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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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PR0232332
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
5/10/2019 1:08:22 PM
Creation date
11/7/2018 4:20:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0232332
PE
2381
FACILITY_ID
FA0003741
FACILITY_NAME
JIFFY LUBE #598
STREET_NUMBER
1130
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
15120405
CURRENT_STATUS
02
SITE_LOCATION
1130 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MAIN\1130\PR0232332\COMPLIANCE INFO 1988-2005.PDF
QuestysFileName
COMPLIANCE INFO 1988-2005
QuestysRecordDate
10/3/2017 6:58:57 PM
QuestysRecordID
3660291
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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AUG-39-96 F12I 12 :40 SHOP HAZARDS SOLUTIONS 209 665 0972WNG <br /> «[ > '4'^N' t ISSUE DATE(MMIDDM't <br /> a,N :1 �� 'qk£f�;r *,✓ a . . £.. ` >`�� [ �. 0/27/95 <br /> SIG<rY.lS 1:<✓, .r:a:.,., o:c :. <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br /> CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE <br /> DOES NOT AMEND.EXTRND OR ALTER THE COVERAGE AFFORDED BY THE <br /> POLICIES BELOW <br /> Angie Comwell Ina Agency,Inc <br /> COMPANIES AFFORDING COVERAGE <br /> P.O.Box 201004 <br /> COMPANY <br /> Stockton,CA 95201.9004 LETTER A General Star Indemnity Company/Heritage General Agency <br /> COMPANY <br /> LRITSR B Empire Fire&Marine/Canyon Pacific Wholesale Ins. <br /> INSURED <br /> COMPANY <br /> LETTER C <br /> Shop Hazards Solutions,Ino. COMPANY <br /> 729 N.Golden State Blvd, #231 LETTER D <br /> Turlock CA 95380 COMPANY Em ire Fire&Marine/ <br /> LEITER E P Canyon Pacific wholesale Ins. <br /> <:. 'rir[ .a �nL n S„[S., •. yS J�, ga.,'.. <br /> F . <br /> .. ,'..:i:: � f fR J• <br /> Mau saS <br /> THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED%BLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THS POLICY PERIOD <br /> INDICATED.NOTW UHS TANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIIIQATE MAY BE ISSUED OR MAY PERTAIN,TIB INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EICLLSMNS AND CONDITtONg OF SUCH POLICIES.LIMITS"SHO WN MAY HAVE BERN REDUCED BYYAID CLAIMS. <br /> CO TYPE OF INSURANCE POLICY NUMBER POLICY BFT. POLICY W. LIMITS <br /> TR DATE(MM/DD/YY) DATE(.MMIDD/YY) <br /> A GENERAL LIABILITYIMA268019 11/01/95 11/01/96 GENERAL AGGREGATE 1000000 <br /> Jam' COMM.CENERALLIABILTTY PRODCOMP/OP AGG. INCL <br /> CLAIMS MADE ®OCC. - PERE.&ADV.INJURY 1000000 <br /> OWNER'S&CONTRACT'S PROT EACH OCCURRENCE 1000000 <br /> FIRE DAMACE(One fire) 50000 <br /> MED.EYP, One Per <br /> B AUTOMOBILE LIABILITY CL529209 11/01/95 11/01/96 COMBINED SINGLE 1200000 <br /> ANY AUTO LIMIT <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Pa Peeeu”) <br /> AIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per sodd.0 <br /> GARAGE LIABILITY —� - <br /> PAOPBRTYDAMAC6 <br /> X POLLUTION <br /> EXCESS LIABILITY EACH OCCURRENCE <br /> UMBRELLA FORM AGGREGATE <br /> OTHER TITAN UMBRELLA FORM <br /> STATIffORY LIMITS [. <br /> WORKERS'COMPENSATION <br /> BACN ACCIOHNT <br /> NW <br /> DISEASE-POLICY LIMB <br /> EMPLOYER'S LIABILITY _ <br /> DISEASE-EACH EMP. <br /> E OTHER CL529209 11/01/95 11/01/96 <br /> AUTOMOBILE SPECIFIED PERILS& <br /> PHYSICAL DAMAGE COLLISION <br /> $1,000.DEDUCTIBLE <br /> DESCRIPTION OF OPERATIONS4I CATIONSNEHICLESMPBC1AL ITEMS <br /> 93 FORD L8000#6896 <br /> cox IFtc T re ," <br /> � 1 x1'£r. <br /> SHOULD ANYOTTHE ABOVE DESCRIBED POLICIES BECANCELLED BEFORBTHR <br /> ' EXPIRATION DATE TIBASOT,TIB 199C[,NG COMPANY WILL ENDEAVOR TO <br /> ?' MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br /> r, LEFT,BUT FAILURE TO M LLa CH ICE SHALL IMPOSE NO OBLIGATION OR <br /> FOR EVIDENCE PURPOSESQNLY- LIABILITY of ANY .rP011 T/ COMPANY,ITS AGENT'S R I rp.' sENTATIVES. <br /> 729 N. GOLDEN STATE BLVD.#231 <br /> TIJRLOCK,CA 95360 AUTHO D R PaN�I',?TIV� <br /> ACOttf12R.S(3190) 7. a, 7777= m7 7 _ <br />
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