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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HENRY LONG
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2900 - Site Mitigation Program
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PR0526314
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COMPLIANCE INFO
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Entry Properties
Last modified
2/21/2020 6:29:47 PM
Creation date
2/21/2020 3:08:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0526314
PE
2950
FACILITY_ID
FA0017804
FACILITY_NAME
MORINAKA
STREET_NUMBER
612
STREET_NAME
HENRY LONG
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
16819006
CURRENT_STATUS
01
SITE_LOCATION
612 HENRY LONG BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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From:Dolores O'Bar At:D&D FaxID: •To:Vanes-' Date:513f'006 01:57 Pt'A Page:2 of 3 <br /> I TWINLAB-01' OBDO <br /> ACORD, CERTIFICATE OF LIABILITI( INSURANCE <br /> ' °A5ia1 oos <br /> 'PRODUCER: .(559)432-0222 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION <br /> DiBuduo&'DeFendis Insurance Brokers,LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR <br /> License#OE02096. ALTER'THE COVERAGE-AFFORDED TJY THE POLICIES BELOW. <br /> P.0:.B6x 5479 ----. <br /> Fresno;CA 93755-5479 INSURERS AFFORDING COVERAGE NAIL# <br /> INSURED' The Twining Laboratories,Inc. INsuRERA,State Compensation Insurance Fund <br /> -Jack Darrah - - -'INSURER B: <br /> P0 Boz 1472 <br /> INSURER c: <br /> Fresno,CA 93721 <br /> INSURER D: . - <br /> IWU;ER E' <br /> ' 'C:OVERplGES I - _THE POLICIES-OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE ItISURED NAMED'ABOVE FOR THE-POLICY PERIOD INDICATED;NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTII'IC�P,TE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE'POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND,CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> .�. INSR D POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR ARTYPE POLICY NUMBER LIMITS <br /> GENERAL LIABLrTY - EACH OCCURRENCE` f-. . <br /> CCAv1MEF:iAL GENERAL 0010 - PREVISESFe x=en e; <br /> .CLA.Ih1S MADE OCCUR •. I MED EXP;Ary XIe W.Onl f . <br /> PERSm4 A'AC INkm <br /> GENERAL.>CGREGATE S . <br /> •GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP'AGG. f <br /> ... - .' POLICY ... PRO-.,... LOC ,•, _ .. . <br /> AUTOMOBILE LIABLTTY - COMBIFEC SIN'LE L10f, f , <br /> AWAUTO' . .. r.: . (Ea rtadeit) - <br /> �'. '.� <br /> ALL CNVI IED AUTOS' '. BOD`LY WARY, <br /> AUTO: <br /> SCNEDU.ED (Par carsa) f <br /> HIRES xUtOS I soocy,,IN.jU4Y. . <br /> .. 'i , (Per acdduti f. <br /> . - NON-OWNED N TOS - <br /> PRDPERTY DAMAGE <br /> - - - (Perpcadentl <br /> .. '' i 'GARAGE LIABLTTY I - AUTO CNLY-EA ACCiD-_TT f' <br /> ANY AIlrJ i GTHER THAW EAACC f <br /> AUTO CNL'^ ..hCG f <br /> .1 R <br /> EXCESSNMBRELLA LWBLRY EACH'&CUP.RENC£ -1, <br /> ' I - <br /> .00CUR CLAIMS MADE .`. I .` AGGREGA`E <br /> F <br /> DEDUCTIBLE - .. <br /> ` RETENTION` I'•3 I,�; _ ,,. _ .I f .. <br /> VJORHERSCOMPENSATION AND ..� - - ' 'X <br /> TOR WS O R . <br /> EMPLOYERS.LIABILITY ,174235106 ., I 51112006 ,,..51112Q07 E.C..- ArxIDENr f - 11000,00 <br /> ANN FROPRIErOR/PAPTtER/EXECLITr.E - -- ..1;000,00 <br /> ' CFFICEPA1EMBER.EXCU'1ID1 ?.. - :�+. -.a - E.L.DISEASE-EA EMPL-GYEE S, <br /> If ves;descr6'under' 1,000,00 <br /> SPECIAL PROVISIONS below - E.L.DISEASE POLICY LIMIT T , <br /> .OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/'VEHICLES 1 EXCLUSIONTADDED BY ENDORSEMENT♦SPECIAL`PRDVISIONS < .. <br /> 10 Day.Notice of.CanceIIatlon'iri'Eyerlt of Noh'Pay hent of Premium <br /> r <br /> CERTIF`ICATE'HOLDER <br /> CANCELLATION <br /> SHOULD ANYOF THE ABOVE DESCRIBED POLICIES 3E CANCELLED BEFORE THE EXPIRATION <br /> 12'`TK TFEF',EOF,7'F♦;ISSURIG MISURER WILL!END'c{VL-R TO:MNL ''.+5•'O DAYS WRrr'rEN <br /> N J-:CE TO THE CERTIFICATE M]LDER NA►AED TO-116 LEFT B64 FAILURE TO DO So SHALL <br /> For Ti-formation' only <br /> IMPOSE NDIUMIGATION OR�LWBILITY'OF-AW VKND JPON THE U4SURER,rr$AGENTS OP. <br /> • - REPRESENTATTVI:§.. <br /> AUTHOPAZEdREPRESENTATIVE ��/�1y.•/�. /�/ � <br /> ACORD 25(20011011) D ACORD'CORPORATION 1988 <br />
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