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SITE HISTORY
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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3500 - Local Oversight Program
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PR0545195
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SITE HISTORY
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Entry Properties
Last modified
1/23/2020 11:49:16 AM
Creation date
1/23/2020 11:37:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545195
PE
3528
FACILITY_ID
FA0002915
FACILITY_NAME
TRACY MARKET INC
STREET_NUMBER
15
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21435004
CURRENT_STATUS
02
SITE_LOCATION
15 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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BERT FICATE OF INSVRANCE 03Z28/94 <br /> PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> DiBuduo and DOFendis IA3uraACO 1 NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, <br /> EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 5665 s f i elCalid o CA Ave. , E t. 100 ----•--•------•.................................... <br /> ..--------- <br /> •-----------I <br /> Bakersfield, CA I� <br /> 93309 COMPANIES AFFORDING COVERAGE I <br /> _PNoNE805-322-9993 <br /> INSURED ...... .....•..- .•......- •-.I-COMPANY- _...LETTER A aGLr3EN_EAGLE._INBDRANCE CO <br /> PACIFIC RIM ENVIRONMENTAL I COMPANY LETTER B ULYCO INDLMNITY CORP . •__.-• <br /> SERVICES INC. _ <br /> P. 0. BOi 192972 <br /> SAN FRANCISCO, CA 'COMPANY LETTER C <br /> GI S ...--•----•------•................................•--••........-•-- <br /> 94119 COMPANY LETTER b <br /> COMPANY LETTER E <br /> !� COVERAGES ==�■■rva.■:.mss■r■ua.r+s■■■■uuass:...zzn:awaa.rzeacs■r.rw■.r.aka■...■■.+rrss■+.e..aasw..ea+■srw.u...rswa■■ <br /> THIS 1S TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED To THE INSURED NAMED ABOVE FOR THE POLICY <br /> PERIOD INDICATED. NOTWITHSTANDING AMY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO I <br /> WHICH THIS CERTIFICATE MAY BE ISSUED OR MAT PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO <br /> _--.ALL TERMS, EXCLUSIONS, AND CONDITIONS-OF SUCH POLICIES. LIMITS-SHOWN-KAY NAVE SEEN REDUCED-BY PAID CLAIMS. <br /> ........ -• P ......--- .......------- <br /> -- ... _..... <br /> COI <br /> TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP ALL LIMITS IN THOUSANDS <br /> ;LTR DATE DATE <br /> _..--- <br /> YABILITY GENERAL AGGREGATE.-- 2000- <br /> Al QC] COMMERCIAL CEN LIABILITY I CCP19952901 09/28/93 09/28/94 •PRODS-COMP/OPS•AGO. 1000 <br /> C <br /> C ] CLAIMS MADE EX OCC. <br /> ..................... ....•......] PER$. & ADVG. INJURY 1000 <br /> .................. ......-----I <br /> I ] OWNER'S L CONTRACTORS <br /> PROTECTIVE EACH OCCURRENCE 1000 <br /> ' ..................... ........... <br /> I -FIRE DAMAGE <br /> I ] (ANY ONE FIRE) 5O <br /> 1 MEDICAL EXPENSE <br /> i <br /> I--- ?•---- -------- (ANY ONE PERSON) 3 <br /> ------ ------_----- --_------ -•--------..._ ............ .............. <br /> AUTOMOBIL$ LIAR ._ . f <br /> CSL -----•--,.. 1000 f <br /> I A I I ANY AUTO P19952901 09/28/93 09/28/94 BODILY............... <br /> .-. INJURY ... ..._"•-• <br /> ( ] ALL OWNED AUTOS <br /> QC) SCHEDULED AUTOS ,-(PER PERSON) <br /> KI HIRED AUTOS -. ........... <br /> KI NON-OWNED AUTOS BODILY INJURY <br /> I ] GARAGE LIABILITY (PER ACCIDENT) <br /> - [ - ----•----^---- 1 ..--•--- •-....----. ---... <br /> PROPERTY EXCE88 LAILITY ...- . ..------------------------- <br /> I <br /> --"'-. •----------- <br /> I C - <br /> I UMBRELLA FORM - I EACH OCC AGGREGATE <br /> ) OTHER THAN UMBRELLA FORM 1 <br /> �•- -------------------------------- ----- -_-----..._ -------------- -------------••--�------------- <br /> A WORAERSDCOMP NWC183579-01 07/05/93 07/05/94 1000oRY EACH ACC <br /> i <br /> EMPLOYERS It LIAR I 0 DISEASE-POLICY LIMIT <br /> �--- ---- --------- <br /> 1000 DISEASE-EACH EMPLOYEE <br /> ...... <br /> OTHER -------------- ----------•--- -..._.......----•;- <br /> $ PROF 90000420 11/06/93111 06 94 <br /> 1 LIABILITY <br /> / / S250,000 <br /> ---- ------- CLAIMS MADE <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ......................... <br /> l <br /> I> CERYIFICATE HOLDER t..■o.aa.■ao.+.z=+srre.es+as■a> CANCELLATION t■■.rz=aasa■rr■:rsa■rr+a+::■rs■:ars■:..■e.+:.r.e.z+sru■e:eef <br /> r SHOULD ANY of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- <br /> INSURED x PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> FAILURE TO NAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br /> ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. <br /> • <br /> CORD 25-$ 3 g8 ■ AUTHORIZEDREPRESENTATIVE <br /> .- ���-"--- �•�- -'• 1 <br /> : 1C.� <br />
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