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Soil Leer Fitt <br />Acceptance Fora. <br />4C� <br />camec <br />'bster <br />wheeler <br />CLIENT: Cripple Creek & Vidor Mining Co, <br />Page t of A - <br />PROJECT: Squaw Gulch VLF Phase I <br />Weather C"">`9 <br />PROJECT NUMBER: 74201125NO <br />Date fZ � <br />Work Activity: Soil Liner Fill <br />Area/Location: See attached sketch <br />Items Depth of Sail Liner Fill verified <br />Inspected-, Non-yeilding surface. <br />No visible low/ponding areas <br />Free of unacceptable materials. <br />Tests Nuclear density testing Moisture/Density Lab Tests <br />Completed: <br />t~aboratory Testing Perr„eabiiity testing <br />Survey Complete <br />Deficient <br />Items: <br />Remedial <br />Action: <br />Accepted: 'Yes � <br />No <br />Explain: <br />Signatures <br />AMr=C <br />Other <br />Ames <br />Other <br />CC&V <br />Other <br />