20110837 Ver 1_401 Application_20110911

20110837
? ? ? Kimley-Horn
and Associates, Inc.
September 9, 2011
Ms. Lauren Witherspoon
Division of Water Quality
3800 Barrett Drive
Raleigh, NC 27609
James Shern
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Re: Retreat at Raleigh, LLC
City of Raleigh Public Utilities Department
CORPUD Retreat Sewer Upgrade
Nationwide Permit #12 Application Submittal
Wake County, North Carolina
Dear Lauren and James:
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P.O. Box 33068
Raleigh, Noah Carolina
27636.3068
On behalf of Retreat at Raleigh, LLC and the Public Utilities Department of the City of Raleigh, Kimley-Horn and
Associates, Inc. is submitting the enclosed Preconstruction Notification Application for authorization to construct the
above referenced project under Nationwide Permit Number 12.
The proposed project includes the construction of approximately 3,500 linear feet of gravity sewer pipeline replacment.
This project will result in exempt temporary impacts to 171 linear feet of stream channel, buffer Zone 1 Impacts of
21,579 SF, and buffer Zone 2 Impacts of 6,687 SF. Mitigation has not been proposed for this project, due to the fact
that the sanitary sewer is being replaced within an existing easement; this opinion was expressed by DWQ's Martin
Richmond during a field review of the stream calls and confirmed by DWQ's Buffer Interpretation/Clarification #2011-
001.
The following information is included with this submittal:
• Review Fee
• Project Summary Sheet
• Preconstruction Notification Form
• Agent Authorization Form
• DWQ Buffer Interpretation Clarification #2011-001
• Permit Maps and Figures
• NCDWQ and USACE Stream Forms
If there is any additional information you need to assist in the processing of this application, please do not hesitate to
contact me at [phone] [e-mail].
Very truly yours,
KIMLEY-HORN AND ASSOCIATES, INC.
Julie R. Parham, E.I.
Enclosures
¦
TEL [phone]
FAX [phone]
Kimley-Horn Project Summary Sheet 2 7
? and Associates, Inc.
Project Name: CORPUD Retreat Sewer Upgrade
Applicant Name and Address: The Retreat at Raleigh, LLC
Attn: Mr. Wesley Rogers
455 Epps Bridge Parkway, Building 100, Suite 201
Athens, GA 30606
Telephone: [phone] Fax: [phone] Email: wes.ropers(-,landmark-properties.com
Type of Request: ® Nationwide PCN (NWP #: 12 GC#: 3819 ) ? Individual Permit Application
? Jurisdictional Determination ® Other: Buffer Authorization
Included Attachments: ® Project Plans ® USGS Map ® NRCS Soil Survey
® Agent Authorization ? Delineation Sketch ? Delineation Survey
? Data Forms (Up & Wet) ® NCDWQ Stream Forms ® USACE Stream Forms
? NCEEP Confirmation ® Aerial Photo ? Site Photos
? Agency Correspondence ? USACE JD Form ? Other:
Check if applicable: ? CAMA County ? Trout County ? Isolated Waters
? Section 7, ESA ? Section 106, NHPA ? EFH
? Mitigation Proposed (? NCEEP ? Bank ? On-Site ? Off-Site ? Other)
County: Wake Nearest City/Town: Raleigh
Waterway: UTs to Walnut Creek, Walnut Creek
H.U.C.: 03020201
Property Size (acres): 1.59 acres
Site Coordinates (decimal degrees) - Longitude: 78.7295
River Basin: Neuse
USGS Quad Name: Raleigh West
Approx. Size of Jurisdiction on Site (acres): 0.665
°W Latitude: 35.7739 ON
Project Location: This project consists of approximately 3,500 LF of 12-inch PVC, HDPE, and ductile iron gravity sewer
pipeline located in southwest Raleigh, originating at the Walnut Creek Interceptor, located north of I-440, approximately
halfway between its intersections with I-40 and Jones Franklin Road. Beginning at the connection to the Walnut Creek
Interceptor, the proposed gravity sewer replacement follows the existine eravity sewer. extendine north alone the easement
to Dana Drive, Lakeside Drive, and terminating just north of Buck Jones Road. The pipeline will be installed via both open
cut and pipe bursting, as indicated on the attached drawings.
Site Description: The project corridor is located within an existing City of Raleigh 20' sanitary sewer easement it crosses
the public right-of-way at Buck Jones Road, Lakeside Drive, and Dana Drive in Raleigh.
Impact Summary (if applicable): This project will result in temporary impacts to 171 linear feet of stream channel buffer
Zone 1 impacts of 21,579 SF1 and buffer Zone 2 Impacts of 6,687 SF.
Impact Table

P Open Water Wetland Stream Channel Impact Buffer Impact
Impact GC Impact (ac) Impact (ac) Temp. Perm. Intermittent Mitigation (ft)
Temp. Perm. Temp. Perm. LF SF LF SF or Perennial Ratio Zone 1 Zone 2
Buffer B1 12/381 0 0 0 0 0 0 0 0 N/A N/A 1,478 952
Buffer B2 12/381 N/A N/A 6,679 1,681
Stream SC, Buffer B3 12/381 111 549 Intermittent N/A 3,835 500
Buffer B4 12/381 N/A N/A 415 264
Stream SA,Buffer B5 12/381 60 165 Perennial N/A 9,172 3,290
Total 0 0 0 0 171 715 0 0 21,579 6,687
Kimley-Horn Contact: Julie Parham Direct Number: [phone]
Email: Julie.Parham(d,kimley-horn.com
P.0 Box 33068 TEL [phone]
Raleigh, North Carolina FAX [phone]
27636.3068
2011 .??
Office Use Only
Corps action ID no. -
DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps: ?X Section 404 Permit ? Section 10 Permit
1 b.
~ Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number: 3819
1c. Has the NWP or GP number been verified by the Corps? ? Yes ? No
1d. Type(s) of approval sought from the DWQ (check all that apply):
?X 401 Water Quality Certification - Regular ? Non-40 4 Jurisdictional General Permit
? 401 Water Quality Certification - Express ?X Riparia n Buffer Authorization
1e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
? Yes ?X No ? Yes ?X No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for --y
mitigation of impacts? If so, attach the acceptance letter from mitigation bank ? Yes ?X No
or in-lieu fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
b
l
E] Yes Z No
e
ow.
h Is the project located
a NC DCM Area of Environmental Concern (AEC)? ',
El
Yes ? No
r 2 Project
Ject Information -
-
-_-
2a. Name of project: CORPUD Retreat Sewer Upgrade
I
2b. County: Wake
2c. Nearest municipality / town: Raleigh
2d. Subdivision name: N/A
------
2e. ---------------- -- -- --
NCDOT only, T.I.P. or state project no: N/A
3. Owner Information ?p
3a.
- Name(s) on Recorded Deed: City of Raleigh , U Z

-----
---- O
Deed Book and Page No. N/A Linear Utility Project in City Easement S
,??
3c. Responsible Party (for LLC if
applicable): N/A --------
3d. Street address:
--------- One Exchange Plaza, Suite 620
=

3e.
City, state, zip: -- --------------
Raleigh, NC 27601 -
-------------
-----
3f. Telephone no.. 919-857-4540
3g. Fax no.: 919-857-4545
3h. Email address: [e-mail]
Page 1 of 10
PCN Form - Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ?X Other, specify: Financially Responsible Party
4b. Name: Wesley Rogers
4c. Business name
(if applicable): Retreat at Raleigh, LLC
4d. Street address: 455 Epps Bridge Parkway, Building 100, Suite 201
4e. City, state, zip: Athens, GA 30606
4f. Telephone no.: 706-543-1909
4g. Fax no.: 706-543-1910
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Julie Parham
5b. Business name
(if applicable): Kimley-Horn and Associates, Inc.
5c. Street address: 3001 Weston Parkway
5d. City, state, zip: Cary, NC 27513
5e. Telephone no.: 919-677-2212
5f. Fax no.: 919-677-2050
5g. Email address: [e-mail]
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A - Along City Sewer Easement
1 b. Site coordinates (in decimal degrees): Latitude: 35.7739 Longitude: -78.7295
1 c. Property size: 1.59 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Walnut Creek
2b. Water Quality Classification of nearest receiving water: B; NSW
2c. River basin: Neuse
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project site is a linear corridor spanning approximately 3,500 linear feet. The majority of the proposed pipeline will be constructed along an
existing City sanitary sewer easement, where additional clearing will be minimal. The proposed pipe line crosses three existing City of Raleigh
roadways: Buck Jones Road, Lakeside Drive, and Dana Drive; all three roadways are paved with asphalt. This is in a residential area.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 171
3d. Explain the purpose of the proposed project:
This project is needed to accommodate both an existing deficiency in the capacity of the City's sanitary sewer for current flows and a proposed future
multi-family residential development, The Retreat at Raleigh. This proposed development has served as a catalyst for upgrading the existing sanitary
sewer to a larger capacity. This project will replace the existing sanitary sewer with a new and larger main and will not generate wastewater.
3e. Describe the overall project in detail, including the type of equipment to be used: The proposed project involves the construction of approximately
3,500 linear feet of 12-inch PVC, HOPE, and DIP pipeline, extending from just north of Buck Jones Road to the Walnut Creek Interceptor, south of Dana Drive. The project will extend along the existing
City easement to replace the existing 8-inch VCP sewer. Construction will be performed using two methods: open cut trench (heavy equipment such as bulldozers and excavators to dig a trench, install
the pipe, and backfill) and trenchless pipe bursting. The project corridor will be accessed along the existing easement and City roads. Some clearing of woody vegetation and trees along the easement
will be required for construction of the pipeline, but will be minimzed to allow for the installation and maintenance of the sanitary sewer pipe, manholes, and service connections.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
roject (including all prior phases in the past?
? Yes ? No Q Unknown
Comments: DWQ made stream determinations.
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Anna Reusche Agency/Consultant Company: Kimsey-Horn and Associates
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
?Yes E] No Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes No
6b. If yes, explain.
Page 3 of 10
PCN Form - Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ?X Streams -tributaries ?X Buffers ? 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 impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) (acres)
Temporary T
W1 Choose one Choose one Yes/No
W2 Choose one Choose one Yes/No
W3 Choose one Choose one Yes/No
W4 Choose one Choose one Yes/No
W5 Choose one Choose one Yes/No
W6 Choose one Choose one Yes/No
2g. Total Wetland Impacts:
2h. Comments:
No wetlands have been identified along the project corridor.
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) or Type of Average Impact
number intermittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S+A T Utility Replacement UT to Walnut Creek INT Corps 6 111
S2LC T Utility Replacement UT to Walnut Creek PER Corps 12 60
S3 Choose one
S4 Choose one
S5 Choose one
S6 Choose one
3h. Total stream and tributary impacts 171
3i. Comments:
All impacts will be temporary in nature. Streams will be returned to their approximate original condition. Note that the existing sanitary sewer
easement extends across these portions of the streams, therefore all stream impacts are assumed to be exempt or allowable, per Buffer Interpretation/
Clarification #2011-001.
Page 4 of 10
PCN Form - Version 1.4 January 2009
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 individual) list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Temporary T
01 Choose one Choose
02 Choose one Choose
03 Choose one Choose
04 Choose one Choose
4f. Total open water impacts
4g. Comments: ere wi 11 be no open water impacts.
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments: There will be no new pond 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:
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 miti ation, then you MUST fill out Section D of is form.
6a. Project is in which protected basin? ? Neuse ? Tar-Pamlico ? Catawba ? Randleman ? Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number -
Permanent (P) or mitigation impact impact

Temporary T required? (square (square
feet feet
B1 T Utility Replacement Walnut Creek No 1,478 952
B2 T Utility Replacement UT to Walnut Creek No 61679 1,681
B3 T Utility Replacement UT to Walnut Creek No 3,835 500
B4 T Utility Replacement UT to Walnut Creek No 415 264
B5 T Utility Replacement UT to Walnut Creek No 9,172 3,290
B6
Yes/No
6h. Total Buffer Impacts: 21,579 6,687
61. Comments: All impacts will be temporary in nature and will occur within an existing sanitary sewer easement, therefore all stream impacts are
assumed to be exempt or allowable, per Buffer Interpretation/Clarification #2011-001.
Hage 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Performed feasibility study to see if it would be possible to pipe burst the entire stretch of sewer to be replaced; this included CCTV of the sewer.
Upon review of the CCTV, it was determined that it is possible to pipe burst some of the sewer, but other sections are not feasible for pipe bursting and
must be replaced via open cut since these sections need to be re-laid in order to achieve a uniform slope. Also, the replacement sewer will be
installed in the same location as the existing sewer in order to keep the impacts within the existing easement.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sections of the sewer will be replaced via pipe bursting, where feasible. The existing sanitary sewer easement extends along several buffers and
several portions of the sewer need to be re-laid to a uniform slope, so there are some locations that impacts could not be avoided.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ? Yes ?X No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

El Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:

3b. Credits Purchased (attach receipt and letter) Type: Choose one
Type: Choose one
Type: Choose one Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Makin a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ?...Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form - Version 1.4 January 2009
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires Yes ?X No
buffer mitigation?
6b. 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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. 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).
All impacts will be temporary in nature and will occur within an existing sanitary sewer easement, therefore all stream impacts are
6h. Comments: assumed to be exempt or allowable, per field meeting with Martin Richmond (DWQ) and DWQ Buffer Interpretation/Clarification
#2011-001.
Page 7 of 10
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 0 Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Existing drainage patterns and capacities will be maintained. No new stormwater runoff will be
generated. X? Yes ? No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 2%
2b. Does this project require a Stormwater Management Plan? ? Yes 0 No

2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
The impervious area along the sanitary sewer easement is existing. There will be no new impervious area added as part of the sewer upgrade
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan? N/A
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? City of Raleigh
0 Phase II
3b. Which of the following locally-implemented stormwater management programs ?X NSW
apply (check all that apply): ? USMP
? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
E]Coastal counties
?HQW
4a. Which of the following state-implemented stormwater management programs apply ?ORW
(check all that apply): ?Session Law 2006-246
OOther: Diffuse Flow
4b. Has the approved Stormwater Management Plan with proof of approval been ? Yes ?X No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ?X Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ?X Yes ? No
Page 8 of 10
PCN Form - Version 1.4 January 2009
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the 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 ? Yes No
(North 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
letter.) ? Yes ? No
Comments: NIA
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, ?Yes ?X No
or 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):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ?X Yes ? 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.
This project is needed to accommodate both an existing deficiency in the capacity of the City's sanitary sewer for current flows and a proposed future
multi-family residential development, The Retreat at Raleigh. This proposed development has served as a catalyst for upgrading the existing sanitary
sewer to a larger capacity. Currently, there are no other known proposed developments that will contribute additional flow to this sanitary sewer
outfall. The Retreat at Raleigh development has been designed to meet the City of Raleigh stormwater requirements, which will protect the water
quality of this area.
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.
This project will replace the existing sanitary sewer with a new and larger main to convey wastewater. It will not generate wastewater.
Page 9 of 10
PCN Form - Version 1.4 January 2009
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 ?X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ?X No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The Natural Heritage Program database access through the virtual workroom. No federally threatened or endangered species were identified in the
project corridor.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ? No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The project is located in Wake County, and is therefore not anticipated to impact EFH
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
status (e.g., National Historic Trust designation or properties significant in E] Yes Z No
North Carolina history and archaeology)?
i
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
I I
The project corridor is located in existing utility right-of-ways and city maintained roads. No structures will be disturbed as part of the project,
accordingly, no impacts to Historic or Prehistoric Cultural Resources are anticipated.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ?X Yes ? No
8b. If yes, explain how project meets FEMA requirements:
The project is the installation of a new utility line that will not result in above-ground fill.
8c. What source(s) did you use to make the floodplain determination?
FIRM Panel downloaded from www.ncfloodmaps.coni
Julie R. Parham
pplicant/Agent's Signature
(Agent s signature is valid only if an authorization
letter from the applicant is provided.)
09-09-2011
Date
Applicant/Agent's Printed Name
Page 10 of 10
Letter of Authorization
Retreat at Raleigh, LLC, authorizes Kimley-Horn and Associates, Inc., to act as
our agent to prepare and coordinate the application to the U.S. Army Corps of
Engineers and the N.C. Division of Water Quality for 404/401 permits and
jurisdictional determinations associated with the Retreat Sanitary Sewer Line
Replacement located in Wake County, North Carolina. Authorization will
terminate on either final agency action or upon written notification.
Title
Date
-:5'0 WeSIeL c ?.rs
Printed Name
K*AANCDENR
"north Carolina Department of ',nvironment and Natura' Resources
Februar\3. 2011
Buffer Interpretation Clarification =2011-001
MEMORANDUM
Background: Currently in the Neuse (15A NCAC 2B. 0233). Tar-Pamlico (15A NCAC 2B. 0259)_ Randleman Lake
(15A NCAC 2B. 0250). Catawba (15A NCAC 2B. 0243). Goose Creek (15A NCAC 2B. 0607)", and Jordan Lake
(15A NCAC 2B. 0267) Buffer Rules. a buffer authorization and mitigation is required for non-electric utility lines
other than perpendicular crossings with Zone I riparian buffer impacts. Perpendicular crossings are defined by the
afore-mentioned buffer rules as crossings between 75 and 105 degrees. There is also not an explicit use in the table
to address how vehicles can access the utility lines for maintenance that is required.
Problem: Several questions have arisen as to when notification to the Division of Water Quality (DWQ) is required
and when riparian buffer mitigation is required for non-perpendicular. non-electric utility line riparian buffer
impacts ks hen a maintenance corridor is not maintained or a pipe is replaced or upsized. Another question was if the
vehicular access associated with utility line maintenance was considered a prohibited activity since it is not a use in
the table of uses.
Solution: Non-electric utility lines with riparian buffer impacts other than perpendicular crossing scenarios are
outlined in the attached table. If a scenario arises that is not specified in the attached table, DWQ shall make a
determination of when a non-electric utility line-parallel buffer impact would require mitigation.
In addition. the "utility. non-electric, perpendicular crossings of streams" use has an additional item that potentially
allows for impacts to the protected buffers for vehicular access for utility line maintenance.
The attached table outlines the utility uses. whether each use is "exempt". "allowable". or "allowable with
mitigation" and what current table of uses activity can be used to permit these.
For the Goose Creek Buffer Rules, riparian huffier mitigation is required Jnr non-perpendicular impacts lur non-
electric wilit Y lines i?+ ithin /ifn• (.i 0),1eet / the stream.
Signature: ????6???/(
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Date X
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North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date: 7/25/2011 Project/Site: The Retreat - Stream SA Latitude:
Evaluator: JRH, AKR County: Wake Longitude:
Total Points: 34.5 Stream Determination (circle one Other
Stream is at least intermittent Ephemeral Intermittent Perennial e.g. Quad Name: Raleigh West
if >_ 19 or perennial if ? 30
A. Geomorphology Subtotal = 17 Absent Weak Moderate Strong Score
1a. Continuity of channel bed and bank 0 1 2 3 3
2. Sinuosity of channel along thalwe 0 1 2 3 2
3. In-channel structure: ex. riffle-pool, step-pool, ripple-
ool se uence 0 1 2 3 2
4. Particle size of stream substrate 0 1 2 3 3
5. Active/relic flood lain 0 1 2 3 2
6. Depositional bars or benches 0 1 2 3 1
7. Recent alluvial deposits 0 1 2 3 2
8. Headcuts 0 1 2 3 0
9. Grade control 0 0.5 1 1.5 1.5
10. Natural valley 0 0.5 1 1.5 0.5
11. Second or greater order channel No = 0 Yes = 3 0
artificial ditches are not rated; see discussions in manual
B. Hvdroloav Subtotal = 10
12. Presence of Baseflow 0 1 2 3 3
13. Iron oxidizing bacteria 0 1 2 3 0
14. Leaf litter 1.5 1 0.5 0 1.5
15. Sediment on plants or debris 0 0.5 1 1.5 1
16. Organic debris lines or piles 0 0.5 1 1.5 1.5
17. Soil-based evidence of high water table? No = 0 Yes = 3 3
C. Bioloav Subtotal = 7.5
18. Fibrous roots in streambed 3 2 1 0 3
19. Rooted upland plants in streambed 3 2 1 0 3
20. Macrobenthos note diversity and abundance 0 1 2 3 1
21. Aquatic Mollusks 0 1 2 3 0
22. Fish 0 0.5 1 1.5 0
23. Crayfish 0 0.5 1 1.5 0
24. Amphibians 0 0.5 1 1.5 0.5
25. Algae 0 0.5 1 1.5 0
26. Wetland plants in streambed FACW = 0.75; OB L = 1.5; Other = 0 0
'perennial streams may also be identified using other methods. See p. 35 of manual.
Notes: Bedrock substrate. Good strona baseflow. Channel is
incised with exposed roots along banks on both sides. Channel is
approximately 12'W and 1-2' average depth. There are pools up and
downstream that are approximate 3' deep.
Photo 1 shows stream SA.
North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date: 7/25/2011 Project/Site: The Retreat - Stream sB Latitude:
Evaluator: JRH, AKR County: Wake Longitude:
Total Points: 23.5 Stream Determination circle one) Other
Stream is at least intermittent Ephemeral Intermittent Perennial e.g. Quad Name: Raleigh West
if >_ 19 or perennial if > 30
A. Geomorphology Subtotal = 10 Absent Weak Moderate Strong Score
1a. Continuity of channel bed and bank 0 1 2 3 3
2. Sinuosity of channel along thalwe 0 1 2 3 0
3. In-channel structure: ex. riffle-pool, step-pool, ripple-
ool se uence 0 1 2 3 1
4. Particle size of stream substrate 0 1 2 3 2
5. Active/relic flood lain 0 1 2 3 1
6. Depositional bars or benches 0 1 2 3 2
7. Recent alluvial deposits 0 1 2 3 1
8. Headcuts 0 1 2 3 0
9. Grade control 0 0.5 1 1.5 0
10. Natural valley 0 0.5 1 1.5 0
11. Second or greater order channel No = 0 Yes = 3 0
artificial ditches are not rated; see discussions in manual
B. Hvdroloqv Subtotal = 7.5
12. Presence of Baseflow 0 1 2 3 2
13. Iron oxidizing bacteria 0 1 2 3 0
14. Leaf litter 1.5 1 0.5 0 1
15. Sediment on plants or debris 0 0.5 1 1.5 1.5
16. Organic debris lines or piles 0 0.5 1 1.5 0
17. Soil-based evidence of high water table? No = 0 Yes = 3 3
C. Bioloqv Subtotal =
18. Fibrous roots in streambed 3 2 1 0 3
19. Rooted upland plants in streambed 3 2 1 0 3
20. Macrobenthos note diversity and abundance 0 1 2 3 0
21. Aquatic Mollusks 0 1 2 3 0
22. Fish 0 0.5 1 1.5 0
23. Crayfish 0 0.5 1 1.5 0
24. Amphibians 0 0.5 1 1.5 0
25. Algae 0 0.5 1 1.5 0
26. Wetland plants in streambed FACW = 0.75; OB L = 1.5; Other = 0 0
'perennial streams may also be identified using other methods. See p. 35 of manual.
Notes: SB is a very straight intermittent channel. It appears to
regularly flood or handle high flow due to presence of dual 2'x3' RCBC
upstream of SB-2. SB is channelized and substrate is well sorted.
SB is shown by Photo 2.
North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date: 7/25/2011 Project/Site: The Retreat - stream SC-2 Latitude:
Evaluator: JRH, AKR County: Wake Longitude:
Total Points: 20.75 Stream Determination circle one) Other
Stream is at least intermittent Ephemeral Intermittent Perennial e.g. Quad Name: Raleigh West
if >_ 19 or perennial if ? 30
A. Geomorphology Subtotal = 10.5 Absent Weak Moderate` Strong Score
1 a. Continuity of channel bed and bank 0 1 2 3 2
2. Sinuosity of channel along thalwe 0 1 2 3 1
3. In-channel structure: ex. riffle-pool, step-pool, ripple-
ool se uence 0 1 2 3 2
4. Particle size of stream substrate 0 1 2 3 2
5. Active/relic flood lain 0 1 2 3 1
6. Depositional bars or benches 0 1 2 3 1
7. Recent alluvial deposits 0 1 2 3 0
8. Headcuts 0 1 2 3 0
9. Grade control 0 0.5 1 1.5 1
10. Natural valley 0 0.5 1 1.5 0.5
11. Second or greater order channel No = 0 Yes = 3 0
artificial ditches are not rated; see discussions in manual
B. Hydroloqy Subtotal = 4.5
12. Presence of Baseflow 0 1 2 3 0
13. Iron oxidizing bacteria 0 1 2 3 0
14. Leaf litter 1.5 1 0.5 0 0.5
15. Sediment on plants or debris 0 0.5 1 1.5 0
16. Organic debris lines or piles 0 0.5 1 1.5 1
17. Soil-based evidence of high water table? No = 0 Yes = 3 3
C. Bioloqy Subtotal = 5.75
18. Fibrous roots in streambed 3 2 1 0 2
19. Rooted upland plants in streambed 3 2 1 0 3
20. Macrobenthos note diversity and abundance 0 1 2 3 0
21. Aquatic Mollusks 0 1 2 3 0
22. Fish 0 0.5 1 1.5 0
23. Crayfish 0 0.5 1 1.5 0
24. Amphibians 0 0.5 1 1.5 0
25. Algae 0 0.5 1 1.5 0
26. Wetland plants in streambed FACW = 0.75; OB L = 1.5; Other = 0 0.75
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes: Stream SC-2 is the intermittent break of SC. The channel
exits at a 24" CMP and the channel widens and substrate changes. Water begins pools and channel begins to mearn
Water begins pools and channel begins to meander. SC ends at SA.
Photo 4 shows SC-INT
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: Williams & Associates.
3. Date of evaluation: 7/25/11
5. Name of stream: SA
7. Approximate drainage area:
9. Length of reach evaluated:
2. Evaluator's name: JRH/AKR
4. Time of evaluation: 8:00am
6. River basin: Neuse River
400 acres 8. Stream order:
100'
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex. 34.872312):
10. County:
12. Subdivision name (if any):
Longitude (ex. -77.556611):
Method location determined (circle): GPS Touo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
Wake
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
South of Buck Jones Rd, North of I440 in SE Raleigh/Cary Area,
14. Proposed channel work (if any):-none
15. Recent weather conditions: No recent rainfall, considered in moderate drought by NC DMC
16. Site conditions at time of visit: Humid, sunny at 96 de egr es F
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES 20. Does channel appear on USDA Soil Survey? YES
21. Estimated watershed land use: _50_ % Residential _% Commercial % Industrial % Agricultural
-50-% Forested % Cleared / Logged % Other ()
22. Bankfull width: 15 feet
23. Bank height (from bed to top of bank): 5-10 feet
24. Channel slope down center of stream: Flat (0 to 2%) _X_Gentle (2 to 4%) Moderate (4 to 10%) Steep (>10%)
25. Channel sinuosity: Straight -Occasional bends -X -Frequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to
each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics
identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot
be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where
there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream
may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score
assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality.
Total Score (from reverse): 61 Comments: Healthy appearing bedrock stream. Area is
largely residentially developed impacting buffer quality and size. Channel alternates between deep bedrock vallevs and high
banked clav meanders. Good baseflow despite drought conditions.
Evaluator's Signature Jason Hartshorn
Date 7/25/11
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering
the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score
resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or
requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x 26.
[STREAM SA]
Stream Quality Assessment Worksheet
# Ecore 'on Point Ran
e
i
ti
Ch
t g S
arac
er
s
cs
Coastal
Piedmont
Mountain core
1 Presence of flow / persistent pools in stream 0-5 0-4 0-5 4
no flow or saturation = 0; strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5 3
extensive alteration = 0; no alteration = max points)
3 Riparian zone 0-6 0-4 0-5 2
(no buffer = 0; contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4 4
extensive discharges = 0; no discharges = max points)
,.a
5 Groundwater discharge
0-3
0-4
0-4
0
U no discharge = 0; springs, seeps, wetlands, etc. = max points)
6 Presence of adjacent floodplain 0-4 0-4 0-2 1
no flood lain = 0; extensive flood lain = max points)
x 7 Entrenchment / floodplain access 0-5 0-4 0-2 1
P. (deeply entrenched = 0; frequent flooding = max points)
8 Presence of adjacent wetlands
j 0-6 0-4 0-2 0
no wetlands = 0; large ad
acent wetlands = max points)
9 Channel sinuosity 0-5 0-4 0-3 3
extensive channelization = 0; natural meander = max points)
10 Sediment input 0-5 0-4 0-4 3
extensive deposition-- 0; little or no sediment = max points)
11 Size & diversity of channel bed substrate NA* 0-4 0-5 4
fine, homogenous = 0; large, diverse sizes = max points)
12 Evidence of channel incision or widening 0-5 0-4 0-5 2
F (deeply incised = 0; stable bed & banks = max points)

13 Presence of major bank failures
0-5
0-5
0-5
3
severe erosion = 0; no erosion, stable banks = max points)
M 14 Root depth and density on banks 0-3 0-4 0-5 4
no visible roots = 0; dense roots throughout = max points)
rA 15 Impact by agriculture, livestock, or timber production 0-5 0-4 0-5 4
substantial impact =0; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 5
no riffles/riles or pools = 0; well-developed = max points)
Q
1 Habitat complexity
0-6
0-6
0-6
4
little or no habitat = 0; frequent, varied habitats = max points)

1 S Canopy coverage over streambed
0-5
0-5
0-5
4
no shading vegetation = 0; continuous canopy = max points)
19 Substrate embeddedness NA* 0-4 0-4 3
(deeply embedded = 0; loose structure = max
20 Presence of stream invertebrates (see page 4) 0-4 0-5 0-5 2
>+ no evidence = 0; common, numerous types = max points)
C7 21 Presence of amphibians 0-4 0-4 0-4 1
0 no evidence = 0; common, numerous types = max points)

22 Presence of fish
0-4
0-4
0-4
2
0-0
no evidence = 0; common, numerous types = max points)
23 Evidence of wildlife use 0-6 0-5 0-5 2
(no evidence = 0; abundant evidence = max points)
Total Points Possible 100 100 100
TOTAL SCORE (also enter on first page) 61
* These characteristics are not assessed in coastal streams.
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: Williams & Associates 2. Evaluator's name: JRH/AKR
3. Date of evaluation: 7/25/11 4. Time of evaluation: 8:15am
5. Name of stream: SB
7. Approximate drainage area: <10 acres
6. River basin: Neuse River
8. Stream order:
9. Length of reach evaluated: 25' (from out of corridor) 10. County:
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex. 34.872312):
12. Subdivision name (if any):
Longitude (ex.-77.556611):
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
Wake
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
Just south of Dana Drive, flows into SA at S132
14. Proposed channel work (if any): none
15. Recent weather conditions: No recent rainfall, considered in moderate drought by NC DMC
16. Site conditions at time of visit: Humid, sunny at 96 degrees F
17. Identify any special waterway classifications known:
Trout Waters Outstanding Resource Waters
Section 10 Tidal Waters Essential Fisheries Habitat
Nutrient Sensitive Waters Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? NO 20. Does channel appear on USDA Soil Survey? NO
21. Estimated watershed land use: 75_ % Residential _% Commercial % Industrial % Agricultural
_% Forested % Cleared / Logged _25_% Other (field)
22. Bankfull width: 4 feet
23. Bank height (from bed to top of bank): 2 feet
24. Channel slope down center of stream: _X Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) Steep (>10%
25. Channel sinuosity: _X-Straight -Occasional bends Frequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to
each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics
identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot
be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where
there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream
may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score
assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality.
Total Score (from reverse): 27 Comments: V-cut drainage ditch that has become
channelized. Evidence of frequent high water or flooding. Upstream of reach is 4'x3' box culvert (dual RCBC). Low base flow.
very shallow water depth.
Evaluator's Signature
Date 7/25/11
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering
the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score
resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or
requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x 26.
Jason Hartshorn
[STREAM SB]
Stream Quality Assessment Worksheet
# Ch
i
ti
t Ecore ion Point Range S
arac
er
s
cs
Coastal
Piedmont
Mountain core
1 Presence of flow / persistent pools in stream 0-5 0-4 0-5 1
no flow or saturation = 0; strop flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5 1
extensive alteration = 0; no alteration = max points)
3 Riparian zone 0-6 0-4 0-5 2
(no buffer = 0; contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4 1
extensive discharges = 0; no discharges = max points)
5 Groundwater discharge 0-3 0-4 0-4 0
U no discharge = 0; springs, seeps, wetlands, etc. = max points)
6 Presence of adjacent floodplain 0-4 0-4 0-2 3
no flood lain = 0; extensive flood lain = max points)
??, 7 Entrenchment / floodplain access 0-5 0-4 0-2 2
a (deeply entrenched = 0; frequent flooding = max points)
8 Presence of adjacent wetlands
j 0-6 0-4 0-2 Q
no wetlands = 0; large ad
acent wetlands = max points)
9 Channel sinuosity 0-5 0-4 0-3 0
extensive channelization = 0; natural meander = max points)
10 Sediment input 0-5 0-4 0-4 3
extensive deposition-- 0; little or no sediment = max points)
I 1 Size & diversity of channel bed substrate NA* 0-4 0-5 2
(fine, homogenous = 0; large, diverse sizes = max points)
12 Evidence of channel incision or widening 0-5 0-4 0-5 1
H (deeply incised = 0; stable bed & banks = max points)

13 Presence of major bank failures
0-5
0-5
0-5
4
severe erosion = 0; no erosion, stable banks = max points)
d 14 Root depth and density on banks
0-3
0-4
0-5
no visible roots = 0; dense roots throughout = max points)
15 Impact by agriculture, livestock, or timber production 0-5 0-4 0-5 4
substantial impact =o; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 1
F no riffles/ripples or pools = 0; well-developed = max points)

1 Habitat complexity
0-6
0-6
0-6
little or no habitat = 0; frequent varied habitats = max points)
18 Canopy coverage over streambed 0-5 0-5 0-5 1
no shading vegetation = 0; continuous canopy = max points)
19 Substrate embeddedness NA* 0-4 0-4 1
(deeply embedded = 0; loose structure = max)
20 Presence of stream invertebrates (see page 4) 0-4 0-5 0-5 Q
>+ no evidence = 0; common, numerous types = max points)

21 Presence of amphibians
0-4
0-4
0-4
Q no evidence = 0; common, numerous types = max points)

22 Presence of fish
0-4
0-4
0-4
0-4
no evidence = 0; common, numerous types = max points)
23 Evidence of wildlife use 0-6 0-5 0-5 0
(no evidence = 0; abundant evidence = max points)
Total Points Possible loo 100 loo
TOTAL SCORE (also enter on first page) 27
* These characteristics are not assessed in coastal streams.
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: Williams & Associates 2. Evaluator's name:
3. Date of evaluation: 7/25/11
5. Name of stream: SC-INT
7. Approximate drainage area: <10 acres
9. Length of reach evaluated: 120'
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex. 34.872312):
RUVAKR
4. Time of evaluation: 9:30am
6. River basin: Neuse River
8. Stream order:
10. County: Wake
12. Subdivision name (if any):
Longitude (ex. -77.556611):
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
Downstream of SC-EPH. West of Barclay Street
14. Proposed channel work (if any):-none
15. Recent weather conditions: No recent rainfall, considered in moderate drought by NC DMC
16. Site conditions at time of visit: Humid, sunnv at 96 decrees F
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? NO 20. Does channel appear on USDA Soil Survey? NO
21. Estimated watershed land use: 75% Residential _% Commercial % Industrial % Agricultural
25_% Forested % Cleared / Logged % Other (field)
22. Bankfull width: 5 feet
23. Bank height (from bed to top of bank): 4 feet
24. Channel slope down center of stream: Flat (0 to 2%) _X Gentle (2 to 4%) Moderate (4 to 10%) Steep (>10%
25. Channel sinuosity: Straight -X-Occasional bends Frequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to
each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics
identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot
be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where
there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream
may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score
assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality.
Total Score (from reverse): 44 Comments: INT break in SC. Channel exits culvert,
deepens, and beeins to meander towards SA. Sorting, minor headcuts present. Vegetation is not present in thalwae like
upstream reach.
USA
Evaluator's Signature Jason Hartshorn Date 7/25/11
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering
the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score
resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or
requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x 26.

[STREAM SC]
Stream Quality Assessment Worksheet
# Ch
t
i
ti Ecore ion Point Range S
arac
er
s
cs
Coastal
Piedmont
Mountain core
1 Presence of flow / persistent pools in stream 0-5 0-4 0-5
1
no flow or saturation = 0; strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5 2
extensive alteration = 0; no alteration = max points)
3 Riparian zone 0-6 0-4 0-5 3
no buffer = 0; contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4 4
extensive discharges = 0; no discharges = max points)
5 Groundwater discharge 0-3 0-4 0-4 2
U no discharge = 0; springs, seeps, wetlands, etc. = max points)
6 Presence of adjacent floodplain 0- 4 0- 4 0- 2 3
no flood lain = 0; extensive flood lain = max points)
7 Entrenchment / floodplain access 0-5 0-4 0-2 2
P, (deeply entrenched = 0; fre uent flooding = max points)
8 Presence of adjacent wetlands
j 0-6 0-4 0-2 0
no wetlands = 0; large ad
acent wetlands = max points)
9 Channel sinuosity 0-5 0-4 0-3 2
extensive channclization = 0; natural meander = max points)
10 Sediment input 0-5 0-4 0-4 3
extensive deposition-- 0; little or no sediment = max points)
11 Size & diversity of channel bed substrate NA* 0-4 0-5 3
fine, homogenous = 0; large, diverse sizes = max points)
12 Evidence of channel incision or widening 0-5 0-4 0-5 3
(deeply incised = 0; stable bed & banks = max points)
.y
13 Presence of major bank failures
0-5
0-5
0-5
3
severe erosion = 0; no erosion, stable banks = max points)
M 14 Root depth and density on banks 0-3 0-4 0-5 3
(no visible roots = 0; dense roots throughout = max points)
rA 15 Impact by agriculture, livestock, or timber production 0-5 0-4 0-5 4
substantial impact -0; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 0
no riffles/riles or pools = 0; well-developed = max points)

1 Habitat complexity
0-6
0-6
0-6
2
little or no habitat = 0; frequent, varied habitats = max points)
M 18 Canopy coverage over streambed 0- 5 0- 5 0- 5 2
(no shading vegetation = 0; continuous canopy = max points)
19 Substrate embeddedness NA* 0-4 0-4 2
(deeply embedded = 0; loose structure = max

20 Presence of stream invertebrates (see page 4) 0-4 0
-5
0-5 0
no evidence = 0; common, numerous types = max points)
CX
21 Presence of amphibians
0-4
0-4
0-4
0
? no evidence = 0; common, numerous types = max points)

0
22 Presence of fish
0-4
0-4
0-4
0
(no evidence = 0; common, numerous types = max points)
23 Evidence of wildlife use 0-6 0-5 0-5 0
no evidence = 0; abundant evidence = max points)
Total Points Possible 100 100 100
TOTAL SCORE (also enter on first page) 44
* These characteristics are not assessed in coastal streams.