20130229 Ver 1_Certification of Completion_20130326

A �
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.: 20130229 County: Haywood
Applicant: NC Department of Transportation
Project Name: Bridge No. 162 on SR 1313 (Hemphill Road) over Hemphill Creek
Date of Issuance of 401 Water Quality Certification: March 8, 2013
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
I, Mark S. Davis, Division 14 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 materiajq
Signature: h�� Date:
Agent'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:
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
Registration No.
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1650 Mail li Raleigh, Carolina 27699-1650 r ?�ADS
Location. 512 Service
St Floor 9 Raleigh North 277603 NOST �R, Qt J . One
Phone. [phone]\ FAX 919 - 807 -6494 %5 r6
NorthCarolina
Internet: wvuw.ncwaterquality.org 111k,,Cy a'����r� //�
An Equal Opportunity 1 Affirmative Action Employer � �/ ` "