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N <br />FEDERAL EMERGENCY MANA lE lT AGENCY O.M.B. Burden ft. 3067 -0148 FE MA USE ONLY <br />CERTIFICATION BY REGISTERED PROFESSIONAL ENGINEER Expires July 31,199 7 <br />AND/OR LA lD SURVEYOR FORM <br />PUBLIC BURDEN DISCLOSURE NOTWE <br />Public reporting burden for this form is estimated to average. 23 hour per response. The burden estimate includes the <br />Lime for reviewing- instructions, searching exciting data sources, gathering and maintaining the needed data, and <br />completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any <br />suggestions for reducing this burden, to; Information Collections Management, Federal Emergency Management <br />Agency, boo C Street, .W., Washington, DC 0472; and to the Office of Management and Budget, Paperwork <br />Reduction Project (3087- 0148), Washington, 0503. <br />1. This certification is in accordance with 44 CFR Ch. 1, Section 65.2 <br />2. 1 am licensed vrith are expertise in Professional Enga. r g QLydrology1hydraulics) <br />[example: water resources (hydrology, hydraulics, sediment transport, interior drainage)* structural, <br />geotechnical, land surveying.) <br />3. I have 29 years experience in the expertise listed above. <br />4. 1 have IV prepared ❑ reviewed the attached supporting data and analyses related to my expertise. <br />5. 1 M have 11 have not visited and physically viewed the project. <br />. In my opinion, the following analyses and/or designs, dare being ceftolflad: <br />The erosion protection of the levee. Additional analyses/ des i ertifled by others <br />7. Lase upon the following review, the modifications in place have been constructed in general accordance w'lLh plans <br />and specifications. <br />Basis for above statement: (check all that apply) <br />a. IN Viewed all phases of actual construcLion. <br />b. [N Compared plans and specificraLions with as -built surrey information. <br />c. 12 Co x reined plans and specificaLions and compared with completed projects. <br />d. n Other. <br />1. All *Information submitted in support. or this request is correct to the best. of ray knowledge. I undorstand Lhat any <br />false statement may be punishable by line or imprisonment under Title t 8 of Lhe United States Code, Section 1001. <br />Marne: <br />,r ftle: <br />Registration istration No. 16626 <br />Douglas R. La o <br />(please print or type) <br />P.E. <br />(please print or type) " <br />*Specify Subdiscipline <br />Expiration Date: <br />Note: insert not applicable l when s#.atement does not apply. <br />FERIA Form 8 1-89 4. OCT 94 Certification by Registered Professional <br />Engineer and/or Land Surveyor Fora <br />5/31/2000 <br />eesisj� <br />9of <br />41 <br />NAlE�6� <br />Seal <br />MT -2 f•orrn <br />