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Geomembrane Acceptance Notification <br />Project CC &y CQA Project No. 8420112SE0 <br />Activity LOB GCL Installation Geomembrane Date to tot <br />The following area/activity is complete and conforms to the Technical Specifications: <br />After inspection of the 80 mil primary geomembrane, it was found to be acceptable and met project specifications. <br />Any deficiencies found during the inspection will be repaired. <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 />Am <br />y icKE <br />to /r— A I <br />/o -1'3- 1 <br />l L <br />1 fclt <br />1 rG <br />// <br />iL <br />Description of Attachments: <br />Reviewed By: Date: <br />