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Home My WebLink About2001-0619 Ambulance Renewal CITY OF kSHLAND Memo TO: FROM: DEPT: RE: Greg Scoles, City Administrator Keith E. Woodley, Fire Chief ~ Ashland Fire & Rescue Annual Ambulance Service License Renewal DATE: June 11,2001 In compliance with AMC 6.40.120, an inspection and test of all ambulance service vehicles, equipment and fixed facilities has been completed incident to the renewal of the ambulance service operator's license of Ashland Fire & Rescue. All vehicles, equipment and facilities associated with the provision of ambulance services to the City of Ashland have been found to be in compliance with ordinance requirements. Ashland Fire & Rescue Tel: 541-482-2770 \455 Siskiyou Blvd Fax: 541-488-5318 F~i,~ .'~ Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us CITY OF SHLAND Council Communication TITLE: DEPT: DATE: SUBMITTED BY: APPROVED BY: APPROVED BY: Ambulance License Renewal Ashland Fire & Rescue June 19, 2001 .~ \ Keith E. Woodley, Fire Chief Greg Scoles, City Administrator Paul Nolte, City Attorney Synopsis: Ashland Municipal Code (AMC) Chapter 6.40.110 requires ambulance service providers operating within the City of Ashland to apply annually for an ambulance operator's license. Fiscal Impact: None. Recommendation: Staff recommends approval of the request by Ashland Fire & Rescue for renewal of their ambulance operator's license. Background Information: AMC Chapter 6.40.110 requires ambulance service providers operating within the city limits to apply annually for an operator's license. The issued license shall be valid from the date of issuance to the next following thirtieth day of June, commencing on the first day of July by ordinance. AMC Chapter 6.40.100 sets forth license requirements, all of which have been met by the applicant. CITY OF ASHLAND APPLICATION FOR AMBULANCE OPERATOR LICENSE AMC Ch. 6.6.40 Applicant's Name: CITY OF ASHLAND Trade Name, if any: ASHLAND FIRE & RESCUE Address: 455 Siskiyou Boulevard Ashland, OR 97520 Telephone number: (541 ) 482-2770 Ambulance descriptions Manufacturer Vin # License # 1. 1985 BRAUN BRAUN 1FDJE3OL8FHA49888 EXEMPT 2. 1992 FORD WHEELED 1FDJS34M4NHA34394 EXEMPT COACH 3. 1992 FORD LIFELINE IFDKE30M7PHAO5945 EXEMPT 4. 1996 FORD LIFELINE 1FDKE30F8THA48282 EXEMPT 5. 1999 FORD LIFELINE 1FDXE40F2XHA00469 EXEMPT 9 Attach information showing that every proposed driver, attendant and driver-attendant is qualified as required in Ashland Municipal Code Chapter 6.40 and as required by the laws of the State of Oregon. -gEnclose with the aPplication, the initial license fee of $300 plus $100 per ambulance. 9Enclose a performance bond in the amount of $500,000. 9Enclose an insurance policy meeting the requirements of AMC [}6.40.110.7. Attach additional pages as necessary. Explain any box not checked. Submit your application and required enclosures to Barbara Christensen, City Recorder, City Hall, 20 East Main Street, Ashland, Oregon 97520. I certify that each ambulance listed above is adequate and safe for the purposes for which it is to be used and that it is equipped as required by Ashland Municipal Code Chapter 6.40 and the laws of the State of Oregon. Signature: Print name: Title: /~-//¢. Date: DEPARTMENT OF HUMAN RESOURCES OREGON STATE HEALTH DIVISION AUDIT NO. EPIERGENCY PIEDICAL SERV !CE SECTION - APIBULANCE L ICENSE3 ~ ~ ~ 4 9 $80. O0 PAYMENT RECEIVED EXPIRATION DATE MO. DAY YR, JUN 30 O1 GROUND ~ 1999 FORD TYPE III LICENSE NO. E211465 City o{ Ashland Keith E. Woodley, 455 Siskiyou Blvd L^shl~nd Ch i e-~' ADMINISTRATOR State Health Division I I]R ?TGZO __J 05/09/0 6~Z3 462 17590 MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE 22-2 DEPARTMENT OF HUMAN RESOURCES OREGON STATE HEALTH DIVISION ^UO~T NO. ! .5° l -E 198560 CERT. NO. F GROUND--] 1996 FORD TYPE III LICENSE NO. E198560 $80. O0 PAYMENT RECEIVED EXPIRATION DATE MO. DAY YR. JUN 30 O1 City o¢ Ashland Kei%h E. Woodley, 455 Siski¥ou Blvd Ashland Chie¢ OR ~75E0 __~ ADMINISTRATOR State Health Division 462 175~0 ;':: MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE ~ - J~ _~ ..... __7 ........ ;;. -;~-~-~.-T-~.. _ 7- --L-~ . ~.: - . .. . ...... . , ...:. ; ~7 DEPARTMENT OF HUMAN RESOURCES OREGON STATE HEALTH DIVISION EMERGENCY MEDICAL SERV ICE SECT ION 1501 -E 186951 CERT. NO. AUDIT NO. "AMBULANCE LICENSE388598 $8(i]. O0 PAYMENT RECEIVED [-- GROUND'--~ 1993 FORD TYPE III LICENSE NO. E186951 EXPIRATION DATE MO. DAY YR JUN 30 O1 City o¢ Ash{lnd Keith E. Woodley, 455 Siskiyou Blvd L Ashland Chie¢ OR ?TSZO ADMINISTRATOR State Health Division 05109/0 622.5 462 MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE 175~0 22-2 (8/~ DEPARTMENT OF HUMAN RESOURCES OREGON STATE HEALTH DIVISION EMERGENCY MEDICAE SERVICE SECTION - 1501 -E 1 '70'.~77 CERT. ,NO. F- GROUND 1985 FORD TYPE III LI'C:ENSE NO. AUDIT NO. . ^,~u~^,c~ ~ ~c~,s~3 8 8 5.8 2 E 170f~77 $80. O0 PAYMENT RECEIVED EXPIRATION DATE MO DAY YR JUN 30 O1 City o¢ Ashland Keith E. Woo,'lley, Chie¢ 455 Siskiyou Blvd L_ Ash I and OR i ADMINISTRATOR State Health Division 05/09/0 6227 462 1Y59c) MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE 22-2 ,?~[EpARTMENT OF HUMAN RESOURCES OREGON ~T~ATE HEALTH DIVISION AUDIT NO. EMERGENCY MEDICAL SERVICE oECTION - AMBULANCE LZCENSE388621 1501 - E 195689 $80 . OO CERT. NO. PAYMENT RECEIVED [--- GROUND .... i 199~ FORD TYPE II LICENSE NO. E195689 EXPIRATION OATE MO. DAY YR JIUN 30 01 City o¢ Ashland Keith E. Woodley, £:hie¢ 455 Siskiyou Blvd L Ashl~nd OR 975Z0 ADMINISTRATOR State Health Division 05/09/0 6~Z6 46Z 17590 MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERABLE (~; 22-2 (8/87) Last name First Name Date of Birth Driver Employment Oregon cert. Cert. Number License # Status Number Anders Walt 10/30/56 1955034 Full Time 11248:5 Basic Beck Todd 09/26/69 5837326 Full Time 124331~' Paramedic · Bums Kelly 11/25/69 5207865 Full Time 120248 Paramedic Case Greg 06/15/58 3254941 Full Time 113788 Paramedic Cherry Dean 02/20/59 9711954 Full Time 128118 Paramedic Clayton ' Todd ' 01/03/73 4836726 Full Time 123797 Paramedic Cockell Robert 12/25/61 " 6109120 Full Time 1239415 Paramedic Comer Adam 08/24/71 5914985 FUll Time 128117 Paramedic Curtis Danny 08/25/36 2042833 Full Time 10419:5' Basic Eaton WesleY 08/26/40 1533069 Full Time 100386 ]~asic Formolo Curt 09/20/61 3~38940 Full Time 118901 Paramedic Freiheit Matthew 03/16/68 4927105 Full Time 12123'7 Paramedic Hadden Jennifer 12/02/64 3535298 Full Time 124336 Paramedic Hanstein David 09/23/60 2524064 Full Time 11181,4 Paramedic Hard David 11/30/58 8581745 Fuli Time 12793,8 Paramedic Hollingsworth Scott 10/23/61 2830146 Full Time 113607 Paramedic Jones Greg°ry 12/06/50 1423603 Full Time 11097'.2 Basic Kieffer Luean 11/12/78 5904401 Full Time 125847 Paramedic Rosenlund Derek 01/16/59 5541498 Full Time 121067 paramedic . Sallee Dana 06/29/65 3654752 Full Time 116336 Paramedic Saurman Daniel 09/02/49 2518612 Full Time 109202 Basic Shepherd David 10/06/65 3667291 Full Time 123197 Paramedic Stephens Robert 02/07/67 58565.09 Full Time 12378,7 Paramedic Stoy John 08/18/65 4856227 Full Time 118911 Paramedic White Danial 10/26/44 3697732 Full Time 11 642;2 Basic · ' 23 Wilson Ashland, · The individual card has compl~ J level indicated. STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION I STATE OF OREGON EMERGENCY MEDICAL' TECHNICIAN )N EM'r, HT: 6' WT: I ATTACH PHOTO HERE 3877:[ Th~ cert~F~te is the property of the Oregon Health OiviSX:~ and must be i Dk'ectOL Emergency Medical Services Aaminislrato¢. Oregon Health Division I ,~ffendered by the holder o~ demand. 'J STATE OF OREGON - DEPARTMENT OF HUMAN RE$OUROES J OREGON HEALTH DIVISION 1 CliNICIAN ['. "',.., RKI/~n the reverse el this t~ in ORS ~3.010 ~ i EMERGE! ~ERT.#12~333 PA~ BECK. TO.D)~, 12735 Hil[h~; /ack. nv level ~. Eme~ ~l AFl-ACH PHOTO HERE 38830 STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDEN~~ON STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN HT: 6' Brown WT: 21: ATTACH PHOTO HERE 39409 The card has compl~[ed'~ ~. and is cenifi~aS' level indicated. R,~& j,,,,, 7' Eme~gen~ STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION NICIAN ,-. 6/30/2001 ~'l~h~-'8~'J, grib~d~ the reverse o, this ~t~t t..C~h in ORS 823.010 et _.. ...... ~/ (~_ ~ ~f Hall. MPH ~n~traloC Or~ H~h ~S~ I t,:~ ............ -;.. -- ~ STATE OF OREGON- DEPARTM~ OF HUMAN ~URCES ] OREGON H~ DIVISION '~" [ : EMERGE~~N'~ ~. n.~,,,~ ~-/' a~.,~.,~'~ J ......... STATE OF OREGON EMERGENCY MEDICAL TEOHNICIAN IDE] F.,MT, HT: 5' Brown WI': I ATTACH PHOTO HERE 38815 This certificate i~'the pm~erly of ~ha Orego~ HeaMt Diwsion and must be surrenderecl Oy the holder on o~mand. I:: UI- Uflt"l, JUfl - OREGON HEALTH DIVISION 945 N As~and, ~ i~Mdua~a~~~d,~n ~he reveme of ~is ~rd has ~. and is ~dif~M~di~l T~ni~an at ~e level indictS. STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION CL~O~ 220 W~t ~fi' The individual~ad card has ~ ~. a~ is ~f~ level i~i~l~. I EMERGENCY MEDICAL' TECHNICIAN IDI )N HT: :ht Brown WI': lue .. ATTACH PHOTO HERE 42577 This certificate is the properly of the Oregon Health Ofidsion and must be sum~x~ed by the hok~er on demand. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN HT: 5' WT: I ATTACH PHOTO HERE 38779 IDEN )N This certiracate ~s the property of the Om~w Health Division and must be sunmxfemdbyEmhofd~ondemand. OREGON HEALTH DIVISION I EMERGENCY MEDICAL TECHNICIAN EMERG ...... AL ~)EC. HNICIAN .... ~':; i : '., , : - -.,:l- -;, The i~~:~3~':'~3~d I~ the reverse of this card ,.s ..,,~"~ ~~:4, ,~h i. ORS ~.0,0 o, .... level indicated. . ..... .. . ~ /...---~/__ ( ~ A. aymo~dJester ~ Elino~ Hall, MPH OtrecloL Eme~ge~-y Medical Sen4ces Admimsl;ato~. O~ego~ Health D~vlsio~ HT: 5' lnClc WT: ATTACH PHOTO HERE 3.8828 This cedttlcate i~ the prope~y of the O~eo~ H~lth OtvlsiO~ a~ ~ ~ surre~r~ ~ ~ ~r ~ ~. STATE OF OREGON-~'EPARTMENT OF HUMAN R~SO-~R~-E~- -~ STATE OF OREGON OREGON HEALTH DIVISION I EMERGENCY MEDICAL TECHNICIAN EMERGE! CERT.//128117 PA~ 885 Clay card has ~. and is ce~fl~ level indicaled. Oif~OC Emor~n~ Mod~l Solids ~<~~? E,CHNICIAN 1,4.,',~,:~ ,,-,.- f-%.~,.~.<: :.~: . . . ,~ ~~ ~ ri~,~ me reverse of this m~?~m~nr~as '.M~dicat Technician al tho ~ " Eli~ Ha~. MPH Admlnistrat~. Ore~ Hoalth Di~sion EMT )N HT: 5 Brown WT: I ATTACH PHOTO HERE 4 2579 this ceailicate !s the propeay of tho Ore~) Health Otv,$ton and must ~ sucro~or~ by tho ~ldor ~ doma~, b IAI I- UI- UHt-LjUN - OREGON HEALTH DIVISION E M E R G E,~/~ '.~.~.C'A ~'~_CH NICIA N CURTIS. ~~:~'i 455 Siski)~.'e~;.,/./.kb ..:.~ i ,~":."~'.~'~. Ashland ~'f~': '9j~:~2~.,'~I · :'~' '~';~ ~Ji' .;-~ c~,, has comp,~t<,d'ih~ .~tg. and is cedifi~cl, as' aP-l~ar'Oer~_.,.~,M~Klical Technician al Ihe level indicated. ".,!~ 5 .~..,~"/,./,~, A. Raymond Ja$1ef/' Ellm:x Hal. MPH O~eclo~. Emocgency Medical Services Adminl$ffalO¢. t STATE OF OREGON . DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION E M E R G Ey.~¥~l--(~ (": ~EC, HNICIAN · EA~O~ w~-~[(~-~-~-'.:: ~-'...~, ~ ;, · . __ '.'. I I '/ '" " ;.. ;. ,,-,e.,?¥,~'up~ ,~),~,. ,~ ,m reverse o~ mis card has. .com_pl~'e.:[..~{., _1~_...._~'~~ 1,! ~ in ORS 823.010 el .r~;i...an.o. ~s cerlme~:!, as ~lp:-~i~_/g~i~ ',M~lical Technician at the level m~lcated. :..:(_..~._~_.._.~.~ .. ~' _ , . / Elin~ Hall. MPH Emergency MediCal Sandoa$ Adminlstcalo~. Ofeg<m Health STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES EMERGENO¥ MEDIOAL TEOHNICIAN D; HT: WT: IOl ray AT-TACH PHOTO HERE 38833 this ce~tl~cate I~ the pn~peify o~ the Oregon Health O/vfs/on and must be surrendered br/he ho/der o~ demand STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN HT: 5' WI': EX~I{ AFFAC PHOT( HERE IOl 3875 · STATE OF OREGON --i OREGON HEALTH DIVISION EMERGEN.~¥ MEI~I. cAL F~ECHNICIAN .,,,. , . . - . J .' ,. . FO~OLO. ~URT. J:~;.' .... '., _ Ma~brd~ %':/.:.;..,, . : .. ~,~ ~. : .- .-..' .......:', ~. has ~~ ~ ,~~mS.ee~ ~h in ORS e23.om e and is ~ili~. as ~[~/~ M~i~l Te~nician al the ~sle~ / EH~ Hal. MPH EMERGENCY MEDICAL TECHNICIAN IDEN HT: 6' trk Brown WT: 1; ATTACH PHOTO HERE 38812 FI~S C~l~r~..ele i~ ~h~ prO~e~'ly Gl It~ Oregon He,&lth Oivlston and must be surrendered by the holder on demand STATE OF OREGON STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EME.:RG E~-~C~,H NiCiAN l CERT. # 121237 P~~06/30/2001 · card has I~.d'~. ;. f~~ .. ~.~"~t f~ EMERGENCY MEDICAL TECHNICIAN HT: 6' WT: 11 ATTACH PHOTO HERE 38740 this C~ItIc~t~ I~ tt~ p~opan7 o~ tt~ OreOon Health Otvlslo~ and must be aucrendered by the hold~ on demand. ..... 6RE&6N H'~L%'o~VlSij~i ............... EMERGEI~ CERT. # 12,4336 PA~ HADDEN.~ 1313 Mill g/~l~ Ashland. t~ The individu al~a~ level indicated. O~c~o~. Emergency Medical Services ,~HNICIAN ~ ' ~, 06/30/2001 ' ! I!o!1 ~d~the reverse of this ~di~l Technician at the i EMERGENCY MEDICAL TECHNICIAN IDI EMT, ITl': 6' :Brown A'i-rACH PHOTO HERE 38763 Th~ 6'wrtlfic~le I~ If~ ~ Of ff~ Ore~, Health O~ a~ m~t ~ su~ by ~ ~r ~ ~. STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES --1 STATE OF OREGON ~A~ -~-:C'~ ECHNICIAN ~ ~ rev~r~ el ~is t~h in ORS 823.010 4~di~l T~n~an at the ~ ~1. MPH I ICE. RT. # t11814 1516 Larks~ll '~1,~'.: · I Th. ,.~.~.a, t c.,< has ~o~.,~, ~',~., ~g. and is certif level h~licated. I I EMERGENCY MEDICAL TECHNICIAN IDE HT: 6' trk Brown WT: STATE OF OREGON - DEPARTMENT OF HUMAN RESOURC~ OREGON HEALTH DIVISION EM ERGE~/j~IcAC~E~HNiCIAN .^~o. o ~.~.~:-;-:':'.:?::.~.'.',, 671 Sprin~~~' '~'~'' The ,ndiv,dua~pa~~~:d~ the rovers, of card has comp[~t~f~nfs.~t ~h In ORS 823.010~ Emef~n~ ~d~l ~t ~il~al~. O~e~ Health STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES CERT. · OREGON HEALTH DIVISION EMERGEI~~_'~'~ :~':T..ECHNICIAN ' ~' '~'~F'- "--' ~rd has ~pl~~~~~~--~~n~6t ~h in ors 823.010 ~e~. Emef~ ~d~l ~s ~nlst~al~. O~ Health ATTACH PHOTO HERE 38783 STATE OF OREGON EMERGENCYMEDICAL TECHNICIAN IDI ~ndc tluc ATTACH PHOTO HERE 41947 · This certificate Is the prope~y Of the Oregon Health ~v~sion and must be surrendoro(f by tho hotdor ell demand 1 STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDE )N HT: 6' WT: 1' A'H"ACH PHOTO HERE 3880( fhls certificate is the property of the Ore,Tom Health Oh4slon and must be surrendered by the holder o~ demand i o.~o..~^~, o,v,s,o. iONS. i · 455 Siskiy_,d_d;B_l~d_ ( ~,~ ':,.'-X "~ I Th,, i~v~uai':~a~";~ J ~eve~ ~icat~d. ". ...... j Oireclo¢. Emei'gellcy Medical STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDEN HT: 6' rk Brown WT: ATTACH PHOTO HERE 38769 This ce~lacate ~ the properly of the OretTon Health O~viston and mu~t be NOISIAla I-U.-IV3H NOg'::lt:lO Ii S:qOt::lnOSBt:l NV~RH dO .LN3r, IJ.t:lVcl3a ' N09-:::II::IO :10 :I..LV. LS J , o I-~ '-j I I j .I -'~x~~ ~-'7', : 40745 This certificate Js the properly of the O~egon Health O~vis~O~ and must be STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES I J EMER~ J CERT. # 121067 I I OREGON HEALTH DIVISION PA~~ :~.HNICIAN ROSENLU~ pO ~42 WUs~// · ~hland, ~t~ in ORS 8~3.010 oe~lf as - ~. and R~ Je~er ~ EII~ H~. MPH D~. Em~ STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION ,70 B~~,;~ Talcn,. :~: . ; . .~' , . .. ...... ~h~. . .... r,, ~iv~ual'~a~ f.~'~d ~ Ih, rever~ ol this card ~s level indicaled. · '" a~ Jeslm ~' Eli~ Haa. MPH 1 STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDEN' )N EMT, HT: 6' ~rk Brown WT: ATTACH PHOTO HERE 38742 This certificate is the ptope~y of tt~ OregOn Health ~ ancl must be surrendered by the holder on demand. S'IAI'E OF OREGON EMERGENCY MEDICAL TECHNICIAN IOEN EMT HT: 6' Brown WT: ATTACH PHOTO HERE ~x~ 38764 This ce~1iPcate ~s Ihe proper~y of ~ ~ Hea~ Oi~s~ a~ must ~ s~re~r~ ~ ~ ~r ~ ~. IAI t: L)t; OREGON - DEPARTMENT OF HUMAN RESOURCES., OREGON HEALTH DIVISION · EMERGE~HNICIAN '.CERT. # 109202 B~d~~~O/2001 ; SAU ' ___ ~rd has~mp~_~~t ~h In ORS 823.010 ~. and l, ; ~ ~ ~er ~ ~ ~1. MPH STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDEN HT: 5' Brown WT: I AFT'ACH PHOTO HERE 38811 card has ~~ ~~~t ~h In ORS 823.010 ~. a~ Is ~difl~a~~~l~l T~hnl~an at the ~ ~ster / E~ ~. MPH I I I! STATE OF OREGON EMERGENCY MEDICAL TECHNIC:lAN IDI HT: 6' Brown WT: ATTACH PHOTO HERE 38805 STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCE~ STATE OF OREGON 100 Alder~.. Phoenix, . The indivtdual'~t,a~ card has _compl4~: It~. and ia certlfle~ level Indicated. OREGON HEALTH DIVISION ~ CHNICIAN '~~ ~1 Tea.ida. al the E~ ~. MPH I I EMERGENCY MEDICAL TECHNICIAN IDI HT: 6' Brown WT: 2 ATTACH PHOTO HERE 38825 Yhle certificate I~ the properly of Ihe Orego~ Health O/vision add mu~t be eu~rendered by ~ IX)lder o~ demand. .. STATE OF OREGON ~ DEPARTMENT OF HUMAN RESOURCES '~] STATE OF OREGON OREGON HEALTH DIVISION I EMERGENCY MEDICAL TECHNICIAN IDENTIEI~.i'ION · ' ':"~: ' '.~i~' ¥ HT: 6' r:'~.~.~.[;~.,~'rk: Brown - WT: "~.~ ~:..!A:: ~' " ,J.,' i -. Ex~~°b~~' I I I EMERGENCY MEDICAL TECHNICIAN · CERT. # 118911 pAR~: 'MEDIC EXPIRES 06/3012001 STOY, JOHN'T . "' 955 Orandvi6~.Dr · '," Ashland. OR 97520 ,; . ~'; · . '.:~ The individual named .above enid described on the reverse of this card has completed the requfr.'em, ents set fodh in ORS 823.010 ,S.e~. and is certified as aD Emergency Medical Technician at lhe level indicated. ; .:{ "L '~ A. Raymond Joslo¢ / Elino¢ Hall. MPH Director. Emocgoncy MoOre--al Services Administralo¢. Oceej~'~'t Hoallh {:)iviSiO~ ATTACH PHOTO HERE 38750 this cortd~,ato IS tho prOperty OI t/id Orogon Health Oiviston and must Oe surrendered Oy lbo holder o~ (lomand STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EM ERGEN. CY'I~EmCAL' ~.~ECHNICIA. CERT. # 116422 ^~,,,,d. o.~:~ ..,,, ~'..~i~.~.} ! iiO:'?~.. · ~1. and is certili~d as a/tEmdr'got~/,l~l~lical fecht~ian at Ihe A. Raymot~ Jeste¢ ~ Ellno~ Hall. MPH Okeclo~. Em~'ge~'y Medical Set~e$ Adminlslrllo~. O~e~o~ Heallh STARE OF. OREGON .... EMERGENCY MEDICAL TECHNICIAN IDI HT: 6' ~rk Brown WT: I A~-I'ACH PHOTO HERE 38822 .