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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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H
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HAMMER
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1630
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2300 - Underground Storage Tank Program
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PR0518624
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
10/18/2024 2:22:06 PM
Creation date
3/4/2024 4:34:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0518624
PE
2371 - UST FACILITY - 1702 COMPLIANT
FACILITY_ID
FA0024496
FACILITY_NAME
Costco Wholesale #38 (Gas Station)
STREET_NUMBER
1630
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
Stockton
Zip
95210
APN
09428011
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
Site Address
1630 E Hammer LN Stockton 95210
Tags
EHD - Public
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RECEIVED <br /> Ac v® CERTIFICATE OF LIABILITY INSURANCAR 2 2024 DATE (MMIDDMlYY) <br /> 12/27/2023 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT k ru THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CO MQ I�L�46�F �IC1ES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I (RN1ff$( W,)fL6HORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) 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 AHOICINNo Ext): (949) 852-0909 FAX <br /> 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 : Everest Premier Insurance Co. 16045 <br /> 8281 Commonwealth Ave. INSURER D : Ohio Casualty Insurance Company 24074 <br /> INSURER E : <br /> Buena Park CA 90621 INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: 23-24 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 AUUL bUbti POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDD/YYYY MMIDDIYYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000,000 <br /> CLAIMS-MADE ❑X OCCUR DAMAGE TRENTED50 ,000 <br /> PREMISES Ea occurrence $ _ <br /> X Contr. Pollution Liab $ 1 M/$2M MED EXP (Any one person) $ 5 , 000 <br /> A X Prof. Liab. Claims Made $ 1 M/$2M EFlCE00006-231 12/31 /2023 12/31 /2024 PERSONAL & ADV INJURY $ 1 , 0001000 <br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2 , 0001000 <br /> POLICYPROJECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2 , 0001000 <br /> X OTHER: XCU Silent $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 110002000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY (Per person) $ <br /> B OWNED SCHEDULED EFlCA00044231 12/31 /2023 12/31 /2024 BODILY INJURY (Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> X Comp $ 1000 Ix Coll $ 1000 $ <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10 , 0003000 <br /> A X EXCESS LIAB CLAIMS-MADE EF1XS00007-231 12/31 /2023 12/31 /2024 AGGREGATE $ 10 , 0003000 <br /> DED RETENTION $ $ <br /> WORKERS COMPENSATION X STATUTE ETH <br /> AND EMPLOYERS' LIABILITY Y / N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT $ 11000 , 000 <br /> C OFFICER/MEMBEREXCLUDED7 NIA CA10003737231 12131 /2023 12/31 /2024 <br /> (Mandatory in NH) E. L. DISEASE - EA EMPLOYEE $ <br /> D 1 , , <br /> 1 ,000 , 000 <br /> yes, describe under 000000 <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ - <br /> Installation Floater <br /> D Rented/Leased Equipment BM02459216368 12/31 /2023 12/31 /2024 Installation LimiUDed . $250021500 <br /> Rented/Leased LimiUDed $ 15002 , 500 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> *Evidence of Coverage* ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> © 1988-2015 ACORD CORPORATION. All rights reserved . <br /> ACORD 25 (2016/03 ) The ACORD name and logo are registered marks of ACORD <br />
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