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COMPLIANCE INFO 1986-1997
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231191
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COMPLIANCE INFO 1986-1997
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Entry Properties
Last modified
7/6/2020 4:39:19 PM
Creation date
11/8/2018 9:45:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-1997
RECORD_ID
PR0231191
PE
2381
FACILITY_ID
FA0003836
FACILITY_NAME
LOCAL FOOD MARKET
STREET_NUMBER
2650
STREET_NAME
MONTE DIABLO
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
13311131
CURRENT_STATUS
02
SITE_LOCATION
2650 MONTE DIABLO AVE
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\M\MONTE DIABLO\2650\PR0231191\COMPLIANCE INFO 1986-1997.PDF
QuestysFileName
COMPLIANCE INFO 1986-1997
QuestysRecordDate
8/11/2017 6:31:58 PM
QuestysRecordID
3573212
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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- - - <br /> OFRI IFI CA TE OF INSUR0E ISSUE FATE, 06/28/S <br /> ------------------- <br /> PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> W. H, <br /> FOOTENKENVALLINS. I NO RIGHTS UPON THE CERTTFICATE HOLDER. THIS CERTIFICATE DOES NOT AM-END, <br /> LLFL GAMINE bIN EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> SACRAMENTO, CALIFORNIA I COMPANIES AFFORDING COVERAGE <br /> ZIP CODE 95821 <br /> _ _ I COMPANY LETTER A MARYLAND CASUALTY <br /> - ------------------------------I <br /> INSURED I COMPANY LETTER B USFBG INSURANCE <br /> SACRAMENTO FOIIIPMFNT f COMPANY LETTER C <br /> MATNTENANCF. CO , INC. <br /> 2.533 CONNIF CU. <br /> I COMPANY LETTER D <br /> SACRAMENTO, CALTFORNTA <br /> ZIP CODE 95815 I COMPANY LETTER E <br /> ------------------- <br /> COVERAGES ----------- ----------- - - -- <br /> THIS IS TO CFRTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br /> PFRIOO INDICATED NOTWITHSTANDING ANY RF.OUIRFMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER Di1CUMFNT WITH RESPECT TO <br /> WHICH THIS CE.RTI6CATE MAY BE ISSUFD OR MAY PFRTA}N, THE INSURANCE AFFORDED BY THE POLICIES DF5CRIBED HEREIN IS SUBJFC' <br /> TO ALL. THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLiCIFS. <br /> t'0 POLTCY POLTCY <br /> ITR TYPE OF INSURANCE POLICY NUMBER EFF. DATE EXP. DATE ALL LIMITS IN THOUSANDS <br /> i <br /> GENERAL l_IAFILI?Y <br /> A (X) COMMERCIAL r,FNERAL LIABILITY 10193FC 07/01/88 07/01/89 ( r,ENFRAL AOGRFGATE $1,0rr^ <br /> ! O CLAIMS MADE (X) OCCURRENCE I I PRODUCT-COMP/OPS AGGREGATE $1,00. <br /> ( 1 OWNERS d CONTRACTORS PROTErTlUEJ PERSONAL d ADVERTISING INJURY $1,00( <br /> ( ) I I FIRE DAMAGEE(ANY ONE FIRE) f1 016+ <br /> _ ___________________ MEDICAL EXPENSE (ANY ONE PERSON) $ 5 <br /> !AUTOMOBILE LIAFILiTY -------"----- <br /> - -------------------------- <br /> AI (X) ANY AUTO ) 10193AL1 07/01/88 07/01/89 1 CSL $1,000 <br /> I O ALL OWNED AUTOS I I BODILY INJURY <br /> fX) S HEDULRD ED AUTOS I I (PER PERSON) $ <br /> (X) NON-OWNED AUTOS BODILY INJURY <br /> IIj <br /> O GARAGE LIABILITY I DAMAOETYIUENT) E! O <br /> -----------------------------------------------------------------------I----------------------------------------- <br /> jF.XCF.BS LIABILITY I! ! EACH <br /> Al (X) UMBRFILA FORM 1 10193_x5 07/01/88 07/01/89 j OCCURRENCE. AGGREGATE <br /> I ( ) OTHER THAN UMBRFLLA FORM I $1,000 f1,000 <br /> --=------------------------------------ ------------------- Il <br /> AIWORKERS' CEMPFNSATION 174022738h5 10/01/87 10/01:88 I $ 100 (FArH ACC.IDFNT) <br /> 1 AND I E 500 (IiISEASE-POLICY LIMIT) <br /> J IFMF'LOYFk5' LIABILITY I STATUTORY <br /> I i $ 100 (DISEASE-FAL'H EMPLOYEE) <br /> ------------ ----------------------------------- <br /> !OTHER I I ----------------- <br /> 1 I <br /> DESCRIPTION <br /> ---------------OF--------------------OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL------------------------------------ITEMS----------------------------------------------- <br /> 1 ! <br /> THIS CERTIFICATE SUPERSEDES ANY FRFVIOUSLY ISSUED CERTIFTCATFS. 6/28/4 i)H <br /> CERTIFICATE HOLDER I CANCELLATION <br /> SAN JOAOUIN LOCAL HEALTH DEPT I SHOULD ANY OF THE ABOVE DESCRIBED! POLICIES BE CANCELLED BEFORE THE EX- <br /> ATTN; ENVIRON. HEALTH PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS <br /> -- P.O. BOX 2009 is WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE <br /> STOCKTON, CA TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITS OF ANY KIND <br /> -- ZIP CODE 95201 UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> ------------------ - -------------------------------------------------------------------------- <br /> AUTHORIZED REPRESENTATIVE <br /> BILL STENKEN <br />� ,ti <br />
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