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NOTE:
 Upon receipt of the following statement completed by a professional engineer licensed in Virginia, the owner shall forward a copy to the appropriate field office of the Department of Environmental Quality.
 

 

 

______________________________________________________________________________________

SUBJECT: Statement Required Upon completion of Construction
TO: (Sewerage Works Owner)
FROM: (Appropriately Licensed Professional Engineer)
DATE:  


 

 

 

 

For your use in complying with (9 VAC 25-790-180) of the Virginia Sewerage Collection and Treatment Regulations, I submit the following statement:

The sewerage work described as

 

(Project Description)

 

was completed substantially in accordance with approved documents. I certify that I made sufficient inspections (or that such inspections were made at my direction) to ensure that my statement above is correct.

 

___________________________________, P.E._____
(Signature)

_______________________
(Date)

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