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COMPLIANCE INFO_2001-2009
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231691
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COMPLIANCE INFO_2001-2009
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Last modified
12/6/2023 4:56:44 PM
Creation date
6/3/2020 9:50:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2001-2009
RECORD_ID
PR0231691
PE
2361
FACILITY_ID
FA0003593
FACILITY_NAME
Nella Oil #487
STREET_NUMBER
983
STREET_NAME
MOFFAT
STREET_TYPE
Blvd
City
Manteca
Zip
95336
APN
221-15-06
CURRENT_STATUS
01
SITE_LOCATION
983 Moffat Blvd
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231691_983 MOFFAT_2001-2009.tif
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EHD - Public
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CORD CTIFI F <br />LIABILITY IU E OP ID S DATE (MM /DDJYYYY) <br />WALTO-2 03/06/07 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />TLB Insurance Services <br />1000 Broadway Suite 289 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Oakland CA 94607-4090 <br />Phone: 510-628-9100 Fax:510-628-9115 <br />INSURERS AFFORDING COVERAGE NAIL# <br />INSURED <br />INSURER A: Evanston Insurance Co. <br />INSURERS: Redland Insurance Company <br />03/06/07 <br />03/06/08 <br />INSURER C: State compensation Insnzance <br />Walton Engineering, Inc. <br />P.O. BOX 1025 <br />West Sacramento CA 95691 <br />MED EXP (Any one person) $ 5,000 <br />INSURER D: Hartford Insurance Co 34690 <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 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 CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES 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 />NZ5KLTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MM/DD <br />DATE MWOD i N <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE ® OCCUR <br />X $5,000 Ded <br />07PKG01395 <br />03/06/07 <br />03/06/08 <br />EACH OCCURRENCE $1,000,000 <br />PREMISES (Eaoccurence) $50,000 <br />MED EXP (Any one person) $ 5,000 <br />PERSONAL &ADV INJURY $1,000,000 <br />GENERAL AGGREGATE $2,000,000 <br />PRODUCTS - COMP/OP AGG $2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY JECT LOC <br />EI0. BEA. 11000,000 <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />8001121446 <br />03/06/07 <br />03/06/08 <br />COMBINED SINGLE LIMIT $1,000,000 <br />(Ea accident) <br />X <br />ALL OWNED AUTOS <br />BODILY INJURY $ <br />(Per person) <br />SCHEDULED AUTOS <br />X <br />HIRED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />X <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />AUTO ONLY: AGG $ <br />A <br />EXCESSIUMBRELLA LIABILITY <br />OCCUR E-1 CLAIMSMADE <br />07EFX00007 <br />03/06/07 <br />03/06/08 <br />EACH OCCURRENCE $4,000,000 <br />AGGREGATE $4,000,000 <br />DEDUCTIBLE <br />RETENTION $ <br />`, <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />713000492706 <br />10/01/06 <br />10/01/07 <br />X TORY LIMITS ER <br />E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE - EA EMPLOYEE $ 1, 000, 00OOFFICER/MEMBER <br />E.L. DISEASE -POLICY LIMIT $ 1, 0 0 0 , 0 0 0 <br />OTHER <br />A Pollution/E&O 07PKGO1395 03/06/07 03/06/08 Poll/E&O $1,000,000 <br />D installation Fltr 57MSIZ6050 03/06/07 03/06/08 Inst Fltr $1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />*10 days notice applies if cancelled for non-payment of premium. <br />CERTIFICATE HOLDER CANCELLATION <br />TOWHOMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />To Whom It May Concern IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />© ACORD CORPORATION 1988 <br />ACORD 25 (2001108) <br />
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