20120579 Ver 1_Certification of Completion_20130524

Thomasville Quarry Entrance Road
DWQ# 12 -0579 reissuance
August 23, 2012
Page 3
DWQ Project No.: 12 -0579
Applicant: Martin Marietta Materials
County: Davidson
Project Name: Thomasville Quarry
Date of Issuance of 401 Water Quality Certification: August 24, 2012
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, 1621 Mail Service Center, Raleigh, NC, 27699 -1621. 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.
Anlicant's Certification
I, Jay Nivens , hereby state that, to the best of my abilities, due care and diligence was
used m 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 . S.
Signature: Date:
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:
Engineer's Certon
Partial Final
Date:
I, . as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the projectfor the
Permittee 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
Registration No.
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