HomeMy WebLinkAbout20141296 Ver 1_Application_20141217
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
PAT L. MCCRORY ANTHONY J. TATA
GOVERNOR SECRETARY
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
TELEPHONE: 919-707-6000
FAX: 919-212-5785
WEBSITE:NCDOT.GOV
LOCATION:
CENTURY CENTER, BUILDING B
1020 BIRCH RIDGE DRIVE
RALEIGH NC 27610
December 12, 2014
U. S. Army Corps of Engineers
Regulatory Field Office
3331 Heritage Trade Drive Suite 105
Wake Forest, NC 27587
ATTN: Mr. Andrew Williams
NCDOT Coordinator
Subject: Application for Section 404 Nationwide Permit 13 for the proposed
replacement of Bridge No. 29 over Cub Creek on SR 1001 (Oakwoods Road)
in Wilkes County, Federal Aid Project No. BRZ-1001(29), Division 11, WBS
Element No. 33831.1.1, TIP No. B-4676.
Dear Sir:
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge No.
29 over Cub Creek with a two-span box beam bridge in a new location adjacent to the
existing alignment. Traffic will be maintained during construction via an off-site detour.
There will be 27 linear feet of stream bank stabilization due to protecting the outlets of three
roadside ditches.
Please see enclosed copies of the Pre-Construction Notification (PCN), Approved
Jurisdictional Determination Form, stormwater management plan, permit drawings and
design plans for the above-referenced project. The Categorical Exclusion (CE) was
completed in April 2014 and distributed shortly thereafter. Additional copies are available
upon request.
1
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: Section 404 Permit Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 13 or General Permit (GP) number:
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):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. 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
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
Yes No
1g. Is the project located in any of NC’s twenty coastal counties. If yes, answer 1h
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 project: Replacement of Bridge #29 over Cub Creek on SR 1001
2b. County: Wilkes
2c. Nearest municipality / town: Wilkesboro
2d. Subdivision name: not applicable
2e. NCDOT only, T.I.P. or state
project no: B-4676
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. not applicable
3c. Responsible Party (for LLC if
applicable): not applicable
3d. Street address: 1598 Mail Service Center
3e. City, state, zip: Raleigh, NC 27699-1598
3f. Telephone no.: (919) 707-6108
3g. Fax no.: (919) 212-5785
3h. Email address: ekcheely@ncdot.gov
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.3 Dec 10 2008
2
4. Applicant Information (if different from owner)
4a. Applicant is: Agent Other, specify:
4b. Name: not applicable
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: not applicable
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
3
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): not applicable
1b. Site coordinates (in decimal degrees): Latitude: 36.14882 Longitude: - 81.14268
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 0.9 acre
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Cub Creek
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Yadkin-Pee Dee
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:
Land use in the vicinity consists of about 30% forest land, 65% developed or disturbed lands (residential and urban
areas, roadsides, utility corridors) and 5% cultivated land (agricultural fields and pastures).
3b. List the total estimated acreage of all existing wetlands on the property:
No wetlands within construction limits.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
350
3d. Explain the purpose of the proposed project:
The purpose of this project is to replace a structurally deficient and functionally obsolete bridge. Sufficiency rating 8.89 of
100, structural evaluation 3 of 9 and deck geometry 2 of 9.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project involves replacing an 81-foot, three-span bridge with a 182-foot, two-span bridge on new location adjacent to
the existing alignment while maintaining traffic with an off-site detour during construction. Standard road building
equipment, such as trucks, dozers, and cranes will be used.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments: Only one perennial stream, Cub Creek
Yes No Unknown
A JD is requested as part of this permit. Approved JD
form (Rapanos) is included with this application.
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): Erin Cheely
Agency/Consultant Company: NCDOT
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 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.
4
C. Proposed Impacts Inventory
1. Impacts Summary
1a. 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.
Wetland impact
number –
Permanent (P) or
Temporary (T)
2b.
Type of impact
2c.
Type of wetland
(if known)
2d.
Forested
2e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404, other)
2f.
Area of impact
(acres)
Site 1 P T Yes
No
Corps
DWQ
Site 2 P T Yes
No
Corps
DWQ
Site 3 P T Yes
No
Corps
DWQ
Site 4 P T Yes
No
Corps
DWQ
2g. Total wetland impacts 0 Permanent
0 Temporary
2h. Comments: No wetlands located within the construction footprint of this project.
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.
Stream impact
number -
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial
(PER) or
intermittent
(INT)?
3e.
Type of
jurisdiction
(Corps - 404, 10
DWQ – non-404,
other)
3f.
Average
stream
width
(feet)
3g.
Impact length
(linear feet)
Site 1 P T Bank
Stabilization Cub Creek PER
INT
Corps
DWQ 20 27
Site P T PER
INT
Corps
DWQ
Site P T PER
INT
Corps
DWQ
Site P T PER
INT
Corps
DWQ
Site P T PER
INT
Corps
DWQ
Site P T PER
INT
Corps
DWQ
3h. Total stream and tributary impacts 27 Permanent
0 Temporary
3i. Comments: All permanent stream impacts (27 linear feet) are from bank stabilization. No temporary access is required to
remove existing bridge or construct new one.
5
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.
Open water
impact number –
Permanent (P) or
Temporary (T)
4b.
Name of
waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
O1 P T
O2 P T
O3 P T
O4 P T
4f. Total open water impacts 0 Permanent
0 Temporary
4g. Comments: No open waters.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland (acres)
Flooded Filled Excavat
ed Flooded Fille
d
Excavate
d Flooded
P1
P2
5f. Total
5g. Comments:
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
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?
Neuse Tar-Pamlico Other:
Catawba Randleman
6b.
Buffer impact
number –
Permanent (P) or
Temporary (T)
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1 impact
(square feet)
6g.
Zone 2 impact
(square feet)
B1 P T Yes
No
B2 P T Yes
No
B3 P T Yes
No
6h. Total buffer impacts
6i. Comments: This project is not located within a protected buffer area.
7
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed bridge will span the creek and will be constructed near the existing alignment. It will be significantly longer
than the existing structure (and also higher to allow clearance for a greenway under the bridge). Bridge deck drainage
will not be allowed to discharge directly into the water. The proposed bank stabilization at the ditch outfalls will protect the
slopes from erosion. All existing stormwater drainage patterns were maintained on the project to the fullest extent
possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Best Management Practices (BMPs) will be utilized during construction to attempt to reduce the stormwater impacts to
the receiving stream due to erosion and runoff. Traffic will be maintained via an off-site detour.
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 No
If no, explain: Bank stabilization impacts only.
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
Payment to in-lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: not applicable
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: N/A
4c. If using stream mitigation, stream temperature: warm cool cold
4d. Buffer mitigation requested (DWQ only): 0 square feet
4e. Riparian wetland mitigation requested: 0 acres
4f. Non-riparian wetland mitigation requested: 0 acres
4g. Coastal (tidal) wetland mitigation requested: 0 acres
4h. Comments: The NCDOT does not propose mitigation for the 27 linear feet of stream bank stabilization. These actions do
not require permanent fill in the stream bed and, therefore, under Section 404 of the Clean Water Act, do not constitute Loss
of Waters of the U.S. and are not subject to compensatory mitigation. Furthermore, the proposed bank stabilization activities
are necessary to prevent erosion and sedimentation, i.e. preventing bank destabilization.
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.
8
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:
9
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?
Yes No
1b. If yes, then is a diffuse flow plan included? If not, explain why.
Comments: If required from 1a, see attached buffer permit drawings. Yes No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? N/A
2b. Does this project require a Stormwater Management Plan? Yes No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
See attached permit drawings.
2e. Who will be responsible for the review of the Stormwater Management Plan?
Certified Local Government
DWQ Stormwater Program
DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government’s jurisdiction is this project? not applicable
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
Session Law 2006-246
Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? Yes No N/A
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? Yes No N/A
5b. Have all of the 401 Unit submittal requirements been met? Yes No N/A
10
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land? Yes No
1b. If you answered “yes” to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Yes No
1c. 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.)
Comments: Categorical Exclusion (CE) approved April 2014
Yes No
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
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
additional development, which could impact nearby downstream water quality?
Yes
No
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.
Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence nearby
land uses nor stimulate growth. Therefore, a detailed indirect or cumulative effects study will not be necessary.
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.
not applicable
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):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: B-4676 (Bridge No.29 on SR 1001)
State: North Carolina County/parish/borough: Wilkes City: Wilkesboro
Center coordinates of site (lat/long in degree decimal format): Lat. 36.14882° N, Long. -81.14268° W.
Universal Transverse Mercator:
Name of nearest waterbody: Cub Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Yadkin River
Name of watershed or Hydrologic Unit Code (HUC): 03040101
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:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Are no “navigable waters of the U.S.” 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 U.S.” within Clean Water Act (CWA) jurisdiction (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): 1
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: linear feet: width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Established by OHWM.
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: .
1 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
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.1. 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 waterbody4 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 onsite 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
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
Tributary flows directly into TNW.
Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain: .
Identify flow route to TNW5: .
Tributary stream order, if known: .
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that apply):
Tributary is: Natural
Artificial (man-made). Explain: .
Manipulated (man-altered). Explain: .
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
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/riffle/pool complexes. Explain: .
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Pick List
Estimate average number of flow events in review area/year: Pick List
Describe flow regime: .
Other information on duration and volume: .
Surface flow is: Pick List. Characteristics: .
Subsurface flow: Pick List. 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):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: .
Identify specific pollutants, if known: .
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.
7Ibid.
(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: .
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: Pick 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 are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) 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):
Riparian 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)
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 abuts? (Y/N) Size (in acres) Directly abuts? (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, nesting, 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 foodwebs?
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.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: Cub Creek has strong bed and bank and strong baseflow.
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: .
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 350 linear feet 20 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters: .
3. Non-RPWs8 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: .
4. 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 indicating that wetland is directly
abutting an RPW: .
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. 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 jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. 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.
7. 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).
E. 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
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: .
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.
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. NON-JURISDICTIONAL 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 jurisdiction is the MBR
factors (i.e., 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.e., 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 jurisdiction (check all that apply):
Non-wetland waters (i.e., 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, appropriately 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: .
USDA Natural Resources Conservation Service Soil Survey. Citation: .
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): .
Previous determination(s). File no. and date of response letter: .
Applicable/supporting case law: .
Applicable/supporting scientific literature: .
Other information (please specify): .
B. ADDITIONAL COMMENTS TO SUPPORT JD: .
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