HomeMy WebLinkAbout3012 ORDINANCE NO. ,L? [//< ~
AN ORDINANCE OF THE CITY OF BREMERTON, WASH-
INGTON, RELATING TO THE LICENSING AND REGULAT-
ING OF EMERGENCY MEDICAL SERVICE - AMBULANCES:
SETTING FORTH THE DUTIES OF LICENCEES INCLUDING
DRIVERS AND MEDICAL ATTENDANTS: SPECIFYING RE-
QUIRED EQUIPMENT AND ACCESSORIES; DEFINING
OFFENSES AND PRESCRIBING PENALTIES AND REPEALING
ANY AND ALL ORDINANCES IN CONFLICT HEREWITH.
THE CITY COUNCIL OF THE CITY OF BREMERTON, WASHINGTON DOES ORDAIN
AS FOLLOWS:
SECTION I: This Ordinance shall be known and may be cited as the
"Bremerton Ambulance Regulation Ordinance".
SECTION II: DEFINITIONS:
A. "Ambulance" shall mean any privately or publicly owned
vehicle that is especially designed, constructed, equipped, maintained
or used for the transportation of patients who are sick, injured or
otherwise incapacitated, which is operated as part of an ambulance
service for hire.
B. "Ambulance Service" shall mean any person, as hereinafter
defined, who operates an ambulance for hire which is either stationed
within or without the City of Bremerton or dispatched from within or
without the City to pick up injured or sick fares within the City or
which makes trips to the City of Bremerton, from points outside its
City Limits, for the purpose of transporting sick or injured fares
from points within the City; provided, however, that the provision of
this Chapter shall not apply to any ambulance which shall pass through
the City in the delivery of fares picked up at points beyond the
limits of the City.
C. "Medical Attendant" shall mean any trained or otherwise
qualified individual, responsible for the operation of an ambulance
and the care of the patients whether or not the medical attendant
also serves as a driver.
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D. "Ccmmunication System" shall mean two way radio communica-
tions between ambulances, dispatchers, hospitals and other agencies
as needed. A four (4) bank multi-frequency capability is acceptable.
E. "Patient" shall mean an individual who is sick, injured,
wounded or otherwise incapacitated or helpless.
F. "Person" shall mean any individual, firm, partnership,
association, corporation, company, group of individuals acting to-
gether for a common purpose or organization of any kind, including
any governmental agency other than the United States or the State of
Washington.
G. "License Officer" shall mean that person authorized by the
City Council to provide for the issuance of a license and to enforce
the requirements relating to same. Unless otherwise determined by
the City Council, the City Clerk or a person designated by him shall
act as "License Officer".
SECTION III: LICENSE REQUIRED FOR AMBULANCE SERVICE. No person shall
operate an ambulance service, as defined herein, unless he obtains
a master operator's license from the City Clerk, City of Bremerton,
for such activity. No such license shall be issued unless:
A. The applicant has fulfilled all requirements of this
Ordinance and other provisions of law relating to
ambulance design, equipment, operation, qualifications
of medical attendants; and
B. The applicant has amply demonstrated the need for an
ambulance service in the area where he intends to operate
and demonstrates the applicant's capability and willingness
to provide adequate service in such designated area and
that he has the necessary equipment, attendants and
accessories to operate such service successfully and on
a continuous basis. For the purposes of this sub-paragraph
an applicant's capability to so service shall be presumed
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if he is the owner and/or operator of at least three
or more ambulances, and one of which shall be stationed
within the City limits of Bremerton at all times, unless
on call, together with such backup ambulance and equipment
as may be necessary to provide continuous and prompt
service to the City of Bremerton and its immediate environs.
C. The applicant shall file a copy of liability insurance
policy or policies showing evidence of coverage in accordance
with Section VI of this Ordinance the limits of such public
liability insurance shall be not less than $300,000.00 per
person and $500,000.00 per accident and the property damage
liability coverage to be not less than $50,000.00.
D. The applicant files proof that all medical attendants and
drivers in his employ are certified as hereinafter specified.
SECTION IV: APPLICATION FOR MASTER AMBULANCE LICENSE. An application
for a master ambulance license to operate an ambulance service shall
be made upon forms provided by the City and shall, among others,
contain the following information.
A. Name, home address and telephone number of the applicant.
B. Business name under which the ambulance service will be
operated within the City of Bremerton together with business
address and telephone number.
C. In case of a corporation, the name and address of the
officers and directors of such corporation, and in case of
a partnership, the name and address of each general or
limited partner.
D. A description of each ambulance, including the make, model,
year of manufacture, motor and chassis number, together
with current State license number; the length of time the
ambulance has been in use and the color scheme, insignia,
name, monogram or other distinguishing characteristics
to be used to designate applicant's ambulance.
E. The location and description of the place or places from
which the ambulance service is intended to operate and the
number of licensed medical attendants to be initially
employed.
F. The fee for such master license shall be $100 per calendar
year and Such license shall entitle the holder thereof to
license three ambulance vehicles doing business in the City
of Bremerton without any additional fee. Thereafter the
fee shall be $25.00 per year for each additional ambulance
so licensed.
G. Prior to the issuance of such licenses, all equipment and
accessories of every type and description required for use
shall have been duly inspected by an authorized inspection
service, including licensed or franchise dealer or repair
business or such other agency or specialists as the City may
designate. It shall be the responsibility of each licensee
to furnish unto the City upon request, but at least every
six months, a complete report of inspection warranting the
condition, adequacy and proper function of all such equip-
ment and accessories.
H. Based on the City of Bremerton's present needs, there shall
be issued one such master ambulance license for each 40,000
population, or fraction thereof, residing within the City
of Bremerton. Additional ambulance licenses may be issued
whenever an applicant can demonstrate, by a preponderance of
evidence, that such additional service is needed within the
City, and that he is capable of furnishing such service as
hereinabove set forth.
I. In the event any such license, as hereinabove set forth,
is issued after July 1, of any calendar year, then the fee
shall be one-half of the annual fee set forth above.
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'SECTION V: REQUIRED AMBULANCE EQUIPMENT. Each ambulance shall be
equipped with the following:
A. Sirens and emergency vehicle lamps which shall conform
with the rules and regulations issued under RCW 46.37.194,
which shall be used only in conformity with RCW 46.61.035,
together with any other State imposed requirements now or
hereafter in effect.
B. A two-way radio communication system capable of providing
communication between the vehicle and the hospital emergency
rooms whenever so recommended by the Advisory Committee
as hereinafter set forth.
C. Medical equipment including, but not limited to, an
equipment inventory at least equal to that published by
the Committee on Trauma of the American College of Surgeons
in their May, 1970 Bulletin entitled "Essential Equipment
for Ambulances", of which not less than three (3) copies
are being kept on file in the office of the City Clerk,
together with such additional equipment as the Advisory
Committee may recommend.
D. Each ambulance vehicle shall be of heavy duty type as to
frame, springs, shocks, brakes, transmission, alternator
and engine to provide the utmost in service life of the
vehicle. Stability of the vehicle shall be of primary
importance and the engine shall provide sufficient power to
climb a 15% grade of fully loaded and gross weight. The
patient care compartment shall be of ample space to provide
two litter patients side by side and space enough for the
attendant to work on both patients. Vertical space within
the patient care compartment shall be a minimum of 50 inches
to 72 inches. The interior of the patient care compartment
shall have a protective vinylin coating, where required, so
that a sterile scrub down can be performed without damaging
material.
E. Each ambulance and its equipment shall be maintained
in a sanitary manner and good operating condition as
determined by the vehicle inspection procedures as set
forth in RCW 46.32.
F. Such additional equipment and accessories as set forth
on Exhibit "A" which is attached hereto and made a part
of this Ordinance as if fully set forth herein.
SECTION VI: STANDARDS FOR AMBULANCE LICENSE - LIABILITY INSURANCE.
A. No ambulance operator's license shall be issued, nor shall
such license be valid after issuance nor any ambulance be
operated in the City of Bremerton unless the operator shall
deposit with the City Clerk a policy or policies of liability
insurance, or certified copies of same, together with evidence
of premium payment, issued by a responsible insurance company
to be approved by the City of Bremerton, and naming the
City as an additional insured which insures against all
claims for personal injury, death, malpractice, errors and
omissions and property damage arising out of the operation
of said ambulance and the care of patients. The insurer
shall be a company licensed to do business in the State of
Washington. The limits of said policy shall be not less than
specified in Section III as hereinabove.
B. Said insurance policy shall be submitted to the City Clerk
for approval prior to the issuance of each ambulance license.
Satisfactory evidence that such insurance is at all times
in full force and effect shall be furnished unto the City
Clerk, in such form as it may specify, by all licensees re-
quired to provide such insurance under the terms of this
Ordinance.
C. Every insurance policy required hereunder shall contain
a provision for continuing liability thereunder to the full
amount thereof, notwithstanding any recovery thereon, that
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the liability of the insurer shall not be affected by
the insolvency or the bankruptcy of the insured, and that
until the policy is revoked the insurance company will not
be relieved from liability on account of non-payment of
premium, failure to renew license at the end of the year,
or any other act or omission of the named insured.
D. Every insurance policy required hereunder shall extend for
the period to be covered by the license applied for and the
insurer shall be obliged to give not less than thirty day
written notice to the City Clerk of the City of Bremerton
and to the insured before any cancellation or termination
of the policy earlier than its expiration date and the
cancellation or other termination of any such policy shall
automatically revoke and terminate any license issued for
the ambulances covered by such policy, unless a substitute
insurance policy complying with the provisions of this
Section shall be forthwith provided and be in effect at or
prior to the time of such cancellation or termination.
SECTION VII: MEDICAL ATTENDANTS' LICENSE APPLICATIONS. Applications
for drivers, attendants and attendant-drivers licenses hereunder
shall be made upon such forms as may be prepared or furnished by
the City Clerk of the City and shall, among others, contain the
following information:
A. The applicant's full name, current residence, places
of residence for five years previous to moving to his
present address, and length of time he has resided in
Kitsap County.
B. The applicant's age, marital status, height, color of
eyes and color of hair.
C. Whether applicant has ever been convicted of a felony or
misdemeanor, and if so, state the date and circumstances of
such conviction and all matters relative thereto.
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D. The applicant's training and experience in the transporta-
tion and care of patients, and whether he has previously
been licensed as a driver, chauffeur, attendant or attendant-
driver, and if so, when and where, and whether such license
has ever been revoked or suspended in any jurisdiction and
if so, for what cause and the date and circumstances thereof.
E. Affidavits of good character from not less than two
reputable citizens who have personally known such applicant
and observed his conduct during three years next preceding
the date of his application.
F. Two recent photographs of the applicant of a size to be
designated by the City Clerk, one of which shall be affixed
to the license.
G. Such other information as the City Clerk shall seem reason-
ably necessary to make a proper determination of the
applicant's ability and training to comply with the provisions
of this Ordinance.
H. Such application shall be accompanied by a license fee of
Fifteen Dollars ($15.00) and Five ($5.00) for each renewal
thereof.
SECTION VIII: STANDARDS FOR DRIVERS, ATTENDANTS AND ATTENDANT-DRIVERS
LICENSE.
A. Medical Attendants. Each ambulance service shall have on
duty and available for immediate response, two medical
attendants who are licensed for emergency medical service as
provided in Section VIII B of this Ordinance. A certificate
of license shall be carried on the person of each medical
attendant and driver at all times while on duty.
B. Certificate of License - Medical Attendants. No person
shall perform the duties of a medical attendant without first
obtaining a certificate therefor from the City Clerk. No
such certificate shall be issued to any applicant who has
not previously held such a certificate, or whose certificate
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expired more than one year prior to application for a
new certificate is made, unless he complies with the
following:
1. Prior to licensing and employment such applicant has
successfully completed an advanced Red Cross First Aid
Course and within one hundred eighty (180) days after such
employment and licensing, such licensee shall have
completed a course, consisting of both theory and practical
application, as approved by the Kitsap County Medical
Society, and the State of Washington Health Department
certifying such licensee to be a~"EMERGENCY MEDICAL
TECHNICIAN" In case of any dispute as to the adequacy
of such course completed by any applicant, the decision
of the Advisory Committee, as hereinbelow set forth, shall
be controlling and conclusive..
Each licensee, in addition to the foregoing, may be
requested to attend and successfully complete such other
course or courses reasonably required to enhance and
improve the special training and knowledge of such
"Emergency Medical Technician" as may be recommended by
the Advisory Committee from time to time and which courses
are available at any Co~unity College or similar
institution within 50 miles of Kitsap County, Washington.
2. The applicant has a valid Washington State Driver's
License issued by the Department of Motor Vehicles
provided that the City may consider the driving
record as verified by the Department of Motor Vehicles
in determining whether a certificate shall be issued
or refused for an ambulance driver-attendant.
3. The applicant is eighteen (18) years of age or older.
SECTION IX EXPIRATION AND RENEWAL OF LICENSE.
A. Certificates of Licenses for drivers, attendants and
attendant-drivers shall expire on June 30th of each year.
No such license shall be renewed or extended unless the holder
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has submitted evidence to the City Clerk that he has
successfully completed the course and training hereinabove
set forth within a period of twelve months preceding the
application for renewal or any refresher course approved
by the Advisory Board.
B. It is presently recognized that an applicant, by reason of
lack of training availability, may not be able to fully
comply with the standards set forth hereinabove; in any
such case the City Clerk may issue a conditional license
as follows:
1. Conditional License - Operator
a. When, because of temporary unavailability of
qualified medical attendants, an applicant for a
license will be unable immediately to comply with
provisions of this Ordinance relating to qualifications
of medical attendants, a provisional license may be
issued for a period not to exceed six (6) months,
conditioned on the following:
(1) Diligent and prompt efforts shall be made by
such applicant to fully comply with the provisions
of this Ordinance, including requiring medical
attendants employed by the applicant who do
not have the training and educational qualifica-
tions set forth in Section VIII (1) to take
the first available training and instructional
program thereafter offered in Kitsap County
which meets the requirements of this Ordinance,
and to complete said course of instruction as
promptly as may be consistent with scheduling
for standby crews to meet the requirements of
said Section.
2. Conditional License - Attendant
When, because of current unavailability within Kitsap
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County of a training and instructional program meeting
the requirements set forth in Section VIII B (1), an
applicant for a medical attendant's license is unable
to fulfill the requirements set forth in Section VIII
B (1) a provisional license may be issued for a period
of not to exceed six (6) months, conditioned on such
applicant enrolling in the first available training
and instructional program thereafter offered in Kitsap
County which meets the requirements of said Section,
and thereafter complying with all of such requirements as
promptly as may be practicable under all the circumstances.
3. Conditional License - Attendant, Standards
a. An applicant shall demonstrate emergency medical
knowledge consistent with the standards for the
advance course of the American Red Cross, the Washington
State Department of Labor and Industries (18-hour course)
or the Washington State Fire Training School.
b. After June 1, 1972, provisional licenses will be
issued only because of unavailability of qualified
medical attendants. Holders of such provisional
licenses after June 1, 1972, shall be used only as
ambulance drivers. Not more than one such provisional
license holder shall staff an emergency vehicle after
June 1, 1972.
SECTION X: REVOCATION OF LICENSE.
A. The office of the City Clerk, acting by and through the
City Clerk or duly authorized representative may, and is
hereby authorized to suspend or revoke any license issued
hereunder for failure of licensee to comply with and to
maintain compliance with or for his violation of any
applicable provision, standard or requirement of this
Ordinance or for any regulations promulgated hereunder, or
of any other applicable law or ordinances or regulations
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promulgated thereunder, and further provided that
prior to any such suspension or revocation, due notice
thereof has been given unto the licensee and not less than
ten (10) days for compliance with any such provisions,
standard or requirement.
B. Within ten (10) days after any such suspension or revocation
the licensee shall, upon his written request, be allowed to
petition for a hearing before the City Council and such
hearing shall be held not later than thirty (30) days after
the date of such suspension, for the purpose of determining
adequacy of notice and whether there are sufficient grounds
for suspension or revocation. Subsequent to such hearing
the Council shall uphold or rescind the suspension or re-
vocation. If the licensee shall fail to petition for
hearing, as provided herein, the order of the Clerk shall
become final.
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SECTION XI: INSPECTION AND REPORTS.
A. Each licensee of an ambulance hereunder shall maintain
complete and accurate records, which records shall
include the transportation of each patient within the
City of Bremerton, or from one place within the City to
another place within or beyond its City limits. Ail such
records shall be available for inspection by the City
Clerk or his duly authorized representative at all reason-
able times.
B. The provision of sub-section XI A of this Section shall
likewise apply in case a patient shall die before being
so transported in such ambulance or dies while being so
transported therein or at any time prior to the delivery
of the patient to a hospital or medical or other authority
if the patient is still under the care and responsibility
of the ambulance licensee.
C. Each licensed ambulance, its equipment and accessories and
all records pertaining to its maintenance shall be inspected
at least every ten thousand (10,000) miles or every six (6)
months, whichever occurs first. Such inspection shall be
conducted by the franchise dealer from whom such ambulance
had been purchased if located in Kitsap County, otherwise
from any qualified garage, repair shop or licensed mechanic
conducting such tests regularly in its business. A written
vehicle inspection report shall be submitted unto the City
Clerk within seven days after such examination, and a copy
of such report, labeled Exhibit "B" being attached hereto
and made a part hereof as if fully set forth. The City
reserves the right to amend such vehicle inspection report
from time to time.
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SECTION XII: CODE OF CONDUCT.
A. Every person who operates an ambulance service, as
defined herein, shall be responsible for his attendants'
drivers' actions and conduct while in service within the
City limits of Bremerton. The protection and the integrity
and the well-being of the patient's condition shall be
the prime responsibility of The attendant at all times
while in his custody.
B. No medical information shall be divulged to any unauthorized
individual at any time. The condition or treatment of any
patient shall not be discussed by any licensee with any
party other than other medical personnel involved in the
situation, a member of the medical profession or a law
officer in case of any emergency.
SECTION XIII. CITY FIRE DEPARTMENT AID CAR. In the event that the
City's Fire Department operates an aid car, then in such event the
Fire Department reserves the right to respond to any emergency situation
and/or the transportation of any patient to a hospital when:
A. The patient is in critical condition and no licensed
ambulance is immediately available; or
B. There is a lack of ambulance or ambulances to timely respond
to the scene, or
C. When a number of patients are in dire need of transportation
to a hospital and a bona fide emergency exists.
In all other cases, an ambulance licensee shall transport the
patient to the hospital when the custody of the patient has been
released to such licensee.
No effort shall be made by the licensee to assume the custody
of a patient before release of custody has been made by the
officer in charge.
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SECTION XIV: INSPECTION BY CITY. Notwithstanding any other pro-
vision of this Ordinance, an authorized representative of the City
may, at all reasonable times, inspect any records, equipment and
accessories of any licensee hereunder. In case of any lack of
compliance with any of the requirements hereunder or deficiencies,
such licensee shall promptly remedy same.
SECTION XV: AMBULANCE RATES TO BE FILED: Each ambulance service
licensed hereunder shall, immediately upon the issuance of a license,
file with the City Clerk its schedule of rates to be charged for
service during the license period for which application has been
made, said rate schedule shall be subject to review and approval of
the City Council. Such schedule of rates shall be competitive and a
matter of public record and open to public inspection in the office
of the City Clerk during normal business hours. Each licensee shall
strictly adhere to such schedule throughout the period for which a
license has been issued. It shall be unlawful for anyone driving,
or operating an ambulance, to charge, demand, collect or receive any
greater or less rate of fare than those posted with the City Clerk.
It shall be unlawful for any ambulance operator to give directly
or indirectly, or cause to be given, any rebates, commissions, reserve
rebates or any reduced rates or cash discounts to any person, or
persons, or groups of any nature.
SECTION XVI: AVAILABILITY OF EQUIPMENT AND PERSONNEL.
Each licensee hereunder shall keep ambulance equipment and on-duty
personnel available on a 24 hour basis. In the event all available
equipment and personnel are in use, the Fire Department shall be
immediately advised of such condition and that the licensee could
not respond to any emergency at that time.
SECTION XVII: ADVISORY COMMITTEE.
A. The Mayor shall appoint, with the concurrence of the City
Council, an Advisory Committee composed of sever persons. Such
Advisory Committee shall consist of the Mayor, two duly licensed
physicians affiliated with the Harrison Memorial Hospital, one member
of the Greater Bremerton Chamber of Commerce, the Chiefs of the
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Bremerton Fire and Police Departments, and a representative of the
ambulance company.
B. The terms of the members of the Advisory Committee shall
be as follows: The Mayor, Police Chief and Fire Chief
their respective terms of office; the first physician appointed
two (2) years; the second physician appointed four
(4) years; the member of the Greater Bremerton Chamber of
Commerce two (2) years; and the representative of the
Ambulance Company the period of the license granted to
the Ambulance Company hereunder.
C. The Advisory Committee shall meet at least quarterly to
review and recommend standards and regulations relating
to emergency medical services and submit its recommendations
in writing at least once a year to the City Council for its
approval. Such review may include recommendations for new
or different equipment and regulations relating to para-
medical emergency service and recommend new or different
training procedures and the development of new rules and
regulations relating to any operation licensed hereunder.
SECTION XVIII: PENALTIES: Any person violating or failing to comply
with any terms or provisions of this Ordinance shall, upon conviction
be guilty of a misdemeanor and be fined in an amount not exceeding
$300.00 or imprisoned in the City jail for a period not exceeding
ninety (90) days, or by both such fine and imprisonment for each offense.
SECTION XIX: SEVERABILITY. If any section, sub-section, sentence,
clause, phrase or portion of this Ordinance is for any reason held
invalid or unconstitutional by any Court or competent jurisdiction,
such portion shall be deemed a separate, distinct and independent
provision and such holding shall not affect the validity of the
remaining portions hereof.
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SECTION XX: EFFECTIVE DATE. This Ordinance shall be effective
upon its passage, approval and publication, unless otherwise pro-
vided for hereinabove.
APPROVED by the City Council on first reading this/~f-~ay
of March, 1972.
PASSED by the City Council of the City of Bremerton, signed
by the Mayor and attested by the City Clerk in authentication of
such passage thi~~ day of March, 1972.
'GLENN K. JARSTAD~ Mayor
ATTEST:
G. 6~. YEADON~/City Cler~
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EXHIBIT A
ESSENTIAL EQUIPMENT
FOR AMBULANCES
PUBLISHED BY THE
COMMITTEE ON TRAUMA,
AMERICAN COLLEGE 0F SURGEONS,
MAY 1970 BULLETIN
1. Portable suction apparatus with wide-bore tubing and rigid
pharyngeal suction tip.
2. Hand operated bag-mask ventilation unit with adult-, child-
and infant-size masks. Clear masks are preferable. Valves
must be capable of use with oxygen supply.
3. 0ropharyngeal airways in adult, child, and infant sizes.
4. Mouth-to-mouth artificial ventilation airways for adults and
children.
5. Portable oxygen equipment with adequate tubing and semi-open,
valveless, transparent masks in adult, child, and infant sizes.
6. Mouth gags, either commercial or made of three tongue blades
taped together and padded.
7. Sterile intravenous agents, preferably in plastic bags, with
Administration kits.
8. Universal dressings, approximately 10 inches by 36 inches, com-
pactly folded and packaged in convenient size.
9. Sterile gauze pads, 4 inches by 4 inches.
10. Soft roller self-adhering type bandages, 6 inches by 5 yards.
11. Roll of Aluminum foil, 18 inches by 25 feet, sterilized and
wrapped.
12. Two rolls of plain adhesive tape, 3 inches wide.
13. Two sterile burn sheets.
14. Hinged half-ring lower extremity traction splint (ring 9 inches
in diameter, over-all length of splint 43 inches) with commer-
cial limb-support slings, padded ankle hitch, and traction strap.
15. Two or more padded boards, 4 1/2 feet long by 3 inches wide, and
two or more similarly padded boards, 3 feet long, of material
comparable to four-ply wood for coaptation splinting of leg
or thigh.
16. Two or more 15-inch by 3-inch padded wooden splints for frac-
tures of the forearm. (By local option, similar splints of
c~rdboard, plastic, wire ladder, or canvas slotted lace-on
may be carried in place of the above 36-inch and l$-inch boards.)
17. Uncomplicated inflatable splints in addition to Item 16 above
or as substitute for the short boards.
18. Short and long spine boards with accessories.
19. Triangular bandages.
20. Large-size safety pins
21. Shears for bandages.
22. Sterile obstetrical kit.
23. Poison kit.
24. Blood pressure manometer, cuff, and stethoscope.
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~ EXHIBIT B~
~ CITY OF BREMERTON
VEHICLE INSPECTION REPORT
State
License
Date Vehicle No. No.
MECHANICAL:
1. Tires: Right Front Left Front Right Rear Left Rear
Minimum tread depth of 2/32nd required) Spare
2. FRONT END ASSEMBLY: Idler Arms Tie Rods
Ball Joints* Steering Gear
(~Ball joint check requires Manual and gauge)
3. BRAKES:
Wheel Cylinders Master Cylinder Lining
Drums Parking Brake Road Test
4. TURN SIGNALS:
Right Front Left Front Right Rear Left Rear
5. HEADLIGHTS: High Low 6. STOP LIGHTS: 7. TAIL LIGHTS
8. WINDSHIELD WIPERS: 9. ALL GLASS: 10. HORN:
LL. EXHAUST SYSTEM: 12. DOOR HARDWARE:
13. SHOCK ABSORBERS:
Right Front Left Front Right Rear Left Rear
EXTERIOR:
1. BODY CONDITION: 2. CLEANLINESS
3. AUTHORIZED EMERGENCY EQUIPMENT: SIREN LIGHTS
4. EXTERNAL POWER OUTLETS:
'INTERIOR:
1. SEATS: (Backs)
2. UPHOLS~RY: (General Condition)
3. INTERIOR LIGHTS:
4. CLEANLINESS:
AFFIDAVIT OF CERTIFICATION OF SAFETY INSPECTION:
We have inspected all points enumerated above and have found them to be
in conformity with recognized safety standards.
CITY OF BREMERTON Agency
1. COLORS Inspector
2. NAME AND NUMBERS Date'Approved
3. RATE CARD AND ID CARD
4. ANNUAL METER TEST
INSPECTOR
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