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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ALPINE
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2900 - Site Mitigation Program
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PR0526874
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/1/2018 1:28:00 PM
Creation date
11/1/2018 8:32:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
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
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EHD - Public
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NOV 13 195 11:28AM SAN JOAQUIN PERSONNEL 3FC: P.2 <br /> ` CEAFICATE OF INSoKANCE <br /> This is to certify that Coverages in the name of: N 6v+a rrgd manic trffiara S6W <br /> SAIL JOAQUIN COUNTY CF aay comnrb or ad=dmwaw whh rcqXwttu <br /> COUNTY COURTHOUSE u'mrb ftwbfr&m iLgd,Sm inenmeme a wld <br /> STOCRTON, CA 95202 bptltelmticiuumdd tic cc+t&wisnbjcet <br /> are in farce at the date hereof, as follows: to all weVro of aueh pe[irias" <br /> Coverage Company Policy 0 Period Limits <br /> asp G-wd A sm-C. .my a-74--3591 ar ameodrd Enr.nium S1,000W C ImoseA <br /> cmuotuol uddl y <br /> mR•a9aioamva 6Nuotion <br /> F=7 <br /> af darip in or unceflAti a of slidpel ram'Cor arkrdgaed campaay wig each:..m yva wsiRru.once m thepity to wlw,U dbr crrtllLc is <br /> aueh mf a 1hau!39pran ao oblknim m h"ty Upon tiie eempmy b' adj the terms aat COD9il".of m2 pofeica. <br /> DESCRIPTION: Certificate issued in connection with agreement between the <br /> State of California and San Joaquin County Environmental Health Division to <br /> assess and oversee the work site located at 75 E. Alpine, Stockton, for the <br /> purpose of excavation, soil sampling, backfill and compaction from November <br /> 13 through November 17, 1995. <br /> It is hereby agreed that the State of California, Water Resources Control <br /> Board, its officers and employees are named as additional insured as to <br /> activities under this agreement . It is also agreed such insurance or self- <br /> insurance shall be considered to be primary a.s to similar insurance or self- <br /> insurance carried by same and that thirty (30) clays written notice of <br /> cancellation will be provided to certificate holder. <br /> Companies $ffordino Coverages �utho, a Re resen a ive <br /> A. San Josauin County <br /> Safety and Risk Manag r (.stay <br /> B. <br /> Diane Edwards, Contract Manager, EAR <br /> State of California, Water Resources Control Board <br /> Clean Water Program Division, UST Clean-up Fund Program <br /> P.C. Box 944212 <br /> Sacramento, CA 94244-2120 <br /> Crhis reata la caned et the tvgneat of the paam W QT"iM3M 2Mccd=d the <br /> °r^bPaab'ari6tand agraialpioo wMnmmb mohpxaan of�0Y®ties,tt4Waddroas <br /> shave,aa;w of apardStl{aa sod,whoa pyabk,naive of makfW surge in AW of <br /> the dm bed p4cks.) <br />
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