_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: Pc~, FE2F (p,;;g}.~, ~. LOCATION ~~u„os tU
ADDRESS: 2cce :.:: rV'win,i,..,:;'[ ice. PROJECT ~~y/ PL.e,..aiiy t ,~nC4'~=i~co
(-.; r~+Ct I~r c~a~..; I X -rc~: j i OWNER C:Citi
I, the Undersigned, the duly authorized representative of po(H- F(~ r1~,,,,s ~ ~,
do hereby accept the area of soil surrace bounded by Q,.
r~~ - J~A Ti > .
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 CQA ENGfNEER
NAME
c
TITLE DATE
. Reviewed by: Date:
.Approved by: Date:
File No:
GOLDER ASSOCLATES