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a \ <br /> State ofCalifomia CaUbmia Integrated Waste Management Board <br /> i <br /> CERTIFICATE OF SELF-INSURANCE AND RISK MANAGEMENT <br /> Operator Operator.Address <br /> Solid Waste Division <br /> San Joaquin County 1810 E.Hazelton Ave.,Stockton,CA 95205 <br /> Risk Manager Risk Manager Address <br /> Canlis Building,Room 106 <br /> Richard Pietz 24 S.Hunter St,Stockton,CA 95202 <br /> r <br /> Solid Waste Disposal Facilities Covered:. LIMITS.OF LIABILITY <br /> Facility P Annual <br /> Name Address Information <br /> Number Occurrence:',. Aggregate* <br /> North County 17720 E.Harney Lane <br /> Recycling Center Lodi, CA 39-AA-0022 $ 1;000,000. $ 1,000,000 <br /> &Sanitary Landfill <br /> Corral Hollow 31130 S.Corral Hollow Rd. <br /> Sanitary Landfill Tracy, CA 39--005. $ 1,000,000. $ 1,000,000 <br /> Foothill Sanitary 6484 N.Waverly Rd. <br /> Landfill Linden, CA 39_AA_0004 $ 1,000,000 $ 1,000,000 <br /> Harney Lane 14750 E.Harney Lane -39-AA-0003 $ 1,000,000 $ 1,000,000 <br /> Sanity Landfill Lodi,CA . <br /> TOTAL: TOTAL : <br /> $4,000,000 $4,000,000 .j <br /> •Excluding legal defense costs <br /> CERTIFICATION: <br /> I. The operator and risk manager named above hereby certify that the facilities listed above are$elf-insured for <br /> third party bodily injury and property damage in connection with the operator's obligation to demonstrate <br /> financial responsibility under Title 14,California Code of Regulations,Division 7,Chapter 5,Article 3. The <br /> coverage applies to the above-listed facilities for accidental occurrences arising from the operations of the <br /> facilities. <br /> 2. The limits of liability are the amounts stated above for"per occurrence"and"annual aggregate",exclusive of <br /> legal defense costs. <br /> 3. Coverage isrip mart <br /> 4. Upon request by the Board,the operator agrees to furnish to the Board any documents pertinent to this <br /> coverage. <br /> 5. Termination of this coverage will be effective only upon written notice,sent by certified mail,and only after the <br /> expiration of 60 days after a copy of such written notice is received by the Board and the.local enforcement <br /> agency for the jurisdiction in which the facility is located,as evidenced by the return receipts. <br /> From CIWMB 133(11/91) PAGE t.OF 2 <br />