20091160 Ver 1_Certification of Completion_20121015

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins Dee Freeman
Governor Director Secretary
DWQ Project No Oq 11(0 County MeW i A,06%e
Applicant GTY dF Wl IJMI(WTC p Z64ZF5 S alcf?l�C A&M RIV1=.R ZS II.i�
Project Name GAS'RE IRMX: O: A�.d1,A"MEE FbOW, Aw1D mAPA WME F)&, N4 EAPA1.151 o*j
Date of Issuance of 401 Water Quality Certification 1 Z /4/0q
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 this certificate to the 401/Wetlands 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
Appheant'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 Cerhficatmn
Date
1, , 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
If this project was designed by a Cerh, fled Professional
I, MA193L, "I ; Ad2tZ.UR I , as a duly registened Professional FNCoIN Mi 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 Permitee 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 Is
Signature /v 61e** Registration No 2441 q
Date cc-T. 1 111 Zoi Z.
ID @��0w1 D 1650 Mad Service Center Raleigh North Carolina 27699 1650 OCT 1 � Zo�2 Location 512 N Salisbury St Floor 9 Raleigh North Carolina 27603 NNR One
Phone [phone] FAX 919�07Fi494 & A NorthCarolma
Internet mhrww ncwaterqualrty org �� Amirially
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