Laserfiche WebLink
10/0Irl"t 10:21 12098325152 WRIGHT ENVIPONMENTAL PAGE 01 <br /> � u <br /> c•. <br /> BACKFILL EXCAVA.TlO_N CERTIM ATE <br /> project )Gwation�, k l 7t7 -- s l 'y����fli�.�Y 9 n-.l(t t o 1 Q n o 4 { <br /> Owner_ _ /� .��dJ�4 Phone No. I -Y g A V <br /> Contracior� o.YBame No.a�O� X��,U7 S�' Laccase No. _/.4Z) 1 <br /> INDICATE METHOD OF BACKFU-L QUALITY ASSURANCE <br /> l, Submission of Soil Engineer's CoWgaetioa Report within 30 days of project completion,or <br /> 2. Submission of verification,a+. toad ticket,within 30 days of project completion that one of the following materials was <br /> I'laced in the excavation,in 12 lifts: <br /> Y A. pea gravel-smooth, rounded material not more thin one-half(1/2) inch in diameter <br /> -ke'�B. Crushed rock-selfiomp material not more than three-quarters, (3/4) inch in cross sectional <br /> measurement. (Use of a�rode will not be permitted for b if contact will be made between the <br /> bWMU material and taslo/pipas made of poly train glass or similar ora inks.) <br /> DECLARATION <br /> I hpelty cattily that a Soil Eagiaeex's ComVwdoo Report will be submitted within 30 da s of project completion,or submission of <br /> verifl"110i that the Select marerial described above will be placed at a minimum of FVC ( cubic yards per 1000 gallon tank <br /> displacrmcmt and tbat the entire excavation will be backffiled and compacted to insure compliance with the Uniform Building Code <br /> Appendts Clisptar 70. <br /> • r,oma Irmfj�j n I� <br /> e t <br /> Shall he the responsible managing employee on, the license or authorized agent. <br />