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COMPLIANCE INFO_2008-2009
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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PR0231094
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COMPLIANCE INFO_2008-2009
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Last modified
5/10/2023 1:39:29 PM
Creation date
6/23/2020 6:42:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2008-2009
RECORD_ID
PR0231094
PE
2361
FACILITY_ID
FA0003632
FACILITY_NAME
AJS MINI MART INC
STREET_NUMBER
7906
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95207
APN
07935016
CURRENT_STATUS
01
SITE_LOCATION
7906 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231094_7906 N EL DORADO_2008-2009.tif
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EHD - Public
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CERTHOLDER COPY <br />NO <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 04-01-2009 GROUP: 000238 <br />POLICY NUMBER: 0003058-2009 <br />CERTIFICATE ID: 299 <br />CERTIFICATE EXPIRES: 04-01-2010 <br />04-01-2009/04-01-2010 <br />EVIDENCE OF COVERAGE NO <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 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 <br />by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />THORIZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - JEFF RYAN PRIES, SEC TREAS - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2009 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />GETTLER-RYAN, INC AND/OR GEOSTRATEGIES, INC <br />AND/OR GR PETROLEUM SERVICES, INC AND/OR MPDS <br />SERVICES, INC ET AL <br />6747 SIERRA CT STE J <br />DUBLIN CA 94568 <br />[B11, NA) <br />IREv.2-05) PRINTED : 04-15-2009 <br />
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