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7-. 6-04;. 8:45PM; ;925 bit 7888 # zi <br /> Jul-044 03:62pm From-Gsttler-Ryan l6c +9166311317 T-298 P.002/002 F-995 <br /> 1}rajear Location:t <br /> Owner: e ! 1 Q `l Phone No: f�C/ �1� r� <br /> Contractor. C fl"r— V� G r Phone No: y�, 5 l— S�License No. �-- "i <br /> DMICAM METHOD OF EACKk'YT L QUALITY ASSURANCE <br /> 1. Submission of Soil Eagineces Compaction Report within 30 days of project completion,or <br /> X 2. Submission of veriflcatiop, e.p., load t2cket, within 30 days of project completion that one of the following materials was <br /> placed in the excavation in 12' hits: <br /> A. Pea gravel—smooth,rounded material not more than one-half(112)inch in diameter <br /> _ & Crushed rock--self-compacting material not more thau three-quarters (311) inch in amss sectional <br /> measurement. (Use of crushed rack will not be permltted 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 Sotl Eugeer's Compaction Report will be submitted within 30 days of ect an letion, or submission of <br /> verification that the select material described above will be placed at a minimum of Eve �S�cI is yards per 1000 tank <br /> displacement and.that the entire excavation will be backfilled rind compacted to insure compl aaae with rite Uniform Code <br /> Appendix Chapter 70. <br /> Dlg/o gC10J <br /> nine <br /> e / 6j4 7, <br /> i <br /> i <br /> Shall be the responsible managing employee on the license or wAorized agent. <br /> 1 <br /> M23 046 (Revised 1.0/16103) Page 11 <br />