Laserfiche WebLink
�CKFILL EXCAVATION CERTIFICATE <br /> y' <br /> t Location 1645 Cherokee Rd. , Stockton, CA 95205 <br /> er Central California Traction Co. Phone No. (209)466-6927 <br /> 'h Contractor Jim Thorpe Oil , Inc . Phone No. (209)368-6175 License No. 495699 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> 1_ Submission of Soil Engineer's Compaction Report within 30 days of project completion, or <br /> 2. Submission of verification, e.g., load ticket, within 30 days of project completion that one of the following materials was <br /> placed in the excavation in 12" lifts: <br /> _ A. Pea gravel--smooth, rounded material not more than one-half(1,"2) inch in diameter <br /> X B. Crushed rock—self-compacting material not more than three-quarters (314) inch in cross sectional <br /> measurement.. (Use of crushed rock 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 similar materials.) <br /> Excavations backfilled with customer supplied crushed rock at <br /> customer's request <br /> DECL.4RATION <br /> I hereby certify that a Soil Engineer's Compaction Repon will be submitted within 30 days of project completion, or submission of <br /> verification that the select material described above will be placed at a minimum of five (5) cubic yards per 1000 gallon tank <br /> displacement and that the entire excavation will be back filled and compacted to insure compliance with the Uniform Building Code <br /> Appendix Chapter 70. <br /> * Jim Thorpe Oil , Inc . by Ric)—rd Thox-pe <br /> Name {Fant) <br /> * Cor. ctor <br /> 1 ( rm <br /> Signature <br /> " Shall be the responsible managing employee on the License or authorized agent. <br />