20161108 Ver 1_Certification of Completion_20180501

E'nvironmer�tal
Qualii y
N�C'DVk'R Pr�.ject Nu.: 20161108
Applicant: NCDOT Division 9
Praject 1�1ar�ne: Bridge 188 on SR 2564
I}ate of �ssnanee nf 401 W3tcr {luaGt�� C'erti�ration:
!'.A'I' MC'C'Etc1RY
i)()NAd,D ]Z. �'`AN i3%R VAAit'1�
C�unt,y: Rowan
December 2, 2016
JAY 71ME�11�:ItMAN
Certi�cate of Completion
U�on cr�mpletion ofall work �p,�roved witl�in the 401 Water Quality Certificatic�n or applicahle Buffer RuV�s, and
any subseq�:e�t m�doticatior�s, the applicant is required to ret�rn this certificate to the =�01 Transpoetation Perrrritting
Unit, North Caralina I7ivision of W ater Resowces. 1617 11+�ail Servuce Cente�, Ral�i�,h, NC. 27649-16 fl 7. This form
may be retur�ied to NCDWR bv �I�e applicant, the appVicdn�'s aut�oruzed age�it. or �he prc,je�t engineer. It is �aot
necessary to send ce:�ificates f om all of these.
Applicant's Certiftcation
i, , E�ereby state that, to the best of my abiloties, due care and dil�ge�ce
was used in the abservakion of the construction s�ach that the construction was observed ta be built wirthin substantia!
co�p�iance and intent of the 401 Water Quality Certiticatian and Buffer Ru�es, Che approved plans and
specifications, arid e�tlter supporting mater�als.
S�^�,natU!'e: - -- ---- - ------ ------ �� _--------- �7aTe: --- -- _.___ _a=_
�genP's t`err.^'frcr.tiurr
�, Amy Euliss , hereby state that, to the hest of my� abilat�es, c�ue care ar+d dilo�ence
was used in the observakian of the constructEoru such that 4he c�nstructAan was observed to be built within substantial
compl:ance ���d iniea�t af the 4�03 4�Jat�r Qualoty Ceitificatic�n and Buffcr �ules, the appa�ove:i plar�s an�!
specifications, and other s�ipporting materials.
5ignaturc: v�n p�t�: April 30, 2018
E�rgineer's Certdfcu�irin
Par�ial Final
1, , as a duly registerec: P;ofessia7a! E:��aneer in the Stat� afl�Iocth
Carolina, ha�in� been authorized to observe (periadica9ly, wveekly, fisll time) tf�e constructic�n of the project for the
Permittee hereby state that, to the best of my abi�ities, due eare and diligence was used in the �bservation of the
constr•uctivn such that the canstruction was ��bserveci ta t+e 6�iilt wiihin suh.ta�itial compl�anca and intent of the 401
t�l'ater Quality Ce:3ifieation and Buffer Rules, the apprav�d �plans and specifications, and other supporrtin� materials.
Signature
�ate
Regist�atic�n Na.
=''Nothir�g Compares'� - _
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