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INSTALL_2013
Environmental Health - Public
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PR0518288
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INSTALL_2013
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Last modified
5/31/2022 3:09:55 PM
Creation date
11/8/2018 10:21:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2013
RECORD_ID
PR0518288
PE
2361
FACILITY_ID
FA0013810
FACILITY_NAME
COSTCO WHOLESALE #658
STREET_NUMBER
3250
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
3250 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
Scanner
WNg
Supplemental fields
FilePath
\MIGRATIONS3\G\GRANT LINE\3250\PR0518288\INSTALL 2013.PDF
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EHD - Public
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IMPORTANT <br /> If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed.A statement <br /> on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may <br /> require an endorsement.A statement on this certificate does not confer rights to the certificate <br /> holder in lieu of such endorsement(s). <br /> DISCLAIMER <br /> The Certificate of Insurance on the reverse side of this form does not constitute a contract between <br /> the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it <br /> affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. <br /> ACORD 25(2001108) <br />
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