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10/17/2000 09:00 2094683433 FIFTH FLOOR PAGE 11 <br /> BACKFILL EXCAVATION CMVI- ICATE <br /> PmicetLocatioa 6425 PCIFIC AVENUE STOCKTON, CA 95207 <br /> ��� M NTER IrL.0 MARK YEKTA Pharac No 925_�,,�fl_3444 <br /> �°°; Plronc xa 7 0 7 6 _3—2 9 2 9 License lyp. A 4 5 5 7 5 2 <br /> INDICATE METHOD OF BACKFILL.QUAI TY ASSURANCE <br /> 1 Ion of Soil Eflgmeer'$Compaction Report wider 30 day$of prpjont completion, yr <br /> __y 2. Submission of vcdacatiou, e.J"'toad tieket, within 30 days of project compledon that ana of the following materials was <br /> placed in the excavation m 12 lifts: <br /> A Pea gravel--smooth,rounded matenad not more d,an me-baif(112) inch in diameter <br /> B Crushed rock—self-compacting al not more 9m (3/4)(3/4) inch in cross sectional <br /> ent <br /> mean em {Vse of e� rnittesCrushedreek will W be per=tted for if contact will be made between the <br /> backfill material and tankslpiy"made of poly V*in glass or similar M&vnUls) <br /> DECLARAMON <br /> I hereby certify that a Solt $ngineer's Compaction Report will be submitted within 30 da of ct completion, or svbansmon of <br /> vazd tiara t tl�a xlecx =*costal described abort will be placed za a rammtum to Pave ( t c ywds per 1apta <br /> 00O�om tank <br /> Rpm ttte entire eacravarl will be becMlad and eotztpacted to insure compliance with the Uniform Code <br /> 70 <br /> Shall be the responsible marag erg err pleyee on the hm =e or au bodzed agent. <br />