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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0544208
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Last modified
3/1/2019 5:00:00 PM
Creation date
3/1/2019 3:53:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544208
PE
2957
FACILITY_ID
FA0003628
FACILITY_NAME
ARCO STATION #2168*
STREET_NUMBER
441
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
14707607
CURRENT_STATUS
02
SITE_LOCATION
441 W CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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I_tla`,'H� DRILLIP16 TEL Ido .916 645 7945 Jun 10 , 91 19 : 16 F' . U4 <br /> STATE P.O. BOX 807,SAN FRANCISCO,CA 941010807 <br /> COMPENSATION <br /> IN S U R A N C <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> 04-29-91 POLICY NUMBER. GP 59-225-91 <br /> CERTIFICATE EXPIRES: 0101/92 <br /> r-San Joaquin County Public Health Service <br /> P.U. Box 2009 <br /> Stockton, CA 957.01 <br /> L_ <br /> This is to certify that we have issued a valid Workers'compensation Insurance policy in a form approved by the California _ <br /> insurance Commissioner to the employer named below for the policy period Indicated. <br /> This policy Is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. <br /> We will alto give you TEN days'advance notice should this policy be cancelled prior to its normal expiration. <br /> This certificate of insurance is not an insurance policy and does not emend, extend or alter the coverage afforded by the <br /> policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with <br /> respect to which this cartificate of insurance may b8 issued or may pertain, the insurance afforded by the policies <br /> described herein is subject to all the terms, exclusions and conditions of such policies. X 1A" <br /> PRE6,PENT <br /> EMPLOYER <br /> r-Stephen W. & Linda Hedman <br /> DBA: Wayne Drilling <br /> P.O. Box 726 <br /> Lincoln$ CA 95648 <br /> COPY FOR INSIIREO'S FILE "' <br />
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