20040158 Ver 1_Certification of Completion_20080428

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DWQ Project No.: 3461 040158 County: Chatham 4
Applicant: NC Department of Transportation ,y
Project Name: ___TIP: R-2610A&B US421 South of Siler City
Date of Issuance of 401 Water Quality Certification: May 10, 2004
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: 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, Jeffrey B. Loflin , 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 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 Registration No. 26998
Date Aril 22 0
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O o O` 53 Michael F. Easley, G r
William G. Ross Jr.,
North Carolina Department of Environment and Natural ou
Coleen H. Sullins, Di cto *IJ
Divisio of Dater ity
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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 276042260 (Location)
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EAsLEY DIVISION OF HIGHWAYS LYNDO TIPPETI'
GOVERNOR SECRETARY
April 22, 2008
PROJECT: 34481.3.2
CONTRACT NO.: C201282
F.A. PROJECT: State Funded
TIP NO.: R-261 OA & B
COUNTY: Chatham
DESCRIPTION: US 421 from South of ST-1007 (Plank Rd) at Gulf to 4 Lane
Bypass South of Siler City
MEMORANDUM TO: Mr. Tim Johnson, P.E.
Division Engineer
FROM: Jeff Loflin, P.E.
Resident Engineer /0/#
SUBJECT: Division of Water Quality Certification
Please find the attached DWQ Certification for the above mentioned project. Please review the
certification and forward to the North Carolina Division of Water Quality.
If this office can be of further assistance please advise.
cc: File
MAILING ADDRESS:
RESIDENT ENGINEER'S OFFICE
P. O. BOx 1164
AsHEBoRo. NC 27204
TELEPHONE: [phone]
FAX: [phone]
LOCATION:
272 DOT DRIVE
ASHEBORO, NC 27204
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