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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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SJGOV\kblackwell
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EHD - Public
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WC 00 00 00 C WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> ( Ed . 1 - 15) <br /> F . Other Insurance 2 . The amount you owe has been determined with <br /> We will not pay more than our share of damages our consent or by actual trial and final judgment , <br /> and costs covered by this insurance and other in - This insurance does not give anyone the right to add <br /> surance or self-insurance . Subject to any limits of li- us as a defendant in an action against you to deter- <br /> ability that apply, all shares will be equal until the mine your liability. The bankruptcy or insolvency of <br /> loss is paid . If any insurance or self- insurance is ex- you or your estate will not relieve us of our obliga- <br /> hausted , the shares of all remaining insurance and tions under this Part . <br /> self- insurance will be equal until the loss is paid . <br /> PART THREE <br /> G . Limits of Liability OTHER STATES INSURANCE <br /> Our liability to pay for damages is limited . Our limits <br /> of liability are shown in Item 3 . 13 . of the Information A. How This Insurance Applies <br /> Page . They apply as explained below. 1 . This other states insurance applies only if one or <br /> 1 . Bodily Injury by Accident . The limit shown for more states are shown in Item 3 . C . of the Infor- <br /> " bodily injury by accident—each accident" is the mation Page . <br /> most we will pay for all damages covered by this 2 . If you begin work in any one of those states after <br /> insurance because of bodily injury to one or the effective date of this policy and are not in . <br /> more employees in any one accident. sured or are not self- insured for such work , all <br /> A disease is not bodily injury by accident unless provisions of the policy will apply as though that <br /> it results directly from bodily injury by accident, state were listed in Item 3 .A , of the Information <br /> 2 . Bodily Injury by Disease . The limit shown for Page . <br /> " bodily injury by disease—policy limit" is the 3 . We will reimburse you for the benefits required <br /> most we will pay for all damages covered by this by the workers compensation law of that state if <br /> insurance and arising out of bodily injury by dis. we are not permitted to pay the benefits directly <br /> ease , regardless of the number of employees to persons entitled to them . <br /> who sustain bodily injury by disease . The limit 4 . If you have work on the effective date of this pol- <br /> shown for " bodily injury by disease—each em - icy in any state not listed in Item 3 .A. of the In- <br /> ployee" is the most we will pay for all damages formation Page , coverage will not be afforded for <br /> because of bodily injury by disease to any one that state unless we are notified within thirty <br /> employee . days . <br /> Bodily injury by disease does not include dis- <br /> ease that results directly from a bodily injury by B . Notice <br /> accident . Tell us at once if you begin work in any state listed in <br /> 3 . We will not pay any claims for damages after we Item 3 . C . of the Information Page , <br /> have paid the applicable limit of our liability un - <br /> der this insurance . PART FOUR <br /> YOUR DUTIES IF INJURY OCCURS <br /> H . Recovery From Others <br /> We have your rights to recover our payment from Tell us at once if injury occurs that may be covered <br /> anyone liable for an injury covered by this insurance . by this policy . Your other duties are listed here . <br /> You will do everything necessary to protect those 1 . Provide for immediate medical and other ser- <br /> rights for us and to help us enforce them . vices required by the workers compensation law. <br /> 2 . Give us or our agent the names and addresses <br /> I . Actions Against Us of the injured persons and of witnesses , and <br /> There will be no right of action against us under this other information we may need . <br /> insurance unless : 3 . Promptly give us all notices , demands and legal <br /> 1 . You have complied with all the terms of this poli- <br /> cy; and <br /> j 4of6 <br /> 0 Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved . <br /> i <br />
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