20070546 Ver 1_Certification of Completion_20110701

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Michael F. Easley Governor
'- William G. Ross Jr., Se6etary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water puality

.applicant: ~,~s..,; Tr P C - Nr1\n-r
Project \ame: T"p -T„~„ ~ Rd ce r
Date of Issuance of 401 Rater Quality Certification:
~` ~/7 /o>
Certificate of Completion
Upon completion oCall work approved within the 40! ~~'ater Quality Certification or applicable Buffer Rules, and
am' subsequent modifications, the applicant is required to return this ceni0cate to the 40I Transportation Pemunin_o
Unit, North Carolina Division of Rater Quality, ]650 Mail Service Center, Raleigh, NC, 27699-16.0. This Corm
maybe remmed to DR'Q by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates Crom all of these.
Applicant's Certification
I, , hereb}' state that. [o the best of my abilities, due care and diligence
«as used in the obser~~ation of the construction such [liar the construction u~as obsen-ed to be built wi[hin substantial
compliance and intent of the 401 ~l'ater Quality Ceritcation and Buffer Rules, the approved plan; and
specifications, and other supporting materials.
Signature:
Date:
Agent's Certification
I, .hereby stale [hat, to the best of m.: abilities, due care and diheence
•sas used in the observation of the construction such that the construc[ion.ca; obsen~ed to be built «~ithin substantial
compliance and inten[ of the 40l ~~"a[er Qualit}' Certification and Buffer Rules, the approved plans and
>pecifica[ion>, and other;upponine materials.
Signanu,:
Date:
Engineer's Certification
Putiul / Fir.al
I, G6~ f°"~P`-S D?./tee , a, a duhr registered Pmfzssional Engineer in thz State of\orth
Carolina; ha•. mg been authonzed [o obsen~e (pariodiealle, «~eeklc. full timel the construction of the project for the
Penninee Irerebo state chat, to the best of m}' abilities, dve care and diligenx was used in the obsen~ation of the
construction such that the construction uas observed [o be built within substantial compliance and intent of the 101
\~ aler Qualir, Cert~ticanon and Buffer Rules, the appro~~ed plans and specifications, and other suppornn_ materials.
Si~nanire FQ~; I~o-~a _ 3365
Reeisnation \~o
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Transportation Per: nirying Unit
7650 Mait Service Censer, Raiegn, Hors Carolina 276991550
2327 Cra6vee 9oulevarC. Suite 250. Raiegn, North Carotina 2760a
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