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.7 <br />f -e' b .4 <br />Project Location �"'` e'� _ , ¢ 1 �' - 1 n L . <br />Owner_ Phone No. ,ifo`� �3ft �5�?t!. <br />Contractor 4"Zx6'1 V i ® !.:s Phone No.'q Ito 41J- - XAPEJC License No. <br />1. Submission of Sail Engineer's Compaction Report within 30 days of project completion, or <br />2. Submission of verification, e.j., load ticket, within 30 days of project completion that one of the following materials was <br />® <br />placed in the excavation in 12 lifts: <br />_ A. Pea gravel—smooth, rounded material not more than one-half (1/2) inch in diameter <br />B. Crushed rock--self-compacting material not more than three-quarters (3/4) inch in cross sectional <br />measurement. (Use of crushed rock will not be permitted for backfill if contact will be made between the <br />backfill material and tanks/pipes made of poly resin glass or similar m:aerials.) <br />r • <br />I hereby certify that a Soil Engineer's Compaction Report will be submitted within 30 days of project completion, or submission of <br />verification that the select material described above will be placed at a minimum 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 Chapter 70. <br />* Shall be the responsible managing emPlOYOC on the license or authorized agent. <br />e s <br />i <br />