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COMPLIANCE INFO_2013-2015
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0535432
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COMPLIANCE INFO_2013-2015
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Last modified
1/12/2024 4:04:53 PM
Creation date
6/23/2020 6:39:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2015
RECORD_ID
PR0535432
PE
2351
FACILITY_ID
FA0020431
FACILITY_NAME
COSTCO WHOLESALE #1091
STREET_NUMBER
2680
STREET_NAME
REYNOLDS RANCH
STREET_TYPE
PKWY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
2680 REYNOLDS RANCH PKWY
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0535432_2680 REYNOLDS RANCH_2013-2015.tif
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EHD - Public
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IMPORTANT <br /> If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement <br /> on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may <br /> require an endorsement.A statement on this certificate does not confer rights to the certificate <br /> holder in lieu of such endorsement(s). <br /> DISCLAIMER <br /> The Certificate of Insurance on the reverse side of this form does not constitute a contract between <br /> the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it <br /> affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. <br /> ACORD 25(2001/08) <br />
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