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2009-12-21_REVISION - M1980244 (44)
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2009-12-21_REVISION - M1980244 (44)
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Entry Properties
Last modified
6/15/2021 5:52:23 PM
Creation date
12/30/2009 8:53:52 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980244
IBM Index Class Name
REVISION
Doc Date
12/21/2009
Doc Name
QA Liner Recert- App. A-G, Subgrade Acceptance Forms
From
CC&V
To
DRMS
Type & Sequence
AM9
Media Type
D
Archive
No
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CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE <br />GEOSYN - i HE IC INSTAL! �ER PROJECT <br />COMPANY: ,�� /�; _ =;F x C--� I nc LOCAT ION <br />ADDRESS: i� v��C. ^= h.,cC E7r. PROJECT ' / <br />�C f ✓ iJi�/°JF / ✓ Lin,t� C.xfi Cp <br />TX " - V S 1 OWNER Ce 1 ti <br />I, the Undersigned, the duly authorized representative of �r) /Vk x <br />do hereby accept the area of soil surface bounded by <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 />CERTIFICATE OF ACCEPTANCE RECEIVED BY CQA ENGINEER <br />SIGNATURE TI T LE DA 71 c <br />• Raviewed by: : /� <br />Approved by: Date: <br />He No: <br />GOLDER ASSOCL IES <br />NAME <br />SIGNATURE <br />TITLE <br />DATE <br />CERTIFICATE OF ACCEPTANCE RECEIVED BY CQA ENGINEER <br />SIGNATURE TI T LE DA 71 c <br />• Raviewed by: : /� <br />Approved by: Date: <br />He No: <br />GOLDER ASSOCL IES <br />
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