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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ALPINE
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75
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2900 - Site Mitigation Program
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PR0526874
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FIELD DOCUMENTS
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Last modified
11/1/2018 4:08:21 PM
Creation date
11/1/2018 8:31:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0526874
PE
2960
FACILITY_ID
FA0018201
FACILITY_NAME
FORMER MOBIL SERVICE STATION 99-CAS
STREET_NUMBER
75
Direction
E
STREET_NAME
ALPINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
11514007
CURRENT_STATUS
01
SITE_LOCATION
75 E ALPINE AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
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EHD - Public
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a <br />SIP <br />STATE P.O. BOX 807, SAN,FRANCISCO,CA 94101-0807 <br />•>. COMPENSATION <br />INSURANCE <br />. .. r <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />T �, ✓� �„ ."' _^'" 'CERTIFICATE <br />POLICY NUMBER: 1 - <br />Iss CEfiTIFICATEEXPIRES: 10-01-00-01-0 . 0 _ <br />4 <br />SAN JOAQUIN COUNTY -PHS <br />ENVIRONMENTAL DIVISION <br />304 EAST WEBER AVENUE,, 31 <br />STOCKTON, CALIFORNIA <br />95201-0388 <br />'.'ti=fi �`.+T :-*-t'..F,.xrya f-,-x":n. �. �"-r.<?v �"'�i� �.h.`'N�'�t$ �'�`�xe?'#`-!lf <Y 1-+ z�+`.S�.K-r�-.'�'"�yr't"•.�5-, .n�.i't� t�S' M" <br />This is to certify that we have issued a valid Workers' Compensation insurance policyina 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 30 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 />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document t <br />with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br />ES <br />r.v 1 wy� <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. >; <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10/01/99 -IS ATTACHED TO AND <br />FORMS A PART OF THIS POLICY <br />��e <br />-o-5.....��,Snj..,*�.i <br />0. }� <br />3 <br />F <br />+c , , <br />A Yy <br />W ry EMPLOYER '4 f,a,_ <br />ti <br />ADVANCED GEO ENVIRONMENTAL, INC: <br />3315 E MIRALOMA #117 <br />ANAHEIM CA 92806,3 <br />4 ,} <br />LEGAL <br />-+ ADVANCED GEO ENVIRONMENTAL, INC. <br />f. . <br />
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