20170220 Ver 1_401_Certificate of Completion_379_20171017

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MICI-IAI3L S. RF.GAN
�n�r��iiu�r
Envir'anmrnlnl S.,IA1' LIMMF:RMAN
(.?u c'�li l )� n�,-� ��-r�„�
NCDWR Projecf No.: ZO �� Z� County: ��I�
Appucanr: �� -nrrr �]Vlsron� � — �1-J-f2�1K��LlLLS __.
Pr��jcct Namc: .�C._.� J7�j _ oV� . SQ.—Z"i IS �1��5 ICk �UA-�LYCi._ '2-��
D�dc of Issuancc of d01 Wntcr Qmilily Ccrliticatiun: __�. 9_ a � �_� ---- _—
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Ccrlifir.jle of Completiun
Upon compleliun of ��II wnrk ;ipproved �vi�hin the d01 Waler Qunlily Certilica�ion or ��pplic�ble Bullcr Rules, and
any subsequem modilica�ions, the applicani is raµiired io return this certificate to Ihe �701 Transportation Pennillin�
Unii, Nurlh Carolina Divisiun ol' Waler Rusourcev, 1G17 Mail Service Center, Raleigh, NC', _'7G99-IG17. This form
mpy be returned �o NCDWR by ihe applieont. Ihe applicanl's aulhori�ad agen�. or the prnject engineer. 1� is not
necessary to send ceniticntes li�om all uf Ihcse.
dpplicnnP.c Cerlrficnlin�i
.�' 9 ��" • .
L_�._{�(ij_. /w,! /.S _. , herehv st:ile lhal, lo Ihe besl of mp :dnlilics, duc c.irc and diliecncc
�vas used in Ihe observaiion uf ihe construclion such ihai [he conslruclion �vas observed lo be buil� �rithin subs�antiul
compli�nce and intent of the 401 W�ler Qu�ilily Cerlilicution �ind I3ulfer Rules, the approved plams and
specificaiions, �ncl oiher supporting materi;ils.
si�nann���� y///��� �.�o�J nare:/D —l.� -�/ %
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:Igeu!'s ' lificaRrn�
I, , hereby statu �h�iL �o the besl of my nbililies, due care and dilieence
was used in Ihe obseivaiion uf [hc construc�ion such diat the construction tiv;is ubserved to be built wilhin subslaniial
compliance and intcnl of the d01 W�Icr Qunlity Certi�ica�iun and f3ul'fer Rules, tl�e appruved plans and
sp�citicalions, nnd otlirr suppurting ma�cri;ils.
Signaiurc: . _ . . . _. Ua�e:
Engineer'.s Ce�liftcrrliou
P;u'litil I'inal
I, . as a duh� registered Prolossional E;nginecr in lhe Suue uf Norlh
Carolina, h�rving been awhorized lo obscrve (periodicallv, �veckly, full iime) the canslruction of Ihe project lur Ihe
Pemiiuee hereby state Ihat, In �he bes� ol'my abilities, due c.ue and diligence �vas used in the ubscrv��ion of ihc
eonstruction such ihai the consU'uctiun was obscived io be buili �vithin substaniial coinplit�nee nnd intent of the d01
Waler Qutilily Cerlilication and Bufl'a' Rules. Ihe �ipproved plans �md specilicatinns. and otlier supporling maferials.
Signature
Datc
Regish�alion No. _
"Nntliinq i'i)In�1[N�c�
tilalr nl' Munh Cnrolina � I[nvvunmenlW Ouala�
1017 piail tiiyricrCenirrl Italrigh. Nnnh C�,uoliva'7��49-IG17