REP49590

• Permit No: M1994117
• IBM Index Class Name: Report
• Doc Date: 11/14/1995
• Doc Name: QUALITY ASSURANCE AND QUALITY CONTROL MANUAL
• Media Type: D
• Archive: No

IN
'NE PLASTICS, INC, -
SUBGRADE SURFACE ACCEPTANCE
PROJECT: JOB NUMBER:
LOCATION: DATE:
I, the undersigned duly authorized representative of In-Line Plastics, Inc., certify that
upon visual inspection the subgrade surface described below meets criteria for installation
of a mil flexible membrane liner. By signing below, however, In-Line
acknowledges no responsibility for the subgrade design, degree of moisture or
compaction, integrity, elevation, or maintenance thereof, in any way.
Approximate size of azea:
Description of
area:
In-Line Representative OwnerlContractor
Inspector
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