Laserfiche WebLink
.*SAN JOAOUIN COUNTY <br /> > !�''A <br /> �` " COMMUNITY DEVELOPMENT DEPARTMENT <br /> 6 1810 E HAZELTON AVE.,STOCKTON.CA 95205 <br /> • ��CI'dbn'�`* DEVELOPMENT SERVICES PHONE 12091 468.3120 <br /> PLANNING PHONE 12091 4683120 <br /> BUILDING PHONE 1209)4683123 <br /> NEIGHBORHOOD PRESERVATION PHONE 12091 468.3021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location �� 13� � ()� LL,,- e✓ MaV1+C&_ 26 95625(c <br /> Owner Anne- Ln _ =hone No. 635a <br /> Contractor 6)&t 6wai " ()p• Phone No. q License No. <br /> INDICATE METHOD OF SACKFILL 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 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. ^l <br /> Name p( rint) <br /> UWE ii-Eom <br /> Title - <br /> Signature <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/BECERT.DOC <br />