20110365 Ver 1_Certification of Completion_20130306

PLDPiedmont Land Design, LLP
8522 -204 Sig Forks Road • Raleigh, NC 27615 • (919) 845 -7600 . Fax [phone]
March 5, 2013
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Wetlands, Buffers, Stormwater — Compliance and Permitting (Webscape) Unit
1650 Mail Service Center
Raleigh, North Carolina 27699 -1650
Reference: DWQ Project No. 11 -0365
Rex Hospital Lots 1 & 2
Dear Sir:
Attached is the Certificate of Completion for the work being performed within the scope
of DWQ Project No. 11 -0365. This work has been certified to be complete by the
Applicant in accordance with the 401 Water Quality Certification and Buffer Rules of the
State of North Carolina.
If you have any questions, please contact me at (919) 845 -7600 or Deborah Edwards at
Soil & Environmental Consultants, PA at (919) 846 -5900.
Sincerely,
David Lasley
Principal
Attachment
C. Chad Lefteris, Rex Hospital w/ attachment
Deborah Edwards, S &EC w/ attachment
Civil Engineers . Landscape Architects • Land Planners

A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E. John E. Skvada, III
Governor Director Secretary
DWQ Project No: 11 -0365
Applicant: Rex Hospital -Mr. Chad Lefteris
County: Wake
Project Name: Rex Hospital Lots 1 & 2
401 Water Quality Certification Issued Date: May 11, 2011
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
Webscape Unit, NC DWQ, 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.
Applicaip* Cgrtifltio,
I, ( DW' I - -4kJ 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 s if a ions, her supporting materials.
Signature:�J Date: cal ?
Agent's Certification
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 Certified Professional
1, . 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 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.
Signature: Date:
Wetlands, Buffers, Stommater— Compliance and Permitting (Webscape) Unit
1650 Mail service Center, Raleigh, North Carolina 27699 -1650
Location, 512 N Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX 919 - 807 -64941 Customer Service: 1-877-623-6748
Internet www.ncwaterqualtty org
GC CR01(�4
One
FOR 0 6 2013 Aaurally Carolina
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