20090411 Ver 2_Certification of Completion_20120410

Lucas, Annette
From
Warren Sugg [WSugg @mulkeyinc com]
Sent
Tuesday April 10 2012 2 40 PM
To
Lucas Annette
Subject
DHHS Labs close out
Attachments
DWQ stormwater certification pdf
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Annette
I have attached the certification for DHHS labs project Thanks for your help
Waircn NI Bugg PI 1 H- Dll' \P
Nltilkcti I ngint -Lv, & Cow ult ints
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From Lucas Annette [mailto annette lucas(cbncdenr Qov]
Sent Thursday, March 15, 2012 8 53 AM
To Warren Sugg
Subject Closing out projects
Warren
After projects are completed a Certificate of Completion Form should be submitted to DWQ at the address below The
form can be found on the following web page (second from bottom)
http / /portal ncdenr ore/ web /wq /swp /ws/ 401 /certsandpermits /apply /forms
Please let me know if you have questions
Thanks
Annette
Annette M Lucas PE
Environmental Engineer
NCDENR I DWQ I Wetlands and Stormwater Branch
1650 Mail Service Center Raleigh NC 27699 1650 (M id)
512 N Salisbury St Raleigh NC 27604 ( 911 Floor (Location & I iic( ls)
Phone [phone] Fax [phone] Email !\mint 1 uc is r ncc'c nr cn
Website http //portal ncdenrorg/we`b/wq/swp/ws/401
`JA Before pi intro, this enrul pie-ise consider your budt,et and the environment
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
1

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North Carolina Department of Envllonment and Natural Resources
Divl,lon of Wat( r Qu 111ty
Beverly Eaves Perdue Coleen H SUIIIIIS
Governor Director
DWQ Ptoject No 2009 0411 County Wale
Applicant _ Department of Health and Human Services
Pi oJect Name —State Laboratory for Public Health & Medical Examiners Office
Date of Issuance of 401 Watei Quality Ceitification
(ci t►fic'111c of C on►plchon
Dee Freeman
Secretary
Upon completion of all woik appioNed within the 401 Watei Quality Certification of applicable Buffer Rules and an}
subsequent modifications the applicant is iequued to tetuin this certificate to the 401/Wetlands Unit North Carolina Division
of Water Quallt) 1650 Mail Service Centel Raleigh NC 27699 1650 This four may be returned to DWQ b) the applicant
the applicant s authorized agent of the pioJect engineer It is not necessary to send certificates fiorn all of these
Applicant s Cettafacatraa
I hereby state that to the best of n1) abilities due case and diligence was used
in the observation of the conshuction such that the conshuction wis observed to be built within substantial compliance and
intent of the 401 Watei Quility Certification and Buffer Rules the appio%ed plans and specifications and other supporting
mater ials
Signature
Agent s Certification
Date
hereby state that to the best of my abilities due care and diligence «as used
in the obseivation of the constluctron such that the conshuction x\ as obsei`,ed to be built within substantial compliance and
intent of the 401 Water Qualrt) Certification and Buffet Rules the appio\ed plans and specifications and other suppoiting
mater ials
Signature Date
If this pagject spas designed bi a Certified Aoftsstonal
1 �/A[ttzG�.4 M SvGu as a dull registered Professional (► a Engineer Landscape
r
Architect Surve)oi etc) in the State of North Carolina having been authorized to observe (peiiodically \Neekl) full time)
the conshuction of the pioject for the Peinutee lieteby state that to the best of m) abilities due cafe and diligence mas used
in the obseivat►on of the conshuction such that the constiuct►on was observed to be built within substantial compliance and
intent of the 401 Watei Quality Certification and Buffer Rules the approved plans and specifications and other suppoiting
mater ials
Signature
Date Z.-
T
1650 t lid Service Center Raleigh North Carolina 27699 1650
Location 512 N Salisbury St Floor 9 Raleigh North Caroline 2/603
Phone [phone] FAX [phone]
Intern ) %N r nwnterquali y org
An F11 I Opp rlun ly t AC r ),it i ct o t nip cr
Registration No 0'$Z413
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