20100862 Ver 1_401 Application_20101010

Robert J. Goldstein & Associates, Inc.
ENVIRONMENTAL CONSULTANTS
1221 Corporation Parkway, .Raleigh, NC 27610
Tel: [phone] Fax:_ [phone]
email: [e-mail]
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20100862
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WE ARE SENDING YOU )Q Attached ? Under separate cover via the following items:
? Shop, drawings ? Prints ? Plans ? Samples ? Specifications
? Copy of letter ? Change order ?
COPIES DATE NO. DESCRIPTION
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THESE ARE TRANSMITTED as checked below:
? For approval ? Approved as submitted ? Resubmit copies for approval
? For. your use ? Approved as noted ? Submit copies for distribution
'. ? As requested ? Returned for corrections ? Return corrected prints
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? FOR BIDS DUE 19 ? PRINTS RETURNED AFTER LOAN TO US
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COPY TO }---
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PRMTt4at mess k..Q.1m.M_ 01AY1 If enclosures are not as noted. kindly notify us at once.
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
ANd
A. Applicant Information ft USE,"
1. Processing ??.....??
1 a. Type(s) of approval sought from the
Corps:
0 Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: NWP-3, -16 or General Permit (GP) number: DWQ IWGP
1 c. Has the NWP or GP number been verified by the Corps? O Yes: Andy Williams ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
0 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express 0 Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes 0 No For the record only for Corps Permit:

? Yes 0 No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes 0 No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes 0 No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes 0 No
2. Project Information
2a. Name of project: Burlington Old Stony Creek Dam and Lake Cammack Dam Repairs
2b. County: Alamance
2c. Nearest municipality / town: Burlington, Glencoe US ki::7 L=E;
2d. Subdivision name: NA
2e. NCDOT only, T.I.P. or state
project no:
NA DENR - WATER QUAUTy
WETLANDS AND STQRWVATER J
3. Owner Information
3a. Name(s) on Recorded Deed: "Burlington Water Works" (City of Burlington Water Resources Dept)
3b. Deed Book and Page No. NA
3c. Responsible Party (for LLC if
applicable): Robert Patterson Jr., P.E., Water Resources Director
3d. Street address: 1302 Belmont Street 90
3e. City, state, zip: Burlington, NC 27216
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1of12
PCN Form - Version 1.3 December 10, 2008 Version
provided in the Supplementary Text at the end of Section B.
Repairs at Old Stony Creek Dam include: 1) replace the clogged low-level outlet with a new riser and drain pipe installed through
the old low-level drain pipe; 2) install anchors drilled vertically through the spillway crest and abutments into bedrock; 3) construct a
secant pile wall (by drilling) to extend the right dam abutment 180 feet landward; 4) excavate the left dam abutment and construct a
concrete gravity extension 90 feet landward; and 5) install a concrete toe wall and riprap armoring along the eroding left bank of Stony
Creek below the dam. This work may require temporary lake drawdown of five feet and/or a temporary cofferdam near the left
abutment to protect against abutment failure during construction.
>> Repairs at Lake Cammack Dam include: 1) install anchors drilled vertically through the dam crest into bedrock; 2) remove existing
trees, riprap and topsoil on both dam abutments, then add fill to raise each abutment level with top of dam (approx two feet); 3) replace
riprap on abutment slopes and replace topsoil and grass on abutment crests; 4) excavate behind each training wall below the dam to
install a waterproofing barrier and drainage system for seepage; 5) backfill to original grade and re-establish grass behind each training
wall. The spillway anchoring work may require temporary fill or grading along the right shoreline as needed to launch the drilling
barge. It will also require a temporary cofferdam in Stony Creek to dewater a 10-foot wide area in front of the right training wall
during construction of the training wall drainage system.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this
El Yes 0 No El Unknown
property / project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what ? Preliminary 0 Final
ry
type of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Robert J. Goldstein & Assoc
Name (if known): Gerald Pottem, RJG&A Other: NA
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
6. Project History
5a. Have permits or certifications been requested or obtained ? Yes ?X No ? Unknown
for this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions. None
6. Future Project Plans
6a. Is this a phased project? ? Yes Z No
6b. If yes, explain.
Project Description, Supplementary Response to Item 3e:
Old Stony Creek Dam Repairs:
1) Low-Level Drain Outlet: Replace the existing 48-inch low-level drain pipe and gate, which is corroded and clogged with
sediment, with a new 36-inch low-level drain pipe, riser and gate. Accumulated sediment surrounding the inlet of the old pipe will
be vacuum-dredged from a barge in the lake, and sediment inside the pipe and immediately downstream and will be removed by
dredge and/or excavator from the Stony Creek tailrace at the pipe outlet. The sediment removed will be dewatered in the
construction staging area, and either disposed of in uplands in the staging area or trucked offsite to an approved landfill in an upland
area. Sediment drainage water will run back into Stony Creek or the lake. A sediment curtain or similar device to capture sediment
and reduce turbidity will be placed in the tailrace downstream of t1W outlet prior to dredging, to prevent mobilized sediment from
escaping into Stony Creek. With the old drain pipe inlet blocked, the new 36-inch drain pipe will be installed through the old pipe
from the downstream side, and the space between the old and new pipes will be grouted. The outlet of the new drain pipe will be
capped off while the new 36-inch riser and gate are installed at the pipe inlet in the lake. The rehabilitated low-level outlet will be
for emergency drawdowns only; it is not intended for routine reservoir releases, and will not release sediment from the lake unless
used in an emergency. The low-level outlet repair work will be completed prior to the other dam remediation work described below.
2) Spillway Anchoring: Anchor the existing spillway and abutments into underlying bedrock with a series of 39 steel and concrete
anchors installed b drilling vertically through the existing dam crest. The drilling rig will be mounted on a bare in the lake, and
Page 4 of 12
PCN Form - Version 1.3 December 10, 2008 Version
drilling debris will be captured and removed using a collar and containment device around the drill. The barge for drilling the
spillway anchors and dredging sediment around the low-level drain inlet will be launched at the existing boat ramp near the right
dam abutment. The construction staging area will be on uplands just south of the water intake pump station building.
3) Extend Right Abutment with Secant Pile Wall: Extend the right dam abutment approximately 180 feet landward (south) by
constructing a secant pile wall. This wall is constructed by drilling a staggered series of overlapping 4-foot diameter shafts down to
bedrock and filling them with concrete and reinforcing steel bars. The existing concrete block emergency spillway in this area will
be removed. The secant pile wall top will be level with the existing grade. Construction of the secant pile wall will be entirely in
uplands (no direct impact to waters) but may require that the lake level be lowered five feet for about one month to protect against
abutment failure during construction.
4) Extend Left Abutment with Concrete Gravity Section: Excavate a trench down to bedrock immediately north of the existing
short left abutment, and construct a 90-foot long concrete gravity overflow abutment extension, 16 feet wide at the base and 4 feet
wide at the crest. The new abutment crest will match the existing grade, and is designed to overflow during flood events onto the
proposed rock-armoring along the left bank of Stony Creek (see below). To protect against abutment failure during construction,
either lake drawdown (five feet for about one month) or a temporary cofferdam (sheet piling) placed in the lake in front of the left
abutment will be needed. The construction staging area for this work and item 5 below will be in an upland field (abandoned
pasture) along the access road east of the lake. No wetland, stream, or riparian buffer will be affected by the off-site access road and
staging area.
5) Stabilize Eroding Left Bank of Stony Creek: Construct a concrete toe wall anchored to bedrock along the left bank of Stony
Creek, beginning at the spillway and extending approximately 75 feet downstream. Steel anchors in the wall will be drilled into the
bedrock. The base of the proposed toe wall is about 8 to 10 feet in elevation above the OHWM of Stony Creek, and 25 to 35 feet
laterally from the creek. Upslope of the toe wall, an area of approximately 2300 square feet (mostly forested) will be cleared,
graded, and stabilized with riprap underlain with geotextile filter material and gravel bedding. Trees along the steep bank just above
the proposed toe wall are being undercut during major storms, and many have already fallen.
Lake Cammack Dam Repairs:
1) Spillway Anchoring: Anchor the existing spillway into underlying bedrock with a series of 20 steel and concrete anchors
installed by drilling vertically through the existing dam crest. The drilling rig will be mounted on a barge in the lake, and drilling
debris will be captured and removed using a collar and containment device around the drill. The barge for drilling the spillway
anchors will be launched from the construction staging area (existing upland grassed areas) near the right dam abutment. Minor
grading along the lake shore may be needed to create a temporary ramp for the barge.
2) Raise Right and Left Abutments to Design Elevation: Remove and stockpile the existing riprap and topsoil on both dam
abutments. The area to be excavated extends 300 feet landward from Lake Cammack on the right abutment and 400 feet landward
from the lake on the left abutment. The left abutment also includes a row of large loblolly pines that must be removed. About five
of these trees are within the lake's riparian buffer, but NC Dam Safety Program recommends that all large trees on dams be removed
to protect against dam failure. Each abutment will then be raised (up to two feet in some areas) using earth fill from on-site borrow
areas (existing upland grassed areas) to match the dam design elevation of 590.7 feet. Riprap will then be replaced on the abutment
slopes, and topsoil and grass re-established on the abutment crests.
3) Training Wall Seepage Drainage: Excavate the soil behind the right and left training walls on the downstream face of Lake
Cammack dam, and stockpile the soil it in the corresponding upland staging area. The right training wall will also require a
temporary cofferdam placed in Stony Creek to dewater a 10-foot wide area in front of the wall during construction. The left training
wall sits atop bedrock at a higher elevation and will not need dewatering for construction. On the back side of each training wall,
install a waterproofing membrane, drainage board over the membrane, drainage piping, and drainfill material. The drainage piping
will discharge into Stony Creek through 4-inch drain holes drilled at the base of each wall. Then backfill the stockpiled soil, install
three piezometers behind each training wall to monitor the effectiveness of the drainage system, and re-establish grass cover.
Page 5 of 12
PCN Form - Version 1.3 December 10, 2008 Version
Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
Wetlands ?D Streams - tributaries Buffers
X Open waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, (acres)
Temporary other
W1 ? P ? T NA NA ?? Nos ?? CDWQ NA
W2 ? P ? T NA NA 11 Nos El Corps NA
W3 ? PEI T NA NA E Nos El Corps NA
2g. Total wetland impacts NA
2h. Comments: No wetland impacts, but the lake shorelines have a linear fringe of emergent marsh vegetation in some areas, including
near the left abutment at Old Stony Creek Dam and near the right abutment and staging area at Lake Cammack Dam .
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER) Type of Average Impact
number or intermittent jurisdiction stream length
-Permanent (P) (INT)? (Corps - 404, 10 width (linear
or Temporary (T) DWQ - non-404, (feet) feet)
other)
Dewater edge of stream
POT adjacent to right
l Stony Creek below R ?
see figure 20 training wall be
ow Lake Cammack INT X pWQ 10 feet 90 feet
Cammack Dam with Dam.
temporary cofferdam

S2 ? P M T Dredge accumulated
sediment from low- Stony Creek Tailrace
below Old Stony
?X PER X
? Corps
25 feet
10 feet
see figure 5 level drain pipe outlet Creek Dam ? INT DWQ
area
PER Corps
S3 ? P ? T NA NA ? N
T ? DWQ NA NA
3h. Total stream and tributary impacts 100 feet
3i. Comments: Permanent Impacts: New stilling basin and concrete endsill across Salem Creek will impact the upper 401in.ft., and riprap
dissipator will impact the next 601in.ft. Temp Impacts: Temp earth fill cofferdam below new stilling basin to dewater the stilling basin
construction area.
Page 6 of 12
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the
U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact
Permanent (P) or (acres)
Temporary
01 ? P ?X T Old Stony Creek Dredge accumulated sediment from low- Lake 0
035 acre
see figure 5 Reservoir level drain pipe inlet area in lake .
02 ? POT Old Stony Creek Dewater corner of lake adjacent to left dam
see figure 7 Reservoir abutment with temporary cofferdam during Lake 0.006 acre
abutment construction
03 ? P 0 T Lake Cammack Gravel ramp into lake for launching Lake 0
005 acre
see figure 15 drilling barge .
04 ? P ? T NA NA NA NA
4f. Total open water impacts 0.046 acre
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond F
I

Flooded
Filled
Excavated o
o
Filled Excav
Flooded
d ated
e
d
P1 NA 0 0 0 0 0 0 0
P2 NA 0 0 0 0 0 0 0
5L Total 0 0 0 0 0 0 0
5g. Comments: Proposed repairs to two existing public water supply dams; no new dam construction.
5h. Is a dam high hazard permit required? ? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 7 of 12
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a. ? Neuse ? Tar-Pamlico Other: Jordan Lake
Project is in which protected basin? Jordan Lake ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason for impact Buffer mitigation Zone 1 impact Zone 2 impact
Permanent (P) or Stream name required? (square feet
)
(square feet)
Temporary
B1 ? P 0 T Right abutment
Old Stony Creek
? Yes
see figure 6 improvements, secant Reservoir 0 No 360 sf, cleared 700 sf, cleared
pile wall construction
Left abutment
B2 ? P 0 T improvements, concrete Old Stony Creek ? Yes 1400 sf, forest 800 sf, forest
see figure 7 gravity abutment Reservoir N No 400 sf, cleared 400 sf, cleared
extension
Left bank toe wall and
B3 0 P ? T riprap stabilization Stony Creek below ? Yes 1150 sf, forest 500 sf, forest
see figure 8 below overflow Old Stony Cr Dam 0 No 350 sf, cleared 400 sf, cleared
abutment
B4 ? P 0 T Right abutment staging E] Yes

see figure 15
and barge launch area Lake Cammack
0 No 3900 sf, cleared 2800 sf, cleared
B5 ? POT Right abutment to be El Yes
see figure 17 raised Lake Cammack N No 2200 sf, cleared 1300 sf, cleared
B6 ? P 0 T Left abutment to be Lake Cammack ? Yes 1900 sf, cleared, 1250 sf, cleared,
see figure 18 raised N No a few trees a few trees
B7 ? P 0 T Right training wall
excavation for drainage Stony Creek below ? Yes 350 sf, forest 750 sf, forest
see figure 20 installation Cammack Dam 0 No 2200 sf, cleared 1150 sf, cleared
B8 ? POT Left training wall
excavation for drainage
Stony Creek below
? Yes
200 sf, forest
150 sf, forest
see figure 21 installation Cammack Dam 0 No 2150 sf, cleared 1450 sf, cleared

6h. Total buffer impacts 3,100 sf, forest 2,200 sf, forest
13,460 sf, cleared 9,450 sf, cleared
6i. Comments: Buffer areas that are currently covered in grass or riprap will be restored to their pre-construction condition. The only
permanent buffer change will be the toe wall and riprap stabilization area (B3) where 1650 sq.ft of forest will be converted to riprap.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Construction access to both dams will use existing roads and trails on opposite sides of the dam, thus avoiding the need to construct a
temporary vehicle crossing across Stony Creek. No stream, wetland or buffer impacts are located along these access roads. The areas to be
used for construction staging and borrow areas for embankments are in grassed uplands, away from riparian buffers, except for an area
along the right shoreline of Lake Cammack where the drilling barge needs to be launched. This barge launch area is within the lake's
riparian buffer but is grassed, not forested.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Drilling for the spillway anchors will be conducted from a barge, minimizing disturbance to the stream and lake bed, and spillway drilling
tailings will be collected and disposed of on uplands. In-stream sediment control measures will be used in the Old Stony Creek dam tailrace
to prevent excessive sediment release during dredging for the low-level drain replacement. The minimum release bypass pipe at Old Stony
Creek Dam will remain in operation during and after construction.
Page 8 of 12
PCN Form - Version 1.3 December 10, 2008 Version
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
a. Does the project require Compensatory Mitigation for impacts
to Waters of the U.S. or Waters of the State? Yes ?D No
2b. If yes, mitigation is required by (check all that apply): DWQ ? Corps

c. If yes, which mitigation option will be used for this project? Mitigation bank
Payment to in-lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
a. Name of Mitigation Bank: NA
b. Credits Purchased (attach receipt and letter) ?ype NA ?uantity NA
c. Comments: NA
4. Complete if Making a Payment to In-lieu Fee Program
a. Approval letter from in-lieu fee program is attached. Yes
b. Stream mitigation requested: A linear feet
c. If using stream mitigation, stream temperature: warm ? cool ?cold
d. Buffer mitigation requested (DWQ only): *** A square feet
e. Riparian wetland mitigation requested: A acres
f. Non-riparian wetland mitigation requested: A acres
g. Coastal (tidal) wetland mitigation requested: A acres
h. Comments: ? ? ? ? ?
Complete if Using a Permittee Responsible Mitigation Plan
a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan. NA
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? Yes ?D No
b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone c
Reason for impact d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 NA NA 3 (2 for Catawba) NA
Zone 2 NA NA 1.5 NA
6f. Total buffer mitigation required: NA
g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund). NA
h. Comments: NA
Page 9 of 12
PCN Form -Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified within ?x Yes ? No
one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: The only new impervious surfaces proposed are dam abutment and toe wall ? Yes 0 No
structures adjacent to Stony Creek or the two lakes. See also 2c below.
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? NA %
2b. Does this project require a Stormwater Management Plan? ? Yes ?D No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: This project comprises repairs and safety
upgrades to two existing water supply dams. It is not a new development project, and the impervious areas to be added (concrete
abutmants and toe wall) are both negligible in size and located too close to the lake or stream to effectively capture and infiltrate their
stormwater runoff.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
NA
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? City of Burlington and Alamance
County
?X Phase II
3b. Which of the following locally-implemented stormwater management programs apply 0 NSW
El USMP
(check all that apply): 0 Water Supply Watershed
? Other: ?????
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
D HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
? Other: ? ? ? ? ?
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
6. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
Page 10 of 12
PCN Form - Version 1.3 December 10, 2008 Version
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the 0 Yes ? No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State (North ? Yes ?X No
Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
? Yes ? No
letter.)
Comments: Repair Repair and maintenance of existing dams does not require a SEPA EA.
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H.1300), DWQ Surface Water or Wetland Standards, or ? Yes 0 No
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ?X No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): NA
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ?X No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
Project will not increase lake elevation or water withdrawal capacity; it is solely for dam safety purposes, not for growth.
4. Sewage Disposal (DWQ Requirement)
4a. 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.
NA
Page 11 of 12
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes 0 No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act Nx Yes ? No
impacts?

Raleigh
?D
5c. If yes, indicate the USFWS Field Office you have contacted. ? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
US-FWS and NC-NHP online lists of protected species reported from Alamance County and Lake Burlington USGS Quad, and field
survey by RJG&A to demonstrate that no protected species habitat exists in the project area.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes 0 No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NC-DMF and NC-WRC
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation N Yes 0 No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Online database of National Register of Historic Places sites.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? 0 Yes ? No
8b. If yes, explain how project meets FEMA requirements: This project will shift flood flows at Old Stony Creek Dam from the right
abutment (park and pump station) to the undeveloped left abutment, but will not otherwise affect flood elevations or flood flow
passage. The intent of this project is to improve the safety and stability of these two dams in accordance with NC Dam Safety Program
policies.
8c. What source(s) did you use to make the floodplain determination? A Conditional Letter of Map Revision (CLOMR) application
has been submitted to North Carolina Floodplain Mapping Program, showing that there will be no change to the 100-year flood
elevations downstream of the dam.
Gerald Pottern f2? 18 October 2010

Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 12 of 12
PCN Form - Version 1.3 December 10, 2008 Version
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Robert C Patterson, Jr., T.F.
Water Resources 27irector
10/18/2010
Mr. Gerald B. Pottern
Robert J. Goldstein & Associates, Inc.
Environmental Consultants
1221 Corporation Parkway, Suite 100
Raleigh, North Carolina 27610
To Whom It May Concern:
The City of Burlington is planning to repair and rehabilitate our two public water supply dams on Stony
Creek in northern Alamance County: Lake Cammack Dam and Old Stony Creek Dam. This letter
authorizes Robert J. Goldstein & Associates, Inc. of Raleigh, North Carolina to serve as an agent of the
City of Burlington for the purpose of obtaining jurisdictional waters determinations and environmental
permitting as needed for these dam repairs. Please do not hesitate to contact the undersigned if you
have any questions.
Sincerely,
C 1
Robert C. Patterson, Jr., P.E.
Water Resources Director
Cc: Mark Landis, P.G., P.E., Schnabel Engineering
Connecting the Triad and the Triangle
1302 Behnont Street-110 Box 1358-Burlington, NC 27216
336-222-5133--Fax: [phone]-vi,wx? Bur1ingionNC.gov

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AREA TABLE
AREA DESCRIPTION SQUARE FEET ACRES
LEFT SIDE LIMIT OF

DISTURBANCE 2484725 0.57
LEFT SIDE BORROW AREA 8084.96 0.19
LEFT SIDE STAGING/

STOCKPILE AREA 19225.31 0A4
RIGHT SIDE UMIT OF
DISTURBANCE 25247.49 0.58
RIGHT SIDE BORROW AREA 14315.25 0.33
RIGHT SIDE STAGINGI

STOCKPILE AREA 2388828 0.54
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