard 951 Railroad Right-of-Way
669 Forest (Timberland) 960 Other Street
Outdoor Storage Area Description
807 961 Highway/Divided Highway
919 Dump or Sanitary Landfill 962 Residential Street/Driveway Look up and enter a Property Use code and 931 Open Land or Field 981 Construction Site description only if you have NOT checked a 936 Vacant Lot 984 Industrial Plant Yard Property Use box.
K2
Owner JL
Local Option Person/Entity Type Business Name (if applicable) Phone Number JL
Mr., Ms., Mis First Name MI Last Name Suffix
JL
Number Prefix Street or Highway Street Type Suffix
Post Office Box Apt./Suite/Room City
State Zip Code.
L Remarks:
ME202 responded along with ME204 to a reported vegetation fire at Birdsall Park. ME202 arrived on scene and found a 20 X 100 grass fire moving in light Fuels with a quick rate of spread. There was an immediate structure threat to the north off of Persimmon Road. ME204 took Persimmon and was assigned structure defense by BC806. ME202 took the grass fire and was assigned Division A. BC806 took Linden IC and requested additional Type 1 engines. Structure defense was assigned ME81, ME78, and ME201 Division A was assigned ME176. The fire was extinguished without incident and no homes were damaged. There was damage to some fences and sheds in some of the backyards. This fire occurred on a vacant lot owned by the City of Rialto. The fire was nvestigated by 1864. The origin of the fire was found to be along Linden Avenue on the east side of the street just north of Birdsall Park. The cause of the fire was undetermined.
M Authorization
001265 Huber, Jake | Battalion Chief _ 06/30/2025
Officer In Charge ID Signature Position or Rank Assignment Date 001059 Westphal, Brett Battalion Chief || 06/30/2025
Member Making Report ID Signature Position or Rank Assignment Date
NFIRS-2 Fire
A
36185 2025 | 25-157354 0
FDID Station Number Exposure
Property Details On-Site Material: n-Site Materia
Or Products torage Us
Not Residential
shither or not al units beanie involvenits in the building of origin B2
Buildings Not Involved
Number of buildings involved
B3 None Less than 1 acre
Acres burned (outside fires)
E1 E3
Ignition Cause of Ignition Human Factors Contributing to 1 - Intentional Ignition
D1 Check all applicable boxes
2 - Unintentional
Area of Fire Origin 3- Failure of Equipment or Heat None Source 2-Assiby impaired by alcohol or
4 - Act of Nature
Heat Source 5 - Cause Under Investigation drus Unattended person U - Cause Undetermined After
D3 Investigation 4 - Possibly Mentally Disabled
5 - Physically Disabled
Item First Ignited 6 - Multiple Persons Involved
D4
7 - Age Was A Factor
Type of Material First Ignited
E2
Factors Contributing to Ignition Male Female
F1 F2 G
Equipment Involved In Ignition Equipment Power Source Fire Suppression Factors Equipment Involved Equipment Power Source
Brand F3
Model Equipment Portability
Serial #
1- Portable
2 - Stationary
Year
Portable equipment normally can be moved by one or two
persons.
H1 H2 Local Use
Mobile Property Involved Mobile Property Type and Make
1 - Not involved in ignition, but burned Pre-Fire Plan Available 2 - Involved in ignition, but did not burn Mobile Property Type Arson Report Attached 3 - Involved in ignition and burned Police Report Attached None Coroner Report Attached
Mobile Property Make Other Reports Attached
Mobile Property Model Year
State License Plate Number VIN
NFIRS-9 Apparatus or Resources
A
36185 CA 10 20 12025 Sain 202 25-157354
FDID Station Number Exposure
Numbe
Apparatus/Resource Dates/Times Sent of Peopl Apparatus Use Actions Taken ID: BC804 Dispatch: 06/30/202515:34 Sent Suppression
EMS
Arrival: ayao
Type: 91-Mobile command post |06/30/2025 | 15:44
Clear: 06/30/2025|17:26
ID: BC806 Dispatch: |06/30/2025 | 15:21 Sent 1
EMS
Type: 91-Mobile command post Arrival: 06/30/2025|15:25
Clear: |06/30/2025 | |17:39
ID: MAZOS Dispatch: | 06/30/2025 | | 15:56| Sent |z| Suppression 1a470
Type: 76-ALS unit Arrival: 06/30/2025||16:15
Clear: |06/30/2025 16:37
ID: ME201 Dispatch: 06/30/202515:17 Sent 3 Spression
Other
Arrival:
Type: 11-Engine 06/30/2025 15:34
Clear: 17:32
06/30/2025
Dispatch: Sent |3| Suppression П
ID: ME2o2 06/30/2025 15:21
1a470
Arrival: 06/30/2025|15:23
Type: 11-Engine
Clear:
06/30/2025 18:09
ID: Dispatch: 06/30/2025|15:17 Sent 3 vosa Sins
ME204
Arrival: 15:45 1a40
Type: 11-Engine 06/30/2025
Clear: 06/30/202517:47
NFIRS-10 Personnel
A
36185 CA | 25-157354
FDID Month Station Number Exposure
Apparatus/Resource Sent Apparatus Use Actions Taken
Dates/Times
ID: BC804 Dispacch: 06/30/2025 15:34 Sent Suppression
EMS
Other
Type: Arrival:
91-Mobile command post 06/30/2025 15:44
Clear:
06/30/202517:26
Personnel ID Name Rank Role Attend Actions Taken
ID: BC806 Dispatch: 06/30/2025 15:21 Sent Supression
Arrival: Other
Type: 91-Mobile command post 06/30/2025 15:25
Clear: 06/30/2025 17:39
Personnel ID Name Rank Role Attend Actions Taken
001265 Huber, Jake Battalion
Chief
ID: MA205|| Dispatch: 06/30/2025 | 15:56 Sent Suppression EMS
Arrival: Other
Type: 76-ALS unit 06/30/2025 | 16:15
Clear: 06/30/2025 16:37
Personnel ID Name Rank Role Attend Actions Taken
002770 Bugarin, Samantha Paramedic
002111 Carrillo, Frank EMT
ID: {MEZ01 | Dispatch: 06/30/2025 15:17 Sent Suression
Arrival: 06/30/202515:34 Other
Type: 11-Engine
Clear: 06/30/2025|17:32
Personnel ID Name Rank Role Attend Actions Taken
001769 Mendoza, Jeremiah Captain
002034 Gerardi, Joseph Engineer
002164 Klein, Christian Firefighter
Paramedic
ID: MEZOZ Dispatch: 06/30/2025|15:21 Sent suppression
EMS
Other
Type: |11-Engine Arrival: 06/30/2025|115:23
Clear: |06/30/2025||18:09|
Personnel ID Name Rank Role Attend Actions Taken
001059 Westphal, Brett Battalion
Chief
001058 Vogtman, Chad Engineer
002446 Lopez, Devin
ID: Sent 13| Suppression
Me204 Dispatch: 06/30/202515:17 EMS
Arrival: Other
Type: 11-Engine / 106/30/2025 | 1545|
Clear: |06/30/2025 | |17:47|
Personnel ID Name Rank Role Attend Actions Taken
000850 Brownlee, Todd Captain
000969 Frederick, Dewayne Engineer
002676 Rendon, Eduardo Firefighter
Paramedic
NFIRS-1S Supplemental
A
36185 25-157354
Exposure
Primary Narrative:
Additional Narrative (#1 of 1):
06/30/2025 15:15:53SYS [1] WPH2 LAT:34.14890885 LON:-117.400910 METERS:3 %:090 | 06/30/2025 [2] ELV 445 UNC 1.125 | 06/30/2025 15:15:53SYS [3] Validity of address cannot be determined:2611 N LINDEN AVE. | 06/30/2025 15:16:12SYS [4] WPH2 LAT:34.14890885 LON:-117.400910 METERS:3 %:090 | 06/30/2025 15:16:12SYS [5] ELV 445 UNC 1.125 | 06/30/2025 15:16:12SYS [6] Validity of address cannot be determined:2611 N LINDEN AVE. | 06/30/2025 15:16:12SYS [7] A cellular re-bid has occurred, check the ANI/ALI Viewer for details | 06/30/2025 15:16:56K2626 [8] RIAC | 06/30/2025 15:17:05K2626 FLAMES VISIBLE // SMOKE VISIBLE | 06/30/2025 15:17:11K2626 [10] APPROX 15 FT IN SIZE | 06/30/2025 15:17:27K2626 [11] FIELD AT BIRDSALL PARK | 06/30/2025 15:17:30PAGINGSERVICE [12] Paging Groups Notified:USFS - AUTO-NOTIF | 06/30/2025 15:17:39C5716 [13] * PRD REVIEWED THE INCIDENT * | 06/30/2025 15:18:46K4593 MULTIPLE REPORTS *** | 06/30/2025 15:19:00K4593 [15] 2ND RP ADVD FIRE GREW TO 50 FT | 06/30/2025 [16] BC806 ADD ME202 TO THIS CALL IPO ME201/ ADD BC 806 TO CALL | 06/30/2025 15:24:04J6558 [17] BC803 RE ADDED ME201 TO CALL AND ADD TAC | 06/30/2025 15:30:10|4957 [18] ME81 IPO ME79 | 06/30/2025 [19] *** BC ADVISED OF OUT OF AREA RESPONSE*** BC122 FOR ME78 AND ME81 | 06/30/2025 [20] [Page] Unit: ME78, Sent From: DISPATCH03, AF, ME78 CONFIRM RESPONSE AF/CCC | 06/30/2025 [21] ***LEVEL 1 PAGE SENT***| 06/30/2025 15:35:516558 [22] LAET NOTE BC806 OS 20/100 WITH STRUCTURE THREAT / START 3 TYPE 1 | 06/30/2025 15:35:55J3263 [23] ME78 SHOWING OS PER AVL | 06/30/2025 124] IC FORWARD PROG STOPPED / WORKING ON EXPOSURE ISSUES | 06/30/2025 15:46:22J6558 [25] ME81 AND ME204 OS PER AVL | 06/30/2025 15:56:41J6558 [26] IC DISPATCH AMB FOR MED AID | 06/30/2025 [27] IC FIRE KNOCKDOWN 3 ACRES OVERHAUL APPROX 45 MIN | 06/30/2025 17:39:53J6558 IC TERMN CMD RELEASE ME202 WILL BE POC FOR THE NEXT 5 MIN / RELEASE CORE STA MOVEUP