20100387 Ver 1_Certification of Completion_20120814

Certificate of Completion
DNN Q Project No
Applicant
Project Name
Z01
�T�4kp�q �Sq�RvU�`ry Z
County 6�L 'Q'RBRAtH
Date of Issuance of 401 Water Quality Certification Sure {�
Upon completion of all xNork appioved �kithin the 401 Watcr Quaht} Certification and Butler Rules
and any subsequent modifications the applicant is requned to return this certificate to the
401 /Wetlands Unit North Carolina D►kis►on of Water Quality 1621 Mail Ser\ ice Center Raleigh
NC 27699 1621 1-his toim ma) 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
4pplicant s Certification
iCl hereby state that to the btst of m) abilities due care and
diligence xNas used in the obser\ation of the construction such that the construction kNa
s obserN ed to
built xxithin substantial compliance and intent of the 401 Water Qual►t) Certification and Buftc.r
Rules the app�t�,,// ?,0 and s ieat►o is and other supporting materials
Signature Q� D ite �....
Agent's Certification
I hereb) state that to the best of m) abilities due care and
diligence N%as used in the obserNation of the construction such that the construction N\as obser\ed to
built Withm substantial compliance and intent of the 401 Water Qualit) Ccrtification and Butler
Rules the appioxed plans and specifications and other supporting materials
Signature
If this project it as designed b} a Certified Proftssional
Date
i as a duly registered Professional
(i e Engineer Landscape Architect Sur\e)or etc ) in the State of North Carolina havmi-, been
authorized to obscr\e (periodically \Aeekl) full time) the construction of the project for the
Peimittee hert-bv state that to the best of my abilities due ca►e and diligence \gas used in the
obser� ation of the construction such that the consti uction �� is obsei \ ed to built �k ith►n substanti it
compliance and intent of the 401 Water Quality Certification and Butter Rules the appro\ cd plans
anu specifications and other supporting materials
Signature Re�,�istration No Date

4
SR 1302, Crowders Mountain Rd
Pipe Replacement
Gaston County
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