20090451 Ver 1_Certification of Completion_20131220

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Thomas A. Reeder John E. Skvarla, III
Governor Director Secretary
DWQ Project No.: 20090451 (IC No. WQC 0003806)
County: Macon
Applicant: NCDOT
Project Name: TIP No. R -2408B —Widening of NC 28
Date of Issuance of 401 Water Quality Certification: July 21, 2009
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.
Applicant's Certification
1, Mark S. Davis, Division Environmental Program Supervisor, 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. 1---)
Signature:' —�ZLI> a 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:
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: Registration No.
Date o,
DEL 9
1650 Mail Service Center, Raleigh, North Carolina 27699 -1650 2013
Phone [phone]b AX:t919 8076494 Raleigh North Carolina 27603'ti(gN� lip `�. c��t ry NOrthCarOlina
Internet wunru ncwaterquality.org �cRyp:1CN �atura!!r�
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