20140379 Ver 1_Certification of Completion_20141117

V/
A*411A LDENR, i2014
®ENR RESOURCES
North Carolina Department of Environment and Natural PERMITTING
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A Reeder John E Skvada, III
Governor Director Secretary
DWR Project No: 14 -0379 County: Alamance
Applicant: Cardinal Pipeline Company LLC Attn: Ashley Sylvester
Project Name: Cardinal Pipeline at Haw River
401 Water Quality Certification Issued Date: May 27, 2014
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 DWR
401 & Buffer Permitting Unit, 1650 Mail Service Center, Raleigh, NC, 27699 -1650. This form may be
returned to DWR by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Appilcant's Certificatlon
I,- Ashley Svlvester 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: II (i2.� ►>
Agent's Certlflcatlon
I, George lunkin 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 ap4specificati s and other supporting materials.
Signature: / Date:
If this project wa desig ed by a Certified Professlonal
I, 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:
401 & Buffer Permitting Unit
1650 Mad Service Center, Raleigh, North Carolina 27699.1650
Locabon 512 N Salisbury St Raleigh, North Carolina 27604
Phone [phone] FAX [phone]
Internet wvmncwater(ivalavoro
AnEqualOpportumty1At rimib"ActionEmployer
Date: