20230155 Ver 1_ePCN Application_20230125

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
4/21/2022
BIMS # Assigned* Version#*
20230155 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Mooresville Regional Office - [phone]
Information for Initial Review
la. Name of project:
Statesville Logistics Center
la. Who is the Primary Contact?*
Chris Tinklenberg
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Andrew Pitner:eads\ahpitner
lb. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
1/25/2023
Nearest Body of Water
Fifth Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.849791 -80.864608
A. Processing Information
County (or Counties) where the project is located:
Iredell
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No

la. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
Please provide the date of the previous submission.*
5/23/2022
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 39 - Commercial/Institutional Developments
NWP Numbers (for multiple NWPS):
ld. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
If. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
Id. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Viola G. Robertson
2b. Deed book and page no.:
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
1759 Mocksville Hwy
Address Line 2
City
Cleveland
Postal / Zip Code
27013
State / Province / Region
NC
Country
USA
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address: *
[e-mail]
2a. Name(s) on recorded deed:
Lowell E Harmon
2b. Deed book and page no.:
2c. Contact Person:
2d. Address
Street Address
747 Turnersburg Hwy
Address Line 2
City
Statesville
Postal / Zip Code
28625
2e. Telephone Number:
[phone]
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Dominic Reinecker
3b. Business Name:
NC Development Acquisition, LLC
State / Province / Region
NC
Country
USA
2f. Fax Number:
3c. Address
Street Address
1776 Peachtree Street NW
Address Line 2
Suite 100
City State / Province / Region
Atlanta NC
Postal / Zip Code Country
30004 USA
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Chris Tinklenberg, PWS
4b. Business Name:
Kimley-Horn and Associates

4c. Address
Street Address
200 South Tryon Street
Address Line 2
Suite 200
City
Charlotte
Postal / Zip Code
28202
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
USA
4e. Fax Number:
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Statesville
2. Project Identification
2a. Property Identification Number:
4747702049.000, 4746676347.000
2c. Project Address
Street Address
751 TURNERSBURG HWY
Address Line 2
City
STATESVILLE
Postal / Zip Code
28625
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Fifth Creek
3b. Water Resources Classification of nearest receiving water: *
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401020108
4. Project Description and History
2b. Property size:
178.09
State / Province / Region
NC
Country
USA
4a. 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 subject property evaluated for the proposed development is an approximately 178.09-acre parcel, comprised of undeveloped forestland and agricultural fields. The subject property is
bound by undeveloped forestland to the north, agricultural fields and undeveloped forestland to the west, single-family residences, commercial development, and Turnersburg Highway to
the south, and 1-77 to the east. Elevation trends from higher in the center of the property towards the edges of the project boundary and Fifth Creek.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
20
4g. List the total estimated linear feet of all existing streams on the property:
8,325
4h. Explain the purpose of the proposed project: *
Statesville Logistics Center is a proposed 178-acre industrial park in Statesville, Iredell County, NC. The purpose of the project is to provide new warehouse distribution space to the
surrounding area.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project proposes the development of two (2) distribution buildings, on -site roadway, truck/trailer parking, employee parking, and stormwater facilities. Permanent impacts include 475
LF/0.049-acre to streams and 0.40-acre to wetlands. General construction equipment includes, but are not limited to, bulldozers, excavators, front-end loaders, etc. used for construction
purposes.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
Comments:
No Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2021-02509
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Chris Tinklenberg, PWS
Kimley-Horn and Associates
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
01/10/2022
6. Future Project Plans
6a. Is this a phased project?*
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries
Open Waters Pond Construction
2. Wetland Impacts
Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
Impact4
Grading/Fill
P
Bottomland Hardwood Forest
W1
Yes
Both
0.400
(acres)
Impact 5
Construction access
T
Bottomland Hardwood Forest
W1
Yes
Both
0.250
(acres)
2g. Total Temporary Wetland Impact
0.250
2g. Total Wetland Impact
0.650
2i. Comments:
2g. Total Permanent Wetland Impact
0.400
The proposed development seeks authorization under NWP 39 for wetland impacts associated with the grading activities necessary to construct the
distribution building. The proposed project will result in a total of 0.40-acre of permanent impacts and 0.25-acre of temporary impacts to Wetland 1. 0.25-
acre of temporary impacts to Wetland 1 are necessary to construct the retaining wall surrounding the wetland in the northeastern corner of the site.
Timber or rubber wetland mats will be used to access the area, contours will be returned to pre -construction grades, and the area will be replanted with
native woody vegetation.
3. Stream Impacts
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*

S1
Impact 1
Permanent
Fill
S2
Perennial
Both
4
Average (feet)
198
(linear feet)
S2
Impact 2
Permanent
Fill
S5
Perennial
Both
5
Average (feet)
92
(linear feet)
S3
Impact 3
Permanent
Fill
S7
Intermittent
Both
4
Average (feet)
185
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
475
3i. Total stream and ditch impacts:
475
3i. Total temporary stream impacts:
0
3j. Comments:
The proposed development seeks authorization under NWP 39 for stream impacts associated with grading activities necessary to construct the industrial
development. The proposed project will result in 198 LF/0.021-acre of permanent impacts to Stream 2, 92 LF/0.011-acre of permanent impacts to
Stream 5, and 185 LF/0.017-acre of permanent impacts to Stream 7. The proposed project will result in a total of 475 LF/0.049-acre of permanent
impacts to streams.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Avoidance and minimization efforts were implemented during development planning and design to the greatest extent practicable in order to reduce the
overall impacts on the aquatic environment while staying within nationwide permit thresholds. The final plan demonstrates maximum avoidance and
minimization efforts by reducing the proposed stream and wetland impacts. The rationale to support avoidance and minimization efforts includes the
following:
• Avoidance of the remaining 7,880 LF of streams on -site
• Avoidance of the remaining 19.6-acres of wetlands on -site
o The final design plan placed the building outside of the existing FEMA 100-year floodplain.
• Impact 1 — Stream 2
o A 14 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize stream impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of Stream 2 to promote subsurface
drainage/hydrology.
• Impact 2 — Stream 5
o A 30 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize stream impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of Stream 5 to promote subsurface
drainage/hydrology.
• Impact 3 — Stream 7
o A 28 ft tall retaining wall has been strategically placed to reduce grading fill slopes and to avoid further impacts
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of Stream 7 to promote subsurface
drainage/hydrology.
• Impact 4 — Wetland 1
o A 27 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize wetland impacts.
• Impact 5 — Wetland 1
o Timber or rubber wetland mats will be used to access the area, contours will be returned to pre -construction grades, and the area will be replanted with
native woody vegetation.
• Contech Con/Span bottomless arch culverts are proposed at the crossings of Stream 4 to avoid 219 LF/0.035-acre of further stream impacts. Arch
culverts 1 and 2 include 33 ft tall and 28 ft tall retaining walls, respectively, to reduce grading fill slopes and avoid stream impacts (see plans).
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Stormwater facilities are sized and positioned to minimize impacts to the greatest extent practicable. Temporary erosion control measures, including but
not limited to skimmer basins and silt fences, will be implemented to minimize sediment -laden runoff from exiting the site.
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
2c. If yes, mitigation is required by (check all that apply):
DWR Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
Yes No

4b. Stream mitigation requested:
(linear feet)
475
4d. Buffer mitigation requested (DWR only):
(square feet)
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
0.4
4f. Non -riparian wetland mitigation requested: 4g. Coastal (tidal) wetland mitigation requested:
(acres) (acres)
4h. Comments
Compensatory mitigation will be met by the purchase of credits through the NC Division of Mitigation Services (NCDMS) in -lieu fee program. Based on
an NCSAM assessment of Medium for perennial Streams 2 and 5 mitigation is proposed at a 2:1 ratio for impacts to these features, or 580 stream
mitigation credits. Based on an NCSAM assessment of Medium for intermittent Stream 7 mitigation is proposed at a 1.5:1 ratio for impacts to this
feature, or 278 stream mitigation credits. Based on an NCWAM assessment of High for Wetland 1 mitigation is proposed at a 2:1 ratio for impacts to this
feature, or 0.8 wetland mitigation credits. In total, 858 stream mitigation credits and 0.8 wetland mitigation credits will be purchased to offset impacts
associated with this project. Quality assessment results and Statement of Availability are included.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no, explain why:
The project does not include and is not adjacent to protected riparian buffers indicated within one of the NCRiparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
2d. Which of the following stormwater management program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
City of Statesville
Comments:
The stormwater management plan will consist of two wet detention ponds sized in accordance with NCDEQ and City of Statesville requirements for Phase II water quality and quantity.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land? *
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No

3b. If you answered "no," provide a short narrative description.
The project is designed to construct two (2) distribution buildings, on -site roadway, truck/trailer parking, employee parking, and stormwater facilities. No
additional or cumulative impacts are anticipated due to the construction of the proposed project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
The proposed industrial distribution project is anticipated to generate a low water demand (approximately 6,000 GPD) based on NCDEQ design
guidelines. Sanitary sewer will discharge from the building via 6" laterals to a private 8" sewer main on -site. Flow from the smaller building will be
pumped to the onsite main via a small grinder pump. The private main will flow via gravity to a new City of Statesville sewer main currently in design
which will flow under 1-77 to an existing manhole on Jennings Road.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
A review of the North Carolina Natural Heritage Program (NCNHP) database on August 30, 2021, did not indicate known occurrences of threatened or
endangered species within the project boundary. Potentially suitable habitat for threatened and endangered species on -site was surveyed. A
concurrence request letter was submitted to the USFWS on March 3, 2022. A concurrence response letter from USFWS was received on April 4, 2022,
indicating that the USFWS was in agreeance with the MANLAA biological conclusion. A copy of the USFWS correspondence is included.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NCNHP element occurrence database did not indicate the presence of EFH within the project boundary.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS service on March 3, 2022. No historical,
archeological, or cultural resources were identified within the site boundary. A request letter was submitted to SHPO to determine the presence of
archeological, cultural, or historic resources on March 3, 2022. SHPO responded on April 21, 2022, and requested further information regarding all
structures 50 years or older within the project site. Kimley-Horn visited the site on May 3, 2022, to photograph and document the existing 50-year-old
structures. Following the site visit, Kimley-Horn prepared a photographic documentation package and submitted the information to SHPO. SHPO
responded on June 30, 2022, and was "aware of no historic resources which would be affected by the project." A copy of the SHPO correspondence is
attached.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No

Sc. What source(s) did you use to make the floodplain determination?*
FIRM Panel 3710474700J
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
_20230125_Statesville_Logistics_Center_PCN_Mod_FINAL.pdf 13.21 MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Chris Tinklenberg
Signature
Date
1/25/2023

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- 2021-02509
Prepare file folder ❑
Begin Date (Date Received):
Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]: Statesville Logistics Center
2. Work Type:
Private 7Institutional
Government
Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
NC Development Acquisition, LLC is seeking authorization under NWP 39 to impact 0.40-acre of wetlands and 475 LF/0.049-acre of
streams necessary to construct an industrial development on an approximately 178-acre site. The site is located off Exit 54 on T-77
along Turnersburg Highway in Statesville, Iredell County, North Carolina.
4. Property Owner / Applicant [PCN Form A3 or A4]: NC Development Acquisition, LLC (POC: Dominic Reinecker)
1776 Peachtree Street NW, Suite 100, Atlanta, GA 30004 ; [phone] ; [e-mail]
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Chris Tinklenberg, PWS (Kimley-Horn)
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
The project is located off Turnersburg Highway in Statesville, Iredell County, NC. Project Coordinates
(decimal degrees): 35.849791, -80.864608
8. Project Location — Tax Parcel ID [PCN Form Bla]: 4747702049.000, 4746676347.000
9. Project Location — County [PCN Form A2b]: Iredell
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Statesville
11. Project Information — Nearest Waterbody [PCN Form B2a]: Fifth Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]: Yadkin -Pee Dee 03040102
Authorization: Section 10 fl Section 404
Regulatory Action Type:
F7 Standard Permit
F7 Nationwide Permit #39
Regional General Permit #
Jurisdictional Determination Request
Section 10 and 404 ❑
Pre -Application Request
n Unauthorized Activity
F7 Compliance
FINo Permit Required
Revised 20150602

Kimley»>Horn
January 25, 2023
Krysta Stygar
Regulatory Specialist
US Army Corps of Engineers
Wilmington District
Charlotte Field Office
8430 University Executive Park Drive, Suite 611
Charlotte, NC 28262
Paul Wojoski
NC DWR, 401 & Buffer Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604
Re: Pre -Construction Notification (NWP #39 and Individual 401 WQC)
Statesville Logistics Center (SAW-2021-02509)
Statesville, Iredell County, NC
Dear Ms. Stygar and Mr. Wojoski:
On behalf of our client, NC Development Acquisition, LLC, Kimley-Horn (KH) is submitting the enclosed Section
404/401 Pre -construction Notification for the above -referenced project for your review pursuant to Nationwide
Permit #39 and Individual 401 Water Quality Certification (WQC). The proposed project seeks to construct two (2)
warehouse buildings totaling ±1,311,600 square feet (SF), including access roads, utilities, and stormwater
management facilities. Authorization is requested under NWP 39 to permanently impact 475 Linear feet (LF)/0.049-
acre of streams and 0.40-acre of wetlands necessary for site development. The center of the project area is located
at 35.849791°, -80.864608°. The following information is included as part of this application submittal:
• Project Summary Sheet
• Pre -Construction Notification Form
• Agent Authorization
• Project Site Figures
• Figure 1 — Vicinity Map
• Figure 2 — USGS 7.5' Topo (Statesville East Quadrangle) Map
• Figure 3 — Iredell Co. SSURGO Soils and NWI Map (2022 Nearmap Aerial)
• Figure 4 — Existing Conditions (2022 Nearmap Aerial)
• Permit Drawings
• Agency Correspondence
• Compensatory Mitigation
PROJECT BACKGROUND
Statesville Logistics Center is a proposed industrial park located in Statesville, Iredell County, NC. The subject
property evaluated for the proposed development is an approximately 178-acre parcel, comprised of undeveloped
forestland and agricultural fields. The subject property is bound by undeveloped forestland to the north, agricultural
fields and undeveloped forestland to the west, single-family residences, commercial development, Turnersburg
Highway to the south, and 1-77 to the east. The project proposes the development of two (2) distribution buildings,
on -site roadway, truck/trailer parking, employee parking, and stormwater facilities. The site will be brought into
compliance with both state and local regulations for zoning, landscaping, and stormwater.
kimley-horn.com
200 South Tryon Street, Suite 200, Charlotte, NC 28202
704-333-5131

Kimley»>Horn
Page 2
AGENCY CORRESPONDENCE
CULTURAL RESOURCES
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS service on
March 3, 2022. No historical, archeological, or cultural resources were identified within the site boundary. A request
letter was submitted to SHPO to determine the presence of archeological, cultural, or historic resources on March
3, 2022. SHPO responded on April 21, 2022, and requested further information regarding all structures 50 years or
older within the project site. Kimley-Horn visited the site on May 3, 2022, to photograph and document the existing
50-year-old structures. Following the site visit, Kimley-Horn prepared a photographic documentation package and
submitted the information to SHPO. SHPO responded on June 30, 2022, and was "aware of no historic resources
which would be affected by the project." A copy of the SHPO correspondence is attached.
PROTECTED SPECIES
A review of the North Carolina Natural Heritage Program (NCNHP) database on August 30, 2021, did not indicate
known occurrences of threatened or endangered species within the project boundary. Potentially suitable habitat
for threatened and endangered species on -site was surveyed. A concurrence response letter from USFWS was
received on January 20, 2022, indicating that the USFWS was in agreeance with the "May affect, not likely to
adversely affect" (MANLAA) biological conclusion. A copy of the USFWS correspondence is attached.
PROPOSED IMPACTS TO JURISDICTIONAL WATERS
The proposed development seeks authorization under NWP 39 for wetland impacts associated with the grading
activities necessary to construct the distribution building. The proposed project will result in a total of 0.40-acre of
permanent impacts and 0.25-acre of temporary impacts to Wetland 1. 0.25-acre of temporary impacts to Wetland
1 are necessary to construct the retaining wall surrounding the wetland in the northeastern corner of the site. Timber
or rubber wetland mats will be used to access the area, contours will be returned to pre -construction grades, and
the area will be replanted with native woody vegetation.
The proposed development seeks authorization under NWP 39 for stream impacts associated with grading activities
necessary to construct the industrial development. The proposed project will result in 198 LF/0.021-acre of
permanent impacts to Stream 2, 92 LF/0.011-acre of permanent impacts to Stream 5, and 185 LF/0.017-acre of
permanent impacts to Stream 7. The proposed project will result in a total of 475 LF/0.049-acre of permanent
impacts to streams.
Overall, impacts associated with the proposed development will result in 0.40-acre of permanent impacts
to wetland waters of the US and 475 LF/0.049-acre of permanent impacts to non -wetland waters of the US.
AVOIDANCE AND MINIMIZATION
Avoidance and minimization efforts were implemented during development planning and design to the greatest
extent practicable in order to reduce the overall impacts on the aquatic environment while staying within nationwide
permit thresholds. The final plan demonstrates maximum avoidance and minimization efforts by reducing the
proposed stream and wetland impacts. The rationale to support avoidance and minimization efforts includes the
following:
• Avoidance of the remaining 7,880 LF of streams on -site
• Avoidance of the remaining 19.6-acres of wetlands on -site
o The final design plan placed the building outside of the existing FEMA 100-year floodplain.
• Impact 1 — Stream 2
o A 14 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize
stream impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus
of Stream 2 to promote subsurface drainage/hydrology.
kimley-horn.com
200 South Tryon Street, Suite 200, Charlotte, NC 28202
704-333-5131

Kimley»>Horn
Page 3
• Impact 2 — Stream 5
o A 30 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize
stream impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus
of Stream 5 to promote subsurface drainage/hydrology.
• Impact 3 — Stream 7
o A 28 ft tall retaining wall has been strategically placed to reduce grading fill slopes and to avoid
further impacts
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus
of Stream 7 to promote subsurface drainage/hydrology.
• Impact 4 — Wetland 1
o A 27 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize
wetland impacts.
• Impact 5 — Wetland 1
o Timber or rubber wetland mats will be used to access the area, contours will be returned to pre -
construction grades, and the area will be replanted with native woody vegetation.
• Contech Con/Span bottomless arch culverts are proposed at the crossings of Stream 4 to avoid 219
LF/0.035-acre of further stream impacts. Arch culverts 1 and 2 include 33 ft tall and 28 ft tall retaining walls,
respectively, to reduce grading fill slopes and avoid stream impacts (see plans).
COMPENSATORY MITIGATION
Compensatory mitigation will be met by the purchase of credits through the NC Division of Mitigation Services
(NCDMS) in -lieu fee program. Based on an NCSAM assessment of Medium for perennial Streams 2 and 5 mitigation
is proposed at a 2:1 ratio for impacts to these features, or 580 stream mitigation credits. Based on an NCSAM
assessment of Medium for intermittent Stream 7 mitigation is proposed at a 1.5:1 ratio for impacts to this feature,
or 278 stream mitigation credits. Based on an NCWAM assessment of High for Wetland 1 mitigation is proposed at
a 2:1 ratio for impacts to this feature, or 0.8 wetland mitigation credits. In total, 858 stream mitigation credits and
0.8 wetland mitigation credits will be purchased to offset impacts associated with this project. Quality assessment
results and Statement of Availability are included.
Please feel free to contact me at [phone] if you have any questions or if additional information is necessary.
Sincerely,
KIMLEY-HORN AND ASSOCIATES, INC.
Chris Tinklenberg, PWS
Environmental Scientist
kimley-horn.com
200 South Tryon Street, Suite 200, Charlotte, NC 28202
704-333-5131

Kimley>>>Horn
Project Summary Sheet
Project Name: Statesville Logistics Center
Applicant Name and Address: NC Development Acquisition, LLC (POC: Dominic Reinecker)
1776 Peachtree Street, NW, Suite 100
Atlanta, GA 30309
Telephone Number:[phone]
Type of Request:
Included Attachments:
Check if applicable:
® Nationwide PCN (NWP #39) ❑ Individual Permit Application
❑ Jurisdictional Determination ❑ Other:
® Project Plans
® Agent Authorization
❑ Data Forms (Up & Wet)
❑ NCDMS Confirmation
® Agency Correspondence
❑ CAMA County
❑ Section 7, ESA
❑ Mitigation Proposed (❑
County: Iredell
Waterway: Fifth Creek
H.U.C.: 03040102
Property Size (acres): 178 acres
Site Coordinates (in decimal degrees):
Project Location: The subject property is located off
County, NC.
® USGS Map
❑ Delineation Sketch
❑ NCDWR Stream Forms
® Aerial Photo
❑ Other:
® NRCS Soil Survey
® Delineation Survey
❑ USACE Stream Forms
❑ Site Photos
❑ Other:
❑ Trout County ❑ Isolated Waters
❑ Section 106, NHPA ❑ EFH
NC EEP ❑ On -Site ❑ Off -Site ❑ Other)
Nearest City/Town: Statesville
River Basin: Yadkin -Pee Dee
USGS Quad Name: Statesville East
Approx. Size of Jurisdiction on Site (acres): 8,355 LF & 20-ac
35.849791°N -80.864608°W
Exit 54 on I-77 along Turnersburg Highway in Statesville, Iredell
Site Description: The subject property evaluated for the proposed development is an approximately 178-acre parcel,
comprised of undeveloped forestland and agricultural fields. The subject property is bound by undeveloped forestland to
the north, agricultural fields and undeveloped forestland to the west, single-family residences, commercial development,
Turnersburg Highway to the south, and I-77 to the east.
Impact Summary (if applicable): Impacts associated with the proposed development will result in 0.40-acre of permanent
impacts to wetland waters of the US and 475 LF/0.049-acre of permanent impacts to non -wetland waters of the US.
NWP
#
Open Water
(acres)
Wetland
(acres)
Stream Channel
Intermittent and/or Unimportant
Aquatic Function
Perennial and/or Important
Aquatic Function
Temp.
Perm.
Temp.
Perm.
Temp.
Perm.
Temp.
Perm.
if
ac
if
ac
if
ac
if
Ac
39
0.25
0.40
185
0.017
290
0.032
Total
0.25
0.40
185
0.017
290
0.032
Total Permanent (Loss) Impact to Wetland Waters of the U.S.
0.40 ac
Total Permanent (Loss) Impact to Non -Wetland Waters of the U.S.
475 LF/0.049 ac
Kimley-Horn Contact: Chris Tinldenberg, PWS Direct Number: [phone]
Email: [e-mail]
kimley-hom.com
200 South Tryon Street, Suite 200, Charlotte, NC 28202
704-333-5131

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the
Corps:
10 Permit
0 Section 404 Permit ❑ Section
lb. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
0 Yes ❑ No
ld. Type(s) of approval sought from
the DWQ (check all that apply):
— Regular ❑ Non-404 Jurisdictional General Permit
— Express ❑ Riparian Buffer Authorization
0 401 Water Quality Certification
❑ 401 Water Quality Certification
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
For the record only for Corps Permit:
❑ Yes 0 No
❑ Yes 0 No
1f. Is payment into a mitigation bank or in -lieu fee
of impacts? If so, attach the acceptance letter
fee program.
program proposed for mitigation
from mitigation bank or in -lieu
0 Yes ❑ No
lg. Is the project located in any of NC's twenty coastal counties? If yes, answer
lh below.
❑ Yes 0 No
lh. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes 0 No
2. Project Information
2a. Name of project:
Statesville Logistics Center
2b. County:
Iredell
2c. Nearest municipality / town:
Statesville
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
N/A
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

3. Owner Information
3a. Name(s) on Recorded Deed:
1)Viola G. Robertson 2) Lowell E. Harmon
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
1) 1759 Mocksville Hwy 2) 747 Turnersburg Hwy
3e. City, state, zip:
1) Cleveland, NC 27013 2) Statesville, NC 28625
3f. Telephone no.:
POC: Dominic Reinecker [phone]
3g. Fax no.:
3h. Email address:
[e-mail]
4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent
0
Other, specify: Land purchaser
4b. Name:
POC: Dominic Reinecker
4c. Business name
(if applicable):
NC Development Acquisition, LLC
4d. Street address:
1776 Peachtree Street NW, Suite 100
4e. City, state, zip:
Atlanta, GA 30004
4f. Telephone no.:
[phone]
4g. Fax no.:
[e-mail]
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
Chris Tinklenberg, PWS
5b. Business name
(if applicable):
Kimley-Horn and Associates
5c. Street address:
200 South Tryon Street, Suite 200
5d. City, state, zip:
Charlotte, NC 28202
5e. Telephone no.:
704-409-1802
5f. Fax no.:
5g. Email address:
[e-mail]
Page 2 of 12
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
la. Property identification no. (tax PIN or parcel ID):
4747702049.000, 4746676347.000
1 b. Site coordinates (in decimal degrees):
Latitude: 35.849791 Longitude: -80.864608
(DD.DDDDDD) (-DD.DDDDDD)
lc. Property size:
178.09 acres (Project Boundary)
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to proposed
project:
Fifth Creek
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Yadkin -Pee Dee (HUC 03040102)
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 subject property evaluated for the proposed development is an approximately 178-acre parcel, comprised of
undeveloped forestland and agricultural fields. The subject property is bound by undeveloped forestland to the north,
agricultural fields and undeveloped forestland to the west, single-family residences, commercial development, Turnersburg
Highway to the south, and 1-77 to the east.
3b. List the total estimated acreage of all existing wetlands on the property:
20 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
8,355 linear feet.
3d. Explain the purpose of the proposed project:
Statesville Logistics Center is a proposed 178-acre industrial park in Statesville, Iredell County, NC. The purpose of the
project is to provide new warehouse distribution space to the surrounding area.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project proposes the development of two (2) distribution buildings, on -site roadway, truck/trailer parking, employee
parking, and stormwater facilities. Permanent impacts include 475 LF/0.049-acre to streams and 0.40-acre to wetlands.
General construction equipment includes, but are not limited to, bulldozers, excavators, front-end loaders, etc. used for
construction purposes.
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: SAW-2021-02509
a Yes ❑ No Unknown
4b. If the Corps made the jurisdictional determination, what type of
determination was made?
a Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Chris Tinklenberg, PWS
Agency/Consultant Company: Kimley-Horn and
Associates
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
1/10/2022
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

5. Project History
5a. Have permits or certifications been requested or obtained for this
project (including all prior phases) in the past?
Yes
Unknown
// No
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes
0 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):
❑ Buffers
a Wetlands a Streams - tributaries
❑ 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)
Impact 4 - W1
Grading/Fill
PFO
Y
a Corps
0.40
a P ❑ T
a DWQ
Impact 5 - W1
Construction access
PFO
Y
a Corps
0.25
❑ P a T
a DWQ
2g. Total wetland impacts
0.65
2h. Comments:
The proposed development seeks authorization under NWP 39 for wetland impacts associated with the grading activities
necessary to construct the distribution building. The proposed project will result in a total of 0.40-acre of permanent impacts
and 0.25-acre of temporary impacts to Wetland 1. 0.25-acre of temporary impacts to Wetland 1 are necessary to construct the
retaining wall surrounding the wetland in the northeastern corner of the site. Timber or rubber wetland mats will be used to
access the area, contours will be returned to pre -construction grades, and the area will be replanted with native woody
vegetation.
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)
Impact 1 - S2
Grading/Fill
S2
a PER
0 Corps
4.7
198
a P ❑ T
❑ INT
a DWQ
Impact 2 - S5
Grading/Fill
S5
a PER
a Corps
5.3
92
a P ❑ T
❑ INT
a DWQ
Impact 3 - S7
Grading/Fill
S7
❑ PER
0 Corps
4
185
a P ❑ T
a INT
a DWQ
3h. Total stream and tributary impacts
475 LF/0.049-acres
3i. Comments:
The proposed development seeks authorization under NWP 39 for stream impacts associated with grading activities necessary
to construct the industrial development. The proposed project will result in 198 LF/0.021-acre of permanent impacts to Stream
2, 92 LF/0.011-acre of permanent impacts to Stream 5, and 185 LF/0.017-acre of permanent impacts to Stream 7. The proposed
project will result in a total of 475 LF/0.049-acre of permanent impacts to streams.
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.
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)
4f. Total open water impacts
4g. Comments:
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
p and
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Exeadvat
Flooded
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. 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)
❑P❑T
Yes
❑ No
6h. Total buffer impacts
6i. Comments: The proposed project will not impact protected riparian buffers.
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 the project.
Avoidance and minimization efforts were implemented during development planning and design to the greatest extent
practicable in order to reduce the overall impacts on the aquatic environment while staying within nationwide permit
thresholds. The final plan demonstrates maximum avoidance and minimization efforts by reducing the proposed stream
and wetland impacts. The rationale to support avoidance and minimization efforts includes the following:
• Avoidance of the remaining 7,880 LF of streams on -site
• Avoidance of the remaining 19.6-acres of wetlands on -site
o The final design plan placed the building outside of the existing FEMA 100-year floodplain.
• Impact 1 — Stream 2
o A 14 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize stream
impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of
Stream 2 to promote subsurface drainage/hydrology.
• Impact 2 — Stream 5
o A 30 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize stream
impacts.
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of
Stream 5 to promote subsurface drainage/hydrology.
• Impact 3 — Stream 7
o A 28 ft tall retaining wall has been strategically placed to reduce grading fill slopes and to avoid further
impacts
o To prevent indirect impacts downstream, a French drain system is proposed at the impact terminus of
Stream 7 to promote subsurface drainage/hydrology.
• Impact 4 — Wetland 1
o A 27 ft tall retaining wall has been strategically placed to reduce grading fill slopes and minimize wetland
impacts.
• Impact 5 — Wetland 1
o Timber or rubber wetland mats will be used to access the area, contours will be returned to pre -
construction grades, and the area will be replanted with native woody vegetation.
• Contech Con/Span bottomless arch culverts are proposed at the crossings of Stream 4 to avoid 219 LF/0.035-
acre of further stream impacts. Arch culverts 1 and 2 include 33 ft tall and 28 ft tall retaining walls, respectively,
to reduce grading fill slopes and avoid stream impacts (see plans).
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Stormwater facilities are sized and positioned to minimize impacts to the greatest extent practicable. Temporary erosion control
measures, including but not limited to skimmer basins and silt fences, will be implemented to minimize sediment -laden runoff
from exiting the site.
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
2b. If yes, mitigation is required by (check all that apply):
// DWQ 0 Corps
2c. If yes, which mitigation option will be used for this project?
❑ Mitigation bank
// Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
Page 7 of 12
PCN Form — Version 1.3 December 10, 2008 Version

3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type: Stream
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
a Yes
4b. Stream mitigation requested:
475 LF
4c. If using stream mitigation, stream temperature:
a warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
0.4 acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
Compensatory mitigation will be met by the purchase of credits through the NC Division of Mitigation Services (NCDMS)
in -lieu fee program. Based on an NCSAM assessment of Medium for perennial Streams 2 and 5 mitigation is proposed
at a 2:1 ratio for impacts to these features, or 580 stream mitigation credits. Based on an NCSAM assessment of Medium
for intermittent Stream 7 mitigation is proposed at a 1.5:1 ratio for impacts to this feature, or 278 stream mitigation credits.
Based on an NCWAM assessment of High for Wetland 1 mitigation is proposed at a 2:1 ratio for impacts to this feature,
or 0.8 wetland mitigation credits. In total, 858 stream mitigation credits and 0.8 wetland mitigation credits will be purchased
to offset impacts associated with this project. Quality assessment results and Statement of Availability are included.
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.
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 a 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)
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
within one of the NC Riparian Buffer Protection Rules?
Yes // No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
The proposed project will not impact protected riparian buffers within one of the NC
Riparian Buffer Protection Rules.
❑ Yes 0 No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
33%
2b. Does this project require a Stormwater Management Plan?
0 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:
The stormwater management plan will consist of two wet detention ponds sized in accordance with NCDEQ and City of
Statesville requirements for Phase II water quality and quantity.
2e. Who will be responsible for the review of the Stormwater Management Plan?
0 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?
City of Statesville
3b. Which of the following locally -implemented stormwater management programs
apply (check all that apply):
0 Phase II
NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes 0 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
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
use of public (federal/state) land?
Yes // No
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
❑ Yes ❑ No
lc. 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:
❑ 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 0 No
2b. Is this an after -the -fact permit application?
❑ Yes 0 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.
The project is designed to construct two (2) distribution buildings, on -site roadway, truck/trailer parking, employee parking,
and stormwater facilities. No additional or cumulative impacts are anticipated due to the construction of the proposed
project.
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:
The proposed industrial distribution project is anticipated to generate a low water demand (approximately 6,000 GPD) based
on NCDEQ design guidelines. Sanitary sewer will discharge from the building via 6" laterals to a private 8" sewer main on -
site. Flow from the smaller building will be pumped to the onsite main via a small grinder pump. The private main will flow
via gravity to a new City of Statesville sewer main currently in design which will flow under 1-77 to an existing manhole on
Jennings Road.
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
habitat?
❑ No
0 Yes
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ No
0 Yes
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Raleigh
0 Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
A review of the North Carolina Natural Heritage Program (NCNHP) database on August 30, 2021, did not indicate known
occurrences of threatened or endangered species within the project boundary. Potentially suitable habitat for threatened
and endangered species on -site was surveyed. A concurrence request letter was submitted to the USFWS on March 3,
2022. A concurrence response letter from USFWS was received on April 4, 2022, indicating that the USFWS was in
agreeance with the MANLAA biological conclusion. A copy of the USFWS correspondence is included.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes
0 No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NCNHP element occurrence database did not indicate the presence of EFH within the project boundary.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
Yes //
No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS service on March 3,
2022. No historical, archeological, or cultural resources were identified within the site boundary. A request letter was
submitted to SHPO to determine the presence of archeological, cultural, or historic resources on March 3, 2022. SHPO
responded on April 21, 2022, and requested further information regarding all structures 50 years or older within the project
site. Kimley-Horn visited the site on May 3, 2022, to photograph and document the existing 50-year-old structures. Following
the site visit, Kimley-Horn prepared a photographic documentation package and submitted the information to SHPO. SHPO
responded on June 30, 2022, and was "aware of no historic resources which would be affected by the project." A copy of
the SHPO correspondence is attached.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes 0 No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FIRM Panel 3710474700J
Chris Tinklenberg, PWS
Applicant/Agent's Printed Name
G�� % `
1 /25/2023
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Date
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

AGENT AUTHORIZATION

AGENT AUTHORIZATION FORM
Name: NC Development Acquisition, LLC (Dominic Reinecker)
Address: 1776 Peachtree Street, NW, Suite 100, Atlanta, GA 30309
Phone: [phone]
Email: [e-mail]
Project Name/Description: Statesville Logistics Center
Date: 09/23/2021
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Charlotte Regulatory Field Office
Attention: Krysta Stygar
Re: Wetland Related Consulting and Permitting
NC Development Acquisition, LLC . hereby designates and authorizes Kimley-Horn and Associates,
Inc. to act in my/our behalf as my/our agent solely for the purpose of processing Jurisdictional
Determinations, Section 404 permits/Section 401 Water Quality Certifications applications and
to furnish upon request supplemental information in support of applications, etc. from this day
forward until successful completion of the permitting process or revocation by the owner.
In addition, I, the undersigned, under contract to purchase the property/properties identified
herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers
(Corps) to enter upon the property herein described for the purpose of conducting on -site
investigations and issuing a determination associated with Waters of the U.S. subject to Federal
jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and
Harbors Act of 1899.
Authorized this the 24 day of September , 2021
Dominic Reinecker
Digitally signed by M. Dominic Reinecker
M. Dominic Reinecker DN: C=us, D=DReinecker@tpa-gg,.cem,
CN=M. Dominic Reinecker
Date: 2021-09 24 09.09.54-04'00'
Authorized Representative Authorized Representative
(Print Name) (Signature)

FIGURES

.013.6
Bea illy Farm FLU
p
OA flat l �•
M1Wi•cum R:I
c1r
Nrr Rd
eL I
�J m
n a'
Rd
koF
1,r,chtyy�� R'
R rnokrinr Rd
0
Ss
�kari e R d
A
pa,15 aP G ¢n R n
Cners
Iredell
County
Kimley>>»Horn
Legend
Project Boundary
Figure 1
Vicinity Map
Statesville Logistics Center (SAW-2021-02509)
Statesville, Iredell County, NC
January 2023

Kimley>»Horn
Figure 2
USGS Topographic (Statesville East) Map
Statesville Logistics Center (SAW-2021-02509)
Statesville, Iredell County, NC
January 2023

Legend
Project Boundary
NWI Wetlands
SSURGO Soils
Hydric Rating
Not Hydric (0%)
Hydric (1-32%)
0
Feet
550 1,100
N
A
t000kd
IWO
Kimley»>Horn
Figure 3
SSURGO Soils and NWI Map
Statesville Logistics Center (SAW-2021-02509)
Statesville, Iredell County, NC
January 2023

14.01141WVF/X41710.4-111. IMP
Legend
EJ Project Boundary
Ca Wetlands
Streams
Intermittent
Perennial
Existing Contours
0
N
A
Feet
550 1,100
Kimley»>Horn
Figure 4
Existing Conditions
Statesville Logistics Center (SAW-2021-02509)
Statesville, Iredell County, NC
January 2023

PERMIT DRAWINGS

\C001 -COVER SH EET.d ug
pm K1CHL PRJ\01
STATESVILLE LOGISTICS CENTER
NW CORNER OF TURNERSBURG HWY AND 1-77
STATESVILLE, IREDELL, NORTH CAROLINA
UTILITY AND GOVERNING AGENCIES
CONTACT LIST:
WATER COMPANY
IREDELL WATER
PO BOX 711
STATESVILLE, NC 28687
[phone]
CONTACT: KEITH SNODDY
PUBLIC UTILITIES
CITY OF STATESVILLE
301 SOUTH CENTER ST.
PO BOX 1111
STATESVILLE, NC 28687
TELEPHONE: [phone]
CONTACT: BILL VAUGHAN
FIRE MARSHAL
CITY OF STATESVILLE
MAURY JENKINS
227 S. CENTER ST.
STATESVILLE, NC 28687
[phone]
MJEN KINS@STATESVI LLENC.N ET
EROSION CONTROL
IREDELL COUNTY
JONNYWILLIAMS
349 N. CENTER STREET
STATESVILLE, NC 28677
[phone]
POWER COMPANY
ENERGY UNITED
[phone]
SANITARY SEWER COMPANY
STATESVILLE CITY PUBLIC WORKS
301 S CENTER ST,
STATESVILLE, NC 28677
[phone]
DEPARTMENT OF TRANSPORTATION
NCDOT (DIVISION 12, DISTRICT 2)
124 PRISON CAMP ROAD
STATESVILLE, NC 28625
TELEPHONE: [phone]
CONTACT: JOHN COOK
EMAIL: [e-mail]
PLANNING/ZONING DEPARTMENT
CITY OF STATESVILLE
227 SOUTH CENTER ST.
PO BOX 1111
STATESVILLE, NC 28677
TELEPHONE: [phone]
ENGINEERING DEPARTMENT
CITY OF STATESVILLE
301 SOUTH CENTER ST.
PO BOX 1111
STATESVILLE, NC 28687
TELEPHONE: [phone]
CONTACT: MARK TAYLOR
GAS COMPANY
DOMINION ENERGY
121 HOUSTON RD
TROUTMAN, NC 28166
[phone]
PHONE COMPANY
AT&T
[phone]
CABLE COMPANY
SPECTRUM CABLE
1-833-789-0305
jI
2
SITE LOCATION MAP
NOT TO SCALE
KIMLEY-HORN SHALL HAVE NO LIABILITY WHATSOEVER FOR
ANY COSTS ARISING OUT OF THE CLIENTS DECISION TO OBTAIN
BIDS OR PROCEED WITH CONSTRUCTION BEFORE
KIMLEY-HORN HAS ISSUED FINAL, FULLY -APPROVED PLANS AND
SPECIFICATIONS. THE CLIENT ACKNOWLEDGES THAT ALL
PRELIMINARY PLANS ARE SUBJECT TO SUBSTANTIAL REVISION
UNTIL PLANS ARE FULLY APPROVED AND ALL PERMITS
OBTAINED.
ANTICIPATES DATES:
BEGIN LAND DISTURBANCE: 6/1/2023
FINAL STABILIZATION: 12/1/2024
SHEET INDEX
Sheet N0
SheetTltle
REV
N0
REV
N0
C001
COVER SHEET
0002
GENERAL NOTES
C101
EXISTING CONDITIONS PLAN
C105
DEMOLITION PLAN
C201
EROSION CONTROL PLAN NOTES
C202
EROSION AND SEDIMENT CONTROL PLAN -
PHASE I
C203
EROSION AND SEDIMENT CONTROL PLAN -
PHASE I
C204
EROSION AND SEDIMENT CONTROL PLAN -
PHASEI
C205
EROSION AND SEDIMENT CONTROL PLAN -
PHASEI
C200
EROSION AND SEDIMENT CONTROL PLAN -
PHASEI
C207
EROSION AND SEDIMENT CONTROL PLAN -
PHASE I
C208
EROSION AND SEDIMENT CONTROL PLAN -
PHASE I
C209
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C210
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C211
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C212
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C213
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C214
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C215
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 2
C216
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C2n
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C218
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C219
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C220
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C221
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C222
EROSION AND SEDIMENT CONTROL PLAN -
PHASE 3
C223
EROSION AND SEDIMENT CONTROL
DETAILS
C224
EROSION AND SEDIMENT CONTROL
DETAILS
C225
EROSION AND SEDIMENT CONTROL
DETAILS
C220
EROSION AND SEDIMENT CONTROL
DETAILS
C227
EROSION AND SEDIMENT CONTROL
DETAIL
PROJECT OWNER AND CONSULTANT INFORMATION
DEVELOPER:
ENGINEER:
SURVEYOR:
ARCHITECT:
NC DEVELOPMENT ACQUISITION, LLC
KIMLEY-HORN AND ASSOCIATES, INC.
ATLAS SURVEYING, INC
COMPANY
1776 PEACHTREE STREET, NW
200 SOUTH TRYON STREET
13331 YORK CENTER DRIVE,
ADDRESS
SUITE 1001
SUITE 200
SUITE E
SUITE #
ATLANTA, GA 30309
CHARLOTTE, NORTH CAROLINA 28202
CHARLOTTE, NC 28273
CITY, STATE ZIP
PHONE [phone]
[phone] TEL
PHONE [phone]
PHONE [phone]
CONTACT: KEITH BURNS
FAX [phone]
CONTACT: DOMINIC REINECKER
CONTACT: AUSTIN L. WATTS, P.E.
CONTACT: PERSON
C301
SITE PLAN OVERALL
C302
SITE PLAN AREA -A
C303
SITE PLAN AREA-B
C304
SITE PLAN AREA-C
C305
SITE PLAN AREA-0
C401
GRADING AND DRAINAGE PLAN OVERALL
C402
GRADING AND DRAINAGE AREA -A
C403
GRADING AND DRAINAGE AREA-B
C404
GRADING AND DRAINAGE AREA-C
C405
GRADING AND DRAINAGE AREA-0
C400
GRADING AND DRAINAGE AREA-E
C410
STORM PROFILES -A
O 11
STORM PROFIL S-B
O 12
STORM PROFIL S-C
O 13
STORM PROFILES-0
O 14
STORM PROFIL S-E
C415
STORM PROFILES-F
C416
STORM PROFILES-G
Con
STORM PROFILES-H
C418
STORM PROFILES -I
C420
SCM-A
C421
SCM-B
C422
STORM WATER MANAGEMENT DETAILS
CHO
UTILITY PLAN OVERALL
C601
UTILITY PLAN AREA -A
C002
UTILITY PLAN AREA-B
C003
UTILITY PLAN AREA-C
C004
UTILITY PLAN AREA-0
C005
SEWER PLAN and PROFILES
C701
ROAD -A PLAN and PROFILE
C705
TYPICAL SECTIONS
C700
ROAD -A CROSS SECTIONS - A
C901
SITE DETAILS
L101
LANDSCAPE PLAN -OVERALL
L102
LANDSCAPE PLAN - AREA -A
L103
LANDSCAPE PLAN - AREA-B
L104
LANDSCAPE PLAN - AREA-C
L105
LANDSCAPE DETAILS
NOT FOR
CONSTRUCTION
GEOMETRIC
CONTROL
HORTONAL DATUM.
NAD 83(2011)
VERTICAL DATUM
NAVD 88
REVISIONS
O-
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030861
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COVER SHEET
PREPARED FOR
SHEET NUMBER
DRAWER UNITS.
U S. SURVEY FEET
Know what's below.
Call before you dig.
C001
This document, together with the concepts and designs presented herein, as an instrument of service, is intended only for the specific purpose and client for which it was prepared Reuse °land improper reliance on this document without written authorization and adaptation by Kimley-l-lorn and Associates, Inc shall be without liability to Kimley-Horn and Associates, Inc

2
3
4
6
7
9
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12
14
16
17
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19
20
22
23
24
25
26
27
28
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A
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AREA E
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PROPOSEQ BUILDING
AREA: I.I I.6O0 SF
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GRADING NOTES
1. REFER TO THE GENERAL NOTES SHEET FOR NOTES PERTAINING TO PAVING GRADING
ACCESSIBILITY, AND STORM DRAINAGE.
2 EXISTING AND PROPOSED GRADE CONTOURS INTERVALS SHOWN AT 1 FOOT.
3. ALL SPOT ELEVATIONS WITH TP. REPRESENTS THE TOP OF PAVEMENT SURFACE (ADD 050 FOR
TOP OF CURB IF SPOT IS SHOWN IN GUTTER PAN OF CURB LINE )
4. ALL SPOT ELEVATIONS WITH TC REPRESENTS THE TOP OF CURB ELEVATION (SUBTRACT 050'
FOR PAVEMENT OR ELEVATION OF GUTTER AT CURB LINE.)
5. RIM'. ELEVATIONS OF CURB INLETS EQUALS THE TOP OF CURB ELEVATION ABOVE THE FLOW
LINE OF GUTTER PAN. RIM ELEVATIONS OF DROP INLETS, MANHOLES, AND CLEANOUTS EQUALS
THE CENTER OF GRATE OR LID ELEVATION.
B. ALL STRUCTURES SHALL BE ADJUSTED AS NECESSARY TO BE FLUSH WITH FINAL PAVEMENT.
]. MANHOLES WITHIN NON PAVED AREAS SHALL BE B" ABOVE ADJACENT GRADES. UNLESS
OTHERWISE SHOWN.
B. CONTRACTOR SHALL PROVIDE SMOOTH TRANSITION BETWEEN PROPOSED PAVEMENT AND
EXISTING PAVEMENT AND STORM STRUCTURES
9. DURING CONSTRUCTION AND AFTER FINAL GRADING, NO SURFACE WATER RUNOFF MAY BE
DIRECTED TO ADJACENT PROPERTIES, AND ALL SURFACE WATER RUNOFF MUST BE ROUTED
TO APPROVED DRAINAGE FACILITIES OR BE RETAINED ON SITE. ALL RUNOFF FROM THE SITE,
BOTH DURING AND AFTER CONSTRUCTION MUST BE FREE OF POLLUTANTS, INCLUDING
SEDIMENT PRIOR TO DISCHARGE.
ADA COMPLIANCE
A. CURB RAMPS ALONG PUBLIC STREETS AND IN THE PUBLIC RIGHT -OF- WAY SHALL BE
CONSTRUCTED BASED ON THE CITY STANDARD CONSTRUCTION DETAILS AND SPECIFICATIONS.
B. PRIVATE CURB RAMPS ON THE SITE (IE. OUTSIDE PUBLIC STREET RIGHT -OF- WAY) SHALL
CONFORM TO THE ADA STANDARDS FOR ACCESSIBLE DESIGN AND SHALL HAVE A DETECTABLE
WARNING SURFACE THAT IS FULL WIDTH OF THE CURB RAMP, NOT INCLUDING FLARES.
C. ALL ACCESSIBLE ROUTES, GENERAL SITE AND BUILDING ELEMENTS, RAMPS, CURB RAMPS,
STRIPING, AND PAVEMENT MARKINGS SHALL CONFORM TO ADA STANDARDS FOR ACCESSIBLE
DESIGN, LATEST EDITION.
D. ANY COMPONENTS OF THE PROJECT SERVING MULTIFAMILY DWELLINGS IN BUILDINGS THAT
HAVE OR MORE UNITS PER DWELLING SHALL ALSO CONFORM TO THE FAIR HOUSING ACT
(FHA), AND COMPLY WITH THE FAIR HOUSING ACT DESIGN MANUAL BY THE US DEPARTMENT OF
HOUSING AND URBAN DEVELOPMENT.
E. BEFORE PLACING PAVEMENT, CONTRACTOR SHALL VERIFY THAT SUITABLE ACCESSIBLE
PEDESTRIAN ROUTES (PER ADA AND FHA) EXIST TO AND FROM EVERY DOOR AND ALONG
SIDEWALKS, ACCESSIBLE PARKING SPACES, ACCESS AISLES, AND ACCESSIBLE ROUTES. IN NO
CASE SHALL AN ACCESSIBLE RAMP SLOPE EXCEED 1 VERTICAL TO 12 HORIZONTAL. IN NO CASE
SHALL SIDEWALK CROSS SLOPE EXCEED 2 0 PERCENT. IN NO CASE SHALL LONGITUDINAL
SIDEWALK SLOPE EXCEED 50 PERCENT. ACCESSIBLE PARKING SPACES AND ACCESS AISLES
SHALL NOT EXCEED 20 PERCENT SLOPE IN ANY DIRECTION
F. CONTRACTOR SHALL TAKE FIELD SLOPE MEASUREMENTS ON FINISHED SUBGRADE AND FORM
BOARDS PRIOR TO PLACING PAVEMENT TO VERIFY THAT ACCESSIBLE SLOPE REQUIREMENTS
ARE PROVIDED. CONTRACTOR SHALL CONTACT ENGINEER PRIOR TO PAVING IF ANY
EXCESSIVE SLOPES ARE ENCOUNTERED NO CONTRACTOR CHANGE ORDERS WILL BE
ACCEPTED FOR ADA COMPLIANCE ISSUES.
ALERT TO CONTRACTOR: CONFIRM WITH GEOTECH REPORT
THE PRESENCE OF GROUNDWATER SHOULD BE ANTICIPATED ON THIS PROJECT. CONTRACTORS
BID SHALL INCLUDE CONSIDERATION FOR THIS ISSUE. WHEN PERFORMING GRADING OPERATIONS
DURING PERIODS OF WET WEATHER, PROVIDE ADEQUATE DEWATERING, DRAINAGE AND GROUND
WATER MANAGEMENT TO CONTROL MOISTURE OF SOILS. REFER TO MASTER SITE SPECIFICATIONS.
ALERT TO CONTRACTOR: RETAINING WALLS
RETAINING WALLS SHOWN SHALL BE DESIGNED AND BUILT BY THE CONTRACTOR. WALL DESIGNERS
SHALL PROVIDE SIGNED AND SEALED SHOP DRAWING FOR ALL RETAINING WALLS. WALLS SHALL BE
DESIGNED BY A PROFESSIONAL ENGINEER. SIGNED AND SEALED CALCULATIONS FOR RETAINING
WALLS SHALL BE PROVIDED BY THE WALL DESIGNER. THE ANALYSIS SHALL INCLUDE INTERNAL,
EXTERNAL, GLOBAL STABILITY, AND BEARING CAPACITY CALCULATIONS. THE WALL DESIGNER
SHALL BE RESPONSIBLE FOR SELECTING AND SPECIFYING THE APPROPRIATE REINFORCING FILL
MATERIALS, GEOGRID, AND OTHER WALL APPURTENANCES. THE DESIGN SHALL ADDRESS
HYDROSTATIC LOADING, SEISMIC LOADING, RAPID DRAWDOWN SURCHARGE, AND BACKSLOPES
WHERE APPROPRIATE.
SPOT GRADE SCHEMATIC
H-ss:V 0-DV.I-Y11 ST.100-YVI;-AI ST:100-MH
RIMELEJ RIM'. ELEV. RIM: ELEVST
INDOWI AREA INLET INV EL-FES
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IIIII�
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FLON, LINE CONTRACTOR SHALL
V.
CURB &GUTTER INV. ELETO
/
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PER STRUCTURE STANDARD Der. WALL
GRAPHIC SCALE IN FEET
0 100 200 400
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PROPOSED TOPOGRAPHIC LEGEND
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GRADING PLAN NOTES
OUTLINED AREA REPRESENTS THE OUTLINE OF ADA SPACES (PAVEMENT SLOPES WITHIN
OTHE LIMITS OF THIS AREA HAVE BEEN DESIGNED AT, 0% MAXIMUM GRADE. CONTRACTOR
SHALL GRADE THESE AREAS NO STEEPER THAN 20% )
OSIDEWALK AND CROSSWALK CROSSSLOPES SHALL NOT EXCEED %1 B" PER LINEAR FOOT
(MAX 2°o sEE DETaU 5°o MAX. LONGITUDINAL SLOPE.
(=ADAACCESSIBLERAMPINSIDEWALK TO CONFORM TO FEDERAL, STATE, AND LOCAL
AccessewTY GUIDeu NEs.
STANDARD SPILL CURB TO PROVIDE NATURAL FLOW A WAY FROM CURB.
VARIABLE HEIGHT SEGMENTED RETAINING WALL (SEE WALL DETAILS)
ALL PAVE EM ENT SPOT GRADES ELEVATIONS ALONG CURB AND GUTTER REFER TO EDGE
of PAVEMENT ELEVATIOIvs uNLEss oTHERwISE NOTED.
© ALL SPOT GRADES DEPICT FINISH GRADE UNLESS OTHER WISE NOTED.
NO EARTHEN SLOPE SHALL BE GREATER THAN 3.I, UNLESS OTHERWISE NOTED.
MATCH EXIST) NA ELEVATIONS AT THE PROPERTY LIM ITS GRADING ON ADJACENT
O WORK ON ADJACEREQUI RE SLOPE PERMISSION. CONTRACTOR PLACE
WORK ON ADJACENT PROPERTY UNTIL SUCH AGREEMENT IS IN PLACE.
30' NOT COMMENCE
30' SIDEWALK RAMP WITH 5' LANDING AT TOP AND BOTTOM, , 12 MAX. SLOPE, MAX RISE OF
( 30-INCHES, AND SHALL MEET ALL REQUIREMENTS OF THE ADA STANDARDS FOR
ACCESSIBLE DESIGN FOR RAMPS.
DRAINAGE PLAN NOTES
B" (TYP L ROOF DRAIN LATERAL (RD). CONNECTION TO ROOF DRAIN DOWNSPOUTS OR
STANDPIPES. LATERALS SHALL LOCATIONA DINVER WITH ARCH/MOPE TOMAIN OR
coLLEcroR PIPE. COORDINATE LocATION AND INVERT wITH ARCH/MEP PLANS.
ECLEANOUT(S)-('H-20" TRAFFIC RATED IN ALL PAVED AREAS), SPACING PER GOVERNING
AGENcv.
A MINIMUM VERTICAL SEPARATION OF ,a -INCHES SHALL BE MAINTAINED AT CROSSINGS.
EINTHEEVENTTHATMINIMUM SE zAmLIIONREQUI REMENTSCANNOT BEMETTHE
CONTRACTOR SHALL UTILIZE MI NIM UM PIPE SEPARATION REQUIREMENTS PER THE
GOVERNING AGENCV.
ELOWPOINT(LP) DRAINAGE BREAK FLOWLNE IN PAVEMENT SECTION. POSITIVE GRADE
DRAW
EPERMANENTRIP RAP DISSIPATER PAD AT STORM OUTLET. SEE DETAIL FOR STONE SIZE
AND DIMEsN.
STORMWATER RETENTION FACILITY/STRUCTURE- WET POND. SIZED TO TREAT
ESTORMWATER QUALITY AND QUANTITY PER THE NC DIVISION OF WATER QUALITY
STORM WATER BM P DESIGN MANUAL.. SEE DETAILS THIS PLAN SET.
STORM WATER BM P FACILITY / STRUCTURE- BI O-RETENTION. SIZED TO TREAT
ESTORMWATER QUALITY PER THE NC DIVISION OF WATER QUALITY STORMWATER BM
DESIGN MANUAL SEE DETAILS THIS PLAN SET.
EOUTLET CONTROL STRUCTURE (CS) SEE DETAIL
E20' PUBLIC DRAINAGE EASEMENT (DE)
10 CORE AND CONNECT TO EXISTING STORM SEV5ER MANHOLE.
OPEN CUT TRENCH. REMOVE EXISTING PAVEMENT, CURB,(SI DEWALK) TO FACILITATE
11 UTILITY INSTALLATION. SAWCUTA CLEAN EDGEON BOTH SIDESOF TRENCH. THE
I R STRUCTUREPAVINGANYOR To ITS oRI GIANL OR BETTER coNDITION.
CONTRACTOR WILL BE COVER
12 JACK&BE-JACKING AND RECEIVING PITS AND PROCEDURE SHALL BE PER THE
GovERwORNG AGNcv.
13 SERVICE STUB WITH CAP & PLUG WITH SURFACE MARKER.
14 PERMANENT GRASS SWALE. SEE DETAIL FOR DIMENSION AND CAPACITY.
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GRAPHIC SCALE IN FEET
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AGENCY CORRESPONDENCE

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Asheville Field Office
160 Zillicoa Street
Asheville, North Carolina 28801
April 4, 2022
Taylor Kiker
Kimley-Horn
200 South Tryon Street, Suite 200
Charlotte, North Carolina 28202
[e-mail]
Subject: Statesville Exit 54 Industrial Development; Iredell County, North Carolina
Dear Taylor Kiker:
f us. 1
FISH &WILDLIFE
SERVICE
The U.S. Fish and Wildlife Service (Service) has reviewed the information provided in your
correspondence dated March 3, 2022, wherein you solicit our comments regarding project -
mediated impacts to federally protected species. We submit the following comments in
accordance with the provisions of the Fish and Wildlife Coordination Act, as amended
(16 U.S.C. 661-667e); the National Environmental Policy Act (42 U.S.C. §4321 et seq.); and
section 7 of the Endangered Species Act of 1973, as amended (16 U.S.C. 1531-1543) (Act).
Project Description
According to the information provided, the Applicant proposes to construct an industrial
development and appurtenances on approximately 185 partially forested acres in Statesville,
North Carolina. The information provided suggests that the proposed project will require
authorization from the U.S. Army Corps of Engineers to impact Waters of the United States. No
project design plans or a description of impacts to onsite habitats have been prepared or provided
to our office at this time.
Federally Listed Endangered and Threatened Species
According to Service records, suitable summer roosting habitat may be present in the action area
(50CFR 402.02) for the federally threatened northern long-eared bat (Myotis septentrionalis).
However, the final 4(d) rule, (effective as of February 16, 2016) exempts incidental take of
northern long-eared bat associated with activities that occur greater than 0.25 miles from a
known hibernation site, and greater than 150 feet from a known, occupied maternity roost during
the pup season (June 1 — July 31). Based on the information provided, the project would occur at
a location where any incidental take that may result from associated activities is exempt under
the 4(d) rule for this species. Although not required, we encourage the Applicant to avoid any
associated tree clearing activities during this animal's pup season, maternity roosting season
(May 15 — August 15) and/or active season (April 1 — October 15). If adhered to, a tree
clearing moratorium would support our concurrence with a "may affect, not likely to
adversely affect" determination from the action agency for this animal.

The information provided indicates that suitable habitat is present within the action area for the
federally threatened dwarf -flowered heartleaf (Hexastylis naniflora) and the federally
endangered Schweinitz's sunflower (Helianthus schweinitzii). However, surveys conducted
within the appropriate timeframes for these plants (respectively, May 18, 2021 and August 19,
2021), did not detect evidence for these species at that time. Therefore, we believe that the
probability for inadvertent loss of this plant species is insignificant and discountable and we
would concur with a "may affect, not likely to adversely affect" determination from the action
agency. Botanical survey results for the two species above are valid for two years for the
purposes of consultation under the Act:
https://www.fws. gov/asheville/pdfs/Optimal%20Survey%20Windows%20for%201isted%20plant
s%202020.pdf
In accordance with the Act, it is the responsibility of the appropriate federal action agency or its
designated representative to review its activities or programs and to identify any such activities
or programs that may affect endangered or threatened species or their habitats. If it is
determined that the proposed activity may adversely affect any species federally listed as
endangered or threatened, formal consultation with this office must be initiated. Our
concurrence with "no effect" determinations from action agencies is not required.
Erosion and Sediment Control
Measures to control sediment and erosion should be installed before any ground -disturbing
activities occur. Grading and backfilling should be minimized, and existing native vegetation
should be retained (if possible) to maintain riparian cover for fish and wildlife. Disturbed areas
should be revegetated with native vegetation as soon as the project is completed. Ground
disturbance should be limited to what will be stabilized quickly, preferably by the end of the
workday. Natural fiber matting (coir) should be used for erosion control as synthetic
netting can trap animals and persist in the environment beyond its intended purpose.
Impervious Surfaces and Low -Impact Development
Increased storm -water runoff also degrades aquatic and riparian habitat, causing stream -bank and
stream -channel scouring. Impervious surfaces reduce groundwater recharge, resulting in even
lower than expected stream flows during drought periods, which can induce potentially
catastrophic effects for fish, mussels, and other aquatic life. Accordingly, we recommend that all
new development, regardless of the percentage of impervious surface area they will create,
implement storm -water -retention and -treatment measures designed to replicate and maintain the
hydrograph at the preconstruction condition to avoid any additional impacts to habitat quality
within the watershed.
We recommend the use of low -impact -development techniques, such as reduced road widths,
grassed swales in place of curb and gutter, rain gardens, and wetland retention areas, for
retaining and treating storm -water runoff rather than the more traditional measures, such as large
retention ponds, etc. These designs often cost less to install and significantly reduce
environmental impacts from residential development.
Where detention ponds are used, storm -water outlets should drain through a vegetated area prior
to reaching any natural stream or wetland area. Detention structures should be designed to allow
2

for the slow discharge of storm water, attenuating the potential adverse effects of storm -water
surges; thermal spikes; and sediment, nutrient, and chemical discharges. Also, because the
purpose of storm -water -control measures is to protect streams and wetlands, no
storm -water -control measures or best management practices should be installed within any
stream (perennial or intermittent) or wetland.
The Service appreciates the opportunity to provide these comments. Please contact Mr. Byron
Hamstead of our staff at [e-mail] if you have any questions. In any future
correspondence concerning this project, please reference our Log Number 4-2-22-502.
Sincerely,
- - original signed - -
Janet Mizzi
Field Supervisor
3

North Carolina Department of Natural and Cultural Resources
State Historic Preservation Office
Ramona M. Bartos, Administrator
Governor Roy Cooper Office of Archives and History
Secretary D. Reid Wilson Deputy Secretary, Darin J. Waters, Ph.D.
June 30, 2022
Taylor Kiker
Kimley-Horn
200 South Tryon Street, Suite 200
Charlotte, NC 28202
[e-mail]
Re: Construct industrial development, Turnersburg Highway, Statesville, Iredell County, ER 22-0851
Dear Taylor Kiker:
Thank you for your email of May 9, 2022, transmitting the requested preliminary reconnaissance
photographs and descriptions regarding the above -referenced undertaking. We have reviewed the submittal
and offer the following comments.
We have conducted a review of the project and are aware of no historic resources which would be affected
by the project. Therefore, we have no comment on the project as proposed.
The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation's Regulations for Compliance with Section 106 codified at 36
CFR Part 800.
Thank you for your cooperation and consideration. If you have questions concerning the above comment,
contact Renee Gledhill -Earley, environmental review coordinator, at 919-814-6579
or [e-mail]. In all future communication concerning this project, please cite the
above referenced tracking number.
Sincerely,
kri Ramona Bartos, Deputy
State Historic Preservation Officer
Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, Raleigh NC 27699-4617 Telephone/Fax: [phone]-6898

COMPENSATORY
MITIGATION

ROY COOPER.
Governor
ELIZABETH S. BISER
Secretory
MARC RECKTENWALD
Director
Dominic Reinecker
NC Development Acquistion, LLC
1776 Peachtree Street, NW, Suite 100
Atlanta, GA 30309
NORTH CAROLINA
Environmental Quality
December 16, 2022
Expiration of Acceptance: 6/16/2023
Project: Statesville Exit 54 County: Iredell
The purpose of this letter is to notify you that the NCDEQ Division of Mitigation Services (DMS) is willing to
accept payment for compensatory mitigation for impacts associated with the above referenced project as
indicated in the table below. Please note that this decision does not assure that participation in the DMS in -
lieu fee mitigation program will be approved by the permit issuing agencies as mitigation for project impacts.
It is the responsibility of the applicant to contact permitting agencies to determine if payment to the DMS will
be approved. You must also comply with all other state, federal or local government permits, regulations or
authorizations associated with the proposed activity including G.S. § 143-214.11.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not
received a copy of the issued 404 Permit/401 Certification within this time frame, this acceptance will
expire. It is the applicant's responsibility to send copies of the permits to DMS. Once DMS receives a copy
of the permit(s) an invoice will be issued based on the required mitigation in that permit and payment must
be made prior to conducting the authorized work. The amount of the in -lieu fee to be paid by an applicant is
calculated based upon the Fee Schedule and policies listed on the DMS website.
Based on the information supplied by you in your request to use the DMS, the impacts for which you are
requesting compensatory mitigation credit are summarized in the following table. The amount of mitigation
required and assigned to DMS for this impact is determined by permitting agencies and may exceed the
impact amounts shown below.
River Basin
Impact Location
(8-digit HUC)
Impact Type
Impact Quantity
Yadkin
03040102
Riparian Wetland
0.40
Yadkin
03040102
Warm Stream
506
Upon receipt of payment, DMS will take responsibility for providing the compensatory mitigation. The
mitigation will be performed in accordance with the In -Lieu Fee Program instrument dated July 28, 2010.
Thank you for your interest in the DMS in -lieu fee mitigation program. If you have any questions or need
additional information, please contact [e-mail].
cc: Chris Tinklenberg, agent
DeJa't'Ie:l: n1 (11,-101,11..131 QUA iv
Sincerely,
Acitzhitibituvyk_,„
FOR James. B Stanfill
Deputy Director
North Carolina Department of Environmental Quality I Division of Mitigation Services
217 West Jones Street 11652 Mail Service Center I Raleigh, North Carolina 27699-1652
919.707.8976

NC SAM FIELD ASSESSMENT FORM
Accompanies User Manual Version 2.1
USACE AID #:
SAW-2021-02509 NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): Statesville Exit 54
3. Applicant/owner name: NC Development Acquisition, LLC
5. County: Iredell
7. River Basin: Yadkin-PeeDee
8. Site coordinates (decimal degrees, at lower end of assessment reach):
2. Date of evaluation: 7/13/2021
4. Assessor name/organization: Kimley-Horn
6. Nearest named water body
on USGS 7.5-minute quad: Fifth Creek
35.849791, -80.864608
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): S2 10. Length of assessment reach evaluated (feet): 100
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 2 r Unable to assess channel depth.
12. Channel width at top of bank (feet): 5 13. Is assessment reach a swamp stream? r Yes r No
14. Feature type: (Z Perennial flow C Intermittent flow r Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: r Mountains (M)
C.` Piedmont (P) C Inner Coastal Plain (I)
16. Estimated geomorphic ` J
valley shape (skip for C` a ��
Tidal Marsh Stream): (more sinuous stream, flatter valley slope)
17. Watershed size: (skip C." Size 1 (< 0.1 min) C` Size 2 (0.1 to < 0.5 min)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? ("Z Yes C No If Yes
r Section 10 water r Classified Trout Waters
I- Essential Fish Habitat r Primary Nursery Area
r Publicly owned property r NCDWR riparian buffer rule in effect
Anadromous fish r 303(d) List
I- Documented presence of a federal and/or state listed protected species
List species:
C.`b
(less sinuous stream, steeper valley slope)
C"Size 3(0.5to<5mi2) C`Size 4(>_5mi2)
r Outer Coastal Plain (0)
, check all that appy to the assessment area.
r Water Supply Watershed ( C" 1 C" II C III C IV C V)
✓ " Quality Waters/Outstanding Resource Waters
I- Nutrient Sensitive Waters
✓ CAMA Area of Environmental Concern (AEC)
within the assessment area.
r Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? r Yes C` No
1.
Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
r A Water throughout assessment reach.
r B No flow, water in pools only.
C` C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
C` A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
C*` B Not A
3. Feature Pattern - assessment reach metric
r A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
C*` B Not A.
4. Feature Longitudinal Profile - assessment reach metric
r A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
C*` B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
Q A < 10% of channel unstable
C B 10 to 25% of channel unstable
C C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
{: A f* A Little or no evidence of conditions that adversely affect reference interaction
C` B C" B Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
❑ C C" C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reach/intertidal zone metric

Check all that apply.
r A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
r B Excessive sedimentation (burying of stream features or intertidal zone)
✓ c
✓ D
✓ E
rF
✓ G
rH
rl
✓ J
Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
Odor (not including natural sulfide odors)
Current published or collected data indicating degraded water quality in the assessment reach
section.
Livestock with access to stream or intertidal zone
Excessive algae in stream or intertidal zone
Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
Other: (explain in "Notes/Sketch" section)
Little to ho stressors
Cite source in the "Notes/Sketch"
8. Recent Weather — watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
r- Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
(' B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
C No drought conditions
9 Large or Dangerous Stream— assessment reach metric
( Yes (i No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. • Yes (' No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
r A Multiple aquatic macrophytes and aquatic mosses
(include liverworts, lichens, and algal mats)
r B Multiple sticks and/or leaf packs and/or emergent
vegetation
r c Multiple snags and logs (including lap trees)
I✓ D 5% undercut banks and/or root mats and/or roots
in banks extend to the normal wetted perimeter
r E Little or no habitat
w
0 E
Y -c
L 6
U
c
0
r F 5% oysters or other natural hard bottoms
✓ G Submerged aquatic vegetation
✓ H Low -tide refugia (pools)
r I Sand bottom
✓ J 5% vertical bank along the marsh
r K Little or no habitat
*******'*** ********************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11a. r Yes (.` No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11b. Bedform evaluated. Check the appropriate box(es).
I— A Riffle -run section (evaluate 11c)
r B Pool -glide section (evaluate 11d)
r C Natural bedform absent (skip to Metric 12, Aquatic Life)
11c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) =
absent, Rare (R) = present but < 10%, Common (C) _ > 10-40%, Abundant (A) = > 40-70%, Predominant (P) = > 70%. Cumulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
(' c (" c c Bedrock/saprolite
C r C r C Boulder (256 — 4096 mm)
C r C r C Cobble (64 — 256 mm)
C C C C C Gravel (2 — 64 mm)
C r C r C Sand(.062-2mm)
C r C r C Silt/clay (< 0.062 mm)
✓ C r C r Detritus
C C C C C Artificial (rip -rap, concrete, etc.)
11 d. r Yes C No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. t: Yes r No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. C No Water C Other:
12b. t' Yes (Z No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
11111111111111.E
>1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
r Adult frogs
r Aquatic reptiles
✓ Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
r Beetles (including water pennies)
r Caddisfly larvae (Trichoptera [T])
r Asian clam (Corbicula)
r Crustacean (isopod/amphipod/crayfish/shrimp)
r Damselfly and dragonfly larvae
r Dipterans (true flies)
r Mayfly larvae (Ephemeroptera [E])
r Megaloptera (alderfly, fishfly, dobsonfly larvae)
r Midges/mosquito larvae
✓ Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
r Mussels/Clams (not Corbicula)

✓ r Other fish
✓ r Salamanders/tadpoles
✓ r Snails
✓ r Stonefly larvae (Plecoptera [P])
r r Tipulid larvae
✓ r Worms/leeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
r A r A Little or no alteration to water storage capacity over a majority of the streamside area
rB rB Moderate alteration to water storage capacity over a majority of the streamside area
C` C C" C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage - streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
C A r A Majority of streamside area with depressions able to pond water 6 inches deep
C B rB Majority of streamside area with depressions able to pond water 3 to 6 inches deep
cc cc Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
r Y r Y Are wetlands present in the streamside area?
(• N C• N
16. Baseflow Contributors - assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
r A Streams and/or springs (jurisdictional discharges)
r B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
r C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
r E Stream bed or bank soil reduced (dig through deposited sediment if present)
rF None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
r A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
✓ B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
r C Urban stream (>_ 24% impervious surface for watershed)
✓ D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
✓ E Assessment reach relocated to valley edge
r F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
C•" A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
C` B Degraded (example: scattered trees)
r C Stream shading is gone or largely absent
19. Buffer Width - streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
▪ A (r A (r A (r A >- 100-feet wide or extends to the edge of the watershed
Q B rB rB rB From 50 to < 100-feet wide
cc cc cc cc From 30 to < 50-feet wide
O D cc cc cc From 10 to < 30-feet wide
C` E r E r E r E < 10-feet wide or no trees
20. Buffer Structure - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
(r A (r A Mature forest
C` B C'' B Non -mature woody vegetation or modified vegetation structure
C` C C" C Herbaceous vegetation with or without a strip of trees < 10 feet wide
cc cc Maintained shrubs
C` E C'' E Little or no vegetation
21. Buffer Stressors - streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: P
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
CA CA CA CA CA CA Row crops
rB rB rB rB rB rB Maintained turf
r C r C r C r C r C r C Pasture (no livestock)/commercial horticulture
cc cc cc cc cc cc Pasture (active livestock use)

22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
G A (7 A Medium to high stem density
B C B Low stem density
cc cc No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide.
LB RB
(" A (' A The total length of buffer breaks is < 25 percent.
r B r B The total length of buffer breaks is between 25 and 50 percent.
cc cc The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
r A r A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
(. B (. B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
cc cc Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. r Yes (' No Was a conductivity measurement recorded?
If No, select one of the following reasons. r No Water r Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
0 A <46 ('' B 46 to < 67 0 C 67 to < 79 r D 79 to < 230 C E >_ 230
Notes/Sketch:

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Exit 54- Statesville
Stream Category Pb1
Notes of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Function Class Rating Summary
Date of Evaluation 7/13/2021
Assessor Name/Organization Kimley-Horn
USACE/
All Streams
NO
NO
NO
Perennial
NCDWR
Intermittent
(1) Hydrology
(2) Baseflow
(2) Flood Flow
(3) Streamside Area Attenuation
(4) Floodplain Access
(4) Wooded Riparian Buffer
(4) Microtopography
(3) Stream Stability
(4) Channel Stability
(4) Sediment Transport
(4) Stream Geomorphology
(2) Stream/Intertidal Zone Interaction
(2) Longitudinal Tidal Flow
(2) Tidal Marsh Stream Stability
(3) Tidal Marsh Channel Stability
(3) Tidal Marsh Stream Geomorphology
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
NA
HIGH
HIGH
LOW
HIGH
NA
NA
NA
NA
NA
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
MEDIUM
HIGH
HIGH
HIGH
HIGH
NO
LOW
NA
(1) Habitat
(2) In -stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In -stream Habitat
(2) Stream -side Habitat
(3) Stream -side Habitat
(3) Thermoregulation
(2) Tidal Marsh In -stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In -stream Habitat
(2) Intertidal Zone Habitat
MEDIUM
LOW
HIGH
LOW
HIGH
MEDIUM
HIGH
HIGH
HIGH
NA
NA
NA
NA
NA
NA
NA
Overall
MEDIUM

NC SAM FIELD ASSESSMENT FORM
Accompanies User Manual Version 2.1
USACE AID #:
SAW-2021-02509 NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any):
3. Applicant/owner name:
5. County:
7. River Basin:
Statesville Exit 54
NC Development Acquisition, LLC
Iredell
Yadkin-PeeDee
8. Site coordinates (decimal degrees, at lower end of assessment reach):
2. Date of evaluation: 7/13/2021
4. Assessor name/organization: Kimley-Horn
6. Nearest named water body
on USGS 7.5-minute quad: Fifth Creek
35.849791,-80.864608
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): S5 10. Length of assessment reach evaluated (feet):
11. Channel depth from bed (in riffle, if present) to top of bank (feet):
12. Channel width at top of bank (feet): 5 13. Is assessment reach a swamp stream?
14. Feature type: f: Perennial flow ( Intermittent flow C Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: ( Mountains (M) f: Piedmont (P)
100
1 r Unable to assess channel depth.
r Yes r No
16. Estimated geomorphic
valley shape (skip for
Tidal Marsh Stream):
17. Watershed size: (skip
for Tidal Marsh Stream)
r Inner Coastal Plain (I)
l l
r a
(more sinuous stream, flatter valley slope)
kr: Size 1 (< 0.1 mi`) i Size 2 (0.1 to < 0.5 mi`)
b
(less sinuous stream, steeper valley slope)
i Size 3(0.5to<5mi`) k`Size 4(>-5mi2)
r Outer Coastal Plain (0)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? f: Yes ( No If Yes, check all that appy to the assessment area.
I- Section 10 water I- Classified Trout Waters I- Water Supply Watershed ( f` I f` II f` III ( IV r V)
F Essential Fish Habitat I- Primary Nursery Area I- High Quality Waters/Outstanding Resource Waters
✓ Publicly owned property E NCDWR riparian buffer rule in effect I- Nutrient Sensitive Waters
r Anadromous fish I- 303(d) List E CAMA Area of Environmental Concern (AEC)
✓ Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
E Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? r Yes f: No
1.
Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
r A Water throughout assessment reach.
f` B No flow, water in pools only.
f` C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
r A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
B Not A
3. Feature Pattern - assessment reach metric
r A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
B Not A.
4. Feature Longitudinal Profile - assessment reach metric
r A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
• B NotA
5. Signs of Active Instability- assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
A < 10% of channel unstable
f` B 10 to 25% of channel unstable
f` C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
A ( A Little or no evidence of conditions that adversely affect reference interaction
f` B ( B Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
f` C f` C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reach/intertidal zone metric
Check all that apply.

rA
rB
rc
rD
rE
rF
rG
rH
rl
rJ
Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
Excessive sedimentation (burying of stream features or intertidal zone)
Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
Odor (not including natural sulfide odors)
Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
Livestock with access to stream or intertidal zone
Excessive algae in stream or intertidal zone
Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
Other: (explain in "Notes/Sketch" section)
Little to no stressors
8. Recent Weather — watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
r A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
f` B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
f: C No drought conditions
9 Large or Dangerous Stream — assessment reach metric
f` Yes f: No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. f` Yes f` No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
I— A
• B
• D
E
Multiple aquatic macrophytes and aquatic mosses
(include liverworts, lichens, and algal mats)
Multiple sticks and/or leaf packs and/or emergent
vegetation
Multiple snags and logs (including lap trees)
5% undercut banks and/or root mats and/or roots
in banks extend to the normal wetted perimeter
Little or no habitat
U�
c
0
▪ F
▪ G
▪ H
I— I
▪ J
▪ K
5% oysters or other natural hard bottoms
Submerged aquatic vegetation
Low -tide refugia (pools)
Sand bottom
5% vertical bank along the marsh
Little or no habitat
******************************"""REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
1 la. f` Yes f: No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
E A Riffle -run section (evaluate 11c)
f— B Pool -glide section (evaluate 11d)
r C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) =
absent, Rare (R) = present but < 10%, Common (C) _ > 10-40%, Abundant (A) = > 40-70%, Predominant (P) = > 70%. Cumulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
f r r r r
f r r r r
f r r r r
f r r r r
f r r r r
f r r r r
f r r r r
f r r r r
11d. rYes
Bedrock/saprolite
Boulder (256 — 4096 mm)
Cobble (64 — 256 mm)
Gravel (2 — 64 mm)
Sand (.062 — 2 mm)
Silt/clay (< 0.062 mm)
Detritus
Artificial (rip -rap, concrete, etc.)
r No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. f: Yes f` No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. f` No Water f` Other:
12b. f` Yes
111111111111111-
f: No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
>1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
r Adult frogs
r Aquatic reptiles
r Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
✓ Beetles (including water pennies)
r Caddisfly larvae (Trichoptera [T])
r Asian clam (Corbicula)
r Crustacean (isopod/amphipod/crayfish/shrimp)
✓ Damselfly and dragonfly larvae
✓ Dipterans (true flies)
✓ Mayfly larvae (Ephemeroptera [E])
✓ Megaloptera (alderfly, fishfly, dobsonfly larvae)
✓ Midges/mosquito larvae
✓ Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
✓ Mussels/Clams (not Corbicula )
r Other fish

r Salamanders/tadpoles
▪ r Snails
▪ r Stonefly larvae (Plecoptera [P])
▪ r Tipulid larvae
▪ r Worms/leeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
f` A f` A Little or no alteration to water storage capacity over a majority of the streamside area
f` B f` B Moderate alteration to water storage capacity over a majority of the streamside area
f` C f` C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage - streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
f` A f` A Majority of streamside area with depressions able to pond water >_ 6 inches deep
f` B f` B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
f` C f` C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
f` Y f` Y Are wetlands present in the streamside area?
N f: N
16. Baseflow Contributors - assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
I- A Streams and/or springs (jurisdictional discharges)
▪ B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
▪ C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
▪ D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
F E Stream bed or bank soil reduced (dig through deposited sediment if present)
▪ F None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
E A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
▪ B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
▪ C Urban stream (>- 24% impervious surface for watershed)
▪ D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
▪ E Assessment reach relocated to valley edge
F F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
f: A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
f` B Degraded (example: scattered trees)
f` C Stream shading is gone or largely absent
19. Buffer Width - streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
f: A f: A f: A f: A >- 100-feet wide or extends to the edge of the watershed
f` B f` B f` B f` B From 50 to < 100-feet wide
f` C f` C f` C f` C From 30 to < 50-feet wide
f` D f` D f` D f` D From 10 to < 30-feet wide
f` E f` E f` E f` E < 10-feet wide or no trees
20. Buffer Structure - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
A ( A Mature forest
• B ( B Non -mature woody vegetation or modified vegetation structure
f` C f` C Herbaceous vegetation with or without a strip of trees < 10 feet wide
f` D f` D Maintained shrubs
f` E f` E Little or no vegetation
21. Buffer Stressors - streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: r
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
rA rA rA rA rA rA Row crops
"' B r B r B r B (" B r B Maintained turf
"' C r C r C r C' C r C Pasture (no livestock)/commercial horticulture
"' D r D r D r D (" D r D Pasture (active livestock use)
22. Stem Density- streamside area metric (skip for Tidal Marsh Streams)

Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
(:A f:A
(` B f` B
i"C f`C
Medium to high stem density
Low stem density
No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer - streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide.
LB RB
A f: A The total length of buffer breaks is < 25 percent.
f` B f` B The total length of buffer breaks is between 25 and 50 percent.
f` C f` C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition - First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
(` A f` A
Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
(: B f: B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
f` C f` C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity- assessment reach metric (skip for all Coastal Plain streams)
25a. f` Yes f: No Was a conductivity measurement recorded?
If No, select one of the following reasons. f` No Water ( Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
i A <46 (` B 46 to < 67 (` C 67 to < 79 r D 79 to < 230 r E >- 230
Notes/Sketch:

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Statesville Exit 54
Stream Category Pb1
Notes of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Date of Evaluation 7/13/2021
Assessor Name/Organization Kimley-Horn
NO
NO
NO
Perennial
USACE/ NCDWR
Function Class Rating Summary All Streams Intermittent
(1) Hydrology HIGH
(2) Baseflow HIGH
(2) Flood Flow HIGH
(3) Streamside Area Attenuation HIGH
(4) Floodplain Access HIGH
(4) Wooded Riparian Buffer HIGH
(4) Microtopography NA
(3) Stream Stability HIGH
(4) Channel Stability HIGH
(4) Sediment Transport LOW
(4) Stream Geomorphology HIGH
(2) Stream/Intertidal Zone Interaction NA
(2) Longitudinal Tidal Flow NA
(2) Tidal Marsh Stream Stability NA
(3) Tidal Marsh Channel Stability NA
(3) Tidal Marsh Stream Geomorphology NA
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
MEDIUM
HIGH
HIGH
HIGH
HIGH
NO
LOW
NA
(1) Habitat
(2) In -stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In -stream Habitat
(2) Stream -side Habitat
(3) Stream -side Habitat
(3) Thermoregulation
(2) Tidal Marsh In -stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In -stream Habitat
(2) Intertidal Zone Habitat
MEDIUM
LOW
HIGH
LOW
HIGH
MEDIUM
HIGH
HIGH
HIGH
NA
NA
NA
NA
NA
NA
NA
Overall MEDIUM

NC SAM FIELD ASSESSMENT FORM
Accompanies User Manual Version 2.1
USACE AID #:
SAW-2021-02509 NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): Exit 54- Statesville 2. Date of evaluation: 7/13/2021
3. Applicant/owner name: NC Development Acquisition, LLC 4. Assessor name/organization: Kimley-Horn
5. County: Iredell
7. River Basin: Yadkin-PeeDee
8. Site coordinates (decimal degrees, at lower end of assessment reach):
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): S7 10. Length of assessment reach evaluated (feet):
6. Nearest named water body
on USGS 7.5-minute quad:
35.849791, -80.864608
Fifth Creek
100
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 4 r Unable to assess channel depth.
12. Channel width at top of bank (feet): 4
14. Feature type: C- Perennial flow ` Intermittent flow C Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: f` Mountains (M) 6- Piedmont (P)
16. Estimated geomorphic
valley shape (skip for
Tidal Marsh Stream):
17. Watershed size: (skip
for Tidal Marsh Stream)
13. Is assessment reach a swamp stream?
� J
f`a
(more sinuous stream, flatter valley slope)
f: Size 1 (< 0.1 mi`) (` Size 2 (0.1 to < 0.5 mi`)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? f: Yes C- No
I- Section 10 water
I- Essential Fish Habitat
I- Publicly owned property
▪ Anadromous fish
I- Classified Trout Waters
I- Primary Nursery Area
NCDWR riparian buffer rule in effect
I- 303(d) List
"' Inner Coastal Plain (I)
b
(less sinuous stream, steeper valley slope)
(` Size 3(0.5to<5mi`) C- Size 4(>-5mi2)
f` Yes ( No
f` Outer Coastal Plain (0)
If Yes, check all that appy to the assessment area.
I- Water Supply Watershed ( C- I C- II C- III C- IV C- V)
I- High Quality Waters/Outstanding Resource Waters
I- Nutrient Sensitive Waters
CAMA Area of Environmental Concern (AEC)
I- Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
I- Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached?
f` Yes No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
f` A
f` B
f` C
Water throughout assessment reach.
No flow, water in pools only.
No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
C- A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
B Not A
3. Feature Pattern - assessment reach metric
A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
C- B Not A.
4. Feature Longitudinal Profile - assessment reach metric
f` A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
. B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
f` A
B
f` C
< 10% of channel unstable
10 to 25% of channel unstable
> 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
C- A C- A Little or no evidence of conditions that adversely affect reference interaction
6-13 6-13 Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
C- C C- C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reach/intertidal zone metric
Check all that apply.
I- A
▪ B
Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
Excessive sedimentation (burying of stream features or intertidal zone)

▪ C
▪ D
▪ E
▪ F
▪ G
▪ H
P I
▪ J
Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
Odor (not including natural sulfide odors)
Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
Livestock with access to stream or intertidal zone
Excessive algae in stream or intertidal zone
Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
Other: Trash and debris at beginning of Stream. (explain in "Notes/Sketch" section)
Little to no stressors
8. Recent Weather — watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
f` A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
f` B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
C No drought conditions
9 Large or Dangerous Stream — assessment reach metric
k` Yes f: No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. f` Yes 6- No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
1— A
F B
F c
F D
▪ E
Multiple aquatic macrophytes and aquatic mosses
(include liverworts, lichens, and algal mats)
Multiple sticks and/or leaf packs and/or emergent
vegetation
Multiple snags and logs (including lap trees)
5% undercut banks and/or root mats and/or roots
in banks extend to the normal wetted perimeter
Little or no habitat
▪ F
▪ G
▪ H
I— I
� J
▪ K
5% oysters or other natural hard bottoms
Submerged aquatic vegetation
Low -tide refugia (pools)
Sand bottom
5% vertical bank along the marsh
Little or no habitat
**"""`******************""`******""REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS*************************""
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
1 la. f` Yes 6- No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
I— A Riffle -run section (evaluate 11c)
(— B Pool -glide section (evaluate 11d)
17. C Natural bedform absent (skip to Metric 12, Aquatic Life)
1 lc. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) =
absent, Rare (R) = present but <_ 10%, Common (C) _ > 10-40%, Abundant (A) = > 40-70%, Predominant (P) = > 70%. Cumulative
100%
NP R C A P
( (` (` (`
(` (` (` (` (`
(� r r (" C`
✓ rrrr
(` (` (` (` (`
re r ( r
(` (` (` (` (`
11d. C Yes C No
Bedrock/saprolite
Boulder (256 — 4096 mm)
Cobble (64 — 256 mm)
Gravel (2 — 64 mm)
Sand (.062 — 2 mm)
Silt/clay (< 0.062 mm)
Detritus
Artificial (rip -rap, concrete, etc.)
Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. 6- Yes f` No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. f` No Water f` Other:
12b. f` Yes
1111111111111111111-
6- No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
>1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
r Adult frogs
r Aquatic reptiles
r Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
r Beetles (including water pennies)
r Caddisfly larvae (Trichoptera [T])
r Asian clam (Corbicula)
r Crustacean (isopod/amphipod/crayfish/shrimp)
r Damselfly and dragonfly larvae
r Dipterans (true flies)
r Mayfly larvae (Ephemeroptera [E])
r Megaloptera (alderfly, fishfly, dobsonfly larvae)
r Midges/mosquito larvae
r Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
r Mussels/Clams (not Corbicula )
r Other fish
r Salamanders/tadpoles
r Snails
r Stonefly larvae (Plecoptera [P])
r Tipulid larvae
percentages should not exceed for each assessment reach.

r Worms/leeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
f: A f: A Little or no alteration to water storage capacity over a majority of the streamside area
f` B f` B Moderate alteration to water storage capacity over a majority of the streamside area
C r C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
f` A f` A Majority of streamside area with depressions able to pond water >_ 6 inches deep
(` B (` B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
C f: C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
f` Y f` Y Are wetlands present in the streamside area?
N N
16. Baseflow Contributors — assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
I— A
▪ B
▪ C
F D
F E
▪ F
Streams and/or springs (jurisdictional discharges)
Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
Stream bed or bank soil reduced (dig through deposited sediment if present)
None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
I- A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
f- B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
✓ C Urban stream (>- 24% impervious surface for watershed)
✓ D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
✓ E Assessment reach relocated to valley edge
r F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
C` B
f C
Stream shading is appropriate for stream category (may include gaps associated with natural processes)
Degraded (example: scattered trees)
Stream shading is gone or largely absent
19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
6- A 6- A 6- A 6- A >- 100-feet wide or extends to the edge of the watershed
{" B f` B {" B f` B From 50 to < 100-feet wide
C` C (" C C` C f` C From 30 to < 50-feet wide
C` D (" D C` D f` D From 10 to < 30-feet wide
f` E k E (" E f` E < 10-feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
A A Mature forest
C` B (` B Non -mature woody vegetation or modified vegetation structure
C` C (` C Herbaceous vegetation with or without a strip of trees < 10 feet wide
C` D (` D Maintained shrubs
C` E f` E Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: ff
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
rA rA rA rA rA rA Row crops
C` B C' B C' B C' B C' B C' B Maintained turf
• c C' C C' C C' C C' C C' C Pasture (no livestock)/commercial horticulture
f` D C` D C` D C` D C` D (` D Pasture (active livestock use)
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
C: A 6- A Medium to high stem density
C` B f` B Low stem density
(- C r` C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)

Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide.
LB RB
A R A The total length of buffer breaks is < 25 percent.
(` B (` B The total length of buffer breaks is between 25 and 50 percent.
f` C f` C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
f` A f` A
Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
B B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
f` C f` C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. f` Yes f: No Was a conductivity measurement recorded?
If No, select one of the following reasons. f` No Water f` Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
C A <46 (` B 46 to < 67 (" C 67 to < 79 C D 79 to < 230 C E >— 230
Notes/Sketch:
i

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Exit 54- Statesville
Stream Category Pb1
Date of Evaluation 7/13/2021
Assessor Name/Organization Kimley-Horn
Notes of Field Assessment Form (Y/N) NO
Presence of regulatory considerations (Y/N) NO
Additional stream information/supplementary measurements included (Y/N) NO
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream) Intermittent
USACE/
Function Class Rating Summary All Streams
(1) Hydrology LOW
NCDWR
Intermittent
LOW
(2) Baseflow HIGH
HIGH
(2) Flood Flow LOW
LOW
(3) Streamside Area Attenuation MEDIUM
MEDIUM
(4) Floodplain Access MEDIUM
MEDIUM
(4) Wooded Riparian Buffer HIGH
HIGH
(4) Microtopography NA
NA
(3) Stream Stability LOW
LOW
(4) Channel Stability MEDIUM
MEDIUM
(4) Sediment Transport LOW
LOW
(4) Stream Geomorphology MEDIUM
MEDIUM
(2) Stream/Intertidal Zone Interaction NA
NA
(2) Longitudinal Tidal Flow NA
NA
(2) Tidal Marsh Stream Stability NA
NA
(3) Tidal Marsh Channel Stability NA
NA
(3) Tidal Marsh Stream Geomorphology NA
NA
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
MEDIUM
MEDIUM
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
NO
NO
LOW
NA
NA
NA
(1) Habitat
(2) In -stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In -stream Habitat
(2) Stream -side Habitat
(3) Stream -side Habitat
(3) Thermoregulation
(2) Tidal Marsh In -stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In -stream Habitat
(2) Intertidal Zone Habitat
HIGH
HIGH
MEDIUM
MEDIUM
HIGH
HIGH
LOW
LOW
MEDIUM
MEDIUM
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
HIGH
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Overall MEDIUM
MEDIUM

NC WAM WETLAND ASSESSMENT FORM
Accompanies User Manual Version 5
USACE AID#: SAW-2021-02509 NCDWR #:
Project Name Statesville Exit 54 Date of Evaluation 07/13/2021
Applicant/Owner Name NC Development Acquisitions, LLC Wetland Site Name W1
Wetland Type Bottomland Hardwood Forest Assessor Name/Organization Kimley-Horn
Level III Ecoregion Piedmont Nearest Named Water Body Fifth Creek
River Basin Yadkin-PeeDee USGS 8-Digit Catalogue Unit 03040102
County Iredell NCDWR Region Mooresville
C Yes (• No Precipitation within 48 hrs? Latitude/Longitude (deci-degrees) 35.849791, -80.864608
Evidence of stressors affecting the assessment area (may not be within the assessment area)
Please circle and/or make note on last page if evidence of stressors is apparent. Consider departure from reference, if
appropriate, in recent past (for instance, approximately within 10 years). Noteworthy stressors include, but are not limited
to the following.
• Hydrological modifications (examples: ditches, dams, beaver dams, dikes, berms, ponds, etc.)
• Surface and sub -surface discharges into the wetland (examples: discharges containing obvious pollutants, presence of nearby
septic tanks, underground storage tanks (USTs), hog lagoons, etc.)
• Signs of vegetation stress (examples: vegetation mortality, insect damage, disease, storm damage, salt intrusion, etc.)
• Habitat/plant community alteration (examples: mowing, clear -cutting, exotics, etc.)
Is the assessment area intensively managed? ('• Yes [. No
Regulatory Considerations - Were regulatory considerations evaluated? (+• Yes r No If Yes, check all that apply to the assessment area.
r Anadromous fish
r Federally protected species or State endangered or threatened species
r NCDWR riparian buffer rule in effect
r Abuts a Primary Nursery Area (PNA)
r Publicly owned property
r N.C. Division of Coastal Management Area of Environmental Concern (AEC) (including buffer)
r Abuts a stream with a NCDWQ classification of SA or supplemental classifications of HQW, ORW, or Trout
r Designated NCNHP reference community
r Abuts a 303(d)-listed stream or a tributary to a 303(d)-listed stream
What type of natural stream is associated with the wetland, if any? (check all that apply)
(` Blackwater
(+• Brownwater
r Tidal (if tidal, check one of the following boxes) r Lunar C Wind r Both
Is the assessment area on a coastal island? ('• Yes (.7 No
Is the assessment area's surface water storage capacity or duration substantially altered by beaver? C Yes (: No
Does the assessment area experience overbank flooding during normal rainfall conditions? (: Yes C No
1. Ground Surface ConditionNegetation Condition - assessment area condition metric
Check a box in each column. Consider alteration to the ground surface (GS) in the assessment area and vegetation structure
(VS) in the assessment area. Compare to reference wetland if applicable (see User Manual). If a reference is not applicable,
then rate the assessment area based on evidence of an effect.
GS VS
(•` A (r A Not severely altered
r B ( B Severely altered over a majority of the assessment area (ground surface alteration examples: vehicle tracks, excessive
sedimentation, fire -plow lanes, skidder tracks, bedding, fill, soil compaction, obvious pollutants) (vegetation structure
alteration examples: mechanical disturbance, herbicides, salt intrusion [where appropriate], exotic species, grazing,
less diversity [if appropriate], hydrologic alteration)
2. Surface and Sub -Surface Storage Capacity and Duration - assessment area condition metric
Check a box in each column. Consider surface storage capacity and duration (Surf) and sub -surface storage capacity and
duration (Sub). Consider both increase and decrease in hydrology. A ditch <- 1 foot deep is considered to affect surface water only,
while a ditch > 1 foot deep is expected to affect both surface and sub -surface water. Consider tidal flooding regime, if applicable.
Surf Sub
(+ A (+` A Water storage capacity and duration are not altered.
C B (` B Water storage capacity or duration are altered, but not substantially (typically, not sufficient to change vegetation).
r C r C Water storage capacity or duration are substantially altered (typically, alteration sufficient to result in vegetation
change) (examples: draining, flooding, soil compaction, filling, excessive sedimentation, underground utility lines).
3. Water Storage/Surface Relief - assessment area/wetland type condition metric (skip for all marshes)
Check a box in each column for each group below. Select the appropriate storage for the assessment area (AA) and the wetland
type (WT).
AA WT
3a. i A r A Majority of wetland with depressions able to pond water > 1 foot deep
( B (-• B Majority of wetland with depressions able to pond water 6 inches to 1 foot deep
(: C (: C Majority of wetland with depressions able to pond water 3 to 6 inches deep
C D (-' D Depressions able to pond water < 3 inches deep
3b. C A Evidence that maximum depth of inundation is greater than 2 feet
( B Evidence that maximum depth of inundation is between 1 and 2 feet
C C Evidence that maximum depth of inundation is less than 1 foot

4. Soil Texture/Structure - assessment area condition metric (skip for all marshes)
Check a box from each of the three soil property groups below. Dig soil profile in the dominant assessment area landscape
feature. Make soil observations within the 12 inches. Use most recent National Technical Committee for Hydric Soils guidance for
regional indicators.
4a. r A Sandy soil
f B Loamy or clayey soils exhibiting redoximorphic features (concentrations, depletions, or rhizospheres)
C Loamy or clayey soils not exhibiting redoximorphic features
C D Loamy or clayey gleyed soil
{ E Histosol or histic epipedon
4b. CT A Soil ribbon < 1 inch
(' B Soil ribbon >_ 1 inch
4c. (7 A No peat or muck presence
C B A peat or muck presence
5. Discharge into Wetland - opportunity metric
Check a box in each column. Consider surface pollutants or discharges (Surf) and sub -surface pollutants or discharges (Sub).
Examples of sub -surface discharges include presence of nearby septic tank, underground storage tank (UST), etc.
Surf Sub
(+ A 07 A Little or no evidence of pollutants or discharges entering the assessment area
[ B r B Noticeable evidence of pollutants or discharges entering the wetland and stressing, but not overwhelming the
treatment capacity of the assessment area
CC r C Noticeable evidence of pollutants or discharges (pathogen, particulate, or soluble) entering the assessment area and
potentially overwhelming the treatment capacity of the wetland (water discoloration, dead vegetation, excessive
sedimentation, odor)
6. Land Use - opportunity metric (skip for non -riparian wetlands)
Check all that apply (at least one box in each column). Evaluation involves a GIS effort with field adjustment. Consider sources
draining to assessment area within entire upstream watershed (WS), within 5 miles and within the watershed draining to the
assessment area (5M), and within 2 miles and within the watershed draining to the assessment area (2M). Effective riparian buffers
are considered to be 50 feet wide in the Coastal Plain and Piedmont ecoregions and 30 feet wide in the Blue Ridge Mountains ecoregion.
WS 5M 2M
FA FA FA >_ 10% impervious surfaces
r B r B r B Confined animal operations (or other local, concentrated source of pollutants)
r C r✓ C P C >_ 20% coverage of pasture
r D r D r D >_ 20% coverage of agricultural land (regularly plowed land)
r E r E r E >_ 20% coverage of maintained grass/herb
r F r F r F >_ 20% coverage of clear-cut land
r G r G r G Little or no opportunity to improve water quality. Lack of opportunity may result from little or no disturbance in
the watershed or hydrologic alterations that prevent dainage and/or overbank flow from affectio the
assessment area.
7. Wetland Acting as Vegetated Buffer - assessment area/wetland complex condition metric (skip for non -riparian wetlands)
7a. Is assessment area within 50 feet of a tributary or other open water?
(Z Yes (' No If Yes, continue to 7b. If No, skip to Metric 8.
7b. How much of the first 50 feet from the bank is weltand? (Wetland buffer need only be present on one side of the water body. Make
buffer judgment based on the average width of wetland. Record a note if a portion of the buffer has been removed or disturbed.)
(: A >_ 50 feet
( B From 30 to < 50 feet
(` C From 15 to < 30 feet
( D From 5 to < 15 feet
( E < 5 feet or buffer bypassed by ditches
7c. Tributary width. If the tributary is anastomosed, combine widths of channels/braids for a total width.
IP <- 15-feet wide (` > 15-feet wide r Other open water (no tributary present)
7d. Do roots of assessment area vegetation extend into the bank of the tributary/open water?
(:Yes (-'No
7e. Is tributary or other open water sheltered or exposed?
(: Sheltered - adjacent open water with width < 2500 feet and no regular boat traffic.
r Exposed - adjacent open water with width >_ 2500 feet or regular boat traffic.
8. Wetland Width at the Assessment Area - wetland type/wetland complex condition metric (evaluate WT for all marshes
and Estuarine Woody Wetland only; evaluate WC for Bottomland Hardwood Forest, Headwater Forest, and Riverine Swamp
Forest only)
Check a box in each column. Select the average width for the wetland type at the assessment area (WT) and the wetland complex at the
assessment area (WC). See User Manual for WT and WC boundaries.
WT WC
( A • A >_ 100 feet
(` B B From 80 to < 100 feet
C C C From 50 to < 80 feet
( D . D From 40 to < 50 feet
C E ( E From 30 to < 40 feet
C F ( F From 15 to < 30 feet
C G C G From 5 to < 15 feet
C H C H < 5 feet
9. Inundation Duration - assessment area condition metric (skip for non -riparian wetlands)
Answer for assessment area dominant landform.
CT A Evidence of short -duration inundation (< 7 consecutive days)
r B Evidence of saturation, without evidence of inundation
C C Evidence of long -duration inundation or very long -duration inundation (7 to 30 consecutive days or more)
10. Indicators of Deposition - assessment area condition metric (skip for non -riparian wetlands and all marshes)
Consider recent deposition only (no plant growth since deposition).
(.7 A Sediment deposition is not excessive, but at approximately natural levels.
r B Sediment deposition is excessive, but not overwhelming the wetland.
C C Sediment deposition is excessive and is overwhelming the wetland.

11. Wetland Size - wetland type/wetland complex condition metric
Check a box in each column. Involves a GIS effort with field adjustment. This metric evaluates three aspects of the wetland area: the
size of the wetland type (WT), the size of the wetland complex (WC), and the size of the forested wetland (FW) (if applicable, see User
Manual). See the User Manual for boundaries of these evaluation areas. If assessment area is clear-cut, select "K" for the FW column.
WT WC FW (if applicable)
C A (' A C A >- 500 acres
{ B i B (` B From 100 to < 500 acres
{ C i C ( C From 50 to < 100 acres
C D {: D (*` D From 25 to < 50 acres
(.` E (E f" E From 10 to < 25 acres
C"F ("F [`F From 5 to < 10 acres
({-- G CG (`G From 1 to < 5 acres
y H (H (`H From 0.5 to < 1 acre
( I C 1 (-` 1 From 0.1 to < 0.5 acre
( J ( J (" J From 0.01 to < 0.1 acre
( K (" K r• K < 0.01 acre or assessment area is clear-cut
12. Wetland Intactness - wetland type condition metric (evaluate for Pocosins only)
A Pocosin is the full extent (>_ 90%) of its natural landscape size.
B Pocosin is < 90% of the full extent of its natural landscape size.
13. Connectivity to Other Natural Areas - landscape condition metric
13a. Check appropriate box(es) (a box may be checked in each column). Involves a GIS effort with field adjustment. This
evaluates whether the wetland is well connected (Well) and/or loosely connected (Loosely) to the landscape patch, the contiguous
metric naturally vegetated area and open water (if appropriate). Boundaries are formed by four -lane roads, regularly maintained utility
line corridors the width of a four -lane road or wider, urban landscapes, fields (pasture open and agriculture), or water > 300 feet wide.
Well Loosely
C A (-' A >- 500 acres
C B (-' B From 100 to < 500 acres
( C (. C From 50 to < 100 acres
(: D ( D From 10 to < 50 acres
( E ( E < 10 acres
( F ('' F Wetland type has a poor or no connection to other natural habitats
13b. Evaluate for marshes only.
C Yes (-' No Wetland type has a surface hydrology connection to open waters/stream or tidal wetlands.
14. Edge Effect - wetland type condition metric (skip for all marshes and Estuarine Woody Wetland)
May involve a GIS effort with field adjustment. Estimate distance from wetland type boundary to artificial edges. Artificial edges include
non -forested areas >_ 40 feet wide such as fields, development, roads, regularly maintained utility line corridors and clear -cuts. Consider
the eight main points of the compass. Artificial edge occurs within 150 feet in how many directiions? If the assessment area is clear-cut,
select option "C."
CA 0
(*`B 1to4
("C 5to8
15. Vegetative Composition - assessment area condition metric (skip for all marshes and Pine Flat)
C A Vegetation is close to reference condition in species present and their proportions. Lower strata composed of appropriate
species, with exotic plants absent or sparse within the assessment area.
(: B Vegetation is different from reference condition in species diversity or proportions, but still largely composed of native species
characteristic of the wetland type. This may include communities of weedy native species that develop after clearcutting or
clearing. It also includes communities with exotics present, but not dominant, over a large portion of the expected strata.
C C Vegetation severely altered from reference in composition, or expected species are unnaturally absent (planted stands of non -
characteristic species or at least one stratum inappropriately composed of a single species), or exotic species are dominant in
at least one stratum.
16. Vegetative Diversity - assessment area condition metric (evaluate for Non -tidal Freshwater Marsh only)
C A Vegetation diversity is high and is composed primarily of native species (<10% cover of exotics).
C B Vegetation diversity is low or has > 10% to 50% cover of exotics.
C C Vegetation is dominated by exotic species (>50% cover of exotics).
17. Vegetative Structure - assessment area/wetland type condition metric
17a. Is vegetation present?
CZ Yes (-' No If Yes, continue to 17b. If No, skip to Metric 18.
17b. Evaluate percent coverage of assessment area vegetation for all marshes only. Skip to 17c for non -marsh wetlands.
C A >- 25% coverage of vegetation
( B < 25% coverage of vegetation
17c. Check a box in each column for each stratum. Evaluate this portion of the metric for non -marsh wetlands. Consider structure
in airspace above the assessment area (AA) and the wetland type (WT) separately.
AA WT
(` A (+ A Canopy closed, or nearly closed, with natural gaps associated with natural processes
B r B Canopy present, but opened more than natural gaps
c- C ` C Canopy sparse or absent
C- A • A Dense mid-story/sapling layer
B . ' B Moderate density mid-story/sapling layer
C r C Mid-story/sapling layer sparse or absent
C- A : A Dense shrub layer
B B Moderate density shrub layer
( C C Shrub layer sparse or absent
A A Dense herb layer
d • C- B . B Moderate density herb layer
C (" C Herb layer sparse or absent
0
m
U
Shrub Mid -Story
18. Snags - wetland type condition metric (skip for all marshes)
C A Large snags (more than one) are visible (> 12-inches DBH, or large relative to species present and landscape stability).

( B NotA
19. Diameter Class Distribution — wetland type condition metric (skip for all marshes)
C A Majority of canopy trees have stems > 6 inches in diameter at breast height (DBH); many large trees (> 12 inches DBH) are
present.
(. B Majority of canopy trees have stems between 6 and 12 inches DBH, few are > 12-inch DBH.
( C Majority of canopy trees are < 6 inches DBH or no trees.
20. Large Woody Debris — wetland type condition metric (skip for all marshes)
Include both natural debris and man -placed natural debris.
C A Large logs (more than one) are visible (> 12 inches in diameter, or large relative to species present and landscape stability).
(+` B Not A
21. Vegetation/Open Water Dispersion — wetland type/open water condition metric (evaluate for Non -Tidal Freshwater
Marsh only)
Select the figure that best describes the amount of interspersion between vegetation and open water in the growing season. Patterned
areas indicate vegetated areas, while solid white areas indicate open water.
CA ("B rC
``
22. Hydrologic Connectivity — assessment area condition metric (evaluate for riparian wetlands and Salt/Brackish Marsh only)
Examples of activities that may severely alter hydrologic connectivity include intensive ditching, fill, sedimentation, channelization,
diversion, man-made berms, beaver dams, and stream incision. Documentation required if evaluated as B, C, or D.
(+` A Overbank and overland flow are not severely altered in the assessment area.
C B Overbank flow is severely altered in the assessment area.
C C Overland flow is severely altered in the assessment area.
C D Both overbank and overland flow are severely altered in the assessment area.
D
Notes

NC WAM Wetland Rating Sheet
Accompanies User Manual Version 5.0
Wetland Site Name W1 Date
07/13/2021
Wetland Type Bottomland Hardwood Forest
Assessor Name/Organization
Kimley-Horn
Notes on Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Wetland is intensively managed (Y/N)
Assessment area is located within 50 feet of a natural tributary or other open water (Y/N)
Assessment area is substantially altered by beaver (Y/N)
Assessment area experiences overbank flooding during normal rainfall conditions (Y/N)
Assessment area is on a coastal island (Y/N)
Sub -function Rating Summary
NO
NO
NO
YES
NO
YES
NO
Function Sub -function
Metrics
Rating
Hydrology Surface Storage and Retention
Sub -Surface Storage and Retention
Condition
Condition
HIGH
MEDIUM
Water Quality Pathogen Change
Particulate Change
Soluble Change
Physical Change
Pollution Change
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
HIGH
HIGH
YES
MEDIUM
MEDIUM
YES
HIGH
HIGH
YES
HIGH
HIGH
YES
NA
NA
NA
Habitat Physical Structure
Landscape Patch Structure
Vegetation Composition
Condition
Condition
Condition
HIGH
HIGH
MEDIUM
Function Rating Summary
Function Metrics/Notes
Rating
Hydrology Condition
Water Quality Condition
Condition/Opportunity
Opportunity Presence? (Y/N)
Habitat Condition
HIGH
HIGH
HIGH
YES
HIGH
Overall Wetland Rating HIGH