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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HAMMER
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2150
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3500 - Local Oversight Program
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PR0545248
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
1/30/2020 12:05:22 PM
Creation date
1/30/2020 11:17:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545248
PE
3528
FACILITY_ID
FA0005604
FACILITY_NAME
TOYOTA TOWN
STREET_NUMBER
2150
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09406058
CURRENT_STATUS
02
SITE_LOCATION
2150 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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SENT ;3Y:iA9ua,&eo=ai rtcw Ir c,? 1n: 1 tr131 1129 :# . <br /> STATE P.O. BOX 807,SAN FRANCISCO,CA 94101-0807 <br /> COMNINSATI01Y <br /> INaUotANQa <br /> FUND CERTIFICATE OF WOSKERS' COMPENSATION INSURANCE <br /> '"A Cd f• 1 a' 1 <br /> POLICY NUMBEM 1125962 41 <br /> CERTIFICATE EXPIRES: <br /> r <br /> POOL COMPANY <br /> p. 0„ 9OX 4271 <br /> HOUSTON <br /> Tx 7'7210 <br /> L <br /> This 19 to Certify that we have issued a valid Workers'CL"pensation insurance policy In a form approved by the California <br /> insurance Commissioner to she ernpkgyAw-n&Mrd Wow for the policy petlod Indicated. _ <br /> This policy Is not subiect to cancellation by the Fund except upon ten days'advance writtan notices to the employer. <br /> We will Alio givo you TEN days'advance notice should this policy be cancs1led 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 /> policies ilsml herein. Notwithstanding any requi,ement, terra, or condition of any Contract or other document with <br /> respect to which this certificate of Insurance Ifay be issued or may parta'n, the insurance afforded by the'policies <br /> described herein is subject to all the terms, exclUMOns and conditions of such policies, <br /> PRESIDENT <br /> 1 <br /> r EMPLOYER <br /> APR 08 <br /> AgUAGEOSCIENCE INC. <br /> �` 17 , 10 E S T M I y 0 D R I V E,, 0103 ENVIRONMENTAL HEALTH <br /> R 11 is F I E ll.b <br /> PERMIT/SERVICES <br /> CA 93301 <br /> L ` <br /> COPY FOR INSUREDS FILE <br /> SCID' 10262 JRKV. 10-861 o�d-2✓aA -- <br />
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