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WP0041093
EnvironmentalHealth
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ZUCKERMAN
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2121
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041093
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Entry Properties
Last modified
11/17/2021 11:55:04 AM
Creation date
10/19/2020 4:24:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041093
PE
4371
STREET_NUMBER
2121
Direction
N
STREET_NAME
ZUCKERMAN
STREET_TYPE
RD
City
STOCKTON
Zip
95206-
APN
12908009
ENTERED_DATE
8/13/2020 12:00:00 AM
SITE_LOCATION
2121 N ZUCKERMAN RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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CHUBBe <br /> ISSUING COMPANY EXTENSION OF INFORMATION <br /> ACE AMERICAN INSURANCE COMPANY <br /> NCCI CARRIER CODE PAGE-CLASSIFICATION <br /> 12165 <br /> POLICY NUMBER ❑ New rx] Renewal ❑ Rewrite <br /> Symbol: WLR Number: C6 60 38 62 2 <br /> PREVIOUS POLICY NO. ❑ Individual n Partnership <br /> Symbol: WLR Number: 065224987 ❑X Corporation <br /> CALIFORNIA <br /> Complete Item 4.of the Information Page <br /> Premium Basis Rate <br /> Classifications Code Estimated Total Per$100 of Estimated <br /> No. Remuneration Remuneration Premium <br /> AEGION CORP <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> BRINDERSON <br /> OIL OR GAS REFINING, DISTILLING OR COMMPRESSING "3719 1.64 <br /> UNITS-ERECTION OR REPAIR-ALL OPERATIONS <br /> MILLWRIGHT WORK NOC 3724 4.01 <br /> PLUMBING-LOW WAGE 5183 5.63 <br /> PLUMBING- HIGH WAGE 5187 3.38 <br /> CONCRETE CONSTRUCTION NOC-INCL. FOUNDATIONS 5213 5.89 <br /> CONTRACTOR-EXECUTIVE SUPERVISOR 5606 .72 <br /> ENGINEERS- INCLUDING OUTSIDE SALESPERSONS AND 8601 .29 <br /> CLERICAL OFFICE EMPLOYEES <br /> SALESPERSONS-OUTSIDE 8742 .36 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> CORRPRO <br /> ELECTRICAL WIRING-LOW WAGE 5190 4.53 <br /> CONTRACTOR-EXECUTIVE SUPERVISOR 5606 .72 <br /> DRILLING-NOT GEOTHERMAL,OIL OR GAS, MINING, 6204 9.65 <br /> QUARRYING <br /> SALESPERSONS-OUTSIDE 8742 .36 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> FYFE <br /> ANALYTICAL OR TESTING LABORATORIES 4511 .59 <br /> PAINTING-HIGH WAGE 5482 4.35 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> ITI <br /> Minimum, Estimated and Deposit Premiums are shown on the Information Page. Total State Premium <br /> THIS EXTENSION OF INFORMATION PAGE IS EFFECTIVE FOR THE POLICY PERIOD INDICATED ON THE POLICY <br /> INFORMATION PAGE UNLESS OTHERWISE STATED. <br /> ISSUE DATE: 06/26/2019 (PAGE 1 CONTINUED) <br /> WC 99 04 18(12/05) Copyright 1987 National Council on Compensation Insurance <br /> INSURED COPY <br />
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