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�Isv <br />Soil Liner Fill <br />Acceptance Form amec <br />foster <br />wheeler <br />CLIENT: Cripple Creek & Victor Mining Co. Page <br />of� <br />PROJECT: Squaw Gulch VLF Phase I Weather <br />SUVs 1 <br />PROJECT NUMBER: 74201125N0 Date_ <br />Work Activity: Soil Liner Fill <br />Area/Location: See attached sketch <br />Items Depth of Soil Liner Fill verified <br />Inspected: Nontyeilding surface. <br />No visible low/ponding areas <br />Free of unacceptable materials. <br />Tests Nuclear density testing Moisture/Density Lab Tests <br />Completed: Laboratory testing Permeability Testing <br />Survey Complete <br />Deficient <br />Items: <br />Remedial <br />Action: <br />Accepted: Yes_ No <br />Explain: Sp,� ic r I rlr�if CD(4 <br />t <br />Signatures <br />AMEC Other <br />Ames Other <br />CC&V ,� Other <br />