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fitle 14 alifornia Integrated Waste Managemen d ¢18245 . <br /> stm of CAMMS& c aom.taoegaoed waft <br /> r� <br /> CERTIFICATE OF SELF-INSURANCE AND RISK MANAGEMENT <br /> (If additional space is needed,add attachment.) <br /> Operator Address <br /> San Joaquin County 1810 E. Hazelton Avenue <br /> Stockton, CA 95205 <br /> Risk Manager Address(if different from above) <br /> Richard Pietz Canlis Building, Room 106 <br /> 24 S. Hunter Street <br /> Stockton, CA 95202 <br /> Solid Waste Disposal Facilities Covered: (Enter Information for Each Facility) LIMITS OF LiABUM <br /> Name Address Facility Information Per * Annual Aggrwm* <br /> North County 17900 E. Number <br /> Recycling Center Harney Lane, 39-AA-0022 $1,000,000 $1,000,000 <br /> Sanitary Landfill. Lodi, CA <br /> Corral Hollow 31130 S. 39-AA-005 $1,000,000 $1,000,000 <br /> Sanitary Landfil Corral Hollow <br /> Road, Tracy, CL <br /> TOTAL;2,000,0® TOTAL$2,000,000 <br /> *Excluding legal defense costs <br /> CERTIFICATION: <br /> 1. The operator and risk manager named above hereby testify that the facilities listed above are self-insured for third party <br /> bodily injury and property damage in connection with the operator's obligation to demonstrate financial responsibility under Title 14, <br /> California Code of Regulations,Division 7,Chapter 5,Article 3.3. The coverage applies to the above-listed facility(ites)for accidental <br /> arising from the operations of the fanliry(ies). <br /> 2 The limits of liability are the amounts stated above for"per occurrence"and"annual aggregate,exclusive of kgal defense <br /> cosm. <br /> 3. Indicate whether this coverage is In primary or 13 mess coverage. <br /> 4. Upon request by the Board,the operator agrees to furnish to the Board any documents pertinent to this coverage <br /> S.Termination of this coverage,will be effective only upon written notice,Sett by certified marl,and only after the expiration <br /> of 60 days aha a copy of such written notice is rived by the Board and the local enforcement agency for the jurisdiction in wbich <br /> the facility is located,as evidenced by the return receipts. <br /> crMe in(I IM) wse t d a <br /> Page 785 R, ua:`-A-s^ <br />