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BACKFILL EXCAVATION CERTIFICATE <br /> Project Location RMC Lonestar, Inc. 30350 South Tracy Blvd. , Tracy. CA <br /> Owner RMC Lonestar Phone No. (510) 426-2279 <br /> Contractor Pacific Excavators Phone No. (510) 370-8783 License No. A 605513 <br /> INDICATE METHOD OF BACKFILL QUALITY ASSURANCE <br /> _ 1. Submission of Soil Engineer's Compaction Report within 30 days of project completion, or <br /> __Xg2. Submission of verification, e.g., load ticket,within 30 days of project completion that one of the following materials <br /> was placed in the excavation to 12" lifts: <br /> _ A. Pea gravel--smooth, rounded material not more than one-half(1/2) inch in diameter <br /> XX 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 <br /> the 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 roject completion,or submission <br /> of 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 <br /> Code Appendix Chapter 70. <br /> * Rita Mendez <br /> ame not <br /> * owner/ a i 'c Excav ors <br /> itnot <br /> * <br /> ignatur <br /> * Shall be the responsible managing employee on the license or authorized agen <br />