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SEP 01 '99 09:33 1111:1 C E1 S'*�F T-623 P.02A3 F-236 <br /> BACYUiLL E-XCAVAT1011 CE1tTIFICATF <br /> p-o3 t l ocatiotl <br /> 401 �a,4 4 Lim,a k y► �� <br /> l?hone NO. <br /> Qwner � %vt ASS 4�5�58 a <br /> No. <br /> Contrac or �+tl M C-0� ,e-b° ?aunt <br /> 07 5'� _l.icanse <br /> IIyAYCATE METHOD OF BACK 'TI-I-Q <br /> UAL.1Ty ".SSUE?ANCE <br /> Suhmissyon n£Soil <br /> s ion Re rt with'n 30 days Of pcnjea cornPledon'or <br /> l. >rag Campac( p° <br /> I.. Submissiau of vcriftCad", a : 1Wticcec, wimv 30 clays of F—j'=. complerxors &at ate or'r#e fo[l0w4 <br /> 4 materials Was <br /> placid�a the tzt:avwOu m l2 lifts: <br /> A. P"gravcE:smodrh, rounded txtaterEal not more.than Ono-half(112}lath in d:at <br /> shna three-gasra", (31a) itch ifl crass stxuflnal <br /> B. Cmhc+d ratio--self-coinpz1;Cjng material tlnE tnnrC ncd for backfila. if contact will be made between. <br /> meant mcmt. (Use of erushed rnctc�1 wc b �0=or sbniur t��aas.) <br /> the backfill muerW and makslpipcS <br /> poly <br /> DECLARATION <br /> eCt corn lotion, or SabMissiOn Of <br /> I hcrcby certify that a Soil E.ngin�cr's Compaction RepOrt will be sttbt3titaeci within 30 days of pcuj � r low slluu mrtic <br /> I x rcbyicc tttac the select uaasersal descn�d above will be placed at a taatttrnwst of five G5? euh:e x <br /> displacement and that ft erttire excavi6aa will be backfilled and compacted to insure cOatpliauce uirh the lfnifOtm Bu d'eug Cade <br /> �' :appendix Chapter 70. <br /> I L. r t-✓ <br /> auuc t U <br /> c10 K-4►r��✓ <br /> y <br /> E�a[utt: <br /> y Shalt be the responsble 17030 Z aZ employee all the 1iCmm or authorized agent. <br />