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COMPLIANCE INFO_2002-2008
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2300 - Underground Storage Tank Program
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PR0231320
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COMPLIANCE INFO_2002-2008
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Last modified
11/8/2022 2:15:47 PM
Creation date
6/23/2020 6:46:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2002-2008
RECORD_ID
PR0231320
PE
2361
FACILITY_ID
FA0003602
FACILITY_NAME
TESORO (SPEEDWAY) 68151
STREET_NUMBER
35
Direction
N
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04318003
CURRENT_STATUS
01
SITE_LOCATION
35 N CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231320_35 N CHEROKEE_2002-2008.tif
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EHD - Public
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RVISTAT <br />ACORD. CERTIFICATE TE (MM/ODYYYY)CLIABILITY D <br />6/5/2007 <br />�.OoucER Commercial Lines Unit (707) 769-2900 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />ABD Insurance & Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1039-A N. LAC Doweli Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Petaluma, CA 94954-5507 <br />NSURED Service Station Systems, Inc. <br />3224 Regional Parkway <br />Santa Rosa, CA 95403 <br />:OVERAGES <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A: Oak River Insurance Company 34630 <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING I <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />.IS <br />N <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />POLICY EXPIRATIONDATE <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED $ <br />CLAIMS MADE 1 OCCUR <br />MED EXP (Any one person) $ <br />PERSONAL 8 ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ <br />POLICY 0 PROT LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />I <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />ANY AUTO <br />AUTO ONLY: AGG $ <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE $ <br />AGGREGATE S <br />OCCUR CLAIMS MADE <br />$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTNE <br />2210020636071 <br />6/4/2007 <br />6/4/2008 <br />X WC STATU- DTH• <br />^— <br />E.L. EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE -.EA EMPLOYEES 1,000,000 <br />OFFICERIMEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />RE: License #485184 <br />Evidence of Coverage. <br />CERTIFICATE HOLDER CANCELLATION I en Uay Notice Tor Non-rayment <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 90 DAYS WRITTEN <br />')Contractors State License Board - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />PO BOX 26000 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Sacramento CA 95826 <br />TH RIZED R P S N A <br />ACORD 25 (2001/08) 46340 <br />0 ACORD CORPORATION 1988 <br />
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