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(C: :OM A N C 1 CERTIFICATE OF PIPE PENETRATION <br />BOOT ACCEPTANCE <br />EN <br />;w-- pp� <br />ICOMANCO NSTALLER: <br />ENVIRONMENTAL CORPORATION <br />PROJECT NAME: Republic Forward Landfill PROJECT NO: 5093548 <br />LOCATION: 1 <br />• <br />'' OO -PANEL a NUMBERS: <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 ZZ` ' Uj #47 -and found the boot to be acceptable <br />for installation of the geomembrane. "F IR <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 />5�1_ G_Q'V-1 -I- -7%-> - — S 0 ti A k /I <br />Signature Title <br />�. 10 /11 r i b cl e. rt 2 1S)00% <br />Print Name -., Date <br />COMANCO <br />Signature <br />TECHNICIAN <br />COMANCO BOOT INSTALLTION TECHNICIAN <br />Signature <br />n so �� z <br />Print Name <br />(n. e <br />Title <br />&I I <br />Date <br />4eck h I C. t C&±1 <br />Title <br />S®� <br />Date <br />CQA INS WIN R REPRESENTATIVE / OWNER <br />CQA A400 <br />dar— <br />Signature Title <br />®54K11 5-b2C� 7 <br />Print Name Date <br />Rev. 11/26/08 <br />