HomeMy WebLinkAbout20090788 Ver 1_Certification of Completion_20100622,.. _ A6
Joshua White
DWQ# 09-0788
August 6, 2009
Page 3 of 3
DWQ Project No.: q 07 H County: Sy l L'
Applicant: To S k Lv k., lam
Project Name: /0?/ ?'! ty KeY, (v yt;.P I ae; ee- A
o d
Date of Issuance of 401 Water Quality Certification:
_ ? D q
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,
1621 Mail Service Center, Raleigh, NC, 27699-1621. 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
1, R 5 Ix ? A, f- , 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 Certificati n and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature: Date: 11V / O
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:
Engineer's Certification
Partial Final
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 Permittee 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.
L-C-j 0 WJ-, st? i oil
,;UN 2 'y 2010
OENR - MTER QUALITY
WETLANDS AND STORgW.UIER BRANCH