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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 />G.OSYNTH=i'1C INST ~ ~ = PROJECT <br />COM?ANY: ~7/,,~_ -.'FX Ce-~=."!'~ l~aC LOChTION ,J.~iP ~ _ % k' <br />ADDRESS: ~~~. 4, ~~,.~:: 1,~„t,{ ~,,. PROJECT `C <br />(re.id ~'";,r.. lX ~SZ'S4 OWNER CC •. l~ . <br />!, the Undersigned, the duly authorized repr=sentative of ~y~~tX <br />do hereby accept the area of soil surface bounded by s - c. ~ S70 .rte 5 <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 />• <br />f ri e <br />NAME <br />O C.' 8- o ~- c~ ~i <br />DATE <br />TITLE <br />CERT1FfCATE OF ACCEPTANCE RECEIVED BY COA ENGINEER <br />_ NAME SIGNA I URE I iTLE DATE <br />• Revi=wad by fe: ~ -/O - ~ <br />Approved by: Date: <br />File No: <br />GOLD~ZASSOCLAT`~S <br />
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