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2010-11-15_REVISION - M1980244 (182)
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2010-11-15_REVISION - M1980244 (182)
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Last modified
6/15/2021 5:52:28 PM
Creation date
7/27/2011 12:43:14 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980244
IBM Index Class Name
REVISION
Doc Date
11/15/2010
Doc Name
QA Monitoring and Test Results 2010, VOL. III, Appendix G.2, PSSA Sec. Liner Subg. Accept. Forms.
From
CC&V
To
DRMS
Type & Sequence
AM9
Media Type
D
Archive
No
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• <br />• <br />amee) <br />Seq L. Sk.i. Cif' <br />Geotnetnitrane <br />Acceptance <br />ACE <br />Acceptance Notification <br />No. <br />Project <br />Activity <br />CC &V CQA Project No. 84201125E0 <br />Phase 5 Geomembrane Acceptance Date 06 /2 . f I v <br />The following area /activity is complete and conforms to the Technical Specifications: <br />After inspection of the ?? ?? geomembrane it was found to be acceptable and met project specifications. <br />Any deficiencies found during the inspection will be repaired. <br />/ 9 g 12 e <br />i / S S— 3 57 , --Mm. S - 3 -',' <br />l <br />Attach any additional or pertinent item /information requiring approval before final acceptance. <br />The following agree the above described area/acitvity is complete and in accordance <br />with the Technical Specifications, except as noted in the attachments. <br />Representing <br />Name <br />Signature <br />Date <br />Attachments <br />(Y/N) <br />/9h-ieG <br />/3 en Nlt° <br />/ 0 6 /21 / /I /n <br />/ <br />. - '- <br />-/nom <br />i <br />Description ofAttachments: <br />Reviewed By: _ND n Date: (0 r 2 Z J b <br />1 <br />• <br />• <br />amee) <br />
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