20170836 Ver 1_Certification of Completion_20190222

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Env�ranmen.tal
Qualiiy �'
NCDtV� Pro;ect i�o.:
Appl9c�nf:
['ra3e�t i�12me:
ROY COOPCR
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M1CI-LALL S. ItGGAN
Se, •rrk,u,u
S. JAY ZIMMERMAN
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Date of €asua�nce af d01 Wa#er Quzlity C�xtificat;cn: �— ��j— ['�
�'l o � �(� 1,�(a�
Certifieat� of �am�let�on
U�on cumpl_etion of a1] work approved within the 4U 1 W�ter Quality Gertiiication or a�plic�tale BuFfer Rules, and any
subsequ�nt mod't6cations, tl-ie applicant i.s reqn�red �.o return r.his certificai� to the 401 Transportation Permir..ting Unit,
Narth Caroiz�ia Division �f �}dater Resources, 1617 Mail Se�v�ce C�nter; Raleigh, NC, 27b99-151 ^,. This fori� ma}�
be returned fo NCDWR by il�e applicant, the applicant's authorized agent, or ttte project e�t�iueer. It is not neeessary
ta sen�i certi �cates from all of ehase.
Applicunt's Certifrcaf�o►t
I, f�, ��� ��" 9 d�'�' , hereby state that, to Che best of my abiliti.es, due care and diligence
was ased ia the observation of the construction such that the construction w�s observed to be built within substantial
compliance and intent of the 401 Water. Quality Certification and Buffer Rules, the approved plans and specifications,
and otner supportinb materials.
Signatur : __'�_ __�_ __� ])ate: � f� � �
��'L'!ti 3'��'i , CQ��TP'�
I., __ �^�^ �°� ��______, hereby state thai, to the b�st of tny abilities, �ue care and dil.i�ence
was i zd � th� observation o; the construction sueh that the construction was observed to be built within suhstantial
corp liance and intent of the d01 Water Quality Certification and ]3uffer Rules, the approved plans anti specifications,
and ut!}er supportu�g it�ateriais. '
Signature: �`� � �r o �' ,� �
. €� Date:
Engi��eer's �'erf3ficnlinn
Partial Fin�l
I, ,���� �p `�; ��'�l as a duly registered Frofessional Engineer in the State of North
�� Caro]':na, having been authoricc;d to obse; ve (periodically, weekl.y, full lime) lhe construction of tl�e proj�ct fc�r Che
� Fer.m.ittx.e hereby state tliai, t�.� th� best of my al�i.lities, duc care and diligenc� kvas used in tlle c,bservatiozi of tl��
construction such that tne constraction was oUserved to be built witnin substantial compliance and intent of ihe 4U 1
Water Quality Certif ;kion a �l Bu Rules, � ap roved plaus and speci icatic�ns, and other supportin� materials.
Signature _ __ _ _�_ � __ _ Registration No. _�� �p g
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Date _ � —� �--------- .
.�..�;,,�.T�loi:l�i,st� Co�2tp�res:'�._..
��aTa oFilon': C'��otlr.a � Enviroemer.lal Q�nliry
lbl7 Muil �ervice Center j Ita;eigh, Nortii Carolina 2Tu49-1517
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