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BACKFa,L EXCAVATION CERTIFICATE <br /> Project Location 24 South AmPriran , gfnctcFnn_ CA — 95,205 <br /> Owner Rosenthal Trust — Bank of Stockton Phone No. 929-1526 <br /> Contractor AGE Phone No- 467-1006 License No. Fun 227 <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?f 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 /> XX A. Pea gravel—smooth, rounded material not more than one-half(1/2) inch in diameter <br /> and sand <br /> B. Crushed rock—sbif-compacting material not more than three-quarters (3/4) inch in cross sectional <br /> measurement. (Use of crushed rock will not be permitted for backfill if contact will be made between the <br /> backfill material and tanks/pipes made of poly resin glass or similar materials.) <br /> DECLARATION <br /> I hereby certify that a Soil Engineer's Compaction Report will be submitted within 30days of pproject completion, or submission of <br /> verification that the select material described above will be placed at a minimum of five (5) cubic yards per 1000 gallon tank <br /> displacement and that the entire excavation will be backfilled and compacted to insure compliance with the Uniform Building Code <br /> Appendix Chapter 70. <br /> Wiulliam little <br /> Name <br /> eolo ist <br /> u e t) <br /> Signature <br /> Shall be the responsible managing employee on the license or authorized agent. <br />