Loading...
HomeMy WebLinkAboutSWP272000(14) TATF'n� RECEIVE[ ti C at` y t' �z MAY 2 6 2015 STATE OF WASHINGTON CITY OF RENTON DEPARTMENT OF ECOLOGY UTILITY SYSTEMS PO Box 47600 • Olympia, WA 98504-7600 • 360-407-6000 711 for Washington Relay Service • Persons with a speech disability can call 877-833-6341 May 20, 2014 Allen Quynn City of Renton 1055 S Grady Wa Renton, WA 98057 Permit Number: WAG992028 RE: Coverage under the Aquatic Mosquito Control General Permit Dear Mr. Quynn: The Washington Department of Ecology(Ecology) reissued the Aquatic Mosquito Control General Permit(permit) on May 20, 2015. Ecology received your renewal application for coverage under the permit at least 180 days before the expiration date of the previous permit. Ecology is issuing you coverage under the updated permit beginning May 20, 2015. The permit and your coverage become effective on June 18, 2015. Retain this letter with your permit. It is part of the official record of permit coverage for your operations. Please read the permit carefully, a copy is included with this letter. As a Permittee, you are legally obligated to comply with its terms and conditions. Please refer to the permit number above when contacting Ecology. Permit Fees State law(RCW 90.48.465) requires that all permit holders pay an annual fee based upon the state fiscal year. The state fiscal year begins each year on July 1, and ends on June 30 the following year. Ecology will mail permit fee bills to all permit holders annually each August. Permittees that have permit coverage on July 1 are billed for annual fees. If you would like more information on the fee process, contact Bev Poston, Permit Fee Administrator at bev.postongecy.wa.gov, or(360)407-6425. ® 1W Allen Quynn May 20, 2015 Page 2 Appeal You or a third party have a right to appeal this permit coverage to the Pollution Control Hearing Board (PCHB)within 30 days of the date of receipt of this letter. This appeal is limited to the general permit's applicability or non-applicability to a individual discharger(WAC 173-226- 190(2)). The appeal process is governed by chapter 43.21B RCW and chapter 371-08 WAC. "Date of receipt" is defined in RCW 43.21B.001(2). To appeal, you must do the following within 30 days of the date of receipt of this letter: • File your appeal and a copy of the permit cover page with the PCHB (see addresses below). Filing means actual receipt by the PCHB during regular business hours. • Serve a copy of your appeal and the permit cover page on Ecology in paper form - by mail or in person(see addresses below). E-mail is not accepted. You must also comply with other applicable requirements in chapter 43.21B RCW and chapter 371-08 WAC. Address and Location Information: Street Addresses: Mailing Addresses: Department of Ecology Department of Ecology Attn: Appeals Processing Desk Attn: Appeals Processing Desk 300 Desmond Drive SE PO Box 47608 Lacey, WA 98503 Olympia, WA 98504-7608 Pollution Control Hearings Board (PCHB) Pollution Control Hearings Board I I I I Israel Road SW, Suite 301 PO Box 40903 Tumwater, WA 98501 Olympia, WA 98504-0903 Ecology Technical Assistance If, after reviewing your permit, you have questions or need more information about permit requirements, please contact Nathan Lubliner at nathan.lublinernecy.wa.gov or(360) 407-6563. Sincerely, r fo- Bill Moore, .E.,Manager Program Development Services Section Water Quality Program cc: Bev Poston, WQP, FMS Nathan Lubliner, WQP, PD Public Notice (See Section S6-a on page 14) The City of Renton is Seeking Coverage under the Aquatic Mosquito Control General Permit The City of Renton is seeking coverage under the Aquatic Mosquito Control General Permit. The City of Renton is located at following address in King County, Washington. City of Renton 1055 S. Grady Way Renton Washington 98057 Phone: 425-430-7247 The proposed coverage applies to the geographical area describe below. Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City. Adulticide treatment areas are generally located in upland areas east of SR-167 and west of Lake Avenue South/Talbot Road South between SW 39th Street to the south and 1-405 to the north, within the City of Renton, Washington. Information about the larvicides, adulticides, and a map of the specific locations are available on the City's website at: www.rentonwa.gov. Areas within the described boundaries may be treated to control mosquitoes. The insecticides planned for use are BIOMIST® and/or Kontrol 4-40 Any person desiring to present their views to the Department of Ecology regarding this application may do so in writing within 30 days of the last date of publication of this notice. Comments must be submitted to the Department of Ecology. Any person interested in the Department's action on the application may notify the Department of their interest within 30 days of the last date of publication of this notice. Submit comments to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504-7600 H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Public Notice.doc\AQtp Public Notice The City of Renton is Seeking Coverage under the Aquatic Mosquito Control General Permit The City of Renton is seeking coverage under the Aquatic Mosquito Control General Permit. The City of Renton is located at following address in King County, Washington. City of Renton 1055 S. Grady Way Renton Washington 98057 Phone: 425-430-7247 The proposed coverage applies to the geographical area describe below. Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City. Adulticide treatment areas are generally located in upland areas east of SR-167 and west of Lake Avenue South/Talbot Road South between SW 39th Street to the south and 1-405 to the north, within the City of Renton, Washington. Information about the larvicides, adulticides, and a map of the specific locations are available on the City's website at: www.rentonwa.gov. Areas within the described boundaries may be treated to control mosquitoes. The insecticides planned for use are BIOMIST® and/or Kontrol 4-46 Any person desiring to present their views to the Department of Ecology regarding this application may do so in writing within 30 days of the last date of publication of this notice. Comments must be submitted to the Department of Ecology. Any person interested in the Department's action on the application may notify the Department of their interest within 30 days of the last date of publication of this notice. Submit comments to: Department of Ecology 1 Q Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504-7600 — �` H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Public Notice.doc\AQtp APPENDIX D: PUBLIC NOTICE TEMPLATE FOR NEW APPLICANTS The public notice must be published at least once each week for two consecutive weeks, in a single newspaper of general circulation in the county or counties where the mosquito control activities will take place. The bold language is required by WAC 173-226-130 and must be included as part of the public notice in its entirety. The Permittee may add information to this template,but no information may be removed or changed. PUBLIC NOTICE TEMPLATE (Insert Applicant Name) is seeking coverage under the Aquatic Mosquito Control General Permit. (Insert Applicant Name) is located at(Insert applicant business address and phone number). The proposed coverage applies to the geographical area describe below (Describe the boundaries of mosquito control operations): Areas within the described boundaries may be treated to control mosquitoes. The insecticides planned for use are (list all active ingredients anticipated for use): Any person desiring to present their views to the Department of Ecology regarding this application may do so in writing within 30 days of the last date of publication of this notice. Comments must be submitted to the Department of Ecology. Any person interested in the Department's action on the application may notify the Department of their interest within 30 days of the last date of publication of this notice. Submit comments to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504-7600 Aquatic Mosquito Control General Permit—May 19, 2010 Page 33 City of Renton Mosquito Abatement Program Page 1 of 2 c:tv o You are here:Living : Environment Quick Links: West Nile Virus Mosquito Abatement Program West Nile virus is a mosquito-borne virus that is spread to humans by the bite of an infected mosquito and not by person-to-person contact. In an effort to reduce the risk of human infection; the City has developed a response plan that includes adulticide and larvicide treatment. Treatment is conducted in accordance with the conditions of the Determination of Non-significance-Mitigated statement issued by the City's Environmental Review Committee and Aquatic Mosquito Control NPDES General Permit, ADULTICIDE TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS (Talbot Hill Area) Beginning in April each year,the Surface Water Utility contracts with a state licensed pesticide applicator to treat the upland area located between the Talbot Hill neighborhood and the Panther Creek Wetlands. The wetlands stretch for over a mile and a half along the east side of SR-167 and are easily visible to motorists traveling northbound. Treatments consist of applying a low concentration of EPA approved insecticide using a gasoline powered,backpack-mounted,portable fogger to control adult mosquitoes. Treatments usually continue until the end of August at which point the mosquito population begins to decline. Treatment is limited to the upland areas only and is conducted in strict accordance with the conditions of the Determination of Non-significance-Mitigated statement issued by the City's / Environmental Review Committee and the Aquatic Mosquito Control National Pollutant Discharge Elimination System State Waste Discharge General Permit. J TREATMENT OF CITY STORMWATER AND IRRIGATION / FACILITIES AND CATCH BASINS J Beginning August each year,water treatment applications of an Environmental Protection Agency registered larvicide may be applied to City-owned storm water/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label,the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit,and other federal and state regulations. The larvicide product to be used is Bacillus Sphaericus(BS)and is sold under the trade name VectoLex. The adulticide treatment program has been highly effective in reducing the number of mosquitoes that are a nuisance to the Talbot Hill area neighborhood. Adulticide Treatment Location Map Larvicide Treatment Location Map Larvicide Treatment Pesticides(planned for use and active ingredients) Adulticide Treatment Pesticides(planned for use and active ingredients) If you would like more information on the Mosquito Abatement Program,please call Hebe C. Bernardo,Surface Water Utility Engineer,at 425.430.7264,or by email. http://www.rentonwa.gov/living/default.aspx?id=10516&printfriendly=l&sdate=9/17/20... 09/17/2014 City of Renton Mosquito Abatement Program Page 2 of 2 If you would like more information on the Aquatic Mosquito Control National Pollutant Discharge Elimination System State Waste Discharge General Permit, please contact the City of Renton or John Jennings,Water Quality Program, Department of Ecology,at 360.407.6238 or by email at ionathat.ienni ngs@ecy.wa.gov. http://www.rentonwa.gov/living/default.aspx?id=10516&printfriendly=l&sdate=9/17/20... 09/17/2014 fA B yr,- m N+30th-St—, .. SE MaY Vao,y Rd $R a Lake Washington O 13 s'r ' 10, r yyC s N.. 1 B4 Wm 5 1 3 Z W m S o 2 J � NESunse7 ®soo SE Renton/ W /`a 900 Ssaq`l © w N m Q Q _41 Q Z © E. D Z. LU o Q Z c Z W m c 0 c = 0.1 m Z NE 7th S� m m m Q 2 U) Z m Q rn Z m x a -NE 4th St= N 3rd St ;; ® ® SE 128th-St Lo A Q S`-3rd St515 T N eo'ar Rrve� m o , 1 MaA Ne�aiie� aCtceµ e ts9 Ceda(.Rive ^111 Q N 9� tvlaPla VatlaYN S Joao>Rd mO Q J2e r7�Y S _ coy �69 E a F ©' m 0 m] G(eaµ +„ I ro>'I... u o" 03 o SE 168th St Madson G 0 r � w j — SE petrovits�� R ' v d Mosquito Abatement Program Exhibit B: Larvicide Treatment Sites ® Itl r The City of Renton may use mosquito larvicides made of a natural bacterium(Bacillus sphaericus) m3', help control mosquitoes in accordance with the Washington State Department of Ecology's > Aquatic Mosquito Control General Permit.Treatments may occur between July 27,2014 and £ J October 30,2014.Larvicide treatment will generally occur in stormwater facilities owned or �%. maintained by the City.For more information about the City's commitment to help reduce the "} threat of West Nile virus and control mosquitoes,contact Alen Quynn,City of Renton 167 $ Surface Water Utility Engineer,at 425-430-7247 or by email at aquynn@rentomva.gov. —` '-° -----SEs192ndxS For additional information about Ecology's Aquatic Mosquito Control General Permit,please ',g O contact the City of Renton or Jon Jennings,Water Quality Program,Washington State 1� Department of Ecology,at 360-407-6283 or by email at jonathan.jennings@ecywa.gov. © £ w 9� 0 0.25 0.5 1 Miles O P7 } Date:09/17/2014 a APPENDIX D: PUBLIC NOTICE TEMPLATE FOR NEW APPLICANTS The public notice must be published at least once each week for two consecutive weeks, in a single newspaper of general circulation in the county or counties where the mosquito control activities will take place. The bold language is required by WAC 173-226-130 and must be included as part of the public notice in its entirety. The Permittee may add information to this template,but no information may be removed or changed. PUBLIC NOTICE TEMPLATE (Insert Applicant Name) is seeking coverage under the Aquatic Mosquito Control General Permit. (Insert Applicant Name) is located at(Insert applicant business address and phone number). The proposed coverage applies to the geographical area describe below (Describe the boundaries of mosquito control operations): Areas within the described boundaries may be treated to control mosquitoes. The insecticides planned for use are (list all active ingredients anticipated for use): Any person desiring to present their views to the Department of Ecology regarding this application may do so in writing within 30 days of the last date of publication of this notice. Comments must be submitted to the Department of Ecology. Any person interested in the Department's action on the application may notify the Department of their interest within 30 days of the last date of publication of this notice. Submit comments to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia,WA 98504-7600 Aquatic Mosquito Control General Permit—May 19, 2010 Page 33 1. New coverages under Washington State Department of Health(DOH) blanket coverage will no longer occur on or after May 19,2010. 2. Existing blanket coverage under DOH expires on October 16, 2010, 120 days after the effective date of this permit. 3. Entities that control mosquitoes currently covered under DOH blanket coverage,have until August 17,2010 to complete a transfer of permit coverage from DOH. 4. To transfer permit coverage from DOH, entities that control mosquitoes must complete the transfer form provided in Appendix C and submit it to Ecology at the following address: Washington State Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia,WA 98504-7600 5. If the applicant does not receive notification of the coverage decision from Ecology, coverage under this permit will begin automatically on the 6 1"day following Ecology's receipt of a complete transfer form. S2. APPLICATION FOR COVERAGE Entities that propose to begin mosquito control activities on or after the effective date of this general permit must: A. Submit a complete and accurate permit application(Notice of Intent or NOI)to Ecology at least 60 days before beginning the mosquito control activity that will result in a discharge to waters of the state. B. Complete the NOI for the proposed activity online. The applicant must access Ecology's online data management system Secure Access Washington (http:Hsecureaccess.wa.gov), fill out the NOI online, then print and sign the document. C. The application must include certification that the application has met the applicable public notice and State Environmental Policy Act (SEPA) requirements in Washington Administrative Code (WAC) 173-226-200(f). D. Mail the complete NOI hard copy to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504-7600 Aquatic Mosquito Control General Permit—May 19, 2010 Page 6 1 ���r I'Y�01 inot -��� 1 �� �fY..y.�8 �� b ��� ��� Issuance Date: May 19, 2010 Effective Date: June 18, 2010 Expiration Date: June 18, 2015 AQUATIC MOSQUITO CONTROL GENERAL PERMIT A National Pollutant Discharge Elimination System (NPDES) and State Waste Discharge General Permit for Pesticide Discharges Associated With Mosquito Control Activities State of Washington Department of Ecology Olympia, Washington 98504-7600 In compliance with the provisions of The State of Washington Water Pollution Control Law Chapter 90.48 Revised Code of Washington and The Federal Water Pollution Control Act (The Clean Water Act) Title 33 United States Code, Section 1251 et seq. Until this permit expires, is modified or revoked, Permittees that have properly obtained coverage under this general permit are authorized to discharge in accordance with the special and general conditions that follow. el Su ewind,P.E., P.G. Water Quality Program Manager Department of Ecology TABLE OF CONTENTS SUMMARY OF PERMIT SUBMITTALS.................................................................................... 4 REQUIRED ONSITE DOCUMENTATION................................................................................. 4 SPECIAL PERMIT CONDITIONS............................................................................................... 5 S1. PERMIT COVERAGE......................................................................................................... 5 A. Who Must Obtain Permit Coverage................................................................................ 5 B. Permit Area..................................................................................................................... 5 C. Authorized Discharges.................................................................................................... 5 D. Transfer of Washington State Department of Health Blanket Permit Coverage............ 5 S2. APPLICATION FOR COVERAGE..................................................................................... 6 S3. DISCHARGE LIMITS......................................................................................................... 7 A. Compliance with Standards............................................................................................ 7 B. Temporary Exceedance of Water Quality Standards for Larvicides.............................. 7 C. Pesticide Application Requirements............................................................................... 7 S4. PESTICIDE ACTIVE INGREDIENTS............................................................................... 8 A. Larvicide Active Ingredients Authorized for Use........................................................... 8 B. Adulticide Active Ingredients Authorized for Use......................................................... 8 C. Additional Restrictions for Larvicides and Adulticides.................................................. 9 D. Experimental Use of Pesticide Active Ingredients ....................................................... 10 S5. INTEGRATED MOSQUITO MANAGEMENT PLAN.................................................... 10 A. Plan Objectives............................................................................................................. 10 B. General Information...................................................................................................... 11 C. Surveillance................................................................................................................... I D. Mapping........................................................................................................................ 11 E. Action Thresholds......................................................................................................... 11 F. Mosquito Control Methods........................................................................................... 12 G. Monitoring for Efficacy/Resistance.............................................................................. 12 H. Record Keeping and Reporting..................................................................................... 12 I. Education and Outreach................................................................................................ 13 J. New Staff Training and Continuing Training for Existing Staff.................................. 13 K. Signature Requirements................................................................................................ 13 L. Public Access to IMM Plans......................................................................................... 13 S6. PUBLIC NOTICIFICATION OF PESTICIDE USE......................................................... 14 A. Public Notice................................................................................................................. 14 B. Posting Requirements................................................................................................... 14 ST MONITORING REQUIREMENTS................................................................................... 15 A. Pesticide Use................................................................................................................. 15 B. Dip Sampling................................................................................................................ 15 S 8. REPORTING REQUIREMENTS...................................................................................... 15 A. Annual Report............................................................................................................... 15 B. Records Retention......................................................................................................... 16 Aquatic Mosquito Control General Permit—May 19, 2010 Page 2 C. Noncompliance Notifications....................................................................................... 16 S9. APPENDICES.................................................................................................................... 17 GENERAL CONDITIONS .......................................................................................................... 19 G1. DISCHARGE VIOLATIONS............................................................................................ 19 G2. PROPER OPERATION AND MAINTENANCE............................................................. 19 G3. RIGHT OF ENTRY........................................................................................................... 19 G4. PERMIT COVERAGE REVOKED.................................................................................. 19 G5. GENERAL PERMIT MODIFICATION AND REVOCATION......................................20 G6. REPORTING A CAUSE FOR MODIFICATION............................................................ 20 G7. TOXIC POLLUTANTS..................................................................................................... 21 G8. OTHER REQUIREMENTS OF 40 CFR........................................................................... 21 G9. COMPLIANCE WITH OTHER LAWS AND STATUTES............................................. 21 G 10. ADDITIONAL MONITORING...................................................................................... 21 G 11. PAYMENT OF FEES...................................................................................................... 21 G12. REQUESTS TO BE EXCLUDED FROM COVERAGE UNDER A GENERAL......... 21 PERMIT.................................................................................................................................... 21 G13. TRANSFER OF PERMIT COVERAGE......................................................................... 22 G14. PENALTIES FOR VIOLATING PERMIT CONDITIONS ........................................... 22 G15. SIGNATORY REQUIREMENTS................................................................................... 22 G16. APPEALS ........................................................................................................................ 23 G17. SEVERABILITY.............................................................................................................24 G18. DUTY TO REAPPLY .....................................................................................................24 APPENDIX A: GLOSSARY........................................................................................................25 APPENDIX B: AREAS OF RESTRICTED PESTICIDE USE DUE TO PRESENCE OF LISTEDSPECIES ........................................................................................................................29 APPENDIX C: TRANSFER OF PERMIT COVERAGE............................................................ 32 APPENDIX D: PUBLIC NOTICE TEMPLATE FOR NEW APPLICANTS............................. 33 APPENDIX E: SECTION S5 IMM PLAN CRITERIA EXAMPLES......................................... 34 Aquatic Mosquito Control General Permit—May 19, 2010 Page 3 SUMMARY OF PERMIT SUBMITTALS Refer to the Special and General Conditions of this permit for submittal requirements. Permit Submittal Frequency Due Date(s) Section S I.D Transfer Coverage from DOH Once By August 17, 2010 S 1.D DOH Blanket Coverage Once October 16, 2010 Expires Application for Permit At least 60 days prior to S2 Coverage Once the start of discharge S2.F Complete Development of Once Before coverage is issued IMM for New Applicants S5 Update IMM for Existing As Necessary By June 18, 2011 then as Permittees necessary S5 Ecology Request for IMM Per Ecology Within 14 days of request Request S&A Annual Report 1/year By December 31 each year S8.0 Noncompliance Notification As Necessary As Necessary S 8.D Public Request for IMM As Necessary Within 14 days of request G5 Permit Modification and As Necessary As Necessary Revocation G6 Request for Modification As Necessary As Necessary G 13 Request for Transfer of As Necessary As Necessary Coverage G18 Re-Application for Permit Once per Must be received by Coverage permit cycle December 20, 2014 REQUIRED ONSITE DOCUMENTATION Permit Document Due Date Section S5 Integrated Mosquito Management Plan Existing Permittees June 18, 2011 S21 and Integrated Mosquito Management Plan Before coverage is issued S5 for New Applicants The text of this permit contains words in italics. Words in italics are the first usage of a word in this permit and are defined in the Glossary, Appendix A. Aquatic Mosquito Control General Permit—May 19, 2010 Page 4 SPECIAL PERMIT CONDITIONS S1. PERMIT COVERAGE This permit covers the use of larvicides and adulticides to control mosquitoes in the State of Washington. A. Who Must Obtain Permit Coverage All entities that control mosquitoes must obtain coverage under this permit when the activity, including activities conducted under a Federal Experimental Use Permit, results in a discharge of pesticide(s) or pesticide residues to waters of the state. Applicants for coverage must be the operator that is in functional control of the pesticide application and may include mosquito control districts, local or state government and private licensed applicators. This permit does not apply to homeowner use of residential pesticides. B. Permit Area This general permit covers mosquito control activities in all areas of Washington State, except for federal and tribal lands. C. Authorized Discharges Permittees are authorized to discharge pesticides and pesticide residues from mosquito control activities provided the Permittee complies with the terms and conditions of this permit. Adulticides may be discharged to the following water bodies. l. Man-made detention or retention ponds designed specifically for wastewater or stormwater treatment that does not have an outlet to surface waters of the state, or ponds that are not likely to discharge during, or for two weeks after, treatment. 2. Any constructed water body five acres or less in surface area with no discharge to other surface waters of the state during, or for two weeks after, treatment. 3. Upland farm ponds with no discharge to other surface waters of the state during, or for two weeks after, treatment. 4. Standing irrigation water that will not discharge to surface waters of the state during application or for two weeks following application. D. Transfer of Washington State Department of Health Blanket Permit Coverage Aquatic Mosquito Control General Permit—May 19, 2010 Page 5 1. New coverages under Washington State Department of Health(DOH) blanket coverage will no longer occur on or after May 19,2010. 2. Existing blanket coverage under DOH expires on October 16,2010, 120 days after the effective date of this permit. 3. Entities that control mosquitoes currently covered under DOH blanket coverage,have until August 17, 2010 to complete a transfer of permit coverage from DOH. 4. To transfer permit coverage from DOH, entities that control mosquitoes must complete the transfer form provided in Appendix C and submit it to Ecology at the following address: Washington State Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia,WA 98504-7600 5. If the applicant does not receive notification of the coverage decision from Ecology, coverage under this permit will begin automatically on the 6 1"day following Ecology's receipt of a complete transfer form. S2. APPLICATION FOR COVERAGE Entities that propose to begin mosquito control activities on or after the effective date of this general permit must: A. Submit a complete and accurate permit application(Notice of Intent or NOI)to Ecology at least 60 days before beginning the mosquito control activity that will result in a discharge to waters of the state. B. Complete the NOI for the proposed activity online. The applicant must access Ecology's online data management system Secure Access Washington (http:Hsecureaccess.wa.gov), fill out the NOI online, then print and sign the document. C. The application must include certification that the application has met the applicable public notice and State Environmental Policy Act (SEPA) requirements in Washington Administrative Code(WAC) 173-226-200(f). D. Mail the complete NOI hard copy to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504-7600 Aquatic Mosquito Control General Permit—May 19, 2010 Page 6 E. Use the Public Notice Template provided as Appendix D of this permit. Publish the public notice twice, one week apart, in a local newspaper of general circulation(or regional newspaper if a local newspaper is not available)that an application for permit coverage has been made. F. If using adulticides, develop a complete Integrated Mosquito Management(IMM)Plan that meets the requirements in Section S5. The IMM plan must be completed so that the public may view it during the public comment period. At the end of the required 30-day public comment period, Ecology will consider comments about the applicability of this permit to the proposed mosquito control activity before deciding to issue permit coverage. If the applicant does not receive notification of a coverage decision from Ecology, coverage under this permit will begin automatically on the 61s'day following Ecology's acceptance of a completed NOI. S3.DISCHARGE LIMITS A. Compliance with Standards 1. The application of pesticides must not cause or contribute to violations of the Water Quality Standards for Surface Water of the State of Washington(chapter 173-201A WAC), Ground Water Quality Standards (chapter 173-200 WAC), Sediment Management Standards(chapter 173-204 WAC), and human health-based criteria in the National Toxics Rule(40 CFR 131.36). Discharges that do not comply with these standards are prohibited. 2. For the purposes of this permit, Permittees must use all known, available, and reasonable methods ofpollution control,prevention and treatment (AKARI)when applying pesticides. Compliance with this permit, the Washington Pesticide Control Act and the requirements of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) label constitute AKART. B. Temporary Exceedance of Water Quality Standards for Larvicides Short and long-term exceedance of water quality standards are allowed under this permit provided the Permittee complies with the provisions of WAC 173-201A-410. C. Pesticide Application Requirements The Permittee must comply with the requirements in this permit and FIFRA label requirements. Permit requirements do not reduce the requirements on the FIFRA label. The Permittee must: 1. Ensure that a licensed pesticide applicator, with the appropriate Washington State Department of Agriculture(WSDA) license and certification, have direct supervision responsibilities for the use of pesticides during application. Aquatic Mosquito Control General Permit—May 19, 2010 Page 7 2. Ensure that all applicators under supervision of the licensed applicator have current training in the use of the equipment necessary to apply pesticides correctly. 3. Use Ultra Low Volume (ULV)application equipment to apply adulticides if available. If ULV equipment is not available,use other FIFRA label-approved application techniques. 4. Appropriately trained personnel must calibrate the application equipment for the pesticide product used. 5. Adulticide discharges to waters of concern may only be incidental. S4.PESTICIDE ACTIVE INGREDIENTS A. Larvicide Active Ingredients Authorized for Use 1. Bacillus sphaericus(H-5a5b) 2. Bacillus thuringiensis israelensis (Bti) 3. Malathion 4. Methoprene 5. Monomolecular surface films (MSF) 6. Paraffinic white mineral oil 7. Spinosad 8. Temephos B. Adulticide Active Ingredients Authorized for Use 1. Etofenprox 2. Malathion 3. Naled 4. Natural Pyrethrins 5. Permethrin 6. Piperonyl Butoxide(PBO) 7. Prallethrin Aquatic Mosquito Control General Permit—May 19, 2010 Page 8 8. Resmethrin 9. Sumithrin(d-phenothrin) C. Additional Restrictions for Larvicides and Adulticides 1. The Permittee may apply larvicides provided one or more of the following conditions are met. a. Pretreatment surveillance of a potential larvicide application site indicates that at least one larvae/pupae is present in at least one of three dips. In the event that the Permittee finds larvae/pupae, and the area is treated, the Permittee may continue pre-emptive larvicide treatments without dipping for the remainder of the treatment season. b. Methoprene may be used as a pre-emergent dry-land treatment without dipping on intermittently flooded areas that have a historical record of mosquito hatches following flooding. c. The Permittee has developed and obtained Ecology approval of a large-site sampling protocol prior to treatment. d. The application site is in, or adjacent to a county in which mosquito, bird, animal, or human mosquito-borne disease cases are confirmed during the current treatment season. e. The treatment site is a catch basin, storm drain, and utility or transportation vault. f. State or local health authorities declare a public health threat or emergency related to mosquito-borne disease. 2. Appendix B of this permit details specific geographical areas that are important to species that are state designated as sensitive, threatened, candidate, and endangered in the State of Washington. Ecology may update Appendix B based on new information. Prior to the use of malathion, monomolecular surface films, paraffinic white mineral oil, or adulticides in Appendix B areas, the Permittee must obtain Washington State Department of Fish and Wildlife(WDFW) approval. Contact information for WDFW Regional Wildlife Biologists may be accessed at http://wdfw.wa.gov/about/contact/. 3. Permittees may only use paraffinic white mineral oil or malathion as larvicides if other pesticides are ineffective at a specific treatment site and the water body is non- fish-bearing. To determine if the water body is fish bearing, consult with WDFW. Contact information for WDFW Regional Wildlife Biologists may be accessed at http://wdfw.wa.gov/about/contact/. Aquatic Mosquito Control General Permit—May 19, 2010 Page 9 4. The Permittee may not apply temephos in lakes, streams, in the littoral zone of water bodies, or on sites listed in Appendix B of this permit. The permit allows the use of temephos only in response to the development of pesticide resistance within a specific larval mosquito population with the approval of Ecology. 5. The use of malathion and naled as an adulticide shall be done in accordance with the Permittee's IMM plan to control adult mosquito pesticide resistance. D. Experimental Use of Pesticide Active Ingredients The Permittee may apply other pesticide active ingredients not listed in this permit on a limited basis in the context of a research and development effort under the jurisdictions of EPA and WSDA through the issuance of an Experimental Use Permit(State or Federal). Permittees may not apply pesticide active ingredients covered under an Experimental Use Permit to areas identified in Appendix B. Discharges for the sole purpose of research and development are not required to develop and implement an IMM plan(Section S5)but must follow all other permit requirements. S5.INTEGRATED MOSQUITO MANAGEMENT PLAN Permittees that transfer coverage from DOH have one year from the effective date of this permit to develop and implement an IMM plan for the mosquito control activities that take place within their permit coverage area. Permittees with an existing IMM plan in place, must review it to see that it contains the information required in this section. After the effective date of this permit, the Permittee must keep the IMM plan updated. An updated copy of the IMM plan must be maintained at the Permittee's business office and available upon request to Ecology and the public. Permittees who only apply larvicides may use the Ecology publication "Best Management Practices for Mosquito Control, May 2004(publication number 03-10-023) or equivalent in place of developing their own IMM plan. If the Permittee later decides to include adulticides in its mosquito control operations, it must develop a full IMM plan. Appendix E provides examples of information that may be used to satisfy specific IMM plan elements. Appendix E is not an all-inclusive list; there are likely other options available that may be used to satisfy the permit requirements. A. Plan Objectives 1. Ensure that discharges from mosquito control activities do not cause or contribute to a violation of Water Quality Standards for Surface Water of the State of Washington (chapter 173-201A WAC), Ground Water Quality Standards (chapter 173- 200 WAC), Sediment Management Standards(chapter 173-204 WAC), and human health-based criteria in the National Toxics Rule(40 CFR 131.36). Aquatic Mosquito Control General Permit—May 19, 2010 Page 10 2. Adequately control adult mosquitoes while minimizing the incidental discharges to waters of concern. 3. Document the decision process of where,when, and how mosquito control is implemented within a Permittee's permit coverage area. B. General Information 1. Permittee contact information(name,business phone,physical business address, and mailing address if different); 2. Permittee's permit coverage area; 3. Map showing permit coverage area; and 4. Emergency reporting(e.g. pesticide exposure or spills to waters of the state) C. Surveillance 1. Larval Mosquito Surveillance Refer to permit Section S4.C.La. If post-larviciding surveillance is conducted, describe the surveillance method and procedures. 2. Adult Mosquito General Surveillance If the Permittee applies pesticides for the control of adult mosquitoes, the Permittee must implement an adult mosquito surveillance program. Describe the adult mosquito surveillance procedures that are used to determine when and where adult mosquito control is employed. D. Mapping The Permittee must implement a mapping and/or tracking system to document the following. 1. Mosquito breeding sites, 2. No-spray zones including organic farms,beehives, etc., 3. Endangered species critical habitat in the Permittee's permit coverage area(provided in Appendix B), and 4. Other relevant information as decided by the Permittee. E. Action Thresholds 1. Larval Mosquito Action Thresholds Aquatic Mosquito Control General Permit—May 19, 2010 Page 11 For larval mosquito action thresholds,refer to permit section S4.C.1.a-f. 2. Adult Mosquito Action Thresholds The Permittee must identify thresholds to determine when adult mosquito control is necessary. Describe the thresholds used and the surveillance values for the chosen surveillance method or methods (Section S5.C)that meet the thresholds. F. Mosquito Control Methods The Permittee must evaluate and identify the mosquito control methods that will be used in its permit coverage area. Mosquito control methods may include: 1. Physical Control and/or Source Reduction 2. Biological Mosquito Control 3. Pesticide-Based Larval Mosquito Control a. Section S4.A lists allowed larvicides. The Permittee must include labels for all larvicide products used in the IMM plan. b. Equipment Calibration and Maintenance The Permittee must also address schedules and procedures for maintaining the application equipment in proper operating condition, including calibrating, cleaning, and repairing the pesticide application equipment. 4. Pesticide-Based Adult Mosquito Control a. Section S4.B lists allowed adulticides. The Permittee must include labels for all adulticide products used in the IMM plan. b. Equipment Calibration and Maintenance The Permittee must also address schedules and procedures for maintaining the application equipment in proper operating condition, including calibrating, cleaning, and repairing the pesticide application equipment. G. Monitoring for Efficacy/Resistance If the Permittee has implemented a pesticide resistance-monitoring program, describe it here. H. Record Keeping and Reporting Refer to permit section S&A-D. Aquatic Mosquito Control General Permit—May 19, 2010 Page 12 I. Education and Outreach If the Permittee conducts any public education or outreach about mosquito control, describe it here. J. New Staff Training and Continuing Training for Existing Staff Describe staff training procedures for new staff and on-going routine training. Alternatively, the Permittee may reference its training manual, if available. If a training manual is referenced, include the date it was last updated. K. Signature Requirements The person with signature authority(General Condition G15)must sign and certify the IMM plan has been developed and implemented as written using the language below. "I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering information, the information in the IMM is, to the best of my knowledge and belief, true, accurate, and complete and will be updated as necessary. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." L. Public Access to IMM Plans The Permittee must provide access to, or a copy of, the IMM plan to the public when requested in writing. Upon receiving a written request from the public for the IMM plan, the Permittee must: 1. Provide a copy of the IMM plan to the requester within 14 days of receipt of the written request; or 2. Notify the requester within 10 days of the receipt of the written request of the location and times within normal business hours when the requester may view the IMM plan and provide access to the IMM plan within 14 days of receipt of the written request; or 3. Provide a copy of the IMM plan to Ecology, where the requester may view the records, within 14 days of a request; or the Permittee may arrange with the requester for an alternative location for viewing and/or copying the IMM plan. If access to the IMM plan is provided at a location other than an Ecology office, the Permittee will provide reasonable access to copying services for which it may charge a reasonable fee. Aquatic Mosquito Control General Permit—May 19, 2010 Page 13 S6. PUBLIC NOTICIFICATION OF PESTICIDE USE A. Public Notice 1. The Permittee must publish a public notice at least ten(10) days before the first pesticide application of the season. This notice must include: a. The pesticide(s)planned for use and the active ingredient(s). b. The approximate date ranges of planned treatments. c. The approximate treatment location(s). d. The online location where the public may find pesticide application updates (if available online). e. Where the public can find accurate information about the pesticides planned for use. f. The application area posting procedures if the use of larvicides with water-use restrictions is planned. g. The name and telephone number of the Permittee and the Ecology Aquatic Pesticides Permit Manager. h. The telephone number, email address or web site where a person may contact the Permittee to have their name put on a"No Spray" list. 2. State agencies with statewide permit coverage (e.g. WSDOT),may publish a public notice in one major newspaper of general circulation for each agency region(e.g. WSDOT Olympic Region,North Central Region, etc.)where the mosquito control activity will take place. 3. The Permittee's notification to the public regarding mosquito control activities must continue throughout the treatment season if pesticide applications occur. After the initial newspaper notice, the Permittee may notify the public using a method other than notices in the newspaper, such as web site postings, mailings, or radio spots. B. Posting Requirements 1. The Permittee must post notices at all reasonable points of public ingress and egress to the treatment areas when applying larvicides with water-use restrictions to water bodies used for water supply, fish and shellfish harvesting, or water contact activities. 2. The Permittee need not post notices at sites that are not directly accessible to the public(e.g. catch basins, storm drains,utility and transportation vaults, etc). Aquatic Mosquito Control General Permit—May 19, 2010 Page 14 3. The Permittee must make maps available to the public of the adulticide application areas. Web site maps or available hard copies meet this requirement. S7. MONITORING REQUIREMENTS A. Pesticide Use The Permittee must monitor the amounts of pesticides used and report pesticide application quantities as required in Section S8. B. Dip Sampling 1. When Permittees conduct larval treatments requiring dip samples (Sections S4.C.1), the Permittee must record the: a. Date and location dipping occurred; b. The contractor firm or individual who collected the sample or performed the measurement; c. The larvae count of the dip sample. 2. The Permittee need not submit this information as part of the annual report but must make the information available to Ecology upon request. S8. REPORTING REQUIREMENTS The Permittee must submit pesticide application information in accordance with the following conditions. A. Annual Report 1. By December 31 of each year, the Permittees must submit an annual report electronically through Ecology's online data management system(Secure Access Washington at https:Hsecureaccess.wa.gov. A signed and dated hard copy of the annual report must also be mailed to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504-7600 2. The annual report must include: a. Permit Number. Aquatic Mosquito Control General Permit—May 19, 2010 Page 15 b. Permittee Name. c. Name of the location treated. The location is the area for which the Permittee has permit coverage for(e.g. ABC Golf Club, ABC City storm drain system, ABC County, ABC Mosquito Control District, etc), d. Active Ingredient(e.g. Bti,permethrin, etc.), e. Total amount of active ingredient applied for each season, and f. Measurement units(pounds or gallons). B. Records Retention The Permittee must retain records of all monitoring information for a minimum of five (5) years. Such information must include copies of all reports and records required by this permit, and records of all data used to complete the application for this permit. The Permittee must keep records longer in the event of unresolved litigation regarding the discharge of pollutants by the Permittee or when requested by Ecology. The Permittee must make the records, reports, other documents, and information required by this permit available to Ecology upon request. C. Noncompliance Notifications The Permittee must take the following actions when it violates or is unable to comply with any permit condition: I. Immediately take action to minimize potential pollution or otherwise stop the noncompliance and correct the problem. 2. Immediately notify the appropriate Ecology regional office and the aquatic pesticides permit manager of the failure to comply via the regional spills telephone hotline and the aquatic pesticides permit manager's phone number below. a. Southwest Regional Office: 1-360-407-6300 (Clallam, Clark, Cowlitz, Grays Harbor, Jefferson, Mason, Lewis, Pacific, Pierce, Skamania, Thurston, and Wahkiakum counties) b. Northwest Regional Office: 1-425-649-7000 (Island, King, Kitsap, San Juan, Skagit, Snohomish, and Whatcom counties) c. Central Regional Office: 1-509-575-2490 (Benton, Chelan, Douglas, Kittitas, Klickitat, Okanogan, and Yakima counties) Aquatic Mosquito Control General Permit—May 19, 2010 Page 16 d. Eastern Regional Office: 1-509-329-3400 (Adams,Asotin, Columbia, Ferry, Franklin, Garfield, Grant, Lincoln, Pend Oreille, Spokane, Stevens, Walla Walla, and Whitman counties) e. Aquatic Pesticide Permit Manager: 1-360-407-6283 3. The Permittee must provide a written report to Ecology within 30 days of the time that the Permittee becomes aware of any permit non-compliance unless Ecology requests and earlier submission. The report must contain: a. A description of the noncompliance and its cause. b. The exact date, time,place, and duration of the noncompliance. c. Whether the noncompliance has been corrected and, if not, when the noncompliance will be corrected. d. Steps taken or planned to reduce, eliminate, and prevent recurrence of the noncompliance. 4. Compliance with the requirements of this section does not relieve the Permittee from responsibility to maintain continuous compliance with the terms and conditions of this permit of the resulting liability for failure to comply. 5. The Permittee must submit noncompliance reports to: Washington State Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504-7600 6. The Permittee must update its IMM plan to address the noncompliance to reduce the likelihood of the incident occurring again. S9.APPENDICES The attached appendices are incorporated by reference into this permit. A. APPENDIX A: GLOSSARY B. APPENDIX B: AREAS OF RESTRICTED PESITICIDE USE DUE TO PRESENCE OF LISTED SPECIES C. APPENDIX C: TRANSFER OF PERMIT COVERAGE FORM D. APPENDIX D: PERMIT COVERAGE PUBLIC NOTICE TEMPLATE Aquatic Mosquito Control General Permit—May 19, 2010 Page 17 E. APPENDIX E: SECTION S5 IMM PLAN CRITERIA EXAMPLES Aquatic Mosquito Control General Permit—May 19, 2010 Page 18 GENERAL CONDITIONS GI. DISCHARGE VIOLATIONS All discharges and activities authorized by this general permit shall be consistent with the terms and conditions of this general permit. The discharge of any pollutant more frequently than, or at a concentration in excess of that authorized by this general permit shall constitute a violation of the terms and conditions of this general permit. G2. PROPER OPERATION AND MAINTENANCE The Permittee shall, at all times, properly operate and maintain all facilities or systems of treatment and control(and related appurtenances) which are installed to achieve compliance with the terms and conditions of this permit. Proper operation and maintenance also includes adequate laboratory controls and appropriate quality assurance procedures. This provision requires the operation of back-up or auxiliary facilities or similar systems, which are installed by a Permittee only when the operation is necessary to achieve compliance with the conditions of this permit. G3. RIGHT OF ENTRY The Permittee shall allow an authorized representative of Ecology,upon the presentation of credentials and such other documents as may be required by law: A. To enter upon the premises where a discharge is located or where any records shall be kept under the terms and conditions of this permit; B. To have access to and copy at reasonable times any records that shall be kept under the terms of this permit; C. To inspect at reasonable times any monitoring equipment or method of monitoring required in this permit; D. To inspect at reasonable times any collection, treatment, pollution management, or discharge facilities; and E. To sample at reasonable times any discharge of pollutants. G4. PERMIT COVERAGE REVOKED Pursuant with chapter 43.21B RCW and chapter 173-226 WAC, the Director may require any discharger authorized by this permit to apply for and obtain coverage under an individual permit or another more specific and appropriate general permit. Cases where revocation of coverage may be required include, but are not limited to, the following: Aquatic Mosquito Control General Permit—May 19, 2010 Page 19 A. Violation of any term or condition of this permit; B. Obtaining coverage under this permit by misrepresentation or failure to disclose fully all relevant facts; C. Failure or refusal of the Permittee to allow entry as required in RCW 90.48.090; D. A determination that the permitted activity endangers human health or the environment, or contributes to water quality standards violations; E. Nonpayment of permit fees or penalties assessed pursuant to RCW 90.48.465 and chapter 173-224 WAC; F. Failure of the Permittee to satisfy the public notice requirements of WAC 173-226- 130(5), when applicable; or Permittees who have their coverage revoked for cause according to WAC 173-226-240 may request temporary coverage under this permit during the time an individual permit is being developed,provided the request is made within ninety(90) days from the time of revocation and is submitted along with a complete individual permit application form. G5. GENERAL PERMIT MODIFICATION AND REVOCATION This permit may be modified, revoked and reissued, or terminated in accordance with the provisions of chapter 173-226 WAC. Grounds for modification or revocation and reissuance include,but are not limited to,the following: A. When a change which occurs in the technology or practices for control or abatement of pollutants applicable to the category of dischargers covered under this permit; B. When effluent limitation guidelines or standards are promulgated pursuant to the FWPCA or chapter 90.48 RCW, for the category of dischargers covered under this permit; C. When a water quality management plan containing requirements applicable to the category of dischargers covered under this permit is approved; or D. When information is obtained which indicates that cumulative effects on the environment from dischargers covered under this permit are unacceptable. G6. REPORTING A CAUSE FOR MODIFICATION A Permittee who knows or has reason to believe that any activity has occurred or will occur which would constitute cause for modification or revocation under Condition G5 above, or 40 CFR 122.62 shall report such plans, or such information,to Ecology so that a decision can be made on whether action to modify coverage or revoke coverage under this permit will be -Aquatic Mosquito Control General Permit—May 19, 2010 Page 20 required. Ecology may then require submission of a new application for coverage under this, or another general permit, or an application for an individual permit. Submission of a new application does not relieve the Permittee of the duty to comply with all the terms and conditions of the existing permit until the new application for coverage has been approved and corresponding permit has been issued. G7. TOXIC POLLUTANTS The Permittee shall comply with effluent standards or prohibitions established under Section 307(a) of the Clean Water Act for toxic pollutants within the time provided in the regulations that establish those standards or prohibitions, even if this permit has not yet been modified to incorporate the requirement. G8. OTHER REQUIREMENTS OF 40 CFR All other requirements of 40 CFR 122.41 and 122.42 are incorporated in this general permit by reference. G9. COMPLIANCE WITH OTHER LAWS AND STATUTES Nothing in this permit shall be construed as excusing the Permittee from compliance with any applicable Federal, State, or local statutes, ordinances, or regulations. G10. ADDITIONAL MONITORING Ecology may establish specific monitoring requirements in addition to those contained in this permit by administrative orders or permit modification. GIL PAYMENT OF FEES The Permittee shall submit payment of fees associated with this permit as assessed by Ecology. Ecology may revoke this permit coverage or take enforcement, collection, or other actions, if the permit fees established under chapter 173-224 WAC are not paid. G12. REQUESTS TO BE EXCLUDED FROM COVERAGE UNDER A GENERAL PERMIT Any discharger authorized by this permit may request to be excluded from coverage under this general permit by applying for an individual permit. The discharger shall submit to the Director an application as described in WAC 173-220-040 or WAC 173-216-070, whichever is applicable, with reasons supporting the request. These reasons must fully document how an individual permit will apply to the applicant in a way that the general permit cannot. Aquatic Mosquito Control General Permit—May 19, 2010 Page 21 Ecology may make specific requests for information to support the request. The Director shall either issue an individual permit or deny the request with a statement explaining the reason for the denial. When an individual permit is issued to a discharger otherwise subject to this general permit, the applicability of this general permit to that Permittee is automatically terminated on the effective date of the individual permit. G13. TRANSFER OF PERMIT COVERAGE This permit coverage may be automatically transferred to a new Permittee if: A. The Permittee notifies the Department at least 30 days in advance of the proposed transfer date. B. The notice includes a written agreement between the existing and new Permittees containing a specific date transfer of permit responsibility, coverage, and liability between them. C. The Department does not notify the existing Permittee and the proposed new Permittee of its intent to modify or revoke permit coverage. G14. PENALTIES FOR VIOLATING PERMIT CONDITIONS Any person who is found guilty of willfully violating the terms and conditions of this permit shall be deemed guilty of a crime, and upon conviction thereof shall be punished by a fine of up to ten thousand dollars and costs of prosecution, or by imprisonment in the discretion of the court. Each day upon which a willful violation occurs may be deemed a separate and additional violation. Any person who violates the terms and conditions of a waste discharge permit shall incur, in addition to any other penalty as providdd by law, a civil penalty in the amount of up to ten thousand dollars for every such violation. Each and every such violation shall be a separate and distinct offense, and in case of a continuing violation, every day's continuance shall be and be deemed to be a separate and distinct violation. G15. SIGNATORY REQUIREMENTS All applications, reports, or information submitted to Ecology shall be signed and certified. A. In the case of a municipal, State or other public facility, all permit applications shall be signed by a principal executive officer or ranking elected official. In the case of a corporation,partnership, or sole proprietorship, all permit applications shall be signed by either a principal executive officer of at least the level of vice president of a corporation, a general partner of a partnership, or the proprietor of a sole proprietorship. B. All reports required by this permit and other information requested by Ecology shall be signed by a person described above or by a duly authorized representative of that person. A person is a duly authorized representative only if: Aquatic Mosquito Control General Permit—May 19, 2010 Page 22 1. The authorization is made in writing by a person described above and submitted to Ecology. 2. The authorization specifies either an individual or a position having responsibility for the overall operation of the regulated facility, such as the position of plant manager, superintendent,position of equivalent responsibility, or an individual or position having overall responsibility for environmental matters. (A duly authorized representative may thus be either a named individual or any individual occupying a named position.) C. Changes to authorization. If an authorization under paragraph 13.2 above is no longer accurate because a different individual or position has responsibility for the overall operation of the facility, a new authorization satisfying the requirements of paragraph 13.2 above must be submitted to Ecology prior to or together with any reports, information, or applications to be signed by an authorized representative. D. Certification. Any person signing a document under this section shall make the following certification: I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. G16.APPEALS The terms and conditions of the mosquito control general permit are subject to appeal. There are two different appeal categories. A. The permit terms and conditions as they apply to the appropriate class of dischargers are subject to appeal within thirty(30) days of issuance of the mosquito control general permit in accordance with chapter 43.21(B)RCW and chapter 173-226 WAC; and B. The applicability of the permit terms and conditions to an individual discharger are subject to appeal in accordance with chapter 43.21(13) RCW within thirty(30)days of the effective date of coverage of that discharger. An appeal of the coverage of the mosquito control general permit to an individual discharger is limited to the applicability or non-applicability of the mosquito control general permit to that same discharger. Appeal of this permit coverage of an individual discharger will not affect any other individual dischargers. If the terms and conditions of the mosquito control general permit are found to be inapplicable to any discharger(s), the matter shall be remanded to Ecology for consideration of issuance of an individual permit or permits. Aquatic Mosquito Control General Permit—May 19, 2010 Page 23 G17. SEVERABILITY The provisions of this permit are severable, and if any provision of this general permit or application of any provision of this general permit to any circumstance is held invalid,the application of such provision to other circumstances, and the remainder of this general permit, shall not be affected thereby. G18.DUTY TO REAPPLY The Permittee shall reapply for coverage under this permit at least one hundred and eighty (180) days prior to the specified expiration date of this permit. An expired permit and coverage under the permit continues in force and effect until Ecology issues a new permit (coverage) or until Ecology cancels it. Only those facilities that have reapplied for coverage under this permit are covered under the continued permit. Aquatic Mosquito Control General Permit—May 19, 2010 Page 24 APPENDIX A: GLOSSARY All definitions listed below are for use in the context of this permit only. Active Ingredient(s): The ingredient(s) in a pesticide product that provides the insecticidal effects. Action Threshold: A level of mosquito abundance, based on surveillance, at which mosquito control is conducted. Adulticide: A pesticide product designed to kill adult mosquitoes. All known, available, and reasonable methods of pollution control,prevention and treatment(AKART): a technology-based approach to limiting pollutants from discharges. Described in chapters 90.48 and 90.54 RCW and chapters 173-201A, 173-204, 173-216 and 173- 220 WAC. Applicant: An entity that submits a completed NOI and SEPA checklist to Ecology for permit coverage after the effective date of this permit. This does not include entities that transferred coverage from DOH before blanket coverage expired October 16, 2010. Best Management Practices (BMP): Practices,procedures,techniques, equipment,physical controls, or any actions that minimize the discharge of pollutants to waters of the state in addition to other permit requirements. Blanket Coverage: Coverage extended to entities that control mosquitoes by Washington Department of Health under their NPDES permit coverage. Expires October 16, 2010. Constructed water body: A human-made water body that is not part of a previously existing natural water of the state, such as ponds, streams, wetlands, etc. Dip(s)/Dipping: The act of scooping up a small amount of water and examining it for the presence/absence of mosquito larvae. Discharge: The addition of any pollutant to a water of the state. Entity(s): Any person or organization that is in operational control of mosquito control pesticide applications. This may include mosquito control districts, commercial pesticide applicators, cities, counties,public utility districts,public health districts, municipalities, state and local agencies, and any other commercial,private, public, or government entity providing mosquito control. Experimental Use Permit: Federal and state permits that allow the use of unregistered pesticides in the context of research and development for registration of the pesticide under FIFRA Section 3. Also covers research and development for registration of a new use of a currently registered pesticide under FIFRA Section 3. See 40 CFR 172, RCW 15.58.405, and WAC 16-228-1460. Aquatic Mosquito Control General Permit—May 19, 2010 Page 25 Federal Insecticide, Fungicide, and Rodenticide Act(FIFRA): A set of Federal regulations that establishes uniform pesticide product labeling,use restrictions, and review of new pesticides. Incidental: A trivial amount of adulticide that does not cause or contribute to a violation of water quality standards and which occurs due to circumstances beyond the control of the applicator during a proper pesticide application following the terms and conditions of this permit including FIFRA label requirements and practices to control incidental discharges of adulticide to surface water. Circumstances beyond the applicators control include,but are not limited to, sudden shifts in wind direction, an increase in wind speed at the target application area, equipment malfunction, etc. Practices to control incidental discharge to surface waters include, but are not limited to, altering course around waters of concern,using other types of spray equipment that have a smaller spray width(swath), and turning application equipment off when passing waters of concern. Integrated Mosquito Management(IMM) Plan: An ecologically-based strategy for mosquito control that incorporates monitoring,biological,physical, and chemical controls in order to manage pests with the least possible hazard to people, the environment and property. IMM considers all available control actions, including no action. Larvicide: A pesticide product that targets mosquito larva and pupa life stages. Mosquito Control District(MCD): A district organized under the authority of chapter 17.28 RCW for the control of mosquitoes in Washington State. Permittee: Entities that are in operational control of the pesticide discharge and have coverage under this permit. Permit Coverage Area: The area included in a Permittee's coverage, for example, a city that has permit coverage would have coverage for entire area within the city's incorporated area. Pesticide: A product that has toxic properties and is used to control pest organisms. Pesticide Applicator: An individual with the appropriate Washington State Department of Agriculture(WSDA) license(s)to apply larvicides and/or adulticides. Pesticide Resistance: Adaptation of a pest to a specific pesticide that results in reduced efficacy on the target pest. Planned Treatments: A schedule of treatment dates developed by the Permittee at the beginning of the treatment season. Pollutant(s): Any substance discharged that would alter the chemical,physical, thermal, biological, or radiological integrity of the waters of the state or would be likely to create a nuisance or renders such waters harmful, detrimental or injurious to the public health, safety, or welfare, or to any legitimate beneficial use, or to any animal life, either terrestrial or aquatic. Pollutants include, but are not limited to, the following: dredged spoil, solid waste, incinerator residue, filter backwash, sewage, garbage, sewage sludge,munitions, chemical wastes, biological Aquatic Mosquito Control General Permit—May 19, 2010 Page 26 materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, pH, temperature, TSS, turbidity, color, BOD5, TDS, toxicity, odor, and industrial, municipal, and agricultural waste. Primary Contact Recreation: Means activities where a person would have direct contact with water to the point of complete submergence including,but not limited to, skin diving, swimming, and water skiing(WAC 173-201A-020). Product(s): The set of active, inert, and other ingredients specific to a pesticide formulation(e.g. Altosid, Perrnanone, or Trumpet EC). Range(s): A specific series of dates that anticipates the months of planned treatment. This is a planned range- it can be exceeded if public health concerns arise. Residue: Any excess pesticide applied during an application or any excess pesticide and its degradation products left behind after the pesticide has completed its purpose. Restricted Access Systems: Restricted access areas that are accessible only through manholes or other means. Not readily accessible to the public(e.g. water, electrical or transportation vaults, storm drains, catch basins, etc.) Secondary Contact Recreation: Means activities where a person's water contact would be limited(e.g. wading or fishing)to the extent that bacterial infections of eyes, ears, respirator or digestive systems or urogenital areas would normally be avoided(173-201A-020 WAC). Secure Access Washington (SAW): The web-based application where entities may apply for permit coverage and Permittee's may update permit coverage information and submit annual reports. SAW is located at https:Hsecureaccess.wa.gov. State Environmental Policy Act: Chapter 43.21C RCW and chapter 197-11 WAC. Surveillance: For larviciding purposes, this is using a dip sampler to check for the presence/absence of mosquito larva and/or pupa in a waterbody. For adulticiding this is using the method(s) specified in the IMM plan for determining, if necessary, when and where to initiate adult mosquito control measures. Ultra Low Volume (ULV): A type of pesticide application in which an extremely fine aerosol fog is generated with a particle size between 0.1 and 50 microns(microns=micrometers) and 80% of the particles are between 0.1 and 30 microns. Actual particle size is regulated on the FIFRA label. Uses approximately 1 fluid once per acre, depending FIFRA label requirements. Upland farm pond: Private farm ponds created on upland sites that did not incorporate natural water bodies(WAC 173-20 1 A-260(3)(f)). Washington Pesticide Control Act: Chapter 15.58 Revised Code Washington(RCW) Water Contact Activities: Activities defined in 173-201A-020 as primary contact recreation or secondary contact recreation. Aquatic Mosquito Control General Permit—May 19, 2010 Page 27 Waters of Concern: All natural bodies of water, including but not limited to, lakes,rivers, streams,ponds and wetlands, and the natural tributaries to those bodies of water. Waters of the State: includes those waters defined as "waters of the Unites States" in 40 CFR Subpart 122.2 within the geographic boundaries of Washington State. State statute defines "waters of the state"to include lakes rivers,ponds, streams, wetlands, inland waters, underground waters, salt waters and all other surface waters and water courses within the jurisdiction of the state of Washington(chapter 90.48. RCW). Water-Use Restriction: This refers to any product labeled for restricted water use immediately after treatment(currently applies only to malathion(larvicide),temephos, and paraffinic white mineral oil). In the absence of other definitions set forth herein, the definitions set forth in 40 CFR Part 403.3 or in chapter 90.48 RCW apply. Aquatic Mosquito Control General Permit—May 19, 2010 Page 28 APPENDIX B: AREAS OF RESTRICTED PESTICIDE USE DUE TO PRESENCE OF LISTED SPECIES Criteria Used for the Restrictions The criteria WDFW uses for denoting species as vulnerable are: 1) State species of concern(e.g., listed as state endangered, threatened, sensitive, or candidate). 2) Current range and distribution of the species was highly localized. 3)The species inhabited freshwater wetlands during most of the mosquito control treatment period. Six species initially met those criteria: northern leopard frog(Rana pipiens), Oregon spotted frog (Rana pretiosa), western toad(Bufo boreas), western pond turtle(Clemmys marmorata), American white pelican(Pelecanus erythrorhynchos), and one butterfly, the Yuma skipper (Ochlodes yuma). WDFW identified areas occupied by the two extant populations of northern leopard frog;two extant western Washington populations of Oregon spotted frog; western toad breeding ponds (for western Washington only); the three remaining western pond turtle populations; the single American white pelican breeding colony; and the one known Washington Yuma skipper population. Based on the review of published literature, expert advice, and the vulnerability of these rare and endangered animals and their freshwater invertebrate food resources WDFW requested that if mosquito control is deemed necessary in the areas WDFW described in April 2003, that it be restricted to the use of Bacillus products. Aerial Applications An exception to the WDFW request regarding the use of certain larvicides was made for the single American white pelican breeding colony. The colony resides on islands and along the shores of the Columbia River, south of the confluence of the Snake River, in Walla Walla and Benton counties. While bio-chemicals such as methoprene were not of concern for the pelican breeding colony, the method of aerial application was believed to be unacceptably disturbing for their successful breeding. It was agreed that aerial applications would not be made on the pelican breeding areas, whereas less obtrusive methods of mosquito control were acceptable near these sites. Discussions among several WDFW biologists found that aerial applications of larvicides disturbed work being done in a few wildlife refuge areas around the state. It was therefore agreed that operators making aerial applications over wildlife refuges should notify the appropriate regional WDFW office of their scheduled aerial applications at least 24 hours prior to spraying. The notification can be made by phone or fax. Area of Impact Aquatic Mosquito Control General Permit—May 19, 2010 Page 29 Only a few populations of northern leopard frog, Oregon spotted frog, western toad, western pond turtle, and Yuma skipper remain in Washington. The total area occupied by these species in rivers, lakes,ponds, and wetlands is tiny, comprising of portions of 117 sections(<O.18% of Washington State). The areas identified for northern leopard frog(36 Sections) and western pond turtle(13 Sections) are owned or managed by WDFW. A prudent, risk-adverse approach is warranted with vulnerable threatened and endangered species. The following areas are restricted to the use of Bacillus thuringiensis israelensis (Bti) and Bacillus sphaericus (H-5a5b): 1. Grant County,north of Moses Lake, within the Crab Creek watershed: T21N R27E Sections 1, 12, and 13; T21N R28E Sections 7, 17, 18, 19, 28, 29, 30, 31, 32, and 33. 2. Grant County, south and west of Moses Lake and south of Interstate-90, the northern portion of the Potholes: T19N R27E Sections 33, 34, 35, and 36;T19N R28E Sections 31 and 32, 29, 30; T18N R27E Sections 1, 2, 3, 4, 8, 9, 10, 11, 12, 13, 14, 15, and 16, 17; T18N R28E Sections 5, 6, 7, 8, 17, and 18. 3. Grant County, area within and near the Sun Lakes-Dry Falls State Park wetlands: T24N R27E and 28E. 4. Kitsap County: lakes, ponds, and wetlands located in T22N RI Sections 1, 2, 10, 11, and 12. 5. Klickitat County, west of the Klickitat River, all waters in T3N R12E Sections 28, 29, 32, and 33. 6. Mason County, on the Kitsap Peninsula: lakes,ponds, and wetlands located in T23NR2W Sections 11, 12, 13, 14, 15, 22, and 23. 7. Pierce and Kitsap counties, Carney Lake, located in T22N R1W. 8. Pierce, Thurston, and Lewis counties, within the Nisqually River watershed: Alder Lake (or Alder Lake Reservoir), located in townships: T15N R4E and 5E. 9. Pierce County, south of Tacoma, Chambers Creek and associated waters in T20NR2E Sections 26 and 27. 10. Skamania County, east of Carson, all waters in UN R8E Sections 23, 24, 25, 26, and 36; T3NR9E Sections 30 and 31. 11. Thurston County, west of Yelm: lakes, ponds, and wetlands located in T l 7N R 1 E Sections 8, 9, 16, and 21. 12. Thurston County, south of Olympia and east of Interstate-5, within the Black River watershed, the Beaver Creek drainage, located in T16N R2W Sections 9, 10, 11, and 12; T16N R1W Section 7. Aquatic Mosquito Control General Permit-May 19, 2010 Page 30 13. Thurston County, south of Olympia and west of Interstate-5, within the Black River watershed: Black River proper from south of Black Lake to the Chehalis River confluence, and the following tributaries, Stony Creek, Dempsey Creek, Salmon Creek, and Blooms Ditch. Legal description as follows for these sensitive areas: T17N R3W Sections 10, 11, 12, 13, 14, 15, 23, 24, 25, 35, and 36; T17N R2W Sections 7, 18, 19, and 30; T16N R3W Sections 2, 11, 14, 19, 20, 21, 22, 23, 30, and31; T16N R4W Sections 25, 26, 27, 31, 32, 33, 34, 35, and 36. Aquatic Mosquito Control General Permit-May 19, 2010 Page 31 r,� APPENDIX C: TRANSFER OF PERMIT COVERAGE Mosquito Control General Permit DO NOT ALTER THIS FORM DEPARTMENT OF The new Permittee(s)must sign this form. Provide the date that the new Permittee ECOLOGY assumes responsibility for the permit coverage. Attach additional sheets if necessary. State of Washington I. Original Permittee Permittee's Name: Permit Number: Mailing Address: City: State: Zip: Phone Number: Fax Number: Email address: II. New Permittee Name: Title: Agency/Company: Mailing Address: City: State: Zip: Phone Number: Fax Number: Email address: New Permittee will assume responsibility and liability for coverage on: Month/ Day/Year **Signature: III. New On-Site Contact Person (if different than above) Contact Name: Title: Company Name: Mailing Address: City: State: Zip: Phone: Cell Phone: Email Address(optional): ** The new Permittee signature in Section II of this form must be in compliance with General Condition G15 of this permit. Aquatic Mosquito Control General Permit—May 19, 2010 Page 32 APPENDIX D: PUBLIC NOTICE TEMPLATE FOR NEW APPLICANTS The public notice must be published at least once each week for two consecutive weeks, in a single newspaper of general circulation in the county or counties where the mosquito control activities will take place. The bold language is required by WAC 173-226-130 and must be included as part of the public notice in its entirety. The Permittee may add information to this template,but no information may be removed or changed. PUBLIC NOTICE TEMPLATE (Insert Applicant Name) is seeking coverage under the Aquatic Mosquito Control General Permit. (Insert Applicant Name) is located at(Insert applicant business address and phone number). The proposed coverage applies to the geographical area describe below(Describe the boundaries of mosquito control operations): Areas within the described boundaries may be treated to control mosquitoes. The insecticides planned for use are (list all active ingredients anticipated for use): Any person desiring to present their views to the Department of Ecology regarding this application may do so in writing within 30 days of the last date of publication of this notice. Comments must be submitted to the Department of Ecology. Any person interested in the Department's action on the application may notify the Department of their interest within 30 days of the last date of publication of this notice. Submit comments to: Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia,WA 98504-7600 Aquatic Mosquito Control General Permit—May 19, 2010 Page 33 APPENDIX E: SECTION S5 IMM PLAN CRITERIA EXAMPLES This appendix provides examples of criteria that may be used to meet IMM planning requirements listed in Section S5. These examples cover the sections that have many possible options for meeting the requirements. Other possible options may be available. C. Surveillance Examples of adult mosquito surveillance include,but are not limited to: • Complaints • Historical data(e.g. mapping from previous seasons) • Landing counts • Mosquito population density • Mosquito trapping(e.g. female mosquito counts) • Mosquito identification • Service requests • Staff observation Mosquito-borne disease surveillance may also include,but is not limited to: • Avian morbidity/mortality and disease testing • Community involvement(e.g. reporting of dead birds, horse disease cases, etc) • Animal disease case monitoring • Historical disease data • Human disease case monitoring • Live bird surveillance(captive or free-range sentinel birds) • Mosquito trapping, identification, and disease testing • RAMP testing for West Nile Virus from Response Biomedical Corporation • VecTest for West Nile virus, St. Louis Encephalitis,Western Equine Encephalitis from Medical Analysis Systems, Inc. • State,university, commercial lab testing(e.g. PCR testing) D. Mapping Examples of what may be included in a mapping system include,but are not limited to: • Mosquito surveillance data • Mosquito breeding sites • Mosquito population trends • Where and what mosquito control measures are implemented • Mosquito-borne disease surveillance data • Organic farm locations • Locations of chemically sensitive individuals, • No-Spray request locations Aquatic Mosquito Control General Permit—May 19, 2010 Page 34 E. Action Thresholds Examples of action thresholds include,but are not limited to: • Mosquito population densities (e.g. community accepted mosquito population density levels) • Larval counts (e.g. dip counts— 1 larval in three dips) • Routine adult mosquito control thresholds based on surveillance • Actions when surveillance indicates a threat of disease outbreak. • Actions during a mosquito-borne disease outbreak. F. Mosquito Control Methods 1. Physical Control or Source Reduction Examples include, but are not limited to: • Habitat modification—public and private lands(e.g. ditch and impoundment maintenance) • Vegetation Management • Sanitation(cleaning gutters,bird baths, unused swimming pools, etc) • Water holding container cleanup (e.g. tire pile removal) • Water management(e.g. irrigation water, stormwater run-off) • Regional water management projects(e.g. proactive collaboration with public and/or private landowners, wastewater treatment facilities, etc) 2. Biological Control Examples include, but are not limited to: • Stocking of native or non-native fish species. • Terrestrial predator(e.g. bird, bat, and predatory insect) habitat creation and/or restoration. • Aquatic predator(e.g. dragonfly naiads, diving beetles, etc)habitat restoration/creation. 3. Pesticide-Based Larval Mosquito Control Larvicides allowed for use are listed in S4.A. 4. Pesticide-Based Adult Mosquito Control Adulticides allowed for use are listed in S4.13. I. Education and Outreach Aquatic Mosquito Control General Permit—May 19, 2010 Page 35 Examples of what may be included in education and outreach include,but are not limited to: • Fairs • Workshops for community • Education materials • Web site • Presentations J. New Staff Training and Continuing Training for Existing Staff Examples of what may be included in a training program include,but are not limited to: • Employee training manual or program • Employee quick reference guides • New employees work with experienced employees • Conferences • Training classes • WSDA pesticide licensing Aquatic Mosquito Control General Permit—May 19, 2010 Page 36 Denis Law City Of Mayor 1 Y N t0 Public Works Department-Gregg Zimmerman,P.E.,Administrator December 1, 2014 Washington State Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager PO Box 47600 Olympia, WA 98504 RE: Aquatic Mosquito Control General Permit Coverage Renewal (No. WAG992028) Dear Aquatic Pesticide Permit Manager: Attached is a signed Notice of Intent for renewal of the City's Aquatic Mosquito Control General Permit No. WAG992028. If you have any questions, please call me at 425-430-7247 or email me at aguynn@rentonwa.gov. Sincerely, Allen Quynn, E. Surface �Iater Utility Engineer i Enclosure H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Permit Coverage Renewal Cover Letter.docx\AQtp Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov PUBLIC WORKS DEPARTMENT D City of M E M O R A N D U M DATE: November 17, 2014 TO: Gregg Zimmerman, Public Works Administrator FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Allen Quynn, Surface Water Engineer, x7247 SUBJECT: Aquatic Mosquito Control General Permit Reissuance The City received notice from the Washington State Department of Ecology (Ecology) that its Aquatic Mosquito Control General Permit (permit) will expire in June 2015. Ecology issued the permit to the City in 2010. Although the five-year permit will expire in June of 2015, Ecology requires that permit holders submit an updated permit application, entitled Notice of Intent, by December 15, 2014, in order for the City's coverage to continue under the next permit cycle. The City applied for and was issued the permit as part of its annual Mosquito Abatement Program. The permit is required when the treatment of mosquitoes results in the discharge of Ecology approved larvicides and adulticides to waters of the state. In accordance with General Condition G15 of the permit, applications, reports or information submitted by a municipality shall be signed by a principal executive officer or ranking elected official. Please sign the Application for Coverage - Notice of Intent certifying that it was prepared by qualified personnel who properly gathered and evaluated the information submitted, and that the information is true, accurate, and complete. Please return the signed document to Allen Quynn, Surface Water Utility, for submission to the Department of Ecology. Attachment H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Permit Renew Memo.doc\AQtp Mosquito General Permit - Print Page 1 of 3 `Y Application for Coverage Aquatic Mosquito Control General Permit Notice of Intent w a s h I h s r o h s i n I g To comply with the terms of the statewide general permit for discharges of aquatic � EFaeTN ; nr � c py 9 P 9 q E C 0 l 0 G Y pesticides to control mosquito larvae to surface waters of the state Permit Number: WAG992028 I. Permittee Name of Entity: City of Renton Are you a commercial pest control business? Yes No II. Mailing and Contact Information Contact Name: Allen Quynn Mailing Address: 1055 S. Grady Way City: Renton ZIP: 98057 County: King E-Mail Address: aquynn@rentonwa.gov Daytime Phone: 425-430-7247 Cell Phone: III. Chemical Information Anticipated Pesticides to be Used Bacillus sphaericus IV. Regulatory Status Department of Agriculture Pesticide Applicator License number 374 Department of Agriculture Pesticide Applicator License expiration date 12/31/2015 Licensee has a Public Health Pest Control, Aquatic Pest Control, or a Statewide category endorsement or will be supervised by someone with one of these endorsements. `/ My renewal has been satisfied and will remain current. https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 2 of 3 .� V. Spill Kit Do you have a complete and up-to-date kit? st Yes _.'No VI. Project and SEPA Information Project Type: City Project Name: Mosquito Abatement Program Provide a description (such as legal description of boundaries and maps) of the project. You may include attachments with your application if you need more room. Talbot Hill area, near the Panther Creek wetlands and City owned drainage facilities Is SEPA review been completed? Yes No Type of SEPA Determination: Mitigated DNS (MDNS) Agency issuing DNS, MDNS, or Final EIS: City of Renton Determination Date: 03/29/2010 If Ecology will be the lead agency for the SEPA determination, attach a completed and signed SEPA checklist to this NOI. VII. Public Notice The public notice must be published at least once each week for two consecutive weeks, in a single newspaper that has general circulation in the county in which the project is to take place. See the NOI instructions for the public notice language requirements. Permit coverage will not be granted sooner than 31 days after the date of the second public notice. Note: This NOI must be submitted to Ecology on or before the date of the first public notice. Provide the exact dates for the first and second public notices will appear in the newspaper: First Public Notice Date: 09/26/2014 Second Public Notice Date: 10/03/2014 Newspaper publishing the public notice: Renton Reporter VIII. Certification "I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." Printed name o ermittee Gregg Zimmerman Signature 7?4 Date )L Sign and return this document to the address below. For questions call(360) 407-6283 https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 3 of 3 Washington Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504 Washington State use ONLY Permit Number Ecology Region Date Received Coverage Date https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page I of 3 'Y Application for Coverage Aquatic Mosquito Control General Permit Notice of Intent µ a s u ;h s 1 o n I a i To comply with the terms of the statewide general permit for discharges of aquatic oE � aRrNEr; r of py g p g q E C U L 0 G y pesticides to control mosquito larvae to surface waters of the state Permit Number: WAG992028 I. Permittee Name of Entity: City of Renton Are you a commercial pest control business? _'Yes ;No II. Mailing and Contact Information Contact Name: Allen Quynn Mailing Address: 1055 S. Grady Way City: Renton ZIP: 98057 County: King E-Mail Address: aquynn@rentonwa.gov Daytime Phone: 425-430-7247 Cell Phone: III. Chemical Information Anticipated Pesticides to be Used Bacillus sphaericus IV. Regulatory Status Department of Agriculture Pesticide Applicator License number 374 Department of Agriculture Pesticide Applicator License expiration date 12/31/2015 Licensee has a Public Health Pest Control, Aquatic Pest Control, or a Statewide category endorsement or will be supervised by someone with one of these endorsements. My renewal has been satisfied and will remain current. https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 2 of 3 V. Spill Kit Do you have a complete and up-to-date kit? Yes No VI. Project and SEPA Information Project Type: City Project Name: Mosquito Abatement Program Provide a description (such as legal description of boundaries and maps) of the project. You may include attachments with your application if you need more room. Talbot Hill area, near the Panther Creek wetlands and City owned drainage facilities Is SEPA review been completed? V Yes No Type of SEPA Determination: Mitigated DNS (MDNS) Agency issuing DNS, MDNS, or Final EIS: City of Renton Determination Date: 03/29/2010 If Ecology will be the lead agency for the SEPA determination, attach a completed and signed SEPA checklist to this NOI. VII. Public Notice The public notice must be published at least once each week for two consecutive weeks, in a single newspaper that has general circulation in the county in which the project is to take place. See the NOI instructions for the public notice language requirements. Permit coverage will not be granted sooner than 31 days after the date of the second public notice. Note: This NOI must be submitted to Ecology on or before the date of the first public notice. Provide the exact dates for the first and second public notices will appear in the newspaper: First Public Notice Date: 09/26/2014 Second Public Notice Date: 10/03/2014 Newspaper publishing the public notice: Renton Reporter VIII. Certification "I certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." Printed name of permittee Signature Date Sign and return this document to the address below. For questions call (360) 407-6283 https://seeureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 PUBLIC WORKS DEPARTMENT D 0���O� 0A I T it 14 IT�T M E M O R A N D U M OATP I ( AlS*MIE " I IA A c DATE: November 17, 2014 S TO: Gregg Zimmerman, Public Works Admini tra or "� I FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Allen Quynn, Surface Water Engineer, x7247 SUBJECT: Aquatic Mosquito Control General Permit Reissuance The City received notice from the Washington State Department of Ecology (Ecology) that its Aquatic Mosquito Control General Permit (permit) will expire in June 2015. Ecology issued the permit to the City in 2010. Although the five-year permit will expire in June of 2015, Ecology requires that permit holders submit an updated permit application, entitled Notice of Intent, by December 15, 2014, in order for the City's coverage to continue under the next permit cycle. The City applied for and was issued the permit as part of its annual Mosquito Abatement Program. The permit is required when the treatment of mosquitoes results in the discharge of Ecology approved larvicides and adulticides to waters of the state. In accordance with General Condition G15 of the permit, applications, reports or information submitted by a municipality shall be signed by a principal executive officer or ranking elected official. Please sign the Application for Coverage - Notice of Intent certifying that it was prepared by qualified personnel who properly gathered and evaluated the information submitted, and that the information is true, accurate, and complete. Please return the signed document to Allen Quynn, Surface Water Utility, for submission to the Department of Ecology. Attachment H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP(\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Permit Renew Memo,doc\AQtp PUBLIC WORKS DEPARTMENT loolciq,of M E M O R A N D U M DATE: November 17, 2014 TO: Gregg Zimmerman, Public Works Administrator FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Allen Quynn, Surface Water Engineer, x7247 SUBJECT: Aquatic Mosquito Control General Permit Reissuance The City received notice from the Washington State Department of Ecology (Ecology) that its Aquatic Mosquito Control General Permit (permit) will expire in June 2015. Ecology issued the permit to the City in 2010. Although the five-year permit will expire in June of 2015, Ecology requires that permit holders submit an updated permit application, entitled Notice of Intent, by December 15, 2014, in order for the City's coverage to continue under the next permit cycle. The City applied for and was issued the permit as part of its annual Mosquito Abatement Program. The permit is required when the treatment of mosquitoes results in the discharge of Ecology approved larvicides and adulticides to waters of the state. In accordance with General Condition G15 of the permit, applications, reports or information submitted by a municipality shall be signed by a principal executive officer or ranking elected official. Please sign the Application for Coverage - Notice of Intent certifying that it was prepared by qualified personnel who properly gathered and evaluated the information submitted, and that the information is true, accurate, and complete. Please return the signed document to Allen Quynn, Surface Water Utility, for submission to the Department of Ecology. Attachment H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Permit Renewal\Permit Renew Memo.doc\AQtp Mosquito General Permit - Print Page 1 of') `Y Application for Coverage Aquatic Mosquito Control General Permit Notice of Intent 11 a s i u n .0 i ; To comply with the terms of the statewide general permit for discharges of aquatic sE � aq � N � r� T of E C U L U G Y pesticides to control mosquito larvae to surface waters of the state Permit Number: WAG992028 I. Permittee Name of Entity: City of Renton Are you a commercial pest control business? Yes No II. Mailing and Contact Information Contact Name: Allen Quynn Mailing Address: 1055 S. Grady Way City: Renton ZIP: 98057 County: King E-Mail Address: aquynn@rentonwa.gov Daytime Phone: 425-430-7247 Cell Phone: III. Chemical Information Anticipated Pesticides to be Used Bacillus sphaericus IV. Regulatory Status Department of Agriculture Pesticide Applicator License number 374 Department of Agriculture Pesticide Applicator License expiration date 12/31/2015 Licensee has a Public Health Pest Control, Aquatic Pest Control, or a Statewide category endorsement or will be supervised by someone with one of these endorsements. My renewal has been satisfied and will remain current. https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 2 of 3 V. Spill Kit Do you have a complete and up-to-date kit? Yes No VI. Project and SEPA Information Project Type: City Project Name: Mosquito Abatement Program Provide a description (such as legal description of boundaries and maps) of the project. You may include attachments with your application if you need more room. Talbot Hill area, near the Panther Creek wetlands and City owned drainage facilities Is SEPA review been completed? J Yes No Type of SEPA Determination: Mitigated DNS (MDNS) Agency issuing DNS, MDNS, or Final EIS: City of Renton Determination Date: 03/29/2010 If Ecology will be the lead agency for the SEPA determination, attach a completed and signed SEPA checklist to this NOI. VII. Public Notice The public notice must be published at least once each week for two consecutive weeks, in a single newspaper that has general circulation in the county in which the project is to take place. See the NOI instructions for the public notice language requirements. Permit coverage will not be granted sooner than 31 days after the date of the second public notice. Note: This NOI must be submitted to Ecology on or before the date of the first public notice. Provide the exact dates for the first and second public notices will appear in the newspaper: First Public Notice Date: 09/26/2014 Second Public Notice Date: 10/03/2014 Newspaper publishing the public notice: Renton Reporter VIII. Certification "1 certify under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Unless the Department of Ecology Permit has more stringent requirements, all FIFRA label directions and requirements will be followed." Printed name Of ermittee Gregg Zimmerman 711 Signature Date Sign and return this document to the address below. For questions call(360) 407-6283 https://secureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 3 of 3 Washington Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504 Washington State use ONLY Permit Number Ecology Region Date Received Coverage Date https:Hsecureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Mosquito General Permit - Print Page 3 of 3 Washington Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit Manager P.O. Box 47600 Olympia, WA 98504 Washington State use ONLY Permit Number Ecology Region Date Received Coverage Date https:Hsecureaccess.wa.gov/ecy/wgmosquito/PrintPermit.aspx 11/12/2014 Debra Mikolaizik From: Allen Quynn Sent: Thursday, May 15, 2014 8:36 AM To: Debra Mikolaizik Subject: File Folder For SWP-27-2000 Hi Debra, Could you please provide me a 2"file folder for Project File Number SWP-27-2013. Please include on the label: "2014 Mosquito Abatement Program" Label can be side mounted. Let me know if you have any questions. Thanks, Allen 1 S PATE A r. v d — x RECEIVED 1859� STATE OF WASHINGTON DEPARTMENT OF ECOLOGY SEP 0 8 2014 PO Box 47600 • Olympia, WA 98504-7600 •360-407-6000 711 for Washington Relay Service • Persons with a speech disability can call 877-833-QViY OF RENTON UTILITY SYSTEMS September 5, 2014 Mr. Allen Quynn City of Renton Renew your permit coverage by: 1055 S Grady Wa December 15, 2014 Renton, WA 98057 RE: Renew Your Permit Coverage, No. WAG992028, under the Aquatic Mosquito Control General Permit by December 15,2014 Dear Mr. Quynn: The Washington Department of Ecology(Ecology) issued the Aquatic Mosquito Control General Permit(permit) in 2010. It expires in June of 2015. Ecology will be starting the process to update and reissue the permit soon. Action on your part is necessary to ensure your coverage remains uninterrupted and continues under the next version of the permit. In order to ensure your coverage continues, you will need to submit an updated permit application(renewal application) to Ecology. Ecology must receive your renewal application by December 15, 2014, 180 days before the current permit expires, in order for your coverage to continue under the next version of the permit. To update your permit application: 1. Log into your Secure Access Washington(SAW) account and access your online permit application. SAW may be accessed here: https://secureaccess.wa.gov/. 2. Update the information contained in the application as necessary. 3. Once you are finished with your updates, click the "Update Application"button at the bottom of the application. This will generate a form that you need to print and sign. 4. Send your completed and signed renewal application to: Department of Ecology, Water Quality Program, Attn: Jon Jennings, PO Box 47600, Olympia, WA 90504. ®< AD Allen Quynn September 5, 2014 Page 2 Failure to submit your renewal application will result in your permit coverage expiring on June 18,2015,when the general permit expires. If this occurs, you will need to reapply for permit coverage as a new applicant(including meeting public notice and comment period requirements) and be issued permit coverage again before applying larvicides or adulticides. If you have questions about the permit renewal process or need assistance,please contact me at jonathan Jennings@ecy.wa.gov or(360) 407-6283. Sincerely, Jonathan"Jon"Jennings Permit Writer Water Quality Program Washington State Department of Ecology Printed: Jul 14,2014 Wastewater Permit Invoice D E P R^�R T N O ER N i i A 0 F �'l' 2 E C O L O G Y lll��-///1111IAVVJ J RENTON,CITY OF Invoice#: 2015-WAG992028 Attn:DENIS LAW Permit: WAG992028 1055 S GRADY WAY U (oC�r:�� �/' ' (/� Fee Type: Wastewater RENTON,WA 98057 Category: Aquatic Pest Control-Mosquito Control Districts Date Description Annual Fee Amount Billed'' Amount Paid Amount Due Due Date 07/14/2014 Annual Fee Amount $496.00 $0.00 $0.00 $0.00 07/14/2014 Billing Amount $0.00 $496.00 $0.00 $496.00 08/28/2014 Total Annual Fee: $496.00 $496.00 — $0.00 This invoice covers Fiscal Year 2015(July 1,2014,through June 30,2015). • An annual fee will no longer be assessed once the permit has been canceled by Ecology. However,the full annual amount will be owed for the current fiscal year regardless of the permit termination date within that fiscal year. ECOLOGY DOES NOT PRORATE FEES FOR PERMIT TERMINATIONS. • Delinquent accounts will be turned over for collection and a 20%surcharge will be added to the amount owed. This surcharge is Ecology's cost for the collection action. • Small business/extreme hardship fee reduction application requests can be found at the following web address: http://www.ecy.wa.gov/programs/Wq/pen-nits/permit fees/PermitFeeForms.html • Questions regarding the permit fee assessment should be directed to:Bev Poston at 360/407-6425 or via email to l eo JUL 18 2014 CITY OF RENTON 1,1TUTY SYSTEMS Please send check or money order payable to: (DO NOT SEND CASH!) Department of Ecology Cashiering Unit PO Box 47611 Olympia WA 98504-7611 7/14/2014 2:37:48PM986.00 Detach and return this portion with your check. PLEASE INCLUDE THE INVOICE NUMBER ON YOUR CHECK. Printed: Jul 14,2014 Wastewater Fee Billing Notice Past Due Amount This Fiscal Year: $0.00 Current Amount Due: _ $496.00 Total Amount Due: $496.00` This Amount Due By 08/28/2014 RENTON,CITY OF Invoice#: 2015-WAG992028 Attn:DENIS LAW Permit: WAG992028 1055 S GR.ADY WAY Coding: 176 - WWD - 02-86-000196 RENTON,WA 98057 ECY 010-72b (6/99) CAG-13-106, Adden #1-14 FORM: ADD-2010 ADDENDUM NO. 1 to CAG-13-106 CONSULTANT CONTRACT FOR ENTOMOLOGIST/PEST CONTROL AGENT SERVICES for 2013-2014 MOSQUITO ABATEMENTPROGRAM This Addendum is made and entered into this o27 day of 12014, by and between the City of Renton, hereinafter called the "City", and Whitworth 4st Solutions, Inc., whose address is 2533 Inter Ave., Puyallup, WA 98372-3428, hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS,the City engaged the services of the Consultant under Consultant Agreement CAG-13-106 dated May 22, 2013, to provide entomologist/pest control agent services for the 2013- 2014 Mosquito Abatement Program; and WHEREAS,the 2013 Mosquito Abatement Program has been completed in accordance with the original agreement; and WHEREAS,the City desires that the Consultant provide the services identified in the attached Exhibit A for the 2014 Mosquito Abatement Program. NOW,THEREFORE, in accordance with Section VIII- Extra Work of the original Agreement CAG-13-106, dated May 22, 2013, it is mutually agreed upon that Consultant Agreement CAG-13-106 is amended as follows: 1. The scope of work for the 2014 Mosquito Abatement Program shall be as set forth in Exhibit A of this addendum. 2. Payment for the work defined in Exhibit A shall be at the rates set forth in Exhibit C of this addendum. Payment for services rendered in 2014 shall not exceed $78,938.56 without a written amendment to the contract, agreed to and signed by both parties, All other provisions of Consultant Agreement CAG-13-106 dated May 22, 2013, apply to this addendum. EXECUTION IN WITNESS WHEREOF,the parties have executed this Addendum No. 1 to CONSULTANT AGREEMENT CAG-13-106 as of the day and year first above written. WHITWORTHP ST OLUTIONS Cl CI YOF ENTON pF RF�� 5 Signature VQis Law,Mayor Date %/� ��1 = _* 'r1 ITTEST: Type or Print Name Title Bonnie I. Walton, City Clerk H:Tile Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Contracts\2014 Addendum 1.doc EXHIBIT A SCOPE OF WORK 2014 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05-022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label, the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City Page 1 of 12 Pia zza/Data_Cente r/forms/City/Contra cts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name Vectol-ex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Stonegate/WQ Pond NE 26th and Lyons Ave 2 Surface Water Utility NE 10th St Pond/Detention NE 10th St and Anacortes Ave 3 Surface Water Utility Talbot Ridge 2/WQ Pond S 47th St`and 102"d Ave SE 4 Surface Water Utility Talbot Estates/Pond Talbot Rd S 5 Surface Water Utility Olympic Peak Estates/Pond S. 196th'PL 6 Surface Water Utility Larson Parke/Pond 112th Ave SE 7 Surface Water Utility Watershed Terrace/Pond SE 200th St 8 Surface Water Utility Wilkens Wood/Pond 113th Ave SE 9 Surface Water Utility Serenity Ridge Tract A/Pond 110th PL SE 10 Surface Water Utility Serenity Ridge Tract B/Pond 110th PL SE 11 Surface Water Utility Auria Woods Tract C/Pond SE 186thSt 12 Surface Water Utility SR-169/Pond 140th Way SE 13 Surface Water Utility Fredericks Place/Pond SE 186th St 14 Surface Water Utility Aster Park/Pond NE 13th PL 15 Surface Water Utility Hamilton Place/Pond 160th Ave SE 16 Surface Water Utility Evendell/Pond 160th Ave SE 17 Surface Water Utility Nichols Place/Pond 160th Ave SE/SE 5th St I Ne, . ... ... .... 18 Surface Water Utility Ellis Park 124th St. SE/ 149th Ave. SE. 19 Surface Water Utility Windsor circle 13502 162"d AveSE 20 Surface Water Utility Heritage Renton Hill S 7th St./S 7th Ct. 21 Surface Water Utility Amberwood 6001 Ne 4"St. 22 Surface Water Utility Maureen Highlands 6118 Ne 4th St. 23 Surface Water Utility Sienna 250 Jericho Ave NE. 24 Surface Water Utility Brookefield II 1100 Hoquiam Ave NE 25 Surface Water Utility Shy Creek 129 Jericho Ave NE 26 Surface Water Utility Aspen Woods 864 and 852 Hoquiam Ave NE 27 Surface Water Utility Amberwood 11 6135 NE 41h St. 28 Surface Water Utility Morning Glen 176Th St. and 114th PI SE 29 Surface Water Utility Chinquapin Ridge ' SE 192°a and_113 St.SE 30 Surface Water Utility Pioneer Place Maple Valey Rd and 149th Ave SE 31 Surface Water Utility Highland Estates SE 136th St and 152"d Ave SE 32 Surface Water Utility Jericho Plat Intersection of Jericho Ave NE And NE 4th St Extending West To Hoquiam Ave NE 33 Surface Water Utility Liberty Grove and Liberty Grove SE 1361h,St and.r160th Ave SE. Contiguous 34 Surface Water Utility Highpointe II 3722 NE 12th St Page 2 of 12 Piazza/Data_Center/Forms/City/Contracts 35 Surface Water Utility Laurelhurst Phase I Duval Ave_and,,NE Vt.:St ; :M 36 Surface Water Utility Parkside Court Lions Ave and SE 2°d PI E - : 37 Surface Water Utility Emma's SE 1st Place fronting Lyons Ave NE 38 Surface Water Utility Reserve'at Stonehaven,,111 S 47tn St and Main Ave S 39 Surface Water Utility Sunnybrook Plat 3721 Morris Ave S 40 Surface Water Utility Winsper(Libertyview Phase I`i& S. 32"d Stand Talbot 11) 41 Surface Water Utility Kimberly Lane 17228 125th Ave SE 42 Surface Water Utility Maple Glen Addition SE 182"d Stand 108th Ave S;E 43 Surface Water Utility Christian Short Plat 11129 SE 189th PI 44 Surface Water Utility Greenfield II (Highpointe If) 1318 Redmond PI NE 45 Surface Water Utility Windsong Field PI NE and NE 4th PI 46 'Surface Water Utility Liberty Ridge Phase 2 NE 1StSt and Glennwood Ave SE. 47 Surface Water Utility Liberty Ridge Phase 1 2511 NE 15t St (behind residence) 48 Surface Water Utility Liberty Ridge Phase 1 Index Ave SE and SE 1st St 49 Surface Water Utility Elmhurst Whitman PI NE and NE 2"d Ln 50 Surface Water Utility Zetterberg Burnett PI S and S'215t St 51 Surface Water Utility Magnussen Plat Field Ave NE and NE 2nd St 52 Surface Water Utility Magnussen Plat 4814 NE 2dn St (behind residence) 53 Surface Water Utility Cottages at Honey Creek NE Sunset Blvd and Elma PI NE 54 Surface Water Utility Highlands Park Rosario PI SE and SE 2"d PI 55 Surface Water Utility Shamrock Glen (aka Martin Lyons PI NE and NE 5th Cir Prop) 56 Surface Water Utility Beclan Place Plat Hoquiam Ave NE and NE 2"d St 57 Surface Water Utility NE 4th Detention Field Ave NE and NE 2nd PI 58 Surface Water Utility Catch Basins Various 59 Golf Course Hole #18 Pond/Irrigation Maplewood Golf Course (west) 60 Golf Course Hole 1#9 Pond/irrigation Maplewood Golf Course (west- central) 61 Golf Course Hole #7 Pond/Irrigation Maplewood Golf Course (east- central) 62 Golf Course Hole #6 Pond/Irrigation Maplewood Golf Course (east) 63 Golf Course Catch Basins Various 64 Parks Maintenance Catch Basins Various Division 65 1 Facilities Division City Hall/WQ Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Page 3 of 12 Pia zza/Data_Ce nter/Form s/City/Contracts Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip).- 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course—Whitworth Pest Solutions, Inc. shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 12 P iazza/Data_Center/Fo rms/City/Co ntracts EXHIBIT B TIME OF COMPLETION 2014 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2014. Page 5 of 12 Piazza/Data_Center/Forms/City/Contracts EXHIBIT C COST ESTIMATE 2014 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The estimated total cost of Task 1 including Washington States sales tax is $19,315.80. The cost shall include all necessary work for 21 treatments including clearing of the trails. Work conducted in performance of Task 1 will be billed at the following rates: For 12 or more total treatments: $840/treatment For 6 to 11 total treatments: $890/treatment For 1 to 5 total treatments: $990/treatment The billing rates include state sales tax. Subtotal Contract Cost: $17,640.00 State Sales Tax (9.5%) $1,675.80 Total Cost Task 1: $19,315.80 TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is $59,622.76. The cost shall be based on a rate of$125.00 per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under "Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. Below is the estimated contract cost for the three City divisions, based on the billing rate of$125.00 per manhour for a total of 1W manhours: u3S.w Surface Water Utility Costs Stormwater facilities: 57 Total number of treatments per stormwater facility: 8 Page 6 of 12 Piazza/Data_Center/Forms/City/Contracts Total manhours per stormwater facility (including travel time): 0.6 hrs Total stormwater facility manhours: 273.60 hrs Subtotal cost for stormwater facilities: $34,200.00 Sales Tax (9.5%): $3,249.00 Total cost for stormwater facilities: $37,449.00 Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $7,500.00 Sales Tax (9.5%): $712.50 Total cost for catch basin treatment: $8,212.50 Total manhours (stormwater facilities + catch basins): 333.60 hrs Subtotal cost (stormwater facilities + catch basins): $41,700.00 Sales Tax (9.5%): $3,961.50 Total cost (stormwater facilities + catch basins): $45,661.50 Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility (including travel time): 1 hr Total irrigation facility manhours: 32 hrs Subtotal cost for irrigation facilities: $4,000.00 Sales Tax (9.5%): $380.00 Total cost for irrigation facilities: $4,380.00 Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $375.00 Sales Tax (9.5%): $35.63 Total cost for catch basin treatment: $410.63 Total manhours (irrigation facilities + catch basins): 35 hrs Subtotal cost (stormwater facilities + catch basins): $4,375.00 Sales Tax (9.5%): $415.63 Total cost (stormwater facilities + catch basins): $4,790.63 Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Page 7 of 12 Piazza/Data_Center/Forms/City/Contracts Subtotal cost for catch basin treatment: $7,625.00 Sales Tax (9.5%): $724.38 Total cost for catch basin treatment: $8,349.38 Total manhours (irrigation facilities + catch basins): 61 hrs Subtotal cost (stormwater facilities + catch ba.sins): $7,625.00 Sales Tax (9.5%): $724.38 Total cost (stormwater facilities + catch basins): $8,349.38 Facilities Division Costs Stormwater facilities: 1 Total number of treatments per facility: 8 Total manhours per stormwater facility (including travel time): 0.75 hrs Total stormwater facility manhours: 6 hrs Subtotal cost for stormwater facilities: $750.00 Sales Tax (9.5%): $71.25 Total cost stormwater facilities: $821.25 Catch Basin: 0 Total manhours (stormwater facilities + catch basins): 6 hrs Subtotal cost (stormwater facilities + catch basins): $750.00 Sales Tax (9.5%): $71.25 Total cost: $821.25 Total Contract Cost for all Divisions: $56,850.00 State Sales Tax (9.5%): $5,400.76 Total Cost Task 2: $59,622.76 B. Total Contract Cost (Task 1 +Task 2): $78,938.56 C. Invoicing Whitworth Pest Solutions, Inc. shall submit all invoices to the City of Renton Surface Water Utility Section. Invoices shall include the division (Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division) for which the service was provided under this project. Payment cannot be authorized or payment may be delayed until the invoices include the division to which the service was provided. Page 8 of 12 Piazza/Data_Cen ter/Forms/City/Contracts COST PLUS NET FEE DETERMINATION DIRECT SALARY COST: Hourly Rates of Pay Personnel Pesticide applicator 17.50-26.25 Bookkeeper 23.43 Department Manager 29.95 Cars at$ n/a /mile Per Diem na Reproduction Expenses @ $ fcopy ............................................................$ Communications ......................................................................................................$ Page 9 of 12 Piazza/Data_Cente r/Forms/City/Contracts r EXHIBIT C(cont.) SUMMARY OF FEE FOR ENGINEERING SERVICES BREAKDOWN OF OVERHEAD COST ProfitSharing............................................................................................................ 1 % FICA.......................................................................................................................... 3.8 Unemployment Compensation................................................................................ 1.1 % Medical Aid and Industrial Insurance....................................................................... 2.1 Company Insurance and Medical............................................................................. 1.7 % Vacation, Holiday and Sick Leave.............................. ° State B &O Tax& Other Business Tax..................................................................... 0.8 % Insurance.................................................................................................................. 2.7 Administration and Time Unassignable................................................................... 5.1 Printing, Stationery and Supplies............................................................................. 0.9% TravelNot Assignable............................................................................................... % Telephone and Telegraph Not Assignable ............................................................... 0.8% Fees, Dues, Professional.Meetings........................................................................... 0.3 % Utilities and Maintenance........................................................................................ 0.5% Rent.......................................................................................................................... 6.3% RentalEquipment..................................................................................................... % Office Miscellaneous, Postage ................................................................................. 0.4% Professional Services................................................................................................ 0.6 6994.00 TOTAL 31 % SUMMARY OF COSTS Project No. Name of Project_2013 Mosquito Abatement Program DirectSalary Cost........................................................................................................................$_7868. 00_ Overhead Cost (including payroll additives........................................................................... % $_6994.00_ Sub-Total $14862.00. NetFee.............................................................................................................. % $_7638.00 ........................................................................................................................ 51 Direct Non-Salary Costs: a. Milleage,travel and per diem.................................$_11250.00 b. Computer expense.................................................$ c. Scanning and faxing services..................................$ d. ................................................................................$ e. Other(specify)........................................................$ Total $ 11250.00 Sub Total $ 14862.00 Page 10 of 12 Piazza/Data_Center/Forms/City/Contracts PUBLIC WORKS DEPARTMENT 001city of M E M O R A N D U M DATE: r (\ E ITIA4. TE DATE: May 28, 2014 ,y TO: Denis Law, Mayor FROM: Gregg Zimmerman, Administrator I-Y\ STAFF CONTACT: Ronald Straka, Surface Water Utility Manager, x724 Allen Quynn, Surface Water Utility Engineer, x7247 SUBJECT: Addendum No. 1 to CAG-13-106, 2013-2014 Mosquito Abatement Program with Whitworth Pest Solutions, Inc. Please sign and execute Addendum No. 1 to the 2013-2014 Mosquito Abatement Program contract (CAG-13-106), in the amount of$78,938.56, with Whitworth Pest Solutions, Inc. authorizing Whitworth Pest Solutions, Inc., as a sole-source provider of the 2014 Mosquito Abatement Program to apply adulticide in the areas upland and east of the Panther Creek Wetlands (Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities and catch basins for the control of mosquitoes. cf. 1 t'1,(;e,fi .M I A? I/,ru Whitworth ha been the sole-source provider of pest control consultant services for the City's mosqui o abatement efforts since 1990. Whitworth is the only known, qualified provider of this type of service and is familiar with the overall project area, including the areas where mosquitoes tend to congregate; e.g., access trails, wetlands, springs and adjacent residences. Whitworth also has an experienced entomologist on staff to provide assistance in responding to public inquiries. Last year, Washington had one human case which contracted the virus outside of the state. In addition, there were two horse/mammal cases, 18 positive mosquito samples and no bird cases. This compares to four human cases (two contracted the virus outside of the state), one horse/mammal case and five positive mosquito samples in 2012. In an effort to reduce the risk of human infection, the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment and adulticide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Department of Ecology. Denis Law,Mayor Page 2 of 3 May 28,2014 The total expenditure required for the Pudces 4 Mosquito Abatement Program contract Addendum No. 1 is $78,938.56 and inc the following tasks: Task 1 Treatment of Upland Areas Adjacent to Panther Creek Wetlands Whitworth will apply an Environme tal Protection Agency registered insecticide spray to brush and other upland vegetatio , using a gasoline-powered, backpack-mounted, portable fogger. The applicatio will be conducted at a maximum frequency of twice per week during the months o May through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit, and other federal and state regulations. The cost for adulticiding the areas upland and east of the Panther Creek wetland area is $19,315.80 and will be funded through the approved 2014 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$75,000. Task 2 (Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins) Larvicide treatment is scheduled to begin July 2014 and will continue for the duration of the mosquito season, which typically extends through the end of September. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities and catch basins. These facilities and catch basins are owned and maintained by the Surface Water Utility, and the Community Services Department's Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile virus in King County. The total cost to treat City stormwater and irrigation facilities and catch basins is $59,622.76 and will be funded as follows: Surface Water Utility: Larvicide treatment will be funded through the approved Surface Water Utility 2014 Capital Improvement Program budget for the 2014 Mosquito Abatement Program. The approved budget for the Mosquito Abatement Program is ,000 (Account No. 427.475020). The estimated cost to treat the stormwater facil�ti "sand catch basins with larvicide is $45,661.50. The remaining balance in the project account of$54,338.50 will be used to complete Task 1 ($19,315.80) leaving a balance of$35,022.70 for City staff time to administer both tasks. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\2014 Memo to Mayor Addendum No. l.doc\AQtp s Denis Law,Mayor Page 3 of 3 May 28,2014 Maplewood Golf Course: Larvicide treatment will be funded through the 2014 Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, and catch basins with larvicide is $4,790.63. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $4,790.63. Parks Division: Larvicide treatment will be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $8,349.38. Facilities Division: Larvicide treatment will be funded through the 2014 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $821.25. Attachments cc: Terry Higashiyama,Community Services Administrator Lys Hornsby,Utility Systems Division Director Kelly Beymer,Parks and Golf Course Director Greg Stroh,Facilities Maintenance Manager File H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\2014 Memo to Mayor Addendum No.1.doc\AQtp Allen Quynn From: Gregory E Stroh Sent: Thursday, May 22, 2014 2:31 PM To: Allen Quynn; Kelly Beymer Subject: RE: Addendum to 2013-2014 Mosquito Abatement Program Contract(CAG-13-106) Hi Allen, I have reviewed the documents and have no comments or concerns. Best Regards, Greg Stroh Facilities/Project Manager Community Services Department Phone:425-430-6614 Cell:425-766-6162 mailto:gstroh@rentonwa.gov From: Allen Quynn Sent: Thursday, May 22, 2014 11:39 AM To: Kelly Beymer; Gregory E Stroh Subject: Addendum to 2013-2014 Mosquito Abatement Program Contract (CAG-13-106) Hi Kelly/Greg: Please review and provide any comments on the attached contract addendum No. 1, Scope of Work, Schedule, Budget and Mayor approval memo. Please pay close attention to the budget (Exhibit C) and make sure you are ok with the amount budgeted for the treatment of your respective facilities. It should be ok since it is the same as last year. Also, make sure I've correctly described the funding sources in the memo to the Mayor. I would appreciate your feedback as soon as possible (The mosquitoes are getting hungry!). Thanks, Allen Allen Quynn From: Steve Brown Sent: Tuesday, May 27, 2014 11:00 AM To: Allen Quynn Cc: Kelly Beymer Subject: RE: Allen, Looks good to me. If you require anything additional let me know. Steve From: Allen Quynn Sent: Tuesday, May 27, 2014 9:16 AM To: Steve Brown Cc: Kelly Beymer Subject: Hi Steve, Attached is the 2014 Mosquito Abatement Contract that includes larvicide treatment of catch basins on Park property. Kelly usually reviews the contract and gives me the ok before I send it up to the Mayor for signature. Since she is on vacation, I was wondering if you could review and approve it for Parks. Steve Meyers is reviewing it for the Golf Course. The amount budgeted of$8,349.38 is the same as last year. Thanks, Allen 1 Allen Quynn From: Steve Meyers Sent: Tuesday, May 27, 2014 9:23 AM To: Allen Quynn Cc: Kelly Beymer Subject: RE: Addendum to 2013-2014 Mosquito Abatement Program Contract (CAG-13-106) Allen, On the Golf Course portion, I would say go ahead as planned, it looks to be the same as last year. As far as the Parks portion that may need to go to Steve Brown or Terri Higashiyama. Thanks Golf Course Supervisor Maplewood Golf Course 425-430-6806 smevers@rentonwa.gov From: Allen Quynn Sent: Tuesday, May 27, 2014 9:08 AM To: Steve Meyers Cc: Kelly Beymer Subject: FW: Addendum to 2013-2014 Mosquito Abatement Program Contract (CAG-13-106) H i Steve, Please take a look at the mosquito abatement contract and let me know if it's ok. The cost to treat the 4 ponds and catch basins is$4,790.63 the same as last year. Thanks, Allen Quynn, P.E. Project Manager City of Renton Surface Water Utility Engineer 425-430-7247 aquynn@rentonwa.gov From: Allen Quynn Sent: Thursday, May 22, 2014 11:39 AM To: Kelly Beymer; Gregory E Stroh Subject: Addendum to 2013-2014 Mosquito Abatement Program Contract (CAG-13-106) 1 Hi Kelly/Greg: Please review and provide any comments on the attached contract addendum No. 1,Scope of Work, Schedule, Budget and Mayor approval memo. Please pay close attention to the budget (Exhibit Q and make sure you are ok with the amount budgeted for the treatment of your respective facilities. It should be ok since it is the same as last year. Also, make sure I've correctly described the funding sources in the memo to the Mayor. I would appreciate your feedback as soon as possible (The mosquitoes are getting hungry!). Thanks, Allen z HUMAN RESOURCES City of AND RISK MANAGEMENT M E M O R A N D U M DATE: May 14, 2014 TO: Hebe Bernardo FROM: Gary B. Lamb, Risk Manager SUBJECT: Insurance Review/Whitworth Pest Solutions, Inc. Project: Mosquito Abatement I have reviewed the certificate of insurance for the above-mentioned entity. The insurance certificate meets the city's risk management requirements. h:\file sys\swp-surface water projects\swp-27-surface water projects(cip)\27-2000 mosquito abatement program\2014 program\contracts\risk management certificate of liability insurance approval.doc WHITW-3 OP ID:AB CERTIFICATE OF LIABILITY INSURANCE DATE 412 01 4Y) 05/14/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Brendon A Nepon ______ ___ _ _ Wheat&Associates Insurance P.O.Box 3548 a°NN E>n:509-922-2937 nAic No: 509-922 4103 Spokane,WA 99220-3548 EMAIL Brendon A Nepon ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Capital Risk Underwriters A INSURED Whitworth Pest Solutions, Inc. INSURER B Erik Hodson 2533 Inter Avenue INSURERc__ Puyallup,WA 98372 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE 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 CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE DDL UBR POLICY NUMBER MM DDPOLICY/YYYY MMlDD EFF Y/YYYY LIMITS EXP LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X IIC-GL-02865-00 12/01/2013 12/01/2014 PREMISES Ea occurrence $ 100,00 -] CLAIMS-MADE OCCUR MED EXP(Any one person) $ - 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,001 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY F PRO-T FLOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ A X ANY AUTO IIC-CA-00528-00 12/01/2013 12/01/2014 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS PER ACCIDENT $ X UMBRELLA LIAB X_ OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS-MADE IIC-EX-00209-00 12/01/2013 12/01/2014 AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE IIC-GL-02865-00 12/01/2013 12/01/2014 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) WA STOP GAP E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder is additional insured per written contract or agreement per form IIC GL 50 04 0410. Primary and Non Contributory coverage applies. Project: Mosquito Abatement CERTIFICATE HOLDER CANCELLATION CITRE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Renton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hebe Bernardo Civil Engineer II 1055 S Grady Way AUTHORIZED REPRESENTATIVE Renton,WA 98055 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD City(A� r CITY ATTORNEY M E M O R A N D UM DATE: May 19, 2010 TO: Teresa Phelan, Administrative Secretary Public Works Department, Utilities Systems Division FROM: Lawrence J. Warren, City Attorney Staff Contact: Mark Barber, Senior Assistant City Attorney Telephone: (425)430-6485 SUBJECT: Approval as to legal form of Template Addendum ADD-2010 Please be advised that I have reviewed the above-referenced Template Addendum ADD- 2010, and the same is approved as to legal form, and may be used in the future so long as there are no material changes or modifications to the standard form.. hA02 mark\public works--contracts and agreements\2010-05-19 memo approving addendum template add-2010 with continuing approval.doc FORM:ADD-2010 ADDENDUM NO. 1 to CAG-13-106 CONSULTANT CONTRACT FOR ENTOMOLOGIST/PEST CONTROL AGENT SERVICES for 2013 -2014 MOSQUITO ABATEMENT PROGRAM This Addendum is made and entered into this day of 2014, by and between the City of Renton, hereinafter called the "City", and Whitworth Pest Solutions, Inc., whose address is 2533 Inter Ave., Puyallup, WA 98372-3428, hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS, the City engaged the services of the Consultant under Consultant Agreement CAG-13-106 dated May 22, 2013, to provide entomologist/pest control agent services for the 2013- 2014 Mosquito Abatement Program; and WHEREAS, the 2013 Mosquito Abatement Program has been completed in accordance with the original agreement; and WHEREAS,the City desires that the Consultant provide the services identified in the attached Exhibit A for the 2014 Mosquito Abatement Program. NOW,THEREFORE, in accordance with Section Vill- Extra Work of the original Agreement CAG-13-106, dated May 22, 2013, it is mutually agreed upon that Consultant Agreement CAG-13-106 is amended as follows: 1. The scope of work for the 2014 Mosquito Abatement Program shall be as set forth in Exhibit A of this addendum. 2. Payment for the work defined in Exhibit A shall be at the rates set forth in Exhibit C of this addendum. Payment for services rendered in 2014 shall not exceed $78,938.56 without a written amendment to the contract, agreed to and signed by both parties. All other provisions of Consultant Agreement CAG-13-106 dated May 22, 2013, apply to this addendum. EXECUTION IN WITNESS WHEREOF, the parties have executed this Addendum No. 1 to CONSULTANT AGREEMENT CAG-13-106 as of the day and year first above written. WHIT WO/THIST OLUTIONS CITY OF RENTON Signature Denis Law,Mayor Date ATTEST: Type or Print Name I itle Bonnie I . Walton, City Clerk H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Contracts\014 Addendum 1.doc EXHIBIT A SCOPE OF WORK 2014 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF UPLOAD AREAS ADJACENT TO THE PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment must be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05-022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005). Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit D, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit A of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The City will aso provide public notification of persitice use in accordance with section S6 of the NPDES Permit included. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label, the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City Page 1 of 12 Piazza/Data_Center/Fo rms/City/Contracts obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name Vectol-ex. Area of Treatment: The treatment areas consist of the following facilities: ID Owner Facility Name/Type Facility Location 1 Surface Water Utility Stonegate/WQ Pond NE 26th and Lyons Ave 2 Surface Water Utility NE 10th St Pond/Detention NE 10th St and Anacortes Ave 3 Surface Water Utility Talbot Ridge 2/WQ Pond S 47th St and 102nd Ave SE 4 Surface Water Utility Talbot Estates/Pond Talbot Rd S 5 Surface Water Utility Olympic Peak Estates/Pond S. 196th PL 6 Surface Water Utility Larson Parke/Pond 112th Ave SE 7 Surface Water Utility Watershed Terrace/Pond SE 200th St 8 Surface Water Utility Wilkens Wood/Pond 113th Ave SE 9 Surface Water Utility Serenity Ridge Tract A/Pond 110th PL SE 10 Surface Water Utility Serenity Ridge Tract B/Pond 110th PL SE 11 Surface Water Utility Auria Woods Tract C/Pond SE 186th St 12 Surface Water Utility SR-169/Pond 140th Way SE 13 Surface Water Utility Fredericks Place/Pond SE 186th St 14 Surface Water Utility Aster Park/Pond NE 131h PL 15 Surface Water Utility Hamilton Place/Pond 160th Ave SE 16 Surface Water Utility Evendell/Pond 160th Ave SE 17 Surface Water Utility Nichols Place/Pond 160th Ave SE/SE 5th St 18 Surface Water Utility Ellis Park 124th St. SE/ 149th Ave. SE. 19 Surface Water Utility Windsor circle 13502 162nd AveSE 20 Surface Water Utility Heritage Renton Hill S 7th St./S 71h Ct. .21 Surface Water Utility Amberwood 6001 Ne 4th St. 22 Surface Water Utility Maureen Highlands 6118 Ne 4th St. 23 Surface Water Utility Sienna 250 Jericho Ave NE 24 Surface Water Utility Brookefield II 1100 Hoquiam Ave NE 25 Surface Water Utility Shy Creek 129 Jericho Ave NE 26 Surface Water Utility Aspen Woods 864 and 852 Hoquiam Ave NE 27 Surface Water Utility Amberwood II 6135 NE 4th St. 28 Surface Water Utility Morning Glen 176Th St. and 114th PI SE 29 Surface Water Utility Chinquapin Ridge SE 192nd and 113 St. SE 30 Surface Water Utility Pioneer Place Maple Valey Rd and 149th Ave SE 31 Surface Water Utility Highland Estates SE 136th St and 152nd Ave SE 32 Surface Water Utility Jericho Plat Intersection of Jericho Ave NE And NE 4th St Extending West To Hoquiam Ave NE 33 Surface Water Utility Liberty Grove and Liberty Grove SE 136th St and 160th Ave SE. Contiguous 34 Surface Water Utility Highpointe II 3722 NE 12th St Page 2 of 12 Piazza/Data_Cente r/Forms/City/Contracts 35 Surface Water Utility Laurelhurst Phase I Duval Ave and NE 1". St 36 Surface Water Utility Parkside Court Lions Ave and SE 2nd PI 37 Surface Water Utility Emma's SE 1st Place fronting Lyons Ave NE 38 Surface Water Utility Reserve at Stonehaven S 47th St and Main Ave S 39 Surface Water Utility Sunnybrook Plat 3721 Morris Ave S 40 Surface Water Utility Winsper (Liberty view Phase I & S. 32nd St and Talbot Rd. S. II) 41 Surface Water Utility Kimberly Lane 17228 125th Ave SE 42 Surface Water Utility Maple Glen Addition SE 182nd St and 1081h Ave SE 43 Surface Water Utility Christian Short Plat 11129 SE 189th PI 44 Surface Water Utility Greenfield II (Highpointe II) 1318 Redmond PI NE 45 Surface Water Utility Windsong Field PI NE and NE 4th PI 46 Surface Water Utility Liberty Ridge Phase 2 NE 1st St and Glennwood Ave SE 47 Surface Water Utility Liberty Ridge Phase 1 2511 NE 1st St (behind residence) 48 Surface Water Utility Liberty Ridge Phase 1 Index Ave SE and SE 1st St 49 Surface Water Utility Elmhurst Whitman PI NE and NE 2nd Ln 50 Surface Water Utility Zetterberg Burnett PI S and S 21st St 51 Surface Water Utility Magnussen Plat Field Ave NE and NE 2nd St 52 Surface Water Utility Magnussen Plat 4814 NE 2dn St (behind residence) 53 Surface Water Utility Cottages at Honey Creek NE Sunset Blvd and Elma PI NE 54 Surface Water Utility Highlands Park Rosario PI SE and SE 2nd PI 55 Surface Water Utility Shamrock Glen (aka Martin Lyons PI NE and NE 5th Cir Prop) 56 Surface Water Utility Beclan Place Plat Hoquiam Ave NE and NE 2nd St 57 Surface Water Utility NE 4th Detention Field Ave NE and NE 2nd PI 58 Surface Water Utility Catch Basins Various 59 Golf Course Hole #18 Pond/Irrigation Maplewood Golf Course (west) 60 Golf Course Hole #9 Pond/Irrigation Maplewood Golf Course (west- central) 61 Golf Course Hole #7 Pond/Irrigation Maplewood Golf Course (east- central) 62 Golf Course Hole #6 Pond/Irrigation Maplewood Golf Course (east) 63 Golf Course Catch Basins Various 64 Parks Maintenance Catch Basins Various Division 65 1 Facilities Division I City Hall/WQ I Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Page 3 of 12 Piazza/Data_Center/Forms/City/Contracts Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count (larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). A. Notification: Maplewood Golf Course —Whitworth Pest Solutions, Inc. shall contact the Golf Course golf course maintenance supervisor 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property (this is a mandatory safety requirement). Page 4 of 12 Pia zza/Data_Cent er/Fo rms/City/Contra cts EXHIBIT B TIME OF COMPLETION 2014 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City, testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. All work and treatment reports as required by the Aquatic Mosquito Control NPDES Permit are to be completed by December 31, 2014. Page 5 of 12 Piazza/Data_Cente r/Fo rms/City/Con tracts EXHIBIT C COST ESTIMATE 2014 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The estimated total cost of Task 1 including Washington States sales tax is $19,315.80. The cost shall include all necessary work for 21 treatments including clearing of the trails. Work conducted in performance of Task 1 will be billed at the following rates: For 12 or more total treatments: $840/treatment For 6 to 11 total treatments: $890/treatment For 1 to 5 total treatments: $990/treatment The billing rates include state sales tax. Subtotal Contract Cost: $17,640.00 State Sales Tax (9.5%) $1,675.80 Total Cost Task 1: $19,315.80 TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is $59,622.76. The cost shall be based on a rate of$125.00 per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under "Areas of Treatment" above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. Below is the estimated contract cost for the three City divisions, based on the billing rate of$125.00 per manhour for a total of 180 manhours: Surface Water Utility Costs Stormwater facilities: 57 Total number of treatments per stormwater facility: 8 Page 6 of 12 Pia zza/Data_Ce nter/Fo rm s/City/Contracts Total manhours per stormwater facility (including travel time): 0.6 hrs Total stormwater facility manhours: 273.60 hrs Subtotal cost for stormwater facilities: $34,200.00 Sales Tax (9.5%): $3,249.00 Total cost for stormwater facilities: $37,449.00 Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $7,500.00 Sales Tax (9.5%): $712.50 Total cost for catch basin treatment: $8,212.50 Total manhours (stormwater facilities + catch basins): 333.60 hrs Subtotal cost (stormwater facilities + catch basins): $41,700.00 Sales Tax (9.5%): $3,961.50 Total cost (stormwater facilities + catch basins): $45,661.50 Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility (including travel time): 1 hr Total irrigation facility manhours: 32 hrs Subtotal cost for irrigation facilities: $4,000.00 Sales Tax (9.5%): $380.00 Total cost for irrigation facilities: $4,380.00 Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $375.00 Sales Tax (9.5%): $35.63 Total cost for catch basin treatment: $410.63 Total manhours (irrigation facilities + catch basins): 35 hrs Subtotal cost (stormwater facilities + catch basins): $4,375.00 Sales Tax (9.5%): $415.63 Total cost (stormwater facilities + catch basins): $4,790.63 Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Page 7 of 12 P is zza/Data_Center/Forms/City/Contracts Subtotal cost for catch basin treatment: $7,625.00 Sales Tax (9.5%): $724.38 Total cost for catch basin treatment: $8,349.38 Total manhours (irrigation facilities + catch basins): 61 hrs Subtotal cost (stormwater facilities + catch basins): $7,625.00 Sales Tax (9.5%): $724.38 Total cost (stormwater facilities + catch basins): $8,349.38 Facilities Division Costs Stormwater facilities: 1 Total number of treatments per facility: 8 Total manhours per stormwater facility (including travel time): 0.75 hrs Total stormwater facility manhours: 6 hrs Subtotal cost for stormwater facilities: $750.00 Sales Tax (9.5%): $71.25 Total cost stormwater facilities: $821.25 Catch Basin: 0 Total manhours (stormwater facilities + catch basins): 6 hrs Subtotal cost (stormwater facilities + catch basins): $750.00 Sales Tax (9.5%): $71.25 Total cost: $821.25 Total Contract Cost for all Divisions: $56,850.00 State Sales Tax (9.5%): $5,400.76 Total Cost Task 2: $59,622.76 B. Total Contract Cost (Task 1 +Task 2): $78,938.56 C. Invoicing Whitworth Pest Solutions, Inc. shall submit all invoices to the City of Renton Surface Water Utility Section. Invoices shall include the division (Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division) for which the service was provided under this project. Payment cannot be authorized or payment may be delayed until the invoices include the division to which the service was provided. Page 8 of 12 Pia zza/Data_Center/Form s/City/Contracts COST PLUS NET FEE DETERMINATION DIRECT SALARY COST: Hourly Rates ofPay Personnel Pesticide applicator 17.50-2625 Bookkeeper 23.43 ManagerDepartment 29.95 Cars at ile Per Diem nu __ ___ Reproduction Expenses @ $ copy --------------------$ Communications......................................................................................................5 Page 9 of 12 EXHIBIT C (cont.) SUMMARY OF FEE FOR ENGINEERING SERVICES BREAKDOWN OF OVERHEAD COST ProfitSharing............................................................................................................ 1 % FICA .......................................................................................................................... 3.8% Unemployment Compensation................................................................................ 1.1 % Medical Aid and Industrial Insurance....................................................................... 2.1 % Company Insurance and Medical............................................................................. 1.7 % Vacation, Holiday and Sick Leave............................................................................. 2 % State B & 0 Tax& Other Business Tax..................................................................... 0.8 % Insurance.................................................................................................................. 2.7 % Administration and Time Unassignable................................................................... 5.1 % Printing, Stationery and Supplies............................................................................. 0.9% .... Travel Not Assignable.......................................................................... ................. % Telephone and Telegraph Not Assignable ..............................................I................ 0.8% Fees, Dues, Professional Meetings........................................................................... 0.3 % Utilities and Maintenance........................................................................................ 0.5% Rent.......................................................................................................................... 6.3% RentalEquipment..................................................................................................... % Office Miscellaneous, Postage ................................................................................. 0.4% Professional Services................................................................................................ 0.6% 6994.00 TOTAL 31 % SUMMARY OF COSTS Project No. Name of Project_2013 Mosquito Abatement Program DirectSalary Cost........................................................................................................................$ 7868.00 Overhead Cost (including payrolladditives........................................................................... % $ 6994.00 Sub-Total $14862.00. NetFee.............................................................................................................. % $ 7638.00 ........................................................................................................................ 51 Direct Non-Salary Costs: a. Milleage, travel and per diem .................................$ _11250.00 b. Computer expense.................................................$ C. Scanning and faxing services.................................. $ d. ................................................................................ $ e. Other(specify)........................................................$ Total $_11250.00 Sub Total $ 14862.00 Page 10 of 12 Piazza/Data_Cente r/Forms/City/Contracts STATE OF WASHINGTON, COUNTY OF KING } The City of Renton is Seeking AFFIDAVIT OF PUBLICATION Coverage under the Aquatic Mosquito Control General Permit The City of Renton is seeking PUBLIC NOTICE coverage under the Aquatic Mos- quito Control General Permit. Linda M Mills, being first duly sworn on oath that she is the Legal The City of Renton is located at Advertising Representative of the following address in King County,Washington. RECEIVED City of Renton 1055 S.Grady Way Renton Washington 98057 Renton Reporter Phone:425-430-7247 20t The proposed coverage applies NOV 1 4 to the geographical area describe below. Larvicide treatment will a weekly newspaper, which newspaper is a legal newspaper of !� _, fON generally occur in stormwater fa- eneral circulation and is now and has been for more than six months CITY O, oie Ci owned ci maintained by prior to the date of publication hereinafter referred to, published in UTILITY SYSTEMS the City.generally treatment p- p p p eas are generally located in up- the English language continuously as a weekly newspaper in King land areas east of SR-167 and County, Washington. The Renton Reporter has been approved as west of Lake Avenue South/Talbot Road South between SW a Legal Newspaper by order of the Superior Court of the State of 39th Street to the south and 1-405 Washin ton for Kin COunt . to the north, within the City of g g Y Renton, Washington. Informa- The notice in the exact form annexed was published in regular issues tion about the larvicides, adulti- of the Renton Reporter (and not in supplement form) which was cides, and a map of the specific locations are available on the regularly distributed to its subscribers during the below stated period. City's website at: www.renton- The annexed notice, a: waTeov. Areas within the described Public Notice boundaries may be treated to control mosquitoes. The insecti- cides planned for use are BIOMISTR and/or Kontrol 4-40 was published on September 26, 2014 and October 3, 2014. w� llll# to�yv a person desiring to present ws ent of Ecology regarding this a lica- � r`G'\O'1 /i% tion a do so in writing pwithin The full amount of the fee charged for said foregoing publication is =�`r_�4,� %'`%��'% cation days of the last date of menu p p p l� t� firr �� ;, cation of this notice. Comments sum of$231.00. Y yFo u�% must be submitted to the Depart- the ment of Ecology. Any person interested in the Department's / � L9dO >' i% �� _ action on the application may %�`L W���/it, Sf_ c ." --{�"9� notify the Department of their inda M. Mills %/;�J�f''E \� interest within 30 days of the last ltl�Y ©r:, v'�' �.. date of publication of this notice. Legal Advertising Representative, Renton Reporter 3��,,,,,,,,�,,..��` Submit comments to: Subscribed and sworn to me this 3rd dayof October, 2014. Department of Ecology Water Quality Program Attn: Aquatic Pesticide Permit �� ` Manager jvvlke� P.O.Box 47600 Olympia,WA 98504-7600 Ka Teen C. Sherman, Notary Public for the State of Washington, Jason A.Seth Residin in Buckle Washin ton Acting City Clerk g Y� g Published in Renton Reporter on September 26, 2014 and October 3,2014.#1140758. - HI I( _ _/ -) - I- - • 236635 P EST SOLUTIONS , INC TIME IN: TIME OUT: ,Zl Curing for Your Home, Business, and Environment CW6,,13 Zd�o 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 9763 TECH Tom 253.845.1818 206.248.2222 1.888.959.1818 APPOINTMENT 236635 •.Z�- RVic�ADDRESS DATE&TIME 09/25/14 LICENSE# 72235 City of Renton-Retention Ponds TARGET PEST MOSQ 1055 S Grady Way r�IU� Re nton, WA 98057 �.�✓ El Lawn: ❑ Fertilization(please water in 1 inch) ❑ Weed control 0. ❑ Moss control ❑ Crane fly control ❑ ph Correction .......................................................................................................................... 7City of Renton ��������� 5 S Grady Way Ot Benton ❑ Trees&Shrubs: ❑ Insect spray ❑ Disease control ❑ Foliar fertilization Renton, WA 98057 q�Ounts Payab e ❑ Injection ❑ Other ........................................................................................................................................ SERVICE TYPE Am • ❑ Weed Control: ❑Gravel ❑Noxious weeds ❑Shrub beds ❑ Total vegetation kill ❑ Other ...................................................................................................................... Tax XOther: ... Mosquitoes(Day 2) $650.00 .. RECEIVED $61.75 fi7�SQGa�rD COA$0.00 :DtsCQUNTS $0.00 TOTAL o $711.75 Other: n COMMENTS: 'QW.V Y,rZC'/ITE�? 'o`VAJ-P.T A�SNE�OC`I� ft7:� �*i7tJJ�IiP>TGJ �.�I.�YA CITY OF UTILITY SYS7-ci. 7-T-11. �� n4 •• -O• • • •enton-Retention Ponds Mosquitoes(Day 2) $650.00 LTax $61.75 COA$0.00 DISCOUNTS $0.00 WHITIWORTII I 236110 P E S T SOLUTIONS , I N C TIME IN: ;/v �.y TIME OUT. j"< Caring for Your Home, Business, and Environment C t�K3 t3—loco 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Art t8 cow t�o0 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 236110 ADDRESSSERVICE DATE&TIME 09/25/14 LICENSE# 224 City of Renton TARGET PEST MOSQ Renton, WA 98055 RECEIVED ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM �1 ❑ NO RESTRICTIONS ADDRESSBILLING GENERAL INSPECTION&REPORT OF FINDINGS City Of Renton CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT 1055 S Grady Way ❑ CRAWLSPACE VENT SCREENS INADEQUATE TERIOR City of Renton ❑CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton,WA 98057 gocpunts Payable ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE El CRACKS/CREVICES SERVICE TYPE ❑ BAITED STATION(S) ❑WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION ❑TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR MOSgUIto Control Weekly __$840.00 ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Tax $79.80 ❑ GAPS AROUND DOORS ❑ATTIC COA-$0,00 DISCOUNTS $0.00 ❑ WOOD TO EARTH CONTACT ❑ BASEBOARDS ❑CRACKS/CREVICES ----TOTAL DUE $919.80 ❑ OTHER VOID APPLICATION BAIT CONSUMPTION #1 % 92 % #3 % #4 % 95 % #6 % #7 % ° % COMMENTS: 6 r � � vs� , ry r SEP302014 PAYMENT RECEIPP.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton Mosquito Control Weekly $$79 Tax $79.80' .80 n COA$0,00. ;.. _.. ...1 DISCOUNTS $0 Q0 5�•e el S�� HITWORT - 234798 PEST SOLUTIONS , I N C TIME IN: 7Jd TIME OUT: Caring for Your Home, Business, and Environrnent Lr AC,-t8-1014 2533 Inter Ave. • Puyallup,WA98372 CUSTOMER# 9764 TECH Tom lS�oc�t4 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 234798 SERVICE .• DATE&TIME 09/25/14 LICENSE# 72235 TARGET PEST MOSQ Maplewood Golf Course 4050 Maple Valley Highway > Lawn: ❑ Fertilization(please water in 1 inch) ❑ Weed control Renton, WA 98058 RECEIV ❑ Moss control ❑ Crane fly control ❑ ph Correction BILLING i ................................................................................................................ �� 1 ...................... City of Renton 1055 S Grady Way ElTrees&Shrubs: ❑ Insect spray ElDisease control ElFoliar fertilization Renton, WA 98057 City of Renton ❑ Injection ❑ Other Accounts Pay ble upig • ❑ Weed Control: ❑Gravel ❑Noxious weeds ❑Shrub beds ❑ Total vegetation kill ❑ Other ......................................................................................... Mosquitc Control Visit $375.00 -_ Tax $35.63 WOther: rr�©. uiy71 COA$0.00 DISCOUNTS $0.00 ❑other: RECEIVED • M Neill $410.63 COMMENTS: )',0g6Te0 OQAIV r�s,vrr-or� tn✓ �;��,,a f f+.�VA SEE' 3 0 2014 CITY OF RENTON UTILITY SY .T--Mr Maplewood Golf Course Mosquito Control Visit $375.00 Tax $35.63 - -- - COA$0.00 u DISCOUNTS ,. $Q,:00} WHITWO��TH INVOICE PEST SOLUTIONS , INC Caring for Your Horne, Business, and Environment INVOICE DATE 09/24/14 DUE DATE 10/24/2014 CUSTOMER# CW®,�t3�tu�c PO# City of Renton Lob Iwo Li c$ Utility Systems QS13.\3 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $958.13 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/ Product Description Quantity/ Price Amount Mosquitoes 1 @ $875.00 $875.00 RECEIVED ECEIVED SEP 2 S[P 3 0 2014 City of Renton CITY OF REi YTON Accounts Payable UT`LiTY SYSTEMS City of Renton Send Payment To Utility Systems Total Tax: $83.13 1055 S Grady Way Total This Invoice: $958.13 Renton, WA 98057 Payments Received: $0.00 Invoice: 234786 Invoice Date: 09/24/14 , $958.13 TAKE KEY WITH YOU.Dip and then apply larvicide as necessary. see additional sheet for locations �ontactt@ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment cost, ariesepfrtditgz� needed,bill $125 per man hour, $375 min per contract. Tn:VectoIex 73049-20--11oz--Ponds z)cU>° Qc - 5 H ITWORT '1 • 236109 PEST SOLUTIONS INC TIME IN: dy TIME OUT: Caring for Your Home, Business, and Environment 2533 Inter Ave. - Puyallup,WA98372 CUSTOMER# 2347 TECH Art =8/b�yctbS 253.845.1818 - 206.248.2222 - 1.888.959.1818 APPOINTMENT 236109 224 4 �� � DATE&TIME 09/18/14 LICENSE# City of Renton TARGET PEST MOSQ -�-;°�� Renton,WA 98055j ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM ❑ NO RESTRICTIONS BILLING ADDRESS GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR Renton, WA 98057 S Grady Way O CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Rent +�'Y; �-^'r L' ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) El EAVES SERVICETYPE El TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ CRACKS/CREVICES AMOUNT ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR Mosquito Control Weekly $840 00 ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE .��. ,.., Tax El GAPS AROUND DOORS ❑ATTIC $79 80 ❑ WOOD TO EARTH CONTACT V E"' ❑ BASEBOARDS COA. OAO DISCOUNTS :;. <.. _.$0.00; ❑ CRACKS/CREVICES TOTAL1 ❑ OTHER ❑ VOID APPLICATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % # % #8 % #9 % COMMENTS: CITY OF RENTON UTILITY S PAYMENT RECEIPT PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax $79.80 DISCOUNTS $090 cusTornERs --_ INvoice# • l e $919.80 5 GL3 iy WINT1 j(T�_//pJ R 17H • 236108 P E S T SOLUTIONS , I N C TIME IN: c > TIME OUT: Caring for Your Home, Business, and Environment C K��i`fg 10(0 2533 Inter Ave. - Puyallup,WA 98372 CUSTOMER# 2347 TECH Art 253.845.1818 - 206.248.2222 • 1.888.959.1818 APPOINTMENT 236108 ADDRESSSERVICE DATE&TIME 09/11/14 LICENSE 224 �gf4•�f� City of Renton _ TARGET PEST M�SQ Renton,WA 98055j ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM ❑NO RESTRICTIONS ADDRESSBILLING GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton WiNDJ J ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR 1055 S Grady Way Renton, WA 98057 � 'L _ ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER IN � � ��, ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ CRACKS/CREVICES SERVICE TYPE � ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION --" ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR Mosquito Control Weekly $840.00 ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Tax $79 80 ❑ GAPS AROUND DOORS ❑ATTIC COA$0.00 D_ISGOUNTS $0.00 ❑ WOOD TO EARTH CONTACT ❑ BASEBOARDS ❑ CRACKS/CREVICES • i $919,80 ❑ OTHER ❑VOID APPLICATION BAITCONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % #7 % #8 % #9 % COMMENTS: PAYMENT RECEIPT:PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax $79.80 $919.80 CUSTOMER H 2347 INVOICE# ,,,,,��,,,A • A D swe�l INVOICE OICLPEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE 10/11/2014 CUSTOMER# C14LAi- 63-IN- PO# City of Renton 1g/ccoIg06 Utility Systems 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $821 .25 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/Price Amount Mosquitoes Day 2 1 @ $750.00 $750.00 RECEIVED S E P 15 2014 CITY OF;'RENT N UTILITY SY S,TE-MS AIJ City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 235909 Invoice Date: 09/11/14 . $821.25 ^� "g, TAKE KEY WITH YOU.Dip and then apply larvacide as necessary. see additional sheet for iocatons.'con#act of renton is Hebe Bernardo. Fax daysheet and reports after eve treatment. cost varies depending on treat_ -a p every p 9 . needed, bill$125 per man hour, $375 m n per contract Vectolex 73049-20--25oz pond Temp 76 Wind NE 15mnh 9 INVOICE PEST SOLUTIONS , INC 'WIWI Caring for Your Home, Business, and Environment INVOICE DATE 09110/14 DUE DATE CUSTOMER# Pon City of Renton (�f Ca$ Utility Systems Tech . 9225 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $410.63 For Service At: Maplewood Golf Course Kelly Beamer 4050 Maple Valley Highway Renton, WA 98058 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 RECEIVED SEP 15 2014 CITY OF [,.T'elTON City of Renton Send Payment To Utility Systems Total Tax: $35.63 1055 S Grady Way Total This Invoice: $410.63 Renton, WA 98057 Payments Received: $0.00 Invoice: 234797 Invoice Date: 09/10/14 . $410.63 BE THERE BY 7AM. CHECK IN AT THE PRO SHOP AND THEY WILL GET YOU A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvacide as necessary. Bill$125 per man hour, $375 min per contract.Vectolex 73049- 20--4oz- ponds Temp 56 Wind SW @ 0-2mph ��•e,\ �e t U st=5 WH 1T ORTH INVOICE PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE CUSTOMER# 9763 PO# C 14A-13—t�Cc City of Renton l�/c5oo t qo� Utility Systems 1055 S Grady Way $��I Renton, WA 98057 AMOUNT DUE $821 .25 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/Price Amount Mosquitoes 1 @ $750.00 $750.00 RECEIVED SEP 15 2014 CITY OF RENTON UTILITY 'SYSTEtAS City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 234785 Invoice Date: 09/10/14 • $821.25 TAKE KEY WITH YOU.Dip and then apply larvacide'as necessary. see additional sheet for locations. contact @ city of renton is'Hebe Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill,$125 per man hour,$375 min per contract.Vectolex 73049-20 -- 18oz`-- ponds Temp 70 Wind SW:@ 7-10mnh �_//I=II I��I�����i III � • 235648 P E S T 5 0 L U T I O N S I N C TIME IN: �� u J TIME OUT: c': S' Caring for Your Home, Business, and Environment 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Art C►�•-1 3 253.845.1818 206.248.2222 1.888.959.1818 APPOINTMENT 235648 S/ G�}CE� SERVICE ADDRESS DATE&TIME 09/04/14 LICENSE# 224 N-930 "City of Renton TARGET PEST MQSQ �'� Renton,WA 98055 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM C�i` ❑ NO RESTRICTIONS BILLING ADDRESS GENERAL INSPECTION&REPORT OF FINDINGS '�" CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR 1055 S Grady Way q F P @ 9 ❑❑ CRAWLSPACE ACCESS DOOR INADEQUATE [I PERIMETER Renton, WA 98057 �� • ❑ EAVES CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ CRACKS/CREVICES AMOUNTSERVICE TYPE ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATIONS) �l ❑ WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR MOSgUitO Control Weekly $S4O:0O ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Tax $79,80 El GAPS AROUND DOORS 0 ATTIC ❑ BASEBOARDS y,C" 0,00 DISCOUNTS - _„ j _$0;00 � WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES TOTAL DUE0 ❑ OTHER ❑ VOIDAPPLICATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % 95 % #6 % #7 % #8 % #9 % COMMENTS: PAYME14T RECEIPT PLEASE RETURNWITH PAYMENT FOR • DITING OF s City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $$0 00 CUSTOMER# INVOICE# TOTAL DUE INVOICE WWHtTW0RTHW PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE CUSTOMER# PO# City of Renton Utility Systems 1 g t9 0$ Tech Tom License' 7?235 1055 S Grady Way �/�/p� 3 Renton, WA 98057 AMOUNT DUE $410.63 For Service At: Maplewood Golf Course Kelly Beamer 4050 Maple Valley Highway Renton, WA 98058 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 RECEIVED SEP152014 CITY OF RENTON UTILITY ;YSTENIS City of Renton Send Payment To Utility Systems Total Tax: $35.63 1055 S Grady Way Total This Invoice: $410.63 Renton, WA 98057 Payments Received: $0.00 Invoice: 227417 Invoice Date: 07/02/14 .� $410.63 NMI BE THERE BY 7AM. CHECK IN AT THE PRO SHOP AND THEY WILL GET YOU A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvacide as necessary. Bill $125;per man hour, $375 min per contract.Tn:Vectolex 73049-20--37oz--Ponds SW/0-2/69: 9 J r WHITWORTH '3'37427 PEST SOLUTIONS , INC TIME IN: TIME OUT: Caring for Your Horne, Business, and Environment 0—Vk4l, wto 2533 Inter Ave. • Puyallup, WA 98372 CUSTOMER# 2347 TECH Mike / 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 227427 �`���Q d$ SERVICE ADDRESS DATE&TIME 06/05/14 LICENSE# 81151 c'-46© TARGET PEST MOSQ City of Renton / j� Renton, WA 98055 RECEIVED ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM NO RESTRICTIONS ADDRESSBILLING pm GENERAL INSPECTION & REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton O CRAWLSPACE VENT SCREENS INADEQUATE Ifl EXTERIOR` / 1055 S Grady Way of Rento+) Renton, WA 98057 Ae=nts Payable D CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER CLOGGED RAIN GUTTERS/DOWNSPOUT(S) EAVES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ CRACKS/CREVICES SERVICE TYPE ❑ BAITED STATION(S) O WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION U TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.0Q C_] GAPS AROUND DOORS ❑ ATTIC Tax pSCQUNTS $$a:0� ❑ WOOD TO EARTH CONTACT • ❑Ro OTHER ❑ VOID APPLICATION BAITCONSUMPTION #1 % #2 % #3 % #4 % #5 ._% #6 % #7 �% #9 % COMMENTS: /7e-Cj CITY OF RENTON UTILITY SYSTEMS-- --- FOR City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $7 .80 CUSTOMER# 1 2347 INVOICE# 2 919.80 �/H j(��'WORTHI • 22742 P EST S O L U T I O N S , I N C mw 7APPOINTMENT TIME OUT: (1 Caring for Your Home, Business, and Environment e-AA-6i-wr' 2533 Inter Ave. • Puyallup,WA 98372 TECH Mike t�/�1908 253.845.1818 • 206.248.2222 • 1.888.959.1818 28 SERVICE ADDRESS DATE&TIME 06/12/14 LICENSE# 81151 TARGET PEST MQSQ City of Renton �j A Renton, WA 98055 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM c l ] NO RESTRICTIONS ADDRESSBILLING GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton 7E0]'CRAWLSPACE VENT SCREENS INADEQUATE ❑ EXTERIOR 1055 S Grady Way t ' CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton, WA 98057 Y CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ElCRACKS/CREVICES SERVICE TYPE • ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 El ATTIC ❑ GAPS AROUND DOORS Tax $79.80 ❑ BASEBOARDS DISCOUNTS $om ❑WOOD TO EARTH CONTACT REVICES TOTAL DUE $919 Fla '/\t❑ OTHER- RE VIFCATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #8 % #7 % #8 % #9 % COMMENTS: `i IN n 3 Z014 PAYMENT RECEIPM PLEASE RETURN WITH PAYMENT •R PROPER CREDITING OF • City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $$0.00 CUSTOMER# 1 2347 INVOICE# TOTAL DUE 0,919.80 H I(` WORTH • 227429 7AAPPOINTMENT IN: TIME OUT: PEST SOLUTIONS , iNC _Curiogfor Your Home, Business, and Environlnenf 02533 Inter Ave. • Puyallup, WA 98372 TOMER# 2347 TECH Mike253.845.1818 • 206.248.2222 • 1.888.959.1818 22742g SERVICE ADDRESS DATE&TIME 06/19/14 LICENSE# 81151 ` TARGET PEST MQSQ City of Renton PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM!PM Renton, WA 98055 t NO RESTRICTIONS BILLING ADDRES'-z GENERAL INSPECTION& REPORT OF FINDINGS a" CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City `� of Renton rJ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR 1055 S Grady Way ❑ CRAWLSPACE ACCESS DOOR INADEQUATE Cl PERIMETER Renton, WA 98057 ❑ El EAVES CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ CRACKS/CREVICES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATION(S) AMOUNTSERVICE TYPE ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $640.fl0 171 GAPS AROUND DOORS ❑ ATTIC Tax $79.80 O BASEBOARDS {.iQA._ 0,00 DISCOUNTS $� �� ❑ WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES s 919 80 ❑ OTHER ❑ VOID APPLICATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % #7 % #8 % #9 % COMMENTS: PAYMENT RECEIPT. PLEASE RETURN WITH PAYMENT FOR PROPER CREDIT ING OFYOUR ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS :$0.00 C 1RTClMFR# IN MIC.F# /I72-114 'V� NTH � 227430 mw P E S T S O L U T 1 O N S , I N C TIME IN: S TIME OUT: f �` Caring for Your Horne, Business, and Environment C1�-13-t0(c 2533 Inter Ave. - Puyallup, WA 98372 CUSTOMER# 2347 "S I00c)ICtC)B TECH Andrew Mendiola 253.845.1818 - 206.248.2222 - 1,888,959.1818 APPOINTMENT 227430 `Wim f3c) ADDRESSSERVICE DATE &TIME 06/26/14 LICENSE# 85776 TARGET PEST MQSQ City of Renton Renton, WA 98055 EIV ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM f� NO RESTRICTIONS BILLING ADDRESS GENERAL INSPECTION&REPORT OF FINDINGS ( o iy ryq O CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton t! F 8 ❑ CRAWLSPACE VENT SCREENS INADEQUATE RgPg�VED 1055 S Grady Way Renton ❑ CRAWLSPACE ACCESS DOOR INADEQUATE R Renton, WA 98057 city Accnts payable ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) El EAVES ..� ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE �� SA3IN(S) SERVICE TYPEo ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION 1,21TWEO R R"PN-_0 1 f_I FOUNDATION HAS GAPS/HOLES I I �AIISPAGEj--C M a I'vlosgulto Control Weekly $34u.00 ❑ GAPS AROUND DOORS �-PT(C Tax $79,80 FI BASEBOARDS DISCoWR1T$ :00 ❑ WOOD TO EARTH CONTACT $0 C CRACKS/CREVICES • . i ❑ OTHER ❑ VOID APPLICATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % #7 % #8 % #9 % COMMENTS: PAYMENT RECEIPT-�PLEASE RETURN WITH PAYMENT FOR PROPER CREDITIING OF 0ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax 79.80 DISCOUNTS . $$0.00 n on 5c� o. I1 ;4 Lei _rIR_I !T Y/Y/O R 11 H 4-0101 Rqm-� PEST SOLUTIONS , INC 7APPOINTMENT TIMEOUT: Caring for Your Home, Business, and Environment 2533 Inter Ave. • Puyallup,WA98372 CUSTOMER 2347 TECH Mike e*aw i3r�� 253.845.1818 • 206.248.2222 • 1,888,959.1818 229216 Le ADDRESSSERVICE DATE&TIME 07/03/14 LICENSE# 81151 `T�q•� TARGET PEST MOSQ City of Renton Renton, WA 98055 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL —AM/PM 0 RESTRICTIONS BILLING ADDRESS FAI GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR 't'�r^:�_t 1055 S Grady Way ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton, WA 98057 ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑ CRACKS/CREVICES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATION(S) SERVICE TYPE ❑WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATIOfa(1 ❑ INTERIOR El FOUNDATION HAS GAPSIHOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 ❑ATTIC 'Fax DISCOUNTS 14 ❑ GAPS AROUND DOORS y ❑ WOOD TO EARTH CON ❑ BASEBOARDS $0.00 - �N ❑ CRACKS/CREVICES • • ❑ OTHER TO N BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #MA�o % #7 0 #8 % #9 % COMMENTS: JUL 11 2014 IN I'ON PAYMENT RECEIPTPLEASE RETURN WITH PAYMENT ,. PROPER City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $0.00 n icrnnnca k 914 inwnir❑a1 22921 1 PIP4111 _ .1t919 R() WHATWORTH 00 PEST S O L LI T I O N S I N C TIME IN: TIME OUT: i[) Caring for Your Home, Business, and Environment Cy>�_t3��to 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Mike t 253,845.1818 • 206.248,2222 • 1.888.959.1818 APPOINTMENT Q�r t��g 229217 �49t�t'�8c> ADDRESSSERVICE DATE&TIME 07/10/14 LICENSE# 81151 TARGET PEST MOSQ City of Renton ,q Renton, WA 98055 n PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL Atli off f"NO RESTRICTIONS ADDRESSBILLING GENERAL INSPECTION&REPORT OF FINONG1 CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE T� 'P 1'REN-roN 1055 S Grady Way ❑ CRAWLSPACEACCESS DOOR INADEQUATE Renton,WA 98057 ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) �0C� � �VICES > ❑ CRACKS/CREVICES SERVICE TYPE ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATION(S) • ❑ WATER POOLING NEAR STRUCTURE ❑ VOIDAPPLICATION ❑TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES E CRAWLSPACE Mosquito Control Weekly $840.00 ❑ GAPS AROUND DOORS ❑ATTIC Tax $79.80 ❑ BASEBOARDS RISCOUNTS $0 00 ❑ WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES ❑ OTHER ❑ VOID APPLICATION TOTAL DUE BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % #7 % #8 % #9 _% COMMENTS: PAYMENT RECEIPT:PLEASE RETURN WITH PAYMENT FOR •PER CREDITING OF • ACCOUNT City of Renton Mosquito Control Weekly $840,00 Tax $79,80 DISCOUNTS $0.00 riisTnnnFR 9. wvninre • _ �A1Q Rtl - -/ - - '_ _/ _ T_H ' 229218 P E S T S O L U T 1 O N S I N C TIME IN: TIME OUT. Caring for Your Horne, Business, and Environment (.F C,- . 2533 Inter Ave. • Puyallup, WA 98372 CUSTOMER# 2347 TECH Manitas 253.845.1818 • 206.248.2222 1,888,959.1818 APPOINTMENT 229218 r r - DATE&TIME 07/17/14 LICENSE# 87648 E/ TARGET PEST MO$Q City of Renton 4�' V'� Renton, WA 98055 PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM JUL ❑❑ NO RESTRICTIONS leyQ a i GENERAL INSPECTION & REPORT OF FINDINGS 1 �/ Of lento CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton AccOUnts Pa n ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR ®-�Y .9 , - 1055 S Grady Way Yab1e ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton';WA 98057 [I EAVES ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) • ❑ [I CRACKS/CREVICES TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR O FOUNDATION HAS GAPS/HOLES 0 CRAWLSPACE Mosq1.uito Control Weekly. $840,00 ❑ GAPS AROUND DOORS '� Tax $79.80 pIGOUtS $00 ❑ WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES ® ) 919 80 ❑ OTHER ❑ VOID APPLICATION BAIT CONSUMPTION #1 % #2 _% #3 _% #4 % #5 % #6 % #7 % #IU L COMMENTS: T. CITY OF RENTON UTILITY SYSTF AS PAYMENT RECEIPT.�PLEASE.RETURN WITH PAYMENT e OPER CREDITINGOF • ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax $79.80 . DI FN CUSTOMER# INVOICE# ® A $919.80 �-r�n "'7/A�/A A " �[ )TI JOR PEST SOLUTIONS I N C TIME11 TIME OUT: Caring for Your Home, Business, and Environment 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# TECH c7 253.845.1818 206.248.2222 1.888.959.1818 APPOINTMENT 2347 Mike t ��,��}��l0SERVICE g 229219 ADDRESSDATE&TIME 07/24/14 LICENSE# 81151 *119 City of Renton TARGET PEST MOSQ Renton,WA 98055 � ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM �j NO RESTRICTIONS GENERAL INSPECTION&REPORT OF FINDINGS i CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE I(I EXTERIOR Tf P��5 1055 S Grady Way ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton,WA 98057 ❑ ❑ EAVES CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ CRACKS/CREVICES SERVICE TYPE � ❑ BAITED STATION(S) ❑WATER POOLING NEAR STRUCTURE ❑ VOIDAPPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 El ATTIC ❑ GAPS AROUND DOORS Tax $79.80 ARDS DISCOUN.T.S $0.00 ❑ WOOD TO EARTH CONTACT CREVICES TOTALAD OTHER ❑ V PLICATION BAIT CONSUMPTION #1 % #2 % #3_ % #4 % #5 % #6 % #7 - (0 ✓ % #9 % COMMENTS: "Jul L �, IIJR- CITY OF RENTON UTILITY SYST-F--US-- PAYMENT RECEIPT*.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUN City of Renton Mosquito Control Weekly $840.00 J Tax DISCOUNTS CUSTOMER# 1 2347 INVOICE# 229219 OMTAL ViUHITWORTH[ 60 SERVICE SLIP INVOICE229220 PEST SOLUTIONS , INC TIME IN: ��� ili! TIME OUT. Lr.�/!l Caring for Your Horne, Business, and Environment _ 13 I Uh 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Art 253.845.1818 • 206.248.2222 • 1.888.9 1818 APPOINTMENT 229220 SERVICE ADDRESS DATE&TIME 07/31/14 LICENSE# 224 -{'9'jot TARGET PEST MQSQ City of Renton Renton, WA 98055 ,�9 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM t J �� ❑ NO RESTRICTIONS BILLING A00RESS GENERAL INSPECTION&REPORT OF FINDINGS h CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE VEXTERIOR 1055 S Grady Way ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton, WA 98057 ❑ EAVES❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ CRACKS/CREVICES SERVICE TYPE • ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 ❑ GAPS AROUND DOORS ❑ATTIC Tax - $79.80 ❑ BASEBOARDS DISCOUNTS '-.; $O.00 ❑ WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES TOUCDUE OTHER ❑VOID APPLICATION BAIT CONSUMPTION #1 % #2 % 93 __ % #4 % #5 % #6 % #7 % #8 % #9 COMMENTS: ------------ PAYMENT RECEIPT.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITINGOF • ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $0.00 IJ._9 Y�_.. i lL e J a ✓ P E S T S O L U T I O N S I N C 00 TIME IN: TIME OUT: (�J Caring for Your Home, Business, and Environment Ct.l3 Io 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Andrew !$IcCO I DE 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 231864 '�`I SERVICE ADDRESS DATE&TIME LICENSE# / gC� 08/07/14 85776 City of Renton TARGET PEST MOSQ E C I V Renton, WA 98055 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM ❑ NO RESTRICTIONS BILLING ADDRESSGENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE ❑ EXTERIOR 1055 S Grady Way CITY OF R�i�T01 ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton,WA 98057 UTILITY SYSTFNV--- ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE El CRACKS/CREVICES SERVICE TYPE � ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION ❑TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR Mosquito Control Weekly $84O.UO ❑ FOUNDATION HAS GAPS/HOLES Q ATTIC CRAWLSPACE ❑ GAPS AROUND DOORS Tax $79.80 ❑ BASEBOARDS DISCOUNTS $0.00 El WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES . • ❑ OTHER ❑VOIDAPPLICATION BAIT CONSUMPTION #1 % #2 % o #4 % #5 % #6 % #7 % #8 % #9 % COMMENTS: ,r+ PAYMENT RECEIPT:PLEASE RET(JPN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax DISCOUNTS $7 .980 CUSTOMER# INVOICE# TOTAL t/t/ H MWO 1i111-1I • PEST SOLUTIONS , INC TIME IN: TIME OUT: U" Caring for Your Home, Business, and Environment 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# TECH 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 231 Manitas 231865 ADDRESSSERVICE DATE&TIME 08/14/14 LICENSE# 87648 C 13 t?Cy-{�, TARGET PEST MOSQ City of Renton Renton, WA 98055 h R 1 q �� -P� EASE AVOID CONTACT WITH TREATED AREAS UNTIL L �PM [ t ❑ NO RESTRICTIONS ADDRESSBILLING GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR TAU! 1055 S Grady Way ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton, WA 98057 ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE El CRACKS/CREVICES SERVICE TYPE � ❑ BAITED STATION(S) ❑ WATER POOLING NEAR STRUCTURE ❑ VOID APPLICATION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 ❑ GAPS AROUND ❑ATTIC Tax $79.80 ❑ WOOD TO EAR H�C % E ❑ BASEBOARDS Sc ;" $0,00 ❑ CRACKS/CREVICES • ❑ OTHER ❑ VOID APPLICATION BAIT CONSUMPTION #�•- �°1q #2 % #3 ° a 741:Z' _% #5_ U Cj 6 #7 % #8 % #9 % COMMENTS: ° ' Q� CITY OF RLENTON M, 20 10 7 S PAYMENT RECEIPT:PLEASE RETURN WITH PAYMENT . PROPER CREDITING OF YOUR ACCOUNT - - 1- t \ $ Mosquito Control Weekly $840,00 City of Renton JTIL.ITY SYSTEMS Tax $79.80 .�.... DISCOUNTS $0.00 CUSTOMER# 1 2347 1 INVOICE# 1 231865 TOTAL WHtT'W0R-)Tjk-7j2' SERVICE SLIP INVOICE IF PEST SOLUTIONS INC TIME IN: TIMEOUT: Caring for Your•Home, Business, and Environment �Iq +3_July 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Mike 253,845.1818 • 206.248,2222 • 1.888.959.1818 APPOINTMENT 231866 C"d l d d d 6QUg SERVICE ADDRESS DATE&TIME 08/21/14 LICENSE# 81151 TARGET PEST MOSQ City of Renton Renton, WA 98055 ❑ PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM V-NO RESTRICTIONS BILLING ADDRESS GENERAL INSPECTION&REPORT OF FINDINGS CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton ElCRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR / 1055 S Grady Way AUG 2 7 2014 ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ❑ PERIMETER Renton, WA 98057 ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) ❑ EAVES i _ ❑ CRACKS/CREVICES ❑ TREES AND/OR SHRUBS TOO CLOSE TO STRUCTURE ❑ BAITED STATION(S) SERVICE TYPE 7 ❑ WATER POOLING NEAR STRUCTURE ❑VOID APPLICATION ❑TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES ❑ CRAWLSPACE Mosquito Control Weekly $840.00 ❑ GAPS AROUND DOORS ❑ATTIC Tax $79.80 ❑ BASEBOARDS DISCOUNTS $O 00 ❑ WOOD TO EARTH CONTACT ❑ CRACKS/CREVICES i ❑ OTHER ❑VOID APPLICATION BAIT CONSUMPTION #1___ - % 42 % #3_� = % #5 % #6 % #7 % #8 % #9 COMMENTS: + .a PAYMENT RECEIPT*PLEASE RETURN WITH RAYMENT FOR • OF • ACCOUNT City of Renton LT osquito Control Weekly $840.00 a . x DISCOUNTS $798 00 CUSTOMER# 12347 INVOICE# 231866 �" TOTAL . ItA1P an Vi1_C HI IITWQ RTI_"_� � - - - -- . - � 231867 PEST SOLUTIONS , INC TIME IN: TIME OUT: Caring for Your Horne, Business, and Environment e-4 4_l3—tco(v 2533 Inter Ave. • Puyallup,WA 98372 CUSTOMER# 2347 TECH Art 253.845.1818 206.248.2222 1.888.959.1818 APPOINTMENT 231867 ®l°®d t4da SERVICE ADDRESS DATE&TIME 08/28/14 LICENSE# 224 City of Renton TARGET PEST MOSQ Renton, WA 98055 PLEASE AVOID CONTACT WITH TREATED AREAS UNTIL AM/PM V ❑ NO RESTRICTIONS BILLING ADJKESS GENERAL INSPECTION&REPORT OF FINDINGS n �a CONDITIONS FAVORING PEST INFESTATION AREAS OF TREATMENT City of Renton �J 1055 S Grady Way ❑ CRAWLSPACE VENT SCREENS INADEQUATE EXTERIOR Renton, WA 98057 ❑ CRAWLSPACE ACCESS DOOR INADEQUATE ElPERIMETER �-• ❑ CLOGGED RAIN GUTTERS/DOWNSPOUT(S) EAVES ElTREES AND/OR SHRUBS TOO CLOSE TO STR ❑ CRACKS/CREVICEST QS/T IONS) ❑SERVICE TYPE WATER POOLING NEAR STRUCTURE q IC TION ❑ TRASH/DEBRIS FAVORING PEST INFESTATION ❑ INTERIOR ❑ FOUNDATION HAS GAPS/HOLES S[ 4l JR� Mosquito Control Weekly $840.00 Ip(I,$PACE ❑ GAPS AROUND DOORS �j 1# �} Tax $79.80 ❑ BASEBOARDS COA$0.00 DISCOUNTS $0.00 ❑WOOD TO EARTH CONTACT CITY Ef7� I�t�fVICES TOTAL DUE 919.80 ❑ OTHER ❑ 1 A��(I ATION BAIT CONSUMPTION #1 % #2 % #3 % #4 % #5 % #6 % #7 I /° o`� #9 COMMENTS: PAYMENT RECEIPT.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton Mosquito Control Weekly $840.00 Tax $79.80 DISCOUNTS $0.00 rl icrnnnr-o a "'919.80 't�)We-.N aCA18SF6 ON"" Washington State Department of Ecology Printed: Jul 14,2014 Wastewater Permit Invoice W A S NI N 6 7 D N S T A T E D E P A a T N E N T 6 F E C O L O G Y RENTON,CITY OF Invoice#: 2015-WAG992028 Attn:DENIS LAW Permit: WAG992028 1055 S GRADY WAY UUq SOS F O l 0 Fee Type: Wastewater RENTON,WA 98057 �! l �a�l �� c?, ,71( 1.. ' , �a4 Category: Aquatic Pest Control-Mosquito Control Districts Date Description Annual Fee Amount Billed Amount Paid Amount Due Due Date 07/14/2014 Annual Fee Amount $496.00 $0.00 $0.00 $0.00 07A 2014 Billing Amount $0.00 $496.00 $0,00 $496.00 08/28/2014 Total Annual Fee: $496.00 $496.00' ' $0.00 = $496.00 This invoice covers Fiscal Year 2015(July 1,2014,through June 30,2015). • An annual fee will no longer be assessed once the permit has been canceled by Ecology. However,the full annual amount will be owed for the current fiscal year regardless of the permit termination date within that fiscal year. ECOLOGY DOES NOT PRORATE FEES FOR PERMIT TERMINATIONS. • Delinquent accounts will be turned over for collection and a 20%surcharge will be added to the amount owed. This surcharge is Ecology's cost for the collection action. • Small business/extreme hardship fee reduction application requests can be found at the following web address: http://www.ecy.wa.gov/programs/wq/permits/Permit fees/PermitFeeForms.html • Questions regarding the permit fee assessment should be directed to:Bev Poston at 360/407-6425 or via email to JUL 18 Z014 CITY OF RENTON UTILITY SYSTEMS Please send check or money order payable to: (DO NOT SEND CASH!) Department of Ecology Cashiering Unit PO Box 47611 Olympia WA 98504-7611 7/14/2014 2:37 48PM 986.00 Detach and return this portion with your check. PLEASE INCLUDE THE INVOICE NUMBER ON YOUR CHECK. Printed: Jul 14,2014 Wastewater Fee Billing Notice Past Due Amount This Fiscal Year: $0.00 Current Amount Due: $496.00 Total Amount Due: $496.00 4— This Amount Due By 08/28/2014 RENTON,CITY OF Invoice#: 2015-WAG992028 Attn:DENIS LAW Permit: WAG992028 1055 S GRADY WAY Coding: 176- WWD - 02-86-000196 RENTON,WA 98057 ECY 010.72b (6/99) INVOICE Whitworth Pest Solutions 2533 Inter Avenue to joy I'lo8 Puyallup , WA 98372 eat• &5' 253-845-1818 INVOICE DATE DUE DATE CUSTOMER# -06/17/14 9763 PO# City of Renton Utility Systems Tech To m 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $821 .25 For Service At: City of Renton-Retention Ponds '1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquitoes 1 @ $750.00 $750.00 RECEIVED JUN 19 2014 CITY OF RENTON UTILITY SYSTEMS City of Renton Send Payment To Utility Systems Whitworth Pest Solutions Total Tax: $71.25 1055 S Grady Way 2533 Inter Avenue Total This Invoice: $821.25 Renton, WA 98057 Puyallup , WA 98372 Payments Received: $0.00 253-845-1818 ;1 ,1W Invoice: 227410 Invoice Date: 06/17/14 •: $821.25 **See Erik**TAKE KEY WITH YOU.Dip and then apply larvacide as necessary. see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill $125 per man hour, $375 min per contract. Tn:Vectolex--73049-20--32oz--Ponds: F&A WHMWORTHI - • 228776 Iry -PEST SOLUTIONS , INC TIME IN. Lrp TIME OUT: ; Caring for Your Horne, Business, and Environment 2533 Inter Ave. • Puyallup,WA98372 CUSTOMER 9763 TECH Tom 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 228776 SERVICE ADDRESS DATE&TIME 06/19/14 LICENSE# 72235 City of Renton-Retention Ponds TARGET PEST 1055 S Grady Way Renton,WA 98057 ❑ Lawn: El Fertilization(please water in 1 Inch) El Weed control BILLING ADDRESS ❑ Moss control ❑ Crane fly control ❑ ph Correction City of Renton ❑ Trees&Shrubs: ❑ Insect spray ❑ Disease control ❑ Foliar fertilization 1055 S Grady Way Renton,WA 98057 ❑ Injection ❑ Other ........................................................................................................................................ • ❑ Weed Control: ❑Gravel ❑Noxious weeds ❑Shrub beds ❑ Total vegetation kill ❑ Other ............................ Mosquitoes $650.00 . Tax $61.75 XOther: U. D COA$0.00 DlscouNTs $0.00 ❑Other: n�11 ® $711.75 COMMENTS://S/SPEC-TEzJ f?/+� 'Ti2G�q: J-f)H-ox J\ /X),a ��caearrev c.vevs+ PAYMENT RECEIPT.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton-Retention Ponds Mosquitoes $650.00 Tax $61.75 COA$0.00 DISCOUNTS $0.00 $711.75 Whitworth Pest Solutions INVOICE F-2-��8- 2533 Inter Avenue Puyallup , WA 98372 253-845-1818 ` -- INVOICE DATE - 1 4 DUE DATE 7h-7/201. CUSTOMER k 5035 NET 30�_�. r'O# City of Renton Utility Systems TechT Mr Li e se 72235 1055 S Grady Way Renton, WA 98057 ,AMOUNT DUB 1 $410.63 For Service At: Maplewood Golf Course Kelly Beamer 4050 Maple Valley Highway Renton, WA 98058 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 I I City of Renton Send Payment To Utility Systems Whitworth Pest Solutions Total Tax: $35.63 1055 S Grady Way 2533 Inter Avenue Total This Invoice: $410.63 Renton, WA 98057 Puyallup , WA 98372 Payments Received: $0.00 253-845-1818 - -_ Invoice: 227418 Invoice Date: 06/17/14 .• . $410,63 DO 6/17 tt Melly V6, kh/Im 6/16 for 6/17. kh/BE THERE BY 7AM, CHECK IN AT THE PRO SHOP AND THEY i WILL GET YOU A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvaclde as necessary, Bill$125 per man hour, $375 rein per contract. Tn:Vectolex--73049-20--12oz--Ponds: l Lity tit Menton Mosquitoes - Day 1 Total Total Time In Number Sq.Et. Amount of Name Location Type Date EaneaE Product NamejEPA /out j of Dips Count Treated Larvacide ' Applied -iWevv cic C-;�.oL�rse lwest) M:4Plewo+d Golf Course Hole 018/Pond e _ I -aolewooa Zjol 76uese I (West-central) Maplewood,Golf Course Hole 99/Pond '® ,F=•r,' � � � E a 7700 �p,< .,�Urrie (e3s centra€) M,�,,I-wood Golf Course Hole 07/Pond 2�Y ave o G0 _ours ( xSti Maolewood Goal co;Ir, H .it t# /Pond iclf Course.Vat ous Maolewcwd Golf Course Catch Basins S.3rAgat? NE 26th and I,yont,Ave �Ve^Cd'`oncf .- ` +�� Ir A Park NE 13Eh PI Pond . .�... ,y, -- �.�::• �- € NE I9th st>o.^/Dvtent on NE 10th St and Anacort- Av I,,etentiran 1 f E. park 124th St S.E&149th Ave SA Har°-f,tur, lfivth Ave SE Pcrtc Nicn,.is Place 16 th Ave SE/SE 1w,St Pond I Everdei= 160th Ave SE Ponc Z C ,.I W A Y b t ar=. -,3p i.? t 5q'1v Valiey fad Pond v •Sa' �V P 3 " ,,,r �i A,sria INood;Trdw'C SE 1861h St and 120tb Ave SE f-'ono LVe r L �' g ia3 r,ft I Ave.S--a nd SE 183 rd 1,t Pond Wccdsl 111th Pi SE and SE 13 th St Pond 5. S.2OCth St and 1D15,Ave,SE Pond are demo:a p ace E SE I Kth st and 102nw Ave SE Pond �.� S remty RId ;-act A 110th PI St Pond I , t r" Serenity Ridge T,jcr ES ( 110th PI SFt Pond fast ,•`'' % P s . 112t Pi SE and 152ni: F'ortd lyrrpic Peak Estate S.19rath P•&Tolbot Rd 5 Pond e I Td€.,vi rsta;c-s Talbot Rd S Pond J of R dar 2 S 4P,h St and 10'nd Ave:SE WQPord i I '.Various Locations L;ar"sou_. Catch 81,;su,;s :Various V,3r nu5 Catch�iaws 1 ra I '.S I.Jr e, l as €Ly'' Grady Way ,.ot VVQ t-11Y UT Kenton mosquimes- uay z Total Number Total Sq.Ft. Amount of Name Locit,w Type Date Time In/Out Larval Product Narne/EPA 4 of Dips Count Treated Larvacide Applied wig"Po,nw 131,,,5-,Recrnond R.NE ,Rro or.Ce3ci II 5311 N--1 It h C t As n Woods NE 8th.PJ/ 4w�dl P1.NE J,r M3ureen H.=griancls NE 4th Stg-,4,,4r-o Ave NE Ar,tefwood 315 Quincy Aw)NE erwcod 304 Rosano PLNE e Untras Pace 561:SE Ist P1 ..........- Sienna 5402 NE 2nd SP J ............. �er:c-no P,ray NE 3rd Pl/Hoqiu4rn Ave NF _V, J Shy creek 129 Ilericho Ave NE Z,ml�......... Rtmton Mlapkl Valley Ra/ pioneer Place l 145th Ave 5E Morning Gen 1 176412114th P'SE thin ivap Riclow SE 192nd St/ I 113th Way SE At Str,rw,,,haven 5 4 7th St/M&n Av: 5 3,4 6we-1 INVOICE JW W H tTWO TK29932 J Caring for Your Horne, Business, ad Environment 2533 Inter Avenue, Puyallup,WA.98272 INVOICE DATE 07/03/14 DUE DATE CUSTOMER# 9763 CtAc�-l3-totp PO# City of Renton It low 1.(o5 Utility Systems 4156, 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $958.13 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquitoes Day 2 1 @ $875.00 $875,00 RECEIVED JUG. J 0 2014 CITY OF RENTON UTII-I1"Y SYSTEM City of Renton Send Payment To Utility Systems Total Tax: $83.13 1055 S Grady Way Total This Invoice: $958.13 Renton, WA 98057 Payments Received: $0.00 Invoice: 229932 Invoice Date: 07/03/14 Day 2 TAKE KEY WITH YOU.Dip and then apply larvacide as necessary. see additional sheet for locations.contact @ city of renton is Hebe;Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill $125 per man hour, $375 min per contract. TnVectolex-73049-20--65oz--Ponds SW/0-2/76: i S��I a-�f�LIStiS.. WHI - -/ORTH 40 • 230641 PEST SOLUTIONS , INC TIME IN: / TIME OUT; Curing for Your Home, Business, and Environment (ti.��y..1 3 407 2533 Inter Ave. • Puyallup,WA 98372 cusroMER# 9763 TECH Tom je> ; 253.845.1818 • 206.248.2222 • 1.888.959.1818 APPOINTMENT 230641 t"J SERVICEADDRESS DATE&TIME 07/17/14 LICENSE# 72235 City of Renton-Retention Ponds TARGET PEST 1055 S Grady Way RECEIVE Renton, WA 98057 ❑ Lawn: ElFertilization(please water in 1 inch) El Weed control •- ❑ Moss control ❑ Crane fly control ❑ ph Correction ........................................................................................................................................ City of Renton 1055 S Grady Way pity of Renton ❑ Trees&Shrubs: ❑ Insect spray ElDisease control ElFoliar fertilization Renton, WA 98057 Accounts PayablF ❑ Injection ❑ Other ........................................................................................................................................ • El Weed Control: El Gravel ❑Noxious weeds El Shrub beds ❑ Total vegetation kill ❑ Other MosquitoesDay 2 $375.00 ................................................................................... _ ...�................................... Tax $35.63 XOther: rrlG a?LLr7O f i E C I �//-E D COA$0.00 DISCOUNTS $0.00 ❑Other: • $410.63 COMMENTS:ii�s/��L�G'!✓ l9fF!' 1i2Li`T%Z�fl ir'L+/��'S xs- CITY OF RENTON UTILITY SYSTEMS PAYMOT RECEIPT.PLEASE RETURN WITH PAYMENT FOR PROPER CREDITING OF YOUR ACCOUNT City of Renton-Retention Ponds Mosquitoes Day 2 $375.00 Tax $35.63 C DISCOUNTS $0.00 CUSTOMER# ���� INVOICE# ��,,,-A • ® $410.63 ad a.4:5,c WOO K MWORT • 229197 PEST SOLUTIONS I N C 7APPOINTMENT ? TIME OUT: �;16 Coring for Your Horne, Business, and Environment 2533 Inter Ave. • Puyallup,WA 98372 763 TECH Tom I e/cca [fir 253.845,1818 • 206.248.2222 • 1.888.959.1818 29197 7 I i .7 J;, SERVICE ADDRESS DATE&TIME 07/16/14 LICENSE# 72235 City of Renton-Retention Ponds TARGET PEST MOSQ 1055 S Grady Way R E C E I Renton, WA 98057 wn: ❑ Fertilization(please water in 1 inch) ❑ Weed control .- • ❑ Moss control ElCrane fly control ❑ ph Correction ................ ............................................................................................................... City Of Renton ❑ Disease control ❑ Foliar fertilization 1055 S Grady Way City of Re titTrees&Shrubs: ❑ Insectspray Renton,WA 98057 AcCOUnts P yable ElInjection El Other ............................ ...................................................................................................... SERVICE TYPE AMOUNT ❑ Weed Control: ❑Gravel ❑Noxious weeds ❑Shrub beds ❑ Total vegetation kill ❑ Other Mosquitoes $650.00 ................................................. Tax $61.75 P"Other: ,0Td?Ce ,0 COA$0.00 DISCOUNTS $0.00 ❑ -� Other: TOTAL • $711,7� r� A COMMENTS: l.�3-i'CGTCrB/9�tJ 13Z�.;F7 .`Fr�✓ JUL 2 3 2014 ij��ECC,lE O/tdJ� IY�cJJ6�tf/�C?L-��✓� U CITY OF RENT ON ae City of Renton-Retention Ponds Mosquitoes $650.00 Tax $61.75 COA$0.00 DISCOUNTS $0,00 CUSTOMER# 07RI INVOICE# !17/9 1 I n is] A ® $711.75 VN H IT1WORTH7APPOINTMENT 229205 PEST SOLUTIONS , INC p TIME OUT: �;dy2 Caring for Your Horne, Business, and Environment Ctt � t3 tvt" 2533 Inter Ave. • Puyallup,WA 98372 64 TECH Tom 253.845.1818 • 206.248.2222 • 1,888,959.1818 9205 t�w{'<-'I i'G3 SERVICE ADDRESS DATE&TIME 07/16/14 LICENSE# 72235 ��i Maplewood Golf Course T PEST MOSQ 4050 Maple Valley Highway RE•CE.! Renton, WA 98058 ❑ Lawn: ❑ Fertilization(please water in 1 inch) ❑ Weed control ••• — 2014 ❑ Moss control ❑ Crane fly control ❑ ph Correction ..................................................................................................................I.................... City of Renton 4 n 1055 S Grady Way Clty Of N�&Shrubs: El Insect spray ❑ Disease control ❑ Foliar fertilization Renton, WA 98057 Accounts ❑ Injection ❑ Other ........................................................................................................................................ • ❑ Weed Control: ❑Gravel ❑Noxious weeds ❑Shrub beds ❑ Total vegetation kill ❑ Other NG :Ta Control Visit $375.00 ........................................................................................................... $35.63 Mother: /YIIJT�tI RECEIVED 0 DISCOUNTS $0.00 ❑Other: � � $410.63 COMMENTS: XS�c/CE©�D /�vr2 hJpSeilNlTl3 I�AdY.•'�' CITY OF RENTON UTILITY SYSTEMS Maplewood Golf Course Mosquito Control Visit $375.00 Tax $35.63 COA$0.00 - DISCOUNTS $0,00 CUSTOMER# 1�f14 r, INVOICE# $41 0.63 c' 5 S r= TH INVOICE [��06---J WH ITWOR PEST SOLUTIONS , INC Caring ftr Your Home, Business, and Environment 2533 Inter Avenue, Puyallup,WA.98272 j INVOICE DATE 07130114 DUE DATE CUSTOMER# 0 V\' ( 3 1 (<> PO# City of Renton Utility Systems �}�i ;r;,t,;�, 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $410.63 For Service At: Maplewood Golf Course Kelly Beamer 4050 Maple Valley Highway Renton, WA 98058 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 RECEIVED AUG 0 5 2014 CITY OF REINTOIV UTILITY SYSTEMS City of Renton Send Payment To Utility Systems Total Tax: $35.63 1055 S Grady Way Total This Invoice: $410.63 Renton, WA 98057 Payments Received: $0.00 Invoice: 229206 Invoice Date: 07/30/14 ® $410.63 BE THERE BY 7AM. CHECK IN AT THE PRO SHOP AND THEY WILL GET YOU'A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvacide as necessary. Bill $125 per man hour, $375 min per contract. Vectolex 73049- 20-- 15oz-- Ponds Temp 68 Wind S @ 0-2mph � � � > INVOICE C:��274 3 PEST SOLUTIONS , INC Caringfor Your How, Business, and Environment 2533 Inter Avenue, Puyallup,WA.98272 j INVOICE DATE 07/30/14 DUE DATE CUSTOMER# c ,. PO City of Renton ' ,�' _�.(�l'jv Utility Systems s 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $821 .25 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquitoes Day I J 1 @ $750.00 $750.00 'RECEIVED AUG 0 5 2014 City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 232743 Invoice Date: 07/30/14 ,n $821.25 i I INVOICE PEST SOLUTIONS , INC Caringfor Your Home, Business, and Environment 2533 Inter Avenue, Puyallup,WA.98272 INVOICE DATE 08101114 DUE DATE 813112014 CUSTOMER# PO# City of Renton Utility Systems 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $958.13 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/ Product Description Quantity/ Price Amount Mosquitoes-Day 2 1 @ $875.00 $875.00 RECEIVED AUG 4 8 2014 CITY OF RENTON UTILITY SYSTE"'IS y_ 9 IN ,\ City of Renton Send Payment To Utility Systems Total Tax: $83.13 1055 S Grady Way Total This Invoice: $958.13 Renton, WA 98057 Payments Received: $0.00 Invoice: 229198 Invoice Date: 08/01/14 ® $958.13 TAKE KEY WITH YOU.Dip and then apply larvacide as necessary. see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment, cost varies depending on treatments needed, bill$125 per man hour, $375 min per contract. Vectolex 73049-10--81oz--ponds Temp 78 Wind S @ 5- 7mnh uH1T < ORTH 231845--J INVOICE PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE CUSTOMER# CIP -t3�1�(o PO# City of Renton t voc�ttipg Utility Systems ens 1055 S Grady Way8�1•d� Renton, WA 98057 AMOUNT DUE $821 .25 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/ Product Description Quantity/ Price Amount Mosquitoes 1 @ $750.00 $750.00 REECEIVED AUG 18 Z014 CITY OF RE N ON UTILITY SYSTEMS City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 231845 Invoice Date: 08/13/14 •. $821.25 TAKE KEY WITH YOU.Dip and then apply larvacide as necessary. see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment, cost varies depending on treatments needed, bill $125 per man hour,$375 min per contract. Tn:Vectolex-73049-20--120oz--Ponds: ------------ 60-qte2'j WHtTWORTHI INVOICE PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE CUSTOMER# City of Renton ti�I�a�19�8 Utility Systems 1055 S Grady Way �4i�' Renton, WA 98057 AMOUNT DUE $410.63 For Service At: Maplewood Golf Course Kelly Beamer 4050 Maple Valley Highway Renton, WA 98058 PLEASE RETURN WITH PAYMENT Service/ Product Description Quantity/ Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 RECEIVED AUG 18 2014 CITY OF RENTON UTILITY SYSTEM City of Renton Send Payment To Utility Systems Total Tax: $35.63 1055 S Grady Way Total This Invoice: $410.63 Renton, WA 98057 Payments Received: $0.00 Invoice: 231855 Invoice Date: 08/13/14 • $410.63 BE THERE BY 7AM. CHECK IN AT THE PRO SHOP AND THEY WILL GET YOU A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvacide as necessary. Bill $125 per man hour, $375 min per contract. Tn:Vectolex- 73049-20--27oz--Ponds: al`I8 3 -` WHtTWORTH INVOICE PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE 08114114 DUE DATE 911312014 CUSTOMER# C4�4 - 13-1�4 PO# City of Renton $/pad tg0 g Utility Systems Tech Tom License: 72235 1055 S Grady Way / �o Renton, WA 98057 AMOUNT DUE $1 ,026.56 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service / Product Description Quantity/ Price Amount Mosquitoes Day 2 1 @ $937.50 $937.50 REC" I AUG 19 Z014 CITY OF RENTON UTILITY' YSTEM_r-, City of Renton Send Payment To Utility Systems Total Tax: $89.06 1055 S Grady Way Total This Invoice: $1,026.56 Renton, WA 98057 Payments Received: $0.00 Invoice: 233449 Invoice Date: 08/14/14 � A $1,026.56 Vectolex 73049-20-- 153oz-- ponds Temp 75 Wind SE @ 2-5mph WHtTWORTH INVOICE Caring for Your Home, Business, and Environment INVOICE DATE 114 DUE DATE 9.127.12014 CUSTOMER# 9763 NET C Vb _at l ov PO# City of Renton L$f coo 19 D8 Utility Systems seal as 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $821 .25 N0iN_0j`3 CIO M.10 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Noz t 0 d3S Renton, WA 98057 4 V 7 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/Price Amount Mosquitoes 1 @ $750.00 $750.00 City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 231846 Invoice Date: 08/28/14 EN wom $821.25 TAKE KEY WITH YOU.Dip and then apply larvacide as necessary, see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill $125 per man hour, $375 min per contract.Vectolex 73049-20--28oz-- Ponds Temp 64 Wind W @ 0- 2mnh CJ v1 MT �1O��TH INVOICE EM- 856. lwnr NS , INC Caring for Your Home, Business, and Environment INVOICE DATE DUE DATE 9/27/2014 CUSTOMER# 15035 NET 30 City of Renton l�Ic�n!�jo Utility Systems '�' Tech Tom License: 72235 1055 S Grady Way �#A1te 1.3 Renton, WA 98057 AMOUNT DUE $410.63 RE CTIVED For Service At: Maplewood Golf Course Kelly Beamer SEP cI 3 2014 4050 Maple Valley Highway Renton, WA 98058 CITY OF RENTON PLEASE RETURN WITH PAYMENT UTILITY Service/Product Description Quantity/ Price Amount Mosquito Control Visit 1 @ $375.00 $375.00 City of Renton Send Payment To Utility Systems Total Tax: $35.63 1055 S Grady Way Total This Invoice: $410.63 Renton, WA 98057 Payments Received: $0.00 Invoice: 231856 Invoice Date: 08/28/14R%. 91wom $410.63 BE THERE BY 7AM. CHECK IN AT THE PRO SHOP AND THEY WILL GET YOU A GOLF CART.(CONTACTS ARE KELLY OR STEVE)Larvacide as necessary. Bill $125 per man hour, $375 min per contract.Vectolex 73049- 20 -- 15oz- Ponds Temp 79 Wind W @ 2-5mph r WHITI WORTH INVOICE PEST SOLUTIONS , INC Caring for Your Home, Business, and Environment INVOICE DATE 08.129.114DUE DATE CUSTOMER# i City of Renton PO#l�/������ Utility SystemsTech Tom Lfficens 72235 1055 S Grady Way heal a �� Renton, WA 98057 AMOUNT DUE $821 .25 NO1NDH JO A110 For Service At: City of Renton-Retention Ponds 1055 S Grady Way VIOZ g 0 dis Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/ Product Description Quantity/ Price Amount Mosquitoes Day 2 1 @ $750,00 $750.00 i City of Renton Send Payment To Utility Systems Total Tax: $71.25 1055 S Grady Way Total This Invoice: $821.25 Renton, WA 98057 Payments Received: $0.00 Invoice: 234448 Invoice Date: 08/29/14 m $821.25 TAKE KEY WITH YOU.Dip and then apply larvicide as necessary. see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill $125 per man hour, $375 min per contract, Tn:Vectolex73049-20--25oz--Ponds W/2-5/68: Q6,55f WHIT WORTH INVOICE PEST SOLUTIONS , INC Caringfor Your Home, Business, and Eiivironmew 2533 Inter Avenue, Puyallup,WA.98272 INVOICE DATE CJ7102114 DUE DATE CUSTOMER# NET 30 C A67-13 _i PO# City of Renton Utility Systems 1055 S Grady Way Renton, WA 98057 AMOUNT DUE $684.38 For Service At: City of Renton-Retention Ponds 1055 S Grady Way Renton, WA 98057 PLEASE RETURN WITH PAYMENT Service/Product Description Quantity/ Price Amount Mosquitoes 1 @ $625.00 $625.00 RECEIVED JUL 0 7 2014 CITY OF RENTON UTILITY SYSTEIViS City of Renton Send Payment To Utility Systems Total Tax: $59.38 1055 S Grady Way Total This Invoice: $684.38 Renton, WA 98057 Payments Received: $0.00 Invoice: 227411 Invoice Date: 07/02/14 swummow o $684.38 TAKE KEY WITH YOU.Dip and then apply iarvacide as necessary. see additional sheet for locations. contact @ city of renton is Hebe Bernardo. Fax day sheet and reports after every treatment. cost varies depending on treatments needed, bill $125 per man hour, $375 min per contract. Tn:Vectolex 73049-20--18oz--Ponds SW/2-5/84: City Of Renton Mosquitoes - Day 1 Total Total Nance Location Type Date Time In Number Larval Sq.Ft. Product Name/EPA# Amount of /out of Dips Count Treated Larvacide Applied Mlap ewood,Golf 17,0-ur-'e J" (West) Maplewood Golf Courw Hoie#18/Pond MaWewood Golf ourse (West-centrai) Maplewood Golf Course Hole#9/Pond Maplewood Go?t 70-Urst, 7 (east-central) Maplewood Golf Course Hole M7/Pond 7-a,-i Y A, Maplewcoa 6o4 Course (east) Maplewood Golf Course Hole#6/Pond 7-J-tq VZ, 7 Golf Course-Various Maplewood Golf Course Catch Basins '7 J, Y� S"nogate NE 261h and Lyons Ave WO Pond �Ll Aster Park NE 13th PI Pond NE 10th st Pond/Detention NE 10th 51,and Anacones Ave Detention Ellis Park 124th St S,E&149th Ave S,E Ha-nilton Place 160th Ave SE Pond -i� Nichols Place I.60th Ave SE/SE 5th St Pond Everdell 160th Ave SE Pond I t, V an , ape ;,o"ef Vailey Rd Pond 71-4,- 'e, -r, Au,ia Woods Tract C SE 186th St and 120th Ave SE Ponr. -.,w IK$1, ;41 tl Larson Parke 114th Ave SE and SE 183rd Ct Pond v Senscr,Woods 111th PI SE and SE 189th St Pond 7c'-A, Watershed Terrace I SE 200th St and 101st Ave SE Pond ;g A Frederick's Race SE 186th St and 102nd Ave SE Pond Serenity Ridge Tract A 110th PI Se Pond Serenity Ridge Tract a 110th P1 Se Pond 'Pr, Wkens Wood 11 2th P1 SE and 192nd Pond 7-J -AA, Olympic Peak Estates S.196th PI&Talbot Rd S Pond Estates Talbot Rd S Pond .......... Talbm RRUP 2 S 47',b St acid 102nd Ave SE WQ Pond var:ous Locations 7i`vision Various Catch Casin ,�. s Prks Mairtenancu `vmon vanoU5 Various lCa lch ftaV Parking Lot WQ New for 2014 Total Type Number Total Ft Product Name/EPA 4 Amount of Name Date Time In(put Larval S . of Dips Count Treated Larvacide Agglied ,on Hill h S 7� St/S 71h Wit..1"berty G,ove&Jberty �Z:,Ove Contliguaw"; SE 136th S',&160th Ave SE Duval Ave&NE 1st 51 P a rk 7-1 1 J Ae 8,SE,n"I P� �txnvnt,�Piat 3721 NIQri�s A,;e -,,a Vin5per'r io'!view phase-1 32rd St. Talbot Rd ,,i,nb-,,dv Lane 17228 125th AvfY Sr 7- f W- W,W P U U),Le- N[- '44 F,,,�.d 91 NE&Nil 4th P" ------ Ljbf, ty Rj�4ge j�jje 2 NE"st St&Glenw"d Ave SE , pi �,151 I NF IsT M tbehind Ubeil.V Ridge Pilase I residt,,Ke, 14 Rldg—pijasp I lnoex Ave SE&SE 1A St 4 Whitfnar,PI NF NE 2i 1,Urnhurs d l.ri ---------- ..... zo'terbe�K Burnett PI 21st St Niagnusser,Plat �-teld Ave NE NF 2nd St 481,1 NF 2noSt(beh,nd Magn�,Sen Nat r(sidpncel L -'iwa PI NF 4 a,Hcoey 0 N 't Hig?-,iands Part.. R<�s-i6u P1 SF SE 2rid N 41, Vj 14� 'Yons P!NE 15 N; 2- e,e HoQuiam Ave NE&NI:arid S, W 9±' 1 f i,,ici Av NE 4,nd ADMINISTRATIVE SERVICES DEPT p o c'n'°f City Clerk Office M E M O R A N D U M RECEIVED JUN 0 2 2014 DATE: June 2, 2014 TO: Allen Quynn, PW-Utilities CITY OF RENTON UTILITY SYSTEMS FROM: 90 Sandi Weir, Records Management Specialist SUBJECT: CAG-13-106, Adden #1-14 —Whitworth Pest Solutions The attached document has been fully executed and is being returned to you. The City Clerk has retained an original for the file. Thankyou! Attachment STATE OF WASHINGTON, COUNTY OF KING } AFFIDAVIT OF PUBLICATION PUBLIC NOTICE RECEIVE Linda M Mills, being first duly sworn on oath that she is the Legal U 1 2014 Advertising Representative of the The City of Renton to Apply JUG Mosquito Control Pesticides The City of Renton may use ENTON mosquito larvicides made of a CITY OF R Renton Reporter sphaelicus)bactandm (Bacillus adulltcides UTILITY SYSTEMS (BIOMISTO and/or Kontrol 4-49) to help control mosquitoes in accordance with the Washing- a weekly newspaper, which newspaper is a legal newspaper of ton State Department of Ecolo- gy's circulation and is now and has been or more an six months Aquatic Mosquito control g f than i th General Permit. Treatments may prior to the date of publication hereinafter referred to, published in occur between June I and the English language continuously as a weekly newspaper in King October 31, 2014. Larvicide treatment will generally occur in County, Washington. The Renton Reporter has been approved as stormwater facilities owned or a Legal Newspaper by order of the Superior Court of the State of maintained by the City. Adulti- Washin ton for Kin COUnt cide treatment areas are generally g g y`. located in upland areas east The notice in the exact form annexed was published in regular issues of SR-167 and west of Lake of the Renton Reporter (and not in supplement form) which was Avenue SoutWFalbot Road South between SW 39th Street to regularly distributed to its subscribers during the below stated period. the south and 1-405 to the north, The annexed notice, a: within the City of Renton, Wash- ington. Information about the Public Notice larvicides, adulticides and a map of the specific locations are available at www.rentonwa.eov. For more information about was published on May 16, 2014. the City's commitment to help reduce the threat of West Nile virus and control mosquitoes, contact Heb@ Bernardo, City of The full amount of the fee charged for said foregoing publication is Renton Surface Water utility g g g p ��� !liii1411 Engineer, at 425-430-7264 or the sum of$105.00. ,�`` �ty(l tk/,/ by email at hbernardo cnre renton- ` g10Nt�++++� � /,�ii who For additional information about AZ w ol q '�i`�i,�p �i, Ecology's Aquatic Mosquito Mills��in�&M. YcC Os� ,�► J- �� 2 � Control General Permit, please (P 'y contact the City of Renton or e Jon Jennings, Water Quality Legal Advertising Representative, Renton Reporter % %,, 'OUB0; 2 : Program, Washington state De- �j N /' O = partment of Ecology, at 360-407- Subscribed and sworn to me this 16th day of May, 2014. �i, �` a,,4.19_\6 A _= 6283 or by email at Jonathanjen- // nings@ecv.wa.gov. Z) //41IltOF�yp5''` `���� Bonnie Walton Renton City Clerk Published in the Renton Reporter Kat Teen C. Sherman, Notary Public for the State of Washington, on May 16,2014.#1053440. Residing in Buckley,Washington WHITWORTH PEST SOLUTIONS, INC Caring for Your Home, Business, and Environm RECEIVED JUN 16 2014 Allen Quynn, CITY OF RENTON UTILITY SYSTEMS During the hours of 8:50am and 11:15am on Thursday June 12, 2014 we serviced the Panther Creek Wetlands.The Chemical used was (Kontrol 4-4). During the application on the north end, the mosquito levels were low.The water levels on the north end were still high prohibiting us from treating any further. South end trail mosquito levels were moderate. During the south end treatment there was a conflict with Mr. Clifford, he stated we trespassed over his property line and proceeded to create conflict. I asked him to call the police so that conflict would not escalate.This was at 10:30am. Police arrived at 10:50am, at 11:00am I offered a resolution to back track from the end of fogging location on south end and proceed to drive to the end of the south end trail and proceed to finish the application; in which part we will bypass Mr. Clifford, he stated he will put up a fence today and will be recommending his neighbors do the same. Information was given to the police and resolution stated to the home owner Mr. Clifford; this will work as long as we follow it. Thank you! Michael Batten Technician Whitworth Pest Solutions 2533 Inter Ave • Puyallup, WA 98372 • 253-845-1818 • 888-959-1818 • Fax 253-845-1133 • www.whitworthpestsolutions.com Denis Law j City Ofr..k U Mayor � INV Public Works Department-Gregg Zimmerman,P.E.,Administrator 2014 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex (Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray (Exhibit C). A portable fogger (gasoline-powered backpack-mounted) will be used to apply the spray to upland vegetation. During May through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit B) form, to allow the applicator access through your property, if needed, to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided by May 30, 2014. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you would like information on precautions you may take to help repel mosquitoes, please see Exhibit C. if you have any questions, or would like more information about the Mosquito Abatement Program, please contact Hebe C. Bernardo, Surface Water Utility Engineer, at 425-430-7264, or by email at hbernardo@rentonwa.gov. Enclosures H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Release Request.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov hS 1-405 Ramp 4t St Ca - S CD Q N c a cv _ LY r. S CD - ® N CO Mosquito ADatement Program N Exhibit A: Site Plan 0 500 1,000 W E Note: Treatment will not be applied within 100'of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge 0 Project Boundary and the residential areas. Property owner approval required prior to C treatment on private property. Denis Law -- City of, Y o Mayor74 ! Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059012 Resident 3315 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov EXHIBIT C Insecticide Products: As in previous years,we will be using products containing the insecticide permethrin. See below for more information. Permanone'31-66: Permanone'31-66 is sold under the trade names of BioMist,and Kontrole 4- 4. They contain a synthetic version of permethrin as an active ingredient. The insecticides are formulated for dilution with oil products, such as mineral oil, and are applied at a rate between 0.0035 and 0.0070 pounds of permethrin per acre. Permanone'31-66 is degraded in soil and may last for several days. BioMist'and Kontrol`4-4 are not applied within 100-feet from water or wetland areas. Repel Mosquitoes: Not all mosquitoes will be eliminated during our Mosquito Abatement Program. Some precautions you may take to further reduce the number of mosquitoes in your area include: Mosquito Breeding Places: Some mosquitoes may breed in stagnant water. If you eliminate standing water around your home,you may eliminate their breeding places. Stagnant water may be found in ornamental pools, birdbaths, old tires, and flower pots. Methods to eliminate these and other potential breeding sites are listed in the Extension Bulletin PLS-121 April 2007 by the Washington State University Cooperative Extension titled "Pest Management for Prevention and Control of Mosquitoes". Natural Predators: By encouraging natural predators that feed on mosquitoes, you may also reduce the number of mosquitoes in your area. Natural predators include bats, swallows,frogs, and fish. In order to stock mosquito fish and three-spine stickleback fish, a permit is required from the Washington State Department of Fish and Wildlife. However,you may attract other natural predator animals by enhancing habitat and constructing cavity type houses. More information on attracting natural predators, such as instructions for constructing and locating bat houses, may be obtained from the State Department of Fish and Wildlife. Mosquito Repellent: By using mosquito repellent, netting, and screens you may reduce your exposure to mosquitoes. Additional precautions include: ♦ Wear clothes that reduce the area of exposed skin; ♦ Install screens or netting over open patios or windows; and/or ♦ Apply repellents, especially those containing the ingredient diethyltoluamide (DEET), to exposed skin. Since young children and certain adults can be sensitive to DEET, please follow application instructions carefully. Note: While bug lights eliminate some mosquitoes, they are not highly recommended, since studies show they also eliminate a large amount of beneficial and non-pest insects. Furthermore, Aedes, the most aggressive of the mosquito species,found in the Talbot Hill area, are not attracted to light and the noise emitted by the bug lights may annoy some neighbors. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Description Exhibit C.DOC/HBah PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 3023059012 NAKANISHI RUTH Y 3315 TALBOT RD S RENTON WA 98055 3315 TALBOT RD S RENTON, WA 98055 2 3023059016 SCHULTEK JEFF& BERNADINE 2921 TALBOT RD S RENTON WA 98055 2921 TALBOT RD S RENTON, WA 98055 3 3023059018 OLSON SHAWN &JAIME 3101 TALBOT RD S RENTON WA 98055 3101 TALBOT RD S RENTON, WA 98055 4 3023059019 TATRO DON L 3211 TALBOT RD S RENTON WA 98055 3211 TALBOT RD S RENTON, WA 98055 5 3023059025 NOBLE JANICE M 2819 TALBOT RD S RENTON WA 98055 2819 TALBOT RD S RENTON, WA 98055 6 3023059036 LEE BRANDON V 2709 TALBOT RD S RENTON WA 98055 2709 TALBOT RD S RENTON, WA 98055 7 3023059050 HAWKINS JACK M+JANE 1 2825 TALBOT RD S RENTON WA 98055 2825 TALBOT RD S RENTON, WA 98055 s 3023059063 NGHIEM HOA 3001 TALBOT RD RENTON WA 98055 3001 TALBOT RD S RENTON, WA 98055 9 3023059068 PHAM VANG VAN+NGOCLOAN THI 408 S 33RD PL RENTON WA 98055 408 S 33RD PL RENTON, WA 98055 10 3023059075 TURNER DAVID E&JODIE D 3107 TALBOT RD S RENTON WA 98055 3107 TALBOT RD S RENTON, WA 98055 11 3023059081 SCHNEIDER KATHLEEN E 3037 TALBOT RD S RENTON WA 98055 3037 TALBOT RD S RENTON, WA 98055 12 3023059105 CLIFFORD CHRISTOPHER P/CHINN SHERI J 2721 TALBOT RD S RENTON WA 98055 2719 TALBOT RD S RENTON, WA 98055 13 3023059106 CHINN MARY JEAN 2715 TALBOT RD S RENTON WA 98055 2715 TALBOT RD S RENTON, WA 98055 14 3023059107 KREBS FREDERICK D 2703 TALBOT RD S RENTON WA 98055 2703 TALBOT RD S RENTON, WA 98055 is 3023059114 SMITH ARTHUR L& MARIE W PO BOX 59512 RENTON WA 98058 3117 TALBOT RD S RENTON, WA 98055 16 3023059115 BERRY PAUL 3129 TALBOT RD S RENTON WA 98055 3129 TALBOT RD S RENTON, WA 98055 17 3023059116 FULLER NATHAN C 3113 TALBOT RD S RENTON WA 98055 3113 TALBOT RD S RENTON, WA 98055 18 3023059121 TRAN THANH VAN+THU HA NGUYEN ET ALTHI 3011 TALBOT ROAD SO RENTON WA 98055 3011 TALBOT RD S RENTON, WA 98055 19 3023059122 PENA ELMER C+EVELYN D 3021 TALBOT RD S RENTON WA 98055 3021 TALBOT RD S RENTON, WA 98055 20 3023059123 WOO PETER C 3031 TALBOT RD S RENTON WA 98055 3031 TALBOT RD S RENTON, WA 98055 21 3023059127 RAMIREZ RENE Q+DANILEE 426 S 33RD PL RENTON WA 98055 426 S 33RD PL RENTON, WA 98055 22 3023059128 CHEUNG MUI HO+CHIM KUEN KAU 420 S 33RD PL RENTON WA 98055 420 S 33RD PL RENTON, WA 98055 23 3023059129 WONG WING TIN 553717TH AVE S SEATTLE WA 98108 414 S 33RD PL RENTON, WA 98055 24 3023059130 HERNANDEZ JORGO& MARTHA 402 S 33RD PL RENTON WA 98055 402 S 33RD PL RENTON, WA 98055 25 3340401110 AMBERWOOD LLC 19129 SE 145TH ST RENTON WA 98059 VACANT RENTON, WA 26 3340401115 CARROLL ELIZABETH 1805 LAKE AVE S RENTON WA 98055 1805 LAKE AVE S RENTON, WA 98055 27 3340401120 LARSEN KELLY F+JESSICA E 1803 LAKE AVE S RENTON WA 98055 1803 LAKE AVE S RENTON, WA 98055 28 3340401125 ALLEN JUSTIN P 1801 LAKE AVE S RENTON WA 98055 1801 LAKE AVE S RENTON, WA 98055 29 3340401130 MONTANEZ CHERIE D+MEDILO BENJIE P 1737 LAKE AVE S RENTON WA 98055 1737 LAKE AVE S RENTON, WA 98055 3o 3340401131 LEWIS OLGA M 1717 LAKE AVE S RENTON WA 98055 VACANT RENTON, WA 31 3340401132 GIENG HONG 1731 LAKE SOUTH RENTON WA 98055 1731 LAKE AVE S RENTON, WA 98055 32 3340401133 VILLAR MARILOU 430 TEMPLETON DR VANCOUVER BC 0 VACANT RENTON, WA 33 3340401140 VILLA CHARLES A+CONSTANCE M 1717 LAKE AVE S RENTON WA 98055 1717 LAKE AVE S RENTON, WA 98055 PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 3340401145 BROWN WAYNE ARTHUR JR 1711 LAKE AVE S RENTON WA 98055 1711 LAKE AVE S RENTON, WA 98055 35 3340401150 DELLA ROSSA EDWIN 1625 LAKE AVE! RENTON WA 98055 1625 LAKE AVE S RENTON, WA 98055 36 3340401151 TOBACCO JANA A 1701 LAKE AVE S RENTON WA 98055 1701 LAKE AVE S RENTON, WA 98055 37 3340401160 WILLIAMS DON D 9308 46TH AVE S SEATTLE WA 98118 1619 LAKE AVE S RENTON, WA 98055 38 3340401165 POZZOBON TERESA& EDA 1615 LAKE AVE S RENTON WA 98055 1615 LAKE AVE S RENTON, WA 98055 39 3340401170 DOMINGCIL MARYANN 1521 LAKE AVE S RENTON WA 98055 1521 LAKE AVE S RENTON, WA 98055 4o 3340401171 SCHNEIDER SHAWN M+KATRINA M 1523 LAKE AVE S RENTON WA 98055 1523 LAKE AVE S RENTON, WA 98055 41 3340401172 CHAVEZ KATHRYN G 1607 LAKE AVE S RENTON WA 98055 1607 LAKE AVE S RENTON, WA 98055 42 3340401180 GUAN QING HUA+LI QI FENG 6916 S 124TH ST SEATTLE WA 98178 1515 LAKE AVE S RENTON, WA 98055 43 3340401190 MCCALLISTER GLEN A 1503 LAKE AVE S RENTON WA 98055 1503 LAKE AVE S RENTON, WA 98055 44 5070000010 AG00 SILVER D+GRACE T 3621 SHATTUCK AVE S RENTON WA 98055 3621 SHATTUCK AVE S RENTON, WA 98055 45 5070000020 GILLILAN ANNE LIVING TRUST 3615 SHATTUCK AVE S RENTON WA 98055 3615 SHATTUCK AVE S RENTON, WA 98055 46 5070000030 HOANG BAY T 3609 SHATTUCK AVE S RENTON WA 98055 3609 SHATTUCK AVE S RENTON, WA 98055 47 5070000040 KUMARAN RUDRA+SAVITRI 3603 SHATTUCK AVE S RENTON WA 98055 3603 SHATTUCK AVE S RENTON, WA 98055 48 5070000050 BOSTICK HARRY G 3527 SHATTUCK AVE S RENTON WA 98055 3527 SHATTUCK AVE S RENTON, WA 98055 49 5070000060 HARVEY RICHARD D& FRANCINE 21015 148TH AVE SE KENT WA 98042 3521 SHATTUCK AVE S RENTON, WA 98055 5o 5070000070 MOSS KATHERINE E 3509 SHATTUCK AVE S RENTON WA 98055 3509 SHATTUCK AVE S RENTON, WA 98055 51 5070000080 CAMERINI DONALD A+CARMEL D 3503 SHATTUCK AVE S RENTON WA 98055 3503 SHATTUCK AVE S RENTON, WA 98055 52 7222000410 FORD GLEN 1925 SHATTUCK AVE RENTON WA 98055 1925 SHATTUCK AVE S RENTON, WA 98055 53 7222000511 GREGORIS NINFA 223 S 19TH ST RENTON WA 98055 VACANT RENTON, WA 54 8557000170 HURST CHARLES HERMAN 2325 TALBOT CREST DR S RENTON WA 98055 2325 TALBOT CREST DR S RENTON, WA 98055 55 8557000180 MAGNO LILY 0 2331 TALBOT CREST DR S RENTON WA 98055 2331 TALBOT CREST DR S RENTON, WA 98055 56 8557000190 VU HAI V 16020 SE 156TH ST RENTON WA 98058 2337 TALBOT CREST DR S RENTON, WA 98055 57 8557000200 NGUYEN XIN 2401 TALBOT CREST DR S RENTON WA 98055 2401 TALBOT CREST DR S RENTON, WA 98055 58 8557000210 NGUYEN THANG T 2407 TALBOT CREST DR RENTON WA 98055 2407 TALBOT CREST DR S RENTON, WA 98055 59 8557000220 PICKREIGN CYNTHIA J 2413 TALBOT CREST DR S RENTON WA 98055 2413 TALBOT CREST DR S RENTON, WA 98055 6o 8557000230 ESPEY DIANE 2419 TALBOT CREST DR S RENTON WA 98055 2419 TALBOT CREST DR S RENTON, WA 98055 61 8557000240 WILLIAMS BARTOW 1R+MINNIE L 2503 TALBOT CREST DR S RENTON WA 98055 2503 TALBOT CREST DR S RENTON, WA 98055 52 8557000250 CUMMINGS RAYMOND+MARILYN L 2509 TALBOT CREST DR S RENTON WA 98055 2509 TALBOT CREST DR S RENTON, WA 98055 63 8557000260 TONSGARD PATRICIA L 2515 TALBOT CREST DR RENTON WA 98055 2515 TALBOT CREST DR S RENTON, WA 98055 64 8557000270 NESS ROSEMARY 2521 TALBOT CREST DR S RENTON WA 98055 2521 TALBOT CREST DR S RENTON, WA 98055 65 8557000280 HOLZBOOG DAVID S+AMY L 2527 TALBOT CREST DR S RENTON WA 98055 2527 TALBOT CREST DR S RENTON, WA 98055 8557000290 TRAUTMANN JOHN F 2601 TALBOT CREST DR S RENTON WA 98055 2601 TALBOT CREST DR S RENTON,WA 98055 PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 8557000300 GOLDMANN CHARLES J 2607 TALBOT CREST DR S RENTON WA 98055 2607 TALBOT CREST DR S RENTON, WA 98055 8860500080 HOBSON LEE C/DIGGSHOBSON MARY 206 S 20TH PL RENTON WA 98055 206 S 20TH PL RENTON, WA 98055 69 8860500090 THOENNES NICHOLAS A 200 S 20TH PL RENTON WA 98055 200 S 20TH PL RENTON, WA 98055 7o 8860500100 NGUYEN THUAN Q+ANH NGOC 545 INDUSTRY DR TUKWILA WA 98188 2005 DAVIS AVE S RENTON, WA 98055 71 8860500110 MAI JOANNE 2011 DAVIS AVE S RENTON WA 98055 2011 DAVIS AVE S RENTON, WA 98055 72 8860500120 CHINN MARCUS 2017 DAVIS AVE S RENTON WA 98055 2017 DAVIS AVE S RENTON, WA 98055 73 8860500130 LUONG HINH 2O23 DAVIS AVE S RENTON WA 98055 2023 DAVIS AVE S RENTON, WA 98055 74 8860500140 KIAZIMOV ALI+JOULIA BOGACHOV 2101 DAVIS AVE S RENTON WA 98055 2101 DAVIS AVE S RENTON, WA 98055 75 8860500150 O'STEEN JONAKAN H 2107 DAVIS AVE S RENTON WA 98055 2107 DAVIS AVE S RENTON, WA 98055 76 8860500160 DAVIS GEORGE E+DAVIS DALIA P 671 HARRINGTON AVE NE RENTON WA 98056 303 S 21ST ST RENTON, WA 98055 77 8860500170 DURDUEVA SVETLANA 307 S 21ST ST RENTON WA 98055 307 S 21ST ST RENTON, WA 98055 78 8860500180 MARTIN ROBERT P& NIDA B 2111 DAVIS AVE S RENTON WA 98055 2111 DAVIS AVE S RENTON, WA 98055 79 8860500190 KING ALBERT WONG+LYNN WING 2115 DAVIS AVE S RENTON WA 98055 2115 DAVIS AVE S RENTON, WA 98055 so 8860500200 VO ANTHONY+LE TAMMIE 2121 DAVIS AVE S RENTON WA 98055 2121 DAVIS AVE S RENTON, WA 98055 81 8860500210 FERARA CHERYL ANN 2127 DAVIS AVE S RENTON WA 98055 2127 DAVIS AVE S RENTON, WA 98055 82 8860500220 BROADDUS SUSAN G PO BOX 58154 RENTON WA 98058 2133 DAVIS AVE S RENTON, WA 98055 83 8860500350 VALLEY VUE ESTATES HOA 332 S 20TH PL RENTON WA 98055 VACANT RENTON, WA 84 9899200010 FAST JOHN L 3431 SHATTUCK AVE S RENTON WA 98055 3431 SHATTUCK AVE S RENTON, WA 98055 8s 9899200020 HILL JAY G+DORI A 3425 SHATTUCK AVE S RENTON WA 98055 3425 SHATTUCK AVE S RENTON, WA 98055 86 9899200030 LEMAFA MOLIUILA M 3419 SHATTUCK AVE S RENTON WA 98055 3419 SHATTUCK AVE S RENTON, WA 98055 87 9899200040 BALDRIDGE BRUCE T 3422 SHATTUCK AVE S RENTON WA 98055 1 3422 SHATTUCK AVE S RENTON, WA 1 98055 PID TAXPAYER ADDRESS CITY STATE HOUSE# STREET CITY STATE ZIP 1923059016 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 2 3023059002 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 3 3023059003 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 4 3023059004 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 5 3023059026 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 6 3023059062 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 7 3023059076 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 8 3023059119 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 9 3023059124 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 10 3023059125 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 11 3023059126 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 12 3340400995 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 13 3340401010 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 14 3340401020 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 15 3340401065 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 16 3340401075 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 17 3340401076 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 3340401185 RENTON CITY OF 1055 S GRADY WAY RENTON WA 98055 RECEIVED MAY 12 2014 CITY OF RENTON UTILITY SYSTEMS Public Notice The City of Renton to Apply Mosquito Control Pesticides The City of Renton may use mosquito larvicides made of a natural bacterium (Bacillus sphaericus) and adulticides (BIOMIST° and/or Kontrol 4-41)to help control mosquitoes in accordance with the Washington State Department of Ecology's Aquatic Mosquito Control General Permit. Treatments may occur between June 1 and October 31, 2014. Larvicide treatment will generally occur in stormwater facilities owned or maintained by the City. Adulticide treatment areas are generally located in upland areas east of SR-167 and west of Lake Avenue South/Talbot Road South between SW 39th Street to the south and 1-405 to the north, within the City of Renton, Washington. Information about the larvicides, adulticides and a map of the specific locations are available at www.rentonwa.gov. For more information about the City's commitment to help reduce the threat of West Nile virus and control mosquitoes, contact Hebe Bernardo, City of Renton Surface Water Utility Engineer, at 425-430-7264 or by email at hbernardo@rentonwa.gov. For additional information about Ecology's Aquatic Mosquito Control General Permit, please contact the City of Renton or Jon Jennings, Water Quality Program, Washington State Department of Ecology, at 360-407-6283 or by email at jonathan.iennings@ecY.wa.gov. CMG Bonnie Walton Renton City Clerk Published: Renton Reporter May 16, 2014 Account No. 50640 C:\Users\bwalton\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BNOEWLPM\Mosquito Abatement Program 2014.doc\HCBtp Denis Law City Of Y Y Ma or ♦(� Public Works Department-Gregg Zimmerman,P.E.,Administrator June 3, 2014 Mr. Erik Hodson Whitworth Pest Solutions, Inc. 2533 Inter Avenue Puyallup, WA 98372-3428 RE: 2014 MOSQUITO ABATEMENT PROGRAM CONTRACT ADDENDUM #1-14 TO CAG-13-106, NOTICE TO PROCEED Dear Mr. Hodson: Enclosed please find one original, signed 2014 Mosquito Abatement Contract Addendum #1-14 to CAG-13-106 for your records. You are hereby authorized to begin treatments as set forth in the approved contract scope of work and budget. I look forward to working with you on another successful Mosquito Abatement Program season. Please call me at 425-430-7247, if you have any questions. Sincerely, all� Allen Qu 6n, P.� Y Surface Water Utility Engineer Enclosure H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Contracts\2014 NTP.doc\AQtp Renton City Hall - 1055 South Grady Way- Renton,Washington 98057 - rentonwa.gov PUBLIC WORKS DEPARTMENT D o city of M E M O R A N D U M DATE: May 29, 2014 TO: Denis Law, Mayor FROM: Gregg ZimmermaW, A'cTministrator STAFF CONTACT: Ronald Straka, Surface Water Utility Manager, x7248 Allen Quynn, Surface Water Utility Engineer, x7247 SUBJECT: Addendum No. 1 to CAG-13-106, 2013-2014 Mosquito Abatement Program with Whitworth Pest Solutions, Inc. Please sign and execute Addendum No. 1 to the 2013-2014 Mosquito Abatement Program contract (CAG-13-106), in the amount of$78,938.56, with Whitworth Pest Solutions, Inc. authorizing Whitworth Pest Solutions, Inc., as a sole-source provider of the 2014 Mosquito Abatement Program to apply adulticide in the areas upland and east of the Panther Creek Wetlands (Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities and catch basins for the control of mosquitoes. Whitworth has been the sole-source provider of pest control consultant services for the City's mosquito abatement efforts since 1990. Whitworth is the only known, qualified provider of this type of service and is familiar with the overall project area, including the areas where mosquitoes tend to congregate; e.g., access trails, wetlands, springs and adjacent residences. Whitworth also has an experienced entomologist on staff to provide assistance in responding to public inquiries. Last year, Washington had one human case of West Nile virus which contracted the virus outside of the state. In addition, there were two horse/mammal cases, 18 positive mosquito samples and no bird cases. This compares to four human cases (two contracted the virus outside of the state), one horse/mammal case and five positive mosquito samples in 2012. In an effort to reduce the risk of human infection, the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment and adulticide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Department of Ecology. Denis Law,Mayor Page 2 of 3 May 29,2014 The total expenditure required for the 2014 Mosquito Abatement Program contract Addendum No. 1 is $78,938.56 and includes the following tasks: Task 1 (Treatment of Upland Areas Adjacent to Panther Creek Wetlands) Whitworth will apply an Environmental Protection Agency registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack-mounted, portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of June through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. Treatment must also be conducted in accordance with the Aquatic Mosquito Control National Pollutants Discharge Elimination System General Permit, and other federal and state regulations. The cost for adulticiding the areas upland and east of the Panther Creek wetland area is $19,315.80 and will be funded through the approved 2014 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$75,000. Task 2 (Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins) Larvicide treatment is scheduled to begin July 2014 and will continue for the duration of the mosquito season, which typically extends through the end of September. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities and catch basins. These facilities and catch basins are owned and maintained by the Surface Water Utility, and the Community Services Department's Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile virus in King County. The total cost to treat City stormwater and irrigation facilities and catch basins is $59,622.76 and will be funded as follows: Surface Water Utility: Larvicide treatment will be funded through the approved Surface Water Utility 2014 Capital Improvement Program budget for the 2014 Mosquito Abatement Program. The approved budget for the Mosquito Abatement Program is $100,000 (Account No. 427.475020). The estimated cost to treat the stormwater facilities and catch basins with larvicide is $45,661.50. The remaining balance in the project account of$54,338.50 will be used to complete Task 1 ($19,315.80) leaving a balance of$35,022.70 for City staff time to administer both tasks. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\2014 Memo to mayor Addendum No.l.doc\AQtp Denis Law, Mayor Page 3 of 3 May 29, 2014 Maplewood Golf Course: Larvicide treatment will be funded through the 2014 Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, and catch basins with larvicide is $4,790.63. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $4,790.63. Parks Division: Larvicide treatment will be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $8,349.38. Facilities Division: Larvicide treatment will be funded through the 2014 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $821.25. Attachments cc: Terry Higashiyama,Community Services Administrator Lys Hornsby, Utility Systems Division Director Kelly Beymer, Parks and Golf Course Director Greg Stroh, Facilities Maintenance Manager File H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\2014 Memo to Mayor Addendum No. l.doc\AQtp ;n Contract Number: Contract Checklist C.t. C10 (assigned by City Clerk), Select Type: ❑ Contract/Agr. ❑ Permit ❑ Lease ® Adden/Change Order Contract Type: (assigned by City Clerk) Staff Name: Allen Quynn Extension: 7247 / De artment/Division: PW/Utilities EDEN Queue: I Addenda/CO #: 1 to City Clerk's CAG #: 13-106 (if applicable) Expiration Date: 12/31/14 Contract Class: ❑ Receivable ❑ Payable ❑ Grant ❑ Misc. (no $) Contract Solicitation Method: Contractor Name: Whitworth Pest Solutions, Inc. Sole source Short Description: Full or Additional 2013-2014 Mosquito Abatement Program Contact with Whitworth Pest Solutions, Inc. as sole source Description: provider of Entomologist/Pest Control Consultant Services ® Legal Review (attach memorandum from City Attorney) ® Risk Management review for insurance (attach memorandum from Risk Management) ® Insurance certificate and/or policy (attach original) ❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been met) ❑ Performance bond and verification memo from staff(for Public Works type of contracts $35k& over only) ® Federal excluded parties list verification (Attach printout of search results from Website: www.sam.gov/portal/public/SAM) ® Active business license and Accounts payable W-9 vendor form? (obtain if not already on file with Finance Dept.) Z Yes ❑ No Submitted contracts are signed by contractor? If"No", provide explanation here.- Fiscal Impact to City: ® Expenditure OR ❑ Revenue Amount Budgeted: (line item;see below*):$ 100,000 Amount of Attached (including tax) $ 78,938.56 per year for years = Total Amount of Attached $ Prior Council approval via agenda bill process required if: (see policy 250-02) ❑ Contract or addendum is $100k or over (non-Public Works) or$150k or over(Public Works). ❑ Budget adjustment or fund transfer is necessary. ❑ Interlocal Agreement (most Interlocal Agreements require Resolutions) Date of Council Approval: Resolution Number: NOTE: Mayor signs for the City,except that the Department Head may sign contracts: Under$35,000 when for non-Public Works&Small Public Works Roster(SWR); (if applicable) (if applicable) Under$40,000 when for Public Works single craft -non-SWR;and Under$65,000 when for Public Works multi-craft nor.SWR EXCEPT:Change Orders to PW contracts in any amount can be signed by Project Mgr IF within budget AND under Administrator's authorization. Key words for City Clerk's electronic card file: Whitworth Pest Solutions, Talbot Hills, Mosquito Abatement Contract, Panther Creek Wetlands, West Nile Virus Print Form Revised 1 012 5/2 0 1 3 Hebe Bernardo From: Gregory E Stroh Sent: Tuesday, April 16, 2013 4:23 PM To: Hebe Bernardo; Kelly Beymer Subject: RE: 2013 -2014 Mosquito Abatement Program Contract Follow Up Flag: Follow up Flag Status: Flagged Categories: Red Category Hi Hebe, I have no issues or comments and concur with the addendum. Regards, Greg Stroh Facilities Manager Community Services Department Phone:425-430-6614 Cell:425-766-6162 mailto:gstroh@rentonwa.gov -----Original Message----- From: Hebe Bernardo Sent: Monday, April 15, 2013 11:40 AM To: Gregory E Stroh; Kelly Beymer Subject: 2013 -2014 Mosquito Abatement Program Contract Good morning Kelly and Greg, With the implementation of the updated Purchasing, Bidding and Contracting Requirements Policy 250-02, effective April 1, 2010, we will be asking Gregg to authorize the contract and request the Mayor to sign it. However, before Gregg authorizes the contract, he will want it to have been concurred by the Golf Course, Parks, and Facilities, since it includes participation from each group. Please review the attached addendum and send me your concurrence email by Thursday,April 22, if possible. If you have any questions, please contact me at ext. 7264. Thanks for your help, Hebe C. 1 Hebe Bernardo From: Kelly Beymer Sent: Tuesday, April 30, 2013 2:03 PM To: Hebe Bernardo Subject: RE: 2013 -2014 Mosquito Abatement Program Contract Hi Hebe, Please go ahead with the contract/agreement as it is written. Erik is correct—they did invoice less than the contract amount. Thank you for your patience! Kelly Kelly 3eywwr Parks and Golf Course Director 425-430-6617 kbeymer(aD_rentonwa.gov From: Hebe Bernardo Sent: Friday, April 26, 2013 8:35 AM To: Kelly Beymer Subject: FW: 2013 -2014 Mosquito Abatement Program Contract Good morning Kelly. Do you agree with the response form the contractor? If not, how do you propose we change the scope for treatment in the golf course. Thanks a lot Kelly and please let me know if you have any questions. Best regards, Hgli C Civil Engineer II City of Renton I Public Works Department I Surface Water Utility 1055 S. Grady Way 15th Floor I Renton, WA 98057 42: Direct Office 425.430.7264 Direct Fax 425.430.7241 ®: hbernardo(aDrentonwa.aov �,. tutit From: Erik Hodson [mai Ito:whitworthpestmanCabcomcast.net] Sent: Friday, April 26, 2013 8:24 AM To: Hebe Bernardo Subject: RE: 2013 -2014 Mosquito Abatement Program Contract 1 Public Works Department SAP r City of c, w W z A��� w N ® •F�� �J 7 ® gTNEY BOWES 1055 South Grady Way 00 02 1M 00.460 Renton WA 98057-3232 wW _ 0004278599 MAY 1 5 2014 dLL MAILED FROM ZIP CODE 98032 5070000030 EESIDENT " -4609 SHATT11rx AVF S RENTON," ',q- 98.0 DE- 103E 099.5 /1-9/14. � RETURN TO SENDER NOT DELIVERABLE AS ADDRESSED UNABLE TO FORWARD ; I �- ��+ �(� (��.(j� (3 BC: 98057323255 *2589-@7338-19-36 G21 L-1r- 1 N'Q,7 MY�� 3liilii,i,Il1�4!„illfii,It,ail,�#,�„�„1„f,l3,i„I,ii�llif,l�! 1 Denis Law City Of j- Y Mayor �. �,,.--, � • .0 Public Works Department-Gregg Zimmerman,P.E.,Administrator 2014 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex (Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray (Exhibit C). A portable fogger (gasoline-powered backpack-mounted) will be used to apply the spray to upland vegetation. During May through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit B) form, to allow the applicator access through your property, if needed, to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided by May 30, 2014. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you would like information on precautions you may take to help repel mosquitoes, please see Exhibit C. If you have any questions, or would like more information about the Mosquito Abatement Program, please contact Hebe C. Bernardo, Surface Water Utility Engineer, at 425-430-7264, or by email at hbernardo@rentonwa.gov. Enclosures H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Release Request.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov 6b h S 4t 1-405 Ramp 6j St CO a) 5 M th r OV t9 t �N O d N c Q F a1 S CO i-Mosquito Abatement Programs N Exhibit A: Site Plan 0 500 1,000 w_ E Note: Treatment will not be applied within 1 00' of water. Feet S Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge 0 Project Boundary and the residential areas. Property owner approval required prior to S atrw t 91 , treatment on private property. Surface Water Utility I G.Del Rosario I Printed 03/312010 nis DeMa oraw ® City Of �t Y Y + �N,rO Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000030 Resident 3609 SHATTUCK AVE S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov EXHIBIT C Insecticide Products: As in previous years, we will be using products containing the insecticide permethrin. See below for more information. Permanone'31-66: Permanone® 31-66 is sold under the trade names of BioMist®and Kontrol®4- 4. They contain a synthetic version of permethrin as an active ingredient. The insecticides are formulated for dilution with oil products, such as mineral oil, and are applied at a rate between 0.0035 and 0.0070 pounds of permethrin per acre. Permanone 31-66 is degraded in soil and may last for several days. BioMist®and Kontrol®4-4 are not applied within 100-feet from water or wetland areas. Repel Mosquitoes: Not all mosquitoes will be eliminated during our Mosquito Abatement Program. Some precautions you may take to further reduce the number of mosquitoes in your area include: Mosquito Breeding Places: Some mosquitoes may breed in stagnant water. If you eliminate standing water around your home,you may eliminate their breeding places. Stagnant water may be found in ornamental pools, birdbaths, old tires, and flower pots. Methods to eliminate these and other potential breeding sites are listed in the Extension Bulletin PLS-121 April 2007 by the Washington State University Cooperative Extension titled "Pest Management for Prevention and Control of Mosquitoes". Natural Predators: By encouraging natural predators that feed on mosquitoes,you may also reduce the number of mosquitoes in your area. Natural predators include bats, swallows, frogs, and fish. In order to stock mosquito fish and three-spine stickleback fish, a permit is required from the Washington State Department of Fish and Wildlife. However, you may attract other natural predator animals by enhancing habitat and constructing cavity type houses. More information on attracting natural predators, such as instructions for constructing and locating bat houses, may be obtained from the State Department of Fish and Wildlife. Mosquito Repellent: By using mosquito repellent, netting, and screens you may reduce your exposure to mosquitoes. Additional precautions include: ♦ Wear clothes that reduce the area of exposed skin; ♦ Install screens or netting over open patios or windows; and/or ♦ Apply repellents, especially those containing the ingredient diethyltoluamide (DEET), to exposed skin. Since young children and certain adults can be sensitive to DEET, please follow application instructions carefully. Note: While bug lights eliminate some mosquitoes, they are not highly recommended, since studies show they also eliminate a large amount of beneficial and non-pest insects. Furthermore,Aedes,the most aggressive of the mosquito species,found in the Talbot Hill area, are not attracted to light and the noise emitted by the bug lights may annoy some neighbors. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Description Exhibit C.DOC/HBah NO POSTAGE „ NECESSARY IF MAILED THE UNITED STATES N�1 BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO.646 RENTON WA POSTAGE WILL BE PAID BY ADDRESSEE Utility Systems Division Attn: Hebe C.Bernardo CITY OF RENTON 1055 S GRADY WAY RENTON WA 98057-9808 Public Works Department g�A City of Cc a ® PeiNEV BOWES 1055 South Grad Wa 00 Renton WA 98057-3232 wy 00042 78599 MAY 1 201,4 46� is MAILED FROM ZIP CODE 98032 3023059105 RESIDENT 2719 TALBC'T' nn c RENTON,W v#ixiE 480 DE 1e.a Df34 5I's Ja.4 RETURN TO SENDER NOT DELIVERABLE AS ADDRESSED I UNABLE TO FORWARD if B-C> 98057323255 *0126-00479-16-41 "iiilll,ilil,Illllsl,�;�(,Itl1,ail!„�I,e,�lt�)il��iilil119#,I,$ Denis Law Mayor Cat 0 SE �� �i N Public Works Department-Gregg Zimmerman,P.E.,Administrator 2014 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex (Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 39th Street on the south to 1-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray (Exhibit C). A portable fogger (gasoline-powered backpack-mounted) will be used to apply the spray to upland vegetation. During May through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit B) form, to allow the applicator access through your property, if needed, to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided by May 30, 2014. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you would like information on precautions you may take to help repel mosquitoes, please see Exhibit C. If you have any questions, or would like more information about the Mosquito Abatement Program, please contact Hebe C. Bernardo, Surface Water Utility Engineer, at 425-430-7264, or by email at hbernardohbernardo@rentonwagov. Enclosures H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Release Request.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov U) h S 1-405 Ramp 4t O, St CO m CD CU CD t NFEM (P c Q F CU ►� S co � ® N CO i osquit® ;�'L--)ate ent Program �T Exhibit A: Site Plan 0 500 1,000 w E Note: Treatment will not be applied within 1 00' of water. Feet S ' Treatments will not be performed near homes. Treatment will only be done on the upland area between the wetland eastern edge 0 Project Boundary _ and the residential areas. Property owner approval required prior to _���...•►�""r ct `4 treatment on private property. Surface Water Utilitv I G.Del Rosario I Printed 03f3121110 nis DeMayor aw ® Clty Of �,� o Y e j, '� Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059105 Resident 2719 TALBOT RD S RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov EXHIBIT C Insecticide Products: As in previous years, we will be using products containing the insecticide permethrin. See below for more information. Permanone'31-66: Permanone® 31-66 is sold under the trade names of BioMist®and Kontrol®4- 4. They contain a synthetic version of permethrin as an active ingredient. The insecticides are formulated for dilution with oil products, such as mineral oil, and are applied at a rate between 0.0035 and 0.0070 pounds of permethrin per acre. Permanone® 31-66 is degraded in soil and may last for several days. BioMist®and Kontrol®4-4 are not applied within 100-feet from water or wetland areas. Repel Mosquitoes: Not all mosquitoes will be eliminated during our Mosquito Abatement Program. Some precautions you may take to further reduce the number of mosquitoes in your area include: Mosquito Breeding Places: Some mosquitoes may breed in stagnant water. If you eliminate standing water around your home, you may eliminate their breeding places. Stagnant water may be found in ornamental pools, birdbaths, old tires, and flower pots. Methods to eliminate these and other potential breeding sites are listed in the Extension Bulletin PLS-121 April 2007 by the Washington State University Cooperative Extension titled "Pest Management for Prevention and Control of Mosquitoes". Natural Predators: By encouraging natural predators that feed on mosquitoes,you may also reduce the number of mosquitoes in your area. Natural predators include bats, swallows, frogs, and fish. In order to stock mosquito fish and three-spine stickleback fish, a permit is required from the Washington State Department of Fish and Wildlife. However, you may attract other natural predator animals by enhancing habitat and constructing cavity type houses. More information on attracting natural predators, such as instructions for constructing and locating bat houses, may be obtained from the State Department of Fish and Wildlife. Mosquito Repellent: By using mosquito repellent, netting, and screens you may reduce your exposure to mosquitoes. Additional precautions include: ♦ Wear clothes that reduce the area of exposed skin; ♦ Install screens or netting over open patios or windows; and/or ♦ Apply repellents, especially those containing the ingredient diethyltoluamide (DEET), to exposed skin. Since young children and certain adults can be sensitive to DEET, please follow application instructions carefully. Note: While bug lights eliminate some mosquitoes, they are not highly recommended, since studies show they also eliminate a large amount of beneficial and non-pest insects. Furthermore, Aedes,the most aggressive of the mosquito species,found in the Talbot Hill area, are not attracted to light and the noise emitted by the bug lights may annoy some neighbors. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Description Exhibit C.DOC/HBah ��Y Q NO POSTAGE �> NECESSARY �= IF MAILED .,u IN THE UNITED STATES r BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO.646 RENTON WA POSTAGE WILL BE PAID BY ADDRESSEE Utility Systems Division Attn: Hebe C.Bernardo CITY OF RENTON 1055 S GRADY WAY RENTON WA 98057-9808 nis D2Ma oraw City of �y y ��■� 1 �'1V`t� Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500150 Resident RECEIVED 2107 DAVIS AVE S RENTON,WA 98055 JUN 3 0 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an AUTHORIZATION AND RELEASE form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT SIG URE Telephone Number Print Name COMMENTS: � ( e' Gv� al-e- ow f/Z2 2 o/Y PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law —® City OfMayor Public Works Department-Gregg Zimmerman,P.E.,Administrator .EUIBIT B 8860500140 RECEIVED Resident 2101 DAVIS AVE S JUN 19 2014 RENTON, WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mosquito abatement. r/ r, AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. Iot t �fboa olio DATE SIGNATURE 14 -���—�r�3� J-0U/( ill pq UApt� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMis a oraw Y City Of tiC O [ (( Y _... +1 Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 8557000230 RECEIVED Resident 2419 TALBOT CREST DR S RENTON, WA 98055 JUN p 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTONUTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. T SIGNATURE ��Iephidne Number Print Name COMMENTS: Soy r PLEAS RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Dellis a oraw City Of Y SC O Y ..► - rvC Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B Resident t R RECEIVED Reside 2413 TALBOT CREST DR S RENTON, WA 98055 JUN 0 9 Z014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print 4ame COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DenisoLaw ® Clt Of ��y 1 May Public Works Department-Gregg Zimmerman,P.E.,Administrator 8860500190 R E C EWEf5 Resident JUN 0 9 2014 2115 DAVIS AVE S RENTON, WA 98055 CITY OF f(ENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: ✓� � = - d4 41Y G7 ILA PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Y Mayor r pti �at� ..rriJ Ole Public Works Department-Gregg Zimmerman,P.E.,Administrator RECEIlDB 8557000290 Resident JUN 0 5 Z014 2601 TALBOT CREST DR S RENTON, WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE S104ATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall 9 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor ® s � i ♦(R I Public Works Department-Gregg Zimmerman,RE.,Administrator EXHIBIT B 5070000010 Resident 3621 SHATTUCK AVE S RECEIVED RENTON, WA 98055 PUBLIC WORKS DEPARTMENT JUN 0 5 2014 ENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, w CITY OF R�L t �- eN rtoy of Renton or its representative to inspect, analyze, and treat your property for the purpose MOSF�d GuR abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SI N URE as. s'T2 . 5 Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of ,ty O Mayor �ur4 Public Works Department-G &W.Zi .E.,Administrator CCC (/tu EXHIBIT 5070000060 MAY 2 7 2014 Resident 3521 SHATTUCK AVE S Utility Systems RENTON,WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telep one Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor �. a Public Works Department-Gregg Zjgimprman,P.E.,Administrator lI``(( CEI VET EXHIBIT B 3340401140 Mqr 2 7 2014 Resident 1717 LAKE AVE S vlll%ty System,, RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement1hrough the use of the following methods: 1. Inspection; 2. Testing and Analysis- and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in i efforts e e t mosquito control on my property. i ' 2UZ2 DATE SIG URE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of. �Y Mayor �_ _ �, Q Public Works Department-Gregg Zimmerman,P.E.,Administrator RECEIVED EXHIBIT B 3023059081 Resident MAY 2 7 2014 3037 TALBOT RD S RENTON,WA 98055 Utility Systems PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. A-/� � DATE SIG ATURE fe e AJ n 10,Ar Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Den is Law © City Of tiTY o v I � p• .t, Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059012 RECEIVED Resident MAY 2 7 3315 TALBOT RD S 20�4 RENTON, WA 98055 Ut"ty SYStemS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. s7k /gyp /LI 2 C4��� DATE SIGNATURE I 4 Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law `Mayor City Of Y ,. _yr- z O� Ua ` �'N,rO MONA Public Works Department-Gregg Zimmerman,R E.,Administrator EXHIBIT B 8557000180 Resident RECEIVE® 2331 TALBOT CREST DR S RENTON,WA 98055 MAY 19 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SNP ��nS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the Lif�Ui"' Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-men ' ods and chemicals in its efforts to effect mosquito control on my property. lfxl DATE SIGNATURE Te ephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis DeMa oLraw ® City Of Y Y own As ♦(� Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401120 Resident 1803 LAKE AVE S RECEIVED RENTON, WA 98055 PUBLIC WORKS DEPARTMENT MAY 19 2014 CITY OF RENTON Below is an "AUTHORIZATION AND RELEASE" form that,when signed by you, v J���tre� of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. T b p(,o 120 IV DATE SIGNATURE 1__� 5 �5 y 35/1 _ I-e r-(-e-e L_- b o a a n Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeM yor City of,k, 00000 .w WN r0 Public Works Department-Gregg Zimmerman,P.E.,Administrator RECEIDB 3340401151 Resident MAY 2 0 2014 1701 LAKE AVE S RENTON,WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. L-r / 0),4 (- DATE SIGNA E _ 4 LL 77-�O Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30,2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law Mayor ��CltY Of ♦ �V Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000170 RECEIVED Resident 2325 TALBOT CREST DR S MAY 2 U 2014 RENTON,WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 5 I 1'+ 114 AmIlta �61a DATE SIGNATURIf C4z5) qq3 -5- 140 w1PO CesiA(,t4L Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30,2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law ® City Of �`R oMayor Y Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401150 RECEIVED Resident 1625 LAKE AVE S RENTON, WA 98055 MAY 2 O 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNA E )01� /V te, L:::�"—t;F Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of ��y 1 yo Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000070 Resident RECEIVED 3509 SHATTUCK AVE S RENTON,WA 98055 MAY 2 0 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an AUTHORIZATION AND RELEASE form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of,- �Y Mayor ll � � 1 ♦(ate � 6NT Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 9899200020 RECEIVED Resident MAY 2 8 2014 3425 SHATTUCK AVE S RENTON, WA 98055 Utility Systems PUBLIC WORKS DEPARTMENT . Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT SIGNATURE �15 356v - D eS` ems- //ory'� S Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057• rentonwa.gov Denis Law City Of ��y Mayor0000 p i • I '�+ Public Works Department-Gregg Zimmerman,P.E.,Administrator 3023059018 RECEIVED EXHIBIT B Resident MAY 2 8 2014 3101 TALBOT RD S RENTON, WA 98055 Utility systems PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SI N TURE LIZ5-2-s4- 15z) Ja A ,rne (Noon Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov on Denis Law City 0f Mayor Y 1� +\j 0R Public Works Department-Gregg Zimmerman,P.E.,Administrator 8860500170 RECEIVED EXHIBIT B Resident MAY 2 S 2014 307 S 21ST ST RENTON, WA 98055 Utility Systems PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. o s� I . a-0 DATE SIGNATURE Q)LX 7IV (?i6 ,R 7- Ti r ) LX r u_cd L't et/ Telephone Number Print Name COMMENTS: �,'' yo C % A 4Q _I^C..(-- 4e_ PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Y o Mayor00000 . w-- p e or �Vol Public Works Department-Gregg Zimmerman,R E.,Administrator RECEIVED EXHIBIT B 8860500210 Resident MAY 2 8 2014 2127 DAVIS AVE S RENTON, WA 98055 utility Systems PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 0,51Z3 /q- Y� DAT( SIGNATURE �Z06) 350 C/IL=RYL Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMa nis Y Y Law © City Of �� o i ® \\�,N rp Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3340401165 Resident RECEIVED 1615 LAKE AVE S RENTON, WA 98055 MAY 2 0 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. �yy DATE SIGNATURE TERESf! � Jr aZSS=74VI lw,4/Si EU) WA PDZ20230W Telephone Number Print Name COMMENTS: /ha���f►J./�,aJ.���t.�lt. �czcr�2.�7uL,�R. ^�-ec�/l�fi �7jLttG�L�_,02 � . PLEASE RETURN THIS FORM BY May 30, 2014 f USING THE ENCLOSED BUSINESS REPLY ENVELOPE 1 ' H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\201� Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis s City Of, �Y � # �- - ;Y ✓~ Ufa ,� •( .�.r �Iv Public Works Department-Gregg Zimmerman,P.E.,AREi r E Iv E EXHIBIT B 3023059123 MAY 2 0 2014 Resident 3031 TALBOT RD S CITY OF RENTON RENTON, WA 98055 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. HA y /q, �0 l DATE SIGNATUR (2-06 ) 6 97- 620 S l cJzuzgms Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Della Law Y City of �� o Y INV Public Works Department-Gregg Zimmerman,P.E., N E D 8557000260 MAY 2 0 2014xHlBlr B Resident CITY OF RENTON 2515 TALBOT CREST DR S UTILITY SYSTEMS RENTON, WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE C. Telep one Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov De Law City Of Ma yo •( i� Public Works Department-Gregg Zimmerman,P. psa'ar a n I""( t ��E�91 BIT B 8557000200 MAY 2 0 2014 Resident 2401 TALBOT CREST DR S CITY OF RENTON RENTON, WA 98055 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 058 i 5 I I 4 DATE SIGNAT Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30,2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law Mayor Clty of, [ o �'N f Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8557000270 Resident RECEIVED 2521 TALBOT CREST DR S RENTON, WA 98055 MAY 2 0 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON Y I TIYTY SYSTEM)l Below is an "AUTHORIZATION AND RELEASE" form that,when signed by you, wil aut orize the City o Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. �C DATE SIGNATURE � Z6 - 77807 RUsleYrl 1�ess Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law O City of �� o Y Y ® t Nv Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500110 Resident RECEIVED 2011 DAVIS AVE S RENTON, WA 98055 MAY 2 0 Z014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SINANAT 9'E Telephone Number rint Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMayor i w ® City Of ��y '1i ti T Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000080 Resident RECEIVED 3503 SHATTUCK AVE S RENTON, WA 98055 MAY 2 O 20% PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis DeMa v o Law Clty Of ��y c Ilk - o � • { . moss Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 5070000050 RECEIVED Resident 3527 SHATTUCK AVE S MAY 2 O 2014 RENTON, WA 98055 PUBLIC WORKS DEPARTMENT CITY OF RENTONUTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SI NATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov is DeMa oraw y city Of sty O U .n e ��NTo Public Works Department-Gregg Zimmerman,P.E.,Administrator 3340401115 Edv* ED Resident 1805 LAKE AVE S MAY 21 2014 RENTON,WA 98055 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE 4USI�14ATRE IS 1?.4QiM-Q4_L Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP - Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov DeMis a oraw City Of �,ty y • �iN,rp Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 8860500080 RECEIVED Resident 206 S 20TH PL RENTON, WA 98055 MAY 2 1 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTONUTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 510_1z�l M DATE SIGNATURE Telephone Number Print Name JJ COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis Dena Law City of :8�WRD, Y 110 AS 1 Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B Resident Resident RECEIVED 3001 TALBOT RD S RENTON, WA 98055 MAY 21 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of, i Mayor -., _ + Public Works Department-Gregg Zimmerman,P.E.,Administrator 8860500090 RECENEDEXHIBIT B Resident Zo14 200 S 20TH PL MAY 2 2 RENTON, WA 98055 CITY OF RENT ON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. .. 7 DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law City Of Mayor pti Y O� � a ® •( , Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059116 Resident RECEIVED 3113 TALBOT RD S RENTON, WA 98055 JUN 0 2 2014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. ' DATE i` SIGNNATURF y Telephone Number PIrint Name COMMENTS: PLEASE RETURN THIS FORM BY May 30,2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis -- _ City Of;Mayor QAR Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBITA 3023059068 Resident " 408 S 33RD PL RENTON,WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE - \IA-u 6- -f�1146� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Denis Law r City Of Mayor Public Works Department-Gregg Zimmerman,P.E.,Administrator RECEdWED 8860500220 Resident JUN 0 2 2014 2133 DAVIS AVE S RENTON,WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. AN I O :�5 8AkoAdvo- DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov Den is Law © Clty of y � s Public Works Department-Gregg Zimmerman,P.E.,Administrator EXHIBIT B 3023059107 Resident RECEIVED 2703 TALBOT RD S RENTON, WA 98055 JUN 0 2 Z014 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. .5";,Z 7114- - DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30, 2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov nis DeMa oaw City Of y +(� Public Works Department-Gregg Zimmerman,P.E.,Administrator RECF-41OBD 8860500160 Resident MAY 21 2014 303 S 21ST ST RENTON, WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY May 30,2014 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2014 Program\Release request\2014 Signature Authorization Exhibit B.doc\HBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov