20050848 Ver 1_Certification of Completion_20080128

?OF WAP, Michael F. Easley, Governor
iam G. ?C G North Carolina pepartrnent of Environment d Natural Resources
y 9
> r- Alan W. Klimek, P.E. Director
p - Division of Waler Quality
DWQProjectNo.: 0509Y8' County:
Applicant: AJC DOr PI V
S W ,?y wrr
Project Name• A - C RrJ?
Date of I.sicuance of 401 Water Qualk Cerlifica6on: 2lo/ OS
Cer ifrcate of Completion
Upon completion of all work approved within the 40.1 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, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be
returned to DWQ by the applicant, the applicant's authori7ed agent, or the project engineer. It is not necessary to
send certificates from all of these.
Applicant's Ccrtificatiion
1. 2. 0 , 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 ----.911711,017
,agent's Certification
1. , 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 withia substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Date:
Engineer's Certification
Partial Final
1' --- , as a duly registered Professional Engineer in the State of North
Carolina, having beeu authorized to observe (periodically, weekly, full time) the construction of the project, for the
,Pcrmittcc 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.

Trentpcrl Un PermlNnp Unh
1650 Mod S9rvles Caniar. Raleigh, North Carolina 27s%-1650
2321 Crebbge Boulevard. Suita 250, Raleigh. North Carofrb 27604
Phone: [phone] /FAX [phone] / Internet t!pJJh2o. am stwa.nc.uaJncwa11AnAs