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BACKFILL EXCAVATION CERT:FICATE <br /> P:ojec[I.ocarion <br /> 35 E. Jackson St . , Stockton, CA <br /> Owner Joe Omaehi phone No. (209)368-6175_ <br /> Contractor <br /> Jim Thorpe Oil, Inc. Phone No. (209)368-6175 License No. 495699 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> _ 1. Submission of Soil Engineer's Compaction Repot-,w',thun 30 days of project completion, or <br /> X 2 Submission of verifiaaion, e.g.,,load ticket, within 30 days of project complerion that one of the following materials wcs <br /> placed m the excavadon in 12' ifa: <br /> X A. Pea gravel—smooth, rounded material not more than one-heif(1!2) itch in diameter <br /> B. Crushed rock•-self-compacting material not more than hreetluartors '(314) inch in cross sectional <br /> measurement. (Use of crushed 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 materials.) <br /> DECLARATION <br /> I hereby terrify that a Soil Engirv='s Compaction Report will be submittea within 30 days of project completion. or submission.of <br /> verification that the select material desc:tbed above will be placed at a m:nimimt 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 Cbapter 70. <br /> Richard Thorpe <br /> Name <br /> Contractor <br /> e <br /> signs=-- <br /> Shall be the :esporuible managing eirployee on the license or authu:ized spent. <br />