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COMPLIANCE INFO_1998-2003
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231876
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COMPLIANCE INFO_1998-2003
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Last modified
11/16/2023 11:23:59 AM
Creation date
6/3/2020 9:54:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1998-2003
RECORD_ID
PR0231876
PE
2361
FACILITY_ID
FA0000421
FACILITY_NAME
DINO MART
STREET_NUMBER
1001
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
1001 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231876_1001 E YOSEMITE_1998-2003.tif
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EHD - Public
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STATE <br />COMPENSATION <br />INSURANCE <br />P.O. BOX 807, SAN FRANCISCO,CA 94101-0807 <br />F U N D CERTIFICATE OF WORKERS' COMPENSATIOA <br />1 <br />ISSUE DATE: 08-01-98 CERTII <br />SAN JOAQUIN HEALTH DEPARTMENT <br />1601 EAST HAZELTON AVENUE <br />STOCKTON CA 95205 <br />I INSURANCE <br />'OLICY NUMBER: 421.8105 - 98 <br />:ICATE; EXPIRES: 08-01-99 <br />�. J 0 y <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. <br />We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the <br />policies described herein is subject to all the terms, exclusions and conditions of such .policies. <br />PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING. DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. <br />ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS NOTICE EFFECTIVE 08/01/98 IS ATTACHED TO AND <br />FORMS A PART OF THIS POLICY. <br />NF <br />
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