Laserfiche WebLink
SAN JOAQUIN COUNTY <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />1810 E HAZELTON AVE. STOCKTON. CA 95205 <br />DEVELOPMENT SERVICES PHONE 12091 468-3120 <br />PLANNING PHONE 1209) 4683120 <br />BUILDING PHONE 12091468-3123 <br />NEIGHBORHOOD PnESEnVATION PHONE 12091 4683021 <br />BACKFILL EXCAVATION CERTIFICATE <br />Project Location 4!_tas /=LEUcAlri( y37 37C <br />Owner a7V 6F �.4GY Phone No. Zpy 83L• ' �/�/20 <br />Contractor {(%/,y/j Erc/(/iQc�(Phone No. 769-ff337)7SX License No. 4$1s0/ <br />jr,rj i JK .L•NL. <br />INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br />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. <br />ifts:_.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 1Q00 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 />* Jo�IN F <br />Name (Print) <br />* <br />* Shall be the responsible managing <br />agent. <br />6/91-LC/BECERT.DOC <br />oyee on the license or authorized <br />