20000959 Ver 1_Complete File_20000721

a
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
1 • •
ON% loom
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
6. Deed restrictions must be placed on all remaining wetlands on the parcel after appropriate use of this
and other Certifications. DWQ shall be sent copies of all deed restrictions applied to this parcel. If
this condition is not met, written DWQ approval is needed to utilize this General Certification (and
Nationwide Permit);
7. Measures shall be taken to prevent live or fresh concrete from coming into contact with waters of the
state until the concrete has hardened;
8. Concurrence from DWQ that this Certification applies to an individual project shall expire three
years from the date of the cover letter from DWQ.
Non-compliance with or violation of the conditions herein set forth by a specific fill project shall result in
revocation of this Certification for the project and may also result in criminal and/or civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a formal
application for individual certification for any project in this category of activity, if it is determined that the
project is likely to have a significant adverse effect upon water quality or degrade the waters so that existing
uses of the wetland or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications prior to a Certification
decision if deemed in the public's best interest by the Director of the North Carolina Division of Water
Quality.
Effective date: 11 February 1997.
DIVISION OF WATER QUALITY
By
A. Preston Howard, Jr. P.E. Director
gencert.18
WQC # 3106
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
T
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you
have any questions, please telephone John Dorney at 919-733-1786.
Sincerely,
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Washington Field Office
Washington DWQ Regional Office
Central Files
c:\ncdot\SR 1528\wqc\000959wgc.doc
tevens
won W
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
1 ? •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 31, 2000
Beaufort County
DWQ Project No. 000959
APPROVAL for 401Water Quality Certification and ADDITIONAL CONDITIONS and Tar-Pamlico River
Buffer Rules
Mr. William D. Gilmore, P.E., Manager
Planning and Environmental Branch
North Carolina Department of Transportation
P.O. Box 25201
Raleigh. NC. 27611-5201
Dear Mr. Gilmore:
You have our approval, as described in your application dated July 21, 2000, and in accordance with the
attached conditions and those listed below, to place fill material in 0.01 acres of wetlands for the purpose of
paving and widening SR 1528 in Beaufort County. After reviewing your application, we have decided that
this fill is covered by General Water Quality Certification Number 3106. This certification corresponds to
the Nationwide Permit Number 18 issued by the Corps of Engineers. This approval is also valid for the Tar-
Pamlico River Buffer Rules (15A NCAC 2B..0259). In addition, you should acquire any other federal, state
or local permits before you proceed with your project including (but not limited to) Sediment and Erosion
Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire when the
accompanying 404 permit expires unless otherwise specified in the General Certification.
This approval is valid solely for the purpose and design described in your application (unless modified below).
Should your project change, you must notify the DWQ and submit a new application. If the property is sold, the new
owner must be given a copy of this Certification and approval letter, and is thereby responsible for complying with
all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or of total impacts to .
streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h) (6) and (7). ). This approval shall expire with the corresponding Nationwide Permit expires or
as otherwise provided in the General Certification. For this approval to be valid, you must follow the conditions
listed in the attached certification and any additional conditions listed below.
1.) When written concurrence is required, the applicant is required to use the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed. The
responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the Division of
Water Quality upon completion of the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 60 days of the date that you receive this letter. , To ask for a
hearing, send a written petition, which conforms to Chapter 150B of the North Carolina General
Statutes to the Office of Administrative Hearings, P.O. Bo 27447, Raleigh, N.C. 27611-7447.
This certification and its conditions are final and binding unless you ask for a hearing.
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
1 •
A;1 A
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
GENERAL CERTIFICATION FOR PROJECTS ELIGIBLE
FOR CORPS OF ENGINEERS NATIONWIDE PERMIT NUMBER 18 (MINOR
DISCHARGES)
This General Certification is issued in conformity with the requirements of Section 401, Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality
Regulations in 15A NCAC 2H, Section .0500 and 15A NCAC 2B,.0200 for the discharge of fill material to
navigable waters and adjacent wetland areas tributary to interstate waters or navigable waters of the United
States (i.e., isolated wetlands) as described in 33 CFR 330 Appendix A (B) (18). This certification replaces
Water Quality Certification Number 2669 issued on January 21, 1992 and Water Quality Certification
Number 2733 issued on May 1, 1992. This WQC is rescinded when the Corps of Engineers reauthorize
Nationwide Permit 18 or when deemed appropriate by the Director of DWQ.
The State of North Carolina certifies that the specified category of activity will not violate applicable
portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-217 if conducted in
accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Activities authorized by this Nationwide Permit require written concurrence from the Division of
Water Quality;
2. That appropriate sediment and erosion control practices which equal or exceed those outlined in the
most recent edition of the "North Carolina Erosion and Sediment Control Planning and Design
Manual" or the "North Carolina Surface Mining Manual" (available from the Division of Land
Resources in the DEHNR Regional or Central Offices) are utilized to prevent violations of the
appropriate turbidity water quality standard (50 NTUs in streams and rivers not designated trout
waters by DWQ; 25 NTUs in all saltwater classes, and all lakes and reservoirs; and 10 NTUs in trout
waters);
3. All sediment and erosion control measures placed in wetlands or waters shall be removed and the
natural grade restored after the Division of Land Resources has released the project;
4. If an environmental document is required, this Certification is not valid until a FONSI or ROD is
issued by the State Clearinghouse;
5 This Certification shall not be used in conjunction with the Certification for Nationwide Permit 14 to
create high ground for road access;
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
t
0009 59
2 1 2000
WETLAND y8ECJI:"7'y? WATER .:
DWQ ID: CORPS ACTION ID: U
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 18
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
L. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
I. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR-1 528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Long: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int. of SR 1742
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES 7 NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES F-1 NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F NO x IF YES. DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sy. Ft-
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE liMPACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED.
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: I FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT. DIRECTOR STATE CLEARINGHOUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES S"fRf.:E"F. RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS. STREAMS. LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14. 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
%? , ?ift'1 ?? ? ? ?n v, ?dri rH f? c??r c.c..-
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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51

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: Date: _? a oar

Applicant/Owner: Al cgs-ar --
County
Investigator:
" --r- -_-------
-----------
State: ?tJ -e. ---
Do Normal Circumstances exist on the site? )G No Community ID:

Is the site significantly disturbed (Atypical Situation)?
Yes i® ---
Transect ID:

Is the area a potential Problem Area?
Yes J? _ ---
Plot ID: _-
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator

3.??f.111B?yf1;l€4__ 11.---------------
4.??--------? -3 ' ' 1 z.---------------- - - ---

464/ -

7.------------ -- ---- 15.-----
------------- ----- -----

Percent of Dominant Species that are 08L, FACW or FAC
(excluding FAC-).
Remarks: i?jl 6(i/? (f? e?-••y? i 5 j?v?'-S-p.v V
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
ther
o Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands

?- Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches

? Water-Stained Leaves
Depth to Free Water in Pit: (in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks:

132 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class: -_-----
Field Observations
Taxonomy (Subgroup): _-< <??/ ? r?3 -_-___-_ Confirm Mapped Type? Yes No
f'
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
------ --- -- - - -----
Hydric Soil Indicators:
__ Histosol _ Concretions
Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor --0 r is Streaking in Sandy Soils
Aquic Moisture Regime iste on Local Hydric Soils List
Re ing Conditions
l
d
Ch
C
l ed on National Hydric Soils List
h
O
ors
eye
or Low-
roma
o t
er (Explain in Remarks)
-
Remarks: ^`?' S 4J 1 6 4S G? V-?`
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? e® No
Remarks:
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
?y h G?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:_- !e h_.o /7? a .S?-+-C,`__- Date: _???o____
Applicant/Owner: i-____ _ `_-________ _
- County: A? Cw (-
--

Investigator: __? $?r. ___- -__ --
State: __ 1, c;_____
Do Normal Circumstances exist on the site? es No Community ID: __--__-
Is the site significantly disturbed (Atypical Situation)? es ( o Transect ID: _?___

Is the area a potential Problem Area? Yes ? __
Plot ID: _____
If needed, ex lain on reverse.
VEGETATION
Dominant Plant S ecie Stratum Indicator Dominant Plant Species Stratum Indicator
1.ddv, T-- ------ -- 6. -/Oa Fa ?_,?0 9.------------ ---
2.- ' St rc.olSl?? ?1 yob F`ac_3•? 10.----------- --- ---
3.??vEY+Lw. --- --?? /UJo_ I w.G 3' ? 11.------------- -- - - -
4.L
??ie?cs:,.,?Jw ?r?c!?J?b FctG_? 12.------------- - ----
e
5.1! K-bid----- -- c!?.s? 3j b f?'a ?. 3. e 13.---------------- ----- ---

7.------------------- --- ---- ---- 15.---------

Percent of Dominant Species that are OBL, FACW or FAC
>So?
(excludin FAC-1. b
Remarks: GtJG'??t?lf i??C.V'wT?i?Y+ tS ??'+?
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
l?Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
? Secondary Indicators (2 or more required):
?
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: ?a^ (in.) - Local Soil Survey Data

i
D
h
d S
il
>
S _ FAC-Neutral Test
Other (Ex
lain in Remarks)
ept
to
aturate
o
:
(
n.) p
-
Remarks: ?? (ate /?'yG? :moo ?v5? i 5 Na
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class:
Q?y??\T -'?-?^-( Field Observations
Taxonomy (Subgroup): Confirm Mapped Type. Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
Hydric Soil Indicators:
Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils List
__ Reducing Conditions - Listed on National Hydric Soils List
_- Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: W e-4-(o.' -GY ,; (S c?,.2 n 1a'?" ?v^Q-
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Zj No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes 1z
Remarks: A ( o vN U13 C-4., t-"
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With:
Lu..-r y /Y' Date:
7??1?o2oco Time:
A!0'- 3o PM
Of: ?J0.?ccr?c+-f /rlcw,:?¢ l=. s l?ca..i ?s Phone #: a3-? 7? S3
Re: F; /? .? o / 4 r?s .. ?!D f? w?ef?w? •?s rd?a?a.? .u..u,O i 8 ,'-, 0?.....f
I laced Call ® Party Called ?
My Message Reply
Party's Message Reply 0
Action or Follow up Necessary N0
Refer to: File #:
Signed:

Phone Conversation Record
Talked With: Date: Time: (ED
Of.
S ?,? G f s S /v?-, c.
?i?3 ¢?,ic ? ?a-p e ? c¢,
Phone #: y/ q, ? 3 3 - 4c76 3
Re:
I laced Call Pa
rty Called ?
My Message Reply
Party's Message Reply Q je
Action or Follow up Necessary
Refer to:
s,e /6,'L g File #:
Signed:
?0?
?A 4
0 O9 59
DWQ ID: CORPS ACTION ID:
?20
LUoU
P
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 18
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav .Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Lon;: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int_ of OR 1742
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-1
OR WS-II)? YES F? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES F-1 NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES 7 NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F? NO x IF YES, DESCRIBE ANTICIPATED WORK:
(a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sq. 1=t.
10. (a) NUNIBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE INIPACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED.
PROVIDE DISTANCE BOTH BEFORE AND AFTER RE[OC;-\-['ION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: I FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY I 1 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO 7 (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES F-1 NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL. POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED "1-0 MS. CHRYS BAGGETT. DIRECTOR STAKE CLEARINGI-101JSF_.. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES STREET. RALEIGH.
NORTH CAROLINA 27603-5003. TELEPHONE [phone].
1s. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL ikIATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18,21.26,29, AND 35).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
4.J. <4?r -Dl' l) 2 1?5.,
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).

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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: .5,ge,o:;t_8_??f Date: __7 q oar ---
Applicant/Owner: N_QQs2r ___-------- ---_-------- County:
Investigator: --__-------- -_-------- State: -_ JJ . G' , -----
Do Normal Circumstances exist on the site? `0 No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes 10 Transect ID: _
Is the area a potential Problem Area? Yes V? Plot ID: --
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
----
3.?G?Ge -G??jl?BeG?LsL?Hc?_/.tc_ 3O 11. _
__ __

4.1115--'----- _
___ _
------- - - ---- -
6.A 14.

Percent of Dominant Species that are OBL, FACW or FAC \
(excluding FAC-). r
Remarks: W'-?
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
ther
o Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches

? _ Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data

•/ _ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks: /?t/Y/}'l'.w7J" ?•.?
0'!v?a
O
?
?? 1 ..SA
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class:
(C Field Observations
Taxonomy (Subgroup): -_ ??v' ? --_-__--_ Confirm Mapped Type? Yes No
Profile Description: !s
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
Hydric Soil Indicators:
Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor - Or is Streaking in Sandy Soils
Aquic Moisture Regime _ fisted on Local Hydric Soils List
__ Re ing conditions -d on National Hydric Soils List
-- leyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: RUC ZL?vs 5 c?a ?S cc ?y(/?? a
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ? No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? e No
Remarks:
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Illih 6;J
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: 9 4z? h4_c? 17V?; " Be..A. ?- -r- Co L Date: / o
Applicant/Owner: County: _?? ?w f
Investigator: _ ?.,.. __----- State: tJ, C,_-__--_
Do Normal Circumstances exist on the site? es No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes <::S? Transect ID:
Is the area a potential Problem Area? Yes Plot ID: ---_-
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator

2.?F?,a.? Stra?t?l?a l?/_ZO /=ac 3 10.-----___---_

5 dy 31) 14
6.__/G vh 5--- --- 3_? 1a.---

- ---- -----

Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: GtJef la?v? ????wi-i?^ r S /?
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: (in.) _ Local Soil Survey Data

h t
il
D
S
t
d S
i _ FAC-Neutral Test.
lain in Remarks)
Other (Ex
:
(
ept
o
a
urate
o
n.) p
-
/
Remarks:
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase):__/,??;,!_-- L Drainage Class:
Field Observations
Taxonomy (Subgroup): Confirm Mapped Type'
. Yes NO
Profile Descriotion:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
Hydric Soil Indicators:
Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils List
_ Reducing Conditions Listed on National Hydric Soils List
- Gleyed or Low-Chro Ama Colors - Other (Explain in Remarks)
Remarks: V,J s?o v •cY 15 Gv ¢ /?Ja`? ?v Q-
WETLAND DETERMINATION
Hydrophytic Vegetation Present? E No (Circle) (Circle)
Wetland Hydrology Present? Yes t?o
Hydric Soils Present? Yes ®o Is this Sampling Point Within a Wetland? Yes
Remarks: / j o 1--.1 LAZ
Approved by HQUSACE 3192
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With:
Lcwr y /AI-V-dy Date:
7?7?aao Time: M
/D : 3p PM
Of: [VOpv?o. l /y/av?;• e. l=: s /r?Qv; e8 Phone #: a23-;7 7.7 S'v 4 V
Re: Alim It -1 49-1 -Z.-+
I laced Call ® Party Called ?
My Message Reply
Party's Message Reply 0 k
Action or Follow up Necessary /00
Refer to:
S2 / S7? File #:
Signed: I, _ J
l/?O
Phone Conversation Record
Talked With: Date:
7/Z??aa Time:
PM
Of. Sv?w?G f?i S /,r?-i c. ?.-?.5 ??u s?» a cc.4, Phone #: y? 7 .3 3 - 4,47r 3
Re: ,C, %I:? . u / cc a ?.-a. S ? ?" 5/D 5? vJ i?/?x....?s un??- .tJ.n1f?/g.%,13c?.
S e?? y fj
I laced Call Party Called ?
My Message Reply
Party's Message Reply Q?
Action or Follow up Necessary
Refer to: /
5,Q
/o O? 8 File.#:
Signed:
?a?
O 1013( 359
DWQ ID: CORPS ACTION ID:
s ".. U'
s
..` .2 4 : 2000
WETLANDS GROUP
{MATER QUF>UTY SECTION
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 18
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Lon;: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int of 4R 17,17
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F-1 NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES F-1 NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES F? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES 7 NO x IF YES, DESCRIBE ANTICIPATED WORK:
). (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sy. Ft.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.0I EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM; FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY I 1 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL. POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT. DIRECTOR STATE CLEARINGI-(OUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES STREET. RALEIGH.
NORTH CAROLINA 27603-5003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS. STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18,21.26, 29, AND 33).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS T'O BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT. INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
//J, (-4- ` D, ,y 0 ze'-r
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
N1.
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:l??_$ _--)mf -'Z?e""-- ------- Date:
Applicant/Owner: tt c-4,0r_---___-_----- ----------- County:

Investigator.
's-? ` -.- State:

- --
Do Normal Circumstances exist on the site? 'tP N Community ID: ___-...
Is the site significantly disturbed (Atypical Situation)? Yes Transect ID:

Is the area a potential Problem Area?
Yes -_-
Plot ID:
If needed, explain on reverse.
VEGETATION
Dominant Plant Species
Stratum Indicator Dominant Plant Species Stratum Indicator
!)
1.. i?sL..????dc: Y/ice II!/T_ LG 3' ° 9.---------------- -- -

3.?. ?,'J.? .. ---------------- - - ----

5.
???-----

??
6. 14.
----
7.----------------- ---- ---- 15.--------------- ---- -- ---
8.------------ -------- -------- ------ 16._
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
--- -----------------------------------------
Remarks: W c?'l 6C' d ve-5 a'u_ __-e_\ ? 5
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
ther
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches

? Water-Stained Leaves
Depth to Free Water in Pit:
(in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: _ (in.) - Other (Explain in Remarks)
Remarks:

B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class: --------
Field Observations
V!c ?? a?3
Taxonomy (Subgroup):
y?i G ?N
Confirm Mapped Type? Yes No
-_
?/ =
----_
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc,

Hydric Soil Indicators:
__ Histosol - Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor - Or is Streaking in Sandy Soils
Aquic Moisture Regime Isted on Local Hydric Soils List
Rye wcing Conditions :i5 a on National Hydric Soils List
-4!tleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks:
1"tC?r? 5 Sa r ?j
Gc v a,1 ?Ry y
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes is this Sampling Point Within a Wetland? es' No
Remarks:)
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
//I9 h 6;-rl
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:g1.S8 Hd_og 17' -,_(3e?,?.5? t Date: S°-°---
_
Applicant/Owner: ______________ County:
Investigator: ?y$ur±___----------- State: xJ. c.____
Do Normal Circumstances exist on the site? es No Community ID:

Is the site significantly disturbed (Atypical Situation)? Yes <::5?) ---
Transect ID:
Is the area a potential Problem Area? Yes ® Plot ID:
If needed, explain on reverse.)
VEGETATION
Dominant Plant S ecie Stratum Indicator Dominant Plant Species Stratum Indicator
1.Qi p?J T - -- ¢? io Fa ?0 9 -------------- - -----
2. s)J yob 10.---
-

3.??-?Lw. o? ?v7o
-------- ---
-
- --
----
f
?J
4.J?s'rL
5. 13.-------------

7.-------------------- - 15.---------------

Percent of Dominant Species that are OBL, FACW or FAC
?
?O`Z
J
u
(excluding FAC-).
-
--
----
---------------------------------------
/
'
^
?
Remarks: (,V-'I-ia"l
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
_ Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: (in.) _ Local Soil Survey Data

il
i
D
S
S _ FAC-Neutral Test
lain in Remarks)
Other (Ex
: (
epth to
aturated
o
n.) p
-
Remarks: (,JeXI?O h'?Ga?;? /oS y i 5 Not"
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name 4 -
(Series and Phase): G+A t ?_ Drainage Class:
Field Observations
Taxonomy (Subgroup): Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions.
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
- - - - - - - - - - - - - - - - -
_7_/ - ---- - ??? -------- ----------- ---- ---
Hydric Soil Indicators:
Histosol - Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils List
Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or Low-Chro Ama Colors - Other (Explain in Remarks)
Remarks: ?f ?av+c} 5 ?; l S a?+. 2 n l?? ??'Q-
WETLAND DETERMINATION
Hydrophytic Vegetation Present? <Zj3?> No (Circle) (Circle)
Wetland Hydrology Present? Yes ?o
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes
Remarks: c-4- Lc,.-
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With: /?yr
L Date:
7?7/a2va? Time: M
/O.3o PM
Of: lUo. CVw.I ,/JIrcv?:•4 i'?s kza,; Phone #: -;2 7 2 V
Re: f; /? . r1 0 / 4 0. ?•..s AP 4eop e wn=6?A.*%J3 +dQ,...u,A+0 it o'r? /?a.....?..+
C'owtt?js
I laced Call Party Called ?
My Message Reply
Party's Message Reply 0
Action or Follow up Necessary N0
Refer to: File #:
Signed: nn

Phone Conversation Record
Talked With-
,?•r-r?-a.?S Date:
7??/,oat Time:
/U PM
Of: S a.? G /?s S fv7^ r L lam.- ?,5 ¢?•-?w?s ?-a ?+ c c ¢, Phone #: y/ 9.7 3 3 - 4e76 3
Re: ,G? %? n C . /acv-? S
I laced Call Pa a c 4?D 5?
rty Called ? r.J e.tr?{c?,..?s r ??- .tl?If?/ 8, %? C3c u.
My Message Reply
Party's Message Reply Qje
Action or Follow up Necessary
Refer to: Q p
s/? /?OZ c7 File #:
Signed:
p
..z
0tp 9 r39
DWQ ID: CORPS ACTION ID:
WETLANDS GROIJ?
WATER Willy S_l r'' ^
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 18
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAULING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Long: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int of CR 17,17
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F-1 NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
X00 SCI. Ft.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE I\-1PACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED.
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: I FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO F? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES 7 NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES F? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL, POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT. DIRECTOR STATE CLEARING] LOUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES STREET. RALEIGH.
NORTH CAROLINA 27603-8003. TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL [MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS. LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18,21. 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
O ? ? ? m m = S
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110+51.60
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: SQ15ag Date: - I J_
Applicant/Owner: _ __-________ County:
Investigator: ??,,? _------ -__------- State:
Do Normal Circumstances exist on the site? fi? N Community ID: ___-___
Is the site significantly disturbed (Atypical Situation)? Yes Transect ID:

Is the area a potential Problem Area? Yes J? _ ---
Plot ID: --
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator

2. X 1U Z -ZO- -
11Z_L° 10.------------
/
J -- --- ------
3.
4-- rmw

5. V AIA 64/
6.??E?G 14.-------------- ---- -----
7.---------------- ----- ---- 15.-------
------ ----- ------
8.---------------- --- 16.-----------
Percent of Dominant Species that are OBL, FACW or FAC ?-Yr
w
-
<o
(excluding FAC-l.
Remarks: ? ? ,?? ?? ,•Y? v,$
?Y
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
_Zfher
o Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
_ Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches
Water-Stained Leaves
Depth to Free Water in Pit: ?(in.) _ Local Soil Survey Data
FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks: IA.'vJ
.sIla
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase):
A --? Drainage Class:
! C ??N(/ ?_ Field Observations
Taxonomy (Subgroup): -_-_-_--_ Confirm Mapped Type? Yes No
Profile Descriotion:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
---- ---- --
Hydric Soil Indicators:
Histosol - Concretions
Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor O?gwis Streaking in Sandy Soils
Aquic Moisture Regime -vCiste on Local Hydric Soils List
Re ing Conditions ed on National Hydric Soils List
-_ leyed or /Low-Chroma Colors - Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? 4Q No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? ' ee s No
Remarks:)
Approved by HQUSACE 3/92
Appendix :B Blank and Example Data Forms B3
/•/19 h 6;J
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: !kALi,5-
,Q8%H?oS /7'
Date: o
-

Applicant/Owner: /tJc_ ___--------- --
County:
Investigator: ---------- State:
Do Normal Circumstances exist on the site? es No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes 0 Transect ID:
Is the area a potential Problem Area? Yes (moo Plot ID: _--_-
(If needed, explain on reverse.) I
VEGETATION
Dominant Plant S ecies Stratum Indicator Dominant Plant Species Stratum Indicator
----- ----- -----
Me_ 10-
----- ---- -----
3. 21 11.----------------- - -
?{?r+? t?%1w ynr1??J? ?ac _4
4.1af. 12.------------- - ---
,e
A-( 30 ;5 13
6.- 14.----
--
7.--------------- ---- ----- 15.---------

Percent of Dominant Species that are 08L. FACW or FAC
>So z
b
(excluding FAC-).
Remarks:
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: ?oZ (in.) - Local Soil Survey Data

S
il
i _ FAC-Neutral Test
Other (Ex
lain in Remarks)
Depth to Saturated
o
: (
n.) p
-
Remarks:
132 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name f
(Series and Phase): (,??Drainage Class: --
T Field Observations
Taxonomy (Subgroup): Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
------- - - - - -- `v --- -------
----------- ------- -----
Hydric Soil Indicators:
Histosol - Concretions
Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor - Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils List
__ Reducing Conditions - Listed on National Hydric Soils List
_- Gleyed or Low-Chroma Colors -iOther (Explain in Remarks)
Remarks: (?j t-?- 1 fo,--+d So, (S C' e n.J? i
WETLAND DETERMINATION
Hydrophytic Vegetation Present? <E?) No (Circle) (Circle)
Wetland Hydrology Present? Yes ?
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes 1z
Remarks: / " o r vz c-4, Lv?J /? ??? m 5 cc via i ?elc? ?- ?? .?-¢_.. -
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With:
Lu.?-r y I??- Date:
7?7?otdoo Time: M
/O : 3o PM
Of: No w ?a v?:•4. 1=. s Lca.- i ?s Phone #: 02?3-a 7.;2 8 acs 4 0
Re: ?; /? .%1 , o a c rss .. 7- ?f0 f? ?,u ?7??KCS s ?.ralc? .uj0 g ?'-? e0.. F
I laced Call ® Party Called ?
My Message Reply
Party's Message Reply D
Action or Follow up Necessary /00
Refer to: File #:
Signed:

Phone Conversation Record
Talked With: Date: Time:
PM
Of. S- „[ a.? G J`?a S fv7? i L ?i?-?5 ¢+r?cu?r ?+ ?c i:s. Phone 7-3 3 - 4,476 3
Re: %?n C . v / cc c v-? S o ?? 5? tN t?/a?.-.?s ?.» - •rl??PrBe :, ?3.
I laced Call Party Called ?
My Message Reply
Party's Message Reply Q?
Action or Follow up Necessary
Refer to:
s,e g as File
Signed:
411-1 p
.4
pzq
DWQ ID: CORPS ACTION ID:
jF_

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) IS
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Long: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int of CR 17d?
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sy. Ft.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: I FT AFTER: I FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DANI;'FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 1 1 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO F (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES F? NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES 7 NO M
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL, POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIREC'T'ED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES STREET. RALEIGH.
NORTH CAROLINA 27603-5003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS. LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 15, 21, 26, 29, AND 35).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/A;riculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
OG M,
QWNFk'S/AGM'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
//3
o r
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9

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: Se/ 5_;M . ->t?A ! Date:
Applicant/Owner: ?t --------- -- ---------- - County:
Investigator: __----- _---------- State: --_____
Do Normal Circumstances exist on the site? )G N
Q Community ID:
Is the site significantly disturbed (Atypical Situation)? ?
Yes 16101 Transect ID:
Is the area a potential Problem Area? Yes J? Plot ID:
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. L, a!- - - b- . _ - Gl -A?L3?T _ -3. o s.---------------- --- ----

3.??il(?as.b ---
4. 4,L,-19j
5. V 13.
14.
7.------------ -- ---- 15.------------
8.-------------- - 16.-----

Percent of Dominant Species that are OBL, FACW or FAC ?-?-
>
_ Fp _____________
(excluding FAC-).
----------------------------
I
Remarks: (?jl E(1/1 (lam j ...y\ L 5 ?ve4 ?.
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
Cher
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
= Saturated in Upper 12 Inches
Water IVIarks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
_ Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches

/
0 Water-Stained Leaves
Depth to Free Water in Pit:
(in.)
1 _ Local Soil Survey Data
FAC-Neutral Test
Depth to Saturated Soil: - (in.) - Other (Explain in Remarks)
Remarks:

B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase):J Drainage Class:
Field Observations
Taxonomy (Subgroup): V'0!7"C-?Kt/?s?.3 Confirm Mapped Type? Yes No
Profile Description j'
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
?y(inches)
Hydric Soil Indicators:
Histosol - Concretions
_ Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor --0 rganic Streaking in Sandy Soils
Aquic Moisture Regime - !ste on Local Hydric Soils List
Reducing Conditions ed on National Hydric Soils List
!I eyed or Low Chroma Colors - Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Q No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? z No
Remarks:
ADDroved by HOUSACE 3/92
Appendix B Blank and Example Data Forms B3
/w/y4 6.1
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:Wi58 t-"4_09 17'/a .,_(3ew..,.,-+- C,?--- Date: _??J°-°-----
Applicant/Owner: - ------ _ _ County:
Investigator: __?s t S!L _---------- State:
Do Normal Circumstances exist on the site? es No Community ID:
Is the site significantly disturbed (Atypical Situation)? es Q Transect ID:
Is the area a potential Problem Area? Yes 09 Plot ID: `-_
If needed, explain on reverse.
VEGETATION
Dominant Plant S ecies Stratum Indicator Dominant Plant Species Stratum Indicator

2.izzc f ??ua1_?{D Focc 3• ? 10.-----_----
-- ----- ----

4.Ls'c:1.?ct.r?VrdrG_??u. yr?r??J7 FcaG_° 12.------------- -- --- ----

6. 14.
7.------------- --- - - 15.---------

Percent of Dominant Species that are OBL, FACW or FAC
}
??`2
(excluding FAC-). J
6
Remarks: (? ???P?i-i n^ S /O?'+?" "v
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: (in.) _ Local Soil Survey Data

il
h
d S
i
D
S _ FAC-Neutral Test
lain in Remarks)
Other (Ex
: (
ept
to
aturate
o
n.) p
-
Remarks: lNri7 (c+r.p? /r'rG+:??aq y i 5 /uo{" ?r'e?.?+"
62 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name /
(Series and Phase): ijot "J5 !_'O0.__ 01 .?/ Drainage Class: ___----
?1 1?ca r. ( Field Observations
Taxonomy (Subgroup): Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
Hydric Soil Indicators:
__ Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sutfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local Hydric Soils List
__ Reducing Conditions - Listed on National Hydric Soils List
-_- Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: W e-?-Jo.v- d Soy 5 c?? nJ?? ?v^?2
WETLAND DETERMINATION
Hydrophytic Vegetation Present? <22?) No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes 1z
Remarks: / " a ?\ N ek L" ci?5 ? - /V-
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With:r y
L h Date:
71q?aZoco Time: M
/U : 3p PM
Of: ttlo?{tic??•.? //lcw,:-?-? l=. :s LLa,,;s Phone #:
oZs-.? 7.28 S"?34 c?
f?•??ls ?.,de,,..v S ,'ti OQ....,t
Re: C- nos .0 %Q ?!O S? ?'? Po. ?
I laced Call ® Party Called ?
My Message Reply
Party's Message Reply k
Action or Follow up Necessary N0
Refer to: File #:
Signed:

Phone Conversation Record
Talked With:
rya ?5 Date:
7????dat? Time:
?C3 % 3? PM
Of. S ae,? G ? 5 fvr, c ?.--?5 ?? ? e c c¢, Phone #: yi 9 ? 3 3 - 4e7C 3
Re:
I laced Call Pa
rty Called ? A/4,-.As h c .- 410401 e t3e?.
My Message Reply
Party's Message Reply Q je
Action or Follow up Necessary Ajj
Refer to:
se File #:
Signed: --
a?
p p9.59
0
DWQ ID: CORPS ACTION ID:
U
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) I8
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort CoutltV
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Long: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int of RR 174?
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES Fj NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES F-] NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F-1 NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED "TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sd. Ft.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE llvIPACTED:.01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: I FT AFTER: I FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM%FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY I I DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO F? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES [] NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES F? NO 71
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT. DIRECTOR STATE CLEARINGHOUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET. RALEIGH,
NORTH CAROLINA 27603-5003, TELEPHONE [phone].
IS. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL i1ATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18,2 1 , 26, 29, AND 35).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
//J, Q4-- ? ? .D,',, 2 E?
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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-74
7?

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: ?+,?------ Date: -? a oab

Applicant/Owner: N_S.DsDr __
County: _
Investigator: State: t?l.C', _--
Do Normal Circumstances exist on the site? feQ N?Q Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes Transect ID:

Is the area a potential Problem Area?
Yes ---
Plot ID-.

If needed, explain on reverse. -_-
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator

3.?l? ° -GjLiBSrLiL-_---- 11.-------------- - ----
4
.14s_1??-------? -3 ' '
1 z.-------------
-
14.

Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-l.
Remarks: w14'1 6kVI'd !f? ?,*-i..?.? i S ?Y?-S-.a-,•
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or ride Gauge
Aerial Photographs
_Zfher
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
_ Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches

? _ Water-Stained Leaves
Depth to Free Water in Pit:
(in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks:

B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name /
(Series and Phase): Drainage Class:
Taxonom Sub rou f C Field Observations -
Y (Sub g p): --f---- '? ? -_-__-_ Confirm Mapped Type? Yes No
Profile Description: l'
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
Hydric Soil Indicators:
Histosol Concretions
_ Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor _ Organic Streaking in Sandy Soils
- Aquic Moisture Regime _ste on Local Hydric Soils List
_ Reducing Conditions ed on National Hydric Soils List
Ieyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: 1 Zliv.v? 5 c?J ?5 yy ;Lti-P?z
WETLAND DETERMINATION
Hydrophytic Vegetation Present? IQ No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? e® No
Remarks:
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
X19 h 6;j
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: Co`__- Date: 1? o_
Applicant/Owner: 1cJcc?1____`W-_`-___________ County: _(?r ?•f.- F
Investigator: ?------------------ ----- State: .......
Do Normal Circumstances exist on the site? es No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes Transect ID:
Is the area a potential Problem Area? Yes (1 Plot ID:
(If needed, explain on reverse.)
VEGETATION
Dominant Plant S ecies Stratum Indicator Dominant Plant Species Stratum Indicator

2._ 1ZJ Y0&- 10.------------ --- ---
----------------- -
a.L,'fst..,.4?t,wr.-fv_•lw yHJ Fac__° 12.--------
--------- --- -----

6. '5
7.----------------- ---- ---- 15.--------
-----
- ----- ----

Percent of Dominant Species that are OBL, FACW or FAC
}SO 2
y
(excluding FAC-).
Remarks:
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
-. Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: ?a (in.) - Local Soil Survey Data

D
th t
S
t
t
d S
il _ FACTest
-Neutral
Other (Ex
lain in Remarks)
ep
o
ura
e
:
a
o p
-
Remarks: 5
B2 Appendix 6 Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): aq -)?-_- ? Drainage Class: --
?j Field Observations
Taxonomy (Subgroup): Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
------ ----- -------- --------- ----------- --------------
Hydric Soil Indicators:
Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
_ Aquic Moisture Regime Listed on Local Hydric Soils List
Reducing Conditions Listed on National Hydric Soils List
Gleyed or Low-ChromAa Colors - Other (Explain in Remarks)
Remarks: (..,J a -?- /o..- SUS (5 C- -e AJWk- e4"Q
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ( , No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes
Remarks: I'll)
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked With: /mar yr

L Date:/

7l?atvco
Time: M
A/) 3o PM
Of: Phone #:-a 7? sv 9 C?
Re: el , o ( .. a .nos .. ?IDS? 1?+?7S?i?..?e?s l?•-?o?aa..v...?ja ?8 ?'., 0?..+d"...,t
C'o•a+t?y
I laced Call Party Called ?
My Message Reply
Party's Message Reply O k
Action or Follow up Necessary N0
Refer to: _ File #:
Signed:

Phone Conversation Record
Talked With: // Date- Time:
Of. s,? a.f G rrs 5 err i z /?.-?.5 ¢r• ?w?r ?» ac ua, Phone #: y? q 7 3 3 - 176 3
Re: ,G? %?,:, v / a e „- t S
S
I laced Call Pa o ?D 5?

rty Called ? w G?-Ier.?..?s c?rr ?S.- •t/r?,0/ 8. %, G3c ?.
esu ? ?j
My Message Reply
Party's Message Reply Q
Action or Follow up Necessary ,to
Refer to:
s)e /6'a.S File #:
Signed:
o?
.A
409 59
DWQ ID: CORPS ACTION ID:
f
"Olo

L
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 18
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEL{ ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1528 Beaufort County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jav Johnson. NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Beaufort - NEAREST TOWN: Bath
USGS TOPO Pinetown Quadrangle Lat: 76 47 23 Long: 35 30 57
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1528 Boyd road at
int. of SR 1742
6. IMPACTED OR NEAREST STREAM/RIVER: Bath Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES 0 NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES F-1 NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES 0 NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES [-? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
500 Sy. Ft.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:.01 EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED: .01
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY I 1 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1528 to end. Realign 1528 at int. of SR 1742
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1528
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 7/19/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 7/19/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO 7 (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES F? NO
(b) IF YES. HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLE,=RINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED 1-0 MS. CHRYS BAGGETT. DIRECTOR STATE CLEAR]NGI-(OUSE. NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION. 116 WEST JONES STREET. RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILE, MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
'S/AG 'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
E-jj

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t

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:5?1? Date: ?,l9ap

Applicant/Owner: N_S4s2r _______._-__-_______-____ ---
County: _IRom
Investigator:
?----= - --------------------
State: -_1tJ •-C'?---
Do Normal Circumstances exist on the site? )0 No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes 16 Transect ID:

Is the area a potential Problem Area? Yes J? _
Plot ID: `-
If needed, explain on reverse.)
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. ;. 4- -- t? ?? aJ ?r_ -3. o s.---------------
di 7 10.

6. -0 6/1 14.
--------- ----- -----

Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: 6kr' i
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
Aerial Photographs
Cher
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
= Saturated in Upper 12 Inches
Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands

?- Secondary Indicators (2 or more required):
Depth of Surface Water:
(in.) _ Oxidized Root Channels in Upper 12 Inches
K
? _ Water-Stained Leaves
Depth to Free Water in Pit:
(in.) _ Local Soil Survey Data

? _ FAC-Neutral Test
Depth to Saturated Soil: -
' (in.) - Other (Explain in Remarks)
,L-
Remarks: /v?/?'?`
?•-_{
?
?' ?
per 1 5?
.
7
z
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class:
t C L Field Observations
Taxonomy (Subgroup): -/`fv ?L? --_--_ Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture. Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moistl Size/Contrast Structure, etc.
Hydric Soil Indicators:
Histosol _ Concretions
_ Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor --0 r is Streaking in Sandy Soils
Aquic Moisture Regime -- iste on Local Hydric Soils List
Reducing Conditions ed on National Hydric Soils List
:?! eyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: G?f ?i?[C?u? 5 S r `?-??t'(?YQ"+
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes 45 Is this Sampling Point Within a Wetland? e® No
Remarks:
V" a-v?-O( !r/ ?Gs2ZH`Lej?Q.?-S ?^A-' ?r`-""?
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
/.//9 h 6;,Zl
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: j ,f z-o? /7'Fa+_?_6e?.• rCo`__- Date: J o_ _
Applicant/Owner: _61c%___________ County:
Investigator: - _-----_-___________ State:
Do Normal Circumstances exist on the site? es No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes 0 Transect ID:
Is the area a potential Problem Area? Yes ® Plot ID: -_-
If needed, explain on reverse.
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Soecies Stratum Indicator
1.'a
J1J?
s.------

d-tgS-l w yv1c7? .?i?!6 ?aG. • P
4.Lt.?s?+4L 12
-- ---- ---

- -- ---- ----
7.------------------- --- -- - 15.----
-
-
------------ ----- -----
Percent of Dominant Species that are OBL, FACW or FAC
2
(excluding FAC-). o
Remarks: GtJ?GLVt? :?Et'e:.4"??i ?'?'• S /?
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
_3,,P ecorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches
Water-Stained Leaves
Depth to Free Water in Pit: / ?oZ (in.) _ Local Soil Survey Data

h
il
i
D
S
d S _ FAC-Neutral Test
lain in Remarks)
Other (Ex
ept
to
aturate
o
: (
n.) p
-
Remarks:
82 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name /
(Series and Phase): Drainage Class:
?T- Field Observations
Taxonomy (Subgroup):??-_ Qt?=_---- Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (_Munsell Moist) Size/Contrast Structure, etc.
----- - ---- ------- --------- ------------- --------------
Hydric Soil Indicators:
Histosol Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local Hydric Soils List
__ Reducing Conditions Listed on National Hydric Soils List
___ Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: I?j a /p,,r-.d Spa;, I S akv-Q nJQ?- ??
WETLAND DETERMINATION
Hydrophytic Vegetation Present? <ZZ> No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes Is this Sampling Point Within a Wetland? Yes Iz
Remarks: a (o v? N C-4-L0-'V ' /? l??a qtr-vv? . ?4-e,? S ?. ?v^a? rc1Q ?- ??
Approved by HQUSACE 3/92
Appendix I3 Blank and Example Data Forms B3
Phone Conversation Record
Talked With:
LGwr y /'+" Date:
7?q?otvao Time: M
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I laced Call ® Party Called ?
My Message Reply
Party's Message Reply OX
Action or Follow up Necessary N0
Refer to:
S2 (5'? ? File #:
Signed:
Phone Conversation Record
Talked With:
¢??'r?a ?S Date:
7???j?dar? Time:
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117
I laced Call Party Called ?
My Message Reply
Party's Message Reply LIZ
Action or Follow up Necessary ?,O
Refer to:
S? ??dS File #:
brgnea: