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EXHIBIT G <br />DATA ENTERED ON THE A-299 FORM <br />Washington State Parks & Recreation Commission — Recreational Boating Program <br />Request for Boating Safety Program Approval <br />Application Year* <br />2018 <br />AGENCY INFO <br />Agency Name* <br />Kittitas County Sheriffs Office <br />Agency Signing Officer Title <br />r Sheriff r Chief <br />Agency Size <br />Medium <br />Signing Officer First Name* <br />Gene <br />Signing Officer Last Name * Dedicated Account Number <br />Dana 13033600840 <br />STAFFING <br />F'" Fiscal Lead <br />r Other RBS Personnel <br />F Marine Lead <br />F" Supervisor <br />F,, Lead Accident Investigator <br />W Boating Safety Officer <br />r' Coordinator of Boating Education <br />r Certified Boating Ed Instructor <br />I� Fiscal Lead <br />r-. Other RBS Personnel <br />Non -WA Parks Courses <br />Last Name Comission <br />.................................................... ...;.., ...............--- ... <br />Severson Regular <br />Training <br />Current <br />Yes <br />....................................................... <br />First Name <br />SAW <br />Mark <br />Role <br />Rank <br />ID <br />First Name <br />F` Marine Lead <br />Detective <br />Brent <br />I� Supervisor <br />...... <br />FTIPT Email Address <br />......................... ... . . .. . ..... ........... ..... ................ <br />Date Of Marine L.E. <br />' <br />Training <br />fJ Lead Accident Investigator <br />Boating Safety Officer <br />Full brent.severson@co.kittitas.wa.us <br />time <br />04/21/2000 <br />FW Coordinator of Boating Education <br />Certified Boating Ed Instructor <br />Non -WA Parks Courses <br />F'" Fiscal Lead <br />r Other RBS Personnel <br />F Marine Lead <br />F" Supervisor <br />F,, Lead Accident Investigator <br />W Boating Safety Officer <br />r' Coordinator of Boating Education <br />r Certified Boating Ed Instructor <br />I� Fiscal Lead <br />r-. Other RBS Personnel <br />Non -WA Parks Courses <br />Last Name Comission <br />.................................................... ...;.., ...............--- ... <br />Severson Regular <br />Training <br />Current <br />Yes <br />....................................................... <br />First Name <br />___ ............ _ _ _........... _...... <br />Last Name ' Comission <br />Mark <br />Rickey Regular <br />Date Of Marine L.E. <br />Training <br />Training <br />Current <br />04/06/2001 <br />............ ..................................... ........................... .........................._;................................. <br />Yes <br />_................................. <br />................ .......................................................... .................. ............._ <br />.............................................................. <br />._ .._ _. <br />_ .. _ ... . <br />SAW <br />Role ID Rank First Name Last Name Comission <br />I Marine Lead Deputy Zach Green Regular <br />........ .. .. <br />W SupervisorFT/PT Email Address Date Of Marine L.E. Training <br />Training Current <br />F" Lead Accident Investigator <br />