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fide 14 California Integrated Waste Managemend LAW CERTIFICATE OF SELF-INSURANCE AND RISK MANAGEMENT (if additional space is needed,add attachment.) Operator Address San Joaquin County 1810 E. Hazelton Avenue Stockton, CA 95205 Risk Manager Address(if different from above) Richard Pietz Canlis Building, Roots 106 24 S. Hunter Street Stockton, CA 95202 Solid Waste Disposal Facilities Covered: (Enter Information for Each Facility) LIMITS OF I7ABUM Name Address Facility Information Per * Annual Aggregatel North County 17900 E. Number Recycling Center Harney Lane, 39-AA-0022 $1,000,000 $1,000,000 & Sanitary Landfill. Lodi, CA Corral Hollow 31130 S. 39-AA-005 $1,000,000 $1,000,000 Sanitary Landfil Corral Hollow Road, Trac , TOTAL$2,000,00 TOTAL#2,000,000 *Excluding legal defense costs CERTOCA71ON: 1. The operator and risk manager named above hereby certify that the facilities listed above are self-insured for third party bodily injury and property damage in connection with the operator's obligation to demonstrate financial responsibility under Titk 14, California Code of Regulations,Division 7,Chapter S,Article 3.3. The coverage applies to the above-listed facility(ies)for accidental oocurrmicies arising from the operations of the facility(ies). 2 The limmits of liability are the amounts stated above for"per occurrence"and"annual aggregate,exclusive of legal 3. Indicate whether this coverage is KI primary or ❑excess coverage. 4. Upon request by the Board,the operator agrees to furnish to.the Board any documents pertinent m this ownr- S. Termination of this coverage,will be effective only upon written notice,sent by certified mail,and only after the of 60 days after a copy of such written notice is arrived by the Board and the local enforcement agency for the jurisdiction in which the facility is located,as evidenced by the serum receipts. awbm 333(1M) Pop r dT Page 785 r NO&0,47-.4-24-91.