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COMPLIANCE INFO_2024
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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4344
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2300 - Underground Storage Tank Program
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PR0231766
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
1/3/2025 1:15:53 PM
Creation date
1/24/2024 1:20:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0231766
PE
2361 - UST FACILITY
FACILITY_ID
FA0003717
FACILITY_NAME
CHEVRON STATION #99840*
STREET_NUMBER
4344
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
Stockton
Zip
95215
APN
10102156
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
Site Address
4344 E Waterloo RD Stockton 95215
Tags
EHD - Public
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7 ® DATE(MMIDD[YYYY) <br /> A�Ro CERTIFICATE OF LIABILITY INSURANCE <br /> 12/28/2022 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Catherine Montoya <br /> NAME: <br /> Milestone Risk Management&Insurance Services AHONNo Et): (949)852-0909 FAX No): (949)852-1131 <br /> License No.OB72766 E-MAIL cmontoya@milestonepromise.com <br /> ADDRESS: <br /> 8 Corporate Park,Suite 130 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Irvine CA 92606 INSURERA: Everest Indemnity Insurance 10851 <br /> INSURED INSURER B: Everest National Ins.Co. 10120 <br /> Wayne Perry,Inc. INSURER C: <br /> 8281 Commonwealth Ave. INSURER D: <br /> INSURER E: <br /> Buena Park CA 90621 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 22-23 City Master REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGET RENTED 300,000 <br /> CLAIMS-MADE J OCCUR PREMISES Ea occurrence $ _ <br /> X Contr.Pollution Liab.$1 M/$2M MED EXP(Any one person) $ 25,000 <br /> A EFlML00079221 12/31/2022 12/31/2023 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN.L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY Fx_1 PROCT FILOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> JE <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident _ <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED EFlCA00044221 12/31/2022 12/31/2023 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 10,000,000 <br /> A X EXCESS LIAB CLAIMS-MADE EFlC000052221 12/31/2022 12/31/2023 AGGREGATE $ 10,000,000 <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION X1 <br /> PER STATUTE ER _ <br /> AND EMPLOYERS'LIABILITY Y/N 1,000,000 <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE NIA CA10003737221 12/31/2022 12/31/2023 E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? 1,000,000 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD <br />
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