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COMPLIANCE INFO 2010-2012
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518624
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COMPLIANCE INFO 2010-2012
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Last modified
3/11/2021 9:19:03 AM
Creation date
11/5/2018 11:19:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2010-2012
RECORD_ID
PR0518624
PE
2371
FACILITY_ID
FA0024496
FACILITY_NAME
Costco Wholesale #38 (Gas Station)
STREET_NUMBER
1630
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
Ln
City
Stockton
Zip
95210
APN
09428011
CURRENT_STATUS
01
SITE_LOCATION
1630 E Hammer Ln
QC Status
Approved
Scanner
SJGOV\rtan
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FilePath
\MIGRATIONS\H\HAMMER\1630\PR0518624\COMPLIANCE INFO 2010-2012.PDF
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EHD - Public
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ENDORSEMENT NO, <br /> This endoraament,aftecllve 1201 AM, 12/31/09 <br /> Forms a partof Ponoy Not PROP1665078 <br /> issued tot Wayne Perry Inc. <br /> Syr Chartis Specialty Insurance Company <br /> THIS EKDORSEMENT CHANGES THE POLICY, PLEASE,READ IT CAREFULLY. <br /> AODITIDNAL INSURED ENDORBEASENT <br /> COVERAGE A.5 AND C <br /> This ardorsemartt muddles insurance provided under the following: <br /> COMMERCIAL GENERAL LIABII ITY AND PROFESSIONAL LIABILITY POLICY <br /> SCHEDULE <br /> Kama of Puts"Or OTgenlzatOn: <br /> AS REQUIRED BYA WRITTEN CONTRACT <br /> (If no entry appearS above,btormagon required M complete Ills endorsement will be Shawn in the Declarations as <br /> applicable to We endorsement) <br /> It Is hereby agreed that 6totlon It.of the policy, WHO IS AN INSURED is amended Io Include as an insured the <br /> person or organization shown In the Schedule above SS respects hzsudn9 AfFOOMO re h B and C,but only with respect <br /> to 1(ablQtr,adsing gut of year ongoing alterations performed ty you or On your behalf for that Insured,Covarage is not <br /> Worded for the additional insured's own tiaaifrty,which Suess solely out of its Acte Or untlas " <br /> The e,dues scheduled above are covered under this Po&y only fair Ilnhae of dabldly,up to but act torceoding the amount <br /> required by the written contract with the insured and sAjacl to the faits bf liability of this Pocky. <br /> As other terms,cmdidoas,and OXCIU6lar15 shelf:amain the same. rt . ` o ` .` • ^ <br /> AUTHOMED REPRES,hNTATIVE <br /> or countersignature(in states w ore applicable) <br /> rgplf5(ret) PAGE I OF i <br /> CI1466 <br /> mrr xe.i szsaxss ams arazn.xvxsnasa a,m,o se vy. z ee > <br />
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