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San Joaquin County <br /> Community Development Department <br /> 1810 E.Hazelton Avenue,Stockton,CA 95205 <br /> Development Services Phone: (209)468-3120 <br /> Planning Phone: (209) 468-3120 <br /> Building Phone: (209)468-3123 <br /> Neighborhood Preservation Phone: (209)468-3021 <br /> BACKFILL EXCAVATION CERTIFICATE <br /> Project Location Lawrence Livermore National Laboratory (LLNL) Site 300, UST 865-D1U1 <br /> Owner U.S.Govt.-Dept. of Energy __Phone No. (510) 423-6577 <br /> Contractor LLNL _________________Phone No. (510)422-8570 License No._ <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> 1. Submission of Soil Engineer's Compaction Report within 30 days of project completion,or <br /> 2. Submission of verification, e.g.,load ticket, within 30 days of project completion that one of the <br /> following materials was placed in the excavation in 12" lifts: <br /> A. Pea gravel-smooth, rounded material not more than one-half(1/2)inch in diameter. <br /> B. Crushed rock-self-compacting material not more than three-quarters (3/4)inch in cross <br /> sectional measurement. (Use of crushed rock will not be permitted for backfill if contact <br /> will be made between 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 of project <br /> completion,or submission of verification that the select material described above will be placed at a minimum <br /> of five (5) cubic yards per 1000 gallon tank displacement and that the entire excavation will be backfilled and <br /> compacted to insure compliance with the Uniform Building Code Appendix Chapter 70. <br /> Charlie Brown <br /> Name (Print) <br /> Manager,Tank Upgrade Project <br /> Title (Print) <br /> x <br /> Signature <br /> Shall be the responsible managing employee on the license or authorized agent. <br /> 6/91-LC/BECERT.DOC <br /> CLOSURE PLAN: 865-DlU1 <br /> I <br />