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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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• CERTIFICATE OF ACCE <br />GEOSYNTHETIC INSTALLER <br />COMPANY: ;~OLV-F/FX Ca~"{'~ LnC <br />ADDRESS: ,,~ue~ ~ 4? ,,w~cr- hw.t,{ Or. <br />'TANCE OF SOIL SURFACE <br />PROJECT <br />LOCATION ,D,/q ~E <br />PROJECT `,C~ Af/Id.IEir~L%~v~ir C'QA~Co <br />OWNER CC ti / <br />I, the Undersigned, the duly authorized representative of ~ /y j~~ X <br />do hereby accept the area of soil surface bounded by J,~y}~/e 5 C- 6 0 >7 / <br />and shall 6e 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 ACCEPTANCE RECEIVED BY CQA ENGINEER <br />`1'l oxk.~.. ~.,.~.-~-~ CQ at- S -z B-a y <br />NAME SIGNATURE .TITLE DATE <br />• Reviewed by: ''~ te: ~(°j~a~ <br />Approved by ~ Date: <br />File No: <br />GOLDER ASSOCIATES <br />
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