HomeMy WebLinkAbout2021-05-06; Carlsbad Palisades Homeowners Association Concerns Regarding the Recycled Water Phase Ill, Segment 5 Project (District 2); Gomez, PazTo the members of the:
CITY COUNCIL
Date 6/ '-IA\ CA _{__ CC _:!_
CM ✓ ACM ✓ DCM (3)..:!_ --
May 6, 2021
CMWD Board Memorandum
To: Carlsbad Municipal Wate Dis rict Board of Directors
From: r, ublic Works
Vicki Quiram, General Mana \: ....,.~-
Via: Scott Chadwick, Executive an ....... .,,...___.
Ccarlsbad
Municipal Water District
Memo ID #2021095
Re: Carlsbad Palisades Homeo.,.,..._, .. _i.or-7\ssociation Concerns Regarding the Recycled
Water Phase Ill, Segment 5 Project (District 2)
This memorandum summarizes recent discussions with the Carlsbad Palisades Homeowners
Association (HOA) regarding concerns on several issues related to the Recycled Water Phase Ill,
Segment 5, Capital Improvement Program (CIP) Project No. 5208 (project), including project
coordination, inadequate landscaping, unplanned costs related to the recycled water irrigation
system retrofit, lost revenue due to construction impacts and its illicit connections to the potable
water system.
Background
On March 3, 2021, the Carlsbad Palisades HOA submitted an email primarily concerning the
"minimal" landscaping that was planted in conjunction with the CIP project. This email complaint
and Carlsbad Municipal Water District (CMWD) staff's response dated March 5, 2021, are
included in Attachment A.
On March 23, 2021, the Carlsbad Palisades HOA submitted another letter (Attachment B), in
which it continues to assert that the landscaping is inadequate and raises several other issues.
These additional issues revolve around illicit connections to the potable water system for spa
water supply and exterior building plumbing modifications, which existed before the CIP project
and were corrected during the project to meet current health and safety regulations. The letter
also mentioned loss of paid parking revenue and renting temporary spa meters. The Carlsbad
Palisades HOA would like for CMWD to cover the costs to abate these conditions and the cost of
recycled water retrofit work.
On May 3, 2021, CMWD staff met virtually using Microsoft Teams with the Carlsbad Palisades
HOA Board and Managing Agent to discuss their concerns. CMWD staff's response to these
concerns is provided in Attachment C.
Discussion
CMWD and city staff have worked closely with the Carlsbad Palisades HOA since the planning
phase of the project in 2017. Recently, staff have been involved with completion of pipeline
Carlsbad Municipal Water District
5950 El Camino Real I Carlsbad, CA 92008 I 760-438-2722 t
Board Memo -Carlsbad Palisades HOA Concerns Regarding the RW Project (District 2)
May 6, 2021
Page 2
construction and on-site inspections related to the recycled water retrofit of this HOA's irrigation
system. Staff provided information on financial rebates for recycled water retrofit work during
the planning and design phases of the project. Most recently, staff engaged a communications
consultant for project-related communications during construction.
CMWD's professional landscape architect prepared a revegetation plan for the slope in which a
water easement and pipeline are located, and staff presented the revegetation plan and solicited
input from the HOA in October 2020. Staff did not receive any input from the HOA, so the
revegetation plan was executed as presented. During recent construction activity, a large tree
and mature vegetation were removed from the slope. The easement was replanted with one-
gallon shrubs and mulched for erosion control to partially restore the landscaping improvements,
though CMWD was not required to do so and recognized that this effort would not fully mitigate
the landscaping which was removed. During the May 3, 2021, meeting with the HOA, staff
explained that the easement prohibits planting oftrees and shrubs to protect the integrity of the
pipeline and it provides CMWD maintenance access and the ability to repair the pipeline in the
future.
The HOA raised the issue of construction impacts on parking space revenue. During the
May 3, 2021, meeting, staff informed the HOA of the claim procedure through the City Clerk's
Office. Staff also informed the HOA that communications regarding the ongoing personal injury
claim by one ofthe homeowners related to construction should be directed to the city's risk
manager.
Also, during the May 3, 2021, meeting, the HOA mentioned new issues regarding paving,
sidewalks and fences that have not been fully restored following construction. Staff notified the
HOA in March 2021 of the project close-out phase and solicited input on outstanding items or
conditions. Staff did not receive any feedback from the HOA on these recent matters until today,
so staff have scheduled an on-site meeting to review these concerns.
Next Steps ·
Staff will continue to work with the Carlsbad Palisades HOA to resolve concerns so long as
resolutions are consistent with the rights granted in CMWD's water easement, recycled water
health and safety regulations, and requirements of the construction contract documents. Claims
of personal injury and loss of revenue will be handled by the city's Risk Management Office and
the General Counsel's Office.
Attachments: A. CMWD email and letter dated March 5, 2021, including Carlsbad Palisades HOA
email of March 3, 2021
B. Carlsbad Palisades HOA letter dated March 23, 2021
C. CMWD letter dated May 3, 2021
Board Memo -Carlsbad Palisades HOA Concerns Regarding the RW Project (District 2)
May 6, 2021
Page 3
cc: Geoff Patnoe, Assistant Executive Manager
Celia Brewer, General Counsel
Robby Contreras, Assistant General Counsel
Dave Padilla, District Engineer
Eric Sanders, Utilities Manager
Babaq Taj, Engineering Manager
Valerie Airey, Municipal Projects Manager
From:
To:
Cc:
Subject:
Date:
Attachments:
Dave Padilla
·tsagapolutele@AssociatedAsset.com
David Hull
ATTACHMENT A
RE: Carlsbad Palisades -Slope Area behind Birchwood
Friday, March 5, 202110:35:33 AM
LETTER to HOA-Slope Landscaping 2021-03-05.pdf
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Hello Mr. Tsagapolutele,
Thank you for your email of March 3. Please find our response in the attached letter and photos of
the site taken yesterday.
Please contact me if you would like to discuss the matter further.
Sincerely,
Dave Padilla, PE, QSD
District Engineer
5950 El Camino Real
Carlsbad, CA 92008-8802
o: 760-603-7356 I m: 760-331-3586 I fax: 760-431-1601 I dave.pad illa@carlsbadca.gov
From: David Hull <David.Hull@carlsbadca.gov>
Sent: Wednesday, March 3, 20211:37 PM
To: Dave Padilla <Dave.Padilla@carlsbadca.gov>
Cc: Vicki Qu iram <Vicki.Quiram@carlsbadca.gov>; Jeanette Brown
<Jeanette.Brown@carlsbadca.gov>
Subject: Fw: Carlsbad Palisades -Slope Area behind Birchwood
Hi all,
I spoke to Tafu the Palisades property manager and he informed me of additional perceived
slope and landscaping issues which are described below.
Thank you,
David Hull, P.E.
Associate Engineer
City of Carlsbad, Public Works
Office: 760-602-7322
Mobile: 760-497-4044
From: Tafu Sagapolutele <tsagapolutele@AssociatedAsset.com>
Sent: Wednesday, March 3, 20211:23 PM
To: David Hull <David.Hull@carlsbadca.gov>
Subject: Carl sbad Palisades - Slope Area behind Birchwood
Hi David,
Thank you for your time on the phone today. As discussed below are the
concerns that we would like your Department to review and advise on mutual
resolutions for both the City and the Association. This follows the planting on
the Birchwood Circle slope. The following are concerns from former Board
President just before he got off the Board .
Currently the swath of property is lacking in suitable vegetation and erosion
protections. The replacement plantings are not sufficient to reasonably replace
or replicate the amount of vegetation that was in place prior to the installation
of the recycled lines. The path, post recycled water line installation is quite
bare and ugly when compared to the rest of the community. The minimal
plantings that the City has provided are not adequate to back fill the missing
landscape in a reasonable amount of time.
The community needs to have better landscaping to rehabilitate the scared
hillside between Amberwood and Birchwood . The neighbors in this part of the
community should not have to experience a 3, 5 or 10 year wait to have the
landscape esthetic resume to where it was before the installation of the
recycled water lines. The neighbors in this part of the community would like
the board, city and community management to take immediate action to
augment and bring the bare area back into line with the rest of the
community's landscaping.
It appears that the City has not lived up to the communities expectation of
leaving the community whole after participating in the recycled water
installation program. It only seems fair that the City provide more suitable
plantings and vegetation to return the area back to its previous condition.
Please see attached photos of the area in question.
Following review of the Birchwood Circle street slope attached are some
pictures that have been compared the current plantings to those on the
landscape plan.
There a re two issues,
One, is the slope stable in its scarred unvegetated condition? Not sure if the
city knows that the 4730B residence has in the past experienced significant
foundation/ soil issues in the past that were remediated at the owner's
expense a couple of years ago. Having an elevated risk of erosion and soil
compromise in my view is something that the board and city should take very
seriously especially with foundations that are at elevated risk.
Two, the landscape that has been planted is far too sparse and immature
(small) to address the restoration of the slopes in any reasonable time frame.
The 10 - 1 gallon low boy acacia plants are miniscule (they are nearly
impossible to distinguish) in my photos) They are approximately 6 -10 inches
tall. They will likely take 5 or 10 years to grow out to where the slope will look
even marginally restored, especially since that area does not look like it will be
irrigated on a regular basis or at all.
The one gallon plants cost about $8.50 each at Evergreen Nursery in
Oceanside. These plants are similar to the very mature (20 or 30 year old)
acacia plants currently on the hill. 20 years from now i am sure the slope will
look amazing.
It also appears that not all of the plants on the plan were planted. The plan
shows 5 - 5 gallon soft tipped agave at the bottom of the slope on Amberwood,
that do not appear to be planted.
It would be nice to have a few more larger specimens to help soften the look of
the slope until the tiny little 1-gal plants get established. Perhaps the city can
put in some 5 gal or 15 gal specimens?
Lastly, with regard to planting on the slopes in what I assume now is an
easement, can we plant our own plants using our own landscapers?
That could be an easy work around provided the hoa is allowed to do such
work after the project is completed. It would be good to have a clear idea of
what we can and cannot do on the slope going forward.
Please let me know of any clarification I can provide.
Regards,
Tafu T. Sagapolutele
Managing Agent
760-603-0501 {Office)
760-603-0505 {Fax)
tsagapolutele@AssociatedAsset.com
AssociatedAsset.com I HomeownerResources.com
AAM
Professional Community
Association Management
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March 5, 2021
Mr. Tafu Sagapolutele
Managing Agent, Carlsbad Palisades Homeowner's Association
c/o CHAMPS/a Division of AAM, LLC
3520 Seagate Way, Ste 100
Oceanside, CA 92056
Dear Mr. Sagapolutele:
C_carlsbad
Municipal Water District
The Carlsbad Municipal Water District (CMWD) is responding to your communication of March
3, 2021, regarding concern for potential erosion of the slope which was disturbed as part of the
Recycled Water Phase Ill -Segment 5 project and insufficient landscaping installed by CMWD's
contractor.
The project installed recycled and potable water mains in the Carlsbad Palisades development
and surrounding areas. As part of the project, an existing water main located within an existing
CMWD water easement and earthen slope was replaced with a new water main. The easement
prohibits the construction of structures, walls or fences; the planting of trees or shrubs; or
changing the surface grade without written permission from CMWD. Although the planting of
shrubs within the easement is prohibited, CMWD's landscaping plan did include some shrub
plantings in an effort to restore the landscaping. This landscaping plan was submitted to the
HOA for review in October 2020. No response was received from the HOA and CMWD
implemented the landscaping plan in early 2021.
In order to avoid potential damage to the water main caused by tree roots, and to ensure the
ability to access the pipe for maintenance or repair, the landscaping cannot accommodate
larger or more closely spaced plantings. CMWD's contractor did follow the contract
requirements for compaction of trench backfill within the slope and the construction of
concrete barriers within the trench to reduce the potential for water seepage and surface
erosion of the backfill soil.
Although the slope restoration efforts are intended to mitigate the potential for erosion to
occur in areas disturbed by the project, CMWD cannot guarantee erosion of the slope will not
occur because erosion is influenced by other factors including the steepness of the slope and
the soil type. CMWD will monitor the condition of the slope within the area disturbed by the
project and require its contractor to restore the slope if erosion occurs within the one-year
warranty period.
Carlsbad Municipal Water District
5950 El Camino Real I Carlsbad, CA 92008 I 760-438-2722 I 760-431-1601 fax I www.carlsbadca.gov
Mr. Tafu Sagapolutele
March 5; 2021
Page 2
CMWD understands your concern regarding past foundation issues in this development. The
project does not contribute to or exacerbate the potential for soil-related distress to structure
foundations and CMWD cannot mitigate such a condition as it is beyond the authorization and
scope of the District to do so.
CMWD appreciates your input and hopes this response addresses your concerns. If you have
any questions or require additional information, please contact me at 760-438-2722 or by email
at Dave.Padilla@carlsbadca.gov.
Sincerely,
~~
Dave Padilla, P.E.
District Engineer
JB:dp
cc: Paz Gomez, Deputy City Manager, Public Works
Vicki Quiram, CMWD General Manager
March 23, 2021
Mr. Dave Padilla
District Engineer
Carlsbad Municipal Water District
5950 El Camino Real, Carlsbad, CA 92008
Dear Mr. Dave Padilla:
ATTACHMENT B
Mr. Tafu Sagapolutele
Managing Agent, Carlsbad Palisades Homeowner's Association
c/o CHAMPS/a Division of AAM, LLC
3520 Seagate Way, Ste 100
Oceanside, CA 92056
Thank you for your communication dated March 5, 2021 responding to our community's concern with regard to
insufficient landscaping and the potential for erosion and mudslides. We are grateful as a community for the newly
installed water mains and the city's continued efforts to maintain our vital water services. Although, Carlsbad Municipal
Water District (CMWD) considers this and other matters closed, Carlsbad Palisades Homeowner's Association and the
homeowners we represent do not.
Even though you did not receive a response from management or the HOA with regard to CMWDs proposed landscaping
plan, we kindly ask for your reconsideration and for a continuance. Communication from CMWD to the HOA and
residents has been poor over the lifetime of the project; surely you can understand one missed email. Repeatedly,
residents have had no warning as to the impact or inconvenience of the work of the day, week or month.
CMWDs "effort to restore the landscaping" seems to have fallen far short of the stated objective of 'making us whole'.
This could easily be accomplished, building off the plan you have already implemented, by adding more mature plants
and shrubs while leaving yourselves adequate access. We would be grateful if our landscaping contractor could work
with you to achieve a satisfactory outcome in the near term. We are not asking for any express guarantee from CMWD;
that said, common sense would dictate that increased vegetation on the slopes might diminish runoff, erosion and the
risk of landslides into the adjacent homes, sidewalks and streets.
The HOA also requests recovery of lost revenue due to the prolonged construction and its impact on our paid parking
revenue and the necessity of renting temporary spa meters. As a result of the ongoing construction, numerous
homeowner-paid parking spaces were unavailable for weeks to months at a time. We have calculated the association's
lost revenue to be $1800 (36 months credited at $50). The temporary spa meters will have cost the HOA $8000 between
February and May 2021. The sum of these additional costs with ~ $40,000 paid to convert Carlsbad Palisades irrigation
system to reclaimed water are a large, municipally-mandated expenditure for a legacy community like ours.
Lastly, one of our homeowner's has ongoing litigation with the city and the contractors you hired to perform the work.
We would love to see you or the responsible party step up and take responsibility for the damages Mrs. Patricia Hargett
incurred. Additionally, it would be premature to close this project without resolving this lawsuit.
Sincerely,
Tafu Sagapoltele
Managing Agent, Carlsbad Palisades Homeowner's Associat ion
ATTACHMENT C
May 3, 2021
Mr. Tafu Sagapolutele
Managing Agent, Carlsbad Palisades Homeowner's Association
c/o CHAMPS/a Division of AAM, LLC
3520 Seagate Way, Ste 100
Oceanside, CA 92056
Dear Mr. Sagapolutele:
{_Carlsbad
Municipal Water District
The Carlsbad Municipal Water District (CMWD) received the Carlsbad Palisades' HOA letter
dated March 23, 2021, which notes additional concerns regarding the Recycled Water Phase Ill
-Segment 5 project and an April 28, 2021, email complaint of exterior water faucets that have
been disconnected. CMWD appreciates the HOA's participation in yesterday morning's
teleconference to discuss these concerns. The concerns raised in these communications and
CMWD's responses are provided below.
Concern #1:
Even though you did not receive a response from management or the HOA with regard
to CMWDs proposed landscaping plan, we kindly ask for your reconsideration and for a
continuance. Communication from CMWD to the HOA and residents has been poor over
the lifetime of the project; surely you can understand one missed email. Repeatedly,
residents have had no warning as to the impact or inconvenience of the work of the day,
week or month.
Response:
CMWD communicated with the HOA beginning with the planning phase of the project in
2017 and, more recently, through the City of Carlsbad's communications consultant,
Southwest Communications and the city's Construction Manager. Notices of
construction activity were provided via door hangers and communication with the HOA
representatives throughout the project. Thank you for recognizing the excellent
communication that Ela Karczewski has given since 2017. CMWD acknowledges that
there have been a few unanticipated items that have arisen in order to address your
water system set up, but this is a normal part of every retrofit.
Concern #2:
CMWDs "effort to restore the landscaping" seems to have fallen far short of the stated
objective of 'making us whole'. This could easily be accomplished, building off the plan
you have already implemented, by adding more mature plants and shrubs while leaving
Carlsbad Municipal Water District
5950 El Camino Real I Carlsbad, CA 92008 I 760-438-2722 I 760-431-1601 fax I www.carlsbadca.gov
Mr. Tafu Sagapolutele
May 3, 2021
Page 2
yourselves adequate access. We would be grateful if our landscaping contractor could
work with you to achieve a satisfactory outcome in the near term. We are not asking for
any express guarantee from CMWD; that said, common sense would dictate that
increased vegetation on the slopes might diminish runoff, erosion and the risk of
landslides into the adjacent homes, sidewalks and streets.
Response:
As stated in CMWD's March 5, 2021 response, the easement prohibits the planting of
trees or shrubs without written permission from CMWD. CMWD is not agreeable to
larger or denser plantings which will hinder the ability to access the easement for
inspection, maintenance or repair.
Concern #3:
The HOA also requests recovery of lost revenue due to the prolonged construction and its
impact on our paid parking revenue and the necessity of renting temporary spa meters.
As a result of the ongoing construction, numerous homeowner-paid parking spaces were
unavailable for weeks to months at a time. We have calculated the association's lost
revenue to be $1,800 {36 months credited at $50). The temporary spa meters will have
cost the HOA $8,000 between February and May 2021. The sum of these additional costs
with~ $40,000 paid to convert Carlsbad Palisades irrigation system to reclaimed water
are a large, municipally mandated expenditure for a legacy community like ours.
Response:
The HOA may file a claim with the city clerk for lost parking revenue. A claim form is
attached for your use. You may deposit the completed claim, in paper copy with an
original signature, in a drop box outside the city clerk's office or mail it to the city clerk.
Regarding the temporary spa meters, the spas were supplied by an illicit connection to
the potable irrigation system. The conversion to recycled water for irrigation
necessitated the disconnection of the spa supply water lines from the irrigation system.
The fee for the temporary meters to supply the spas is estimated to be $2,586 for the
months of February through May 2021, not including the refundable $900 deposit per
meter.
California Water Code, Section 13550 requires the use of recycled water for irrigation
when recycled water meeting the conditions of the Water Code becomes available and
the. cost of irrigation system conversion is borne by the user. In a letter dated August 2,
2017, CMWD provided the HOA with information on the implementation of recycled
water for irrigation and financial incentives (via the Metropolitan Water District of
Southern California's On-site Retrofit Pilot Program) to convert from potable water
irrigation to recycled water. Furthermore, CMWD provided irrigation water meter use
data to the HOA for use in obtaining eligibility for the pilot program. CMWD did not
receive a request to verify water consumption records as part of the program eligibility
screening from the Metropolitan Water District of Southern California or its program
Mr. Tafu Sagapolutele
May 3, 2021
Page 3
administrator. CMWD sent a reminder via email to the HOA on February 6, 2020
encouraging the HOA to apply for the rebates.
Concern #4:
One of our homeowner's has ongoing litigation with the city and the contractors you
hired to perform the work. We would Jove to see you or the responsible party step up
and take responsibility for the damages Mrs. Patricia Hargett incurred. Additionally, it
would be premature to close this project without resolving this lawsuit.
Response:
CMWD understands the Hargett matter is being addressed separately through the city's
Risk Management office and any related communications should be directed to that
office.
Concern #5 (April 28 email, non-functioning exterior water faucets at 4666 Coralwood
Circle):
This is a PUD with least four outside water faucets. After a recycled water (purple pipe}
pipe was brought into our complex, we were forced to have all but one of my outside
pipes capped off because of some regulation that underground pipes carrying potable
water cannot be within a certain number of feet of a recycled water pipe. The one
outside faucet still working does not have an underground pipe but gets water from
within the unit.
There is no convenient workaround for me that provides me with the same functionality
as I had before the outside faucets were turned off. Basically, I can run a very long hose
to the one working outside faucet or run an above ground pipe all around my unit, or
have a plumber find a water source inside the unit and tap into that. None of these work
for me.
It seems to me that the project planner, who should have known all the regulations that
I am now required to comply with, failed to create a project plan that complied with this
regulation about minimum distance between potable and recycled water pipes. My pipe
has been there for 45 years or more, back when the condo was built. The newly
installed recycled water pipe was just installed. The problem is not that my potable
water pipe is illegally placed, the problem is that your recycled water pipe was illegally
placed.
The very notion that I should now suffer because of your project planner's failure is a
monument to the absurd. I propose two solutions.
1} Move your recycled water pipe so that it complies with the law.
2) Make a grandfather exception to my pipe. It has been there all along.
3} Make my potable water pipe acceptable to the regulation by double walling it or
something, at your expense of course.
Mr. Tafu Sagapolutele
May 3, 2021
Page4
Response:
CMWD has a responsibility to implement a cross-connection control program in
accordance with Title 17 of the California Code of Regulations (Sections 7583 through
7586 and 7601 through 7605). With the introduction of recycled water for irrigation in
the HOA's common areas which abut the private yards, the underground, exterior
plumbing modifications at 4666 Coralwood Circle and a few other properties within the
HOA are considered illicit connections and present the potential for future cross-
connections between the potable water and recycled water irrigation systems. The
exterior plumbing was disconnected at the direction of the Carlsbad Palisades HOA in
response to comments from the San Diego County Department of Environmental Health
and Quality to abate potential cross-connections.
The recycled water regulations do not allow for the reconnection of this type of private
plumbing modification and grandfathering this condition does not mitigate the cross-
connection hazard. A possible remedy is to connect the exterior faucets to the indoor
building plumbing in accordance with the California Plumbing Code. Other possible
solutions include the installation of above-ground piping that can be visually inspected
during annual compliance inspections, or the installation of approved backflow
prevention devices at the point of connection to the exterior potable water system.
Unfortunately, the cost of such private modifications is not reimbursable by CMWD.
CMWD and city staff will continue to work with the Carlsbad Palisades HOA to resolve concerns
regarding post-construction conditions within the context of CMWD's water easement rights
and construction contract responsibilities. We look forward to meeting with you and other
interested HOA members the week of May 10, 2021. Please contact me at 760-438-2722 or by
email at Dave.Padilla@carlsbadca.gov if you have any questions prior to our meeting.
Sincerely,
~~
Dave Padilla, P.E.
District Engineer
Attachment: A. Claim Form -CMWD
JB:dp
cc: Paz Gomez, Deputy City Manager, Public Works
Vicki Quiram, General Manager
ATTACHMENT A
Date Distributed ------------Date Received ---~--------
TO: City Attorney _________ _ By:----------------
City Clerk's Office
Risk Manager __________ _ Rec'd: Mail _____ Counter ___ _
Administrative Postmark Date: ------------Services Director ----------
*************************************************************************************
SPACE ABOVE THIS LINE RESERVED FOR CITY USE
CLAIM AGAINST THE CARLSBAD MUNICIPAL WATER DISTRICT
(Government Code S910)
INSTRUCTIONS: Fill out claim form in detail. If more space is needed, use additional sheets of paper
and identify the additional information by appropriate paragraph number. The claim must be signed under
penalty of perjury and dated. FILE THE COMPLETED CLAIM WITH THE CITY CLERK, 1200
CARLSBAD VILLAGE DRIVE, CARLSBAD, CALIFORNIA 92008-1989.
1. Name of Claimant:
Address of Claimant: ___________________________ _
Phone Number:
2. Name of person and mailing address to which person presenting claim desires notice to be sent:
3. Date, place and circumstances of the occurrence or transaction which gave rise to the claim:
a. Date: Time: _____________ _
b. Place: (Street address): ______________________ _
(Closest cross street) ________________________ _
(Other iriformation describing place of occurrence) _____________ _
Revised 4/2015
c. Description of the particular act or omission you claim caused the injury or damage.
Include a full description of the circumstances involved in the act or omission. Please
include a statement of how the Carlsbad Municipal Water District or its employees
caused the injury or damage. If you claim that the injury or damage resulted from a
condition of public prope1iy, please describe the condition in detail. Use additional
sheets of paper if necessary.
4. Description of the nature, indebtedness, obligation, injury, damage or loss so far as known at time of
presenting the claim.
5. Name or names of Carlsbad Municipal Water District employee or employees causing the injury,
damage or loss. (If not known, please state "not known.") If you do not know the name but can
provide other identifying information about the employee or employees, please do so.
Revised 4/2015
6. Amount claimed:
a. Amount claimed as of date of claim $
b. Estimated amount of any future injury, damage
or loss: $
C. Total amount claimed: $
d. Basis of computation of amount claimed:
7. Name and address of witnesses, doctor, hospitals, etc.
NAME ADDRESS PHONE
a.
b.
C.
8. Additional information that might be helpful in considering claim:
9. If you have pictures, sketches, reports or other documents relating to the transaction or occmTence you
may attach them to this claim.
10. Did you report the incident to any Carlsbad Municipal Water District or City of Carlsbad employee or
officer? If so, please identify the person and the date of the report.
I have read the matters and statements made in the above claim and I know the same to be true of my own
knowledge, except as those matters stated upon infonnation or belief and as to such matters I believe that
same to be true. I certify under penalty of pe1j ury that the foregoing is true and correct.
DATED: __________ _ AT: _____________ _
CLAIMANT
Revised 4/2015