20120211 Ver 1_Approval Letter_20120604

ALVEWA
73A
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild P E
Governor Director
June 4 2012
Dr Greg Thorpe PhD Manager
Project Development and Environmental Analysis
North Carolina Department of Transportation
1548 Mail Service Center
Raleigh North Carolma 27699 1548
Subject 401 Water Quality Certification Pursuant to Section 401 of the Federal Clean Water Act and
RANDLEMAN BUFFER RULES with ADDITIONAL CONDITIONS for Proposed improvements to
Greensboro High Point Road (SR 1486 SR 412 1) from US 311 Bypass (future I 74) in High Point to
Hilltop Road m Greensboro Guilford County Federal Aid Project No STP 4121(1) State Project No
WBS Element No 34802 1 1 TIP U 2412 A &B/U2524AE
NCDWQ Project No 2012 0211
Dear Dr Thorpe
Attached hereto is a copy of Certification No 003924 issued to The North Carolina Department of Transportation
(NCDOT) dated June 4 2012
If we can be of further assistance do not hesitate to contact us
n S�mcerely
4,Xharles Wakild
Director
Attachments
cc Monte Matthews US Army Corps of Engineers Raleigh Field Office (electronic copy only)
Mike Mills PE Division 7 Engineer
Jerry Parker Division 7 Environmental Officer
Chris Mihtscher Environmental Protection Agency (electronic copy only)
Travis Wilson NC Wildlife Resources Commission (electronic copy only)
Beth Harmon Ecosystem Enhancement Program
Wetlands /401 Transportation Permitting Unit
File Copy
Transportation and Permitting Unit
1650 Mail Service Center Raleigh North Carolina 27699 1617
Location 512 N Salisbury St Raleigh North Carolina 27604
Phone [phone] FAX [phone]
Internet www ncwaterguality om
An Equal Opportunity 1 Affirmative Action Employer
Dee Freeman
Secretary
NorthCarohna

401 Water Quality Certification Pursuant to Section 401 of the Federal Clean Water Act and RANDLEMAN
BUFFER RULES with ADDITIONAL CONDITIONS
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 (NCDWQ) Regulations in
15 NCAC 2H 0500 and 15A NCAC 213 0250 This certification authorizes the NCDOT to impact 5593 linear feet
of jurisdictional streams 1 81 acres of jurisdictional wetlands 3 65 acres of open water, and 906306 square feet of
protected riparian buffers in Guilford County The project shall be constructed pursuant to the application dated
received February 24 2012 with additional information dated received March 15 2012 May 23 2012 and May 24
2012 The authorized impacts are as described below
Stream Impacts in the Cape Fear River Basin for U 2412A
Site
Permanent Fill in
Intermittent Stream
(linear ft)
Temporary Fill
in Intermittent
Stream (linear
ft)
Permanent
Fill in
Perennial
Stream
linear ft
Temporary
Fill in
Perennial
Stream (linear
ft )
Total Stream
Impact
(linear ft)
Stream
Impacts
Requiring
Mitigation
(linear ft
1
(ac)
265
34
34
0
2
Wetland
353
106
459
353
3A
213
11
503
7
224
0
313
307
64
331
19
371
0
4
336
17
353
336
6
283
21
304
283
7A
418
33
451
418
713
208
208
0
8
215
215
0
10A
100
100
0
lOB
40
40
80
0
11
492
55
547
492
12
82
82
0
13
24
40
64
0
14
29
0
29
0
Total
728
75
2157
561
3521
1882
Total Stream Impact for U2412A 3521 linear feet
Stream Im acts in the Cape Fear River Basin for U 2412B
Site
Permanent Fill in
Intermittent Stream
(linear ft)
Temporary Fill
in Intermittent
Stream (linear
ft)
Permanent
Fill in
Perennial
Stream
linear ft
Temporary
Fill in
Perennial
Stream (linear
ft )
Total Stream
Impact
(linear ft)
Stream
Impacts
Requiring
Mitigation
(linear ft
1
(ac)
265
51
316
265
2*
Wetland
295
20
315
295
3
ac
Im act ac)
503
7
510
503
4
331
19
350
331
5
455
33
488
455
6*
83
10
93
83
1932
140
2072
1932
Total Stream Impact for U 2412B/U 2524AE 2072 linear feet
*Sites 2 and 6 are the same stream
Wetland Impacts in the Cape Fear River Basin for U 2412A
Site
Fill
Fill
Excavation
Mechanized
Hand
Area under
Total
(ac)
(temporary)
(ac)
Clearing
Clearing
Bridge
Wetland
ac
ac
(ac)
ac
Im act ac)
2
022
005
027
4
003
003

7A
045
Fill
Excavation
004
Hand
Area under
049
8
002
(temporary)
(ac)
004
019
Bridge
025
11
008
ac
1 56
004
ac
ac
012
12
001
8770
40669
001
122007
002
Total
081
24155
0 14
018
019
0
118
Total Wetland Impact for U2412A 1 18 acres
Wetland Impacts in the Cape Fear River Basin for U 2412B/U 2524AE
Site
Fill
Fill
Excavation
Mechanized
Hand
Area under
Total
10A
(ac)
(temporary)
(ac)
Clearing
Clearing
Bridge
Wetland
13
1 56
ac
1 56
ac
ac
ac
Im act ac
2
007
8770
40669
001
122007
008
6
041
24155
0 14
<0 005
42000
0
055
42000
048
014
001
22048
22048
063
Total
24840
1254
23586
23586
70758
16144
Total Wetland Impact for U 2412B/U 2524AE 0 63 acres
O en Water Impacts in the Cap Fear River Basin for U 2412A
Site
Permanent Fill in Open
Waters ac
Temporary Fill in Open
Waters ac
Total Fill in Open Waters (ac)
2
060
060
10A
0 18
Zone 2
Buffer
Mitigation
Required
0 18
11
131
0
131
13
1 56
1 56
Total
365
3253
365
Total Open Water Impact for U 2412A 3 65 acres
Randleman Lake Riparian Buffer Impacts for U 2412A
Site
Zone 1
Impact
(sq ft)
minus
Wetlands
Zone 1
(sq ft)
= Zone
I
Buffers
(sq ft)
Zone 1
Buffer
Mitigation
Required
Zone 1
Buffer
Mitigation
Required
3 1 ratio
Zone 2
Impact
(sq ft)
minus
Wetlands
Zone 2
(sq ft)
= Zone 2
Buffers
(sq ft)
Zone 2
Buffer
Mitigation
Required
Zone 2
Buffer
Mitigation
Required
15 1 ratio
1
5622
0
5622
5622
16866
3253
0
3253
3253
4888
2
49439
8770
40669
40669
122007
26456
2301
24155
24155
36233
3
42000
0
42000
42000
126000
22048
0
22048
22048
33072
4
24840
1254
23586
23586
70758
16144
35
16109
16109
24164
5
13942
0
13942
30
90
11643
0
11643
1376
2064
6
20445
0
20445
20445
61335
11763
0
11763
11763
17645
7
42395
13883
28512
28512
85536
23822
4811
19011
19011
28517
8
16108
2980
13128
0
1 0
10647
4392
6255
0
0
9
22580
0
22580
0
0
15399
0
15399
704
1056
10
29383
0
29383
29383
88149
16667
0
16667
16667
25001
11
61508
4190
57318
57318
171954
29610
519
29091
29091
43637
12
19695
696
18999
18999
56997
5647
0
5647
5647
8471
13
43041
0
43041
43041
129123
192821
0
192821
192821
289232
14 1
1975
0
1975
1975
5925
680
0
680
680
1020
Totals
392973
31773
361200
311580
934740
v
386600
12058
374542
343325
515000
Total Buffer Impact for U 2412A 735742 square feet

Randleman Lake Riaarian Buffer Impacts for U 2412B/U 2524AE
Site
Zone I
minus
= Zone
Zone 1
Zone 1
Zone 2
minus
= Zone 2
Zone 2
Zone 2
Impact
Wetlands
1
Buffer
Buffer
Impact
Wetlands
Buffers
Buffer
Buffer
(sq ft)
Zone 1
Buffers
Mitigation
Mitigation
(sq ft)
Zone 2
(sq ft)
Mitigation
Mitigation
(sq ft)
(sq ft)
Required
Required
(sq ft)
Required
Required
3 1 ratio
1 5 1 ratio
1
17804
0
17804
17804
53412
11396
0
11396
11396
17094
2
12522
3122
9400
9400
28200
7294
30
7264
7264
10896
3
31864
0
31864
31864
95592
21239
0
21239
21239
31859
4
18850
0
18850
18850
56550
11157
0
11157
11157
16736
5
21169
0
21169
21169
63507
10491
0
10491
10491
15737
6
6412
1161
5251
0
0
5795
1116
4679
0
0
108621
4283
104338
99087
297261
67372
1146
66226
61547
92322
Totals
t
Total Buffer Impact for U 2412B/U 2524AE 170564 square feet
The application provides adequate assurance that the discharge of fill material into the waters of the Cape Fear River
Basin in conjunction 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 heremafter set forth
This approval is only valid for the purpose and design that you submitted in your application dated received
February 24 2012 with additional information dated received March 15 2012 May 23 2012 and May 24 2012
Should your project change you are required to notify the NCDWQ and 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 any 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) Additional buffer impacts may require compensatory mitigation
as described in 15A NCAC 0248 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 Coastal Stormwater Non discharge
and Water Supply watershed regulations This Certification shall expire on the same day as the expiration date of
the corresponding Corps of Engineers Permit
Condition(s) of Certification
Project Specific Conditions
1 All stormwater runoff shall be directed as sheetflow through stream buffers at nonerosive velocities unless
otherwise approved by this certification
2 All riparian buffers impacted by the placement of temporary fill or clearing activities shall be restored to the
preconstruction contours and revegetated Maintained buffers shall be permanently revegetated with non
woody species by the end of the growing season following completion of construction For the purpose of
this condition maintained buffer areas are defined as areas within the transportation corridor that will be
subject to regular NCDOT maintenance activities including mowing The area with non maintained buffers
shall be permanently revegetated with native woody species before the next growing season following
completion of construction
3 Pursuant to 15A NCAC 2B 0250 sediment and erosion control devices shall not be placed in Zone 1 of any
Randleman Buffer without prior approval by NCDWQ At this time NCDWQ has approved no sediment
and erosion control devices in Zone 1 outside of the approved project impacts anywhere on this project
Moreover sediment and erosion control devices shall be allowed m Zone 2 of the buffers provided that Zone
1 is not compromised and that discharge is released as diffuse flow
4 Any modifications to this 401 Water Quality Certification that propose additional stream impacts or
increased impervious surface requiring additional stormwater management may be subject the Jordan Water
Supply Nutrient Strategy [15A NCACO2B 0267] NCDOT shall coordinate with NCDWQ prior to
submitting a modification request to determine the applicability of the Jordan Water Supply Nutrient
Strategy This condition does not apply to major modifications for additional sections of the project that

were covered under the Finding of No Significant Impact or approved in the Avoidance and Minimization
stage of the project
5
The NCDOT Division Environmental Officer or Environmental Assistant will conduct a pre construction
meeting with all appropriate staff to ensure that the project supervisor and essential staff understand the
potential issues with stream and pipe alignment at the permitted site NCDWQ staff shall be invited to the
pre construction meeting
6
Two copies of the final construction drawings shall be furnished to NCDWQ Central Office prior to the pre
construction meeting The permittee shall provide written verification that the final construction drawings
comply with the permit drawings contained in the application dated February 24 2012 Any deviations from
the approved drawings are not authorized unless approved by the NC Division of Water Quality
7
Channel relocations shall be completed and stabilized and approved on site by DWQ staff prior to diverting
water into the new channel Stream banks shall be matted with coir fiber mattmg unless otherwise
approved in this certification Vegetation used for bank stabilization shall be limited to native riparian
vegetation and should include establishment of a vegetated buffer on both sides of the relocated channel to
the maximum extent practical Also rip rap may be allowed beyond the limits approved by this certification
if it Is necessary to maintain the physical integrity of the stream but the applicant must provide written
,justification and any calculations used to determine the extent of rip rap coverage requested Once the
stream has been turned into the new channel it may be necessary to relocate stranded fish to the new
channel to prevent fish kills
8
At locations where ponds will be drained proper measures will be taken to dram the pond with limited
impact to upstream and downstream channel stability as well as to native aquatic species Proper measures
will be taken to avoid sediment release and/or sediment accumulation downstream as a result of pond
draining If typical pond drammg techniques will create significant disturbance to native aquatic species
additional measures such as collection and relocation may be necessary to prevent a significant fish kill
NCDOT shall consult with NC Wildlife Resources staff to determine If there are any sensitive species and
the most appropriate measures to limit impacts to these species The permittee shall ensure that the
.jurisdictional stream channel above and below the drained pond remain stable and that no additional
impacts occur within the natural stream channel as a result of draining the pond
9
Bridge deck drams shall not discharge directly into the stream Stormwater shall be directed across the
bridge and pre treated through site appropriate means (grassed swales pre formed scour holes vegetated
buffers etc ) before entering the stream Please refer to the most current version of Stormwater Best
Management Practices
10
Bridge piles and bents shall be constructed using driven piles (hammer or vibratory) or drilled shaft
construction methods More specifically Jetting or other methods of pile driving are prohibited without prior
written approval from NCDWQ first
11
No drill slurry or water that has been in contact with uncured concrete shall be allowed to enter surface
waters This water shall be captured treated and disposed of properly
12
All pile driving or drilling activities shall be enclosed in turbidity curtains unless otherwise approved by
NCDWQ in this certification
13
All bridge construction shall be performed from the existing bridge temporary work bridges temporary
causeways or floating or sunken barges If work conditions require barges they shall be floated into
position and then sunk The barges shall not be sunk and then dragged into position Under no
circumstances should barges be dragged along the bottom of the surface water
14
If multiple pipes or barrels are required they shall be designed to mimic natural stream cross section as
closely as possible including pipes or barrels at flood plain elevation and/or sills where appropriate
Widening the stream channel should be avoided Stream channel widening at the inlet or outlet end of
structures typically decreases water velocity causing sediment deposition that requires increased
maintenance and disrupts aquatic life passage
15
Riprap shall not be placed in the active thalweg channel or placed in the streambed in a manner that
precludes aquatic life passage Bioengineering boulders or structures should be properly designed sized and
installed
16
The temporary stream impacts due to dewatermg activities shall be graded to preconstruction contours and
revegetated with appropriate native species
17
The stream channel shall be excavated no deeper than the natural bed material of the stream to the
maximum extent practicable Efforts must be made to minimize impacts to the stream banks as well as to
vegetation responsible for maintaining the stream bank stability Any applicable riparian buffer impact for
access to stream channel shall be temporary and be revegetated with native riparian species
18
Compensatory mitigation for 1932 linear feet of impact to streams is required for the U 2412B/U2524AE
project We understand that you have chosen to perform compensatory mitigation for impacts to streams
through the North Carolina Ecosystem Enhancement Program (EEP) and that the EEP has agreed to
implement the mitigation for the project EEP has indicated in a letter dated May 29 2012 that they will

assume responsibility for satisfying the federal Clean Water Act compensatory mitigation requirements for
the above referenced project in accordance with the EEP Mitigation Banking Instrument signed July 28 ,
2010
19 Compensatory mitigation for impacts to 99087 square feet of protected riparian buffers in Zone 1 and 61547
square feet of protected riparian buffers in Zone 2 shall be required for the U 241213/U2524AE project We
understand that you have chosen to perform compensatory mitigation for impacts to protected buffers
through use of the North Carolina Ecosystem Enhancement Program (EEP) Mitigation for unavoidable
impacts to Randleman Riparian Buffers shall be provided in the Cape Fear River Basin and done in
accordance with 15A NCAC 2B 0250 EEP has indicated in a letter dated May 29 2012 that they will
assume responsibility for satisfying the federal Clean Water Act compensatory mitigation requirements for
the above referenced project in accordance with the North Carolina Department of Environment and
Natural Resources Ecosystem Enhancement Program In Lieu Fee Instrument signed July 28 2010
20 Compensatory mitigation for impacts to 0 63 acres of riverme wetlands is required for the U
2412B/U2524AE project We understand that you have chosen to perform compensatory mitigation for
impacts to wetlands through the North Carolina Ecosystem Enhancement Program (EEP) and that the EEP
has agreed to implement the mitigation for the project EEP has indicated in a letter dated May 29 2012 that
they will assume responsibility for satisfying the federal Clean Water Act compensatory mitigation
requirements for the above referenced project in accordance with the North Carolina Department of
Environment and Natural Resources Ecosystem Enhancement Program In Lieu Fee Instrument signed July
28 2010
21 When final design plans are completed for U2412A a modification to the 401 Water Quality Certification
and the Randleman Lake Riparian Buffer Certification shall be submitted with five copies and fees to the NC
Division of Water Quality Final designs shall reflect all appropriate avoidance minimization and
mitigation for impacts to wetlands streams and other surface waters and buffers No construction activities
that impact any wetlands streams surface waters or buffers located in U 2412A shall begin until after the
permittee applies for and receives a written modification of the 401 Water Quality Certification and the
Randleman Lake Riparian Buffer Authorization from the NC Division of Water Quality This modification
shall include compensatory mitigation for applicable impacts to streams wetlands or riparian buffers
associated with U2412A
General Conditions
22 Unless otherwise approved in this certification placement of culverts and other structures in open waters and
streams shall be placed below the elevation of the streambed by one foot for all culverts with a diameter
greater than 48 inches and 20 percent of the culvert diameter for culverts having a diameter less than 48
inches to allow low flow passage of water and aquatic life 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 streambeds or banks adjacent to or upstream and down stream of the above
structures The applicant is required to provide evidence that the equilibrium is being maintained if requested
in writing by NCDWQ If this condition is unable to be met due to bedrock or other limiting features
encountered during construction please contact NCDWQ for guidance on how to proceed and to determine
whether or not a permit modification will be required
23 If concrete is used during construction a dry work area shall be maintained to prevent direct contact
between curing concrete and stream water Water that inadvertently contacts uncured concrete shall not be
discharged to surface waters due to the potential for elevated pH and possible aquatic life and fish kills
24 During the construction of the project no stagmg of equipment of any kind is permitted in waters of the
U S or protected riparian buffers
25 The dimension pattern and profile of the stream above and below the crossing shall not be modified
Disturbed floodplams and streams shall be restored to natural geomorphic conditions
26 The use of rip rap above the Normal High Water Mark shall be minimized Any rip rap placed for stream
stabilization shall be placed in stream channels in such a manner that it does not impede aquatic life
passage
27 The Permittee shall ensure that the final design drawings adhere to the permit and to the permit drawings
submitted for approval
28 All work in or adjacent to stream waters shall be conducted in a dry work area Approved BMP measures
from the most current version of NCDOT Construction and Maintenance Activities manual such as
sandbags rock berms cofferdams and other diversion structures shall be used to prevent excavation in
flowing water
29 Heavy equipment shall be operated from the banks rather than in the stream channel in order to minimize
sedimentation and reduce the introduction of other pollutants into the stream

30 All mechanized equipment operated near surface waters must be regularly inspected and maintained to
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 404 and/or Coastal Area Management Act Permit This Certification shall expire upon the
expiration of the 404 or CAMA permit
prevent contamination of stream waters from fuels lubricants hydraulic fluids or other toxic materials
C' 31
No rock sand or other materials shall be dredged from the stream channel except where authorized by this
certification
32
Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface
waters is prohibited
33
The permittee and its authorized agents shall conduct its activities in a manner consistent with State water
quality standards (including any requirements resulting from compliance with §303(d) of the Clean Water
Act) and any other appropriate requirements of State and Federal law If NCDWQ determines that such
standards or laws are not being met (including the failure to sustain a designated or achieved use) or that State
or federal law is being violated or that further conditions are necessary to assure compliance NCDWQ may
reevaluate and modify this certification
34
All fill slopes located in jurisdictional wetlands shall be placed at slopes no flatter than 3 1 unless otherwise
authorized by this certification
35
A copy of this Water Quality Certification shall be maintained on the construction site at all times In
addition the Water Quality Certification and all subsequent modifications if any shall be maintained with
the Division Engineer and the on site project manager
36
The outside buffer wetland or water boundary located within the construction corridor approved by this
authorization shall be clearly marked by highly visible fencing prior to any land disturbing activities Impacts
to areas within the fencing are prohibited unless otherwise authorized by this certification
37
The issuance of this certification does not exempt the Permittee from complying with any and all statutes
rules regulations or ordinances that may be imposed by other government agencies (i a local state and
federal) having jurisdiction including but not limited to applicable buffer rules stormwater management
rules soil erosion and sedimentation control requirements etc
38
The Permittee shall report any violations of this certification to the Division of Water Quality within 24 hours
of discovery
39
Upon completion of the project (including any impacts at associated borrow or waste sites) the NCDOT
Division Engineer shall complete and return the enclosed Certification of Completion Form to notify
NCDWQ when all work included in the 401 Certification has been completed
40
Native riparian vegetation must be reestablished in the riparian areas within the construction limits of the
project by the end of the growing season following completion of construction
41
There shall be no excavation from or waste disposal into jurisdictional wetlands or waters associated with
this permit without appropriate modification Should waste or borrow sites or access roads to waste or
borrow sites be located in wetlands or streams compensatory mitigation will be required since that is a direct
impact from road construction activities
42
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 Practices in order to
protect surface waters standards
a The erosion and sediment control measures for the project must be designed installed operated and
maintained in accordance with the most recent version of the North Carolina Sediment and Erosion
Control Planning and Design Manual
b The design installation operation and maintenance of the sediment and erosion control measures
must be such that they equal or exceed the requirements specified in the most recent version of the
North Carolina Sediment and Erosion Control Manual The devices shall be maintained on all
construction sites borrow sites and waste pile (spoil) projects including contractor owned or leased
borrow pits associated with the protect
C For borrow pit sites the erosion and sediment control measures must be designed installed operated
and maintained in accordance with the most recent version of the North Carolina Surface Mining
Manual
d The reclamation measures and implementation must comply with the reclamation in accordance with
the requirements of the Sedimentation Pollution Control Act
43
Sediment and erosion control measures shall not be placed in wetlands or waters unless otherwise approved
by 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 404 and/or Coastal Area Management Act Permit This Certification shall expire upon the
expiration of the 404 or CAMA permit

If you wish to contest any statement in the attached Certification you must file a petition for an administrative
hearing You may obtain the petition form from the office of Administrative hearings You must file the petition
with the office of Administrative Hearings within sixty (60) days of receipt of this notice A petition is considered
filed when it is received in the office of Administrative Hearings during normal office hours The Office of
Administrative Hearings accepts filings Monday through Friday between the hours of 8 00am and 5 OOpm except
for official state holidays The original and one (1) copy of the petition must be filed with the Office of
Administrative Hearings
The petition may be faxed provided the original and one copy of the document is received by the Office of
Administrative Hearings within five (5) business days following the faxed transmission
The mailing address for the Office of Administrative Hearings is
Office of Administrative Hearings
6714 Mail Service Center
Raleigh NC 27699 6714
Telephone [phone] Facsimile [phone]
A copy of the petition must also be served on DENR as follows
Mr William Cary General Counsel
Department of Environment and Natural Resources
1601 Mail Service Center
This the 4th day of June 2012
DIVISION OF WATER QUALITY
,./Charles Wakild
Director
WQC No 3924

NCDWQ Project No
Applicant
Protect Name
Date of Issuance of 401 Water Quality Certification
County
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 Quality 1650 Mail Service Center Raleigh NC 27699 1650 This form
may be returned to NCDWQ 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
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 and Buffer Rules 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
Permttee 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