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.... "" '(' "ION <br />CERilI1 .AI.. OF FLEXI.~LE MEMI)RANE LINER iNSTALLATION <br /> <br />PERMIT NO. ~ ~'~ ~"~ <br /> <br />Completed liner installations shall be visually checked for <br />punctures, rips, tears and seam discontinuities before placement <br />of any material or backfill. The installer is required to <br />manually check all factory a~d field seams. In lieu of or in <br />addition to a manual check, ,?-ither one of the following tests can <br />be performed. This form is ~?equired to be filled out completely, <br />signed and submitted by the i. nstaller as verification that the <br />liner evaluation and/or testing has been done. <br /> <br />I have visually checked the liner for punctures~ rips, tears and <br />seam discontinuities and hav.~ manually checked all factory and <br />field seams. <br /> <br />I have/have not (circle one) performed one or more of the <br />following liner tests: <br /> <br />[ ] WET TEST: <br /> <br />The l~.ned basin was flooded with water to <br />a leu..' (4) foot level and the leakage rate <br />over .~ 24 hour period wa[.; no greater than <br />0.25 inches. <br /> <br />[ ] AIR I~NCE TEST: <br /> <br />Ail s,~ams (factory and field) were <br />inspe,:ted for unbonded areas usir~g an air <br />nozzl,.~ device with a minimum 50 PSI air <br />suppl.' througl~ a 3/16 inch nozzle held not <br />more ',.~han 2 inches from the seam edge. <br /> <br />I certify that this fle×ible membrane liner and the installation <br />meets all requirements of earl 340-73-085. <br /> <br />Liner Manufacturer: <br /> <br />Installer Signature Date <br /> <br /> <br />