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COMPLIANCE INFO_2013-2018
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PR0231417
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COMPLIANCE INFO_2013-2018
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Last modified
3/12/2024 12:59:25 PM
Creation date
6/3/2020 9:48:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2018
RECORD_ID
PR0231417
PE
2361
FACILITY_ID
FA0003780
FACILITY_NAME
TRACY SHELL*
STREET_NUMBER
3725
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
21217030
CURRENT_STATUS
01
SITE_LOCATION
3725 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231417_3725 N TRACY_2013-2018.tif
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EHD - Public
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0 <br />STORAGE- OF __ TO <br />DEMONSTRATE⢠<br />STATE OF CALIFORNIA <br />Facility Name and Address: <br />Tracy Shell <br />3725 Tracy Blvd <br />Tracy ,CA 95304 <br />Insurer Name and Address: <br />ACE American Insurance Company a, r <br />c/o Westchester, 11575 Great Oaks Way, Ste 200, Alpharetta, GA 30022 <br />Policy Number: G4665349A 001 <br />Policy Period: <br />From 12:01am 06/30/2017 to 12:01am 06/30/2018 <br />Insured Name and Address: <br />Anabi Oil Corporation <br />1040 N Benson Ave <br />Upland, CA 917862157 <br />ENV1R0NNVzN'_AJ_ HEALTH <br />w wN r <br />I. The Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following <br />Underground Storage Tanks: <br />Facilily <br />Tracy Shell <br />Identification No. <br />000000 <br />4 UST(s) <br />for taking corrective action and/or compensating third parties for bodily injury and property damage caused by either <br />sudden accidental releases or non -sudden accidental releases or accidental releases in accordance with and subject <br />to the limits of liability, exclusions, conditions, and other terms of the Policy arising from operating the underground <br />storage tanks identified above. <br />The Limits of Liability are: <br />a. $1,000,000 <br />b. $3,000,000 <br />Each Occurrence <br />Annual Aggregate <br />exclusive of legal defense costs, which are subject to a separate limit under the policy. This coverage is provided under <br />policy number G4665349A 001. The effective date of said policy is 06/30/2017. <br />II. The Insurer further certifies the following with respect to the insurance described in Paragraph I: <br />A. Bankruptcy or insolvency of the insured shall not relieve the Insurer of its obligations under the Policy to which <br />this certificate applies. <br />B. The Insurer is liable for the payment of amounts within any deductible applicable to the Policy to the provider of <br />corrective action or a damaged third -party, with a right of reimbursement by the insured for any such payment <br />made by the Insurer. This provision does not apply with respect to that amount of any deductible for which <br />coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR <br />280.95-280.102. <br />C. Whenever requested by a Director of an implementing agency, the Insurer agrees to furnish to the Director a <br />signed duplicate original of the Policy and all endorsements. <br />Page 1 of 2 <br />
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