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_ Geomembrane Acceptance Form ■■NewFietds <br /> M Perspective.Vision.Solutions, <br /> Client: Cripple Creek&Victor Mining Co. Contractor: Ames <br /> Project: VLF2 Recertification Weather: "Y ' <br /> Project No.: 475.0106.026 Date: p <br /> -21 <br /> Panels: PRC-17 through PRC-32 <br /> Items Inspected: All seaming and repair work is complete in the accepted area <br /> All seams and repairs have been pressure tested or <br /> vacuum tested <br /> All destructive samples have been tested and meet project <br /> specifications <br /> As-built panel layout,deployment logs,seaming logs, <br /> pressure testing logs,vacuum testing logs,repair logs, <br /> and destructive testing logs have been reviewed and <br /> approved for DCF placement. <br /> Testing Performed: Pressure Testing Destructive Testing <br /> Vacuum Testing Survey Completed <br /> Deficient Items: <br /> Remedial Actions: <br /> Geomembrane Accepted: YES X - NO <br /> Comments: <br /> Signatures: <br /> NewFie Date: 07 0 f <br /> Ames: Date: -t <br /> Comanco Date: 7- - <br /> CC&V: Date: 7,9 <br /> Other: Date: <br />