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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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2908
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3500 - Local Oversight Program
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PR0544111
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SITE HISTORY
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Entry Properties
Last modified
2/7/2019 11:13:05 AM
Creation date
2/7/2019 10:30:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0544111
PE
3528
FACILITY_ID
FA0003625
FACILITY_NAME
ARCO STATION #83560*
STREET_NUMBER
2908
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09763032
CURRENT_STATUS
02
SITE_LOCATION
2908 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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GL 20 09 <br /> (Ed.01 73) <br /> This endorsement forms a part of the policy to which attached,effective on the inception date of the policy unless otherwise stated herein. <br /> (The following information is required only when this endorsement is issued subsequent to preparation of policy.) <br /> Endorsement effective 09/15/87 Policy No. SP899-0755 Erwm, t No. <br /> Named Insured P. C. Exploration, Inc. <br /> Additional Premium$ Countersign, y <br /> 4uthori- <br /> (At <br /> d Representative) ,f <br /> This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: <br /> COMPREHENSIVE GENERAL LIABILITY INSURANCE <br /> MANUFACTURERS AND CONTRACTORS LIABILITY INSURANCE <br /> (Owners or Contractors) <br /> I <br /> Schedule <br /> Name of Person or Organization <br /> (Additional Insured) Location of Covered Operations <br /> City of Stockton Monitoring Well Installations-Benjamin <br /> Premium Bases Rates Holt Dr & PlymotAMInce Premium <br /> Rd. <br /> Bodily injury Liability Cost $100 of cost $ <br /> Property Damage Liability Cost $100 of cost $ <br /> Total Advance Premium $ <br /> I <br /> It is agreed that: <br /> 1. The "Persons Insured" provision is amended to include as an insured the person or organization named above(hereinafter called "additional insured"), <br /> but only with respect to liability arising out of (1)operations performed for the additional insured by the named insured at the location designated above <br /> or(2)acts or omissions of the additional insured in connection with his general supervision of such operations. <br /> 2. None of the exclusions of the policy,except exclusions(a),(c),(f),(g),(i).(j)and(m),apply to this insurance. <br /> 3. Additional Exclusions This insurance does not apply: <br /> (a) to bodily injury or property damage occurring after <br /> (1) all work on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured at the site of the <br /> covered operations has been completed or <br /> (2) that portion of the named insured's work out of which the injury or damage arises has been put to its intended use by any person or organization <br /> other than another contractor or subcontractor engaged in performing operations fora principal as apart of the same project; <br /> (b) to bodily injury or property damage arising out of any act or omission of the additional insured or any of his employees,other than general super- <br /> vision of work performed for the additional insured by the named insured; <br /> (c) to property damage to <br /> (I) property owned or occupied by or rented to the additional insured. <br /> (2) property used by the additional insured, <br /> (3) property in the care,custody or control of the additional insured or as to which the additional insured is for any purpose exercising physical <br /> control,or <br /> (4) work performed for the additional insured by the named insured. <br /> 4. Additional Definition When used in reference to this insurance,"work"includes materials,parts and equipment furnished in connection therewith. <br /> Additional Insured: City of Stockton, Its agents, officers and employees are named <br /> as additional insured under this policy and this policy and this insurance coverage <br /> shall be primary over any other insurance or self insurance in- force <br /> GL 20 09 01 73 <br />
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