20110251 Ver 2_Certification of Completion_20130506

ARCADIS
Infrastructure -Water Environment. Buildings
Ms. Sue Homewood
NCDENR—DWQ
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Subject
DWQ Project No. 11-0251 v2
Winston-Salem, Stream Restoration/Bank Stabilization Improvements
Phases 1 and 2
Dear Ms. Homewood:
Enclosed is a 401 Certificate of Completion along with a CD containing project -
specific photographs.
N.C.Dept. of ENR
MAY 0 6 2013
Please do not hesitate to contact me if you have any questions or need additional
information.
Sincerely,
ARCADIS G&M of North Carolina, Inc.
Linda Pass, PE
Project Manager
Copies
Mr. Mike Patton, Winston-Salem/Forsyth County Utility Commission
Imagine the result
of North Carolina, Inc.
Suite 208
Greensboro
North Carolina 27407
Tel [phone]
Fax [phone]
www.arcadis-us.com
Date
May 3, 2013
Contact
Linda Pass, PE
Phone
336.292.2271
Email
linda.pass@arcadis-
us.com
ARCADIS G&M of North Carolina,
Inc.
NC Engineering License # C-1869
NC Surveying License # C-1869
g 1protectWAnston-salem nclncdenr 401 Itr docx \ y
/1 IJ

NIMA
NCDEE R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
DWQ Project No.: #11-0251 v2 County: ForsyLh
Applicant: Mr. Mike Patton, PE, Winston-Salem /Forsyth County Utility Commission
Project Name: Distribution & Collection Infrastructure Improvements & Stream Restoration/Bank
Stabilization Imvrovements, Phases 1 and 2
Date of Issuance of 401 Water Quality Certification: September 26, 2011
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 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: Date:
If this project was designed by a Certified Professional
I, Linda L. Pass , as a duly registered Professional Engineer (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically, weekly,
full time) the construction of the project, for the Permitee hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the c*nslit�t that the "construction was observed to be built within substantial
compliance and intent of the 401 W ation and Buffer Rules, the approved plans and specifications, and
other suvnortind�mateM s.'_'_'!�..
Signature:
Date M,
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
Location: 512 N Salisbury St Floor 9 Raleigh North Carolina 27603
Phone- 919-807-63011 FAX: [phone]
Internet: www.ncwaterqualq.org
An Equal Opportunity 1 Affirmative Action Employer
Registration No. 023500
Nb11e
Carolina
aturullb,

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