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State of Califomia California Integrated Waste Management Board <br /> CERTIFICATE OF SELF-INSURANCE AND RISK MANAGEMENT <br /> r <br /> Operator Operator.Address <br /> Solid Waste Division <br /> San Joaquin County 1810 E.Hazelton Ave.,Stockton,CA 95205 <br /> Risk Manager Risk Manager Address <br /> Canlis Building,Room 106 <br /> Richard Pietz 24 S.Hunter St,Stockton,CA 95202 6 <br /> P <br /> Solid Waste Disposal Facilities Covered:. LIMITS.OF LIABILITY <br /> Facility Per Annual <br /> Name Address Information <br /> Number Occurrence .. Aggregate*. <br /> North County 17720 E. Harney Lane <br /> Recycling Center Lodi, CA 39-AA-0022 $ 1,000,000 $ 1,000,000 <br /> 8t Sanitary.Landfill <br /> Corral Hollow 31130 S.Corral Hollow Rd. <br /> Sanitary Landfill. Trac , CA 39-AA-005. $ 1,000,000. $ 1,000,000 <br /> Foothill Sanitary 6484 N.Waverly Rd. <br /> Landfill 39-AA-0004 $ 1,000,000. $ 1,000,000 <br /> Linden, CA <br /> Harney Lane 14750 E.Harney Lane <br /> Sanitary Landfill Lodi, CA 39-AA-0003 $ 1,000,000 $ 1,000,000 <br /> TOTAL: TOTAL: <br /> $4,000,000 $4,000,000 . <br /> 'Excluding legal defense costs <br /> CERTIFICATION: <br /> 1. The operator and risk manager named above hereby certify that the facilities listed above are$elf-insured for <br /> third party bodily injury and property damage in connection with the operator's obligation to demonstrate <br /> financial responsibility under Title 14,California Code of Regulations,Division 7,Chapter 5,Article 3. The <br /> coverage applies to the above-listed facilities for accidental occurrences arising from the operations of the <br /> facilities. <br /> 2. The Iimits of liability are the amounts stated above for"per occurrence"and"annual aggregate",exclusive of <br /> legal defense costs. <br /> 3. Coverage is primary <br /> 4. Upon request by the Board,the operator agrees to furnish to the Board any documents pertinent to this <br /> coverage. <br /> 5. Termination of this coverage will be effective only upon written notice,sent by certified mail,and only after the <br /> expiration of 60 days after a copy of such written notice is received by the Board and the.local enforcement <br /> agency for the jurisdiction in which the facility is located,as evidenced by the return receipts. <br /> FromCIWMB 133(11/91) PAGE 1.OE2 <br />