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aK!n• SAN JOAQUIN COUNTY <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> ` 1610 E. I W.ELTON AVE.,STOCKTON.CA 95205 <br /> tl<Clndn?`� DEVELOPMENT SEWCES PHONE 12091 460'3120 <br /> PANNING PHONE 1209146&3120 <br /> BUILDING PHONE 12091 460'3123 <br /> NEIGHBORHOOD PRESERVATION PHONE 12091 4603021 <br /> DACKFILL EXCAVATION CERTIFICATE <br /> Project Location 315 R _ 11th Straat . Tray . CA 95376 <br /> Owner Tracy Joint Union High School DistRhone No. ( 209) 831-5032 <br /> Contractor Wright Environmental Phone No. ( 209 )833-075%icense No. 651501 <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 /> 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 matte: Letween <br /> the backfill material and tanks/pipes made of poly r-eoin glans ur <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 /> John F . Lynch <br /> Name (Print) <br /> P ident <br /> i le (Pr <br /> i nature <br /> * Shall be the responsible managing em�9 oyee on the license or authorized <br /> agent. <br /> 6/91--LC/nECERT.DOC <br />