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} <br /> RECEIVED <br /> SAN JOAQUIN COUNTY ! APR 2 7 1992 <br /> COMMUNITY 0EVELOPMENT DEPARTMeff <br /> �1triC�e�1tIAA�frfTfll HEALTH <br /> 1 1610 E hU$E170N AV[ 9rOGiC1 CN,CA 06206 !1 <br /> isEftrro' <br /> r k1t 1]LVWPMEW,48AVIC65 MCH�120111 408.31;C <br /> _ PLANNwG PHONE 12061 466-0120 I <br /> { BUWNQ PHONE 12491 46$-2tIl I <br /> RMHOOW000 PRUEpYAT10N WONE{209)46a-3421 �E <br /> I� <br /> BACRE'IZ,L EXCAVATION CERTIFXCATEi <br /> =.Pxo j ect Location—— .1127.3-E. Ada Avenue..Stockton._ ,.�Ca -- __ <br /> Sierra Bay Farm Credit Assn. 11(209) 944-8271 <br /> Owner Phone No. ., <br /> Contractor Jim Thorpe Oil Phone No. (209)462-45 TAcense No. 1 <br /> r <br /> INDICATE MT11100 OF l3ACki'ILL OtrAZIWY A 1IAANCE <br /> 1. Submiselon of soil Engineer's Compaction Report within 30 days of project <br /> completion, or <br /> X2, submission; of verification, e.g. load ticket, within 30 days of project <br /> w 1 t excavation Completion that one ct the following materials was placed in he axe ion in <br /> 12' lifts: <br /> X <br /> A. Pea gravel - smooth, rounded material not more than one-hal.# (1/2) <br /> inch in diameter. <br /> X B. Crushed rock - eel!-compacting materl'l not more than three-quarters <br /> (3/4) inch in crosa sectional meaeuroment. (us* of crushed rock <br /> will not be permitted !or backfill if contact will be made between <br /> the backfill material and tanks/pipe's made of poly xaaln glass or <br /> similar materials.) 3/4 AB 1 <br /> i <br /> DECLARATIO14 I' <br /> I Hereby certify that a Soil Engineer,a Compaction Report will be submitted within 30 days <br /> of project completion, or submission of verification that the eeiect material described above <br /> will be placed at a minimum of five (5) cubic yards per 1000 gallon tank displacement and <br /> that the entire excavation will.be backfilled and compacted ,'to insure compliance with the <br />� --..�r„�13aiform-9uildinq,Code-Apgerdix�Chapter-70.•.c�— -----••-�*---•• - - --.ti � - _ -�- <br /> Richard Thorpe^ <br /> Name (PrInt) <br /> President / Jim Thorpe Oil Inc./ Rich-Mart Const. <br /> Tr ht) <br /> IE zgnatua:e � _ <br /> * Shall be the responsible managing employee on the License or authorized <br /> ` agent. � I <br /> s <br /> 6/9I,-LG/B[:CER4.t7t]C <br /> T d 80 91 26/9Ei0 W' ' <br /> j <br />