20130031 Ver 1_Certification of Completion_20150617

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'�"sPORrAnoN ERM,n�Nd'�NT Carolina Department of Enviranment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E
Governor Director
DWQ Project No.: 1D �3 ()C�.
Applicani: G � Q
Project Name: .�� / � 7 �
Date of tssuance of 401 Water Quality Certification:
county: ��ci�r'.io��►
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Dee Freeman
Secretary
Certificate of Completion
Upon complekion of all work approved wiihin the 4D1 WaterQuality Certification or applicable But'f'er Ruies, and
any subseqaent modifications, the applicant is required to return this certificate to the AOi Transportation Perrnitting
Uoit, North Carolina Divisiort of Water Qualtty, 1650 Mail Service Center, Raleigh, NC, 27699-i650. 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.
Applica 's Certi(ic�ion �
�� ��__�/</V , hereby state that, to the best of my abifities, due care and diligence
was used i he observation af the construction such that the constructian was observed to be built within substantial
compliance and intent of the 4Q1 Water Quality CertificaTion and Buffer Rules, the approved plans and
specifications, and other supporting fnaterials.
Signahire: Z �__� U�--- Datc: �' �� .Zf1 �S
Agent's Certitication
�. , 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 Qaality CertiFcation and $uffer Rules, the approved plans and
specifcatians, and other supporting materials.
S ignature: Date:
Engineer's Certification
Partial Final
�� , as a duly registered Professional Engineer in the State ofNorth
Carolina, having been authorized to observe (periadically, weekly, fuil time) the construction of the Project,for the
Permittee hereby.state that, to the best of my abi(ities, due care and diligence was used in the observation ofthe
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
1617 Mal! Servicre Genler, Raleigh, Norih Carolina 27699-ifi 17
Locafion: 512 N. Sallsbury St. Raleigh, North Carolina 27604
Phone: 919-BOT-63001 FAX; 919-807�64921 Customer Servlce:l-877-623-6746 NO�l�lCal'01111r'1.
Inlerner www.ncwaterquallty.org ����N����
An Equal OppoRunily 1 AffirmaGve Aclion Empinyer �