20050142 Ver 2_Certification of Completion_20120113

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Certification of Completion
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DWQ Project No.: �(�Q� —d��{a �/� County: (/✓A�� �glFp_ 1�
Applicant: A LF-XAN1J<�,e- I t4yF-S77nM-r 6iZovP
Project Name: A temQD 3 ' lc FLO( , %Z-Ate.JGt[1 A.14L
Date of Issuance of Certification or Authorization: I /oe>
Certificate of Completion
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 certificate to the 401 Oversight/Express Permitting Unit,
North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, 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, , 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:
Agent's Certification
used in the observation of the
compliance and intent of the 401
and other supporting materials.
Signature:
Date:
' hereby state that, to the best of my abilities, due care and diligence was
construction such that the construction was observed to be built within substantial
Water Quality Certification and Buffer Rules, the approved plans and specifications,
Date:
If this project was designed by a Certified Professional
I, J(yJArV94,,-J t-t-A 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 Permiee hereby state that to the best of my abilities, due care
and diligence was used in the observation of the construction such �*atlffibTfts ction was observed to be built within
substantial complian a and intent of the 401 Water Quality !C@nr9��}'�t}�ffer Rules, the approved plans and
specifications, an er su o materials. Z�•��r�SS�p 9
Signature: Registration No. o Bate
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JOHN A. EDWARDS & COMPANY - TRANSMITTAL
TO: 401 Oversight/Express Permitting Unit, NCDWQ
FROM: Jon Callahan, PE, PLS 14 f7
DATE: January 12, 2012 SA'''�sT�R Z
RE: Certificate of Completion rFRB%cH
It was recently discovered that the COC had not been returned for the attached project.
During construction in 2008, we did make periodical observations of the project and it
was installed in substantial compliance with the 401 permit. Attached is a copy of the
original authorization and COC.
Thanks,
Jon Callahan
333 Wadc Avenue Telephone: [phone]
Post Office Box 10422 Fax: [phone]
Raleigh, North Carolina 27605 F.-Mail: info @jaeco corn