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SAN JOAQUIN COUNTY <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVE..STOCKTON.CA 95205 <br /> c+��! �.�`► DEVELOPMENT SERVICES PHONE 12091 458.3120 <br /> PLANNING PHONE (2091 468.3120 <br /> BUILDING PHONE: (2091 468.312 <br /> NEIGHBORHOOD PRESEnVATION PHONE 1209) 468.3021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location 3507 STEVINSON STREET STOCKTON DA 95205 <br /> Owner WILLIAM VALENCIA Phone No. (209) 948 9003 <br /> ContractorFA, cmPhone No. (209) 403 7108 License No. "A" HAZ <br /> -- E-R� . <br /> 584524 <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 /> 5C A. Pea gravel - smooth, rounded material not more than one-half (1/2) <br /> 01Z 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. <br /> * ,JAMES J. HOBLITZELL <br /> Name. (Print) <br /> V.P. & ENvIRONMENTAL MANAGER <br /> Title (Print) <br /> tt urs <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/BECERT.DOC <br />