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ARCHIVED REPORTS_2009_26
EnvironmentalHealth
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4400 - Solid Waste Program
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ARCHIVED REPORTS_2009_26
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Entry Properties
Last modified
7/17/2020 3:53:35 PM
Creation date
7/3/2020 10:55:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
2009_26
RECORD_ID
PR0440005
PE
4433
FACILITY_ID
FA0004516
FACILITY_NAME
FORWARD DISPOSAL SITE
STREET_NUMBER
9999
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20106001-3, 5
CURRENT_STATUS
01
SITE_LOCATION
9999 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\SW\SW_4433_PR0440005_9999 AUSTIN_2009_26.tif
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EHD - Public
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O <br />(C: :OM A N DCO CERTIFICATE OF PIPE PENETRATION <br />.-, <br />BOOT <br />COMANCO ENVIRONMENTAL --•-. • <br />PROJECT NAME: Republic Forward Landfill PROJECT NO: 5093548 <br />LOCATION: <br />is <br />PIPE BOOTPANEL <br />The undersigned, J. Saenz / P. Medina ,certifies that he/she is a representative of COMANCO <br />Environmental Corporation authorized to execute this certificate, that he/she has inspected and verified the <br />Pipe Boot described above on /' " '&Q ® A- T and found the boot to be acceptable <br />for installation of the geomembrane. 1' 17, <br />This certification is based on the inspection of the pipe penetration boot only. No pipe installation inspections <br />or test have been performed and COMANCO Environmental Corporation makes no representations or <br />warranties regarding conditions which may exist below the surface of the subgrade. <br />AUTHORIZED REPRESENTATIVE OF COMANCO ENVIRONMENTAL <br />Signature Title <br />TIC r 11 1 rye 0 S A G.'l Z l 'sZC2 q <br />Print Name Date <br />COMANCO QUALITY T TECHNICIAN <br />Signature <br />/0 C" <br />Print Name <br />COMANCO BOOT INSTALLTION TECHNICIAN <br />Signature <br />�jr�4hU �c. �! <br />Print Name <br />e <br />Title <br />S-0-5 l o g <br />Date <br />TeCAnfc-fez <br />.Title <br />/®S /®cf <br />Date <br />CQA I O / W ER REPRESENTATIVE / OWNER <br />f�A Moo <br />Signature Title <br />PS�D9 <br />Print Name Date <br />Rev. 11/26/08 <br />
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