20001048 Ver 2_Initial Interest_20091203

NCDENR
Do- 1E)49 4a. Form Version 6.2
June 29, 2009
INITIAL INTEREST IN PARTICIPATION IN THE EXPRESS REVIEW PROGRAM
WITHIN THE 401 OVERSIGHT/EXPRESS PERMITTING UNIT
A. Applicant Information
1. Processing
? 401 Water Quality Certification (List NW(s) or GP# verified by Corps: )
? Non-404 Jurisdictional Permit
? Riparian Buffer Authorization
1a. Type(s) of actions ? Riparian Buffer Minor Variance
requested: ? Coastal General "Major" Variance
(Check all that apply) ? Stream Determination: # Streams
? Non-404 Wetland Determination: # Wetlands
® Stormwater Management Plan Review (fee not additive if combined with 401):
3 # of Drainage Areas/Project Site
2. Project Information
2a. Name of project: Lanesboro Correctional Institute (formerly Anson County Correctional Facility
2b. County: Anson
2c. Latitude/Longitude: Lat: 34° 59' 12" N Long: 80° 11' 3" W
2d. River Basin: Yadkin
2e. Tax PIN or Parcel ID: 644500525165
2f. Nearest Named Stream: Little Brown Creek
2g. Water Quality Classification of Nearest Named Stream: C
2h. Total project acreage (Stream or wetland determinations may omit this item): 177.3 (acres)
2i. Total Built Out Imperviousness (Stream or wetland determinations may omit this item): 7.0 %
2j. Provide a brief description of this project (attach a site plan): This is a previously permitted prison site (permit #:
001048) with the 3 wet detention basins. We are proposing an additional structure to be built on the south end of the
site. This additional structure will drain to 2 of the ponds. The only changes we are proposing are to increase the
orifice sizes in these 2 ponds by 0.5 inches respectively. No other changes are proposed to the plan.
2k. Provide directions from the nearest named town, including street names and/or highway numbers: The site is
located about 0.75 miles south of Prison Camp Road (SR 1121) and U.S. Hwy 74 intersection, near the city of Polkton.
Please attach a map of the site location using USGS 1:24,000 topographic map and a copy of the latest bound
and published County soil survey with the project/site boundaries delineated. A site plan should also be included
for all projects other than stream and wetland determinations.
Initial Interest Form v6.2 Cont.
3. Applicant Information
3a. Applicant is: ® Owner ? Agent ? Other:
3b. Name: William N. Stovall CV^e f l
3c. Business name (if applicable): CDOC
3d. Street address: 2020 Yonkers Road
3e. City, State, zip: Raleigh, NC 27604
3f. Telephone no.: 919-716-3400 3g. Fax no.: 919-716-3978
3h. Email address: 5) e-0 6, - C Qs
4. Agent/Consultant Information (if applicable)
4a. Contact Name: Jeff Thompson
4b. Company Name: Hobbs, Upchurch & Associates
4c. Street address: 8262-201 Market Street
4d. City, State, zip: Wilmington, NC 28411
4e. Telephone no.: 910-686-1212 4f. Fax no.: 910-686-1145
4g. Email address: [e-mail]
5. Proposed Impacts (include both temporary and permanent) [Determination requests may omit this item]
5a. Total 404/401 wetland impacts: 0 (acres) 5b. Total non-404/401 wetland impacts: 0 (acres)
5c. Total 404 stream impacts: Intermittent: 0 (linear feet) Perennial: 0 (linear feet)
5d. Total non-404 stream impacts: Intermittent: 0 (linear feet) Perennial: 0 (linear feet)
5e. Total riparian buffer impacts: Zone 1: 0 (sq. feet) Zone 2: 0 (sq. feet)
6. Project History and Additional Information
6a. Has any DWQ staff visited the site? ? Yes ® No
If yes, provide staff name: and date of visit:
6b. Does this project require a Stormwater Management Plan (SMP)? ® Yes ? No ? Unknown

6c. Who will be responsible for the review of the SMP? ? Certified Local Gov't:
? DWQ Stormwater Program
® DWQ 401/Express Review Unit
6d. Does this project require approval under SEPA or NEPA? ? Yes ® No ? Unknown
6e. Is this project an after-the-fact application or has a DWQ notice of violation been issued? ? Yes ® No
6f. Does this project include buffer impacts that are "prohibited" in the DWQ "Red Rule Book"? ? Yes ® No
6g. If you are aware of any local controversy concerning this project, provide details in a cover letter. Describe the
controversy and any measures that have been taken with respect to public involvement.
This form must be submitted via email (c/o Lia.M.Gilleski(a)_ncdenr.gov), faxed (919-733-6893), or hand-delivered to:
Parkview Building, 2321 Crabtree Blvd. Suite 250, Raleigh, NC 27604. Applicants who are selected to participate in the
Express Review Program will be notified via email or fax. Successful applicants will then be instructed regarding detailed
procedures for full application (Note: Submittals of the review packages on Friday after 12:00 pm will be stamped as
received on the next business day).
Please contact Lia Myott Gilleski or Joseph Gyamfi at 919-733-1786 if you have any questions regarding this form.
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Date: 8/26/2009 Caption: Lanesboro Correctional Institute
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Web Soil Survey
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8/26/2009
Page 1 of 3
Soil Map-Anson County, North Carolina
Lanesboro Correctional Institue
Map Unit Legend
Anson County, North Carolina (NC007)
BaC Badin channery silt loam, 8 to 15 percent slopes 13.7 19.9%
ChA Chewacla loam, 0 to 2 percent slopes, frequently 5.0 7.2%
flooded
CrB Creedmoor fine sandy loam, 2 to 8 percent slopes 0.6 0.9%
MgB Mayodan gravelly sandy loam, 2 to 8 percent 37.9 55.1%
slopes
UdC Udorthents, loamy, 0 to 15 percent slopes 9.8 14.3%
W Water 1.8 2.6%
Totals for Area of Interes t 68.8 100.0%
USDA Natural Resources Web Soil Survey 8/26/2009
?? Conservation Service National Cooperative Soil Survey Page 3 of 3