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COMPLIANCE INFO_2022
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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PR0231458
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COMPLIANCE INFO_2022
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Last modified
10/17/2023 4:14:49 PM
Creation date
2/2/2022 11:07:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231458
PE
2361
FACILITY_ID
FA0001196
FACILITY_NAME
SAVE ON FUEL
STREET_NUMBER
420
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
219-312-06
CURRENT_STATUS
01
SITE_LOCATION
420 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 00 00 C <br /> ( Ed . 1 A 5) <br /> WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> In return for the payment of the premium and subject to PART ONE <br /> all terms of this policy, we agree with you as follows : WORKERS COMPENSATION INSURANCE <br /> A. How This Insurance Applies <br /> GENERAL SECTION This workers compensation insurance applies to <br /> bodily injury by accident or bodily injury by disease . <br /> A . The Policy Bodily injury includes resulting death . <br /> This policy includes at its effective date the Infor- 1 . Bodily injury by accident must occur during the <br /> mation Page and all endorsements and schedules policy period . <br /> listed there . It is a contract of insurance between 2 . Bodily injury by disease must be caused or ag- <br /> you (the employer named in Item 1 of the Infor- gravated by the conditions of your employment . <br /> mation Page) and us (the insurer named on the In - The employee' s last day of last exposure to the <br /> formation Page) . The only agreements relating to conditions causing or aggravating such bodily in - <br /> this insurance are stated in this policy . The terms of jury by disease must occur during the policy <br /> this policy may not be changed or waived except period . <br /> by endorsement issued by us to be part of this <br /> policy . <br /> B . We Will Pay <br /> B . Who is Insured We will pay promptly when due the benefits required <br /> You are insured if you are an employer named in of you by the workers compensation law. <br /> Item 1 of the Information Page . If that employer is a C . We Will Defend <br /> partnership , and if you are one of its partners , you <br /> are insured , but only in your capacity as an em - We have the right and duty to defend at our expense <br /> ployer of the partnership ' s employees . any claim , proceeding or suit against you for benefits <br /> payable by this insurance . We have the right to in - <br /> vestigate and settle these claims , proceedings or <br /> C . Workers Compensation Law suits . <br /> Workers Compensation Law means the workers or We have no duty to defend a claim , proceeding or <br /> workmen ' s compensation law and occupational suit that is not covered by this insurance , <br /> disease law of each state or territory named in Item <br /> 3 .A. of the Information Page . It includes any D . We Will Also Pay <br /> amendments to that law which are in effect during <br /> the policy period . It does not include any federal We will also pay these costs , in addition to other <br /> workers or workmen 's compensation law, any fed - amounts payable under this insurance , as part of <br /> eral occupational disease law or the provisions of any claim , proceeding or suit we defend : <br /> any law that provide nonoccupational disability 1 . reasonable expenses incurred at our request , <br /> benefits , but not loss of earnings ; <br /> 2 , premiums for bonds to release attachments and <br /> D . State for appeal bonds in bond amounts up to the <br /> State means any state of the United States of amount payable under this insurance ; <br /> America , and the District of Columbia . 3v litigation costs taxed against you ; <br /> 40 interest on a judgment as required by law until <br /> E . Locations we offer the amount due under this insurance ; <br /> This policy covers all of your workplaces listed in and <br /> Items 1 or 4 of the Information Page ; and it covers 5 . expenses we incur. <br /> all other workplaces in Item 3 .A . states unless you <br /> have other insurance or are self- insured for such E . Other Insurance <br /> workplaces . <br /> We will not pay more than our share of benefits and <br /> costs covered by this insurance and other <br /> 1 of 6 <br /> © Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved . <br />
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