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HEA1.T1, <br /> SAN JOAQUIN COUNTY PERMIT� j <br /> CE <br /> .y <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> Ll <br /> w: <br /> 3810 E.HAZELTON AVE.,STOCKTON,CA 95205 •T�' _._'' <br /> PLANNING DEVELOPMENT SERVICES (209)468 <br /> PHONE:(209)4683120 3120 <br /> BUILDING PHONE:(209)4683123 <br /> NEIGHBORHOOD PRESERVATION PHONE:(209)4683021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location Valley Showcase, 901 W. Fremont St., Stockton, CA 95203 <br /> Owner Phone No. ( ) 66-5771 <br /> George Lechich 209 4 } <br /> Contractor JIM THORPE OEL CO., INC. Phone No. (209)-368-6175 License No. 495699 ,p <br /> s <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 <br /> 2. Submission of verification,e.g.,load ticket, within 30 days of project commpletion <br /> that one of the following materials was placed in the excavation in 12" lifts: ; <br /> X <br /> A. Pea gravel -- Smoth, rounded material not more than one-half (1/2) inch in . <br /> diameter. I <br /> — B. Crushed rock -- self-compacting material not more than three- uarters 314 <br /> P g q ( ) <br /> inch in cross sectional measurement. (Use of crushed rock will not be IC <br /> permitted for backfill if contact will be made between the backfill material and <br /> tanks/pipes made of poly resin glass or similar materials.) <br /> DECLARATION <br /> --�I-hereby certify=that-a--Soil-Erigineer's Compaction�Report�will be'sunini'tteci within`30 days of project! <br /> completion, or submission of verification that the select material described above will be placed at a <br /> minimum of five (5) cubic yards per 1000 gallon tank displacement and that the entire excavation will be <br /> backfilled and compacted to insure compliance with the Uniform Building Code Appendix Chapter 70. <br /> 41 <br /> * RICHARD THORPE <br /> Name (Print) I' } <br /> Preside <br /> T' Prin <br /> Signature <br /> * Shall be the responsible managing employee on the license or authorized agent. <br /> 6191-LCMECERT.DOC <br /> S <br />