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2004-10-18_REVISION - M1980244 (23)
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2004-10-18_REVISION - M1980244 (23)
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Entry Properties
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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CERTiFfCATE OF ACCE <br />GEOSYNTHETIC INSTALLER <br />COMPANY: ~n1V- =/6X ~:1'f~~ l~nc <br />ADDRESS: ~ce~. ~ AMC.-_.F.~..aC D~^~ <br />PTANGE OF SOIL SURFACE <br />PROJECT <br />LOCATION ,t~,~A,f E <br />PROJECT `G 1 ~/ pi~/~JE r/L%nr~n C'crA~Cc <br />OWNER CC { <br />I, the Undersigned, the duly authorized representative of ~ ° /X f ~cX <br />do hereby accept the area of soil surface bounded by A-,.e.s c -.~5 ~ ~ 69 <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 />NAME SIGNATURE TITLE DATE <br />CERTIFICATE OF,A~ACCEPTANCE RECEIVED BY CQA ENGINEER <br />NANfE SA NATURE TITLE DATE <br />• Reviewed by: Date: <br />Approved by: Date: <br />File Nd: <br />COLDER ASSOCIATES <br />
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