20090197 Ver 1_Certification of Completion_20110209

sa/isb~ryR~~;a~
MEMORANDUM
TO: 401/Wetlands Unit, NCDWQ
1650 Mail Service Center
Raleigh, NC, 27699-1650
FROM: Chris Tester, Utilities Engineer
DATE: February 4, 2011
° ~~~o~~ n
U
~~Q D 9 2011
D1ENR-WATERI~TY
~71ANpS ANp SrORMYYATER BRANCH
SUBJECT: 401 Water Quality Certification, DWQ Project # 09-0197
Please find the attached signed 401 Water Quality Certification for DWQ project # 09-
0197
Cl~u''i~ TP~'P.1'', ~
Salisbury-Rowan Utilities
[phone] (Office)
[phone] (Cell)
[phone] (Fax)
email: [e-mail]
1 Water Street Telephone [phone]
Salisbury, NC 28144 Salisbury-Rowan Utilities Fax [phone]

oox.~.~. oq
Certificate of Completion
D«'Q Project No. _ ~t i ~ County: ~~~~,_,,,,~
Applicant: ~r~`"J c~:._,,-~ ~~
Project Name: n ~(~ ~~ j~~ ~ r. ~~-
Date of Issuance of 401 Water Quality Certification: _ ~ / ~~ ;
r
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules,
and any subsequent modifications, the applicant is required to return this certif sate to the
-:O1%"~~~'ctiards Utrit, ;worth i~aroiina i~ivision of ti~rater Quality, 160 P~laii Service Center,l".aleigh,
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, `~-
~ttiZ~.S ~ ~S 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
b '1 ~~ h~ -
ut t wtt m 5ub~tanual compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the approved plans ands ecifications, and other supporting materials.
Signatur : _____ Date: z ~ ~~ 0
Agent s Certcfication ~®
~~ ~~
I, ~
hereby state that, to the best of my abilitie and ~ ~OJ
diligence was used in the observation of the construction such that the construction a~~d tol
built within substantial compliance and intent of the 401 V4rater Quality Certification and Bu ~~/JY
Rules, the approved plans and specifications, and other supporting materials. 'r~
Sig;~ature:
Date:
If this project was designed 6y 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
Perrnittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that th:; eenstruction was observed to built within substantial
compliance and ir_tent of the 401 ~~'ater Quality Certification and Buffer Rules, the approved plans
and specifications, and other supporting materials.
Signature: Registration No.: Date: