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• <br />• <br />COMPANY: <br />ADDRESS: <br />CERTIFICATE OF ACCEPTANCE OF SOIL SURFACE <br />BASED UPON VISUAL OBSERVATION ONLY <br />GEOSYNTHETIC INSTALLER <br />Lonestar Lining Co. <br />4520 Half Crown Drive <br />Dallas, TX 75237 <br />I, the Undersigned, the duly authorized representative <br />of <br />do hereby ccept the area of soil surf cp bounded by <br />rrivit°,ls s- 2 j,(4 s - -3T_c7 <br />and shall be responsible for maintaining its integrity and suitability in accordance with the <br />project specifications from this date to the completion of the installation. <br />NA E SIGNATURE <br />I, the Undersigned, the duly authorized representative of the CQA Engineer do hereby accept the <br />area of soil surface bounded by <br />k.1%-1 e t } . <br />NAME / S GNATURE <br />Reviewed by: <br />Lonestar Lining Co. <br />amee <br />PROJECT <br />LOCATION: Cresson Project <br />PROJECT: CC &V CQA Phase 5 <br />OWNER: Cripple Creek and Victor Gold <br />TITL ' ' DA E <br />c o6//510 <br />TITLE DATE <br />it4 Date: {D 115110 <br />20 Jv <br />