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SAN JOAQUIN COUNTY <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> w <br /> 1810 E HAZELTON AVE.STOCKTOR CA 95205 <br /> DEVELOPMENT SERVICES PHONE 12091 4683120 <br /> PLANNING PHONE 1209]468-3120 <br /> BUILDING PHONE:12091 468-3123 <br /> NEIGHBORHOOD PRESERVATION PHONE: (209) 468.3021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location TYie Port of Stockton 2201 W. Washin ton St. Stockton CA. <br /> Owner Same as above Phone No. (209)946-0246 <br /> Contractor Jim Thorne Oil, Iric. Phone No. (209)462-4581 License No. 695699 <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 /> X 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 /> X 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. <br /> Name (Print) <br /> rat t r i nt <br /> T (Pr. <br /> ignature <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/SECERT.DOC <br />