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San Tomo Partner , 11291 N. Alpine Rd. S- kton CA 95212 <br /> Project Location Phone No. (209)948-0792 <br /> Owner San Tomo Partners <br /> Jim Thor e Oil , Inc . Phone No. (209)368-6175 License No. ^Q^Fg9 <br /> Contractor P <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> _ 1. Submission of Soil Engineer's Compaction Report within 30 days of project completion, or <br /> X 2. Submission of verification, e.g., load ticket, within 30 days of project completion that one of the following materials was <br /> placed in the excavation in 12" lifts: <br /> X A. Pea gave!--smooch, rounded material not more than one-half(112) inch in diameter <br /> ch in <br /> ross <br /> — B. Crushed <br /> e suremrock-self-compacting <br /> n. (Use of crushed rock will not be pejaed or backfill if mate-jai act more E (con[actt will becmade berHe a <br /> the backfill material and tanks/pipes made of poly resin glass or similar matenais.) <br /> DECLARATION pp <br /> verification that the select material described above will be placed at a minimum of tive (5) cubic yards per na B lding tonic <br /> I hereby certify that a Soil Engineers Compaction Report will be submitted within 30 days of rojec: completion, or submission of <br /> displacement and that he entire excavation will be backfilled and compacted to insure compliance with the Umforn Building Code <br /> Appendix Chapter 70. <br /> Jim Thorne e <br /> N arae rent) <br /> Contractor <br /> e ( nn <br /> c� <br /> scanamre <br /> w Shall be the responsible managing employee on the license or authorized agent. <br />