Document K33mKVZGyGJQnv3594e3w8Q
FILE NAME: Plant Insulation Company (PIC) DATE: 1963 Aug 8 DOC#: PIC005 DOCUMENT DESCRIPTION: Worker's Compensation Claim
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A P P LIC A TIO N
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( P i a PR1KI OR TYPE NAMES AND ADORESSIS)
C A S E N O . , ; - 3 <T-s?< / A
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ROBERT 0 . GOANS____
l\?A2 - 25t h S t r e e t San F ra n cisco , C a l i f o r n i a
LORENTZEM & COMPANY (and o t h e r s )
Social S>r No. -----*....
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1 1 5 5 - S t h S t r e e t ___________________ lvval* 9
Oakland, California
ARGONAUT IN SU RANCE COMPANY
550 C a li f o r n i a S t r e e t
San F r a n c is c o , C a lifo r n ia
R ob ert o . Goans Ml
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SMITH, PARRISH, PADUCK & CLANCY
C e n t e r B u i l d i n g ____ *?*%% # 9999999V
O ak In iwl 12, C a l i f o r n i a O J^ncourt 2-2000
001
EXHIBIT 9>2-
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EMPLOYERS
I . Western Ashesi os P.O. Box 3?8U Hincn Annex San Franci seo , CaX1forala
2 * Hundet Cork Company U\o Talberl Street San Francisco, California
PERIODS 1 9 2 6 -19b 3, 19*16-1950, 19551963 and o th e rs
1937, 1939, 19**0, 19b 1 , 1962 and others
3* P la n t Rubber & A s b e s to s Works 1300 - 6bth Street O ak lan d , C a li f o rn i a
J 9b 1~19b b a nd o th e i s
M, Plant Asbestos Company 1300 - 6b th Street Emeryville 6, California
1957, 1959, i 960 and o th e r s
5 . Army Port Contractos 1501 Maritime Street
Oakland, California
19b1 and 19b2 and o th e rs
6 * Van Arada l e H a r r ia Luraber C o . 5 th and Brannan Streets San Franclseo, Ca1i f o m 1a
19^2 and o th e rs
7 * Bay C i t i e s Asbestos Co., Ltd. 6fch and E a s t 12th S t r e e t Oak 1and. Calilornla
19Mb-19^6 and o th e r s
8 . Harry A. Dutton, Jr#, D utton A sb e sto s Company
19b 1 , 195b a nd o r,he rs
i
532 tatorna B t reel
Son F ra n cisco , C a lifo r n ia
9 . C . F. Braun & Company OOO So u th Fremont Avenue A 1harnbra , California
1938 and ethers
lO* Asbestos Company of California
9 b1 - l6th Street San Franc iseo 7 > Ca 11 fcrn ia
I9 bb and 39b5 and others
I I , John Mansville Sales Curp. P . O . Box 37&'< Rincon Annex San Francisco, C a 3iforn a
19**9 and 195P and o th e r s
1 2 . M arine E n g in e e r in g As Su p p ly C o . 9b 1 E a s t 2t:h S t r e e t Los A n g e le s , C a 11fo rn i a
193ft# 195C
1 3 Armstrong Cork 30b Sha w Road So,, San FrcncJuco, C a 1iCorn n
1950, 195b , 1955, J957, a nd others
}b , M, ft. Carpenter 907 Front 3 1 reo t Sacram nt o , C a I ! f o m 1a
1 5 * taw insulations 3600 - 20Us Avenue Sacram ento 17* C a l i f o r n i a
1 6 . F ib e r g la s s E n g ln o e rl ug < rXtpply 1200 - l / i t Street San F r a n c i a c o , C a 1i fo n i 1a
17 Owe:3 Coming. Fiberglass C<u*p. 1200 - H * h d f r r c t San Francisco, Call fot*n11.
J95<l- J 9 53, 1959, 1982 and O th cr:.195 0* 19^1 and 1962 and o t h e r s
195S, J95b ami others
IT / y V T j i . VJf i , VX-P and o< tlcr.i
002
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EMPLOYERS
18. Charles Ayrea Company 698 Minnesota Street San Francisco, California
I S , Coast Insulation Products 316 San Fernando Hoad Loa Angeles 63, California
2 0 , Thomas C . D o u g la s, J r . D ouglas I n s u l a t i n g Company 2233 i n c a l l s San Francisco, California
PERIODS 1955, 1957-1959 and o th e r s
1956 and o t h e r s
1956 and others
2 1 . J.T. Thorpe & Sons 1353 Ocean Avenue Emeryvllie, Californ1a
2 2 , Armstrong Contracting & Supply c /a Armstrong Cork 30* Shaw Road So. San Francisco, California
2 3 . National Insolation Inc. 503 Polk Strict San Francisco, California
1.959, 1960, 1957 a n d o t h e r s
1958 and o th e rs 1962 and e th e rs
2*1. Lo r e n tz c?n C ampa n y 1193 - 5th s t r e e t Oakland, Ca11forn1a
25. Jac.tson Hopliru* Company, p.o. Box ngt R a k 2r s f i e I d / C a l i f o r n i a
26. Kelly Asbestos l'nc.
2030 Grand Avenue Kansas City 8 , Mo.
In c.
27. Asbestoa Products Inc. 710 Raymond Avenue St* Paul U , Minnesota
1955, 1962 and oth ers 1957 a nd o t he ra 19*19 a nd o t ixr s 19*19 and o th e r s
INSUR&HC5 COMPANIES
State Compensation Insurance F u n d , 5^5 Golden Gate A v e n u e San Francisco, California
Industrial Indemnity, 300 Grand Avenue, Oakland, California
Aetna Casualty Insurance Company, 1-330 Broadway, Oakland, California
Trave!era Insurance Company, 1956 Webster Street, Oakland, California
American Motorista, Busa building, San Francisco, California
Argcnaut Insurance Company, 550 California Street, San FraneIseo, CaIIforn1a
Standard Accldcnt ^33 California Street, San Francisco, Calli.
American Employcr::, Buso Building, San Francisco, California
Hanna Y Brophy, 15**0 San rahiu, Oakland, Cali forni a
003
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(PROOF OF SERVICE BY MAIL-1013* , 2015-5 C . C . P . )
STATE OF CALIFORNIA) COUNTY OF ALAMEDA F
1 am a r e s i d e n t o f
aforesaid county; not a party to the 1a :
315 F in a n c ia l
the U n ited S t a t e s and a r e s id e n t o f the I am o v e r th e a g e o f e i g h t e e n y e a r s and w i t h i n ab ove a c t i o n ; my b u s in e s s a d d r e s s
Center B u ild in g , Oakland 12, C a lif o r n ia
On _________ M G j i _____ I__________, 1963, I served the w ith in AHEHDED
APPLICATION on the v a r i o u s p a r t i e s i n s a i d a c t i o n , by p l a c i n g
a true copy thereof enclosed In a sealed envelope w ith postage thereon fu lly prepaid, in the United States post o f f i c e n a il
box a t O a k la n d , C a li f o r n i a , addressed as fo llo w s;
W estern A s b e s t o s , P .O . Box 378*1, R in c o n Annex, S * F * C a l i f , Mundet Cork Company, U}0 T a lb e r t S t r e e t , 5 . F . , C a l i f ,
P l a n t R u b b e r & A s b e s t o s Works, 1300 - 6U l h S t , , O a k l a n d , C a l i f *
P l a n t A s b e s t o s Company, 1300 - 6U th S t r e e t , E m e r y v i l l e 8 , C a l i f .
Arm*' P o r t C e n t r a c t o r s , 1^01 M a r itim e S t r e e t , O a k la n d , C a l i f .
Van Ax*&dale k a r r i s Lumber, 5t h and Brannan S t s * , S . P . , C a l i f .
B a y .C i t i e s A sb e sto s, 6th and East 12th S t . , Oakland, C a l i f .
Har :y A D u t t o n , 532 Natoma S t . , S . F . , C a l i f .
C.
Braun fc C o . , 1000 S o . Fremont A v e . , Alham bra, C a l i f .
Asbestos Co. of C a l i f ., 9*1 " l 6th S tr e e t, S .F ., C a l i f .
Jo h n Mans v i H e S a l e s , P .O . Box 370* 9 Rincon Annex, S . P . , Marine E n g in e e r in g , 9*1 E a st 12th S t r e e t , L . A . , C ^ i f . A rm stro n g C o r k , 3C* Shaw Road, S o . S . F . , C a l i f . M .R . C a r p e n t e r , 907 Front S t r e e t , S a c t o . , C a l i f . Caw I n s u l a t i o n s , 36OO - 20 th S t . , S a c t o . , C a l i f .
C a lif.
F i b e r g l a s s E n g i n e e r i n g , 1200 - 17t h S t . , S . F . , C a l i f Owens C o r n i n g F i b e r g l a s s , 1200 - 17t h S t . , S . F . , C a l i f . -C h a rle 3 Ayes C o . , 698 M in n e s o ta S t . , S . F . , C a 1i f . Coast I n s u l a t i o n , 2316 San Fernando R d ., L .A . , C a l l f . :
Thomas C . D o u g la s , J r . , 2233 I n g a l l s , S . F . , C a l i f . J . T . T h o r p e , 1351 Ocean Avenue, E m e r y v i l l e , C a l i f . Arm strong C o n t r a c t i n g , 30** S h a w R oad, S o . S - F . , . C a l i f .
N a tio n a l I n s u la t io n I n c . , 503 Polk S t . , S . F . , C a ' l l f . Lor&ntz-en C o . , 1155 - 5t h S t r e e t , O a k la n d , C a l i r ,
Jackson Hopkins C o ., P .O . Box * 90, B a k e r s fie ld , C a l i f .
K e lly Asbestos X n e ., 2030 Grand Avenue, Kansas C i t y * 0 , Mo. A sb e sto s P r o d u c t s , 710 Raymond A v e ., S t . Paul * , M in n .
S t a t e Compensation Insurance Fund, 525 Golden*Gate, S . F . , C a l i f . I n d u s t r i a l I n d e m n it y , 300 Grand A v e . , O a k la n d , C a l i f .
Aetna C a s u a l t y In s u r a n c e Company, 1330 Broadway, O a k la n d , C a l i f . T r a v e le r s In su ra n ce Company, 1956 Webster S t . , O a k la n d , C a l l r . American M o to r is ts , Russ B u ild in g , S . F . , C a l i f . Argonaut In su ra n ce Company, 550 C a l i f o r n i a S t . , S J F . C a l i f .
Standard A ccid e n t, *33 C a lifo r n ia S t . , 3. F . , C a l i f . Ante r 1c a Emp l o y e r s , Ru 33 Bu i Id I n g , S *F . , C a l i f .
Hanna & Brophy, 15*0 San P a b lo , O akland, C a l i f .
I c e r t ify , under penalty of p e rju ry ,* that the foregoing is true
and c o r r e c t .
AUG 9 E x e c u te d o n _____________________________ , 1903# a t O a k la n d , C a l i f o r n i a
/ a / S h aro n McKay
The p r o o f o f s e r v i c e by ir-all form , b e in g sign e d u n d er p e n a l t y o f per' j u r y , d 005 not re*qu i r e n a t a r i an 1.1 on *
004