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2010-11-15_REVISION - M1980244 (175)
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2010-11-15_REVISION - M1980244 (175)
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Last modified
6/15/2021 5:52:28 PM
Creation date
7/27/2011 12:43:22 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.3, PSSA Pri. Liner Subg. Accept. 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 />BASED UPON VISUAL OBSERVATION ONLY <br />• <br />GEOSYNTHETIC INSTALLER PROJECT <br />COMPANY: Lonestar Lining Co. LOCATION: Cresson Project <br />ADDRESS: 4520 Half Crown Drive PROJECT: CC&V CQA Phase 5 <br />Dallas, TX 75237 OWNER: Cripple Creek and Victor Gold <br />I, the Undersigned, the duly authorized representative of <br />do hereby accept the area of soil surface bounded by <br />t LS - - P - 13 <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 />• (?142L ij i <br />NAME SI ATURE <br />I, the Undersigned, the duly authorized representative of the CQA Engineer do hereby accept the <br />area of soil surface bounded by <br />M ety NAME SIGN TURE TITLE DATE <br />Lonestar Lining Co. <br />TITLE <br />DATE <br />(IL' <br />Reviewed by: Date: <br />
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