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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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CERT(FIGA I E OF ACCE~ I „t~GE OF SOIL SURFACE <br />GcOSYNTH= rIC INSTA!_LE R P~OJ=CT <br />COIvtPANY: :~7/ ;~_ ~,~PX Cam-,"I~' l~aC LOCATION ' ~P.,-- <br />P' <br />ADDRESS: ~c~• ~; ~v~.,,F,~..:.C~,^. PROJECT `C 1 / i7i//'JE' ii/G;roe~ fG.4~fo <br />r.-~wd fr`.~,p., l~ ~SZSI OWNER Cc i% <br />I, the Undersigned, the duly authorized repr=_sentative of 1:, /, ~~ y <br />do hereby accept the area of soil surface bounded by ~~`,q,,,e - - f ,~ ~ C- (05~ <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 />NAME <br />I'a`~ <br />CERTlFfCATE OF ACCEPTANCE RECEIVED BY CQP, ENGINEER <br />NAME <br />• ~ ReV10Wed ate: O ~~~ - d Sl <br />Approved 6y: Date: <br />File No: <br />GOLD~ZASSOCLA~S <br />
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