HomeMy WebLinkAbout20130853 Ver 1_Certification of Completion_20150626 (2)�liichael �. �a�iey, Govemor
W�liam Cs_ i�a�s Jr., Searetar}r
C�faRFa C�roEirra i�+aRarEment of �nvirr�rne�i ancf l�9atura� Rsso�aaoes
��leen F!. �u�lins I]'sredor
�livisican of Wates Gtualifyy
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1?ate r�f Ess�a�cce of 4U1
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Qua�it j° +�c�rtif�catio�:
County. '�r-��.
�ert'tficate a#'CampEeLipQ
l�pon c�mplefina aiail vvoFk a�rpraved wit�in the dCl1 Water f�lity Cc:rtritcation car appiicable But�"er Ru3es, and
�sy subseq�ent modifcations, tl�e a�pl�c�a►t is r„�qu�reci �o rett�m this cet�ti�icate ta the �t� iNVe�land.s Un.it, IVnrfih
�arolin� Divisian Qf VVater Quafat�r, i621 Maia Service Center, Ral�igh, Iti[C, 27b94-I621. This form rnay be
re�uumrn�d ta I3V4'Q kry t.�e ap'Pli�t, the applicant's �utho�zed age�t, �or the prnject engi��r. It �s naE necess,ary ta
send c�tifir,a�s frt�na atl of Eh�ese.
A�►�licsnt'S E:�IF�Ii�"ICRf�O�
�, hereby state that, tc� the �iest of my abilities, diue care and d�Ii,gence
was �sed 'aa the c�6servatioa� af the con�truction suc� t�at the canstruction rvas observe� to be bu�it v�thisi subsl�ntial
c�mpliarac� anc� intent afth� 4�}� ''�Vate�° Q�ality Certifi�ation and Huffer Ra�les, the approved ptans at�d
sp�ificati�ns, ar�d ath�r supparti�g materials.
Signature:
t��
.r�,ge�t's Cert`r�c.�tiaa
�, hereby state t�at, t� the best af my abilides, due care and c�iligenr„�
was used i�t the obs�rrratic� af the conslluction s�ch th�t t#ee �rons#xucti�rn was nbserv�d to be 1�u�lt within substaniisi
comp�iance and i�fte�t t�f the 4{f l Water f�ity ��`ti�catit�n acxd �uffer Rul�s, the �presved pians and
speci�tie�ns, and ot�r�er supportic�g matereals,
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E�gia:eer's �ertifcation
artia! � F'
[, _ ��,,� ,,�5 � , as a duly xegisDez°ed Professional En�use�:r �n ti�e Statc af N€r�th
�amlina, h�ving bee�► authaeized ta observe (p�riadically, w+eek�y, full tirne) t€ze consbn�ctiotx oi'the project, for the
Per�sr,ittee hereby st�te �a�, ta the ksest af my abilities, due care and diligence was used �t the abservatiiar� oft�ie
co�strucc�o� such that the coc�stntction wa� obs�rrved to b� 6uilt witl�in substantiai cn�rp�liaetce a� intent csfttre 44f1
Water (Zuaiity C� '�icat' and B ff Rules, ttie appraved plans and s�ecificati4ns, and at�er setppc�rting materials.
Signat�re Registratiaze No. 2�7 � I�
Dat� C� � �-ta � l �,
- N Carn �' a
TransportaUon F�rmitt6ng 4�n°s1 �til1'fJtl�/
165Q t4Aail Senrice GenCer, Rafeu,�h. iVo�tks Caro3in� 276�-185�
2324 Crabti�e Bovlevard. Suite 25i), Ral�iSh, Noo�h Carollna 276[14
Phone: 91�-733-178fi ! FAX 918-733-6693 i Int�etne� ht�p IIh2a.enr.sEafe.nc.uslncv�etlands
An �qual Qpporiurs�ytR�im�6e+e Acti� �pf�yer — 5D% Recycled110°,� Past Cortsumar Paper