Laserfiche WebLink
/ BACKFILL <br /> ` EXCAVATION <br /> ON CERTIFICATE <br /> Project Location� 7i77 EL1,J <br /> Owner—A,/a4c/ rvyd&i <br /> _G(L , Phone No(ZDq) f4i -7,12 1 <br /> Contractor SEMCO Phone No. (209) 524-9653 License No. 449864 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> 1. Submission of Soil Engineer's Compaction Report within 30 days of project completion, or <br /> 2. Submission of verification, e.g., load ticket, within 30 days of project completion that one of the following materials was <br /> placed in the excavation in 12' lifts: <br /> _2�, 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 pertained for backfill if contact will be made between the <br /> backfill material and ranks/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 rank <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 /> Icy ueu�tt <br /> Name rmt) <br /> * <br /> tt t) <br /> * <br /> ')ignanlre <br /> * Shall be the responsible managing employee on the license or authorized agent. <br />