20011347 Ver 1_Certification of Completion_20201005

Strickland, Bev
From: Herndon, T. Mason
Sent: Monday, October 5, 2020 10:10 AM
To: Steenhuis, Joanne
Subject: DWR# 20011347
Attachments: Sampson Bridge 376_20011347_DWR 401 CF.pdf
Attached is the CF for DWR# 20011347, Bridge 376 on SR 1838 (Beaman St) in Sampson Co. This was bridge was not
replaced under this approval and the permit expired. The bridge was later replaced in 2017/2018 as B-5307 under
DWR# 20171440 and a completion form has been submitted for this authorization. Please note the BIMS project
description list this as Bridge 378 and it should be 376.
Mason Herndon
Environmental Program Supervisor
Division 3
NCDOT- Division of Highways
910-341-2036 office
910-604-0050 mobile
[e-mail]
5501 Barbados Blvd
Castle Hayne, NC 28429
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
1

!WC
Water Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
secretary
S. JAY ZIMMERMAN
lhrecror
NCDWR Project No.: 20011347 County: Sampson
Applicant: NCDOT Division 3
Project Name: Bridge 376 on SR 1838
Date of Issuance of 401 Water Quality Certification: 11/7/2001
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 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be returned to NCDWR 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, , 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:
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.
Digitally signed by Mason Herndon
Signature: `-G" Date: 2020.10.05 10:01:38 -04'00'
Engineer's Certification
Partial Final
Date: 10/5/2020
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
Permiee 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 Registration No.
Date
State of North Carolina (Environmental Quality I Water Resources
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone]