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�• `, <br /> ,,,,QSAN JOAQUIN COUNTY <br /> �' ��\= COMMUNITY DEVELOPMENT DEPARTMENT <br /> '•• 1610 E HtiEL104 MT— S1OC✓.1Oq.CA 95705 <br /> C�iTVGw?�� DEVELOPMENT SEFMCES PHONE 17:91166.3120 <br /> PUJt1ANG PHONE 17091 6e•3120 <br /> BUILDING PHONE 12091 461.3123 <br /> NEIGHBORHOOD PRESERVATION FHONE 12091 401-MI <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location KJAX Radio Transmitter <br /> owner FEMA (acting on behalf of the FCC) Phone No. (202) 646-3061 <br /> Contractor SEMCO Phone :„o.(209) 524-9653 License No. 449864 <br /> INDICATE Y.ETROD OF BACKFILL QUALITY ASSLIR70;CE <br /> 1. Submission of soil Encineer' s Compaction nepert 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 folicwing materials was placed in the excavation in <br /> 12” lifts: <br /> A. Fea e_ravel - smooth, rounded material not more than one-half (1/2) <br /> inch in diameter. <br /> B. Crushed rock - self-ccm-pacting 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 class cr <br /> similar materials. ) <br /> DECLARATION <br /> I hereby certify that a Soil Engineer's Cor.pacticn F.epert 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 ccmpacted to insure compliance with the <br /> Uniform building Code Appendix chapter 70. {� <br /> I- ei, Ht7=tV%e <br /> )fame (Print) <br /> Title (Frint) <br /> Signature <br /> ' Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/EECERT.DOC <br />