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.*SAN JOAQUIN COUNTY <br /> r „z COMMUNITY DEVELOPMENT DEPARTMENT <br /> ` 1810 E HAZELTON AVE.STOCKTON.CA 95205 <br /> • ��4�FOA�`' DEVELOPMENT SERVICES PHONE 12091 468-3120 <br /> PLANNING PHONE 12091 468-3120 <br /> BUILDING PHONE 12091 4683123 <br /> NEIGHBORHOOD PRESERVATION PHONE 12091 4683021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location Don Avenue Pump Station <br /> Owner City Of Stockton Phone No. (209)944-8829 <br /> Contractor Helmick & Lerner Inc. phone No. (916)48507222 License No. 589667 <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 /> tl 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 /> y A. Pea gravel - smooth, rounded material not more than one-half (1/2) <br /> inch in diameter. <br /> X 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 /> * J. Brian Goins <br /> Name (Print) <br /> Operations Manager <br /> Title (Print) <br /> Signature <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/BECERT.DOC <br />