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COMPLIANCE INFO_2008-2012
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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PR0231704
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COMPLIANCE INFO_2008-2012
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Last modified
2/1/2024 9:01:55 AM
Creation date
6/3/2020 9:51:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2008-2012
RECORD_ID
PR0231704
PE
2361
FACILITY_ID
FA0001060
FACILITY_NAME
QUIK STOP MARKET #2076*
STREET_NUMBER
1030
Direction
S
STREET_NAME
OLIVE
STREET_TYPE
ST
City
STOCKTON
Zip
95215
APN
157-264-22
CURRENT_STATUS
01
SITE_LOCATION
1030 S OLIVE ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231704_1030 S OLIVE_2008-2012.tif
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EHD - Public
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ACRD. CERTIFICAT ! LI BILIT INVU C WALOP TO -2 S 09/25/08 <br />DATE (MM/DDIYTO <br />>RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />TLB Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />3000 Oak Rd., Suite 210 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />nlalnut Creek CA 94597 <br />Phone: 925-395-2600 Fax:925-287-0710 INSURERS AFFORDING COVERAGE NAIC# <br />NSURED INSURERA: State Compensation Insurance <br />INSURER B: <br />Walton Engineering, Inc. INSURER C: <br />P.O. BOX 1025 INSURER D: <br />West Sacramento CA 95691 <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 />LTR <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EF <br />DATE(M <br />POLICY EXPITION <br />DATE MM1DD <br />LIMITS <br />REPRESENTATIVES. <br />GENERAL LIABILITY <br />Dennis Cote' <br />..ee <br />EACH OCCURRENCE $ <br />PREMISES Ea occurence) $ <br />COMMERCIAL GENERAL LIABILITY <br />MED EXP (Any one {Terson) $ <br />CLAIMS MADE F-] OCCUR <br />PERSONAL & ADV INJURY $ <br />GENERAL AGGREGATE $ <br />GENT AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ <br />POLICY.. PECEl LOC <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT $ <br />(Ea Addident) <br />BODILY INJURY $ <br />(Per person) <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />BODILY INJURY $ <br />(Per accident) <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT. $ <br />OTHER THAN EA ACC II <br />ANY -AUTO <br />AUTO ONLY: AGG $ <br />EXCESS/UMBRELLA LIABILITY <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />OCCUR CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />_.._......._....:..... ....... ..$_.. - <br />RETENTION.. $... <br />_. _ .._.. _ _ .._ <br />_......_,_..__._..._.... <br />.... <br />WORKERS COMPENSATION AND <br />%TORY LIMITS ER <br />E.LEACHACCIDENT $ 1, 0 0 0 <br />A <br />EMPLOYERS' LIABILITY000, <br />ANY PROPRIETORIPARTNERIEXECUTNE <br />OFFICERIMEMBER EXCLUDED? <br />000713-4927-2008 <br />10�01�08 <br />1001/09 <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />E.L. DISEASE -POLICY LIMIT $ 1,000,000 <br />H yes, describe under. <br />SPECIAL PROVISIONS below <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />*10 days notice applies if cancelled for non-payment of premium. Evidence of <br />insurance only. <br />cear-r.e r a r IF <br />TOWEOMI <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 v4 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILU RE TO DO SO SHALL <br />To Whom it .May Concern <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTA'n <br />Dennis Cote' <br />..ee <br />ACORD 26 (2001/08) <br />
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