20050062 Ver 1_050062_B-3887_401 CF_20200521

DWQ Project No: 050062 County: Pender
Applicant: North Carolina Department of Transportation
Project Name: B-3887, Bridge 116 over Shaken Creek on SR 1520
Date of Issuance of 401 Water Quality Certification: February 23, 2005
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules and any subsequent
modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina Division of Water Quality,
1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized
agent, or the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, H. Allen Poke , hereby state that to the best of my abilities, due care and diligence was used in
the observation of the construction such that the construction was observed to be built within substantial compliance and intent of the
401 Water Quality Certificat- and r Rules, the approved plans and specifications, other supporting materials.
Signature: Date: //
Agent's Certification
I, Mason Herndon hereby state that to the best of my abilities, due care and diligence was used in
the observation of the construction such that the construction was observed to be built within substantial compliance and intent of the
401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature: k!?�� S Date:
Engineer's Certification
Partial Final
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (periodically, weekly, full time) the construction of the project, for the Permittee hereby state that,
to the best of my abilities, due care and diligence was used in the observation of the construction such that the construction was
observed to be built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved
plans and specifications, and other supporting materials.
Signature:
Date:
Registration No.
I r � 0 W m
AUG 16 2006
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH