20061939 Ver 1_Certification of Completion_20080626

Certificate of Completion Y l , 4 7nnill
ol `? v+r;r,;on-?aern
DWQ Project No.: 19 County: R ar\d e 1_ R"a' ° `"P
Applicant: UCAX 1??Qil 'lAe , gUk 0inev OL.w O"Y'a"k, NC 1-1203
Project Name:
Date of Issuance of 402 Water Quality Certification: h? ??U Y y n , 2 c+o i
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the Winston-Salem Regional
Office, North Carolina Division of Water Quality, 585 Waughtown Street, Winston-Salem NC, 27107. 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, P r ?bhu st?u?.ka r S?; ., v6, SA K , hereby state that, to the bil 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:
Agent's Certification,- N/,4
Date: (- I %(l
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. V@[90162
Signature: Date:
JUN 2 6 2008
If this project was designed by a Certified Professional
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
I' ?e 6 8 f P , as a duly registered Professional 1[6!
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 Permittee hereby state that,
to the best of my ab4WA14hill and diligence was used in the observation of the construction such that % the construction ...
o * built within substantial compliance and intent of the 401 Water Quality
Certification`'.
? Approved plans and specifications, and other supporting materials.
.Ap t, - It
Signature: >c,_S r n4
_ Registration No.: ?( .36 Date:
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