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2009-12-21_REVISION - M1980244
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2009-12-21_REVISION - M1980244
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Entry Properties
Last modified
6/15/2021 5:52:24 PM
Creation date
12/30/2009 8:54:59 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. F, Subgrade Acceptance Forms
From
CC&V
To
DRMS
Type & Sequence
AM9
Media Type
D
Archive
No
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ame& <br />REA <br />3 <br />CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE <br />BASED UPON VISUAL OBSERVATION ONLY <br />GEOSYNTHETIC INSTALLER PROJECT <br />COMPANY: Lonestar LOCATION: Creson Project <br />ADDRESS: PROJECT: CCBV COA Phase 5 <br />OWNER: Cripple Creek and Victor Gold <br />1, the Undersigned, the duly authorized ropresentdive of d S�fIQ. <br />do hereby accept the area of soil surface shown in the attached skef5ch n <br />and shall be responsible for maholaing its Integrity and suitability in accordance with the project <br />speaftedons from this date to the completion of the installation. <br />• <br />I, the Undersigned, the duly authorized ropmmmtative of the CQA Engineer do hereby accept the area <br />of soil surface bounded by d.h Mdhtg) YVe A=6At~ SWSfC -'A . <br />AJNECEWM cad ffxWrmmm(a) <br />Reviewed by: < Daft: A1 <br />Approved by: j . tmpa Date• <br />
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