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CABARRUSCOUNTY <br /> ACCIDENT REPORT <br /> <br />Send to. <br /> <br />Blair D Bennett or Pat Moser <br />Cabarrus County Flna,nce Dept <br />PO Box 707 <br />Concord, NC 28026-0707 <br /> <br />Type Claim <br /> <br />General L~abd~tv [] <br /> Propertv [] <br /> <br />Telephone <br />Fax <br /> <br />Vehicle Damaqe [] <br /> <br />704-920-2104 <br />704-920-2881 <br /> <br />Accident Date 12/07/2002 <br />County Department Sohd Waste <br /> <br /> County Driver <br /> <br />Time <br /> <br />Locabon Landfill <br /> <br />Vehicle Make/Model <br /> <br /> Dnver Telephone # <br /> <br />Other Party: <br />Vehicle Make/Model <br /> <br /> DnvedOwner Name <br /> Telephone <br /> <br />Persons Injured or Involved: <br />Name <br /> <br />Area of Damage <br />Address <br /> <br />Address <br /> <br />Daytime Telephone <br /> <br />Witnesses: <br />Name Address <br /> <br />Daytime Telephone <br /> <br />Accident Descnpbon <br />Vandahsm to 5 p~eces of heavey equipment <br /> <br />Descnpbon of Property Damage and Cause or Injury Description <br />1) Trash compactor- fire was started underneath machine which cause extensive dama.qe, 2) <br /> <br />motor.qrader was driven around landli caus~n.q dama.qe to wheels and nm, 3) dozer had ~ndows <br />broken bythrown rocks, 4) two scrapers (pans) had cab darraqe result~n.q from fire ext~n.qu~shers <br />d~schar.qed m them <br /> <br />Forward a copy of the Pohce vehicle accident report as soon as possible <br /> Reported by R~ck Payne <br /> <br />Completed by Rick Payne <br /> <br />Date 12/09/2002 <br />Date 12/11/2002 <br /> <br />Telephone # (704) 920-2955 ~-'- j 0 <br /> <br /> <br />