20110083 Ver 1_Certification of Completion_20110609

Strickland, Bev
From: Homewood, Sue
Sent: Thursday, June 09, 2011 4:14 PM
To: Dennison, Laurie; Strickland, Bev
Subject: for file
Attachments: D00060911-002.tif
Sue Homewood
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
City of Lexington
DWQ# 11-0083
February 14, 2011
Page 3 of 3
Permit ii NCG010000
DWQ Project No.: 11-0083
Applicant: City of Lexington
County: Davidson
Project Name; {water main to serve Moran Foods, Inc.
Date of Issuance of 401 Water Quality Certification: 2-14-2n t t
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 tlus certificate to the 40lfWetlands Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form maybe 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 Certi tcati n
1 iFrc o ublic Works Director 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 i tent f the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and
other supportin at ial // (n?Sign: ture: Date: tom - 7 "'70
Avent's Certi {cation
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 X_ 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.
y?
Signature • a.&, Registration No. oa594A
Date 6. °t • !