20021561 Ver 1_Complete File_20020927

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September 30, 2002
Guilford County
DWQ Project No. 021561
Upgrade of SR 3404 (Kearney Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. J.M. Mills, P.E., Division Engineer
NCDOT Division 7
P.O. Box 14996
Greensboro, NC 27415
Dear Mr. Mills:
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact 42 linear feet and incur 40 linear feet of temporary impacts to an unnamed tributary to Polecat
Creek in order to upgrade SR 3404 (Kearney Road) in Guilford County. The project should be
constructed in accordance with your application dated September 16, 2002 (received September 27,
2002). After reviewing your application, we have decided that this fill is covered by General Water
Quality Certification Nos. 3366 and 3375 corresponding to the U.S. Army Corps of Engineers
Nationwide Permit Numbers 33 and 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. The impacted waters are classified as WS-III waters. NCDOT shall use Sedimentation and Erosion
Control Guidelines for Sensitive Watersheds (15A NCAC 4B .0124) and implement Best
Management Practices for the Protection of Surface. Waters (NCDOT, March 1997) to minimize
impacts to downstream aquatic resources. NCDOT shall abide by Water Supply Watershed
Regulations. Additionally, storm water should be directed to buffer areas or retention basins and
must not be routed directly into streams unless the applicant provides evidence that this is not
practicable or feasible.
2. Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for storm
water sheet flow.
3. All work shall be performed during low flow conditions.
4. 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. 1' ?'? ?
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), hftp://h2o.enr.state.nc.us/ncwetiands/
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
5. Riparian vegetation must be reestablished within the construction limits of the project by the end of
the growing season following completion of construction.
6. NCDOT is encouraged to use existing on-site vegetation and materials for stream bank stabilization
and to minimize the use of rip rap.
7. The pipes 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 by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of each culvert. The culvert shall be designed and installed to allow for fish and other
wildlife movement as well as prevent headcutting of the streams. If any of the existing pipes are
perched, they shall be removed and replaced, and installed correctly.
8. NCDOT must submit a plan for written DWQ approval to address any headcutting that will occur as a
result of this project.
9. 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. Rip rap shall not be placed in the
stream bottom.
10. The presence of equipment in the channels must be minimized. 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.
11. 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 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 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 919.733.5715 or Ms.
Jennifer Frye of the Winston-Salem Regional Office at 336.771.4600.
Attachment
Pc
Wilmington District Corps of Engineers
Jean Manuele, USACE Raleigh Field Office
Jennifer Frye, NCDWQ Winston-Salem Regional Office
Central Files
File Copy

Sincerely,
,, )y MSTATE
fLli jJ 1
STATE OF NORTH CAROLINA 0
DEPARTN MNT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
GOVERNOR SECRETARY
September 16, 2002 r
MEMORANDUM TO: Ms. Cynthia Van der Wiele SEP 2 ?C !' f
Wetlands/401 Unit
FROM: Lane Hall fer?oy
District Engineer, District 2, ivision 7
SUBJECT: Payment Information - Water Quality Certificate forGuilford County,
Kearney Road (SR 3404)
In accordance with General Statute 143-215.3D(e) the following information if being provided to
facilitate payment of fees associated with the appropriate Water Quality Certificate:
• Certificates being requested: #3375 (NWP 14) and #3366 (NWP 33)
• Work Order Number : 9.8073103
• Amount of fee: $200
PAYMENT
RECEIVED
PHONE [phone] FAX [phone]
Ty' J n^IZ u
OF NORTH CAROLINA
-,?T OF TRANSPORTATION
MICHAEL F. EA. , ANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
September 16, 2002
Mrs. Jean Manuele
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 2761
(Two Copies)
Ms. Cynthia Van der Wiele
Wetlands/401 Unit
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
(Seven Copies)
LYNDo TIPPETT
SECRETARY
SUBJECT: Guilford County, Upgrade of Kearney Road (SR 3404) from an unpaved secondary
road to a paved secondary road. State Project Number: 9.8073103
To Whom It May Concern:
The North Carolina Department of Transportation (NCDOT) proposes to upgrade Kearney Road
(SR 3404) from an unpaved to a paved secondary road to reduce future maintenance needs and
increase traffic safety. This activity will result in impacts to a stream due to the replacement and
extension of a crossline pipe to facilitate travel lane and shoulder widening. The NCDOT
anticipates that the pipe replacement activity will be authorized under Nationwide Permit (NWP) 14
and the dewatering operation will be authorized under NWP 33. This application is intended as a
request for formal written authorization from the USACE for dewatering activities occurring under
NWP 33. This application is also intended as request for written authorization from the NC
Division of Water Quality to replace the pipe under General Water Quality Certificate # 3375 (NWP
14). The following information is being provided to satisfy Nationwide Permit Condition 13
(Federal Register January 15, 2002) and Condition 1 of General Water Quality Certificate # 3375.
PHONE [phone] FAX [phone]
PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Kearney Road 3404 0.30 Subdivision
River Basin: DWQ
ID Water Quality
Designation % New Impervious
Surface
Cape Fear 17-11-(1) WS-III 5
Buffer Rules Buffer Rule Conditions (where applicable)
No Not Applicable
Protected Species
Presentb Mapped Historic
Pro erties° CAMA
AEC Essential Fishery
Habitat
No No review No No
'Separate documentation attached as needed: See the attached Endangered Species Review Sheet for further
information: `When Applicable - See the attached Historic Review Letter for further information
PIPE REPLACEMENT INFORMATION
Site 1 (26+00) Stream Type Perennial
(Station)
Existing (2) 38' Long 18" T.C. Pipe Proposed 60' Long 48" CMP
Pie Pipe
Construction Pump around with on-site detour Dewatering ABC aggregate
Method Device*
Burial Depth 10" E/C Plan 09-12-02
Date
Construction As soon as practicable Duration 2 weeks
Date
Impacts (ft.) 22-enclosure; 20-rip-rap dissi aters;40-tem ora
Special
Conditions
Restoration Within 15 working days of the of the pipe replacement all cofferdams will be
Plan entirely removed and natural stream contours will be restored and seeded.
Temporary silt screens placed in intermittent channels will be cleaned and
removed following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; EX = Erosion
control. *A less intrusive dewatering device may be used in lieu of the one proposed.
MINIMIZATION INFORMATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
-2-
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Lane Hall at [phone] or Len Smith at [phone]. Your time and effort are
appreciated.
Sincerely,
2c"Iti? Mills, P.E.
Division Engineer, Division 7
cc: Mr. Lenwood E. Smith, H, PWS, Division Environmental Officer 07/17/0
Mr. S. Lane Hall, District 2 Engineer &'L 'e
Mr. Paul Ingram, P.E., County Maintenance Engineer, Guilford
Mr. Donald Pearson, Area Roadside Field Operations Engineer
Mr. Kevin Hazelwood, Grade Crew Foreman
-3-
Office Use Only: J Form Version May 2002
Y t1 i?
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
N Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14 and 33
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 (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: Mr. J.M. Mills, P.E, Division Engineer- Division 7
Mailing Address: P.O. Box 14996
Greensboro, NC
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
2. Agent/Consultant 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: Not Abnlicable
Company Affiliation:
Mailing Address:_
Telephone Number: Fax Number:
E-mail Address:
Page 1 of 8
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 of project: SR 3404 - Kearney Road
2. T.I.P. Project Number or State Project Number (NCDOT Only): 9.8073103 (NON T.I.P)
3. Property Identification Number (Tax PIN): Not Applicable
4. Location
County: Guilford Nearest Town: Greensboro
Subdivision narne (include phase/lot number): Not Applicable
Directions to site (include road numbers, landmarks, etc.):
The project is south of Greensboro.
5. Site coordinates, if available (UTM or Lat/Long): See the attached sheet.
(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. Property size (acres): Not Applicable
7. Nearest body of water (stream/river/sound/ocean/lake): UT Polecat Creek
8. River Basin: Cape Fear
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at littp://li2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Residential Properties
Pauc 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used:
The project will involve paving an unpaved secondary road and bringing the travel lane,
shoulders, ditchlines, and drainage structures up to current standards. Travel lane widening
will be required to bring the road up to current standards. Standard shoulder widths will be
6'-8' with deviations shown on the attached site plan. Ditch widths will vary based onsite
conditions. Proposed right-of-way width is illustrated on the attached site plan. Equipment
used will be standard road construction equipment (trackhoe, grader, backhoe, and
bulldozer).
11. Explain the purpose of the proposed work: To upgrade an unpaved secondary road to a
paved secondary road. Paving and widening are being conducted to reduce future
maintenance costs. bring the road up to current construction standards, and increase traffic
safetv.
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.
Not Applicable
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.
Not Annlicable
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.
Pa,,e 3 of 8
1. Provide a written description of the proposed impacts: Permanent stream impacts will
result from channel enclosure and placement of rip-rap energy dissipaters. Temporary stream
impacts will result from placement of cofferdams (perennial streams) and siltscreens. Silt
screens placed in intermittent channels will be cleaned and removed following vegetation
establishment.
2. Individually list wetland impacts below:
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***
N/A

Lisr eacn unpact separately ano iocnttry temporary impacts. impacts Inciuae, but are not linuted to: mechanized cleanng, grading, till,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year tloodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local Iloodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at lit (I)Wwww.fenul.Lov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog. etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: Not Applicable
Total area of wetland impact proposed: Not Applicable
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on ma)
Type of Impact''' Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please secif )

1 (26+00)
Pipe replacement 22(en)
40(tmp)
20(r p)
UT Polecat Creek
3.0'
Perennial

Llst eacn Impact separamy ano tdenuty temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts clue 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
Www.uM*s.°ov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapclucst.cnm, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 22- enclosure (en),
40- temporary (tmp). 20- rip rap (r]2)
Page 4 of 8
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. 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.): Not Applicable
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): Not Applicable
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Pipe replacement activities are necessary to increase travel lane and shoulder width to current
construction standards. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of wetland and surface waters, restrictions against the staging of
equipment in or adjacent to waters of the US, and coordination (including a pre-construction
meeting) with the Division Environmental Officer.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division ol' Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or 1rcater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 5 of 8
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.
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
http://h2o.cnr.state.nc.us/iicwctIands/striii2i(le.htiTil.
Provide a brief description of the proposed mitigation plan. The description should provide
as muc11 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.
A finding of insignificant impact is anticipated; therefore, a mitigation plan is not provided.
Cumulative impacts are less than 150 feet. The maximum amount of impact to a single
stream is 42 linear feet. No Outstanding Resource Waters, federally protected species or
their habitats. Or essential fisherv habitats occur in the project area. The project is not located
in a Hi,-,Ii Quality Water.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wM/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): Not Applicable
Amount of buffer mitigation requested (square feet): Not Applicable
Amount of Riparian wetland mitigation requested (acres): Not Applicable
Amount of Non-riparian wetland mitigation requested (acres): Not Applicable
Amount of Coastal wetland mitigation requested (acres): Not Applicable
Pa,ie 6 of 8
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) 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
X. Proposed 1 mpacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or c`ent'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
(Neese), 15A NCAC 213 .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's Impact
(square feet) Multiplier Required
Mitigation
I N/A 3
2
I N/A 1.5
Total N/A
/.unc I extends out 30 feet perpendicular (horn near bank of channel; Zone 2 extends an
additional 20 feel fnnn the edge of Zone I.
Pa ,e 7 of 8
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.
Not Anulicable
XI. Stormwater (re(luired by DWQ)
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.
The_existin, travel lane is 16-feet. The proposed travel lane is 18-feet. The proposed right-of-
way is 60-meet. The percent new impervious surface (relative to the right-of-way) is 5%.
Because the percent new impervious surface is less than 30% stormwater controls are not being
provided.
XII. Sewage Disposal (required by DWQ)
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.
Not Applicable:
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No ?
Is this an after-the-fact permit application?
Ye` ? 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).
-LC.) -oZ
Appli at t/A?ent's Signature Date
(Agent's si,n ttu e is valid only if an authorization letter from the applicant is provided.)
Pagc 8 of 8
NATURAL RESOURCE EVALUATION SHEET
State Project # SR Number Road Name Cun Investigator(s)
3404 Kearney Road Guilford Len Smith
Date: River Basin: Water Quality Designation Buffer Rules (Type)
05/23/02 Cape Fear WS-III No
Primary Land Use Percent Residential Percent Agricultural Percent Unmaintained
Agriculture 70 10 20
Anticipated Permits or Consultations High Quality or Rare Wetlands Federally Threatened or Endangered
Species
NWP 14 & 33 No No
Types of Unmaintained Upland Properties
Community Type Dominant Trees Dominant Shrubs Dominant Herb(s)
Pine plantation loblolly pine Absent poison ivy, trumpet creeper
Disturbed forest tulip tree, American sycamore,
sassafras sassafras, black cherry,
smooth sumac Japanese honeysuckle, poison
ivy, trumpet creeper

Waters of the US
Streams

ST.
Stream Name Perennial or
Intermittent Ave. Wdth
OHWM Ave. Dpth
OHW11 Ave. Wdth
TOB Ave. Dpth
TOB
DWQ I.D.
26+02 UT Polecat Creek Perennial 3.0' 0.5' 4.0' 1.5' 17-11-(1)

ST = Station, OHWM = Measurements made from Ordinary High Water Marker, TOB = Measurements
made from the Top of the Bank
Wetlands

ST. Within 100-year
Floodplain Distance to
Nearest Stream
linear feet
Cowardin Classification
Dominant Plants
N/A

Open Water
ST. Name of Waterbody
if applicable) Type of
Waterbod M .M. Name of Waterbody
if applicable) Type of Waterbody
N/A

General Notes/Comments:

Division Environmental Officer
07/03/02
Date
ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 2
State Project # SR Number Road Name Count
3404 Kearney Road Guilford
Guilford County
River Basin: Cape Fear
Bald Eagle (Haliaeetus leucocephalus). Lake Higgins Area.
Is the activity within the primary or secondary zone Yes ? No
James s in ussel Pleurobetna collina - Roanoke Basin
Habitat Survey Date Investigator(s) Man-hours Commcnts/Findings
N/A
Potential Species (Listed in Nearby Counties)
Schweinitz's sunflower (Helianthuc sclnveinitzii) Mav he -mrveved fnr from late Anumt to (lctnher
Habitat Survey Date Investigator(s) Man-hours Comments/ Findings
No 05/23/02 Len Smith 0.5
General Notes/Comments:
Division Environmental Officer
L "LI
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division Seven County Guilford Project ID: 9.8073103
River Basin Cape Fear Bridge No:
Route 3404 Stream UT Polecat Creek
Water Quality Criteria
Yes No
Stream Crossing Blueline on USGS Z ?
ORW ?
WSI ?
WS II, III, or IV Crossing Within 0.5 mi. of W.S. Critical Area E]
Roadway Criteria
Route Designation Yes No
Arterial Urban ? Z
Arterial Rural ? Z
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? ? Z
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
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PROPOSED IMPROVEMENTS
40LDER,. John A. &
4nn M.
D.B. 2805 - 799
P.B.,57 - 87
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SR 3An4 K.EA R NEY RD
FENTRESS TOWNSHIP GUILFORD COUNTY; N..C.
SHEET 1 OF 1 CONST. LENGTH*:..0.30 MILE:
W.O. # 9.8073103 SURVEY LENGTH: 0.60 MILE
DATE : 7-3-02 .60` RM
SCALE 1 60r
UTILITIES
_x DUKE POWER CO.
x_ BELL SOUTH TEL. CO.
PIEDMONT NATURAL GAS CO.
CABLE TELEVISION
31+30.29
60 Ft.
RIGHT OF WAY
ril" oulder
Slope 2:1 / FT 1/4" / FT 1/ "•/ F
6f - < 41
xtldeF Ditch' Slope
1 "/FT 3:1 2:1
01-611
PI - PING ? Pedestal
Rl Pole © well
f Guy Wire ® Witness Post
S.D. Sight Distance Tree - Tree Line
e Sat Dish
- - Property Line
- - - - - - - - Exist Side Glitch.
- Exist RIW
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EROSION CONTROL LEGEND' .
McCLlNTOCK, Bobby F. $ TEMP. ROCK SED, DAM -TYPE A
Wanda G.
D.B. 3781 - 1357
TEMP. ROCKSED. "DAM -TYPE B
TEMP. ROCKSILT CHECK DAM - TYPE`B
i f F. G. ROVING OR E. C. MATTING
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2-2 a-sz
slor?corl
7 Review Ergs lon antrolPlansund;5tartd rds Edenfifyallroleasdpoints - -? STONELINER
,(outlets of Ctos.,iintt pipes; tail ditches roadway ditches, fill slopes, etc.
t
SILT FENCE
TEMP

2 ., l
See
Installa1I measuros @ re[easQ polnta prtarao doaring & grubbing.
.
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Erpslon Control. Standards for proper instaiJpdon.
. PIPE OUTLET PROTECTION

31, .
Begin grading dperatlons'-Jnstall all other measures as grading progtessos
and monitor tttel.'oNecdveness tf sny ti?easuros need to be changed, .

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EARTH BERM
consult'Highway Mainicrtance Engineor Show changes on Erosion
Cdntrot Plans TEMP. SLOPE DfAIN

a. e `el• I borrow P tts.and wastff a?aas with their erosion control measures
; i-orat,
qn Erosion Con?ol Mans-v attach a separate sheet shmVing same:. •:

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TEMP.. SILT. DITCH '

B, ?.
Sefor@ maving to nex! job situ reylpw all rneasuros' for effectiveness; make*.*.'ustmo* , cla n' cuts, or repair, call Floc sldo Envlronmer6l` Dept .
SILT BASIN - TYPE B (M1N, 0'X2'713'}
for lnsG3ltadon of a ditch liner ar#d seodMg and matching of aII disturbed .
aroas BRUSH BARRIER
H conouo to cht3cK and mzlnta* all nioasures after. each slg ficant rainfall.. `
unffait'disturtied ' ea. b'bcome stabilized'
7 F111 In all silt baslrts and`s1ft dt;'ches, rom4vo all slit faaces'and slop© drains; '.
redistrlbut© pIt stDnd frvrrt sht Chocks, sediment dams, and silt screens.
'
fi disturbed areas:'
Seed and rr
HOLDER, B1abol R.
D.. B. 1517 - 591
P.B. 57 - 87
i.S, POLE #2
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N X x ,---. X X -X x x --r--- - X x. x x x x
y WOVEN WIRE FENCE
w23T. BARSEO WRE D 'p X v 4 6T. WSCO N
r EFENCe o+o.
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T CK, Bobby F. & ,
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Wnda
D. B. 3781 - 1357 r
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OONTRQL= I=C??t ? t7Ex4P A
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Rovlew Erosion J"?n?ra? FJ'ana an ta?pt$ f?3 IcfOnttfy aU fefcass3 points

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5. 14
(060ets of Px ' 1iho plpo ,Malt tchcs, taadvuay dflctJes, fi{i :opt; ©tc.).
2 Install ill moasur? @ roteasv points to,, cpmqiGru4bing. ;Seo
Erosion, Control Siandord? iar prop`Cr ln8t~{latlori

3 ; . $egtn Grading opetahons.fndtatl till mhar mtt;siarg3 us grading progresses
. .and r?o?ttor their;efTecdy?npss:: I[ arty 1'tlaasurd3 peud.to be changed,
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EA
consult Nlt,aX:M
f?tea,?wJngt?
eci
:st,aw??i?n p
• C?iltrol:Plank t, t

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ocaro
omiw pits a+,
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eas r,1
was
th their erosion conSroi measures f a
on Erosion Canfrol flans l?r attach a' ep3rsto thCat ;hoMin same,.

.5. 8efora mavlrig: to next jdb 0110,'W ow ail measures far CitvdivCnes9; make
any adjustrrrrenf ; cicatj rdta; ar repair ;;Jl Roadstd4 Envlronrn: ntat Dept. Sal
for instahatiorl of a d{tetj tiriEr itd cootiirig trnd 1?lulchlog pi all disturbed
areas
BF .
& Continue to cbeck and ni?lnWf
ri all moazuro913fter. Cacti signlffcant rainfall
.
untti aTl disturbed i3roAs'tircbme st3biftctJ

7.. Fill In all 5l{ttiasr,S Gttd lit d?tChGs, teRioVq t?tl 3i1t fenw3 and Siopo drains; x
.. rculicMhtn atleMnnn ftnrrt'ii(F Nhn..tre nnr{(rririn? .??..... ....a ..»..??..---
September 16, 2002
Site 26+00
Construction Sequence and Erosion Control Plan for Replacement of
Pipe with Pipe using an On-site Detour - Guilford County, SR 3404
(Kearney Road)
Work to begin as soon as practicable following authorization.
Construction is anticipated to take 2 weeks.
1. Install a rock silt dam downstream of the work area to prevent incidental sediment
loss.
2. Install ABC aggregateor a less intrusive dewatering device to allow dewatering of the
work area.
3. Install pumps to divert flow around the work area.
4. Place a temporary extension at one end of the existing pipe to allow a travel lane
shift.
5. Place a temporary detour over the temporary extension.
6. Opposite the detour, remove existing RC pipe to at least the centerline of the
roadway.
7. Excavate to sufficient depth to allow 20% burial of the pipe, place base stone, and
sections of 30' long 48" CM pipe.
8. Backfill the new section of pipe and place rip rap only as needed.
9. Place the temporary detour over the new sections of pipe.
10. Remove remaining sections of pipe.
11. Excavate to sufficient depth to allow 20% burial of the pipe, place base stone, and
sections of 30' long 48" CM pipe.
12. Backfill the new section of pipe and place rip rap only as needed.
13. Remove the dewatering device and restore the natural stream contours.
14. Place final roadway in desired location.
15. Notify landscape department for final seeding.
16. Silt fences to be placed as site conditions require.
17. A 10' X 15' dirt bag will be used to remove excess water in the hole where the new
pipe is being replaced.
18. Site conditions and weather may alter these plans.
19. A method less intrusive than a pump around system may not be utilized if site
conditions allow.
Supervisor Approved

View immediately upstream from the existing pipe- SR 3404.
View of the existing pipe inlet - SR 3404.