Laserfiche WebLink
�aR n. � SAN JOAQUIN COUNTY <br /> .,*SAN <br /> DEVELOPMENT DEPARTMENT E <br /> 1810 WELTON AVE..STOCKTON.CA 95205 <br /> • r�t1�6p��' DEVELOPMENT SERVICES PHONE 12091 4683120 <br /> PLANNING PHONE: 1209)468-3120 <br /> BUILDING PHONE: (2091468-3123 <br /> NEIGHBORHOOD PRESERVATION PHONE 1209 468-3021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location 4807 AIRPORT WAY, STOCKTON <br /> Owner CUSTOM RV Phone No. (209)982-5723 <br /> Contractor WESTERN METER SERVICE Phone No.(209)948-6124 License No. 414051 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> 1. Submission of Soil Engineer's Compaction Report within 30 days of project <br /> completion, or <br /> xx 2 Submission of verification, e.g. load ticket, within 30 days of project <br /> completion that one of the following materials was placed in the excavation in <br /> 12" lifts: <br /> A. Pea gravel - smooth, rounded material not more than one-half (1/2) <br /> inch in diameter. <br /> B. Crushed rock - self-compacting material not more than three-quarters <br /> (3/4) inch in cross Sectional measurement. (Use of crushed rock <br /> will not be permitted for backfill if contact will be made between <br /> the backfill material and tanks/pipes made of poly resin glass or <br /> similar materials. ) <br /> DECLARATION <br /> I hereby certify that a Soil Engineer's Compaction Report will be submitted within 30 days <br /> of project completion, or submission of verification that the select 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 /> Uniform Building Code Appendix Chapter 70. <br /> * WILLIAM F. MESSIVCK <br /> Name (Print) <br /> PRES. <br /> Title (Print) <br /> * <br /> Signature _ <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/BECERT.DOC <br />