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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 accept the area of soil surface bounded by � f � 7 y <br />Pga'le,l?s p -2 5 9 'y" r � ' /7` 2 <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 />A P.a <br />NA <br />E <br />Ce—A-4 <br />SIGNAT R <br />•4ea /ye ll y <br />NAME / GNATURE <br />Reviewed by: <br />JDIA <br />Lonestar Lining Co. <br />TITLE <br />ame.P <br />PROJECT <br />LOCATION: Cresson Project <br />PROJECT: CC &V CQA Phase 5 <br />OWNER: Cripple Creek and Victor Gold <br />I, the Undersigned, the duly authorized representative of the CQA Engineer do hereby accept the <br />area of soil surface bounded by <br />Date: $ l51ID <br />DATE <br />