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a BACI-M LL M(CAVATION CERTIFICATE <br /> M <br /> 54 <br /> sroject. o tac <br /> Zct �— 0.370 <br /> Phone No, ' <br /> flvr t <br /> Contractor K s-r <br /> INDICATE.METHOD OF BACKFILL QUALITY ASSURANCE ; <br /> a t 1. SubmissiomofsoiL.Ertgineees Compaction Report within 30 days of prOject cvmpieition.or <br /> 2. Submission of verification, e. load ticket, within 10 days of project completion t�1At one of zhe:folIowit�materials was <br /> placed in the e=vatjon.in 12" lifts: <br /> A. Pea ;ravel--smooth,rouaded.material not more than 00 half{1/2� inch in diameter <br /> B. Crushed rock-self-co' actin material not more than, three-q ers (314) mid itt gross :sectional <br /> g quta <br /> measurement. (Use of crashed rock will not be permitted for baeckfilll if contact will be made between the <br /> backftil material attd`tanWpipes made of poly resin glass or similar materials.) <br /> DECLARATION � <br /> .. r.F . . 1 <br /> I hereby certify that a Soil Engin6Ws Quit PW6on Report will be submitted within V �rsof Xect coalas trn,or 0 altomiston k 9 <br /> verification that the select material_described above will be placed at a minimtuu offtve (S�ctibtq yagtds:per IOOQ anon cask <br /> fi <br /> displacement and that the entire excavation will be backfilled and compacted to insure compliance With:rite Unifoin`lauding Code <br /> Appendix:'Chapt+er'.10.0 <br /> ame ; <br /> Ti-de <br /> Shall be the responsible managing employee can the cense or authorized agent. <br /> r <br /> t <br />