HomeMy WebLinkAbout20220863 Ver 1_Approval Letter_20221020ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHAM E. ROGERS, JR.
Director
NORTH CAROLINA
Environmental Quality
October 20, 2022
DWR # 2022-0863 v1
Craven County
Quail Woods Village Ltd.
Attn: Rose Anderson
211 Wilson Point Road
New Bern, North Carolina 28562
Subject: Approval of Individual 401 Water Quality Certification
Refuge at Broad Creek
USACE Action ID. No. SAW-2019-00684
Dear Ms. Anderson:
Attached hereto is a copy of Certification No. WQC005067 issued to Rose Anderson and Quail Woods
Village Ltd., dated October 20, 2022. This approval is for the purpose and design described in your
application. The plans and specifications for this project are incorporated by reference as part of this
Water Quality Certification. If you change your project, you must notify the Division and you may be
required to submit a new application package with the appropriate fee. If the property is sold, the new
owner must be given a copy of this Certification and is responsible for complying with all conditions. [15A
NCAC 02H .0507(d)(2)].
This Water Quality Certification does not relieve the permittee of the responsibility to obtain all other
required Federal, State, or Local approvals before proceeding with the project, including those required
by, but not limited to, Sediment and Erosion Control, Non -Discharge, Water Supply Watershed, and
Trout Buffer regulations.
This Water Quality Certification neither grants nor affirms any property right, license, or privilege in any
lands or waters, or any right of use in any waters. This Water Quality Certification does not authorize
any person to interfere with the riparian rights, littoral rights, or water use rights of any other person
and does not create any prescriptive right or any right of priority regarding any usage of water. This
Water Quality Certification shall not be interposed as a defense in any action respecting the
determination of riparian or littoral rights or other rights to water use. No consumptive user is deemed
by virtue of this Water Quality Certification to possess any prescriptive or other right of priority with
respect to any other consumptive user.
Upon the presentation of proper credentials, the Division may inspect the property.
This Water Quality Certification shall expire on the same day as the expiration date of the corresponding
Section 404 Permit. The conditions shall remain in effect for the life of the project, regardless of the
expiration date of this Water Quality Certification.
D E Q ,�/ North Carolina Department of Environmental Quality I Division of Water Resources
v 512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA � 919.707.9000
oepMem of Envlmnmenml aeel�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 2 of 10
Non-compliance with or violation of the conditions herein set forth may result in revocation of this
Water Quality Certification for the project and may also result in criminal and/or civil penalties.
If you are unable to comply with any of the conditions of this Water Quality Certification you must notify
the Washington Regional Office within 24 hours (or the next business day if a weekend or holiday) from
the time the permittee becomes aware of the circumstances.
The permittee shall report to the Washington Regional Office any noncompliance with, and/or any
violation of, stream or wetland standards [15A NCAC 02B .0200] including but not limited to sediment
impacts to streams or wetlands. Information shall be provided orally within 24 hours (or the next
business day if a weekend or holiday) from the time the permittee became aware of the non-compliance
circumstances.
This approval and its conditions are final and binding unless contested [G.S. 143-215.5]. Please be aware
that impacting waters without first applying for and securing the issuance of a 401 Water Quality
Certification violates Title 15A of the North Carolina Administrative Code (NCAC) 2H .0500. Title 15A
NCAC 2H .0500 requires certifications pursuant to Section 401 of the Clean Water Act whenever
construction or operation of facilities will result in a discharge into navigable waters, including wetlands,
as described in 33 Code of Federal Regulations (CFR) Part 323. It also states any person desiring
issuance of the State certification or coverage under a general certification required by Section 401 of
the Federal Water Pollution Control Act shall file with the Director of the North Carolina Division of
Water Quality. Pursuant to G.S. 143-215.6A, these violations and any future violations are subject to a
civil penalty assessment of up to a maximum of $25,000.00 per day for each violation.
This Certification can be contested as provided in Chapter 150B of the North Carolina General Statutes by
filing a Petition for a Contested Case Hearing (Petition) with the North Carolina Office of Administrative
Hearings (OAH) within sixty (60) calendar days. Requirements for filing a Petition are set forth in Chapter
150B of the North Carolina General Statutes and Title 26 of the North Carolina Administrative Code.
Additional information regarding requirements for filing a Petition and Petition forms may be accessed at
http://www.ncoah.com/ or by calling the OAH Clerk's Office at (919) 431-3000.
A party filing a Petition must serve a copy of the Petition on:
William F. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh, NC 27699-1601
If the party filing the Petition is not the permittee, then the party must also serve the recipient of the
Certification in accordance with N.C.G.S 15013-23(a).
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
!!l 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
pepanmem of EnvlmnmenM1 Uual�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 3 of 10
This letter completes the Division's review under section 401 of the Clean Water Act and 15A NCAC 02H
.0500. Please contact Robert Tankard at 252-948-3921 or robert.tankard@ncdenr.gov if you have any
questions or concerns.
Sincerely,
Plow T""
Robert Tankard, Assistant Regional Supervisor
Water Quality Regional Operation Section
Division of Water Resources, NCDEQ
Washington Regional Office
Electronic cc: Kim Williams, kim.williams@davey.com
Emily Thompson, Emily.b.thompson@usace.army.mil
laserfiche
North Carolina Department of Environmental Quality I Division of Water Resources
NORTH CAROLINA
v 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000
oePere�am of �mronmanui o�si�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 4 of 10
NORTH CAROLINA 401 WATER QUALITY CERTIFICATION
CERTIFICATION #WQC005267 is issued in conformity with the requirements of Section 401, Public Laws
92-500 and 95-217 of the United States and subject to North Carolina's Regulations in 15 NCAC 02H .0500
and 15A NCAC 0213.0200, to Rose Anderson and Quail Woods Village Ltd., who have authorization for the
impacts listed below, as described within your application received by the N.C. Division of Water
Resources (Division) on June 23, 2022 and subsequent information on October 20, 2022, and by Public
Notice issued by the U. S. Army of Engineers on June 29, 2022.
The State of North Carolina certifies that this activity will comply with water quality requirements and
the applicable portions of Sections 301, 302, 303, 306, 307 of the Public Laws 92-500 and PL 95-217 if
conducted in accordance with the application, the supporting documentation, and conditions
hereinafter set forth.
The following impacts are hereby approved. No other impacts are approved, including incidental
impacts. [15A NCAC 02H .0506(b)]
Type of Impact
Amount Approved (units)
Permanent
Amount Approved (units)
Temporary
Stream
0 (linear feet)
0 (linear feet)
404/401 Wetlands
W1 -
0.47 (acres)
0 (acres)
Open Waters
0 (acres)
0 (acres)
This approval requires you to follow the conditions listed in the certification below.
CONDITIONS OF CERTIFICATION [15A NCAC 02H .0507(c)]:
1. Mitigation must be provided for the proposed impacts as specified in the table below. The
Division has received an acceptance letter from the Brice Creek Mitigation Bank to meet this
mitigation requirement. Until the Brice Creek Mitigation Bank receives and clears your
payment, and proof of payment has been provided to this Office, no impacts specified in this
Authorization Certificate shall occur. For accounting purposes, this Authorization
Certificate authorizes payment to the Brice Creek Mitigation Bank to meet the following
compensatory mitigation requirement [15A NCAC 02H .0506 (c)]:
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
!!l 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
pepanmem of EnvlmnmenM1 Uual�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 5 of 10
Compensatory Mitigation
Required
River and Sub -
basin Number
Stream
0 feet
Wetlands
1.0 acres
Neuse NEU10
Waters
0 acres
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. In determining that the proposed activity will
comply with state water quality standards (including designated uses, numeric criteria,
narrative criteria and the state's antidegradation policy), the project must provide for
replacement of existing uses through compensatory mitigation.
2. The permittee shall report to the DWR Washington Regional Office any noncompliance with,
and/or any violation of, stream or wetland standards [15A NCAC 02B .0200], including but not
limited to sediment impacts to streams or wetlands. Information shall be provided orally within
24 hours (or the next business day if a weekend or holiday) from the time the permittee became
aware of the non-compliance circumstances.
Citation: 15A NCAC 02H .0506(b); 15A NCAC 02H .0507(c)
Justification: Timely reporting of non-compliance is important in identifying and minimizing
detrimental impacts to water quality and avoiding impacts due to water pollution that precludes
any best use on a short-term or long-term basis.
3. No waste, spoil, solids, or fill of any kind shall occur in wetlands or waters beyond the footprint
of the approved impacts (including temporary impacts).
Citation: 15A NCAC 02H .0506, 15A NCAC 02H .0507(c)
Justification: Surface water quality standards require that conditions of waters be suitable for all
best uses provided for in state rule (including, at minimum: aquatic life propagation, survival,
and maintenance of biological integrity; wildlife, secondary contact recreation; agriculture), and
that activities must not cause water pollution that precludes any best use on a short-term or
long-term basis.
4. All activities shall be in compliance with any applicable State Regulated Riparian Buffer Rules in
Chapter 2B of Title 15A in the North Carolina Administrative Code.
Citation: 15A NCAC 02H .0506(b); 15A NCAC 02H .0507(c)
Justification: The referenced Riparian Buffer rules were adopted to address water quality
impairments and further protect existing uses.
North Carolina Department of Environmental Quality I Division of Water Resources
NORTH CAROLINA
v 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000
oePere�am of �mronmanui o�si�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 6 of 10
When applicable, all construction activities shall be performed and maintained in full
compliance with G.S. Chapter 113A Article 4 (Sediment and Pollution Control Act of 1973).
Regardless of applicability of the Sediment and Pollution Control Act, all projects shall
incorporate appropriate Best Management Practices for the control of sediment and erosion so
that no violations of state water quality standards, statutes, or rules occur.
Design, installation, operation, and maintenance of all sediment and erosion control measures
shall be equal to or exceed the requirements specified in the most recent version of the North
Carolina Sediment and Erosion Control Manual, or for linear transportation projects, the North
Caroline Department of Transportation Sediment and Erosion Control Manual.
All devices shall be maintained on all construction sites, borrow sites, and waste pile (spoil) sites,
including contractor -owned or leased borrow pits associated with the project. Sufficient
materials required for stabilization and/or repair of erosion control measures and stormwater
routing and treatment shall be on site at all times.
For borrow pit sites, the erosion and sediment control measures shall be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface Mining Manual. Reclamation measures and implementation shall comply with the
reclamation in accordance with the requirements of the Sedimentation Pollution Control Act
and the Mining Act of 1971.
Citation: 15A NCAC 02H .0506(b); 15A NCAC 02H .0507(c), 15A NCACO2B .0200; 15A NCAC 02B
.0231
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. Activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. As cited in Stream Standards: (12)
Oils, deleterious substances, or colored or other wastes: only such amounts as shall not render
the waters injurious to public health, secondary recreation, or to aquatic life and wildlife, or
adversely affect the palatability offish, aesthetic quality, or impair the waters for any designated
uses, and (21) turbidity in the receiving water shall not exceed 50 Nephelometric Turbidity Units
(NTU) in streams not designated as trout waters and 10 NTU in streams, lakes, or reservoirs
designated as trout waters, for lakes and reservoirs not designated as trout waters, the turbidity
shall not exceed 25 NTU; if turbidity exceeds these levels due to natural background conditions,
the existing turbidity level shall not be increased. As cited in Wetland Standards: (c)(1) Liquids,
fill or other solids, or dissolved gases shall not be present in amounts that may cause adverse
impacts on existing wetland uses, and (3) Materials producing color or odor shall not be present
in amounts that may cause adverse impacts on existing wetland uses.
6. Sediment and erosion control measures shall not be installed in wetland or waters except within
the footprint of temporary or permanent impacts otherwise authorized by this Certification. If
placed within authorized impact areas, then placement of such measures shall not be conducted
in a manner that results in dis-equilibrium of any wetlands, streambeds, or streambanks. Any
silt fence installed within wetlands shall be removed from wetlands and the natural grade
restored within two (2) months of the date that DEMLR or locally delegated program has
released the specific area within the project to ensure wetland standards are maintained upon
completion of the project.
North Carolina Department of Environmental Quality I Division of Water Resources
Q 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA �/ 919.707.9000
uepanmem ut enmmnmenrai aeai�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 7 of 10
Citation: 15A NCAC 02H .0506(b); 15A NCAC 02H .0507(c), 15A NCAC 02B .0200; 15A NCAC 02B
.0231
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. Activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. As cited in Stream Standards: (12)
Oils, deleterious substances, or colored or other wastes: only such amounts as shall not render
the waters injurious to public health, secondary recreation, or to aquatic life and wildlife, or
adversely affect the palatability offish, aesthetic quality, or impair the waters for any designated
uses; and (21) turbidity in the receiving water shall not exceed 50 Nephelometric Turbidity Units
(NTU) in streams not designated as trout waters and 10 NTU in streams, lakes, or reservoirs
designated as trout waters, for lakes and reservoirs not designated as trout waters, the turbidity
shall not exceed 25 NTU; if turbidity exceeds these levels due to natural background conditions,
the existing turbidity level shall not be increased. As cited in Wetland Standards: (c)(1) Liquids,
fill or other solids, or dissolved gases shall not be present in amounts that may cause adverse
impacts on existing wetland uses, and (3) Materials producing color or odor shall not be present
in amounts that may cause adverse impacts on existing wetland uses.
Erosion control matting that incorporates plastic mesh and/or plastic twine shall not be used
along streambanks or within wetlands.
Citation: 15A NCAC 02H .0506(b), 15A NCAC 02H .0507(c)
Justification: A project that affects waters shall not be permitted unless the existing uses
(including aquatic life propagation and biological integrity), and the water quality to protect
such uses, are protected. Protections are necessary to ensure any remaining surface waters or
wetlands, and any surface waters or wetlands downstream, continue to support existing uses
during and after project completion. The Division must evaluate if the activity has avoided and
minimized impacts to waters, would cause or contribute to a violation of standards, or would
result in secondary or cumulative impacts.
If the project is covered by NPDES Construction Stormwater Permit Number NCG010000 or
NPDES Construction Stormwater Permit Number NCG250000, full compliance with permit
conditions including the erosion & sedimentation control plan, inspections and maintenance,
self -monitoring, record keeping and reporting requirements is required.
Citation: 15A NCAC 02H .0506(b), 15A NCAC 02H .0507(c), 15A NCAC 02B .0200; 15A NCAC 02B
.0231
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. Activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. As cited in Stream Standards: (12)
Oils, deleterious substances, or colored or other wastes: only such amounts as shall not render
the waters injurious to public health, secondary recreation, or to aquatic life and wildlife, or
adversely affect the palatability offish, aesthetic quality, or impair the waters for any designated
uses, and (21) turbidity in the receiving water shall not exceed 50 Nephelometric Turbidity Units
(NTU) in streams not designated as trout waters and 10 NTU in streams, lakes, or reservoirs
designated as trout waters, for lakes and reservoirs not designated as trout waters, the turbidity
North Carolina Department of Environmental Quality I Division of Water Resources
Q 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
pepanmem of EnvlmnmenM1 Uual�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 8 of 10
shall not exceed 25 NTU; if turbidity exceeds these levels due to natural background conditions,
the existing turbidity level shall not be increased. As cited in Wetland Standards: (c)(1) Liquids,
fill or other solids, or dissolved gases shall not be present in amounts that may cause adverse
impacts on existing wetland uses, and (3) Materials producing color or odor shall not be present
in amounts that may cause adverse impacts on existing wetland uses.
9. If concrete is used during construction, then all necessary measures shall be taken to prevent
direct contact between uncured or curing concrete and waters of the state. Water that
inadvertently contacts uncured concrete shall not be discharged to waters of the state.
Citation: 15A 02H .0506(b), 15A NCAC 02H .0507(c), 15A NCAC 02B .0200, 15A NCAC 02B .0231
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. Activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. As cited in Stream Standards: (12)
Oils, deleterious substances, or colored or other wastes: only such amounts as shall not render
the waters injurious to public health, secondary recreation, or to aquatic life and wildlife, or
adversely affect the palatability offish, aesthetic quality, or impair the waters for any designated
uses. As cited in Wetland Standards: (c)(1) Liquids, fill or other solids, or dissolved gases shall not
be present in amounts that may cause adverse impacts on existing wetland uses; and (3)
Materials producing color or odor shall not be present in amounts that may cause adverse
impacts on existing wetland uses.
10. All mechanized equipment operated near surface waters shall be inspected and maintained
regularly to prevent contamination of surface waters from fuels, lubricants, hydraulic fluids, or
other toxic materials. Construction shall be staged in order to minimize the exposure of
equipment to surface waters to the maximum extent practicable. Fueling, lubrication, and
general equipment maintenance shall be performed in a manner to prevent, to the maximum
extent practicable, contamination of surface waters by fuels and oils.
Citation: 15A NCAC 02H .0506(b); 15A NCAC 02H .0507(c), 15A NCAC 02B .0200; 15A NCAC 02B
.0231
Justification: A project that affects waters shall not be permitted unless the existing uses, and the
water quality to protect such uses, are protected. Activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. As cited in Stream Standards: (12)
Oils, deleterious substances, or colored or other wastes: only such amounts as shall not render
the waters injurious to public health, secondary recreation, or to aquatic life and wildlife, or
adversely affect the palatability offish, aesthetic quality, or impair the waters for any designated
uses. As cited in Wetland Standards: (c)(1) Liquids, fill or other solids, or dissolved gases shall not
be present in amounts that may cause adverse impacts on existing wetland uses; and (3)
Materials producing color or odor shall not be present in amounts that may cause adverse
impacts on existing wetland uses.
11. Heavy equipment working in wetlands shall be placed on mats or other measures shall be taken
to minimize soil disturbance and compaction.
Citation: 15A NCAC 02H .0506(b), 15A NCAC 02H .0507(c), 15A NCAC 02B .0231
North Carolina Department of Environmental Quality I Division of Water Resources
Q 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
pepanmem of EnvlmnmenM1 Uual�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 9 of 10
Justification: Wetland standards require maintenance or enhancement of existing uses of
wetlands such that hydrologic conditions necessary to support natural biological and physical
characteristics are protected, populations of wetland flora and fauna are maintained to protect
biological integrity of the wetland; and materials or substances are not present in amounts that
may cause adverse impact on existing wetland uses.
12. In accordance with 143-215.85(b), the permittee shall report any petroleum spill of 25 gallons or
more; any spill regardless of amount that causes a sheen on surface waters; any petroleum spill
regardless of amount occurring within 100 feet of surface waters; and any petroleum spill less
than 25 gallons that cannot be cleaned up within 24 hours.
Citation: 15A NCAC 02H .0507(c), N.C.G.S 143-215.85(b)
Justification: Person(s) owning or having control over oil or other substances upon notice of
discharge must immediately notify the Department, or any of its agents or employees, of the
nature, location, and time of the discharge and of the measures which are being taken or are
proposed to be taken to contain and remove the discharge. This action is required in order to
contain or divert the substances to prevent entry into the surface waters. Surface water quality
standards require that conditions of waters be suitable for all best uses provided for in state rule
(including, at minimum: aquatic life propagation, survival, and maintenance of biological
integrity; wildlife, secondary contact recreation; agriculture), and that activities must not cause
water pollution that precludes any best use on a short-term or long-term basis.
13. The permittee and their authorized agents shall conduct all 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.
Citation: 15A NCAC 02H .0506(b), 15A NCAC 02H .0507(c)
Justification: Surface water quality standards require that conditions of waters be suitable for all
best uses provided for in state rule, and that activities must not cause water pollution that
precludes any best use on a short-term or long-term basis. The Division must evaluate if the
activity has avoided and minimized impacts to waters, would cause or contribute to a violation
of standards, or would result in secondary or cumulative impacts.
14. The permittee shall require its contractors and/or agents to comply with the terms and
conditions of this certification in the construction and maintenance of this project, and shall
provide each of its contractors and/or agents associated with the construction or maintenance
of this project with a copy of this Water Quality Certification. A copy of this Water Quality
Certification shall be available at the project site during the construction and maintenance of
this project.
Citation: 15A NCAC 02H .0506(b), 15A NCAC 02H .0507(c)
Justification: Those actually performing the work should be aware of the requirements of this
401 Water Quality Certification to minimize water quality impacts.
D E Q�� North Carolina Department of Environmental Quality I Division of Water Resources
!!l 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
pepanmem of EnvlmnmenM1 Uual�
Refuge at Broad Creek
DWR# 2022-0863
Individual Certification #WQC005267
Page 10 of 10
This approval to proceed with your proposed impacts or to conduct impacts to waters as depicted in
your application shall expire upon expiration of the 404 Permit. The conditions in effect on the date of
issuance shall remain in effect for the life of the project, regardless of the expiration date of this
Certification. [15A NCAC 02H .0507(c)]
This, the 20" day of October 2022
Plow T"
Robert Tankard, Assistant Regional Supervisor
Water Quality Regional Operation Section
Division of Water Resources, NCDEQ
Washington Regional Office
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA 919.707.9000
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ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
DWR Project No:
Applicant:
Project Name:
NORTH CAROLINA
Environmental Quality
401 Water Quality Certification Issued Date:
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 DWR
Central Office — Wetlands and Buffer Permitting Unit, NC DWR, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWR 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, , 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, , as a duly registered Professional (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 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:
D E Q ,�/ North Carolina Department of Environmental Quality I Division of Water Resources
v 512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA � 919.707.9000
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