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INSTALL 1992
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231760
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INSTALL 1992
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Last modified
8/23/2019 4:40:15 PM
Creation date
8/23/2019 3:54:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
1992
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
KBlackwell
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EHD - Public
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NOV 10 '92 16:40 SCIF WGODLAND HILLS P.2,/2 <br /> STATE P,O, BOX 420807, SAN FRANCISCO, CA 94142.0807 <br /> COMPENSATION <br /> INSURANGC <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> NOVE019Cii 10♦ 1992 POLICYNUMBER: 446-92 UNIT 000:16+5 <br /> CERTIFICATE EXPIRES: 1 —1 —93 <br /> PUBLIC HEALTH SERVICES 1 SAN JOAQUIN COUNTY <br /> ATTR: CAROL OZ J ENVIRONMENTAL HEALTH DIV . <br /> 443 SAN JOAQUIN <br /> STOCKTON CA. 952u1 <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 f=und except upon ten days'advance written notice to the employer. <br /> We will also 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 amend, extend or alter the coverage afforded by the <br /> poiicies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with <br /> respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies <br /> described herein is subject to ail the terms, exclusions and conditions of such policies. <br /> PRESIDENT <br /> Nps 10 1992 -� <br /> ENUPROEM I SS <br /> SERVICES <br /> EMPLOYER <br /> T & L PEARCt: <br /> P. 0. BOX 4070 <br /> 3UNLAND CA 91040 8 FAX <br /> I <br />
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