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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545394
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/5/2020 2:28:20 PM
Creation date
3/5/2020 2:05:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545394
PE
3528
FACILITY_ID
FA0005372
FACILITY_NAME
MAR-VAL MARKET*
STREET_NUMBER
429
Direction
W
STREET_NAME
LOCKEFORD
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
429 W LOCKEFORD ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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"TEfr No . �";,May 03 ,91 11.'23 P - 02 <br /> STATE P.O. BOX 807,SAN FRANCISCO,lla WO-0807 <br /> COMPEP49ATION <br /> IN9URAN E1991 059=91 bNtT 0000155 <br /> F CERTIFICATE OF WORKERS' COMPENSAT"-ioN INSURANCE 1 -1-92 <br /> POLICY NUM6ER: <br /> CERTIFICATE tWXPIRES' i <br /> COUf47'Y OF' SAN JOQUI N <br /> rATTN STEVE: SCHtjrjl)r ?-HEAr,T11 DEPT . <br /> Pn Liox 2009 <br /> STOUTON CA 95?01 <br /> L 0f i <br /> This it to certify that we have issued.a valid Wotker5' Compensaflop nsurance policy in a Form appraysd by the Califarnii — <br /> Insurance Commissioner to the employer named below for the poli .period indicated. <br /> 30 <br /> This policy Isnot subyo#k to cancellation by the Fund except.upon ten days'advance written notice to the employer. <br /> We will also give you TEN days'advance notice should this policy tie cancelled prior to its normal expiration, <br /> This certificate of insurance is not an insurance policy and does not amend, extend or after the coverage afforded by the <br /> policies listed herein, Notwithstanding any requirement, term, of conditiori of any contract or other'document with <br /> respect to which this certificate of insurance may be issued or fnay pertain, the insurance afforded by the policies . <br /> described herein is subject fo all the terms, exclusions and conditions:of"ditch 0olicies, <br /> ENDORSEMENT # 2065 ENTITLED CEPT1Y1CATF Hnr�D <br /> —s <br /> '01 /01/91 IS ATTACHED TO AND aORES A PART OF' I hlfP?''I 1 <br /> ' E <br /> sf <br /> i <br /> i <br /> li <br /> EMPLOYER <br /> DRILLING CO I ttC . <br /> PO SOX 511.82 <br /> PALO? ALTO CA 94-- <br /> �3 <br /> LO 26 A, <br />
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