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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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<:C=OMANCO <br />ENWRONMENTAL CORPORATION BOOT ACCEPTANCE <br />0 INSTALLER: COMANCO ENVIRONMENTAL CORPORATION <br />PROJECT NAME: Republic Forward Landfill PROJECT NO: 5093548 <br />LOCATION: 1/1 <br />%! W 4 T <br />PIPE BOOT NUMBER: 21 PANEL NUMBERS: / 6 <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 ) r • * W ® A41- and found the boot to be acceptable <br />for installation of the geomembrane. Ir— • 1 <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 />® Pm! <br />Signature <br />'e. r o A <br />Print Name <br />COMANCO QUALITY T TECHNICIAN <br />ignature <br />A<a e-Zp, <br />Print Name <br />COMANCO BOOT INSTALLTION TECHNICIAN <br />Signature <br />Pq r r`4, ot g SR cwt Z <br />Title <br />�sIIs/ ®moi <br />Date <br />e ` s <br />Title <br />46 // SLO <br />Date <br />e Ch •rfc,fg I,, <br />Title q <br />/®s o <br />Print Name Date <br />CQA IN R PRESENTATIVE / OWNER <br />(.QA go" "-fa r <br />Signature Title <br />eQsLac� <br />Print Name Date <br />Rev. 11/26/08 <br />
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