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BACKFILL EXCAVATION CERTIFICATE <br /> Project Location <br /> 2315 N. California St., Stockton, CA 95204 I <br /> Owner Norman Higgins, P.O. Box 369, Clements, CA Phone No.(209)7 59-3400 <br /> Contrector JIM TIIORPE OIL, INC. Phone No. (209)3 -6175 License N0.495699 <br /> INDICATE MEPHOD OF BACKFILL QUALITY ASSURANCE 1 <br /> _ 1. Submission of Soil Engineer's Compaction Report within 30 days of Project completion, or <br /> X 2. Subndssion of vellficatlon, e.gg., load Ucket, within 30 days of project completion that one of the following materials <br /> was placed in the excavation in 12" II(Is: <br /> X A. Pea gravel--smooth, rounded material not more than one-half(1/2) inch In diameter . I <br /> _ D. Crushed vock--self-col"pactiII& material not more than three-quarters (3/4) Inch In cross sectlonnl <br /> the backfill materialUseland(cirlshed Fock will not be tmlks/pipes made of polylresin glass or similaromaterials.nlact will)a made between <br /> DECLARATION <br /> 'i <br /> 1 hotel+}qS'cettify Ihal a Sohl Fnginecr's Compaction Report will be sub/nitted within 30 day.s of roject completion,or submission <br /> of vetlhcalion Ilial the Select material deslalhed above will be placed at a mlllimU111 of five(5S cuble yards per IOU()gallon lank <br /> displacement and that Ole entire excavation will be backfilled and compacted to insure compliance with the Uniform Building <br /> Colic Appendix Chapter 70. <br /> i <br /> • JIM TNORPE OILIINC. j <br /> ame ( r m) <br /> i <br /> • CONTR 'TOR=gnal <br /> r <br /> i <br /> Shall he the responsible managing employee on the license or authorized agent. II <br /> I <br /> i <br /> I' <br /> I <br /> I <br /> I <br /> i <br />