Document RaYwRxBOnR7o3d640NVBoV0w8

FILE NAME Fluor FLU DATE 1984 DOC FLU008 DOCUMENT DESCRIPTION Refiling of Worker's Comp Claim to the Appeals Board - on behalf of L.J. Striethorst WORKERS COMPENSATION APPEALS BOARD 2 STATE OF CALIFORNIA 3 JACQUELINE CLANCY as party applicant in her individual capacity 4 and as personal representative and next of kin of Leo J.Streithorst 5 deceased Applicant 6 VS. 7 WESTERN ASBESTOS COMPANY et al and STATE COMPENSATION INSURANC^ FUND et al CASE No. 60 SF 192-145 CERTIFICATION Defendant 10 11 I hereby certify that the attached documents are true 12 and correct copies of the original documents filed in the records 13 of this office in the entitled matter 14 ATTEST my hand and the Seal of the Workers Compensation 16 Appeals Board of the State of California 16 17 18 19 20 Workers Compensation Judge Workers Compensation Appeals Board 21 22 23 24 Dated at San Francisco 25 California this 16th day 26 of April 1984 27 DIA WGAB FORM 115 NEW -TI MONT MONT & DEFARTMENT OF INDUSTRIAL MELATION DIVISION OF INDUSTRIAL ACCIDENTA KirKwirawann REMIT TO san francisco ^a94101 415 664-3062 LEGAL DOCUMENT DUPLICATING SERVICE PERTAINING TO J. STREITHORST WORKER'S COMPENSATION APPEALS BOARD SAN FRANCISCO ' 637 LINCOLN AVE RICHICHD CALIF ASBESTOSASBESTOS EXPLOYERS - 1944 to 1959 1959 WESTERN ASBESTOS CO PLANTPLANT ASDESTOS CO 1958 WESTERNWESTERN ASESICSASESICS CC . FLOUR HAINENACTON CC C. F. BRAUN & CO ARMSTRONG : c SIXTY-TOWNSED ST 1300 FOURTH EEMRYVILE MERYVILLE & vy on 675 TOWNSEND STS.P. 3 406 WARD ST MARTINEZMARTINEZ P.O.BOX 22 22 L.A. ALHALIA ALHALIA 1000 SO FRENCHT AVE 304 SHAW HD SC S.F. CAL 1957 SAN JOSE ASB.STCS CO WESTERN ASBESTOS CO ARMSTRONG COS CC FLOUR MAINTENNION CO PLANT ACEESICS ACEESICS CC CHAS AYERS CO ' SAN JOSE CALIF 675 TOWNSEND ST S.P. 406 NAND 52. Y_ FUE MARTINEZ MECHVILLEMECHVILE FIBERGLAS rest 19519656 FIOS FIOS M .. 5.7717 04 J. 7. 10.F. 30 LONIZI LONIZI ICC ICC FROM MAI a 1200 - 17th St. S.F. ww as a i - : | 1351 CC A + oe Ln By ene. ren S1 a D DRR .. .. 1767 tae 1767 1767 1767 1767 + dh la re , CHIEN CHIEN CHIENCHIEN 0 NED MA TIZ J. 2 ia TL 1 B 101 02 4- ; E E ( show ) ve ee ee . -- ta wee OARS LEA al aaOe os Rgoy Ne *. ae ae SAE RPaiPo woe RP Ook atte vty . soa Nae mai a Fai woh teh aor Three, s ay ' ae PAGE 2 |- STREITHORST ASDESTOS EMFLCY ct a Ts - ~ Bey : - 3, at oye, A eei 3. eer) ee fps mde wary fee a, eofe Bie Wen TIEN on ae . ope Bol - Y, ry to 1959 incl ee 1953 WESTERN ASBESTOSCo. . we J. THORPE & SO 675 TOWNSEND C. 5.F. 3 1351 OCEANT AVE SHAYVILLE SHAYVILLE 1421 LANDE ST NEC 1952 WESTERN ASHESTOS CO 4 MUNDEN CORK CORP WESTERNCLAD 1951 AYET~ CHAD MTDER MTDER S co COMP COIK INSULATIONINSULATION CC 1950 ARMSTRONG CORK CO J. T. THORPE & SON } 1949 WESTERN ASBESTOS CO J. T. THORPE CO WHO DART 52. .. 198 198 MIRCEA MIRCEAMIRCEA MIRCEA MIRCEA MIRCEA ST , 5.5 BES F. BES BES 140 LOW ENGES ENGES BES y, , F. F. ENGES TCHAD 675 TCHAD TCHAD S. S. 304 SILAN SILAN SILAN ROAD 20. J.F 675 TOSHID TOSHID TOSHID SSQ Q , S.F. 1351 OCLAH AVE , MARYVILLE MARYVILLE MARYVILLE 1940 AEXHA STEEL PRODUCTS CCIF WESTER ASBESTOS CC 61 BROADWAY W YORK 675 TON'SADA TON'SADA TON'SADA .. 3.21 yo 19 All ; ASIA STEEL P.UDICAD CORP te of 1947 1 BROADWAY - 1 ITI. M 1946 ADHA STEEL PRODUCTS ... IIHDET CON CO 40 ERASM ay ERASM ERASM on ERASM = Weale = - tas wea tt 1949 1944 VARSDALE VAARSDALE VenFIF , VAN ARSDARD AG 1a . FIFe DAY CITIES ASBESTOAD SBESTOD Co. I Asbestos Western Taken over : Takenovera by Western Asbestos . Don Co. AVE _ &HAIS - Don Don 599. FIF FIFe y de FIVEFIVE AYL 80 17th " nae fot Arsdale. ' Ven Arsdale Ven HarrisHarris ia Tar 591Arsdale .. CLAD CLAD . ooo Co. Ate FIF * oe ae A. 17th 17th S CAKAND : . : . e ae . { _* 2 . @ * - Revised 7-17-62 - gh Streithorst P 192-14 om . 4 OFFICIAL ADDRESS RECORD LIEN CLAIMANT Department of Employment APPLICANT 269.121IKE 269.121IKE 269.121IKE ClaDEX ClaDEX P. O. Box 1857 Oakland 3310 SS ect ect S S - LoLmoamaench ench a. T SEJAYRS2ND Ny kh ae . I iy hg WI ATTORNEYS FOR APPLICANT Smith Parrish Paduck & Clancy 501 Financial Center Bldg Oakland 12 , WV Vv" LJ Western Go EMPLOYERS Western Western Asbestos hocepee ee 675oy ge: a * 675 TownsendSt. S.F. 3 Plant Asbestos Co. 152 Fluor Maintenance Co. 5-9-68wheel wit 5-9-68 1300 64th Emeryville 4 406 Ward St. Martinez Avi v vi fv Fluor Maintenance Co. 3 P. O. Box 22 Los Angeles V Y; C. P. Braun & Co. u Armstrong Armstrong Cork Co. OAswbeenstLoesinCioo. dba San Jose e San Jose Asbestos Co. 1000 S. Fremont Ave Alhambra 304 Shaw So. S.F. 1140 Lennon Way San Jose 1140 Lennon - Way San Jose J fit vt iV4A|eH4r J JAY et [J u A Coas Ayers Ayers Co. sO 693 Minnesota St. S.P. S.P. v Fiberglas . Fiberglas Eng & Supply Div Fiberglas J. Thorpe Co. 1200 - 17th St. S.F. 1351 Ocean Ave. Emeryville Mundet Mundet vi er, Cork Corp. 440 Brannan St. S.P. 7 Metal De ra Aetna Broadway Saern _ Clad Insulation Co. 21759 Western Torrance Products Corp. ee 61 Steel Produ-cCotrps. 61 TFS, FF - t New York N.Y. v v4 YA J JS Jw 4 V yw I Yi y het 5 [4 J Van Arsdale & Harris Co. 595 Tunnel Ave. S.P. 24 Bay Cities Asbestos Co. 5-1-60 Fifth Ave & 12th St Oakland |- r, Atlas Heating & Ventilating 357 - 4th St. S.F. 7 iy vj vi 4 Fa M. W. Kellogg Co. Foot of Danforth Ave. ALY? F Revised 7-17-62 - gh Streithorst SF 192-145 OFFICIAL ADDRESS RECORD INSURANCE CARRIERS 65 State Comp Ins Fund ,Industrial Industrial Indemnity Indemnity - 525 Golden Gate Ave. S.F. ( ContinentCoa. l California SERVICE AND DA Ss A Hardware Mutual 5 me ee Co. A Ci Aetna Cas & Sur Co. Pacific Hartford Hartford AEcmesploAyc ere ,ss _*InsEmployers_Ins Co. Industrial Ind Exch St. Ag M. 220 Montgomery St. S.F. 6 244 Pine S.F. 4 eo M. Saw! 350 350 Sansome St. S.P. 6 PL] Sn & te 4 ATTORNEYS FOR INSURANCE CARRIERS CECO CECO @ Hanna & Brophy Sedgwick oes - Sedgwick Detert & Arnold By T.P.Niedermuller 1540 San Pablo Ave Oakland / wee Bray fy vo r ye Ff 100 Bush St. S.P. 4 James J. Vonk " | Howard Cliff 1 Mullen & Filippi+ by 315 Montgomery St. S.F. 4 e mea. KN J J ! _ a7; NX | y, --} 7 ri, Brobeck Phleger & Herrison ITs ee in tadehiniemich Pevised 4-27-60 - g~ thorst SF 192-145 Bo.pl/Employerial LIEN Bo.pl/Employerial Bo.pl/Employerial Bo.pl/Employerial Bo.pl/Employerial Bo.pl/Employerial AAPPPLPICLANIT CANT L. J. Streithorst ATTORNEY FOR APPLICANT Smith Parrish Paduck & Clancy EMPLOYERS vs Asbestos Co. Western - prea pote. 6 Plant hebestes -Plour Faintenance Fluor Maintenance Co. Co. ska Fluor Maintenance Maintenance 2 o. 5. Braun Co. OFFICIAL ALLALES RECORD . . Carland B4Ca1r8la5nd7CaryCary 6-2-60 12 Calif 2637 Lincoln Ave Richmond i SPVICE AND Od | otf MSN . aap Pi DATE |(J 501 Financial Center Bldg Calif 675 Townsend St. S.F. 3 : ifs St. trail Pet5-7-60 , Calif P. O. Box 22 Los Angeles 1000 Fremont Alhambra Alhambra J P i Bee) Owen Leirip a, Asbe Asbetos.Co s Asbestos.Ct o Ho es me.C mago 1140 ^ stestos Co. San Jose Jose ^ stestos ^ stestos Co. Chase -29-6-219-61 -29-61 Chase Axeps | 1940 1940 69A Lennon Way San Jose Wer Lennon Wer Sen Jose Minnesota Minnesota St. S.F. S.F. /; . ; uy 3 Fiberglas wr Thorpe i2+ tt po 1200 17th St. 5 J. I Thorpe Co. - -- Oce 1351 Oa ceann Ave Emeryville ae aa a ". Lerontzen Co. 2267 Market St. Oakland- Ly bet Therpe & aos we Son 1715-17 1715-17 1351 Oceen Ave. 5oryville Jd ue J Kunde Corp. Metal Incula - Products Products Corp. I If Aetna Steel Products Corp. Van Arsdale & Harris Co. 8 Bay Co Asbestos 440 Brannan Los Angeles | 61 Broadway York 595 Tunnel Ave. S.F. KIM VET 54.60 Fifth Ave & E. 12th St caref caref le . NY /\" Oakland / k ~aa. ". . Revised 4-27-60 - gh Streithorst SF 192 145 . OFFICIAL ADDRESS RECORD SERVICE AND DATE INSURANCE CARRIERS Fred 40 11-30.00 x Fred 3 11-30.00 _ ~</ State Industrial Comp Ins Fund IndustriaIndemnilty ee 525 Golden Gate Ave. S.F. Sensome 5.7 y, . \ /\ |v # Continental Casualty Continental 11-29-6i Califomie 4\ alt 3 i _ Amarleen Amarleen Motorists_ins Motorists_ins Motorists_ins Hontromery A IrevelerInss urance 11-24-61 11-24-61 11-24-61 wrabitin Irevelers Insurance Standard Lecident dtl 34-41 56_64_ 56_64_ - 1986 | Kontgomery ! 8 Dl Xt EnkitEandnkitand Te TT mUARIY Standard 433-0a1fforia 1 ( _ Hardware Kutual Kutual - Cas P . 5 Hardware Kutual Cas Co. 20 Battery St F Insurance Cronusr Cronusur 7700 7700 6 _ Argonaut Siidd Vv wets ff la r . Aetna & Casualty Surety Co. 220 Montgomery St S.P. 2 rm 2 Pacific Employers Ins Co. 244 Pine St S.P. Hartford 11-24-61 11-24-61 11-24-61 . 4 California St. SP Industrial Indemnity Sansome 6 [A444 ANY Sale Gl AY J 4F Z BannaTTORNEYS FOR INSURANCE CARRIERS hint Banna oe Brophy 5. A. t, ~ 109 tuk SA EW Luli J 4. Putri Practition AE maloney maloney d Practition Practition Practition ' we Jhx -- Jhx Jhx -- treaty maloney--2 , 315 Le treaty treattryeaty Ft 174 174 4 a ) Barlink : eT ae - ... v a ee ~ * ADDRESS * OFFICIAL ADDRESS RECORD ; SERVICE AND DATE : . . Dh fy f a , . Lien Claimant Applicants L. J. Streithorst ; 2637 Lincoln Ave. Richmond Attorney for Applicant Smith Parrish Paduck & Clancy 501 Financial Ctr Bldg Oakland Oakland | Employer | Attorney for Employer Insurance Company Attorney for Insurance Company _. CALIFORNE INSPECTION RATING BUREAU 1453 MISSION STREET SAN FRANCISCO ) CALIFORNIA K. -O'B> RIEN O'BRIEN DAVET jot Benirhel RECEIVED RECEIVED H. HOTAJIAN MWVARY APR 4 1960 DEPARTMENT INDUSTRIAL DEPARTMENT ORION RELATIONS INDUSTRIALACCIDENTSACCIDENTS March 1960 Mi AAEe shed NErey Pan ATTNETION General File Department of Industrial Relations Industrial Accident Commission P. O. Box 603 San Francisco 1 California Attention George W. Lane Referee RE L. J. STREITHORST V. WESTERN ASBESTOS CO ET AL Claim No. SP 192 145 Dear Sir In reply to your letter of March 11 1960 we wish to send the following information Western Asbestos Co. 675 Townsend St. San Francisco California State Compensation Insurance Fund Policy No. D 93224-56 1-1-56-57 . Policy No. D 93224-57 1-1-57-58 Policy No. D 93224-58 1-1-58-59 ; Folicy No. D 93224-59 1-1-59 60 Plant Asbestos Co. 1300 Fourth St. Emeryville California Industrial Ind Co. Folicy No. C 602110 1-1-58-59 and Policy No. CP 608056 1-1-59-60 Fluor Maintenance Co. 406 Ward St. Martinez California Associated Ind Corp. Policy No. 480285 4-25-52-53 . Continental Cus Co. Policy No. 6409667 4-25-53-54 Policy No. Not available 4-25-54-55 Policy No. 1907635 4-25-55-50 Policy No. 1894526 4-20-56-57 Policy No. 1894526 4-25-57-58 Policy No. 1894526 4-25-58-59 C. F. Braun & Co. 1000 South Fremont Ave. Alhambra California American Motorists Ins Co. lolicy No. CM 420840-1-1-52-53 \ and Policy No. CM 426012 1-1-53-54 Lambermens Mutual Casualty Co. Policy No. 0 424664 1-1-53-54 1 American Motorists Inc. Co. Iolicy No. CM 426012 1-1-54-55 Policy No. CM 426001 1-1 -~ , Policy No. CM 425012 1-1-0-97 Policy No. CM 440012 1-1-57-56 und Policy No. CM 42.012 1-1-55-59 r r . a ) - Department of Industrial Relations Industrial Accident Commission RECEIVED leah ota APR 1 - 1950 DEPARTMENT OF INDUSTRIAL March 31 1960 sesamiae DIYYRION OF INDUSTRIAL RELATIONS General File ile - Armstrong Cork Co. 304 Shaw Road South San Francisco California Travelers Ins Co. Holicy No. 2047243 1-1-52-53 Policy No. 267380 1-1-53-54 Policy No. 3386210 1-1-54-55 Policy No. 4490459 1-1-55-56 Policy No. 4991518 1-1-56-57 Policy No. 6433814 1-1-57-58 Policy No. 7226992 1-1-58-59 San Jose Asbestos Co. San Jose Californis We are submitting coverage for Oven Leinio dba 1140 Lennon Way San Jose San Jose Asbestos Co. Hardware Mutual Casualty Co. Policy No. 605551 3-9-56-57 Policy ae No. 705080 3-9-57-58 5-26-53 Ayers 5-26-53 . Co. 696 Minnesota St. San Francisco California Nothing prior to . Argonaut Insurance Co. Policy No. 105668 5-26-53-1-1-54 Policy No. 114699 1-1-54-55 Policy No. 133559 1-1-55-56 Policy No. 147705 1-1-56-57 Policy No. 02044 1-1-57-58 Fiberglas Engineering & Supply Division 1200-17th St. San Francisco California Aetna Casualty & Surety Co. Policy No. 31C 733 9-1-54-55 x Policy No. 310 784 9-1-55-56 Policy No. 310 822 9-1-56-57 Lorentzen Co. 2267 Market St. Oakland California Industrial Ind Co. Policy No. 501 CP 00429 1-1-55-56 ime eee inte Aetna Steel Products Corporation 61 Broadway New York Hartford Accident and Ind Policy No. US 995537 10-6-45-46 Policy No. US 65069 10-6-46-47 Policy No. US 125006 10-6-47-48 Bay Cities Asbestos Co. Ltd. Fifth Ave. & E. 12th St. Oakland Industrial Ind Exchange 3-31-43 until 3-31-5 Policy available Effective 3-31-45 Policy No. 6-3-01168 California numbers not Very truly yours R. T. Read Superintendent Underwriting Department a RO e