Statutes, codes, and regulations
Washington Administrative Code
Title 173 - Ecology, Department of (See also Titles 197, 317, 372, and 508)
Chapter 173-245 - Submission of plans and reports for construction and operation of combined sewer overflow reduction facilities
Section 173-245-075 - Form - Declaration of construction of water pollution control facilities

Wash. Admin. Code § 173-245-075

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Current through Register Vol. 24-20, October 15, 2024
Section 173-245-075 - Form - Declaration of construction of water pollution control facilities

DECLARATION OF CONSTRUCTION OF WATER POLLUTION

CONTROL FACILITIES

Instructions:

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 . . . . . . . . . . ..

I hereby declare that I am the project engineer of the above identified project and that this project was reviewed and observed by me or my authorized agent in accordance with the provisions of the construction quality assurance plan. I further declare that this project was, to the best of my knowledge and information, constructed and completed in accordance with the plans and specification and major change orders approved by the department of ecology and as shown on the owner's "as-built" plans.

. . . . . . . . . . ..

Signature of Professional Engineer

SEAL

OF

ENGINEER

DATE . . . . . . . . . . ..

Please return completed form to the department of ecology office checked below.

[]

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

(See also, WAC 173-240-095.)

Wash. Admin. Code § 173-245-075

Statutory Authority: RCW 90.48.110. 00-15-019 (Order 00-07), § 173-245-075, filed 7/11/00, effective 8/11/00. Statutory Authority: RCW 90.48.035. 87-04-020 (Order DE 86-34), § 173-245-075, filed 1/27/87.