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;7 6�'= 12-13-96 ;10:50AM , F–AMOS E1� IIRO'�"n7-4T � 12 94640133;# 3i 1 <br />BAOU r EXCAVAgI- tnr CEFL=C IE <br />PTDject Location /3 � C- <br />0 <br />-- <br />Owner �.�c7�3n 1.%v.Yilr l� .- Phone No.2r�0�D� <br />(; mtractnr`1�.K#sa1A .•Jy', - 4 _ Phone No. y%b --3j / .0 - <br />�-�r� ircctzse ilia. � ff' �rol r <br />1. SUbMiMi:,n Of Soil E-JJ;iae0eS Comp;xY WU R; port Witt; n IV dw1JS of prO;: ;x C-0mP -tion, or <br />2. Submission of verification, e.g., load ticket, within 30 drys of project compiction that our, vt the foilo%ing mlaiori:tls <br />*a£ placed 1--r-be �=ration m L' lifts: <br />X A. Pea gravel --smooth,, roanded material not more than one-half (1/2) inch in diwMeter <br />&. Crushed rock-iself-mmpatting material not more than three-quarters (3/4) inch in cros s sectional <br />measurement (Use of crushed rock will not be permitted for backfill if contact will be made between <br />the bacienil material and tankslpipm made of poly resin glass or similar materials.) <br />DECLAtZA710N <br />I hefeu.. ce—dfy .JMt a Svii Engineers C3mpwetion Report will be submitted within 30 dsr of roject Wmpletion, or submission <br />of veW94y tion that the select materia! described abcwt: will be placed ata mistitntana of la' ( cubic yards per 1000 gallon tank <br />displacement and that the entire excavation will be backfilled and Corapaeted to insure comp lance with the Uniform Building <br />Cade Appendix Citapter 70. <br />I <br />7 -7 - <br />Name rint <br />btgttiatuxe <br />11 Shall' be the responsible mana&g empioyee on the lit-ei= or authorized agent. <br />