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SA" .10AOU111 COUNTY <br /> ' tix`-4 COMMUN1tY UIrVI✓1_OPMENt OI~PAMMENT <br /> 7t 10►l4 F tPA)Fllp11 AW SI(XIC1911 CA gj791 <br /> i <br /> IFgAe)`� tAW101'"EM SEmoiCE9 Morj 1709) Obs 3170 <br /> MMI MPO Mror1F hoar 46A 7o7D <br /> r"FmIn rotoprF p(lgj 460 777, <br /> t1EK311[1cAMKm rnESEnvAiiuF!n"* 12981 160 3011 <br /> DACKFIGh EACAVATTUtI CERTIFICATE <br /> ojecL 1.,ocaLlott Valley Wholesale Drug Co. Inc. <br /> tier Sarne as above <br /> 4'1lnne No. (209)466-1851 <br /> tilt ncLor Jim Thorpe Oil, Inc I')rptte Flo. (209)368-6175 License No. 495699 <br /> IIIVICAT9 IIETtton or McrwiLL QVALITT ASSutI)icn <br /> i +Ihmlaslnn of Soil rnglneer's compaction Report~ within 30 days of project: <br /> complPtlon, or <br /> 7 41thmlaAlvn of vorificalion, P q load ticket, within 3o days of project <br /> completJon that one of the following materials was placed In the excavation in <br /> !7•' ilftst <br /> A t'ra grhvrl - nmooth, rounded material not more than one-half 11/2) <br /> Inch in diameter. <br /> 8 Crrrghed rock - self-compacting material not more Lhan three-quarters <br /> (3/4) Inch In crone sectional measurement. (Use of crushed rock <br /> will riot be permitted for backfill if contact will be made between <br /> fhP ItackfIIl maLerlal and tanks I es made of 1 <br /> similar materials ) /p p poly resin glass or <br /> DECLARATIon <br /> preby certify that a Sol! Engineer's Compaction Report will be submitted within 30 days <br /> rn)ocF completion, or "bmisrtion of verification that the select material described above <br /> 1 hP pincld at a rain}mum of flame (5) cublc y-irft per 1000 gallon tank displacement: and <br /> t t}re '""ra exc"Ri'10n will 11r har Mlled and compActed to Insure compliance with the <br /> foxm Building Code Appendix Chapter 10 <br /> Jim Thorpe Oil, Inc./Contractor <br /> Richard Thorpe <br /> Name <br /> President <br /> (l'r.int) <br /> A / <br /> Signature <br /> 51ta1 > be the resVolisible marlagirtg employee pn the <br /> agetiL. license or authorized <br /> LC/P8C9nT DoC <br /> i <br />