20130479 Ver 1_Certification of Completion_20130520

NCDWQ Project No.: t O 'I �9 Conuty:
Applicant:
Project Name:
Date of fssaance of 401 Water Quality Certification: � U, ad-
Certificate of Completion _
Upon complexion of all work approvedwiddathe 441 Water Quality Certification or applicable Buffer Ruks, end
any subsequwLmodifiaetious, the applicant is required to return this cer0wate to the441 ThnsportafimPew tting
Unit, North Carolina Division of Water Quality, 1650 Mad Service Cep, Raleigh, NC, 27699-1650, Phis form
mayberermned to NCDWQby the applicant; the applicant's authorized agent; or the projectangih a It is not
necessary to send certificates from all of dhase.
Appticwrt's Can
I, J�d . t–, 1-101 , haeby state that; to the beat of my abilities, due care and dilige�u�ce
was used. in the obsev vzhon of the conshuction such that the cam mxtion was observed to be built wii&k substantial
compliance and intent ofthe 401 Water Quality Certi6cadon and BuffirRules, the approvedglaw and
speckficattons, and hY sappoxsing mataials. ,
S*Mature: ' Datir `
I, , hereby state t4 to the best ofmy abilities, due care and diligence
was used in the Observation of the eonsituctim such that the construction was observed to be built within substantial
compliance and i9enrt ofthe 401 Water Quality Certification and Buffet Rules, the approved plans and
specidcadons, and other mVpordag materials.
Signature: Date;
,iiisgbteer's Gin
Partial Fine]
- as a duly re&e rdProlmional Engineer iath,e State ofNorth
Carolina, having been authonzedto observe (periodically, weekly, full time) the construction ofthe projectfor the
Pesmittee bmby state that, to the best ofmy abilities, due care and diligum was used in the observefian of the
camstructim snahihat the construction was observed to be built wiffim substantial compliance and intent of the 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and ogler supporting materials.
Signature, Reg radon No.
M. AM