20070554 Ver 1_Certification of Completion_20110701

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Michael F. Easley, C+ovenfar
William G. Ross Jr., Secretary
North Carolina Department of Environment and NaNral Resources
Coleen H. Sullins, Director
Division of Water Quality
Count}: L"99'se
.applicant S, 'f. S T P F - A/GD~ %
Project \ame: ~,,,,,,,,, N•l% ad S -[32S
Dateo(Issuanceo(401 «aterQualit} Certification: Cf~_~/„rJ
Certificate o(Comple[ion
Cpon completion of all work approved within [he 40l ~t'ater Qualit; Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to remm this certificate to the 401 Transportation Pet-mittin~
^nit, worth Carolina Division of R'a[er Quality, 160 Mail Sen~ice Center, Raleigh, \C, 27699-160. This form
may be resumed to D~CQ 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' ,hereby ;tare that, to the best of my abilities, due care and diligence
tca~ used m the ob;zrcauon of the construction such that the construction sans obsen~ed to be built within substantial
compliance and intent o[ the 401 Rater Quality Certification and Buter Rules, the approved plan; and
specifications, and other supporting materials.
Signaturz:
Date:
Agent's Certification
I' hereby state that. to the best of me abilities, due care and diligence
'.vas u;ad m the observation of the construction such that the construction was obsen~ed to be built within subsnntial
compliance and intent of the 4Q1 ~~-arer Qualit}~ Certification and Buf[er Rules, the approved plan; and
specification;, and other supporting materials.
S l°_Ra nl; 2:
Date:
Engineer's Certification
Partin! ~_ Fi,^.ai
(, ~~j: r •( n~o. S Da •{ , a; a duI•: regi;tued Pmfes;ional Engineer in the Stare of \orth
Carolina; h~cmg been authorized [o observe (ptriodicall:, uezklc. full time) the construction of thz projeccfor the
Per:ninee herebc ;tare chat, to the best of m: abilities, due care and dilizenx was used in the ob;rn~ation of the
consrn:_tion such that the ron;t:uction ~.ca; observed to be buih «•ithin substantial comoiiance and intent of the 401
ll~a[e; Qualit: Certiticauon and Buffer Rule;, the appro,~ed plan; and specifications, and other supporting maeirials.
Signa~::r_
` Re_ci;rration \o. ~3/ti S
Date
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'`` ~ D
JUG 1 ZO11
Transportation Permitting Unil
1650 Mail Service Censer, Ralegh, NorA Carolina 27fi99.7650
232t Crabtree Balevard. Suite 250, Ralegn, North Carorma 2760a
Ptgne: 519-; 37-t78fi / PqX 919-733c897 r IntemeC hL'p ~in,2o =nr sea [e tic us/tic et'a Cs
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