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"ACKFILL EXCAVATION CERTIFICATE <br /> Project Location_ 730 E. Channel St. - Stockton- <br /> Owner—Raymond <br /> tockton_OwnerRaymond Investment Corp. -_Phone No. 209-466-8604 <br /> Contractor Oil Equipment Service Phone No209-754_1_808 License No. 323417 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> 1. Submission of Soil Engineer's Compaction Report within 30 days of project completion, or <br /> X 2. Submission of verification, e.� , load ticket, within 30 days of project completion that one of the following materials was <br /> placed in the excavation in 12' lifts: <br /> X 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 materials.) <br /> DECLARATION <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 /> * Keith A. Tallia <br /> Name rm[ <br /> * Presi <br /> to / <br /> t atur <br /> * Shall be the responsible managing employee on the license or authorized agent. <br />