6. Excavation closure :
Excavation site restored to normal / safe condition
Yes
Backfilled
Yes
No
Properly compactedYes
No
Reasphalted/repaired with concrete YesNo
Facilities/ supports restored Yes
No
Remarks :
Executer/ Permittee Name……………………………
Signature………………….. Date……….
Agree that excavation restored to our satisfaction.
Remarks :