| Date of birth: | 1966 |
| Arresting agency: | I.N.S. |
| Booking number: | 04-02370 |
| Booking date: | Nov 16, 2004 |
| Release date: | Nov 18, 2004 |
| Jail name: | Washington County Jail |
| Location: | 100 W Cherry Ave, Washington, PA 15301 |
| Description: | HOLD OVER (PAYS PRISONER MAINTANANCE) |