Laserfiche WebLink
---' — ..,.. rAtr n:NVtnuNMENLAL LgJuIJ <br /> FEB-02=04 17:30 FROM-KLEEMAN ROEBBELEN 916-939-1168 T-746 P.15/17 F-539 <br /> BACKFILL EXCAVATION CERTIFICATE ... <br /> Project Location 76 y y A/. As M e-rr/ 4 ,q me STa r-A7-0 <br /> Owner SBG Phone No. VaS, 90/—S.5R y <br /> Contractor TAI j e"AQb1k( bft'}4L Phase No-'rib E-16?o 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.p , load tickmt, within 30 days of project completion that one of the following materials was <br /> placed ' the cavation in 12 lifts: <br /> . Pea grave--smooth, rounded material not more than otic-balf(112)inch in diameter <br /> B. Crushed mek--self-compacting material not more than rhree-quarrers (314) inch in cross sectional <br /> measurement. (Use of crushed rock will not be permitted for backfill it contact will be made between the <br /> backfill material and wikslpipcs made of poly resin glass or similar materials.) <br /> DECLARATION <br /> 1 hereby certify that a Soil Ertyineer's Compaction Report will be submitted within 30 days of ppia=complexion, or submission of <br /> verification that the select material described above will be placed at a minimum of Five t5) cable yards per 1000 q1;allon tank <br /> displacemrnt acrd that the entire excavation will be backfilled and compacted to imm compliance with the Uniform Bur o Code <br /> Appendix Chapter 70. <br /> Signature <br /> * Shall be the respwtsibIc managing employee on the license or authorized agent. <br /> .�V•allw <br /> i <br /> I <br /> i <br /> RECEIVED FEB-11-04 15:09 FROM-9168581011 TO-KLEEMAN ROEBBELEN PAGE 13 <br />