_REVISION - M1980244 ‎(29)‎

• Permit No: M1980244
• IBM Index Class Name: Revision
• Doc Name: Appendix F
• From: Cripple Creek & Victor Gold
• To: DMG
• Type & Sequence: AM8
• Media Type: D
• Archive: No

• CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE
GEOSYNTHETICINSTALLER PROJECT
COMPANY: ~pL~U- F/6'X LaM.'('r hC LOCATION /~.hASE TY
ADDRESS: .~ceo h~ .'"~c.,-;hn,c( CJr. PROJECT +rC: / D{/AJE //LivEir C©A~Co
f~.--end I%~w,r,~e, 7.~C ~SOSI OWNER CC /
1, the Undersigned, the duty authorized representative of Pel,,l ~C...K ~,.,,,~, C„
do hereby accept the area of soil surface bounded by ~,,,,~,1, ta,,..>..~ t-ass--~ ~ a~9 .
and shall be responsible for maintaining its integrity and suitability in accordance with the project
specifications from this date to the completion of the installation.

CERTIFICATE OF ACCEPTANCE RECEIVED BY COA ENGINEER

Reviewed by: Date:
Approved by: Date:
File No:

GOLDER ASSOCIATES