20020452 Ver 1_Complete File_20020326

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Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
DWQ Project No.: GZ County:
Applicant: A,, C, )b T - w/5l caJ /Z -
Project Name: P? .fc? c T of 66-1
Date of Issuance of 401 Water Quality Certification:
-J45 7d
v
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
1, f? ( flat dE2 , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance a ' tent of the 401 Water Quality Certification and Buffer Rules, the
approved plan sp?elf , and other supporting materials.
Signature: ` Date:
Agent's Certification
1, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature: Date:
If this project was designed by a Certified Professional
as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe
(periodically, weekly, full time) the construction of the project, for the Permitee hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No. Date
WTLM/401(MP
JUN ? ?
XATER QUALITY SECTION
r4CDMR
Division of Water Quality
Wetlands/401 Unit: [phone]
Fax: [phone]
1650 Mail Service Center Raleigh, NC 27699-1650
*i
W A rF Michael F. Easley, Governor
\Ot0 R pG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
7 Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
April 23, 2002
Gaston County
DWQ Project No. 020452
Replacement of Bridge No. 80 on SR 1402
APPROVAL of 401 Water Quality Certification with Additional Conditions
Ms. Trish Simon, Division Environmental Officer
NCDOT Division 12
P.O. Box 47
Shelby, NC 28151-0047
Dear Ms. Simon:
You have our approval, in accordance with the attached conditions and those listed below, to incur 80
linear feet of impacts to an unnamed tributary to Long Creek for the purpose of replacing Bridge No.
80 on SR 1402 in Gaston County. The project should be constructed in accordance with your
application dated March 22, 2002 (received March 26, 2002). After reviewing your application, we
have decided that this fill is covered by General Water Quality Certification No. 3375 corresponding
to the U.S. Army Corps of Engineers Nationwide Permit Number 14. 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 with the accompanying 404 permit unless otherwise specified in the Water
Quality Certification.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us in writing and send us 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 conditions. If total wetland fills for
this project (now or in the future) exceed one acre or if stream impacts exceed 150 linear feet,
compensatory mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). For
this approval to be valid- you must follow the conditions listed in the attached certification and any
additional conditions listed below.
1. NCDOT shall follow Best Management for the Protection of'Surface Waters (March 1997) and
comply with the requfrements for WS-11-HQW waters as specified in 15A NCAC 2B .0214.
2. Storm water must be directed to buffer areas or retention basins and must not be routed directly
into streams. Mowing of existing vegetated buffers is strongly discouraged, so that they may be
utilized for storm water sheet flow.
Temporary or permanent herbaceous vegetation must be planted on all bare soil within 10 days of
ground-disturbing activities to provide long term erosion control.
The structure and rip-rap required for this project shall be installed in such a manner that the
original stream profile is not altered (i.e. the depth of the channel must not be reduced nor the
stream channel widened). Existing stream dimensions are to be maintained above and below
locations of the cul\ert. Disturbed floodplain benching should be restored to natural geomorphic
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
conditions in front of the concrete headwall and upstream and downstream of the second, storm
water flow pipe.
5. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If rip-rap is necessary, it must be limited to the stream bank below the high water
mark, and vegetation must be used for stabilization above high water.
6. All work shall be performed during low flow conditions.
7. All mechanized equipment operated near surface waters must be regularly inspected and
maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or
other toxic materials. Heavy equipment should be operated from the bank rather than the stream
channel. Under no circumstances must rock, sand or other materials be dredged from the wetted
stream channel under authorization of this permit, except in the immediate vicinity of the
culverts.
8. Riparian vegetation must be reestablished within the construction limits of the project by the end
of the growing season following completion of construction.
9. Upon completion of the project, the NCDOT shall complete and return the enclosed "Certificate
of Completion" form to notify NCDWQ 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 NC Division of Water Quality when the project is completed.
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 that conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This
certification and its conditions are final and binding unless you ask for a hearing.
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 Ms. Cynthia Van Der Wiele at 919-733-9646
or Mr. Samar Bou-Ghazale of the Mooresville Regional Office at 704.663.1699.
Sincerely,
4ry J. orpe, P .
ti Director
Attachment
Pc: Wilmington District Corps of Engineers
John Hendrix, USACE Asheville Field Office
Samar Bou-Ghazale, NCDWQ Mooresville Regional Office
-?- _ _. _ _ - -- _-Central Files. .
File Copy

r
020452
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
MAR ? ,. ??
Wf41'FR ??? ?L:
ION
MEMO TO: John Dorney, DENR/DWQ/401/Wetlands Unit
FROM: Trish Simon, Division 12 Environmental Officer.15
DATE: March 22, 2002 PAYMENT
SUBJECT: Pre-construction Notification/401 Automated Payment RECEIVED
Enclosed are seven copies of a pre-construction notification permit application for
a bridge replacement project in Gaston County for your review and comments.
Project information for the 401 Automated Payment Procedure
• Work order number: 4312B-549-5.8152-558-SR1402-81080
• TIP #: Not Applicable
• Project Category: $200.00 Fee
is
Post Office Box 47 Shelby, North Carolina 28151-0047
?_l i 0 -, 0, 't°q26 -?

1 1/4 U?un sECi, "
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. Box 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
March 22, 2002
Mr. John W. Hendrix - NCDOT Projects
US Army Corp of Engineers, Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
Dear Mr. Hendrix:
The North Carolina Department of Transportation, Division of Oghways, proposes the following
project for your issuance of a Section 404 Permit. We believe this project can be accomplished
under Regional General Permit 198200031.
COUNTY: Gaston
LOCATION: Bridge #80 replacement on SR 1402, west of Bessemer City
STREAM: Unnamed tributary to Long Creek, WS-II HQW Waters (From source to
a point 1.2 miles upstream of Gaston County SR 1401), Catawba River
Basin
PROJECT DESCRIPTION: The project consists of replacing a deteriorating 20'wide x 20'
long concrete and steel bridge with a 50-foot double line of 96" CMP with a concrete inlet
headwall on 0.10 acres of NCDOT right of way. It is proposed that five-foot riprap aprons will be
placed in the streambed and fifteen feet of riprap will be placed on the streambanks at the pipe inlet
and outlet for structure stabilization. In an attempt to reduce sediment impacts to the stream, the
west pipe is to be installed initially. After installation of the west pipe at stream grade, temporary
cofferdams will be used to route water through the newly installed pipe during construction of the
east pipe and the headwall. These temporary impacts are contained within the 80 feet of permanent
impacts of the fill and riprap. The west pipe is to be installed at streambed grade and the east pipe
is to be buried one foot below streambed elevation (based upon thalweg elevations) to maintain low
flow through only one side of the double pipes. Riprap faced floodplain benches will also be
constructed at the inlet and outlet to divert stream flow through the low flow pipe and to maintain
channel dimensions. No wetlands are impacted by the proposed project. Enclosed is PCN
application, a sketch of planned activities, and location maps relative to the proposed project.
_c,, vED
Mr. John W. Hendrix
Bridge #80 Replacement, SR 1402
March 22, 2002 - Page 2
Based upon the "Guidelines for the Location and Design of Hazardous Spill Basins", which are
referenced in DOT's Best Management Practices for the Protection of Surface Waters, the
applicable locations for the placement of hazardous spill basins are at stream crossings on highways
functionally classified as rural or urban arterials and where the stream crossing is within/2 mile of
the critical area. The proposed project is located in a WS-II HQW watershed within 1/2 mile of the
critical watershed area; however, the road is not functionally classified as a rural or urban arterial.
With consideration to the road's low potential for hazard relative to traffic use, the Department of
Transportation feels that hazardous spill basins are not warranted for the proposed pipe
replacement project. Enclosed is the "Guidelines for the Location and Design of Hazardous Spill
Basins" and the NCDOT hazardous spill basin checklist.
There are three federally listed threatened and endangered species listed for Gaston County - the
bog turtle (Clemmys nnihlenbergii), the bald eagle (Haliaeetus leucocephalus), and Schweinitz's
sunflower (Helianthus sclnveinitzii). A review of available information revealed that there is a
known bog turtle site located -1.5 miles from the project area. This site is located in another
drainage to Long Creek; therefore, no impact on this site is anticipated. A survey was conducted
on September 13, 2001 in the vicinity of the proposed project for the bog turtle, the bald eagle, and
Schweinitz's sunflower. None were found. It was determined that there will be no impact on any
federally listed threatened or endangered species. A review of the available information from the
National Register of Historic Places was also conducted. It is anticipated that there will be no
impacts to the National Register site by the proposed project.
By copy of this letter, we are asking Neil Trivette, NCDOT Roadside Environmental Field
Engineer to comment on the above project. By copy of this letter, we are also requesting
concurrence from the Wildlife Resources Commission and U.S. Fish & Wildlife Service.
By copy of this letter, I am forwarding seven (7) copies of the application package to John Dorney,
NCDENR, Division of Water Quality, 401/Wetland Unit for review.
Your earliest consideration for this request would be greatly appreciated. Should you have any
questions, please call me at 704-480-9020.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
er
Trish Simon
Division 12 Environmental Officer
Mr: John W. Hendrix
Bridge 480 Replacement, SR 1402
March 22, 2002 - Page 3
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Dan Holderman, P.E. , Division Bridge Engineer
Mr. Neil Trivette, Roadside Environmental Field Engineer
Mr. Ron Linville, WRC
Mr. Brian Cole, USF & WS
Mr. John Dorney, DENR,DWQ,401/Wetlands Unit (7 copies)
File.
Office Use Only: Fonn Version October 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: Regional General Permit
#198200031
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: Mike Holder, NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Trish Simon
Company Affiliation: NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: tsimon a,dot.state.nc.us
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name ofproject: Bridge 480 Replacement on SR 1402, Gaston Countv
2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.8152
3. Property Identification Number (Tax PIN): NCDOT Right of way
4. Location
County: Gaston Nearest Town: Bessemer Citv
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): From Hwy 216 north from Kings
Mountain, east on 1402 to bridge.
5. Site coordinates, if available (UTM orLat/Long): 35°17'33N/81°20'23W
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
Bridge on paved secondary road
7. Property size (acres): 0.10 acres NCDOT right of way
8. Nearest body of water (stream/river/sound/ocean/lake): Unnamed tributary to Long Creek
(From source to a point 1.2 miles upstream of Gaston County SR 1401) Class WS-II (HQ%
waters
9. River Basin: Catawba
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at littp:Hh2o.enr.state.ne.us/admin/maps/.)
Page 6 of 12
10. Describe the purpose of the proposed work: The project consists of replacing a deteriorating
20'wide x 20' long concrete and steel brid.Re with a double line of 50-foot long, 96" CMP
with a concrete inlet headwall. At the pipe inlet and outlet, five-foot riprap aprons will be
placed in the stream bed and fifteen feet of riprap will be placed on the stream banks for
structure stabilization and protection.
11. List the type of equipment to be used to construct the project: A trackhoe will be used
for excavation and placement of riprap.
12. Describe the land use in the vicinity of this project: The surrounding area is wooded and
residential yards.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
NA
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
ss 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at hltpJhr,NN-%v.fema.gov.
List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0
2. Stream Impacts, including all intermittent and perennial streams
Stream
Impact Site
Le
Impact Average Width Perennial or
Number Type of Impact* (lin r feet)
? Stream Name** of Stream Intennittent7
(indicate on Before Impact (please specify)
nm
1 96" CMP 50 feet UT to Long
Creek 7 feet Perennial
5 ft Riprap aprons in
1 stream/15 ft of riprap 30 feet "
on banks at inlet/outlet
for structure protection
Constructed within
1 Temporary cofferdams the 80 feet of "
permanent impacts
• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
w'\vw.uses.pov. Several intemd sites also allow direct download and printing of USGS maps (e.g., %NANiv.topozone.com,
xNAv\v.mapqucst.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: Pipe and riprap impacts =
80 feet.
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S. NO OPEN WATER IMPACTS
Open Water Impact Area of Name of Waterbod
y Type of Waterbody
Site Number Type of Impact* Impact
(if applicable) (lake, pond, estuary, sound,
indicate on ma (acres) bay, ocean, etc.

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Page 8 of 12
4. Pond Creation NO POND CREATION
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aestlietic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
NCDOT plans to replace the bridge with a 50' double line of 96" CMP due to the lower cost
(-$40,000) associated with this option. Estimates to replace the bridge with a 50' bridge is
-$100,000. In an attempt to reduce sediment impacts to the stream, the west pipe is to be
installed initially at streambed grade. Temporary cofferdams will then be used to route water
through this pipe during headwall construction and installation of the east pipe, which is to be
buried one foot below streambed level. Riprap faced floodplain benches will be constructed at
the pipe inlet and outlet to divert stream flow through the low flow pipe and to maintain channel
dimensions.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
Page 9 of 12
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
littp://h2o.enr.state.nc.us/ncwetlands/strmgide.htmi.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
IMPACTS < 150 FEET, MITIGATION NOT ANTICIPATED
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http:/Wo.enr state nc usAvm/index htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
M Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
Page 10 of 12
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
No additional impervious surface is proposed in this project.
XII. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Page 11 of 12
X11L Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes El No
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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Name: BESSEMER CITY Location: 035° 17'33.4" N 081° 20' 17.9" W
Date: 3/182002 Caption: Bridge #80 Replacement on SR 1402 on an unnamed tributary to
Scale: 1 inch equals 1000 feet Long Creek, WS-II Waters, Catawba River Basin
Copyright (C) 1997, Maptech, Inc.
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Project Name: L I-.
-? River Bum: Count
DWQ Project Number: ;Icarest Named Sueam` Y uwude:
Data J `, %r? USGSQUAD- T Longitude: 1.
•PLEASE NOTE: /(r.,lvn,r.ndl,n/aw•o,pr, r,S,i stir/recur ir, m,n.,w,Jr ditch, rhrn cur o(rhir/ar,n is nor n,crss,rj,
A4a %in U• Dnr pro/ruio.dju/jr,nmr o(th, rr.(.uor, tA,? u.rr :r . m.n.n,d, ditch -d nor . nal?r/ nu.ra! suns-this
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Cvalumor. I J) n.,y; y I
Signature: J.
LocatioNDircctions:
Loy, V )
Primary Field Tndicatnrs: rcel,o.,N..e..rrri.rl j?C?;'Cft?
t rrn b I
Ah••"t W tr tl I

1) Is There A ilifne•Pool Sequence?
00
O1 Cr
02
2 Is The USDA Texture in Strcanrxd
Dilr
0
erret From Sunoundmst Temin? 0 O 1
?.?
02
3) Arc Natural Levees Present? 04-- 01 02 01
s) Is The Channel Sinuous? 00 01 02
5) Is There An Active (Or Relic) Floodplain Present? 00 01 02 0_3--
6) Is The Channel Braided? G-1 _/ 01 02 03
7) Are Recent Alluvial Deposits Present? 00 01 02 0---
8) Is There A BankEull Bench Present? 00 01 02
Is A Continuous Bed & Bank Present? '''

9) PNOM rlsd d b•, C..ud B, D,, h,.a.t.d 47viour s•,uuy rs.• /(
??
Sens-09 0
01
02 ? /
?,J 3
10) Is A 2nd Order Or Grurcr Channel (As Indicated On Togo
Mae And/Or In Field) Prasent? W'YE S'1 O tb•0
PRIMARY GEOMORPHOLOGY INDICATOR POINTS.
OVA L UEI
11. Hvdrolo• Absent Wcnk Moderate Strone
1) Is There A (;roundwatcr
FlowrOiecha,Ve Present? 00 01 02
07?
PRLMARYHYDROLOGY INDICATOR POINTS.
h VALUE[
111. Biolncv Absent Weak Moderate S(ronr•
1) Are Fibrous Roots Present In Streambcd7 01 01 00
2) Are Rooted Plants Present In Streambed? FS? 0
1, 01 00
3) Is Periphyton Present? 00 01 G_: 03
4) Are Bivalves Present? Q,t!' 01 02 03
PRIMARY BIOLOGY INDICATOR POINTS,
Secondary Field Tndiea t0l•C: rG.cb O•r N,.,N. rr, L'erl #VA L UE1
1. Gcomornhnlo" Absent Weak Moderate S(rnnt!
1) Is Thos A Head Cut Present In Channel? 00 00.5 01
S
2) Is Thera A Grade Control Point In Channel? O 0 O OS O 1
3 Dos Topograpny Indicate A
Natural Dmina ¢e Wavs
cc
00.S
01
.5
SECONDARY GEOMORPHOLOGYINDICATORPOINTS.

1I. IH'drolnsrv
Is This Ycars (Ur Laws) l.utb«er
I) Present In Str-.ambcd? rte'

Absent

al-s-
1.5
9VA L UE!
Weak

01

Moderate

00.s

Strong

(D 0
2) Is Sediment On Planu (Or Debris) Prescnt? 00 00.s 01 O.t:r_
3) Arc Wrack Lines Prtsent? 00

, is Water In Channel And >48 Hrs. Since o
)Last,hnown Rai n? r•vOlE:1/DwAl.e;n,dr. rv ,lyo.. S1?s T1?r S,n,.e al dr?-9 00.S

OOS 01

01
•S
^
1s-tS
Is There Water In Channel During pry
S) Conditions Or in Growing Snsonl? 00
00.5
01
6) Arc Hydric Soils Present in Sidcs O(Channcl (0, 1, Hr.uru«' ?'yes•IS O rvo•o
SECONDARY HI'DROLOGYLYDICATORPOINTS. 1? #VALUE!
Ill. Biology Absent Weak Moderate Strong
1) Arc Fish Present? Qa_ 00.5 01 0,..s
2) Are Amphibians I'ment? 00 00.S 01 • S
3) Arc AquatieTunles Present? 00.5 01 O iS
I) Arc Crayfish Present? 00 00.s 01
1T3.5
5) Are Macrobenthos Present? 00 (D OS 01
6) Arc Iron Osidiiing Bactcria/Fungus Prtscnt? 0 00j 01 O 13
7) Is Filamentous Algae Present? 00 0-c s, 01 O IS
8) Art Wetland Plants In Stresmbcd? SAV
r none:vro.rdarr•ro(.urr..,rasy..a./ArNurd 02 Mostly OBL
01 Mostly FAC1V
rs
Oo Mostly FAC
O Mostly FACU Diostly UPL

db••y Sb, 7su srr UNL£SL S.1 v Avrr•, •/ . o.s Oo 00
SECONDARYBIOLOGYbVDICATORPOINTS -
. C7 "VALUEI
x

TOTAL, POINTS (Pri,,,nn•?,Crro,nlnn•1. MVLUE! (Il Crrarrr than Or Equa(To 1+Poin rs rht scream is (f Lrarr rnrrrminrnrJ
53.._
3"t•D?t>
INTERMITTENT CHANNEL
EVALUATION FORM
ACTION ID APPLICA.YTNA lE DATE 3"? ?'aZ
PROPOSED CHANNEL WORK(i.c., culvert, relocation, etc.) _ ,?r I CP re `? 1 0 r `1'
Pn//tPr?r? D?
WATERBODY/RIVER BASIN I )? ? Lt?r C re<1? I??RCOUNTY/CITY
RECENT WEATHER CONDITIONS 144
SP NP Observation Comments or Description
r Fuh/Shelltrslt/Crustaccans Present
V--*"
Benthic Macro Invertebrates
Amphibians Present/Breeding
Algae And/Or Fungus (water quality function)
Wildlife Channel Use (i.e. tracks, feces, shells, others)
Federally Protected Species Present (Discontinue)
Riffle/Pool Structure
Stable Streambanks
Channel Substrate
(i.e. gravel. cobble. rock, coarse sand)
Riparian Canopy Present (SP =/> 50",o closure)
Undercut Banks/htstream Habitat Structure
Flow to Channel
Wetlands Adjacent ToiContig. With Channel
(Discontinue)
Persistent PooWSaturated Bottom
(June through Sept.)
Seeps/Groundwater Discharge (June through Sept.)
Adjacent Floodplaut Present
Wrack Material or Drift Lines
Hydrophytic Vegetation in/adjacent to channel
Important To Domestic Water Supply? ON
Does Channel Appear On A Quad Or Soils flap?(D N
Approx. Drainage Area: 5v gc r" e S
Delerminotion:
rEphemeral ennial Channel (stop) ptant Channel: LF PROJECT,INIGIL Initials
rmittent Channel (proceed) por
tant Channel: LF
Channel (nojdl (attach map indicating location of important/unimportant channel)
h Through Upland (nojd)
Evaluator's Signature: ', J,
(it other than C.O.E. project manager )
P=Prescnt SP=Siongly Present NP=Not Present 114/98
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1z County: cf? Project ID:/SZ v/ 3
River Basin: Bridge No: oB-o 7z>J
Route: SP /¢oZ Stream: !Ll y T/Zii3 ;? Gavh c,? ?lc_
11
Water Quality Criteria: ?-
Yes No
Stream Crossing Blue Line On USGS r;,' r
ORW f r?
WSI r r?
WS H,HI OR IV, Crossing Within 0.5mi of W.S. Critical Area r?' r
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban F V
Arterial Rural r r?
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required?
r r?
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
APPENDIX O
SHEET 1 OF 2
GUIDELINES FOR-THE LOCATION AND DESIGN
OF HAZARDOUS SPILL BASINS
Hazardous Spill Basins are provided in new highway construction and major
improvment projects at strategic locations along arterial system highways to aid in
containment and clean up of accidental spills. The determination of these strategic
locations is based on concentrated truck usage areas such as; parking sites at rest
areas, weight stations, and runaway ramps, as well as for highway segments in close
proximity to particularly sensitive waters such as; outstanding resource waters and
water supply sources.
The strategy is to configure the highway segment of concern such that any
potential spill runoff would be directed through a facility (basin) where the flow could be
interrupted and temporarily stored to prevent hazardous material from reaching a
receiving stream.
The use of these basins and other management practices to protect receiving
waters is in accordance to the general policies and criteria presented in the departments
document "Best Management Practices for Protection of Surface Waters". The following
is additional specific guidance in the location and design of the basins:
APPLICABLE LOCATIONS
Basins will be provided at stream crossings on highways
functionally classified as a rural or urban arterials and,
• The stream(') is identified as an Outstanding Resource
Water (ORW) or a WS-1 watersupply, or
The stream(l) crossing is within 1/2 mile of the critical
area (2) of a water supply source classified as WS-II, WS-III
and WS-IV.
Provision of basins at crossings of those streams on highways
functionally calssified as collectors and local streets and roads can
be evaluated on a site by site basis with consideration for:
traffic volume, traffic type, accident potential related to the highway
geometries, receiving water quality, and the feasibility of basin
construction at the site.
APPENDIX O
SHEET 2 Of 2
(1) For the purpose of these guidelines "stream " will be defined as those depicted as
blue lines on 7-112 minute (1:24000 scale) United States Geological Survey
(USGS) quadrangles.
(2) Critical area is defined as extending 112 mile from the normal pool elevation of
a reservoir; or 112 mile upstream of, and draining to an intake. This would
make the effective area for hazardous spill basins placement, within 1.0 mile of
the normal pool or upstream of an intake.
DESIGN REQUIREMENTS
The volume of spill containment storage provided will be
approximately 10,000 gallons plus the estimated runoff volume
from a rainfall intensity equating to a two year return period
event.
A means will be provided such that the normal free flow of
runoff at the basin outlet can be interrupted to cause containment
of hazardous runoff. This can be accomplished by providing a
mechanical control gate or by constructing a minimum control
section in the outlet channel that could be readily blocked by such
simple mean as shoveled earth material or stacked bags.
The mechanical gate alternative will generally be utilized in areas
where normal operational activities would allow close scrutiny
and control, reducing the potential for problems with vandalism.
Examples would be rest areas, weight stations and within
controlled access.