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SAN JOAQUIN CONY <br /> .? 's COMMUNITY DEY PMENT DEPARTMENT <br /> 1910 E HAZELTDN AVE, STOCICTON, CA 45205 <br /> DEVELOPMENT SERVICES PHONE 1209E 468.3120 J?St4TJqPLANNING PHONE 12091469.9120BUILDING PHONE (2091468-312NEIGHBORHOOD PRESErIVATION PHONE (2091466.3021 <br /> A Ki Q 7 1994 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> Project Location 221-225 MINER AVENUE, STOCKTON, 'CALIFORNIA 95202 <br /> Owner r.',, J, BEVANDA PROPERTIES Phone No. (213) 87/ 5246 <br /> Contractor FALCON ENERGY Phone No. (209) 463 7108 License No. 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 /> ti[ A. Pea gravel - smooth, rounded material not more than one-half (1/2) <br /> inch in diameter. <br /> Olt- <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 /> DECLAMATION <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 I HOBLITZELL <br /> Name (Print) <br /> V.P. <br /> Title (Print) <br /> n ure <br /> * Shall be the responsible managing employee on the license or authorized <br /> agent. <br /> 6/91-LC/BECERT.DOC <br />