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2004-10-18_REVISION - M1980244 (23)
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2004-10-18_REVISION - M1980244 (23)
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Last modified
6/15/2021 5:49:52 PM
Creation date
11/21/2007 5:44:35 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980244
IBM Index Class Name
Revision
Doc Date
10/18/2004
Doc Name
Ph. IVc VOL.II Subgrade Accept. Forms
From
Golder Associates Inc.
To
DMG
Type & Sequence
AM8
Media Type
D
Archive
No
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• CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE <br />GEOSYNTHETICINSTALLER PROJECT <br />COMPANY: {~p~t/-r/FX Cans"(' 1hC LOCATION /'D/jRSE Tll <br />~~ <br />ADDRESS: ,~~, y. ~~,-7ho.r,C Or. PROJECT `~1 f ~J,NA.IE /i/L%iyEiz CQA~Cc <br />C~•^~»d P.~....~, 7X OS~~I OWNER / Gc <br />1, the Undersigned, the duly authorized representative of ~ / ~(i 1C <br />do he~re.b~y/ accept the area of soil surface bounded by p,,,~ ~; G _ a B <br />'-/h 2v C-3o~i <br />• <br />and shall be responsible for maintaining its integrity and suitability in accordance with the project <br />specifications from this date to the completion of the installation. <br />-0-77 NAME A URE TITLE DATE <br />CERTIFICATE OF ACCEPTANCE RECEIVED BY COA ENGINEER <br />(~-/9-a <br />• <br />Reviewed by ' ~ - C~ - O <br />Approved by: Date: <br />File Nb: <br />GOLDER ASSOCIATES <br />
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