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ijll.GME CONSULTANTS, INC. <br />Geotechnical • Materia • Environmental <br />140CX) 21st Avenue Na <br />Mmeapois. MN 55447 <br />MODULAR BLOCK RETAINING WALL <br />PROJECT QUALITY CONTRACTOR - PROJECT COMPLETION FORM <br />(To be submitted to GME Consultants, Inc. upon completion of the job) <br />Project Name <br />Address <br />Wall Size <br />Wall Height: Maximum Minimum <br />Your Company Name <br />General Contractor <br />Wall Installer (if different) <br />Your Project Manager <br />Your Project Foreman <br />Completion Date <br />CERTIFICATION (to be signed by persons directly constructing and/or <br />supervising said construction) <br />I certify that the above noted project was completed in accordance with <br />the design recommendations. <br />Installer's Name Title <br />Installer's Signature Date <br />Company Officer Title <br />(Please Print) <br />Officer's Signature