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CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE <br /> BASED UPON VISUAL OBSERVATION ONLY <br /> GEOSYNTHETIC INSTALLER PROJECT <br /> COMPANY: Ames Construction, Inc. LOCATION: CC &V Gold Mine <br /> ADDRESS: 18450 E_ 28 Ave. PROJECT: Mill Site Earthworks <br /> Aurora, CO 80011 OWNER: Cripple Creek and Victor Gold <br /> I,the Undersigned,the duly authorized representative of Ames Construction, Inc. do hereby accept <br /> the area of soil surface bounded by 7 <br /> and shall be responsible for maintaining its integrity and suitability in accordance with the project <br /> specifications from this date to the completion of the installation. <br /> t/� Q' <br /> G Cs 1 V - � U fib� 9 C✓"<'��+�/t <br /> NAME SIGNATURE TITLE DATE <br /> I, the Undersigned, the duly authorized representative of the COA Engineer do hereby accept the <br /> area of soil surface bounded by <br /> le � Yid - ✓ � <br /> NAME SIGNATURE TITLE DATE <br />