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BACKFILL EXCAVATION CERTIFICATE <br /> i <br /> project Location Cal Tank Lines, Inc. , 3105 S. E1 Dorado St , Stockton- CA PR20e <br /> owner Cal Tank Lines, Inc. Phone No. (209)466-3554 <br /> Contractor JIM THORPE OIL, INC. Phone No. (209)368-6175 License No.495699 <br /> INDICATE MEI11OD OF BACKFILL QUALI'T'Y ASSURANCE <br /> _ I. Submission or Soil Engineer's Compaction Report within 30 days of project completion, or <br /> X 2. Submission of verification, e. ., load Ockel, within 30 days of project completion that one of the following material <br /> was placed In the excavation�n 12' lifts: <br /> X A. Pea gravel--smooch, rounded material not more than one-half(1/2) inch In diameter <br /> 0. Crashed rock--self-compacting material not more than three-quarters (3/4) Inch In cross sectional <br /> measurement. (Use or crashed rock will not be permitted for backfill If contact will be made between <br /> the backfill material and tanks/pipes made of poly resin glass or similar material.) <br /> DECLARATION <br /> 1 betelyy certify tient a Soil Engineer's Compnclion Report will be submitted within 30 days of roject completion,or submission <br /> of ver ificalIon Ilint the select material desctibed above will be placed at a min hnum of five(5�cubic yards per IOW gallon lank <br /> displacement and that the entire excavation will be backfilled and compacted to insure compliance with the Uniform Building <br /> Code Appendix Chapter 70. <br /> • JIM TNORPE OIL,INC. <br /> Name r nt <br /> • CONTRA "' <br /> �i a nn <br /> gnature tl <br /> " Shall be the responsible managing employee on the license or authorized agent. <br /> ' I <br />