A. | Upon completion, and before using any project or portions thereof, a professional engineer shall complete and sign this form, declaring that the project was constructed in accordance with the provisions of the construction quality assurance plan and with the plans and specifications and major change orders approved by the department of ecology. |
B. | If a project is being completed in phased construction, a map must be attached showing that portion of the project to which the declaration applies. A declaration of construction must be submitted for each phase of a project as it is completed. Additional declaration forms are available upon request from the department of ecology offices listed below. |
name and brief description of project: . . . . | |||||
. . . . | |||||
. . . . | |||||
name of owner. . . . | doe project no. . . . . | ||||
address. . . . | date project or phase completed. . . . | ||||
city. . . . | state. . . . | zip. . . . | |||
doe plan and specification approval date. . . . |
. . . . Signature of Professional Engineer | seal of engineer | |||||||||
date. . . . |
□ | SW Regional Office Department of Ecology P.O. Box 47600 Olympia, WA 98504-7600 | □ | Central Regional Office Department of Ecology 15 W. Yakima Ave. Ste. 200 Yakima, WA 98902-3401 |
□ | NW Regional Office Department of Ecology 3190 160th Ave. SE Bellevue, WA 98008-5452 | □ | Eastern Regional Office Department of Ecology N. 4601 Monroe St., Ste. 100 Spokane, WA 99205-1295 |
□ | Water Quality Program Department of Ecology P.O. Box 47600 Olympia, WA 98504-7611 |