20120011 Ver 1_401 Application_20120112

cws
Carol a WeU d SBN Ca9
Carolina Wetland Services, Inc
550 East Westinghouse Boulevard
Charlotte NC 28273
704 527 1177 Phone
704 527 1133 Fax
TO Mr Ian McMillan
N C Division of Water Quality
401 Wetlands Unit
512 N Salisbury St
9th Floor Archdale Building
Raleigh NC 27603
Date 01 03 12
CWS Project # 2011 2873
2 0 1 20 0 1 1
R12@00YER I
AN 4 2012
nAND5 AND STOR,IMA ER BRA H
LETTER OF TRANSMITTAL
WE ARE SENDING YOU ®Attached ❑Under separate cover via the followmg items
❑ Prints ❑ Plans ❑ JD Package ❑ Specifications
❑ Copy of letter ❑ Change order ❑ Wetland Survey ® Other
TF TwrT nCT TRFQ ARP MnT ec VnTFn VTATnT v ATn=V T Tc AT nXTrr
1'HESE AXE TRANSMI "I "TED as checked below
❑For approval ❑Approved as submitted
®For your use ❑Approved as noted
❑As requested ❑Returned for corrections
❑For review and comment
❑Resubmit copies for approval
❑Submit copies for distribution
❑Return corrected prints
❑For your verification and signature
REMARKS Ian,
Please find attached five copies of the Preconstructron Notification and application for Water OualrtY Certification
No 3687 for the Galax Drive Drainage Improvements Project A check for the application fee is also attached
Copy to File
Thank you
omas Blackwell PWS
NORTH CAROLINA SOUTH CAROLINA
14Certification
1
01/03/11
5
Application for Water Quality No 3687
2
01/03/11
1
Application Fee Check ($240)
1'HESE AXE TRANSMI "I "TED as checked below
❑For approval ❑Approved as submitted
®For your use ❑Approved as noted
❑As requested ❑Returned for corrections
❑For review and comment
❑Resubmit copies for approval
❑Submit copies for distribution
❑Return corrected prints
❑For your verification and signature
REMARKS Ian,
Please find attached five copies of the Preconstructron Notification and application for Water OualrtY Certification
No 3687 for the Galax Drive Drainage Improvements Project A check for the application fee is also attached
Copy to File
Thank you
omas Blackwell PWS
NORTH CAROLINA SOUTH CAROLINA

Corps Submittal Cover Sheet 2 0 1 20 0 1 1
Please provide the following info
1 Project Name Galax Drive Drainage Improvements Project
2 Name of Property Owner /Applicant Charlotte Storm Water Services (CSWS)
3 Name of Consultant/Agent CSWS, Mr Isaac Hinson, PWS
*Agent authorization needs to be attached
4 Related/Previous Action ID number(s) N/A
5 Site Address 4906 Galax Drive, Charlotte, NC
6 Subdivision Name N/A
7 City Charlotte
8 County Mecklenburg
9 Lat N35 254289° Long W80 7842770 (Decimal Degrees Please
10 Quadrangle Name Derita, NC, dated 1996 and Charlotte East, NC, dated 1991
11 Waterway UT to Little Sugar Creek
12 Watershed Santee (HU# 03050103)
13 Requested Action
X Nationwide Permit # 3
General Permit #
X Jurisdictional Determination Request
Pre Application Request
The following information will be completed by Corps office
AID
Prepare File Folder Assign number in ORM Begin Date
Authorization Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose
Site /Waters Name
Keywords

L�WS
Carobna Wetland Services
January 3 2012
Ms Amanda Jones
U S Army Corps of Engineers
151 Patton Avenue Room 208
Asheville NC 28801
Mr Ian McMillan
550 E WESTINGHOUSE BLVD
CHARLOTTE NC 28273
866 527 1177 (office)
704 527 1133 (fax)
NCDWQ — Wetlands and Stormwater Branch
512 N Salisbury St
9th Floor Archdale Building
Raleigh NC 27603
Subject Pre Construction Notification Pursuant to Nationwide Permit No 3
Galax Drive Drainage Improvement Project
Charlotte, North Carolina
Carolina Wetland Services Project No 2011 2873
The Galax Drive drainage improvement project is located at 4906 Galax Drive in Charlotte North
Carolina (Figure 1 USGS Site Location Map attached) The purpose of this project is to upgrade an
existing storm drainage pipe system and alleviate flooding at 4906 Galax Drive Charlotte Storm
Water Services (CSWS) has contracted Carolina Wetland Services Inc (CWS) to provide Section
404/401 permitting services for this project
Applicant Name Charlotte Storm Water Services Isaac J Hinson PWS
Mailing Address 600 East Fourth Street Charlotte NC 28202
Phone Number of Owner /Applicant 704 336 4495
Street Address of Project 4906 Galax Drive Charlotte NC
Tax Parcel ID 091 022 01 091 022 13 091 022 03 and 091 051 09
Waterway UT to Little Sugar Creek
Basin Santee (HU# 03050103)
City Charlotte
County Mecklenburg
Decimal Degree Coordinate Location of Project Site N35 2542890 W80 7842770
USGS Quadrangle Name Derita, NC dated 1996 and Charlotte East NC dated 1991
Current Land Use
The project area is approximately 0 81 acres in extent and is comprised of city streets and single family
residential properties with maintained lawns and yards as well as a parking lot for a commercial
business Dominant vegetation within the project area consists of white clover (Trifolium repens)
sawtooth blackberry (Rubus argutus) Japanese honeysuckle (Lonicera japonica) glossy privet
(Ligustrum lucidum) English ivy (Hedera helix) and fescue (Festuca sp )
NORTH CAROLINA SOUTH CAROLINA
WWW CWS INC NET

Galax Drive Drainage Improvement Protect January 3, 2012
Nationwide Permit No 3 Proiect No 2011 2873
According to the Soil Survey of Mecklenburg County' (Figure 2 NRCS Soil Survey Map attached)
on site soils consist of Helena Urban land complex 2 to 8 percent slopes (HuB) and Helena sandy
loam 2 to 8 percent slope (HeB) Helena soils are moderately well drained and are listed on the North
Carolina Hydric Soils List for Mecklenburg County2 (HeB) and on the National Hydric Soils List3
(HeB and HuB) as having hydric inclusions
Jurisdictional Determination
On December 12 2011 CWS scientist Thomas Blackwell delineated jurisdictional waters of the U S
within the project area Jurisdictional areas were delineated using the U S Army Corps of Engineers
( USACE) Routine On Site Determination Method This method is defined in the 1987 Corps of
Engineers Wetlands Delineation Manua14 with further technical guidance from the Eastern Mountains
& Piedmont Interim Regional Supplements dated July 2010 A Wetland Determination Data Form
representative of non jurisdictional upland areas has been enclosed (DP1)
Jurisdictional stream channels were classified according to recent USACE and North Carolina
Division of Water Quality ( NCDWQ) guidance These classifications included sampling with a D
shaped dip net taking photographs and defining approximate breakpoints (location at which a channel
changes classification) within each on site stream channel A NCDWQ Stream Classification Form
and USACE Stream Quality Assessment Worksheet representative of Stream A are enclosed (SCP1)
The results of the on site field investigation indicate that there is one jurisdictional stream channel (Stream
A) located within the project area (Figure 3 attached) Stream A is an unnamed tributary to Little Sugar
Creek Little Sugar Creek is within the Santee River basin (HU# 03050103)6 and is classified as Class C
waters by the NCDWQ On Site jurisdictional waters are summarized in Table 1 below
Table 1 Summary of On Site Jurisdictional Waters
Jurisdictional
Feature
Jurisdiction
SCP
No
NCDWQ
Steam
Classification
Score
USACE
Stream
Assessment
Score
Approx
Length
Lmear Feet
(10
Approx
Acreage
(ac)
USACE/EPA
Rapanos
Classification
Intermittent/
Perennial
Stream A
RPW
Intermittent
SCP1
20
31
126
00058
On Site Total
126
0 0058
I United States Department of Agriculture 1971 Soil Survey of Mecklenburg County North Carolina
2 United States Department of Agriculture — Natural Resources Conservation Service 1999 North Carolina Hydric Soils List USDA
NRCS North Carolina State Office Raleigh
3 United States Department of Agriculture —Natural Resources Conservation Service 2010 2010 National Hydric Soils List by State
4 Environmental Laboratory 1987 Corps of Engineers Wetlands Delineation Manual Technical Report Y 87 1 US Army Engineer
Waterways Experiment Station Vicksburg Mississippi
5 US Army Corps of Engineers July 2010 Interim Regional Supplement to the Corps of Engineers Wetland Delineation Manual Eastern
Mountains and Piedmont Region US Army Engineer Research and Development Center Vicksburg Mississippi
6 HU# is the Hydrologic Unit Code U S Geological Survey 1974 Hydrologic Unit Map State of North Carolina
2

Galax Drive Drainage Improvement Project January 3, 2012
Nationwide Permit No 3 Protect No 2011 2873
Relatively Permanent Waters with Seasonal Flow
Stream A flows northwest across the project area for approximately 1261mear feet Stream A
exhibited a moderate continuity of channel bed and bank weak substrate weak flow and an average
ordinary high water width of one to two feet Biological sampling revealed a strong presence of iron
oxidizing bacteria and a moderate presence of algae Stream characteristics indicate that continuous
flow is present for at least three months in an average year Stream A was classified as a Relatively
Permanent Water with seasonal flow (RPW) according to USACE/EPA guidance Seasonal RPW
Stream A scored 31 out of a possible 100 points on the USACE Stream Quality Assessment Worksheet
and 20 out of a possible 63 points on the NCDWQ Stream Classification Form indicating intermittent
status (SCP1 enclosed) Photographs A B and C (Figure 3 attached) are representative of
Intermittent Seasonal RPW Stream A
Agency Correspondence
Cultural Resources
A letter was forwarded to the State Historic Preservation Office (SHPO) on December 20 2011 to
determine the presence of any areas of architectural historic or archaeological significance that would
be affected by the project As of the date of this submittal a response from SHPO has not yet been
received CWS consulted the Charlotte Mecklenburg Historic Landmarks Commission database and
found no listed properties within the project area
Protected Species
A letter was forwarded to the North Carolina Natural Heritage Program ( NCNHP) on December 20
2011 to determine the presence of any federally listed candidate endangered threatened species or
critical habitat located within the protect area As of the date of this submittal a response from the
NCNHP has not yet been received
In addition the NCNHP Geographic Information Systems (GIS) database Virtual Workroom and
Element Occurrence (EO) database was reviewed for a listing of EOs of endangered or threatened
species within or near the project area The EO database identified no endangered or threatened species
within a two mile radius of the protect area
Purpose and Need for the Project
The home located at 4906 Galax Drive is experiencing flooding of the crawl space During the
analysis phase of the project it was discovered that the existing pipe system was designed to sustain the
ten year storm event but will flood at the 25 year storm event In addition it is the opinion of the
project engineer that mlet blockages are causing structure flooding during storm events of a lesser
intensity than the 25 year storm event
The purpose of this project is to upgrade an existing storm drainage pipe system at 4906 Galax Drive
to sustain the 25 year storm event In addition the upgraded system will protect the property from
flooding during a 100 year storm event
Avoidance and Minimization
Impacts to on site jurisdictional waters of the U S have been reduced to the maximum extent possible
Proper sediment and erosion control measures will be used to minimize disturbances to downstream
waters All work will be constructed in the dry in accordance with Water Quality Certification No 3687

Galax Drive Drainage Improvement Protect January 3, 2012
Nationwide Permit No 3 Protect No 2011 2873
Impacts to the bed of existing channels have been avoided wherever possible There will be no additional
piping of the jurisdictional stream channel Permanent impacts to jurisdictional waters of the U S will be
limited to approximately 981mear feet of rip rap placement necessary to maintain the stability of the mlet
channel and to dissipate energy at the Galax Road culvert outfall The use of grade control structures
upstream of the proposed pipe replacement was considered However the channel is too small to be
effectively and reliably stabilized in this manner
Proposed Impacts to Jurisdictional Waters
Unavoidable impacts to Jurisdictional Waters of the U S total 981mear feet of permanent stream impacts
(Figure 4 attached) Impacts are the result of rip rap placement to stabilize the channel upstream of the
mlet and to dissipate the energy of the water at the culvert outfall
The project will involve the replacement of the existing 32 inch stormwater pipe with a 42 inch
reinforced concrete pipe (RCP) Permanent impacts to Seasonal RPW Stream A total 98 lmear feet and
are the result of 75 feet of channel gradmg and rip rap installation upstream of the pipe and the
installation of a 23 foot rip rap apron at the pipe outfall (Figure 4 attached) associated with the upsizmg
of the 32 inch pipe to a 42 inch RCP The gradmg and rip rap placement upstream of the pipe is
designed to provide channel stability due to a steep slope and to allow for better drainage into the pipe
system The proposed rip rap apron is designed to protect the stream bed and banks from erosion and to
dissipate the energy of water exiting the pipe A cross section and profile view of the proposed rip rap
installation are included on Figure 4
Table 2 Summary of Impacts to On Site Jurisdictional Waters
Jurisdictional
onal
Intermittent
NWP
/ Permanent
Approx
Feature
/ Perennial
Impact Type
No
Approximate
Acreage
Len th
RPW Stream A
Intermittent
rip rap apron
3
23 if (Permanent)
00011
RPW Stream A
Intermittent
rip rap within
3
75 if (Permanent)
00034
channel
Stream Impacts (Total)
98 if
00045
acre
Stream Impacts (Permanent)
981f
00045
acre
On behalf of CSWS CWS is submitting a Pre Construction Notification Application with attachments in
accordance with Nationwide Permit General Condition No 27 (enclosed) and pursuant to Nationwide
Permit No 3
Compensatory Mitigation
Permanent impacts to ,jurisdictional waters of the U S have been limited to 981mear feet of seasonal
stream channel Therefore no mitigation is proposed for these impacts

Galax Drive Drainage Improvement Protect January 3, 2012
Nationwide Permit No 3 Protect No 2011 2873
Please do not hesitate to contact Isaac Hinson at 704 336 4495 or ihmson @ci charlotte nc us should
you have any questions or comments regarding these findings
Isaac J Json PWS
Wetland Specialist
re .Antemann PWS —
Principal Scientist
Enclosures Figure 1 USGS 7 5 Denta and Charlotte East NC Topographic Quadrangles
Figure 2 NRCS Mecklenburg County Soil Survey
Figure 3 Approximate Jurisdictional Boundary Field Map
Figure 4 Proposed Impacts
Request for Jurisdictional Determination Form
Pre Construction Notification Pursuant to Nationwide Permit No 3
NCDWQ Stream Classification Form (SCP1)
USACE Stream Quality Assessment Worksheet (SCPI)
USACE Wetland Determination Data Form (DPl)
Approved Jurisdictional Determination Form
cc Mr Mark Cantrell U S Fish & Wildlife Service
5

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REQUEST FOR JURISDICTIONAL DETERMINATION
DATE JanuM 3, 2012
COUNTY Mecklenburg_ County, North Carolina TOTAL ACREAGE OF TRACT 0 81
PROJECT NAME (if applicable) Galax Drive Drainage Improvements Project
PROPERTY OWNER/APPLICANT (name address and phone)
Charlotte Storm Water Services
POC Mr Isaac J Hinson, PWS at [phone]
600 East Fourth Street
Charlotte, North Carolina 28202
NAME OF CONSULTANT, ENGINEER, DEVELOPER (if applicable)
STATUS OF PROJECT (check one)
( ) On going site work for development purposes
( X) Project in planning stages
(Type of protect maintenance )
( ) No specific development planned at present
( ) Project already completed
(Type of protect
ADDITIONAL INFORMATION REQUIRED
Check items submitted forward as much information as is available At a minnmum the following first two items must be
forwarded
(X) Figure 1 USGS 7 5 Minute Denta, NC and Charlotte East NC Topographic Quadrangles
(X) Figure 2 NRCS Mecklenburg County Soil Survey
(X ) Figure 3 Approximate Jurisdictional Boundary Field Map
(X) Pre Construction Notification Pursuant to Nationwide Permit No 3
(X) NCDWQ Stream Classification Forms (SCP1)
(X) USACE Stream Quality Assessment Worksheets (SCP1)
(X) USACE Wetland Determination Data Form (DP 1)
(X) Approved Jurisdictional Determination Form C
-�
Signature of Property Owner or
Authorized Agent
Mr Isaac J Hinson, PWS

ot W ATt9O9
� r
o <
20120011
Office Use Only
Corps action ID no
DWQ protect no
Form Version 13 Dec 10 2008
Page 1 of 12
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification C Form
A Applicant Information
1
Processing
1 a
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 3 or General Permit (GP) number
1c
Has the NWP or GP number been venfied by the Corps?
❑ Yes
® No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification — Regular ❑ Non 404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes ® No
For the record only for Corps Permit
❑ Yes ® No
If
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
® No
1g
Is the protect located in any of NC s twenty coastal counties If yes answer 1 h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of protect
Galax Drive Drainage Improvements Protect
2b
County
Mecklenburg
2c
Nearest municipality / town
Charlotte
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
protect no
N/A
3
Owner Information
3a
Name(s) on Recorded Deed
3b
Deed Book and Page No
3c
Responsible Party (for LLC if
applicable)
N/A
3d
Street address
4906 Galax Drive
3e
City state zip
Charlotte NC 28213
3f
Telephone no
3g
Fax no
3h
Email address
Page 1 of 12
PCN Form — Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
❑ Agent ® Other specify City of Charlotte Storm Water Services
4b
Name
Mr Isaac Hinson PWS
4c
Business name
(if applicable)
City of Charlotte Storm Water Services (CSWS)
4d
Street address
600 E Fourth Street
4e
City state zip
Charlotte NC 28202
4f
Telephone no
[phone]
4g
Fax no
[phone]
4h
Email address
ihinson @ci charlotte nc us
5
Agent/Consultant Information (if applicable)
5a
Name
Gregg Antemann PWS
5b
Business name
(if applicable)
Carolina Wetland Services Inc
5c
Street address
550 E Westinghouse Blvd
5d
City state zip
Charlotte NC 28273
5e
Telephone no
704 527 1177
5f
Fax no
704 527 1133
5g
Email address
gregg @cws inc net
Page 2 of 12
PCN Form — Version 1 3 December 10 2008 Version

B
Project Information and Prior Project History
1
Property identification
1a
Property identification no (tax PIN or parcel ID)
091 022 01 091 022 13 091 022 03 and 091 051 09
lb
Site coordinates (in decimal degrees)
Latitude 35 25248 Longitude 80 784277
(DD DDDDDD) ( DD DDDDDD)
1 c
Property size
0 81 acres
2
Surface Waters
2a
Name of nearest body of water (stream river etc ) to
Little Sugar Creek
proposed project
2b
Water Quality Classification of nearest receiving water
Class C
2c
River basin
Santee (HU# 03050103)
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 area is approximately 0 81 acres in extent and is comprised of city streets and single family residential
properties with maintained lawns and yards as well as a parking lot for a commercial business Dominant vegetation
within the project area consists of white clover (Trifolium repens) sawtooth blackberry (Rubus argutus) Japanese
honeysuckle (Lorncera japonica) glossy privet (Ligustrum lucidum) English ivy (Hedera helix) and fescue (Festuca sp )
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
126 linear feet of intermittent stream channel
3d
Explain the purpose of the proposed project
The home located at 4906 Galax Drive is experiencing flooding of the crawl space During the analysis phase of the project it
was discovered that the existing pipe system was designed to sustain the ten year storm event but will flood at the 25
year storm event In addition it is the opinion of the project engineer that inlet blockages are causing structure flooding
during storm events of a lesser intensity than the 25 year storm event
The purpose of this project is to upgrade an existing storm drainage pipe system at 4906 Galax Drive to sustain the 25 year
storm event In addition the upgraded system will protect the property from flooding during a 100 year storm event
3e
Describe the overall project in detail including the type of equipment to be used
The project will involve the replacement of the existing 32 inch stormwater pipe with a 42 inch reinforced concrete pipe
(RCP) The inlet channel will be graded and stabilized with rip rap for 75 linear feet to provide better drainage and entry
into the pipe system A 23 linear foot rip rap apron will also be constructed at the outfall of the pipe to dissipate the
energy of the water exiting the system A track hoe and other typical construction equipment will be used to construct this
project
Page 3 of 12
PCN Form — Version 13 December 10 2008 Version

4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑ Yes ®No ❑ Unknown
project (including all prior phases) in the pasty
Comments
4b
If the Corps made the jurisdictional determination what type
❑ preliminary ❑ Final
of determination was made?
4c
If yes who delineated the jurisdictional areas?
Agency /Consultant Company Carolina Wetland Services
Name (if known) Thomas Blackwell PWS
Inc 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
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
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 4 of 12
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands ® Streams tributaries ❑ 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 jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non 404 other)
(acres)
Temporary
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
2h Comments
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
Type of jurisdiction
Average
Impact
number
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non 404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
Unimportant
S1 ®P ❑ T
Rip Rap Apron
Intermittent
❑ PER
® Corps
2
23
Seasonal RPW
® INT
❑ DWQ
Stream A
Unimportant
S2 ® P ❑ T
Rip Rap
Intermittent
❑ PER
® Corps
2
75
Seasonal RPW
® INT
❑ DWQ
Stream A
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
98
31 Comments Permanent Impacts to Jurisdictional Streams total 98 If (0 0045 acre) of unimportant intermittent stream
Page 5 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 (acres)
Permanent (P) or
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction ro
5a 5b
Pond ID Proposed use or p
number of pond
osed then complete the chart below
5c 5d
Wetland Impacts (acres)
urpose
5e
Stream Impacts (feet) I Upland
Flooded I Filled I Excavated Flooded I Filled I Excavated I Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 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 any impacts require mitigation then you MUST fill out Section D of this form
6a
Project is in which protected basin?
6b 6c 6d
Buffer impact
number — Reason
Permanent (P) or for
Temporary (T) impact
61 ❑P ❑T
B2 ❑P ❑T
B3 ❑P ❑T
61 Comments
❑ Neuse ❑ Tar Pamlico ❑ Other
❑ Catawba ❑ Randleman
6e 6f 6g
Buffer
Stream name mitigation
required?
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
6h Total buffer unpacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
Page 6 of 12
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Impacts to on site jurisdictional waters of the U S have been reduced to the maximum extent possible Proper sediment and
erosion control measures will be used to minimize disturbances to downstream waters All work will be constructed in the dry
in accordance with Water Quality Certification No 3687
Impacts to the bed of existing channels have been avoided wherever possible There will be no additional piping of the
jurisdictional stream channel Permanent impacts to jurisdictional waters of the U S will be limited to approximately 98 linear
feet of rip rap placement necessary to maintain the stability of the inlet channel and to dissipate energy at the Galax Road
culvert outfall The use of grade control structures upstream of the proposed pipe replacement was considered However the
channel is too small to be effectively and reliably stabilized in this manner
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Impacts to on site jurisdictional waters of the U S have been reduced to the maximum extent practicable Proper sediment
and erosion control measures will be used to minimize disturbances to downstream waters All work will be constructed in the
dry in accordance with Water Quality Certification No 3821
2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U S or Waters of the State?
2b If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c If yes which mitigation option will be used for this
project?
❑ 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
Quantity
3c Comments
4 Complete if Making 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
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Ripanan 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 7 of 12
PCN Form — Version 1 3 December 10 2008 Version

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
buffer mitigation?
❑ Yes ❑ No
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
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(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)
6h Comments
Page 8 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
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes then is a diffuse flow plan included9 If no explain why
❑ Yes E] No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why There is no change in mpervious area
associated with this project
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
❑ 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 Charlotte
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ 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
4a
Which of the following state implemented stormwater management programs apply
❑ HQW
❑ 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
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 12
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes
❑ No
use of public (federal /state) land?
lb
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
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
® No
or Riparian Buffer Rules (15A NCAC 2B 0200)7
2b
Is this an after the fact permit application?
❑ Yes
® 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
❑ 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
The project will not result in additional future development
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
N/A
Page 10 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 ® No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
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?
A letter was forwarded to the North Carolina Natural Heritage Program ( NCNHP) on December 20 2011 to determine
the presence of any federally listed candidate endangered threatened species or critical habitat located within the
project area As of the date of this submittal a response from the NCNHP has not yet been received In addition the
NCNHP Geographic Information Systems (GIS) database Virtual Workroom and Element Occurrence (EO) database was
reviewed The EO database identified no endangered or threatened species within a two mile radius of 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 ® No
6b What data sources did you use to determine whether your site would Impact Essential Fish Habitat?
NOAA Fisheries http / /sharpfin nmfs noaa gov /website /EFH_Mapper /map aspx
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
❑ Yes ® 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?
A letter was forwarded to the State Historic Preservation Office (SHPO) on December 20 2011 to determine the
presence of any areas of architectural historic or archaeological significance that would be affected by the project As of
the date of this submittal a response from SHPO has not yet been received CWS consulted the Charlotte Mecklenburg
Historic Landmarks Commission database and found no listed properties within the project area
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination? Mecklenburg County GIS FEMA Layers
Mr Isaac Hinson, PWS
--���
01 03 12
Applicant/Agent s Printed Name
Date
Applicant/Agent s Signature
(Agents signature is valid only if an authorization letter from the applicant
is provided
Page 11 of 12
PCN Form — Version 1 3 December 10 2008 Version

Page 12 of 12
PCN Form — Version 1 3 December 10 2008 Version

NC DWQ Stream identification Form Version 411
Date (2 . h _ 20 1 (
Project/Site �f �V
Latitude 35 S �8 a
Evaluator 17(�
County � �
Longitude U gC) -7&2-?f
Total Points
Stream least intermittent
20
Stream Determinat ion (circle one)
Ephemeral ntermi en Perennial
Other,-:yMm
e g Quad Name
if z 19 or r perennial if 2:30
2 Sinuosity of channel along thalweg
5
A Geomorphology (Subtotal = G S
Absent
Weak
Moderate
Strong
18 Continuity of channel bed and bank
0
1
2
3
2 Sinuosity of channel along thalweg
5
1
2
3
3 In channel structure ex riffle pool step pool
ripple pool sequence
O
1
2
3
4 Particle size of stream substrate
0
05
2
3
5 Active /relict floodplam
0
1
2
3
6 Depositional bars or benches
1
2
3
7 Recent alluvial deposits
24 Amphibians
1
2
3
8 Headcuts
0
1
2
3
9 Grade control
0
05
1
15
10 Natural valley
0
Q.0
1
15
11 Second or greater order channel
No 0
Yes = 3
artificial ditches are not rated see discussions in manual
B Hydrology (Subtotal =
12 Presence of Baseflow
0
1
2
3
13 Iron oxidizing bacteria
0
1
2
3
14 Leaf litter
5
1
(n5
0
15 Sediment on plants or debris
2
05
21 Aquatic Mollusks
15
16 Organic debris lines or piles
0
05
3
15
17 Soil based evidence of high water table?
No = 0
Ye = J3
C Biology (Subtotal = S
18 Fibrous roots in streambed
3
2
1
0
19 Rooted upland plants in streambed
3
2
0
0
20 Macrobenthos (note diversity and abundance)
0
1
2
3
21 Aquatic Mollusks
1
2
3
22 Fish
0
05
1
15
23 Crayfish
0
05
1
16
24 Amphibians
0
05
1
15
25 Algae
0
05
1
15
26 Wetland plants in streambed
I
FACW = 0 75 OBL = 1 5 Other = 0
perennial streams may also be identified using other methods See p 35 of manual
Notes
J
Sketch

OFFICE USE ONLY USACE AID# DWQ #
SCP1— Seasonal RPW Stream A
STREAM '�
1 Applicants Name CSWS 2 Evaluators Name Thomas Blackwell
3 Date of Evaluation 12 12 11 4 Time of Evaluation 10 00 AM
5 Name of Stream Intermittent Stream A 6 River Basin Santee (HU# 03050103)
7 Approximate Drainage Area 28 acres 8 Stream Order first
9 Length of Reach Evaluated 125 feet 10 County Mecklenburg
11 Location of reach under evaluation (include nearby roads and landmarks) Site located at the corner of Galax Drive and Leafinore
Drive
12 Site Coordinates (if known) N35 254289 , W80 784277
13 Proposed Channel Work (if any) N/A
14 Recent Weather Conditions Cold and Dry
15 Site conditions at time of visit Drizzle. 40°
16 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)
17 Is there a pond or lake located upstream of the evaluation pomt9 YES ® If yes estimate the water surface area
18 Does channel appear on USGS quad map9 YES NO 19 Does channel appear on USDA Soil Survey) YES NO
20 Estimated Watershed Land Use 100 % Residential _% Commercial % Industrial _% Agricultural
% Forested _% Cleared / Logged _% Other
21 Bankfull Width 1 2 22 Bank Height (from bed to top of bank) 1 2
23 Channel slope down center of stream X Flat (0 to 2 %) _Gentle (2 to 4 %) _Moderate (4 to 10 %) _Steep ( >10 %)
24 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) 31 Comments
Evaluator's Signature b", 0 Ud Date 12/12/2011
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 in order 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 05/03 To Comment please call 919 876 8441 x 26

STREAM QUALITY ASSESSMENT WORKSHEET
SCP1— Seasonal RPW Stream A
i nese cnaracienstncs are not assesses in coastal streams
#
ECOREGION POINT
RANGE
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow / persistent pools in stream
0-5
0 — 4
0-5
2
no flow or saturation = 0 strop flow = max points)
2
Evidence of past human alteration
0-6
0-5
0-5
0
extensive alteration = 0 no alteration = max points)
3
Riparian zone
0-6
0-4
0-5
0
no buffer = 0 contiguous wide buffer = max points)
4
Evidence of nutrient or chemical discharges
0-5
0-4
0-4
2
extensive discharges = 0 no discharges = max po ints
5
Groundwater discharge
0-3
0-4
0-4
2
no discharge = 0 springs sees wetlands etc = max points)
U
6
Presence of adjacent floodplam
0— 4
0— 4
0— 2
2
no flood lam = 0 extensive flood lam = max points)
a7
Entrenchment / floodplam access
(deeply entrenched = 0 frequent flooding = max points)
0— 5
0— 4
0— 2
2
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
no wetlands = 0 large adjacent 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
2
extensive deposition= 0 little or no sediment = max omts
11
Size & diversity of channel bed substrate
NA*
0-4
0 - 5
1
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)
13
Presence of major bank failures
0-5
0 — 5
0-5
4
severe erosion = 0 no erosion stable banks = max points)
14
Root depth and density on banks
0-3
0 - 4
0-5
4
no visible roots = 0 dense roots throughout = max points)
15
Impact by agriculture or livestock production
substantial impact =0 no evidence = max oints
0-5
0 — 4
0-5
4
16
Presence of riffle pool/ripple pool complexes
no riffles/ripples or pools = 0 well developed = max points)
0-3
0 - 5
0-6
0
d
1
Habitat complexity
0-6
0-6
0-6
1
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
0
(deeply embedded = 0 loose structure = max
20
Presence of stream invertebrates
no evidence = 0 common numerous types = max points)
0-4
0-5
0-5
0
21
Presence of amphibians
0-4
0-4
0-4
0
O
no evidence = 0 common numerous types = max points)
O
22
Presence of
0-4
0-4
0-4
0
no evidence = 0 common numerous types = max p omts
23
Evidence of wildlife use
0-6
0-5
0-5
1
no evidence = 0 abundant evidence = max points)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page)
31
i nese cnaracienstncs are not assesses in coastal streams

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site Galax Drive Drainage Improvements city /county Mecklenburg Sampling Date 12/12/11
Applicant/Owner Charlotte Storm Water Services State NC Sampling Point DP1
Investigator(s) Thomas Blackwell PWS Section Township Range Charlotte NC
Landform (hillslope terrace etc ) valley Local relief (concave convex none) None Slope(/) U 2%
Subregion (LRR or MLRA) MLRA Lat N35 254289 Long W80 784277 Datum NAD 83
Soil Map unit Name Helena Urban Land Complex 2 to 8 percent slopes (HUB) NWI classification N/A
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no explain in Remarks )
Are Vegetation Sod or Hydrology significantly disturbed? Are Normal Circumstances present? Yes ✓ No
Are Vegetation Sod or Hydrology naturally problematic? (If needed explain any answers in Remarks )
SUMMARY OF FINDINGS — Attach site map showing sampling point locations transects important features, etc
Hydrophytic Vegetation Present? Yes No
Is the Sampled Area
Hydric Sod Present? Yes No within a Wetland? Yes No ✓
Wetland Hydrology Present? Yes No
Remarks
Area Is representative of a non -junsd(ct(onal upland area
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply) _
Surface Sod Cracks (136)
Surface Water (A1)
_ True Aquatic Plants (1314) _
Sparsely Vegetated Concave Surface (138)
High Water Table (A2)
_ Hydrogen Sulfide Odor (Cl) —
Drainage Patterns (1310)
Saturation (A3)
— Oxidized Rhizospheres on Living Roots (C3) _
Moss Trim Lines (1316)
_ Water Marks (131)
_ Presence of Reduced Iron (C4) _
Dry Season Water Table (C2)
Sediment Deposits (132)
_ Recent Iron Reduction in Tilled Soils (C6) _
Crayfish Burrows (C8)
Drift Deposits (63)
— Thin Muck Surface (C7) _
Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (134)
_ Other (Explain in Remarks) _
Stunted or Stressed Plants (D1)
Iron Deposits (135)
_
Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (137)
_
Shallow Aquitard (D3)
Water Stained Leaves (139)
_
Microtopographic Relief (D4)
_ Aquatic Fauna (1313)
V
FAC Neutral Test (D5)
Field Observations
Surface Water Present? Yes No
Depth (inches)
Water Table Present? Yes No
Depth (inches)
Saturation Present? Yes No
Depth (inches) >18
Wetland Hydrology Present? Yes No
includes ca illa frin e
Describe Recorded Data (stream gauge monitoring well aerial photos previous inspections) if available
Remarks
No indicators of wetland hydrology were present at the sampling point
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

VEGETATION (Four Strata) — Use scientific names of plants
Sampling Point DP1
Remarks (Include photo numbers here or on a separate sheet )
Less than 50% of the dominant species are FAC or wetter
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version
Absolute
Dominant Indicator
Dominance Test worksheet
Tree Stratum (Plot size )
/ Cover
Species? Status
Number of Dominant Species
1
That Are OBL FACW or FAC 1 (A)
2
Total Number of Dominant
3
Species Across All Strata 3 (B)
4
Percent of Dominant Species
5
That Are OBL FACW or FAC 33% (A/B)
6
7
Prevalence Index worksheet
8
Total / Cover of Multiply by
= Total Cover
OBL species x 1 =
Sapling /Shrub Stratum (Plot size
)
FACW species x 2 =
1 Llgustrum luadum
20
No —
FAC species x3=
2
FACU species x4=
3
UPL species x 5 =
4
Column Totals (A) (B)
5
6
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators
7
8
_ 1 Rapid Test for Hydrophytic Vegetation
9
_ 2 Dominance Test is >50 /
3 Prevalence Index is s3 0'
10
_
20
_ 4 Morphological Adaptations' (Provide supporting
Herb Stratum (Plot size )
=Total Cover
data in Remarks or on a separate sheet)
1 Trlfollum repens
25
Yes FACU
— Problematic Hydrophytic Vegetation' (Explain)
2 Rubus argutus
15
Yes FACU
3 Lonicera Japonica
10
Yes FAC
'Indicators of hydnc sod and wetland hydrology must
Festuca sp
15
No
be present unless disturbed or problematic
4
Hedera helix
10
No
Definitions of Four Vegetation Strata
5
—
6
Tree — Woody plants excluding vines 3 in (7 6 cm) or
more in diameter at breast height (DBH) regardless of
7
height
8
9
Sapling /Shrub — Woody plants excluding vines less
than 3 in DBH and greater than 3 28 ft (1 m) tall
10
11
Herb — All herbaceous (non woody) plants regardless
of size and woody plants less than 3 28 ft tall
12
75
= Total Cover
Woody vine — All woody vines greater than 3 28 ft in
Woody Vine Stratum (Plot size
)
height
1
2
3
4
5
Hydrophytic
Vegetation
6
Present? Yes No
= Total Cover
Remarks (Include photo numbers here or on a separate sheet )
Less than 50% of the dominant species are FAC or wetter
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

SOIL
Sampling Point DP'
Profile-Description (Describe to the depth needed to document the indicator or confirm the absence of indicators )
Depth Matrix Redox Features
(inches) Color (moist) / Color (moist) / Type' Loc Texture Remarks
012 7 5YR 5/6 100 N/A sandy Loam
'Type C= Concentration D= Depletion RM= Reduced Matrix MS= Masked Sand Grains 2Location PL =Pore Lmma M =Matrxx
Hydnc Sod Indicators
Indicators for Problematic Hydnc Sods'
Histosol (Al)
_ Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
Histic Epipedon (A2)
_ Polyvalue Below Surface (S8) (MLRA 147 148)
_ Coast Prairie Redox (A16)
_ Black Histic (A3)
_ Thin Dark Surface (S9) (MLRA 147 148)
(MLRA 147 148)
_ Hydrogen Sulfide (A4)
_ Loamy Gleyed Matrix (F2)
_ Piedmont Floodplain Soils (F19)
_ Stratified Layers (A5)
_ Depleted Matrix (F3)
(MLRA 136 147)
2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
_ Red Parent Material (TF2)
_ Depleted Below Dark Surface (A11)
_ Depleted Dark Surface (F7)
_ Very Shallow Dark Surface (TF12)
_ Thick Dark Surface (Al2)
— Redox Depressions (F8)
_ Other (Explain in Remarks)
Sandy Mucky Mineral (S1) (LRR N
_ Iron Manganese Masses (F12) (LRR N
MLRA 147 148)
MLRA 136)
Sandy Gleyed Matrix (S4)
_ Umbnc Surface (F13) (MLRA 136 122)
'Indicators of hydrophytic vegetation and
Sandy Redox (S5)
_ Piedmont Floodplain Sods (F19) (MLRA 148)
wetland hydrology must be present
_ Stripped Matrix (S6)
unless disturbed or problematic
Restrictive Layer (if observed)
Type
Depth (inches)
Hydnc
Soil Present? Yes No
Remarks
No Indicators of hydrlc soils are present
US Army Corps of Engineers Eastern Mountains and Piedmont – Interim Version

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APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook
SECTION I BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD) October 24 2011
B DISTRICT OFFICE FILE NAME AND NUMBER Asheville Field Office
C PROJECT LOCATION AND BACKGROUND INFORMATION Intermittent Stream A
State North Carolina County/parish/borough Mecklenburg County City Charlottee
Center coordinates of site (lat/long in degree decimal format) Lat 35 254289 N, Long 80 784277 W+
Universal Transverse Mercator NAD 83
Name of nearest waterbody Unnamed Tributary to Little Sugar Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows Catawba River
Name of watershed or Hydrologic Unit Code (HUC) Santee HUC 03050103
Check if map /diagram of review area and/or potential jurisdictional areas is /are available upon request
❑ Check if other sites (e g offsite mitigation sites disposal sites etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
❑ Office (Desk) Determination Date
0 Field Determination Date(s) December 12 2011
SECTION II SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There AA ne navigable waters of the US within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
❑ Waters subject to the ebb and flow of the tide
❑ Waters are presently used, or have been used in the past or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There Are waters of the US within Clean Water Act (CWA) junsdiction (as defined by 33 CFR part 328) in the review area [Required]
1 Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) '
❑ TNWs including territorial seas
❑ Wetlands adjacent to TNWs
❑ Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
❑ Non RPWs that flow directly or indirectly into TNWs
❑ Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
❑ Impoundments of jurisdictional waters
❑ Isolated (interstate or intrastate) waters including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non wetland waters 126 linear feet 2 width (ft) and/or 0 006 acres
Wetlands acres
c Limits (boundaries) of Jurisdiction based on established b OHVYM:
Elevation of established OHWM (if known)
2 Non regulated waters /wetlands (check if applicable) 3
❑ Potentially Jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional
Explain
i Boxes checked below shall be supported by completing the appropriate sections in Section III below
2 For purposes of this form an RPW is defined as a tributary that is not a TNW and that typically flows year round or has continuous flow at least seasonally
(e g typically 3 months)
3 Supporting documentation is presented in Section III F

SECTION III CWA ANALYSIS
d A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert Jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW complete
Section III A 1 and Section III D I only if the aquatic resource is a wetland adjacent to a TNW complete Sections III A 1 and 2
and Section III D 1 otherwise see Section III B below
1 TNW
Identify TNW
Summarize rationale supporting determination
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is adjacent
B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands if any and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met
The agencies will assert jurisdiction over non navigable tributaries of TNWs where the tributaries are relatively permanent
waters (RPWs) i e tributaries that typically flow year round or have continuous flow at least seasonally (e g typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW but has year round
(perennial) flow skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow
skip to Section III D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water even
though a significant nexus finding is not required as a matter of law
If the waterbody° is not an RPW or a wetland directly abutting an RPW a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines for
analytical purposes the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary or its adjacent wetlands or both If the JD covers a tributary with adjacent wetlands complete Section III B 1 for
the tributary Section III B 2 for any ons►te wetlands and Section III B 3 for all wetlands adjacent to that tributary both onsite
and offsite The determination whether a significant nexus exists is determined in Section III C below
1 Characteristics of non TNWs that flow directly or indirectly into TNW
(►) General Area Conditions
Watershed size 40 a erc
Drainage area 32 fPick List
Average annual rainfall 45 inches
Average annual snowfall 5 5 inches
(u) Physical Characteristics
(a) Relationship with TNW
❑ Tributary flows directly into TNW
® Tributary flows through _5 tributaries before entering TNW
Project waters are '15:2A river miles from TNW
Project waters are 11(or less) river miles from RPW
Project waters are 10-15 aerial (straight) miles from TNW
Project waters are 1 or less aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain
Identify flow route to TNW5 Intermittent Stream Flows to Perennial RPW Flows to Little Sugar Creek, Flows to Sugar
Creek, Flows to Catawba River (TNW)
"Note that the Instructional Guidebook contains additional information regarding swales ditches washes and erosional features generally and in the and
West
5 Flow route can be descnbed by identifying e g tributary a which flows through the review area to flow into tnbutary b which then flows into TNW

Tributary stream order if known
(b) General Tnbutary Characteristics (check all that apply)
Tributary is ❑ Natural
❑ Artificial (man made) Explain
® Manipulated (man altered) Explain Has been ditched and straightened
Tributary properties with respect to top of bank (estimate)
Average width 2 feet
Average depth 2 feet
Average side slopes Vertical
Primary tributary substrate composition (check all that apply)
® Silts ® Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation Type/% cover
❑ Other Explain
Tributary condition/stability [e g highly eroding sloughing banks] Explain
Presence of run/nffle /poolam_ complexes Explain Poorly developed riffle pool complexes
Tributary geometry kilati straight
Tributary gradient (approximate average slope) 2 %
(c) Flow
Tributary provides for easonal flow
Estimate average number of flow events in review area/year 7,e 1 2Q
Describe flow regime Discrete and confined
Other information on duration and volume
Surface flow is Discrete and confined Characteristics
Subsurface flow Unknown Explain findings
❑ Dye (or other) test performed
Tributary has (check all that apply)
® Bed and banks
® OHWM6 (check all indicators that apply)
® clear natural line impressed on the bank
❑
the presence of litter and debris
® changes in the character of soil
❑
destruction of terrestrial vegetation
❑ shelving
®
the presence of wrack line
® vegetation matted down bent or absent
®
sediment sorting
® leaf litter disturbed or washed away
®
scour
® sediment deposition
❑
multiple observed or predicted flow events
® water staining
❑
abrupt change in plant community
❑ other (list)
❑ Discontinuous OHWM 7 Explain
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that apply)
❑ High Tide Line indicated by ❑ Mean High Water Mark indicated by
❑ oil or scum line along shore objects ❑ survey to available datum
❑ fine shell or debris deposits (foreshore) ❑ physical markings
❑ physical markings /characteristics ❑ vegetation lines /changes in vegetation types
❑ tidal gauges
❑ other (list)
(m) Chemical Characteristics
Characterize tributary (e g water color is clear discolored oily film water quality general watershed characteristics etc )
Explain Weak flow high turbidity Urban waterhsed
Identify specific pollutants if known sediment
6A natural or man made discontinuity in the OHWM does not necessarily sever jurisdiction (e g where the stream temporarily flows underground or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody s flow
regime (e g flow over a rock outcrop or through a culvert) the agencies will look for indicators of flow above and below the break
'Ibid

(iv) Biological Characteristics Channel supports (check all that apply)
❑ Riparian corridor Characteristics (type average width)
❑ Wetland fringe Characteristics
® Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
® Aquatic /wildlife diversity Explain findings Amphibian habitat
2 Characteristics of wetlands adjacent to non TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain
Wetland quality Explain
Project wetlands cross or serve as state boundaries Explain
(b) General Flow Relationship with Non TNW
Flow is Pick List Explain
Surface flow is Pick List
Characteristics
Subsurface flow Fick -List Explain findings
❑ Dye (or other) test performed
(c) Wetland Adjacency Determination with Non TNW
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain
❑ Ecological connection Explain
❑ Separated by berm/barrier Explain
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW
Project waters ar ick List aerial (straight) miles from TNW
Flow is from Pick List
Estimate approximate location of wetland as within the ick List floodplain
(n) Chemical Characteristics
Characterize wetland system (e g water color is clear brown oil film on surface water quality general watershed
characteristics etc ) Explain
Identify specific pollutants if known
(iii) Biological Characteristics Wetland supports (check all that apply)
❑ Ripanan buffer Characteristics (type average width)
❑ Vegetation type /percent cover Explain
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic /wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (if any Ap
All wetland(s) being considered in the cumulative analysis Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis

• For each wetland specify the following
` Directly abuts9 (Y/N) Size (in acres) Directly abuts9 (Y/N) Size (in acres)
Summarize overall biological chemical and physical functions being performed
C SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical physical and biological integrity
of a TNW For each of the following situations a significant nexus exists if the tributary in combination with all of its adjacent
wetlands has more than a speculative or insubstantial effect on the chemical physical and /or biological integrity of a TNW
Considerations when evaluating significant nexus include but are not limited to the volume duration and frequency of the flow
of water in the tributary and its proximity to a TNW and the functions performed by the tributary and all its adjacent
wetlands It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus
Draw connections between the features documented and the effects on the TNW as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook Factors to consider include for example
Does the tributary in combination with its adjacent wetlands (if any) have the capacity to carry pollutants or flood waters to
TNWs or to reduce the amount of pollutants or flood waters reaching a TNW'?
Does the tributary in combination with its adjacent wetlands (if any) provide habitat and lifecycle support functions for fish and
other species such as feeding nestmg spawning or rearing young for species that are present in the TNW'?
Does the tributary in combination with its adjacent wetlands (if any) have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs9
Does the tributary in combination with its adjacent wetlands (if any) have other relationships to the physical chemical or
biological integrity of the TNW?
Note the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below
1 Significant nexus findings for non RPW that has no adjacent wetlands and flows directly or indirectly into TNWs Explain
findings of presence or absence of significant nexus below based on the tributary itself then go to Section III D
2 Significant nexus findings for non RPW and its adjacent wetlands where the non RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below based on the tributary in combination with all of its
adjacent wetlands then go to Section III D
3 Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below based on the tributary in combination with all of its adjacent wetlands then go to
Section III D
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY)
1 TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area
❑ TNWs linear feet width (ft) Or acres
❑ Wetlands adjacent to TNWs acres
RPWs that flow directly or indirectly into TNWs
D Tributaries of TNWs where tributaries typically flow year round are jurisdictional Provide data and rationale indicating that
tributary is perennial
Tributaries of TNW where tributaries have continuous flow seasonally (e g typically three months each year) are
jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows
seasonally Stream A flows northwest across the project area for approximately 126 linear feet Stream A exhibited a
moderate continuity of channel bed and bank, weak substrate weak flow and an average ordinary high water width of one to
two feet Biological sampling revealed a strong presence of iron oxidizing bacteria and a moderate presence of algae Stream
characteristics indicate that continuous flow is present for at least three months in an average year Stream A was classified as

a Relatively Permanent Water with seasonal flow (RPW) according to USACE/EPA guidance Seasonal RPW Stream A
scored 31 out of a possible 100 points on the USACE Stream Quality Assessment Worksheet and 20 out of a possible 63
points on the NCDWQ Stream Classification Form indicating intermittent status (SCP1 enclosed) Photographs A, B and C
(Figure 3 attached) are representative of Intermittent Seasonal RPW Stream A
Provide estimates foriunsdictional waters in the review area (check all that apply)
�( Tributary waters 126 linear feet2 width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
Non RPWsa that flow directly or indirectly into TNWs
❑ Waterbody that is not a TNW or an RPW but flows directly or indirectly into a TNW and it has a significant nexus with a
TNW is jurisdictional Data supporting this conclusion is provided at Section III C
Provide estimates for jurisdictional waters within the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs
❑ Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands
❑ Wetlands directly abutting an RPW where tributaries typically flow year round Provide data and rationale
indicating that tributary is perennial in Section III D 2 above Provide rationale indicating that wetland is
directly abutting an RPW
❑ Wetlands directly abutting an RPW where tributaries typically flow seasonally Provide data indicating that tributary is
seasonal in Section III B and rationale in Section III D 2 above Provide rationale indicatme that wetland is directly
abutting an RPW
Provide acreage estimates for jurisdictional wetlands in the review area acres
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
❑ Wetlands that do not directly abut an RPW but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands have a significant nexus with a TNW are junsidictional Data supporting this
conclusion is provided at Section III C
Provide acreage estimates for junsdictional wetlands in the review area acres
Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to such waters and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands have a significant nexus with a TNW are jurisdictional Data supporting this
conclusion is provided at Section III C
Provide estimates for jurisdictional wetlands in the review area acres
Impoundments of jurisdictional waters 9
As a general rule the impoundment of a jurisdictional tributary remains jurisdictional
❑ Demonstrate that impoundment was created from waters of the U S or
Demonstrate that water meets the criteria for one of the categories presented above (1 6) or
❑ Demonstrate that water is isolated with a nexus to commerce (see E below)
ISOLATED [INTERSTATE OR INTRA STATE] WATERS INCLUDING ISOLATED WETLANDS THE USE
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) 10
8See Footnote # 3
9 To complete the analysis refer to the key in Section III D 6 of the Instructional Guidebook
10 Prior to asserting or declining CWA jurisdiction based solely on this category Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos

"❑ which are or could be used by interstate or foreign travelers for recreational or other purposes
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
❑ which are or could be used for industrial purposes by industries in interstate commerce
❑ Interstate isolated waters Explain
❑ Other factors Explain
Identify water body and summarize rationale supporting determination
Provide estimates for Jurisdictional waters in the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
❑ Wetlands acres
F NON4URISDICTIONAL WATERS INCLUDING WETLANDS (CHECK ALL THAT APPLY)
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
❑ Prior to the Jan 2001 Supreme Court decision in SWANCC the review area would have been regulated based solely on the
Migratory Bird Rule (MBR)
❑ Waters do not meet the Significant Nexus standard where such a finding is required for Jurisdiction Explain
❑ Other (explain if not covered above)
Provide acreage estimates for non Jurisdictional waters in the review area, where the sole potential basis of Junsdiction is the MBR
factors (i a presence of migratory birds presence of endangered species use of water for irrigated agriculture) using best professional
Judgment (check all that apply)
❑ Non wetland waters (i a rivers streams) linear feet width (ft)
❑ Lakes /ponds acres
❑ Other non wetland waters acres List type of aquatic resource
❑
Wetlands acres
Provide acreage estimates for non Jurisdictional waters in the review area that do not meet the Significant Nexus standard, where such
a finding is required for Junsdiction (check all that apply)
❑ Non wetland waters (i a rivers streams) linear feet width (ft)
❑ Lakes/ponds acres
❑ Other non wetland waters acres List type of aquatic resource
❑
Wetlands acres
SECTION IV DATA SOURCES
A SUPPORTING DATA Data reviewed for JD (check all that apply checked items shall be included in case file and where checked
and requested appropnately reference sources below)
❑ Maps plans plots or plat submitted by or on behalf of the applicant/consultant
® Data sheets prepared/submitted by or on behalf of the applicant/consultant
❑ Office concurs with data sheets /delineation report
❑ Office does not concur with data sheets /delineation report
❑ Data sheets prepared by the Corps
❑ Corps navigable waters study
❑ U S Geological Survey Hydrologic Atlas
❑ USGS NHD data
❑ USGS 8 and 12 digit HUC maps
U S Geological Survey map(s) Cite scale & quad name Charlotte East, 1991 and Denta, 1996 North Carolina Quadrangles
® USDA Natural Resources Conservation Service Soil Survey Citation Mecklenburg County
❑ National wetlands inventory map(s) Cite name
❑ State/Local wetland inventory map(s)
❑ FEMA/FIRM maps
❑ 100 year Floodplain Elevation is (National Geodectic Vertical Datum of 1929)
® Photographs ❑ Aerial (Name & Date)
or ® Other (Name & Date) Site photographs December 2011
❑ Previous determination(s) File no and date of response letter
❑ Applicable /supporting case law
❑ Applicable /supporting scientific literature

I'[] Other information (please specify)
B ADDITIONAL COMMENTS TO SUPPORT JD