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COMPLIANCE INFO_2004-2007
Environmental Health - Public
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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4943
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2300 - Underground Storage Tank Program
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PR0506488
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COMPLIANCE INFO_2004-2007
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Last modified
11/19/2024 1:51:12 PM
Creation date
11/5/2018 8:19:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2004-2007
RECORD_ID
PR0506488
PE
2361
FACILITY_ID
FA0007458
FACILITY_NAME
7-ELEVEN INC #32190
STREET_NUMBER
4943
Direction
S
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95215
CURRENT_STATUS
01
SITE_LOCATION
4943 S HWY 99
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\4943\PR0506488\COMPLIANCE INFO 2004-2007.PDF
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EHD - Public
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DATE <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE page 1 of 206/22/2004 <br /> PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Willie North America, Inc. - Regional Cert Canter HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> P. O. Box 305191 <br /> Nashville, IN 372305191 INSURERS AFFORDING COVERAGE <br /> INSURED Praxair Services, Inc. P/R/A OCISCO, Inc. INSURERA:Old Republic Insurance Company _ 24147-001 <br /> A Subsidiary of Praxair, Inc. INSURERS <br /> 39 Old Ridgebury Road <br /> Danbury, CT 06810-5113 INSURERC: <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSRPOLICY EFFECTNE POLICY EXPIRATION LIMITS <br /> T TYPEOFINSURANCE POUCYNUMBER <br /> A GENERAL LIABILITY MWZY56398 6/30/2004 6/30/2005 EACH OCCURRENCE S 51000,000 <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any ore Are) $ 51000,000 <br /> CLAIMSMADE ®OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONALS ADV INJURY $ 51000,000 <br /> GENERALAGGREGATE E 5.000.0Q0 <br /> GENT AGGR EGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ S 000 00 <br /> POLICY F PRO, F-1 7X LOC <br /> A AUTOMOBILELIABILITY MWTB19003 6/30/2004 6/30/2005 COMBINEDSINGLE LIMIT $ <br /> (Ea a.deM) 5,000,000 <br /> X ANYAUTO <br /> ALLOWNEDAUTOS BODILYINJURY $ <br /> (Per Parson) <br /> :: <br /> SCHEDULEDAUTOS <br /> HIREDAUTOS BODILYINJURY $ <br /> (PeramMent) <br /> NON-WNNEDAUTOS <br /> PROPERTY DAMAGE $ <br /> (PeraccoeM) <br /> GARAGE LIABILITY AUTOONLV-EAACCIDENT $ <br /> ANVAUTO OTHERTHAN EA ACC $ <br /> AUTOONLY: AGG $ <br /> EXCESS LIABILITY EACHOCCURRENCE $ <br /> OCCUR CLAIMSMADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ _ $ <br /> A WORKERSCOMPENSATION AND MWC11103600 6/30/2004 6/30/2005 X T GM ER <br /> EMPLOYERS'LIABILITY E.L.EACHACCIDENT $ 51000,000 <br /> E.L.DISEASE-EA EMPLOYEE $ .5 000,000 <br /> E.L.DISEASE-POLICY LIMIT E 5 000 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONSILOCAnONSMEHK:LESIEXCLUSIONS ADDED BY ENDORSEMENTISPECA.L PROVISIONS <br /> USL&B is included under the Workers Compensation Policy. <br /> CERTIFICATE HOLDER ADDITIONAL INSURED:INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,OS AGENTS OR <br /> Evidence of Insurance REPRESENTATIVES <br /> • AUTHORIZED PRESENTAj <br /> • 4 <br /> ACORD25S(7/97) Coll:1023459 Tpl:271266 Cert:41117258 ©ACORD CORPORATION 1988 <br />
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