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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0220086
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
12/29/2021 6:24:14 PM
Creation date
8/17/2020 2:34:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0220086
PE
2250
FACILITY_ID
FA0006674
FACILITY_NAME
OWENS-BROCKWAY GLASS CONTAINER INC
STREET_NUMBER
14700
Direction
W
STREET_NAME
SCHULTE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
209-240-24
CURRENT_STATUS
01
SITE_LOCATION
14700 W SCHULTE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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r <br /> j <br /> CERTHOLDER COPY <br /> SC <br /> STATE P.O. BOX 420807, SAN FRANCISCO,CA 84142-0807 <br /> COMPENSATION <br /> INSURNCE <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 01-01-2009 GROUP: 000339 <br /> POLICY NUMBER: 0002851-2008 <br /> CERTIFICATE ID: 50 <br /> CERTIFICATE EXPIRES.-01-01-2010 <br /> 01-01-2009/01-01-2010 <br /> SC <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 3o 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 /> I <br /> This certificate of insurance Is not an insurance pollcy and does not amend, extend or alter the coverage afforded <br /> f by the policy 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 to which it may pertain, the insurance <br /> afforded by the policy described herein is'subject to all the terms, exclusions, and conditions, of such policy. <br /> g��- vt-a-,� <br /> tHORIZED REPRE5ENTATI PRESIDENT <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> ENDORSEMENT #1500 - FRED PELL, TREASURER,CFO - EXCLUDED. <br /> ENDORSEMENT #1500 - ROBERT SCOTT, PRESIDENT - EXCLUDED. <br /> ENDORSEMENT #1500 - JAMES SCOTT, SEC,V.P. - EXCLUDED. <br /> ENDORSEMENT #2055 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2008 IS <br /> ATTACHED TO AND FORMS A PART OF THIS POLICY, <br /> EMPLOYER <br /> ENVIRONMENTAL RECOVERY SERVICES INC SC <br /> DSA:ENVIROSERV <br /> 15902 S MAIN ST <br /> GARDENA CA 90248 <br /> IBIX,SCj <br /> (REV.2-05) PRINTED : 01-05-2009 <br />
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