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COMPLIANCE INFO_2016-2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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EL DORADO
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2300 - Underground Storage Tank Program
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PR0231094
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COMPLIANCE INFO_2016-2018
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Last modified
11/18/2020 4:35:26 PM
Creation date
6/23/2020 6:42:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2018
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
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231094_7906 N EL DORADO_2016-2018.tif
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EHD - Public
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MVPPE-1 CIP ID:DIS <br /> CERTIFICATE OF LIABILITY INSURANCE OATS(M <br /> n-1512015 <br /> IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AU RIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is anDITIONAL INSURED,the Policy(les)must be endorsed. If SUBROGATION IS WAIVED,sub' to <br /> the terms and conditions of the policy, in lic!es may require an endorserneft A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsemenIs)- <br /> PRODUCER <br /> s.PROD c E: id Hagen <br /> Inte est Insurance Services � <br /> P.O.Box cense#01301094 0 E @.Fxr):530 5-1 1 <br /> Chico,CA 95927-8110 D Ess:dha en i ComSelect Busin Unit URER�s�EA <br /> soe RA AdMiral Insurance <br /> INSURED MVP Petroleum Engineering,Inc �— --- <br /> PO ox 281 INSURER B <br /> Folsom,CA 95763-0281 MEURER C: <br /> INSURER E• —....—.....__ _.�..._ <br /> COVERAGES CERTIFICATE BER: REVISIO NU B <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED MED A6oWF6fTW9 POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> tNSRj <br /> LTR f TYPE OF INSU LSUM& POLICY NUM ` M RA Y-EXP nm ITS <br /> A X Comm-RCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE I '�J OCCUR FEIECC1732302 09tQ1l2Q15 Q9/Q1f2Q18t <br /> PREMISESE;raccurrence,)_ $ <br /> - j- _'!NEO EXP An person) 5, <br /> — <br /> ' PERS &,ADVINJURY $ 1,0 <br /> GEN'L AGGREGATE LIMIT APPtfES PER: GENERAL AGGREGATE^ $ 2,0W, <br /> X POLICY 1 Pte' r LOC <br /> L___!JECT <br /> L J PRODUCTS-COMPIOP AGO S 2, <br /> OTHER_ � �-- <br /> $ <br /> _F AUTO BOLE ITY C INEDSINGLE LIMIT #$ <br /> Ea accad . .—... <br /> ANY AUTO <br /> BODILY INJURY(Per Person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS 1 BODILY INJURYNO WNED <br /> (Per acaderd) y <br /> HIRED AUTOSAUTOR <br /> PoTY DAMAGE <br /> er <br /> _._.._..,UMBRELLA LL48 OCCUR <br /> I EACH OCCURRENCE $ <br /> -EXCESS LIAB .. <br /> C E AGGREGATE 'S <br /> QED RETENTIONS - —... <br /> (WORKERS NSA $ <br /> AND EMPLOYERS'LIABILITY ; <br /> PER TH- <br /> ANYPROPRIEfORPPARTNER/EXECUTIVE YIN <br /> STATU:7E7ER <br /> OFFICERtMEMBER EXCLUDED? ❑IN/A, E�ACCIDENT Is <br /> i(Mandato*y In NH)}If yes, ' under i EL DISEASE TEA EMPLOYE It <br /> DESCRIPTION OF OPERATIONSE.L.DISEASE-POLICY LfAfltf $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 1®1,A R rks SchedWe,Mybeifis <br /> Confa tion of Coverage. <br /> CERTIFICATE HOLDER CANCELLATION <br /> 0281 <br /> SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATHEREOF, NOTICE LL BE DELIVERED IN <br /> MVP Petroleum Engineering,Inc ACCORD CE VWTH THE POLICY PROVISIONS. <br /> PO Box 281 <br /> Folsom,CA 95763 AUTHORIZED REPRESENTATIVE <br /> 01908-2014 ACORD CORPORATION. AN rights se <br /> ACORD 25(2014/01) The ACORD name and logo are registeredmarks of ACORD <br />
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