HomeMy WebLinkAbout20120211 All Versions_Complete File_200604180v ?:., •?
DWa-iF
Dr. Greg Thorpe, PhD., Manager
Planning and Environmental Branch
North Carolina Department of Transportation
1548 Mail Service Center
Raleigh, North Carolina, 27699-1548
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
April 18, 2006
Subject: NCDOT TIP No. U-2525 B&C, Greensboro Eastern Loop, Guilford County
Dear Mr. Thorpe:
After reviewing the classifications of the streams in the project study area for the referenced project, we have
discovered that the project will impact numerous streams that have been identified as impaired and listed as §303(d)
waters of the state. In accordance the Division of Water Quality's Cumulative Impact Policy dated April 10, 2004
(attached for your reference) a quantitative cumulative impact analysis will need to be conducted for this project. If
you desire, we are available to assist you and your staff with the development of the analysis.
If you have any additional questions or require additional information please contact either myself at 919-733-5694
or Sue Homewood at 336-771-4964 or Sue.Homewood@ncmail.net.
Sinc ely,
John E. Hennessy
Transportation Permitting Unit
cc: Lisa Feller, PDEA, NCDOT
Todd Tugwell, USACE Raleigh Field Office
Chris Militscher, USEPA, c/o Fed. Hwy. Adm., 310 New Bern Avenue, Room 412, Raleigh, NC 27601
Sue Homewood, DWQ WSRO Office
DWQ 401/Wetlands Transportation Unit
NQ;thCarohna
Transportation Permitting Unit durl I'm
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: 919-733-1786 / FAX 919-733-68931 Internet: http://h2o.enr.state.nc.us/newetlands
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
OF W A TF9
4 QG
r
> -I
U ?
July 12, 2002
Mr. William D. Gilmore, P.E., Manager
NCDOT Planning and Environmental Branch
1548 Mail Service Center
Raleigh, NC, 27699-1548
Dear Mr. Gilmore:
Re: Water Quality Certification Pursuant to §401 of the Federal Clean Water Act,
Greensboro Western Urban Loop from south of I-40 to north of Bryan Blvd.
F.A. Project No. STPNHF-NHF-124-1(1); State Project No. 8U492101
TIP No. U-2524 BA & BB
DWQ Project No. 011318
Attached hereto is a copy of Certification No. 3387 issued to The North Carolina Department of
Transportation dated July 12, 2002.
If we can be of further assistance, do not hesitate to contact us.
Sincerely,
Attachments
Alan W. Klimek, P.E.
cc: Wilmington District Corps of Engineers
Eric Alsmeyer, USACE Raleigh Field Office
Jennifer Frye, NCDWQ Winston-Salem Regional Office
Central Files
File Copy
WMENR
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), hftp://h2o.enr.state.nc.us/ncwetlands/
NORTH CAROLINA 401 WATER QUALITY CERTIFICATION
THIS CERTIFICATION is issued in conformity with the requirements of Section 401 Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality (DWQ)
Regulations in 15 NCAC 2H, Section .0500. This certification authorizes the NCDOT to incur the
following permanent impacts:
1. U-2524BA
¦ 1.74 acres of jurisdictional wetlands (through permanent fill, excavation, and mechanized clearing);
¦ 3,429 linear feet of stream channels.
This includes 0.79 acres of wetland impacts and 2,395 feet of stream loss in Hydrologic Unit 03030003
and 0.95 acres of wetland impacts and 1,034 feet of stream loss in Hydrologic Unit 03030002.
2. U-2524BB
¦ 0.13 acres of wetlands;
¦ 4,518 linear feet of stream channels.
These impacts occur in Hydrologic Unit 03030002.
Total combined impacts are 1.87 acres of wetlands and 7,947 linear feet of stream channels for the
combined project.
These impacts occur in Guilford County, as described in the Application dated 29 August 2001, and
additional information dated 29 May 2002 and 25 June 2002. The project shall be constructed pursuant to
the application dated August 29, 2001 and amended May 29, 2002 to construct Greensboro Western
Urban Loop from south of I-40 to north of Bryan Boulevard in Guilford County.
The application provides adequate assurance that the discharge of fill material into the waters of the state
with the proposed development will not result in a violation of applicable Water Quality Standards and
discharge guidelines. Therefore, the State of North Carolina certifies that this activity will not violate the
applicable portions of Sections 301, 302, 303, 306, 307 of PL 92-500 and PL 95-217 if conducted in
accordance with the application and conditions hereinafter set forth.
This approval is only valid for the purpose and design that you submitted in your application. Should
your project change, you are required to notify the DWQ in writing, and you may be required to submit a
new application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter, and is thereby responsible for complying with all the conditions. If additional wetland
impacts or stream impacts for this project (now or in the future) exceed one acre or 150 linear feet,
respectively, additional compensatory mitigation may be required as described in 15A NCAC 2H.0506
(h) (6) and (7). For this approval to remain valid, you are required to comply with all the conditions listed
below. In addition, you should obtain all other federal, state or local permits before proceeding with your
project including (but not limited to) Sediment and Erosion Control, Non-discharge and Water Supply
watershed regulations. This Certification shall expire three (3) years from the date of the cover letter
from DWQ or on the same day as the expiration date of the corresponding Corps of Engineers Permit,
whichever is sooner.
Condition(s) of Certification:
1. The applicant must follow the appropriate sediment and erosion control practices which equal or
exceed those outlined in the most recent version of the North Carolina Sediment and Erosion
Control Planning and Design Manual or the North Carolina Surface Mining Manual, whichever
is more appropriate (available from the Division of Land Resources (DLR) in the DENR
Regional or Central Offices) and shall be in full compliance with all specifications governing the
proper design, installation and operation and maintenance of such Best Management Practices in
order to assure compliance with the appropriate turbidity water quality standard (50 NTUs in all
fresh water streams and rivers not designated as trout waters; 25 NTUs in all lakes and
reservoirs, and all saltwater classes; and 10 NTUs in trout waters);
2. Sediment and erosion control measures shall not be placed in wetlands or waters to the
maximum extent practicable. If placement of sediment and erosion control devices in wetlands
and waters is unavoidable, they shall be removed and the natural grade restored after the
Division of Land Resources has released the project;
3. Storm water shall be directed to buffer areas or retention basins and should not be routed directly
into streams. Existing vegetated buffers shall not be mowed in order to utilize it for storm water
sheet flow.
4. During the construction of the project, the applicant shall strictly adhere to North Carolina
regulations entitled, Design Standards in Sensitive Watersheds (15A NCAC 4B .0124), for
activities undertaken in all waters classified as WS (Water Supply), including: Horsepen Creek,
and Long Branch, as well as their unnamed tributaries.
5. Live or fresh concrete shall not come into contact with waters of the state until the concrete has
hardened.
6. There shall be no excavation from or waste disposal into jurisdictional wetlands or waters
associated with this permit without appropriate modification of this Certification. If this occurs,
compensatory mitigation will be required since it is a direct impact from road construction
activities.
7. Placement of culverts and other structures in waters, streams, and wetlands shall be placed below
the elevation of the streambed to allow low flow passage of water and aquatic life unless it can
be shown to DWQ that providing passage would be impractical. Design and placement of
culverts and other structures including temporary erosion control measures shall not be
conducted in a manner that may result in dis-equilibrium of wetlands or stream beds or banks,
adjacent to or upstream and down stream of the above structures. The applicant is required to
provide evidence that the equilibrium shall be maintained if requested in writing by DWQ.
8. Mitigation: Compensatory mitigation shall be the same as that approved by the US Army Corps
of Engineers as long as the mitigation required equals a ratio of 1:1 restoration or creation of lost
wetland acres as described in 15A NCAC 2H.0506 (h)(6). A report must be submitted to the NC
Division of Water Quality that describes the final approved wetland and stream mitigation for
this project within two (2) months of the issuance of the 404 permit issued by the Army Corps of
Engineers.
¦ NCDOT has agreed to provide 2:1 mitigation for most perennial stream impacts except for
Site 6 of U-2524BA where a 1:1 mitigation ratio is proposed.
¦ Within HU 03030002, the wetland impact total is 1.08 acres, with needed mitigation of 2.16
acres; stream mitigation requirements total 8,240 linear feet.
¦ Within HU 03030003, the wetland impact total is 0.79 acres and 4,127 linear feet of stream.
NCDOT proposes to provide compensatory mitigation for the wetland impacts by providing the
following:
¦ Sandy Creek Mitigation Site (HU 03030003) in Randolph County (restoration of a
bottomland hardwood system at 1:1 mitigation ratio).
¦ Blue Tract Mitigation Site (HU 03030004) in Moore County at a mitigation ratio of 12:1.
NCDOT proposes to provide compensatory mitigation for the stream impacts by providing the
following:
¦ Starmount Forest County Club (HU 03030002) in Guilford County for 2,014 linear feet of
mitigation.
¦ Spring Valley Park Mitigation Site (HU 03030002) in Guilford County for 1,000 linear feet
of mitigation.
¦ Caviness Stream Mitigation Site (HU 03030003) in Randolph County for 2,690 linear feet
of stream.
The remaining compensatory stream mitigation shall be provided via in-lieu payments to
Wetlands Restoration Program which has accepted your payment for impacts associated with the
above referenced projects. In accordance with 15A NCAC 2R.0500, this contribution will satisfy
NC Division of Water Quality's compensatory mitigation requirements under 15A NCAC
2H.0506(h). Until plans are received and approved for the proposed mitigation sites, wetland or
stream fill shall not occur.
9. Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certification of Completion Form" to notify DWQ when all work included in the 401
Certification has been completed. The responsible party shall complete the attached form and
return it to the 401/Wetlands Unit of the Division of Water Quality upon completion of the
project.
10. The Applicant shall require its contractors (and/or agents) to comply with all of the terms of this
Certification, and shall provide each of its contractors (and/or agents) a copy of this
Certification.
Violations of any condition herein set forth shall result in revocation of this Certification and may result
in criminal and/or civil penalties. This Certification shall become null and void unless the above
conditions are made conditions of the Federal Permit. This Certification shall expire upon the expiration
of the 404 Permit.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition that conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
This the 12th day of July 2002
DIVISION OF WATER QUALITY
Alan W. Klimek, P.E.
WQC No. 3387
DWQ Project No.: County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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, , 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, the approved
plans and specifications, and other supporting materials.
Signature:
Date:
Agent'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, the approved
plans and specifications, and other supporting materials.
Signature:
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, the approved plans and
specifications, and other supporting materials.
Signature
Registration No.
Date
0
W ATF9
QG
r
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
June 19, 2003
Mr. Gregory J. Thorpe, Ph.D., Environmental Director
NCDOT Planning and Environmental Branch
1548 Mail Service Center
Raleigh, NC, 27699-1548
Dear Dr. Thorpe:
Re: MODIFICATION to Water Quality Certification Pursuant to §401 of the Federal Clean Water Act,
Greensboro Western Urban Loop from south of I40 to north of Bryan Blvd.
F.A. Project No. STPNHF-NHF-124-1(1); State Project No. 8U492101
TIP No. U-2524 BA & BB
DWQ Project No. 011318
Attached hereto is a copy of Certification No. 3387 issued to The North Carolina Department of
Transportation dated June 19, 2003.
If we can be of further assistance, do not hesitate to contact us.
Sincerely,
Alan W. Klimek, P.E.
Attachments
cc: Wilmington District Corps of Engineers
Eric Alsmeyer, USACE Raleigh Field Office
NCDWQ Winston-Salem Regional Office
Dasha Brown; Contract Administrator, Guilford County Attorney's Office
Sylvia Norman; City of Greensboro Attorney's Office
Kathy Matthews; US Environmental Protection Agency - Region IV
Ron Ferrell, NC Wetlands Restoration Program
Central Files
File Copy
fi-LL? e
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), hftp://h2o.enr.state.nc.us/ncwetlands/
NORTH CAROLINA 401 WATER QUALITY CERTIFICATION
THIS CERTIFICATION is issued in conformity with the requirements of Section 401 Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality (DWQ)
Regulations in 15 NCAC 2H, §.0500. This certification authorizes the NCDOT to incur the following
permanent impacts:
1. U-2524BA
¦ 1.74 acres of jurisdictional wetlands (through permanent fill, excavation, and mechanized clearing);
¦ 3,429 linear feet of stream channels.
This includes 0.95 acres of wetland impacts and 1,034 feet of stream loss in Hydrologic Unit 03030002
and 0.79 acres of wetland impacts and 2,395 feet of stream loss in Hydrologic Unit 03030003.
2. U-2524BB
¦ 0.13 acres of wetlands;
¦ 4,518 linear feet of stream channels.
These impacts occur in Hydrologic Unit 03030002.
Total impacts are 1.87 acres of wetlands and 7,947 linear feet of stream channels for the combined
projects.
These impacts occur in Guilford County, as described in the Application dated 29 August 2001, and
additional information dated 28 May 2002 and 25 June 2002. The project shall be constructed pursuant to
the application dated August 29, 2001 and amended May 28, 2002 to construct Greensboro Western
Urban Loop from south of I-40 to north of Bryan Boulevard in Guilford County.
The application provides adequate assurance that the discharge of fill material into the waters of the state
with the proposed development will not result in a violation of applicable Water Quality Standards and
discharge guidelines. Therefore, the State of North Carolina certifies that this activity will not violate the
applicable portions of Sections 301, 302, 303, 306, 307 of PL 92-500 and PL 95-217 if conducted in
accordance with the application and conditions hereinafter set forth.
This approval is only valid for the purpose and design that you submitted in your application. Should
your project change, you are required to notify the DWQ in writing, and you may be required to submit a
new application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter, and is thereby responsible for complying with all the conditions. If additional wetland
impacts or stream impacts for this project (now or in the future) exceed one acre or 150 linear feet,
respectively, additional compensatory mitigation may be required as described in 15A NCAC 2H .0506
(h) (6) and (7). For this approval to remain valid, you are required to comply with all the conditions listed
below. In addition, you should obtain all other federal, state or local permits before proceeding with your
project including (but not limited to) Sediment and Erosion Control, Non-discharge and Water Supply
watershed regulations. This Certification shall expire three (3) years from the date of the cover letter
from DWQ or on the same day as the expiration date of the corresponding Corps of Engineers Permit,
whichever is later.
Condition(s) of Certification:
1. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practice in
order to assure compliance with the appropriate turbidity water quality standard (50 NTUs in all fresh
water streams and rivers not designated as trout waters; 25 NTUs in all lakes and reservoirs, and all
saltwater classes; and 10 NTUs in trout waters).
a. Erosion and sediment control measures must equal or exceed the proper design, installation,
operation and maintenance outlined in the most recent version of the North Carolina Sediment
and Erosion Control Planning and Design Manual.
b. For borrow pit sites, the erosion and sediment control measures must equal or exceed the proper
design, installation, operation and maintenance outlined in the most recent version of the North
Carolina Surface Mining Manual.
c. NCDOT must develop a DOT-approved erosion and sediment control plan and implement and
maintain the control measures on all construction sites, borrow sites, and waste pile (spoil)
projects, including contractor owned or leased borrow pits associated with NCDOT projects.
d. NCDOT must implement and maintain a DOT-approved reclamation plan on all borrow pit and
waste pile (spoil) projects. The reclamation measures and implementation must comply with the
reclamation in accordance with the requirements of the Sedimentation Pollution Control Act.
e. NCDOT shall strictly adhere to North Carolina regulations entitled, Design Standards in Sensitive
Watersheds (15A NCAC 4B .0124 (b) -(e) only), for activities undertaken in all waters classified
as WS (Water Supply) and draining to the Critical Area, including: Horsepen Creek, and Long
Branch, as well as their unnamed tributaries. NCDOT will not be required to comply with 15A
NCAC 2B .0124(a), which restricts clearing to 20 acres at a time.
2. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within 30 days after the Division of
Land Resources has released the project.
For all streams that are not in the Randleman Lake watershed, stormwater shall be transported by
vegetated conveyance before discharge into the streams. For streams in the Randleman Lake
Watershed, stormwater shall be directed to flow as diffuse flow at non-erosive velocities across the
stream buffers using level spreaders, retention basins, pre-formed scour holes or other site-appropriate
devices. In either case, stormwater shall not be routed to flow directly into streams. Existing wooded
stream buffers shall not be mowed in order to allow them to provide diffuse stormwater flow and/or
streambank stabilization.
4. Live or fresh concrete shall not come into contact with waters of the state until the concrete has
hardened.
5. There shall be no excavation from or waste disposal into jurisdictional wetlands or waters associated
with this permit without appropriate modification of this Certification. If this occurs, compensatory
mitigation will be required since it is a direct impact from road construction activities.
6. Placement of culverts and other structures in waters, streams, and wetlands shall be placed below the
elevation of the streambed to allow low flow passage of water and aquatic life unless it can be shown
to DWQ that providing passage would be impractical. Design and placement of culverts and other
structures including temporary erosion control measures shall not be conducted in a manner that may
result in dis-equilibrium of wetlands or stream beds or banks, adjacent to or upstream and down
stream of the above structures. The applicant is required to provide evidence that the equilibrium shall
be maintained if requested in writing by DWQ.
7. Mitigation: Compensatory mitigation shall be the same as that approved by the US Army Corps of
Engineers as long as the mitigation required equals a ratio of 1:1 restoration or creation of lost
wetland acres as described in 15A NCAC 2H.0506 (h)(6). A report must be submitted to the NC
Division of Water Quality that describes the final approved wetland and stream mitigation for this
project within two (2) months of the issuance of the 404 permit issued by the Army Corps of
Engineers. NCDOT has agreed to provide 2:1 mitigation for most perennial stream impacts except
for Site 6 of U-2524BA where a 1:1 mitigation ratio is proposed.
¦ Within HU 03030002, the wetland impact total is 1.08 acres, with needed mitigation of
2.16 acres; stream mitigation requirements total 8,240 linear feet.
¦ Within HU 03030003, the wetland impact total is 0.79 acres; stream mitigation
requirements total 4,127 linear feet.
Wetland Mitigation
1. Compensatory Mitigation in HU 03030002 of 2.16 acres of wetlands shall be provided via in-lieu
payments to Wetlands Restoration Program, which has accepted your payment, for impacts
associated with the above referenced projects
2. NCDOT proposes to provide compensatory mitigation for all wetland impacts in HU 03030003
using the following sites:
¦ Sandy Creek Mitigation Site (HU 03030003) in Randolph County (restoration of a
bottomland hardwood wetland system at 1:1 mitigation ratio).
¦ Blue Tract Mitigation Site (HU 03030004) in Moore County at a mitigation ratio of 12:1.
Stream Mitigation
1. Compensatory mitigation in HU 03030002 of 8,240 linear feet of stream mitigation shall be
provided via in-lieu payments to Wetlands Restoration Program, which has accepted your
payment, for impacts associated with the above referenced projects.
2. NCDOT proposes to provide compensatory mitigation of 4,127 linear feet for all stream
impacts in HU 03030003 by providing the following:
¦ Starmount Forest County Club (HU 03030002) in Guilford County: 2,014 linear feet.
¦ Spring Valley Park Mitigation Site (HU 03030002) in Guilford County: 1,000 linear feet.
¦ Caviness Stream Mitigation Site (HU 03030003) in Randolph County: 1,113 linear feet.
In accordance with 15A NCAC 2R.0500, this contribution will satisfy NC Division of Water
Quality's compensatory mitigation requirements under 15A NCAC 2H.0506(h). Until plans are
received and approved for the proposed mitigation sites, wetland or stream fill shall not occur.
8. In accordance with the findings of the cumulative impact study dated May 2003 prepared by
Ecoscience Corporation, the anticipated cumulative impacts from this project shall be addressed via
written agreements between NC Division of Water Quality, Greensboro and Guilford County in
accordance with the appropriate signed agreements.
9. Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been
completed. The responsible party shall complete the attached form and return it to the 401/Wetlands
Unit of the Division of Water Quality upon completion of the project.
The Applicant shall require its contractors (and/or agents) to comply with all of the terms of this
Certification, and shall provide each of its contractors (and/or agents) a copy of this Certification.
Violations of any condition herein set forth may result in revocation of this Certification and may result
in criminal and/or civil penalties. This Certification shall become null and void unless the above
conditions are made conditions of the Federal Permit. This Certification shall expire upon the expiration
of the 404 Permit.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition that conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
This the 19th day of June 2003
DIVISION OF WATER QUALITY
Alan W. Klimek, P.E.
WQC No. 3387
DWQ Project No.: County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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, , 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, the approved
plans and specifications, and other supporting materials.
Signature:
Agent's Certification
Date:
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, the approved
plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
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, the approved plans and
specifications, and other supporting materials.
Signature
Registration No.
Date