20150443 Ver 1_Application_20150505

hdrinc.com

3733 National D
T 919.232.6600

November 20

Ms. Natasha M
U.S. Army Co
Asheville Reg
151 Patton Av
Asheville, NC
Ms. Sue Hom
N.C Division o
401 & Buffer P
1617 Mail Ser
Raleigh, NC 2
Re: Nation
Blue R
Prelim
Watau
To Whom It M
HDR Enginee
preliminary ju
404/401 appro
Division of Wa
associated wit
(Figures 1 and
The Project e
Ridge Parkwa
Parkway over
steep mounta
reconditioning
roads as well
potentially affe
the U.S. along

rive Suite 207, Ra
F 919.785.118
0, 2014
McCormick
rps of Enginee
ulatory Office
venue, Room 2
28801-5006
ewood
of Water Resou
Permitting Unit
rvice Center
27699-1617
nwide No. 3 a
Ridge Parkwa
minary Jurisdi
uga County, N
May Concern:
ering, Inc., on
urisdictional de
oval through th
ater Resources
th the propose
d 2).
encompasses a
ay Bridge over
Route 321 as
ain slopes, fo
g/resurfacing of
l as rehabilitat
ected by the Pr
g the 8-mile Stu
aleigh NC 27612
7
ers
208
urces

nd General Ce
ay Section 2F2
ctional Determ
North Carolina
behalf of the
etermination a
he U.S. Army C
s (NCDWR) W
ed Blue Ridge P
approximately
r County Road
shown in the e
orests, and p
f the Blue Rid
tion of structu
roject. HDR’s
udy Area and s
ertification No
24 Resurfacing
mination and
a
e National Pa
and Pre-Cons
Corps of Engin
Water Quality C
Parkway Resu
8 miles beginn
d 1509 and ex
enclosed figure
pasture land
ge Parkway a
res as necess
on-site investig
survey for fede
o. 3883
g and Rehabil
NWP 3/WQC 3
ark Service -
struction Notific
neers (USACE
ertification (WQ
urfacing and Re
ning at approx
xtends to MP 2
es. The Blue R
within the p
and associated
sary. The are
gation included
rally protected
litation Projec
3883 Approva
Blue Ridge P
cation (PCN)
) Nationwide P
QC) No. 3883
ehabilitation Pr
ximately Milepo
291.1, in the v
Ridge Parkway
project limits.
overlooks, pa
eas investigate
d a delineation
species.
ct
al
Parkway, is su
application fo
Permit (NWP) 3
for constructio
roject in Watau
ost (MP) 283 a
vicinity of the B
traverses strea
The projec
arking areas, a
ed are those t
of jurisdictiona
ubmitting a
or Section
3 and N.C.
on activities
uga County
at the Blue
Blue Ridge
am valleys,
ct includes
and access
hat will be
al waters of
Ownership
The project area is owned by the United States Department of the Interior - National Park Service.
Jurisdictional Waters of the U.S.
HDR reviewed the proposed alignment for jurisdictional waters of the U.S. under Section 404 of the Clean
Water Act. The alignment was examined according to the methodology described in the USACE 1987
Wetland Delineation Manual, USACE Post-Rapanos guidance, the recent USACE Regional Supplement, and
the NCDWQ Guidance. On-site reconnaissance, conducted in June and October 2014, revealed that 22
jurisdictional streams and nine jurisdictional wetlands are located within or just outside of the proposed project
area (Figure 3). Completed NCDWQ Stream Identification forms, USACE Wetland Determination forms, and
representative photographs are attached. Table 1 provides a summary of the delineated features.
Table 1. Summary of Waters of the U.S. within the Project Area
Milepost Station
Stream Impact # &
Stream/Wetland
Name
Latitude Longitude Classification
Estimated
Amount of
Aquatic
Resource in
Study Area
(lf or ac)
Class of
Aquatic
Resource
283 7+90 S1 (Ut to Pine Run) 36.218792 -81.590533 Intermittent 50 non section 10
– non-tidal
283 9+80 S2 (Ut to Pine Run) 36.218503 -81.591003 Perennial 20 non section 10
– non-tidal
283 42+50 S3 (Ut to Pine Run) 36.213797 -81.599514 Intermittent 20 non section 10
– non-tidal
284 4+50
S4 (Ut to Sandpit
Branch (Sawpit
Branch))
36.210148 -81.601374 Intermittent 10 non section 10
– non-tidal
284 36+40 S5 (Sandpit Branch
(Sawpit Branch))
36.203267 -81.604443 Perennial 20 non section 10
– non-tidal
285 0+00 S6 (Sandpit Branch
(Sawpit Branch))
36.198779 -81.604418 Perennial 50 non section 10
– non-tidal
285 45+00
S7 (Ut to Sandpit
Branch (Sawpit
Branch))
36.186897 -81.604132 Intermittent 20 non section 10
– non-tidal
285 51+80
S8 (East Fork
South Fork New
River)
36.1739 -81.612561 Perennial 50 non section 10
– non-tidal
Milepost Station
Stream Impact # &
Stream/Wetland
Name
Latitude Longitude Classification
Estimated
Amount of
Aquatic
Resource in
Study Area
(lf or ac)
Class of
Aquatic
Resource
286 36+00 S9 (Goshen
Branch)
36.177619 -81.610972 Perennial 30 non section 10
– non-tidal
286 43+00 S10 (Goshen
Branch)
36.176036 -81.610861 Perennial 40 non section 10
– non-tidal
286 50+00 S11 (Goshen
Branch)
36.1738 -81.61283 Perennial 40 non section 10
– non-tidal
286 52+30 S12 (Goshen
Branch)
36.17384 -81.612745 Perennial 40 non section 10
– non-tidal
287 10+50 S13 (Goshen
Branch)
36.171937 -81.614774 Perennial 40 non section 10
– non-tidal
287 11+75 S14 (Goshen
Branch)
36.171821 -81.614809 Perennial 40 non section 10
– non-tidal
287 18+50 S15 (Ut to Goshen
Branch)
36.171398 -81.615022 Intermittent 20 non section 10
– non-tidal
287 20+20 S16 (Ut to Goshen
Branch)
36.168961 -81.616297 Intermittent 30 non section 10
– non-tidal
287 29+00 S17 (Goshen
Branch)
36.16657 -81.617272 Perennial 50 non section 10
– non-tidal
287 43+25 S18 (Ut to Goshen
Branch)
36.163927 -81.620793 Perennial 40 non section 10
– non-tidal
287 43+25 S19 (Ut to Goshen
Branch)
36.163927 -81.620793 Perennial 30 non section 10
– non-tidal
288 12+75 S20 (Ut to Aho
Branch)
36.163927 -81.620793 Perennial 20 non section 10
– non-tidal
288 18+50 S21 (Ut to Aho
Branch)
36.156895 -81.621555 Perennial 70 non section 10
– non-tidal
291 21+00 S22 (Ut to Aho
Branch)
36.141882 -81.658633 Perennial 20 non section 10
– non-tidal
285 0+00 W1 36.197855 -81.603979 PSS <0.001 non section 10
– wetland
285 0+00 W1a 36.198963 -81.604787 PSS <0.001 non section 10
– wetland
285 37+00 W2 36.18907 -81.603214 PEM <0.1 non section 10
– wetland
285 37+00 W3 36.188963 -81.602872 PEM/PSS <0.1 non section 10
– wetland
Milepost Station
Stream Impact # &
Stream/Wetland
Name
Latitude Longitude Classification
Estimated
Amount of
Aquatic
Resource in
Study Area
(lf or ac)
Class of
Aquatic
Resource
285 45+00 W4 36.187027 -81.60405 PSS <0.1 non section 10
– wetland
285 51+80 W5 36.185607 -81.605696 PSS <0.1 non section 10
– wetland
285 51+80 W6 36.185703 -81.605853 PSS <0.1 non section 10
– wetland
287 36+50 W7 36.165008 -81.618897 PEM <0.1 non section 10
– wetland
291 20+00 W8 36.141943 -81.658708 PEM <0.1 non section 10
– wetland

Impacts to Jurisdictional Waters
This project is to resurface and rehabilitate a section of the Blue Ridge Parkway. There are no new facilities
proposed with this project. Efforts to avoid and minimize impacts to jurisdictional streams and wetlands have
been taken into account for this project. Table 2 provides a summary of impacts to jurisdictional waters.
Table 2. Impacts Summary
Milepost Resource
ID
Stream
Impact
#
Type of Impact
Temporary
Impacts
(linear feet)
Permanent
Impacts
(linear feet /
square feet)
283 7+90 S1 Reset headwall and place 10’ riprap
apron 10
283 9+80 S2 Repair 3 pipe joints 5
283 42+50 S3 Remove and reset stacked masonry
headwall 5
284 4+50 S4 Repoint stone masonry headwall; repair
concrete invert of box culvert 5
285 0+00 S6 Reset headwall and fill behind reset
stones 5
285 44+50 S7 Install new stone masonry headwall 10
285 51+80 S8 Repoint stone masonry headwall 10
286 36+00 S9 Repoint/reset stone headwalls, reline
inverts of box culverts 15
Milepost Resource
ID
Stream
Impact
#
Type of Impact
Temporary
Impacts
(linear feet)
Permanent
Impacts
(linear feet /
square feet)
286 43+00 S10
Recondition stone headwall/Repoint
stone masonry headwall and place 20’
riprap apron
5 10
286 50+00 S11 Repoint stone masonry
headwall/recondition stone headwall 10
286 52+30 S12 Recondition entire length of pipe;
recondition ditch; place 3’ riprap apron 3
287 10+50 S13 Recondition last 3 linear feet of pipe 5
287 11+75 S14
Recondition length of pipe; furnish and
install stone masonry headwall; excavate
outfall channel
5
287 18+50 S15 Recondition last 10’ of pie; repoint stone
masonry headwall 5
287 20+20 S16
Selective clear headwall; remove and
reset stone masonry headwall; replace
missing stones; reline invert of pipe
culvert
10
287 29+00 S17 Repoint stone masonry headwall; replace
missing stones on headwall 20
287 43+25 S18
Selective clear headwall by removing
fallen tree; repoint stone masonry; reset
loose stones; reline invert of culvert
10
288 12+75 S20
Repoint stone masonry headwall; grout
joint between headwall and box culvert;
replace missing top stones on headwall.
Reline invert of box culvert; repair
concrete ceiling on box culvert; place fill
in sink hole; add a 10’ riprap apron.
5 10
288 18+50 S21
Reline invert of box culvert; reset existing
loose stones on both sides of headwall;
replace missing bottom stones; repoint
stone masonry headwall; remove and
dispose of existing stone; place 20’ riprap
apron.
10 20
Milepost Resource
ID
Stream
Impact
#
Type of Impact
Temporary
Impacts
(linear feet)
Permanent
Impacts
(linear feet /
square feet)
291 21+00 S22
Reline invert of box culvert; grout joint
between headwall and box; reset existing
top masonry stones; replace missing top
stones on headwall; repoint stone
masonry headwall; place 10’ riprap
apron; place erosion control matting 50’
downstream
5 10
Total: 143 65
285 37+00 W2 Recondition ditch; remove existing stone
wall, install new stone masonry headwall 0.0007
285 37+00 W3 Excavate outfall channel (Recondition
ditch) 0.0007
285 51+80 W5 Repoint stone headwall 0.003
285 51+80 W6
Repair culverts, reset/reset stone
headwalls; repair concrete ceilings; fill
sink holes
0.004
287 36+50 W7 Recondition last 6’ of pipe; repair pipe
joints; recondition 30’ of ditch 0.001
291 20+00 W8
Repair concrete invert of box culvert;
repoint stone masonry headwall; place
10’ riprap apron; place erosion control
matting 50’ downstream
0.0009
Total: 0.009 0.0009

Only areas in need of rehabilitation are included in this project. The majority of the project is resurfacing of the
exisitng roadway. Where deemed necessary due to deteriorating structures, pipes, and culverts are being
reconditioned to meet current standards. Stream banks will be seeded and matted with erosion control
material as necessary. Sediment and erosion control measures will be employed prior to construction and
inspected and maintained throughout the duration of the project.

Agency Correspondence
Cultural Resources
The project occurs along the Blue Ridge Parkway which is considered a Historic Landmark. This project will
not remove any existing bridge/culvert structures; however, there will be maintenance to several in the form of
handwork to replace missing stones on bridges/headwalls, backfilling where necessary, fixing sink holes, etc.
The Federal Highway Administration completed a screening document for this project and determined that the
cultural survey report was note required (see attached).
Federally Protected Species
HDR obtained and reviewed a list of federally protected species for Watauga County from the U.S. Fish and
Wildlife Service (USFWS) website (http://www.fws.gov/raleigh/species/cntylist/watauga.html), which was last
updated on January 14, 2014. HDR conducted an onsite visits in June and October, 2014 and determined
that the site does not exhibit habitat for any of the federally-listed species. HDR also reviewed the North
Carolina Natural Heritage Program (NCNHP) Element Occurrence database and GIS layer. According to the
NCNHP data, no federally protected species occur within one mile of the proposed project.
We are hereby requesting a preliminary jurisdictional determination for delineated waters of the U.S. and
authorization to construct the proposed Project under a Section 404 NWP 3 and Section 401 WQC No. 3883.
If you have any questions or require additional information after your review of the enclosed information,
please contact me at [e-mail] or 919-232-6654.
Respectfully,
HDR

Jessica Tisdale
Environmental Scientist
Attachments: Figure 1. U.S. Geological Survey Quadrangle
Figure 2. Project Overview
Figure 3. Soils Map
Pre-Construction Notification
Agent Authorization Form
Project Impact Sheets
Request for Preliminary Jurisdiction Determination Form
NCDWQ Stream Identification Forms
USACE Wetland Data Forms
NPS Categorical Exclusion Form
NPS Letter of Compliance Completion
NPS Section 106 Assessment

Cc: Andy Otten– National Park Service
Claudia Walsh – HDR Engineering

S21
S18, S19
W7
S17
S16
S15
S11, S12 (Gos hen Bra nch)
S13, S14 (Goshen Branch)
S10 (Goshen Branch)
S9 (Go shen Bra nch) S8 (East Fork South Fork New River)W5, W6
S7, W 4
W2, W3
W1a, W1, S6
S1, S2
Projec t Start
S3
S4
S5
S20
Copyright:© 2013 National Geographic Society, i-cubedUSGS Topogra phic MapFigure 1A
FHWA | PRA-BLRI 2F24 | 404/401 Permit
H:\GIS\Projects\007259_FHWA-EFLHD\0223152_EFLHD-MD-TO14-002-BLRI2F24\map_docs\mxd\working\USGS_map.mxd | Last Updated: 11.18.2014 F
0 0.5 1Miles
Match Line
S22, W 8
Projec t End
Copyright:© 2013 National Geographic Society, i-cubedUSGS Topogra phic MapFigure 1B
FHWA | PRA-BLRI 2F24 | 404/401 Permit
H:\GIS\Projects\007259_FHWA-EFLHD\0223152_EFLHD-MD-TO14-002-BLRI2F24\map_docs\mxd\working\USGS_map_2.mxd | Last Updated: 11.10.2014 F
0 0.5 1Miles
Match Line
S22, W 8
S21
S18, S19
W7
S17
S16
S15 S11, S12 (Gos hen Branch)
S13, S14 (Goshen Branch)
S10 (Goshen Branch)
S9 (Goshen Branch)
S8 (East Fork South Fork New River)W5, W6
S7, W 4
W2, W3
S4 S1, S2
Project End
Projec t Start
S3S5W1a, W1, S6
S20
Ov ervie w M apFigure 2
FHWA | PRA-BLRI 2F24 | 404/401 Permit
H:\GIS\Projects\007259_FHWA-EFLHD\0223152_EFLHD-MD-TO14-002-BLRI2F24\map_docs\mxd\working\overview_map_1.mxd | Last Updated: 11.20.2014
F
02550Feet 0 1.5 30.75 Miles
Project Lo ca tions
General Im pact Locations
S22, W 8
S21
S18, S19
W7
S17
S16
S15 S11, S12 (Gos hen Branch)
S13, S14 (Goshen Branch)
S10 (Goshen Branch)
S9 (Goshen Branch)
S8 (East Fork South Fork New River)W5, W6
S7, W 4
W2, W3
W1a, W1, S6
S1, S2
Project End
Projec t Start
S3
S4
S5
S20
RdA
SoD
SoD
SnD
NkA
EdC
NkA
UkE
SnC
SnB
NkA
SoD
CdE
EdD
CtD
UkE
NRCS Soils MapFigure 3
FHWA | PRA-BLRI 2F24 | 404/401 Permit
H:\GIS\Projects\007259_FHWA-EFLHD\0223152_EFLHD-MD-TO14-002-BLRI2F24\map_docs\mxd\working\Soils_map.mxd | Last Updated: 11.20.2014
F
0 1.5 30.75 Miles
S oil S ymbol S oils Description W ater Feature
CdE Chandler fine sandy loam, 30 to 50 percent slopes 283s7+90, 283s8+10, 283s9+80
EdC Edney town loam, 8 to 15 percent slopes brw1
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded brw1
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded 285s00+00
SnB Saunook loam, 2 to 8 percent slopes brw2 and brw3
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded 285s44+50
EdD Edney town loam, 15 to 30 percent slopes 285s44+50, brw4
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded 285s51+80 (East Fork South Fork New River)
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded brw5 and brw6
RdA Reddies loam, 0 to 3 percent slopes, frequently flooded 286s43+00 (Goshen Branch)
CtD Cullasaja very cobbly loam, 15 to 30 percent slopes, extremely bouldery 286s43+00 (Goshen Branch)
SoD Saunook loam, 15 to 30 percent slopes, very stony 287s11+70 (Goshen Branch)
UkE Unaka-Porters complex, 30 to 50 percent slopes, very rocky 287s11+70 (Goshen Branch)
SoD Saunook loam, 15 to 30 percent slopes, very stony 287s18+00
SoD Saunook loam, 15 to 30 percent slopes, very stony 287s20+20
SoD Saunook loam, 15 to 30 percent slopes, very stony 287s28+00
UkE Unaka-Porters complex, 30 to 50 percent slopes, very rocky 287s28+00
UkE Unaka-Porters complex, 30 to 50 percent slopes, very rocky 287s43+20
SnC Saunook loam, 8 to 15 percent slopes 288s12+00
SnD Saunook loam, 15 to 30 percent slopes brw7
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded 287s43+20, 287s43+20a, 287s43+20b
NkA Nikwasi loam, 0 to 3 percent slopes, frequently flooded 288s18+50
SoD Saunook loam, 15 to 30 percent slopes, very stony 291s21+00
SoD Saunook loam, 15 to 30 percent slopes, very stony brw9
Soil Symbols
CdE
CtD
EdC
EdD
NkA
RdA
SnB
SnC
SnD
SoD
UkE

Page 1 of 13
PCN Form – Version 1.3 December 10, 2008 Version

Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: Section 404 Permit Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? Yes No
1d. Type(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?

For the record only for DWQ 401
Certification:
Yes No
For the record only for Corps Permit:

Yes No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
Yes No

1g. Is the project located in any of NC’s twenty coastal counties. If yes, answer 1h
below.
Yes No

1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? Yes No
2. Project Information
2a. Name of project: Blue Ridge Parkway Resurfacing and Rehabilitation
2b. County: Watauga
2c. Nearest municipality / town: Boone
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: United State Department of the Interior – National Park Service
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address: 199 Hemphill Knob Road
3e. City, state, zip: Asheville, NC 28805
3f. Telephone no.: 828-271-4313
3g. Fax no.: 828-271-4313
3h. Email address: [e-mail]
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.3 Dec 10 2008

Page 2 of 13
4. Applicant Information (if different from owner)
4a. Applicant is: Agent Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Jessica Tisdale, Certified Ecologist
5b. Business name
(if applicable): HDR
5c. Street address: 3733 National Drive, Suite 207
5d. City, state, zip: Raleigh, NC 27612
5e. Telephone no.: 919.232.6654
5f. Fax no.: 919.785.1187
5g. Email address: [e-mail]

Page 3 of 13
PCN Form – Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): National Park Service
1b. Site coordinates (in decimal degrees): Latitude: 36.185586 Longitude: - 81.605763
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Goshen Branch
2b. Water Quality Classification of nearest receiving water: WS-IV Trout Waters
2c. River basin: map is available at
http://h2o.enr.state.nc.us/admin/maps/ New River

Page 4 of 13
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:
According to aerial imagery and recent onsite visits, the Blue Ridge Parkway traverses stream valleys, steep mountain
slopes, forests, and pasture land within the project limits
3b. List the total estimated acreage of all existing wetlands on the property:
Approximately 0.5 acres (ac.) of wetlands were identified and delineated including:
- <0.1 ac. of Wetland 1
- <0.1 ac. of Wetland 1a
- <0.1 ac. of Wetland 2
- <0.01 ac. of Wetland 3
- <0.01 ac. of Wetland 4
- <0.01 ac. of Wetland 5
- <0.01 ac. of Wetland 6
- <0.01 ac. of Wetland 7
- <0.01 ac. of Wetland 8
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Approximately 150 linear feet (lf) of intermittent stream and approximately 600 lf of perennial stream were identified within
or near by the proposed Project including:
- 50 lf of intermittent Stream 1 (Ut to Pine Run)
- 20 lf of perennial Stream 2 (Ut to Pine Run)
- 20 lf of intermittent Stream 3 (Ut to Pine Run)
- 10 lf of intermittent Stream 4 (Ut to Sandpit Branch (Sawpit Branch))
- 20 lf of perennial Stream 5 (Sandpit Branch (Sawpit Branch))
- 50 lf of perennial Stream 6 (Sandpit Branch (Sawpit Branch))
- 20 lf of intermittent Stream 7 (Ut to Sandpit Branch (Sawpit Branch))
- 50 lf of perennial Stream 8 (East Fork South Fork New River))
- 30 lf of perennial Stream 9 (Goshen Branch)
- 40 lf of perennial Stream 10 (Goshen Branch)
- 40 lf of perennial Stream 11 (Goshen Branch)
- 40 lf of perennial Stream 12 (Goshen Branch)
- 40 lf of perennial Stream 13 (Goshen Branch)
- 40 lf of perennial Stream 14 (Goshen Branch)
- 20 lf of intermittent Stream 15 (Ut to Goshen Branch)
- 30 lf of intermittent Stream 16 (Ut to Goshen Branch)
- 50 lf of perennial Stream 17 (Goshen Branch)
- 40 lf of perennial Stream 18 (Ut to Goshen Branch)
- 30 lf of perennial Stream 19 (Ut to Goshen Branch)
- 20 lf of perennial Stream 20 (Ut to Aho Branch)
- 70 lf of perennial Stream 21 (Ut to Aho Branch)
- 20 lf of perennial Stream 22 (Ut to Aho Branch)

3d. Explain the purpose of the proposed project:
The purpose of this project is to resurface and rehabilitate an approximately 8 mile section of the Blue Ridge Parkway near
Boone, NC. Repair is needed to several culverts/pipes and associated headwalls as well as resurfacing of the existing
pavement structure where there are deficiencies.

Page 5 of 13
3e. Describe the overall project in detail, including the type of equipment to be used:
Standard construction equipment may be used, such as excavators, backhoes, hauling trucks, etc. Because of the scenic and
historic nature of the Blue Ridge Parkway, a lot of the work requires hand setting of stone, etc.

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:
Yes No Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made? Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.

5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? Yes No Unknown
5b. If yes, explain in detail according to “help file” instructions.

6. Future Project Plans
6a. Is this a phased project? Yes No
6b. If yes, explain.

Page 6 of 13
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands Streams - tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact
number –
Permanent (P) or
Temporary (T)
2b.

Type of impact
2c.

Type of wetland
(if known)
2d.

Forested

2e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404, other)
2f.

Area of impact
(acres)
W2 P T Recondition ditch PEM Yes
No
Corps
DWQ T- 0.0007
W3 P T Recondition ditch PEM/PSS Yes
No
Corps
DWQ T- 0.0007
W5 P T Repoint stone
headwall PSS Yes
No
Corps
DWQ T - 0.003
W6 P T Repair culvert; fill
sink holes PSS Yes
No
Corps
DWQ T - 0.004
W7 P T Recondition pipe PEM Yes
No
Corps
DWQ T - 0.001
W8 P T Fill (riprap) PEM Yes
No
Corps
DWQ P - 0.009
2g. Total wetland impacts
T- 0.009
P - 0.0009
Total - 0.0103
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
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)
S1 P T Fill
(Riprap)
S1
(Ut to Pine Run)
PER
INT
Corps
DWQ 1 10
S2 P T Stabilize (repair
pipe joints)
S2
(Ut to Pine Run)
PER
INT
Corps
DWQ 3 5
S3 P T
Fill
(Riprap in
streambed)
S3
(Ut to Pine Run) PER
INT
Corps
DWQ 2 5
S4 P T Repair concrete
culvert
S4 (Ut to Sandpit
Branch (Sawpit
Branch))
PER
INT
Corps
DWQ 3 5
S6 P T
Stabilize
(add fill behind
reset stones)
S6 (Sandpit
Branch (Sawpit
Branch))
PER
INT
Corps
DWQ 3 5
S7 P T
Stabilize
(New stone
headwall)
S7 (Ut to Sandpit
Branch (Sawpit
Branch))
PER
INT
Corps
DWQ 2 10

Page 7 of 13
S8 P T Stabilize
(masonry)
S8
(East Fork South
Fork New River)
PER
INT
Corps
DWQ 5 50
S9 P T Stabilize
(masonry)
S9
(Goshen Branch)
PER
INT
Corps
DWQ 10 15
S10 P T Stabilize
(masonry)
S10
(Goshen Branch)
PER
INT
Corps
DWQ 10 T - 5
P - 10
S11 P T Stabilize
(masonry)
S11
(Goshen Branch)
PER
INT
Corps
DWQ 10 10
S12 P T Fill (riprap on
edge of
streambed)
S12
(Goshen Branch)
PER
INT
Corps
DWQ 10 3
S13 P T Stabilize (pipe) S13
(Goshen Branch)
PER
INT
Corps
DWQ 6 5
S14 P T Stabilize (pipe,
masonry and
ditch)
S14
(Goshen Branch)
PER
INT
Corps
DWQ 6 5
S15 P T Stabilize
(masonry
headwall and
pipe)
S15
(Ut to Goshen
Branch)
PER
INT
Corps
DWQ 1 5
S16 P T Stabilize
(masonry), hand
clearing)
S16
(Ut to Goshen
Branch)
PER
INT
Corps
DWQ 1 10
S17 P T Stabilize
(masonry)
S17
(Goshen Branch)
PER
INT
Corps
DWQ 10 20
S18 P T Stabilize
(masonry, box
culvert) hand
clearing
S18
(Ut to Goshen
Branch)
PER
INT
Corps
DWQ 3 10
S20 P T Stabilize
(masonry, box
culvert), Fill (sink
holes)
S20
(Ut to Aho Branch
PER
INT
Corps
DWQ 5 T - 5
P - 10
S21 P T Stabilize
(masonry, box
culvert), Fill (rip-
rap)
S21
(Ut to Aho Branch)
PER
INT
Corps
DWQ 7 T - 10
P - 20
S22 P T Stabilize
(masonry, culvert,
hand clearing
S22
(Ut to Aho Branch)
PER
INT
Corps
DWQ 3 T - 5
P - 10
3h. Total stream and tributary impacts
P - 65
T - 143
Total -208
3i. Comments: Stream banks will be seeded and matted with erosion control material as necessary. Impacts should not
restrict flow for aquatic life movement.

Page 8 of 13
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number –
Permanent (P) or
Temporary (T)
4b.
Name of waterbody
(if applicable)
4c.

Type of impact
4d.

Waterbody type
4e.

Area of impact (acres)
O1 P T
O2 P T
O3 P T
O4 P T
4f. Total open water impacts 0
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 pond

5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total 0
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)
B1 P T Yes
No
B2 P T Yes
No
B3 P T Yes
No
6h. Total buffer impacts 0
6i. Comments: Not a buffered basin

Page 9 of 13
PCN Form – Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Only areas in need of rehabilitation are included in this project. The majority of the project is resurfacing of the exisitng
roadway. Where deemed necessary due to deteriorating structures, pipes and culverts are being reconditioned to meet
current standards.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Temporary disturbances to wetland areas will be returned to pre-construction contours and re-vegetated with native
riparian species. Sediment and erosion control measures will be employed during construction.
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 Corps
2c. If yes, which mitigation option will be used for this
project?
Mitigation bank
Payment to in-lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: warm cool cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:

Page 10 of 13
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? If yes, you will have to fill out this entire form – please
contact the State for more information.
Yes No

6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)

Multiplier
6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).

6h. Comments:

Page 11 of 13
PCN Form – Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? Yes No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Yes No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 0 %
2b. Does this project require a Stormwater Management Plan? Yes No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Because this is a maintenance project,
there will not be creation of new impervious surfaces.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

2e. Who will be responsible for the review of the Stormwater Management Plan?
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?
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
Session Law 2006-246
Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? Yes No
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 12 of 13
PCN Form – Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land? Yes No
1b. If you answered “yes” to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Yes No
1c. If you answered “yes” to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
Comments: See enclosed Letter of Compliance Completion, Categorical exclusion
form and NPS historic documentation.

Yes No
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
2b. Is this an after-the-fact permit application? Yes No
2c. If you answered “yes” to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
additional development, which could impact nearby downstream water quality? Yes No
3b. If you answered “yes” to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered “no,” provide a short narrative description.
N/A
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A

Page 13 of 13
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. Raleigh
Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
HDR obtained and reviewed a list of federally protected species for Watauga County from the U.S. Fish and Wildlife Service
(USFWS) website (http://www.fws.gov/raleigh/species/cntylist/watauga.html), which was last updated on January 14, 2014.
HDR conducted an onsite visits in June and October, 2014 and determined that the site does not exhibit habitat for any of the
federally-listed species. HDR also reviewed the North Carolina Natural Heritage Program (NCNHP) Element Occurrence
database and GIS layer. According to the NCNHP data, no federally protected species occur within one mile of the proposed
project.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
EFH Mapper
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?
The Blue Ridge Parkway eligible for listing on the National Register of Historic Places. The NPS determined that a
cultural resource survey was not required. See attached documentation.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? Yes No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? NC Flood Maps

Jessica Tisdale

Applicant/Agent's Printed Name

_______________________________
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
11/20/2014

Date

SCALE IN FEET
0 25 50
E4
STREAM AND
WETLAND IMPACTS
MP 284
SE NC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
SCALE IN FEET
0 25 50
E5
STREAM AND
WETLAND IMPACTS
MP 284
SE NC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
SCALE IN FEET
0 25 50
E6
STREAM AND
WETLAND IMPACTS
MP 284 TO MP 285
SE NC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
286
E9SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E10SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E11SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E15SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E16SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E17SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E18SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E19SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E23SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E24SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
E25SENC
PLAN SHEET
BLUE RIDGE PARKWAY

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
STERLING, VIRGINIA
REG STATE PROJECT SHEET NO.NPS
NO.
PMIS NO.
172771 601
120,966 PRA-BLRI 2F24
NC DWO Stream ldentilication Form Version 4.1
Date: l0l l,i i lr:
I
ProjecUSite: Li .1, i
Latitude: U . )'-
./, :r 4'
Evaluator:
",, i:,i Nt
l i,,'l countY: I c,laun,i Lonsitude:.]f l3 u:l
Total Points i '
Stream is at least intermttent f)
if> 1g or Perenniat if> 30- Lr'
Stream Detgrmination fcircle one)
Ephemeral\! nte rm ittenf Pere n n ia I
other 7-!:: t,91 lA
e.g. Quad Namei
."i
A. Geomorphology (Subtotal = \ l Absent Weak Moderate Stronq
1" Continurtv of channel bed and bank 0 e)5
2. Sinuosity of channel along thalweg 0 1 2 J
3. ln-channel structure: ex. riffle-pool, step-pool,
rioole-oool seouence 0 t,3
4. Particle size of stream substrate 0 2 J
5. Active/relict fl oodplain 0 2 J
6. Depositional bars or benches 0 l_r 2 J
7. Recent alluvial deposits 0 2 a
8. Headcuts 0 t 2 J
9. Grade control 0 '0r 1q
'10. Natural valley 0 051 I 1.5
1 'l . Second or qreater order channel No=0 Yes=3
artificial ditches are not rated: see discussions in manual
B. Hvdroloov (Subtotal =
12. Presence of Baseflow 0 2 3;
13. lron oxidizino bacteria G 1 2,3
14. Leaf litter t.J 1 '0 5 0
15. Sediment on olants or debris 0 05 1 1.5
16. Organic debris lines or piles 05 15
17. Soil-based evidence of high water table?No: 0 Yes=3
C. Bioloqv (Subtotal=
18. Fibrous roots in streambed 2 1 0
19 Rooted upland plants in streambed 3 Z 1 0
20. Macrobenthos lnote diversity and abundance)0 1.2 3
21. Aquatic Mollusks 0 2 3
22. Fish 0 05 {q
23 Cravfish 0 0,5 1 l5
24 Amphibians 0 05 ac
25 0 05 1 1.5
26. Wetland plants in sireambed I FACW = 0 75; OBL = 1.5 Other = O
"perennial streams may also be identified using othermethods. See p.35 of manual.
Notes:
i/,, 1/'-'/P'
/IL
Y /.k"l!1,^:l \
T-JSACE AID#
ffi
(-2- s E:Y\Gzt-
Site #_ (indicate on attached rnapt
Provide thc followilrg information for the stream reech under assessment: . .!
l.Applicant's nu ", EFL - 2.Evaluator's n*n", J *rqg- , lU. {-,r,}r,.:r}t
a n^+- ^r^,,^r..-i:^-. Ifi illl-ii''l A T;^^^r-.,ar,,^*i^-. Lo : )L
T.Approximaledrainage u"u' l(g 'fi"^^ (q?ts 8. Stream order: '/
9. Length of reach evaluated: .fO {t r \,10. Ctounn-: Utti.tqd4.
3. Dateot.rruurto,',' |() j'l;?'iit{ 4.Time of evahntion: f o : )L
5.Name orro"*n ,4nW 6.River aasrn: [cul
DWQ #
STREAM QUALITY ASSESSMENT WORKSHEET
12. Subdivision name (if any):
lli]"..1#:",",:,"fr'#';,l'"*'indecimardegrees Longitude(ex -77556611): )o' 13' ,f J jr,' "
Method location determined (circle);fopo Sheet Ortho (Aerial) Photo/GIS Other GIS Othcr
13. Location of reac,h under evalua[iert-(note nearby roads and landmarks and attach map identif,ing stream(s) location):-
./.t/.)!llst'- (/,Q ,/ ,'.,.,. t""i,u i - .t illi 'fr:-1 , Q:G'
14. Proposed channel work (if an,rz): ii-r /j f "r r? t .i. r ,
15. Recentweatherconditions: -.ia;.( (Ota t St4 i,,/r t rls
16. Site conditions at time of 'lt t ;..
17. Identify any special waterway classifications known:
-Section
10
-Tidal
Waters __Essential Fisheries Habitat
Trout Waters
-Outstanding
Resource Waters
-
Nukient SensPe Waters
-Water
Supply Watershed (l-lV)
18. Is rhere a pond or lake located upstream of the evahg\on point? YES f\fO' If yes, estimate the water surface are&: , :.-
19. Does channel appear on USGS quad rnap? YES /fud 20. Does channel appear on USDA Soil Survey? YES $y'tr,/ ,^
21. Estimated watershed land use:
-7o
Residential -!l-% Commercial
-%
Industrial
-%
Agricultural
, fu*Forested YoCleared/ Logged
-*o,n"r,
, ,- - , ,-------i:-'---i--7-T-
22. Banktull widrh: L 23. Bank height (tom bedzto top of ba*): h - I ('" i'/
24.Channel,oo"offiLo2yo)-Gentle(2to4Yo)VModerate{4tol0%)-Steep(>10%)
25. Channel sinuosity: _Straight V Occasional bends
-Frequent
meander _Very sinuous _Braided channel
Instrucfions for completioo of worksheet (located otr page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream ofthe
highest quality.
Totalscore{fromreverser, S} Comments: -'-, " d .:" l't "tl,''
_-
- n. - 'i';;:;;'i-'l'
I
Evaluator's Signature.
Ihis channel to be used only as a guide to assist landowners and enlironmental professionals in
gatbering the dxta
quality. The total
the United States Army Corps of Engineers to make a preliminary assessment of stream
tting from the completion of this form is subject to USACE approval and does not imply a
particular m or requirement. Form subject to change - version 06103, To Comment, please call 919-876-8441 x26
STREA}I QUALITY ASSESSNIE}{T WORKSHE ET
#CEARACTERISTICS ECORNGICN POINTRANGE
Cssttl Picdrort Mimrt&
j
Ulrl
?r,
IIha&
I Presence of flow / persistent pools in strerm
(no flow or saturation = 0: sttong flow = max points)0-5 a-4 0-5
.....-...
2 Evidencc of past human alteration
fextensive alteration :0: no alteration : max Doints)0-6 a-5 0*5
J
Riparian zone
Ino huffer = 0: contisuous- wide buffer : max noin8)0-6 0-4 0-5
4
Evidence of uutrient or chcmical discharges
(extensivc discharses = O: no discharges = max points)0-5 0-4 0*4
5 Groundwater discharge
(no discharse = 0: sDrinss. seeps, wetlands, etc. = max poins)0 -3 a-4 o-4
6 Presence of adiacent lloodPlaia
(ao floo&lair = & extersive floodplain = max points)a-4 0-4 0-2
7 Entrcnchment / f,oodplaio tcccss
(deeolv entrencbed = 0: frequent flooding = max points)0-5 0-4 Q-2
8 Preserce of adjacent wctlalds
(no wetlands: 0; larqe adiacent wetlands : max poinB)0*6 8-4 g-z
9 Clraunel siruoaitY
{extensive chaonelieation = 0: natural nreander = max pointsi-0-5 CI-4 0-3
t0 Sediment inPut
(extensive deposition= 0; little or no sediment = max points)0-5 8-4 0-4
1t Sizc & diversity of chgnnel bed substrate
{fine. homosenous = 0: large. diverse sizs = max points}!.{Ar 0-4 0-5
F
F+
Fl
!e
t{v)
l't
F
l2 Evidence of cbarnel incision or widening
f&eolv incised = 0: stable bed & banks : max poinBi 0-5 0-4 0-5
l3 Presence ofmajor balk failurcs
{severe erosion = 0: no erosion, stable banks: rnax poinB)0-5 0-J 0-5
l4 Root deplh and density on banks
(no visible roots = 0; dense roots throu.qhout = max points)0-3 0-4 0-5
l5 tmpact by agriculture, livestock, or limber production
{substantial impact :0: no evidence: max poinr)0-5 o-4 0-5
16 Presence of riffle-pool/ripple-pool compkxcs
(no riffles/ripples or pools : 0; well-developed : max points)0-3 0*5 0-6
l7 Habitat complexitY
{little or no habitat: 0; frequent, varied habitats : max points)0-6 0-5 0-6
a1 -
I8 Canopy coverage over streambed
{no shading vesetation : 0: continuous canorry = max ooints}
0-5 0-5 0-5
i{,
l9 Substrate embeddedness
(deenfu embedded = 0: Ioose structure = max)NAI 0*4 t-4
).(,o-;ot{!0
20 Presmce of streasr invertebrates (see page 4)
{no evidence = 0: common. numerous types = max points)0-4 0-5 o-5
21 Prcserce of amPbibieos
{no evidence:0; commou, numerous types = m4x PC!nts}-
0-4 o-4 0-4
'r1 Preseme of fish
{no eviderrce:0: common. num€rous tyres = rnax poinlg}0-4 &*4 0*4
23
Evidence of wildlife use
(no widence = 0: abundant evidence = max points)0-6 (}-5 0-5
To*rl'Potolskdbk w,rffi,.,1e
TSTAL SCORE {als* entef o* firstpgel
' flrc't aharaJtgr;)tiei lri n,-\t l>sessed in ;oa:lai iireams
NC DWO Stream Identilication Form Version 4.ll
Date: lo {Zt I 1u7 proiecusite: [f k( Qfr,r-atitucre:fi1 3{ U.di
Evaluator: J .rl1f U--County: Va*auoo t-onsitude:Jl7 i:l *] O
Total Points:
Stream ls at least intermittent ?2,
if > 19 or perennial if > 30- ) -/
Stream Determination (cir9!e one)
Ephemeral lntermittent (erenh$F
other Z#?> S ':? Yq:?
e.g. Quad Name:
A. Geomorpholoqy (Subtotal= lY Absent Weak Moderate Strong
1' Continuity of channel bed and bank 1 2)3
2. Sinuosity of channel along thalweg U 1 a
3. ln-channel structure: ex. riffle-pool, step-pool,
rioole-oool seouence
n 1 2 o
4. Particle size of stream substrate 0 2 7
5. Active/relict fl oodplain I 2 3
6. Depositional bars or benches 0 2 J
7. Recent alluvial deposits 0 )2 2
8. Headcuts U ,l)2 2
9. Grade control 0 0.5 n 1.5
10. Natural valley 0 05 it,1.5
1 1. Second or qreater order channel No=0 /Yes =
artificial ditches are not rated: see d in manual
B. Hvdroloqv (Subtotal =
12. Presence ofBaseflow n 1 2 (r
13. Iron oxidizinq bacteria o 1 2 ?
14. Leaf litter tf's
1 0.5 0
15 Sediment on plants or debris n 0.5)L 1.5
16. Organic debris lines or piles 0.5 1.5
17. Soil-based evidence of high watertable?No=0)Yes=3
C ubtotal =
18. Fibrous roots in streambed J 2 I 0
'1 9. Rooted upland plants in streambed 2 2 1 0
20. Macrobenthos (note diversity and abundance)0 1'2 a
2'l . Aquatic Mollusks O.'t
.I
2 3
22. Fish {b'0.5 1 1.5
23. Crayfish 0 0.5 1i 1.5
24 Amphibians 0 0.5 1 15
25. Alqae t0'0.5 1 15
26. Wetland plants in streambed FACW = 0 75; OBL {1 .51 Other = 0
"perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
N DWO Stream ldentilication Form Version 4.11
Date: lo lZl 1 tt.'Prolecusite:./ f {"1 l!,Latitude: f, 1 ?i,
Evatuator: J ftC,Gounty: ,fuJA L *,rr*ronsitude: jt ll". j"3.
Total Points:
Stream ls at least intermittent t - (
if > 19 or perennrat i> 30' V) ' j
v
Stream D{ermination (circle one)
' Ephemeral lntermittent Perennial
other Lq3 5qt.i'* ";
e.g. Quad Namei
C
:'f ; (',": {'tI ;' L..j I\,/'r , I
,i
-/-- '\--.-..,.'\-)
artificial ditches are not rated: see discussions in manual
A. Geomorpholoqv (Subtotal =Absent Weqk Moderate Strong
'l a Conttnuity of channel bed and bank n 1"a 3
2. Sinuosity of channel alonq thalweq 0 i1 2 J
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool seouence
,/r\/0)!./1 2 3
4. Particle size of stream substrate n 1 2 3
5. Active/relict fl oodplain 16',i 1 2 -1
6. Depositional bars or benches ,0 1 2 3
7. Recent alluvial deposits fi 1 2
8. Headcuts '0.,'_l_".2 2
9. Grade control 0 0.5.'1 .R
10. Natural valley 0 . 0.5 1 1 5.:
1 1. Second or greater order channel No {0.Yes=3
B. Hydroloqv (Subtotal =
12. Presence of Baseflow 0 1 2 3
13. lron oxidizinq bacteria 0 1 2 J
14. Leaf litter '1.5 1 05 0
15. Sediment on plants or debris 0i NA 1 1.5
16. Organic debris lines or piles 0i 05 1 1.5
17. Soil-based evidence of high waler table?No=0,Yes=3
CB
'18. Fibrous roots in streambed J 2 1 0
19. Rooted upland plants in streambed 2 2 1 0
20. Macrobenthos (note diversity and abundance)l0 1 2 3
2l Aquatic Mollusks '0.i 1 2
22. Fish 0)0.5 1 1.5
23 Crayfish ir 0.5 1 15
24. Amphibians tt . 0.:1 15
25. Algae n 0.5 1 1.5
26. Wetland plants in streambed FACW=075; OBL= 1 5 Other.=0
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes.
| )(
fot". c k,r,,, i
j.,rf..: .:. : 1 t't- , ^-' !' 'i !
't
,,' t,'t - d
Sketch:
.^1
NC DWO Stream Identification Form Version 4.11
Date: to tt"t i t ".?Projecusite: Ei * ,"1 f ir,n Latitude jf 3i- i*4,5?
Evaluator: ). rt.,lr.. .,^County: !r'q lqq :A tongitude: Jpr i;!. yrit
TotalPoints:
Stream rs at least intermittent 1 "i"i > 19 or perennial if > 30* U./
Stream Determinattun(circle one)
Ephemeral. lntermitteS Perennial
other 'Zii.
e.g. Quad Name:
ti t.i;-f
'l
artificial
A. Geomorpholoqv (Subtotal =Absent Weak Moderate Strong
1" Continuity of channel bed and bank 0 1 2 J
2. Sinuosity of channel along thalweg 0 1 2 3
3. ln-channel structure: ex. riffle-pool, step-pool,
rioole-oool seouence U 1
,U
5
4 Particle size of stream substrate 0 2 3
5. Active/relict fl oodplain 1 2 J
6. Depositional bars or benches 1 2 3
7. Recent alluvial deposits 0 1)2 J
8. Headcuts 0 rr'i,J/2 3
9. Grade control 0 0.5 (1.5
10. Natural valley 0 05 1
1 1. Second or greater order channel .No=0 Yes=3
!d see orPgus;rlxrs rn manual
B. HydrologV (Subtotal= \,5 )
12. Presence of Baseflow U 2 c9/
13. lron oxidizinq bacteria 0 2-J
14. Leaf litter 1.5 'f (0.,n
15. Sediment on plants or debris 0 t 0.5 1.5
'16. Organic debris lines or piles 0 {o's}1 1.5
17. Soil-based evidence of high water table?No=0 ]Yes=3
C.B Subtotal =
18. Fibrous roots in streambed J 2 1r!0
'1 9. Rooted upland plants in streambed J 2 U
20. Macrobenthos lnote diversity and abundance)0 2 J
2l Aquatic Mollusks 0 2 J
22. Fish 0 05 1 1.5
23. Crayfish 0 0.5 '1.5
24 Amphibians 0 .0-5 1t 1.5
25. Aloae i n 6'x. '1 1.5
26. Wetland plants in streambed FACW = 0.75: oBL j t .51 other = o
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
'--^- --' ' "'- ; '" '- ?
, . ):; {
h'.'' /
L -/i,-,,
ffi$
Provide the
: ,t 1''",
T-]SACE AID#DwQ #Site #_ (indicate on attached mapr
STREAM QUALITY ASSESSMENT
following informatiotr for the stream reech und€r assessment:
t. Applicant's name: 1., ''2. Evaluator') , ,^l"i c,^
3. Date or"ouluurirn llf I , ! I Y' 4.Timeof evaluation:
5. Name of sffeam: Ll 4 ,'7gr1,7;{ f ,'t :..6. River basin: /,/{ up' 11' t1,tr\l"'
7. Approximate drainage area: q tLc,crii, i 8. Stream ord.,, /!'-
9. Length of reach evaluated: (-,' ' : 10. Counry : h/ /J f a ql ,;
l1.Sitecoordinates(ifknown):preferindecimaldegrees.12.Subdivisionname(ifany):-
Latitude(er 34872312): 't;'i 7 Longitude (ex -77 55661 I i: ' i I ;? ' l'1/\
Method location determined (circle): 16l Topo Sheet Ortho (Aerial) Photo/GIS Ottrer GIS Other
l3.Locationofreachunderevalttati-on(notenearbyroadsandlandmarksandattachmapidentifringstream(s)location):-
1.{. Proposed channel work (if any): r'- lr ,-4.
15. Recent weather conditions: (, ,,'{ ,'' ''
WORKSHEET
16. Site conditions at time of visir: fl*'r*o
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed _(I-IV)
18.Isthereapondorlakelocatedupsheamoftheeva[uationpoint?YES/6[fyes'estimatethewatersurfacearea:-\
19. Does channel appear on USGS quad map? YES {S 20. Does channel appear on USDA Soil Survey? YES J:id
21. Estimated watershed land use: 7o Residential S % Commercial % Industrial /(x agricuttural
fu yoForested _o/"Clearod / Logged _% Other 1
22. Banktuli width:Z 23. Bank height (from bed to top of ba*): I "2
,/
24. Channel slope down cey,er of stream:
-Flat
(O to 2o/o)
-Gentle
(2to 4o/o)
-Moderate
(4 to l0%) y' Steep Pfi%)
25. Channel sinuosity: / Straight
-Occasional
bends
-Frequent
meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a sheam of the
highest quality.
Comments:
4iZ,r *..., i I
Total Score (from reverse):_
- - ;' -lth-taL
Evaluator's Siguature
This channel evaluation formj6 intended to be used only as a guide to assist landowners and I professionals in
gathering the data requ the United States Army Corps of Engineers to make a preliminary assessment of slream
quality. The total ing from the completion of this form is subject to USACE approval and does not imply a
particularmitigationratioorrequirement. Formsubjecttochange-versionC6/03. ToComment,pleasecall 919-876-8441 x26
STREA},I QUALITY ASSESSNIE}iT WORKSHEET
#CIIARACTERISTICS DCOXDCIO}{ POIN? RANGE
Corstd ?ic&rioxi Mooateta
rl
UF'w
)xHtst
F{
1
Prescrce of llow / persistent pools in stresm
(no flow or saturatioil = 0: strong flow = max points)0-5 0-4 0-5
z Evidence of past humar alteratioo
{extensive alteration = 0; no alteration = ryqL pe!!tsl-0-6 0-5 0-5
J Ripariac zone
{no buffer = 0: contiguous, wide buffer : rnax points)0-6 0-4 0-5
4 Eviderce of nulrient or chemical discharges
(extensive discharges = 0; no dischargeq = SEI nqtnE)
0-5 a-4 0-4
5
Groundwater discharge
{no discharee = 0: sorinss. seeps. wetlands, etc" -- max poir*s)0-3 0-4 0-4
6 ?resence of adjaccnt llmdPlain
lno floodolain = 0: extensive floodplain: max Foints)
a-4 0- Ji 0-z
7 Estrenchment I floodPlain aceess
(deeply entrenched = 0; frequent floding = ma!( po!!tsl-0-J 0-4 t*2
I Presence of adiecent wetlands
(no wetlands:0: large adiacent wetlands = max pointsi 0-6 g-4 a-2
9 Cbannel sirucitY
fextensive chatnelization = 0: natuml meander = ma-r pointq)0-5 o..4 0-3
t0 Scdimeut inPui
{extensive deposition= 0; little or no sediment = max points)0-5 0-4 0-4
II Sizc & diversity ofchanoel bed substrete
(fine- homoeenous = 0: taree. diverse sizes: max points)a*4 0-5
l'tirHrlB
!B
Cr.
ta1
12 Evidence of charnel incision or wideniug
fdeeolv incised = 0: stable bed & banks : max point)o-5 0-4 0-5
t3 Preseuce ofmajor bark failurs
{severe ero$ion : 0: no erosion. stable banks = ma,r points}0-5 0-5 0 *5
l4 Root deptb and densitY otr btnks
(no visible roots = 0: dense roots thro&ghout = max points)0-3 6-4 0-5
l5 lmpact by agriculture, livestock, or timber productior
tsubstantial imoact:O: no evidence = max poinB)0-5 0-4 0-5
Fr
?1
*
t6 Presence of riflle-pooVripple-poot complexes
(no riffles/ripoles or pools: 0: well-developed: mat points)0-3 o-,0-6
l7 Habitat comPlexitY
(little or no habitat: 0: frequent, varied habitats = max points)0-6 g-6 0-6
l8 Canopy coverage over streambed
Ino shadine veseiaiion = 0: continuous canoDv = max poin8)0-5 0-5 0-5
l9 Substrate embeddedncss
(deeolv embedded = 0: Ioose structure = max)0-4 0-4
),ft
ohIox,e
20 Presesce ofstre*m invertebrates (see page 4)
fno evidence: 0: common, nurnerous types = max points) -
0-4 t)-5 0-J 1..
:2t Prescrce of amPbibiens
(no evidence:0: mrmnon, rum€rous rypes = ma:( po!nts)-0-4 o-4 0-4
,,,Prescnce offish
ino evidence:0: common, num€rous types: rn'ax poiots) ,fi-4 e-4 o-4
23 Evidence of witdlife use
fno evidence: 0: abundan! evidence: max poinls)0-6 0-5 0-5
?oAf Pdr&Pocailk IB rst!
TOTAL SCORE (also anter on first page)
' f hc.l iirarei:tcrisiie s ara n,)i asstj)sed in ioastal -.',rciil.ns
v\'t ""4 1',
NC DWO Stream ldentilication Form Version 4.11
Date: p l;:, iftt ProjecUSite.,,,l j i, { i-ri Latitude:lv i i'litt?i{iDi
Evatuator: J ,-riU L-,.county: it!* ita,.t u..c tongitude: J f :^;_ Jib .-,'a,i
Total Points: .r -,,/Stream is at least intermittent ) ( ',t .
if 2 19 or oerennial i> 30* I ) ' ' '
ptreamQq{erm ination (circle one)
/Ephemerf lntermittent Perennial
^A,tether 7'9'l S5t,;l L
e.g. Quad Name:
A. Geomorphology (Subtotat= \U )Absent Weak ModgJate Strong
1" Continuity of channel bed and bank U 1 ,)3
2. Sinuosity of channel along thalweg 0 I p)J
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool seouence 0 'l;2 J
4. Particle size of stream substrate 0 1 2 2
5. Active/relict fl oodplain tt 2
6. Depositional bars or benches U 2
7. Recent alluvial deposits 0 1 2
8. Headcuts 1 2 3
9. Grade control 0 i 0.5 1 15
10. Natural valley 0 0.5 1 '1.5 ,
1 1. Second or greater order channel No -- 0l Yes=3
artificial ditches are not rated; see discusyns in manual
B.Subtotal=
12. Presence of Baseflow A 1 2 3
13. lron oxidizing bacteria \0/1 2 3^
14. Leaf litter 1.5 1 0.5 (o)
15. Sediment on plants or debris 0l 05 1 'l.5
16. Organic debris lines or piles 0 -3 /0.5 1 15
17. Soil-based evidence of high water table?No/= Q,' v'Yes=3
C.Subtotal=
18. Fibrous roots in streambed J 2 LU 0
19. Rooted upland plants in streambed a 2 1)0
20. Macrobenthos (note diversity and abundance)I0j 1 2 3
21. Aquatic Mollusks i0;1 z 2
22. Fish '(q 0.5 1.5
23. Crayfish 0 0.5 1 '1.5
24. Amphibians 0 0:5 (1t 1.5
25. Algae fif 0.5 1 1.5
26. Wetland plants in streambed 'r FACW; 0.75; oBL = 1 5 other = o
*perennial streams may also be identified using other methods. See p. 35 of manual. \,z,
Notes:
Sketch:f', IL{itr,':'' '' l 7^/ ' ,.':.'t,.. -. o , nr"4'-'*'7 ,
NC DWO Stream ldentilication Form Version 4.11
Date: [r;!r,[;ii Latitude: 0i Se (i.5, l),i,
Evaluator: . ). .\E,-^-.-County: k,,1.,,,, g,,,,
Tota! Points:
Sfream is at least intermittent 4 il
if > 19 or oerenniat if > 30' D'( /
Stream Determ i natioB4qircle one)
Ephemeral zl nterm ittenU Peren n ia I
46;, t'a"- aaOther U', ,r'. ','i'
e.g. Quad Name:
A.IUIU Subtotal= !Absent Weak Moderate Strgng
1" Continuity of channel bed and bank 0 2
2. Sinuosity of channel along thalweg 0 1 2 3,
3. ln-channel structure: ex. riffle-pool, step-pool,
riople-oool seouence 0 1 o J
4. Particle size of stream substrate 0 5
5. Active/relict fl oodplain 0 1 2 J
6. Depositional bars or benches ,{0)2 3
7. Recent alluvial deposits 0 2 5
8. Headcuts 0 !1.:2 a
9. Grade control n J. U,1 't5
10. Natural valley U 05 1 i1 5l
1 1. Second or qreater order channel lNo=0 Yes=3
artiflcial ditches are not rated see discussions in manual
Subtotal - :!
12. Presence of Baseflow
ubtotal =
Sketch:
13. lron oxidizino bacteria
15. Sediment on plants or debris
16. Organic debris lines or piles
17. Soil-based evidence of high watgr table
18. Fibrous roots in streambed
19. Rooted upland plants in streambed
20. Macrobenthos lnote diversity and abundance)
2l Aquatic Mollusks
24. Amphibians
26. Wetland plants in streambed FACW = 0.75; OBL =i1 .5 Other = 0
-perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
i t:.
'.
i ^;a1
Site #_ (indicate on attached rnaplUSACE AID#DwQ #
STREAM QUALITY ASSESSMf,NT WORKSHEET
Provide the following information for the streem relch under assessment:
t. Applicant's nu*", lJl-- L- 2. Evaluator's n*n*, )- ' 44,'*
3. Date of evaluation: la I ,t :. ,'
5. Name of stream: \.s!'i't\4,..,. L i{ "
4. Time of evaluation: I 1; 2a-
6.River aurat /0,'t {i4tr
7. Approximale drainage *ru' 5-
" ". ' {8. Stream order:
9. Length of reach evauated' J0 (;: i 10. Counry:rrlrta I ri,
I l. Site coordinates (ifknown): prefer in decimal degrees 12, Subdivision name (if any
Latirude(ex 348723t2): b/ 's6 ,'1:a? ?q Longitude (ex -:77 556611\:. / ? .", i , I l i
Method location determined (circle): ef$ Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Orhcr-
13.Locationofreachunderevaluation(notenearbyroadsandlandmarksandattachmapidenti!ingstream(s)location):-
t" I I
14. Prooosed channel work (ifanv): .io,^-',
15. Recentweatherconditist5l J O tl-t /"4,'rt, .QA b."q I k l''irS
16. Site conditions at time of visit | ( k.. /r{ - '/O'i-I
17. Identify any special waterway classifications known: _Section 10
-Tidal
Waters Essential Fisheries Habitat
Trout Waters _Outstanding Resource Waters
-
Nutrient Sensitive Waters
-Water
Supply Watershed
-(I-IV)18.IsthereapondorIakeIocatedupstreamoftheevaluationpoint?YES@Ifyes,esrimatethewatersurfacearea;-\z-
-\19. Does channel appear on USGS quad map? YES LO-; 20. Does channel appear on USDA Soil Survey? YES
-N9-
1
21. Estimated watershed iand use:
-7o
Residenrial 04 Commercial ]0 Z tnaustriat
-%
Agricultural
, -t A y"Forested
-o/a
cleared I Logged
-%
other (-)
22. Banktull width:
.L
23. Bank height (fiom bed to top ofbank):/- L'
24. Channel slope down center of stream:
-FIat
(0 to 2o/o)
-Gentle
(Zto 4%) ./ Mod.rut" (4 to l0%d
-Steep
(>10%)/
25. Channel sinuosity: _straight r,/ Occasional bends Frequent meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classi{ication, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), tIe stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a skeam of the
highest qualiry.g_Total,Score. (from reverse):
- j:&--lrl-irr.-.r-ru-co* "o*, Sl, n, ^- '/ ,, *! /,,r,, ,. ., f An L,/Sl-
Evaluator's Signa
This channel eva
gathering the data
quality. The
intended to be used only as a guide to assist landowners aud dnvironmental professionals in
by the United States Army Corps of Engineers to make a preliminary assessment of stream
resuiting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version 06103, To Comment, please call 919-876-8141 x 26
STREA}I QUALITY ASSESSNIE:.iT WORKSHEET
#CIIANACTERISTICS ECOREGION POINT RANGE SCOR-ECoostalPicdarout.lloanah
.l
uF'a
j
IJl{
F{
I Presence of flow / persistent pools in stream
{oo flow or saturation = 0l strong flow = rnax points)0-5 o-4 o-5 i
-2 Evidence of past buman alte ratioq
(extensive alteration = 0t no alteralion : rtix pglltsl 0-6 0-5 0-5
3 Riparian zone
{no buffer = 0: contieuous- wide buffer: max points)0-6 0-4 0-5
4 Evideree of nutrient or chemical discharges
(extensive discharges = 0; no discharges = max points)0-5 0-4 0-4
5 Croundwater diseharge
(no discharse = C: sorinss" seeps. wetlands, etc- = max points)0-3 a-4 0-4
6 Prcscnec of adjacent floodPlain
tno floodolain = {L extensive floodolain = rnax points)a*4 0-4 o-2
7 Entrenchmcnt / lloodPlain access
(deeolv entrenched = 0: tequem flmding = max points)0-J 0-4 8-2
I Prcseoce of adjaeent wetlalds
(no wetlands = 0: Iarqe adiacent wetlands = max points)0-6 q-4 a-2
I Chaunel sinuositY
{extensive channelization = 0: natural meander = max points)0-5 0-4 0*3
t0 Sediment inPut
(extensive deoosition= 0: llttle or no sediment = max points)0-5 0-4 0-4
lt Size & diversity of thanncl bed sulstrete
{fine- homosenous = 0: larse. diverse sizes = max points)o-4 0-5
i't-Fl
,e
Frt)
F
1..g
i*.
l2 Evidence of ehannel inckiou or wklening
fdecotv incised = 0: stable bed & banks : max poinB)0-5 0-4 0-5
I3 Preseace ofmajor bash failurcs
{severe erosion = 0: no erosion. stable banks: max points)o-5 0-5 0*5
l4 Root deptb end densitY oo batrks
{no visible roots:0: dense roots throughout = max poinB)0-3 0-4 &-5
l5 tmpaef by agriculture, livestoek, or timbcr productioo
{substantial impact =0: no evidence = max poinls)0- 5 0-d 0-5
l6 Prcsence of rilfie-pooUripple-p<nl eompkxes
{no riffles/. ripples or pools : 0; well-developed = mar po1!!!}-0-3 o-5 0-6
l7 Habitat eomPlexit'
{little or no habitat = 0: Aequenl varied habitats = max points)0-6 0-6 0-6
l8 Canopy covcrage over streambed
(no shadine vegetation = 0: continuous canopy = max points)0-5 0-J o-5
l9 Substrate embeddedness
(deeoh embedded = 0: loose stmcture = max)NAI.a-4 0-4
7"t,oJoH*
2A Presence ofstream invertebrates {see page 4)
fno evidence: 0: common. numerous types = ma,x points)0*4 0-5 0-5
21 Presence of amphibians
(no evidence = 0: common, numerous ryp€s = ma:< points)0-4 0-4 a-4
17 Prescnce offish
{no evidence:0: commoo, numqrous typ€s = max points)0-4 0-4 s-4
23 Evidence of wildlife usc
ro evidence = 0: abundant evidetce = max 0-6 0-5 0*5
?@tPohtsPos$bl le...t; i: . .;.r:..'@.,,:l'=:,:I08,:
TOTAL SCORE (also enter o* firstimge)
NC DWO Stream ldentilication l'orm Version 4.
Date: /6 it',-{ ! ;
ta_Latitude: 'l'
-_, r:
Evaluator: \ /a .; t ,\) ' t (i.'t.-Longitude:i, !L it
Total Points:
Stream rs at teast intermfttent lL i,l
if > 19 or oerenntal if > 30" J \
Stream Determ i nation (cjrcle-oae)_
Ephemeral lntermittenf PerenniSl
A. Geomorpholoqv (Subtotal - " .' "; t.:Absent Weak Moderate Strq-ng
1" Continurty of channel bed and bank 0 2 'i3,1
2. Sinuositv of channel alono thalweo 0 2 i5)
3. ln-channel structure. ex. riffle-pool, step-pool,
rioole-oool seouence 0 2 6)
4. Particle size of stream substrate 0 1 2 .3)
5. Active/relict floodolain 0 (12
6. Depositional bars or benches 0 i2.t'2
7. Recent alluvial deoosits U 2 3
8. Headcuts 0 2
9. Grade control 0 0.5 1 15
10. Natural valley 0 0.5 '1 1.5
1 1. Second or qreater order channel No=0 Yes j 3;
- artrficral drlches are not rated. see dislusgrons in manual
B. Hvdroloqv (Subtotal = 5.5 )
12. Presence of Baseflow 0 2 @
13. lron oxidizino bacteria /;o)
1 2 J
14. Leaf litter T5 (1)0.5 0
15. Sediment on plants or debris 0 '\ 0.5)1.5
16. Organic debris lines or piles 0 0.5 1/1.5
17. Soil-based evidence of high water table?No=0j Yes=3
c.ts
18. Fibrous roots in streambed J 2,t 1
19. Rooted upland plants in streambed (3',2
20. Macrobenthos (note diversity and abundance)U 1i 2
21. Aquatic Mollusks ;n
1 2 2
22. Fish 0 (6s,:1 1.5
23 Cravfish U 'os
1 1.5
24. Amphibians 0 0.5 1 .E
25 Alqae tt 0.5 1 1.5
26. Wetland plants in sireambed FACW = 0.75; OBL =(1 5i Other = 0
*perennial streams may also be identifled using other methods. See p. 35 of manual
Notes:
USACE AID#DwQ #
, 4, LAOa%'l ! ?v t
Site #_ (indicate on attached mapI
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following infonnation for the strc.m rclch under assessment: \ ,
l, Applicant's n ^"; Ef=)t 2. Evaluator's nu^", J '/ul"i("',*
3. Date of evaluation: i.::l ' .' I lL i 4. Time of evaluation:
-
l/-. -1 t'*'
5. Name of rt "*r,-!4ut-t'1 lr q*i^ 6. River u*in' //r, t.i ,Z iq,r
I ^*,7. Approximatedrainage...",,, J' "'8. Stream order: 3'"'
-
10. CounL!= h/q'/'1 t4 4Q.-_---=--v9. Length ofreach "ualrat"d,
1 f /
I l. Site coordinates (if known): prefer in decimal degrees.12. Subdivision name (if any):
Latitude(ex 348723t2): .t, f *;;, lb, {*;: {Longitude (ex -77 55661l): '','* , l"ij- )l , f Z S I
-r1\Method location determined (circle): 'pPS) Topo Sheet Ortho (Aerial) Photo/GiS Other GIS Other
| -\=.4 -^^r- - -r r--r-^-r-- ^-r -a^^L --^- tr--LrL :,-13. Location of reach under evaluatiofi (note nearby roads and landmarks and attach map identifring stream(s) location):_
L)r,r, ;' i.i t 1:i, y't !i' :':, t i - z t.t . -o
.,, it, Z t 'i $ \,1; ,:..',
14. Proposed channel work(if an)1: /w t ^ v l".t .,-.{ i"-64pL "...1 )
-t -/
['4. rrOpOSeO Cnannel WOfK (lI Any): f w v*'..i{ l'"! rt!:\ :':- . r aLa
15. Recent weather conditions: 9*, {4;'a , !,1,,-i '' "' i /{ ,'?') t
m
16. Site conditions at time of visit ' f-to,-,{. | /'-;,,t.,-f '{1'!rr.,
I7. Identify any special waterway classifications known: _Section l0 _Tidal Waters _Essential Fisheries Habitat
-Trout
Waters _Outstanding Resource Waters
-
Nuhient Sensitive Waters
-Water
Supply Watershed _(l-lV)
'- - )\ty"r,estimate the water surface area:-18. Is there a pond or lake located upstream of tKvaluation point? YES CO
19. Does channel appear on USGS quad mapf (Ve! NO 20. Does channel appear on USDA Soil Survey? YES NO
21. Estimated watershed land use: _% Residential
, i,Cy,For"rr"d
oZ Commercial 1-Q-o/olndustrial {0 r/o Agricultxal
_% Cleared / Logged _7o Other 1
22. Banktult widrh: {- 1 -(, i 23, Bankheight(frombedtotopofbank): /-Z
24. Channel slope down center of steam:
-FIat
(0 to T/o) -y4entte (2b a%)
-Moderate
(4 to l0%)
-Steep
(>107o)
25. Channel sinuosity:
-straight -Occasional
bends ;2aitrequent meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the skeam flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
, (from reyrse):S 4€ s,rt
4o /'l,r"r.rd ( krl ,Comments:
Lu"4 t
ZE
"!xJtu1--*tu---Jt "q3""
il' , r'-'1
Evaluator's Signature,-"' .,' .b"'"' (*--' "Date loltrit,z
-
This channel evaluatibt)foqrrf is intended to be used only as a guide to assist landowners and enviroirmental professionals in
gathering the data ,"("{"A by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does nof imply a
particular mitigation ratio or requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x26.
STREA.\T QL ALITY ASSESS[IE\T \I'ORKSHE ET
#CIIARACTERISfiCS f,COXE€IOX POIIVT AATGB SCORECo*stal ak&nei hfimni:$i
i
U
(r,
ti(tsa*
I Presenee of llow / persistent pools in strcrm
(no flow or saturatioa = 0l strong flow: mat poinBi 0-5 a-4 0-5
L
2 Evidence of past human alteration
(extensive alteration:0; no alteration = max points)0-6 o-5 0-5
3 Ripariaa zonc
(no buffe,r = 0: contisuous. wide buffer: rnax poinls)0-6 o-4 0-5
4 Evidence ofnutrient or chemical dhcharges
(Extensive discharges = 0; no discharges = max points)0-5 0-4 0*4
5 Groundwater discharge
(no discharee = & sorinx- seeDs. w€tlands. etc. = max points)0-3 0-4 0-4
6 Prcsencc of adjaceat lloodplain
lao ffsodslain = 0: extensive floodtlain : max poinb)a*4 0-4 0-?
7 Entrenthmcnt I lloodplain access
(deeply entrenched = 0; frequent flooding = ma:t points)0-5 o*4 q-z
8 Prescace of {diacent wctlands
{no wetlands = 0: Iaree adiacenl wetlands : max points)0-6 8-4 o-?
9 C}auncl sinumity
(extensive channelization = 0: natural meander = max points)0-5 0-4 0-3
lo Sediment input
{extensive deposition= 0: little or no sediment = max points)0-5 0*4 8*4
ll Sizc & divcrsity ofcbanuel bed substrate
{fme. homosenous = 0: laree. diverse sizes = max points)&-4 0-5
F.tF'
Fl-B
f*arl
l2 Evirlence of channel inckiol or widening
(de$lv incis€d = 0: stable bed & banks : ma:c oointsl 0-5 o-4 0-5
t3 Preseece ofmajor benk failures
{severe erosion = 0: no erosion. stable banks: ma:i goints)0-5 0-5 g-5
t4 Rcot dcptb end densif on banks
foo visible rosts = 0; dense roots throu.ehout = max points)0-3 0-4 0-5
l5 Impacf by agricullure, livestoek, or timber productioa
tsubstantial impaci =0: no evidence = max points)0-5 a-4 0*5
l't
F
!e
l6 Presence of riffle-pooUripple-pool complexes
(no riffles/ripples or pools : 0; well-developed = max po!41!q)
0-3 0-5 0-6
l7 Habitat complexity
{little or no habitat:0: freouenl varied habitats = max points}0-6 0-6 0-6
l8 Canopy coverage over streambed
{no shadin-q vesetation = 01 continuous canopy = rnax points)0-5 0-5 0-5
l9 Substrate embeddedness
(deeph embedded = 0: loose structure = rnax)
LIAT,.0 -.4 0-4
>It
:.:oIt
EI
2A Presence ofstream invertebrat$ (see page 4)
(no evidence = 0: cornmon. numerous typ€s : max points)0-4 o-5 0*5
2l Prcsgnce of emphibieos
(ng evideace:0: common, num€roqs tyrs = man points)0-4 a-4 a-4
22 Prcscnce olfish
ino evidence:0; commtrn, numerous tyFS : max points)0-4 0-4 *-4
23 Evidence of wildlife use
no evidence = 0; abundant evidence = man
0-6 0-5 B-3
To{?t?ohts Fos&e ida ,i... ...,{{0
TOTAL SCORE (also enter oI! firstpgc)
' fhe-u cliarlotcri:tii:s ari n,.lt ass-:sed in ;oastli strgllllls
C
,/1-r-
artificial ditches are not rated, see discussions in manual
B. Hvdroloov (subtotal= q'I
NU DWO Stream ldentilication Form Version 4.11
Date:(oltrl tq Projecusite: Il d lL,,Latitude: 6 I Se tb. 5rci
Evatuator: J .tn* g.County: UA{aoao Longitude: 36 lt f;i- L
TotalPoints: f [r"
Strearn ls at least intermittent .l )if > 19 or oerennial if > 30*
Stream Determination (circle qne)
Ephemeral tntermittent fdid@ Other /SS S *cf "ae.g. Quad Name:
A. Geomorpholoqv (Subtotal =Absent Weak Moderate Strolng
1a Continuity of channel bed and bank 0 1 2
2. Sinuosity of channel alonq thalweq U 1 2
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool seouence 0 2 ,Q
4. Particle size of stream substrate 0 2 \i
5 Active/relict fl oodplain ,?2
6. Depositional bars or benches 0 I J
7. Recent alluvial deposits 0 2 3
8. Headcuts 0 2 5
9. Grade control U 05 1.5
10. Natural valley 0 0.5 1 1.5
1'l . Second or greater order channel No=0 YesF:
12. Presence of Baseflow 0 2 3"!t
'13. lron oxidizing bacteria {a 1 2 3
14. Leaf litter 1.5 \15 0.5
15. Sediment on plants or debris 0 \:0 5 1.5
'16. Organic debris lines or piles 0 d.5 41)1.5
17. Soil-based evidence of high water table?No=0 Yes {s}
C. Bio Subtotal =
18. Fibrous roots in streambed 3 lzl 1 0
l9 Rooted upland plants in streambed li3'2 1 tt
20. Macrobenthos (note diversity and abundance)0 1 Q 1
2l Aquatic Mollusks j.\
1 2 J
22. Fish 0 0.5 {'1i 1.5
23. Crayfish 0 05 1i 1.5
24. Amphibians 0 0.5 {T!1.5
25. Algae d0j 05 1 1.5
26. Wetland plants in streambed FACW= 0 75; OBL* 1 5j Other= 0
"perennial streams may also be identifled using other methods. See p. 35 of manual.
Notes:
Sketch:\/ ,t zft
-_.
l.:L l*-.".
'1"J
-/--
TJSACE AID#DWQ #
X.$," :; !)i,:,s
Site #_ (indicate on attached mapr
l. Aoplicant's n*n", /! €' L 2. Evaluator's name: J 'Lt, ,^**
3.Dateofevaluation: "i0i I i / l',', 4.Time of evaluation: I b ;)-5
5.Name orro"*n, 9W 6.River basint /'Ji,
STRf,AM QUALITY ASSESSMENT WORKSHEET
Provide the following information for thc strcam reach under assessment:
7. Approximate drainage i'te*l? .i+ i{' ',1 ,.i<-t, 8. Stream order: i
9. Length ofreach evaluated:10. Coun,y-: l*/c.1.:q a c
I l. Site coordinates (if known): prefer in decimal degrees.12. Subdivision name (if any):').
Latitude 1ex i4 872312)i ;' ( J- | i 7 ,. t ^' .;Longitude (ex -77 55661 li: lt" i /?,'f ,' l "'., ',i\,"'f,.'6
Method location determined (circle):
,l- 'r'r",.-, { i c5 o, " '., u'*'.{.. .f.i'f'r.e { '!.'., i] I ,
1'4. Proposed channel work (if any
15. Recentweatherconditions: J0nC Cat^ ,-
.fuatenql
krylS
16. Site conditions at time of visir , ( I I . ,
17. Identify any special waterway classifications known;
-Section
10
-Tidal
Waters _Essential Fisheries Habitat
-Trout
Waters
-Outstanding
Resource Waters _ Nukient Sensitive Waters _Water Supply Watershed _(I-lV)
ol/ut
18. Is rhere a pond or lake located upstream of tt5\atuation point? YES (fl)lf yes, eslimate the water surface area:-
19. Does channel appear on USGS guad^manZ $/ NO 2A.Doeschannel appear on USDA Soil Survey? YES NO
2l.Estimatedwatershedlanduse: l0 y.n.rXnriut -fYocommercial _-%lndustrial $ r/oAgricultutal
4norr"rr"a _%o Cleared / Logged _Yo Other 1
22. Banktull width: *)
23. Bank height (from bed to top of ba*1: f - L!
24.Channelslopedowncenterofstream:,-FIat (0to2o/o) {C"ntt"(2to4Yo:1
-Moderate(4to
10%)
-Steep
(>10%)
25. Channel sinuosity:
-straight
tlOccasional bends Frequent meander
-Very
sinuous
-Braided
channel
Instructions for completion of workshect (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregiou. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment ofthe stream reach under evaluation. Ifa
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in ihe character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream ofthe
highest quality.
Total Score (from reverse \r- 6 /Comments:
Evaluator's
This channel eva
gathering the data by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total Cl6re resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x26.
lr" d-r' Date 1o1 zt/ r ut
is inrended to be used onfy * " grla" *irr lnndown"rm
STREA.!T Q UALITY ASSESSNIE }{T \I'ORKSH E ET
#CHARACTERISTICS f,COXEGION.rOINT EAN6E.soCInECodrl&iod [Imatab
?H
Urt€a
H*tr
I Presence of llow / percistent pools in slreem
(no flow or saturalion = 0: strong flow: max points)0-5 0-4 0-5 )
_-.'_=-
-1 _ __-
I
I_"
2
{extensive alteratio.l:0; no alteration = miu( ptlts) -
Evidencc of past human alteration 0-6 0-5 0-5
-,
Riparian zone
lno buffer = 0; contisuous. wide buffer: max poin8)0-5 o-4 0-5
4 Evideoee of nulrielt or ehemical discharges
(extensive discharges = O; no discharges = ma,r points)0-5 0*4 0-4
5 Groundwetcr dischargc
(no diSctr,arse = 0l SOrings" seens. wetlands, etc- = max points)0*3 0-4 0*4
6 Prcsence of adjeccat lloodPlain
tno ffoodolain = 0: extensive floodplai$ = max poinB)a-4 0-4 0-2
7 Entrenchmeot / lloodPlaia atcess
f&eolv entrerehed = 0; Aesuenl flooding = max points)0-5 0-4 0-2
I Prescoce of adjecent setlands
{ao wetlands = 0: large adiacent wetlards = max points}0-6 o-4 o-2
9 Channel sinuositY
{exteasive channelization = 0; natural meander = ma.t poi*B}0-5 0-4 0-l
to Sediment inPut
(e$ensive deposition= 0: little or no sediment = max points)0-5 *-4 6*4
ll Sizc & diversity ofehanncl bed substrate
ftine. homosenous = 0: larse. diverse sizes = rtax poifis)0*4 0-5
ir
Fl*!e
:[i
€)
l2 Evidcnce of ehanncl iocision or wideniag
(decolv incised = 0: stable bed & banks : ma;r ooi*tsl 0-5 0-4 0-5
I3 Prescoce of maior benk feilurcs
{severe erosion: 0: no erosio*, stable banls = max points}s-5 0-5 0-5
t4 Root deptt and densitY on baoks
fno visible roots = 0: dense foots throughout = max points)0-3 0-4 0-5
t5 Impact by agriculture, livestock, or timbcr production
{$hstenfiet imnacl 4: rn evidence = max ooinls}0-5 0-4 0-t
t*
,1
16 Presence of riflle-pooUripple-poot complcxct
(no riffles/ripoles or Doots: 6; wsll-developed = max points)0-3 0-5 0-6
t7 Habitat complexitY
{little or no habitat = & frequent, varied habitats = max points)0-6 B-6 0-6 I
/-t8 Canopy eoverage over streambed
(no shading vesetation = 0; cootinuous caropy = max points)0-5 s-5 0*5
l9 Substrate cmbeddedncss
fdeeoly embedded = 0: loose structute = m&x)0-{0-4
*1uo
h]oHf;l
20 Prcsencc of stream invertebrate (se€ page 4)
(no evidence:0: common, numerous typ€s : max pointsJ 0*4 0-s 0-5
21 Prcserce of amPbibiens
(ao evidence = 0; cornmon, nuttlerouli rypes = max points)0-4 0-4 0-4
22 Prescncc of firh
{no eviderrce = G: cornmon, numerou$ types = max poina)0-4 9-4 s-4
23 Evidence sf wildlife use
(no eviderrce = 0; abundant evidence: max points)0-6 0-5 0*5
ftfilh&elodble Ie6 r,'l.til!,
TOT^AL SCORE (also enteroo firstFge).:)al i;l
- f hc;u iiiarlotcr;stics "tra n,-)l assc\ied in coasitti :'.riams.
NC DWO Stream Identification Form Version 4.1I
Date: l0 !-,ProjecUSite: l'/,i I
Evaluator: I County: Wa{Ar,**Longitude: :i.- i, f:.:).,:),
Total Points:
Stream is at least intermittent li ,'
if > 19 or perennial if > 30-
a
Stream Determination (circle one)
Ephemeral lntermittent Perennial
Other Zr.i- :i{
e.g. Quad Name:
ig
artificial ditches are not rated: see discussions in manual
I
C
A. Geomoroholoqv (Subtotal =Absent Weak Moderate Strong
'1" Continuity of channel bed and bank 0 1 :12 J
2. Sinuosity of channel along thalweg 0 1 '2)
3. ln-channel structure: ex. riffle-pool, step-pool,
rioole-oool seouence 0 1 2 5
4. Particle size of stream substrate 0 1 2 3
5. Active/relict fl oodplain 0 1 '2i J
6. Depositional bars or benches 0 1
*2
J
7. Recent alluvial deposits U 1)2 2
8. Headcuts U 1 2 ?
9. Grade control lt 0.5 4 15
10. Natural valley n 0.5 .D 1.5
1'l . Second or qreater order channel ,N6* 0 Yes=3
ts. Hvdroloqv (Subtotal= r-
12. Presence of Baseflow 0 /J
13. lron oxidizinq bacteria 0 1 2 .J
14. Leaf litter t.c '1 0.5 -0
15. Sediment on plants or debris 0 05 1.5
'16 Organic debris lines or piles 0 0_5 1 1.5
17. Soil-based evidence of higf water table?No=0 Yes=3
tstoloqv (Subtotal = r
18. Fibrous roots in streambed 2;1 U
19. Rooted upland plants in streambed J 2'0
20. Macrobenthos (note diversity and abundance)U 2 J
21. Aquatic Mollusks 0 2 J
22. Fish 0 05 1 1.5
23 Crayfish 0 0.5 '1.5
24. Amphibians 0 05 11 1E
25. Alqae 0 0.5 '1.5
26. Wetland plants in streambed FACW=0.75, OBL= 1 5 Other=0
"perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
,I
i , i. l, , t
i ,J
rl,
Site #_ (indicate on attached inaprDWQ #
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following iaformation for thc stream r€Nch underussessment:
1. Applicant's 2.Evaluator'sname: r ) . r*+eC
4. Time of evaluation:
5. Nameof stream: \1 n ,.,,.-.,( :. r-, it 6. River basin: ,.1'i t -.t /?;it{-
USACE AID#
ffi$
7. Approximale drainage "..u, | . 8. Stream order:
9. Length of reach evauated: i-l(l {r , I
I 1. Site coordinates (ifknown): prefer in decimal degrees.12. Subdivision name (if any):
Latitude(ex 348723t2): tsi <rb ;t-( , q fl I
Method iocation determined (circtf: ,{fg Topo Sheet Ortho (Aerial; Photo/GIS Other GIS Other
13. Location of reach under evaluaffi(note nearbv roads and landmarks and attach map identifuin
l0.Counq: dq fean4.,
\r
Longitude (ex -77 55661n; i h ! : ,: j - ""'
j' ,' 4
13. Location of reach under evaluafiof(note nearby roads and landmarks and attach map identiling stream(s) location):
3. Date of evaluation: !7 !; .'",'t;,;
14. ?roposed channel work (ifany):
15, Recent weather conditions: ','
''i I ; '1.; ' ''l . '-;"' l * '"i1
16. site conditions at time of, visit ; {--,-... . ''' ' ,' , i i .'
U
17. Identi! any special waterway classifications known;
-Section
10
-Tidal
Waters Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters
-
Nutrient Sensitive Waters _Water Supply Watershed (l-IV)/-'-_.
18. Is rhere a pond or lake located upsheam of the evaluation point? YES f,p)f yes; estimate the water surface area:
19. Does channel appear on USGS quad map? YES NO 20. Does channel appeiu on USDA Soil Survey? yES NO
21. Estimated watershed land use: % Residential oZ Commercial .i % Industrial , ?Li,/o Agticulttxal
'*l %Forested _YoCleued / Logged _% Other (
22. Banktull width: I 23. Bank height (fiom bed to top of ba*1: 'C- t
24. Channel slope down center of stream , ,rtf Ut (0 to 2o/o)
-Gentle
(2 to 4%:)
-Moderate
(4 to l0%)
-Steep
(>10%),/
25. Channel sinuosity: !,/ Straight _Occasional bends _Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sheam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
- j{ll( -_
Evaluator's Signa
This channel evaluation form_isintended to be used only as a guide to assist landowners atrd environmental professionals in
gathering the data requl.ced'iV the United Statrs Army Corps of f,ngineers to make a preliminary assessment of stream
quality" The total scofe resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigatdn ratio or requirement. Form subject to change -version 06103. To Comment, please call 919-876-8141 x25.
STR EA}I Q L:ALITY ASSESSNI E]{T \['ORKST{E ET
#CEARACTERISTICS ECOREGION POINT RANCE
Co*stal Picdaont Msurt!i!
-I
U-a
HF'&
Presence of flow / pcrsistent pools in str€rm
(no flow or sat$ation = 0l strong flow = rnax points)0-5 0-4 0-5
2 Evidence of past human alteraiion
(extensive alteration = 0; no alteration : max points)0-6 0*5 0-5
3 Riporiar zole
(no buffer = 0; contiguous, wide buffer = max points)0-6 Q-4 0-5
4 Evideoce of uutrient or chemical dkcharges
fextensive discharges = 0: no discharges = ma:t poinrs)0-5 0-4 o*4
5 Groundwater diseharge
{no discharge = 0l springs" seeps, wetllmds, etc. = max poinrs)0-3 0-4 0-4
6 Prcsencc of adjacent {loodPlain
lno floo&hin = O: extensive floodrt&in = max points)0-4 a-4 0*?
7
Eotrcnchment / floodPlain access
(deeply entrenched = 0; frequent flooding = max poinls)0-5 o*4 g-2
8 Prcseoce ofa jacent setlelds
(no wetlands = 0: larse adiacent wetlands = nrax points)0-6 o-4 a*2
9 Chaarel sinuositY
{extensive charnelization = & natural meander = malr points}0-5 0-4 o-3
l0 Sedimeot inPut
(extensive deposition= 0'. little or no sediment = max points)0-5 0*4 a-4
ll Size & divcrsity of chanael bed substrate
{Iine- hornoeenous = 0: laree. diverse sizes: max points}.XA+o-4 0-5
tlrHFI:*
E.€)
t{{
1..
l2 Evidence of channel incision or widening
fdeeolv incised = O: stable bed & banks : max ooints)
0-5 0-4 0-5
13 Presetce ofmsjor bank failures
{severe erosion = 0: no erosion. stable banks: max points}0*5 0-5 0-5
l4 Root dcpth and density on baaks
{no visible rools = 0: dense roots throughout = max points}0-3 0-4 0*5
l5 Impact by agriculture, livestoch or timber production
{suhaltial impact =0: no evidence = max poina)0-5 a-4 6*J
I6 Presence of riflle-pooUripple-pool eomplexes
{no riffles/riooles or pools = 0: well-develooed = ma.x points)0-3 0-5 0-6
t7 Habitat eomplexity
{little or no habitat: 0: fresuenl varied habitats : max roints)0-6 a-6 0-6 I
'/l8 Caoopy coverage over streambed
{no shading vegeialion = 0; eontinuous canopy = n:ax points)0-5 0-5 0*5
l9 Substrate embeddedncss
(deeoh embedded = 0: loose slructure = max)
g-4 0-4
>,(,or]otsg
2A Prcsence of stream invertebrater (see page 4)
(no evidence:0: cornmoo. numerous types = max points)0-4 0-5 0*J
2t Prescrce of ampbibirns
fno evidence:0: csnmon. numerous types = max points)a-4 0-4 B-4
,1 Presencc offisb
ino evidence:0: cornmoo, numerous types = max points)0-4 $-4 o-4
Evidence of wildlife use
(no evidence = 0: abundant evidence = max poirls)0-6 0-5 0-5
TelFotuefocdbh I&:,trffi ir&,
tTOTAL SCORE (alse @r ea fixtPge)
NC DWO Stream ldentilication l'orm Version 4.
Date: lc I ? i/ 1,1 ProjecUsite:f,/ I ,i /r_atitude: S / \C Zt ,(t
Evaluator: ),, ' (n; ,.County:iJ* fa+n*Lonsitude:jfoi iI 0i.':f
TotalPoints: lt.
Stream ls at least intermittent ( J "r:if2 19 or oerenntal i> 30" I I
Stream Determination (circle onel
Ephemeral lntermittent Perenn'i?l
other ? fl- i l il'Fi
e.g. Quad Namei
/L
A. Geomorpholoqv (Subtotal= i.Absent Weak Moderate Strqng
1a Continuity of channel bed and bank 0 2 ,/
2. Sinuosity of channel along thalweg 0 1 2 e)
3. ln-channel structure: ex. riffle-pool, step-pool,
riople-pool seouence 0 2 te,
4. Particle size of stream substrate 0 2
5. Active/relict fl oodplain 0 2 f3"t
6. Depositional bars or benches 0 !2.'
7. Recent alluvial deposits 0 2.!
8. Headcuts U J
9. Grade control 0 0.5 ik"'1.5
10. Natural valley 0 0.5 1.5
1 1. Second or qreater order channel No=0 Yes {3
artificial ditches are not rated: see discussions in manual
B. Hvdroloqv (Subtotal =
12. Presence of Baseflow 0 2 fr)
13. lron oxidizino bacteria '!Q.j 2
14. Leaf litter '1 .5,05 0
15. Sediment on plants or debris -0 0.5 1"1 1.5-
16. Organic debris lines or piles 0 0.5 r-, t 1.5..'
17. Soil-based evidence of high water table?No=0 Yesr3/
C. Bioloov (Subtotal=
18. Fibrous roots in streambed 3 2 0
19. Rooted upland plants in streambed "a 2 1 0
20. Macrobenthos lnote diversity and abundance)U ,2,J
21. Aquatic Mollusks .0 2
22. Fish U 0.5 1.5
23. Crayfish 0 05 1.5
24. Amphibians 0-.0.5 .1 15
25. Alqae 0 05 1 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 'l"gi Qfilgp = Q
*perennial streams may also be identified using other methods. See p. 35 of manual
Notes:
Sketch:
1',q '- {': i ,fr
USACE AID#DWQ #Site #_ (indicate on attached inap)
3, Date of evaluation:4. Time of evalwtion: ll t. (o
6.River a*rn, tUetJ q,U:f
-
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters Essential Fisheries Habitat
5. Name of strearn: {q u P; f Brq.u L-
7. Approximate drainage arcai t) t'0,1"'' i'hh4 { 6{i' - 8. Stream order, 7
-
9. Length of reach evaluated: fut tO. County: l,U2t ta Vtq
I 1. Site coordinates (ifknown): prefer in decimal degrees.12. Subdivision name (if any):
Latitude (ex 34 872312):
Mcthod location determined (circle):Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
(note nearby roads and landmarks and attach map identiling stream(s) Iocation):_
14. Proposed channel work(if any): lhy- Otiyr,r: itt;.'*
15. Recent weather conditions: .Sor',1g fei tr (aS',.* I *r""
16.Siteconditionsattimeofvisit: Stan/1q ,'/O'S I rlot7r*l {i"r-' rr':/:1,'t!/
21. Estimated watershed land use: _7o Residential
! 2 %oForested _o/o Cleared / Logged _% Other (
_Trout Waters _Outstanding Resource Waters _ Nukient Sensitive Waters _Water Supply Watershed (I-ff)
18. Is rhere a pond or lake located upstream of thVqluation point? YES'9lf yes, estimate the water surface jrrga\-
19. Does channel appear on USGS quad mapz $d NO 20. Does channel appear on USDA Soil Survey? @9 wO
o/o Commercial jif % Industrial ,?C_o/o Agricultwal
22. Banktull width: t/,'23. Bank height (from bed to top ofbank):. 5 '
24. Channel slope down center of stream:
-Flat
(0 to ZYo) -vl}entle {Zto 4o/o)
-Moderate
(4 to l0%)
-Steep
(>10%)
25. Channel sinuosity:
-shaight
Occasional bends --yflrequent meander
-Very
sinuous
-Braided
channel
Instructions for completioa of worksheet (located otr page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows ftom a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a sream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse), [4
-]
Comments:
) /";?/'-''n'f I ; utEvaluator's sieruru"" /-t .!'rn| F{ ortu {i,i ',
fhischannel.,,t,"tipffiedonIyasaguidetoassistlandowners,od.,,i.ffi
gathering tne data/eqfrired try the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Forrn subject to change - versicn 06/03. To Comment, please call 919-876-8441 x25.
STREA}T QL ALITY ASSESSNIE).iT WORKSHEET
#CIIARACTERISTICS ECOREGION BOIF{T RAITTGE SCORECffdd?is&fttrt irloortde
j
trtd)
lrang
1
Preserce of flow I pcrsistent poots in strerm
{oo flow or safuration: 0: strong flow: rnax points)0-5 0-4 0*5
2 Evidcnce of past human alteration
(extensive alteratirm = 0: no alteralion = max ooints)0-6 0-5 0-5
l Riparian zoae
(no buffer = 0'. coatiguous. wide buffer: max poinls)0-6 0-4 0-5
4 Evideoee of nrlriert or chemical dischargc
{extensivs dlscharses = 0; no discharges = max poinrs)0-5 0-4 *-4
5 Groundwater discharge
(no discharse = 0: springs. seegs, ur,etlands, etc. = max points)0-3 0-4 o-4
6 Prcscnce of adjacent tloodPlain
trto ffoodtlaiE = & a(tensive floodDlain : max Boinb)
0-4 0-4 o*2
i.,
la-
7 Ertrcnchment / lloodPlaia access
ideertv entrenehed = 0: frequenr flooding = max points)0-5 0-4 0-2
8 Prescccc of a-djecent wctlaltds
{n* wetlands:0: larse diacent wetlands = max points}0*6 0-4 a-2
9 Cbanncl siouositY
{extensive chalrnelization = 0; natural meander = max poinB)0-5 &*4 0-3
l0 Scdimett ioPui
(extensive deposition= 0', little or no sediment = max points)0-t &-4 g-4
lt Size & divcrsity of ehanncl bed substrete
fIine. homosenous = 0: Iarge. diverse sizes = max poinls):!r&[l .,-.''o-4 s-5
>f{FFlha,e
rF.ra
i.(
t{
r{
12 Evidcnce of channel ilcisi,on or ridcning
i&colv furcised = 0: stable bed & banks : ma:r pointsl 0-5 0-4 0-5
I3 Presctce ofm*jor bark failurcs
{severe erosion: 0; no erosioo, stable banks: max poina}O;5 0-5 0-5
t4 Root depih ead density oa barks
{no vkible roots: 0: dense roots throughoBt = max points)0-3 a*4 0-5
l5 lmpact by agrkaltore, livestotk, or timber productioa
(substantial imaact:ft no evi&nce -- max poinls)0"5 o-4 0-5
r6 Presence of riflle-pooUripple-pool eomplexes
(no riffles/ripples or Dools = Q; !rysll-developed = max points)0-3 0-5 0-6
t7 Habitat complexitY
(little or no habitat: 0; frequent, varied habitats = max points)0-6 &-6 0-6
r8 Canopy coverage over streambed
(no shading vegetation = 0: continuous canopy = max points)0-5 0-5 0-5
l9 Substrate embedddness
(deeolv embedded = 0: Ioose structure = maa)0-4 0-4
.?.ri
FloFn
2A Presence ofstream invertebrates (see page 4)
fno evidence:0: aommon. numerous tYDes : max points)0-4 0-:3 0*5
2t Prese*ce of amPbibiars
(no evidence:0: coarmon, rumercus typ€s = ma< points) ,
o*4 {}-*0-4
,)Prcsclce offisb
incl eviderce:0: commor. num€rous types: rnax points)o-4 &*4 0*4
23 Evidcncc of wildlife sse
{no evidence : B: abundant evidence: max roints)0-6 s*J 0-5
?itetlsirBrFoilitb tds
f;$tA,L SCCXE {als*r ent+r e* SrstFSs}
" f hc-c cltaractcr:stiu; are rr,rt assi5sed in ;oasiar i'.rsims
4 I s, brs,- 6 . 1-cgv Sfl toe
!t.;-
,.t;;
NC DWQ Stream ldentitication Form Version 4.11
tatitude: f,l 36 Zp
Evaluator: ) ,L' ,r.County: We-lnV,,;;1 Longitude: ."; ,. lO ?.)
Total Points: , , u- -/'
Sfream ls at /ea st intermittent "l I ,1if > 19 or oerennial if > 30*
Stream Determiriition (circle one)
Ephemeral lntermittent Perennial
otner '26A S':3 foa
e.g. Quad Name:
A.=, ir ')Absent Weak Moderate Strqpg
1" Continuity of channel bed and bank 0 2 (3.t
2. Sinuosity of channel along thalweg 0 1 2 /t)
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool seouence 0 2 3.r
4. Particle size of stream substrate U 2 3
5. Active/relict fl oodplain 0 1 z-)3
6. Depositional bars or benches 2
7. Recent alluvial deposits 0 1 3
8. Headcuts 0 1 2'?
9. Grade control 0 0.5 'il 15
10. Natural valley 0 0.5 1 1.5r
1 '1 . Second or greater order channel No=0 Yes = 3)
artificial ditches are not rated: see discussions in manual
B. Hvdroloov (subtotal = |-.
12. Presence of Baseflow 0 1 2 *)
13. lron oxidizing bacteria 1-Dl 1 2 3
14. Leaf litter 1.5 ('l 0.5 0
15. Sediment on plants or debris U 0.5 (9 1.5
'16. Organic debris lines or piles 0 05 {-1)1.5
17. Soil-based evidence of high water table?No=0 Yes i3j
C. Bioloqv (Subtotal =
18. Fibrous roots in streambed (?2 1 0
19. Rooted upland plants in streambed l)2 1 0
20. Macrobenthos (note diversity and abundance)0 1 a J
2'1 . Aquatic Mollusks {0)1 2 J
22. Fish 0 0.5 1 i9
23. Crayfish U 05 1.5
24. Amphibians 0 0.5 {-l 1.5
25. Algae lu-/0.5 1 15
26. Wetland plants in streambed FACW= 0 75; OBL- 1 5) Other= O
"perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
Z8{, s?J + trs
Site #_ (indicate on attached rnapr
ffi$
Provide the
USACE AID#DWQ #
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the strcam reach under assessment:
l. Applicant's name' 'i' ;L t'&. '-.,2. Evaluator's name: ) /4or.r*-
3. Date of evaluarion: l?/i - i{,.t 4. Time of evaluatioa: /2 j L/ /
-
S.Name o1r1r"*n G,ihe^ SF.rtLi^ 6.Riverb*in,Mv' i1,li'6'
7. Approximatedrainage uea:c,i*k; lLtt !-?t.tt > 8. Streamorder: -3ffi
9. Length ofreach evaluated:" /?Qo 10. Countv.: \)q l.rrutc s-
I 1. Site coordinates (ifknown): prefer in decimal degrees.12. Subdivision name (if any):
Latitude (ex 34 8723 l2)i /,, "ld.7i,r)
Method location determined (circle):Topo Sheet Ortho (Aerial) Photo/GIS Otler GIS Other
13, Location of reach under evaluation (note nearby roads and landmarks and attach map identifuing stream(s) Iocation):_
:.'i, ., ,r..i ,.. ,?6,1r, . :, ,i.l,^ .Z ! ., I i ,': - , ,,
,-
14. Proposed channel work(if any): i? lt n( i r '
15. Recent weather conditions: ( o mz- f 4 /',1 ar:ar1 i le "4 i
16. Site conditions at time of visir: fi'l
17. Iy'entify any special waterway classifications known: _Section l0 _Tidal Waters _Essential Fisheries Habitat
-/ Trout Waters Outstanding Resource Waters
-
Nukient Sensitive Waters
-Water
Supply Watershed (I-ff)
tat-t.,t,",."pono*tut.locatedupstreamoftheevaluationpoint?YES@Ifyes,estirnatethewatersurfacearea:-
19. Does channel appear on USGS quad rnupz i@ NO 20. Does channel appear on USDA Soil Survey? @ *O
21. Estimated watershed land use:
-Yo
Residential
-olo
Commercial --:}f% Industrial
-olo
Agricultural
1l'*ror"rrd yoCleared/Logged
-*orn..(-tt,t
22. Bankturl w;a*: I / ' /L 23. Bank height (from bedfp of bwtk): / - 3'
24'Channel,,oo"offifi2o/o)-Gentle(2to4o/o)-v!Moderate(4to|0%)-SteePP|0%)
25. Channel sinuosity:
-straight
,/Occasional bends
-Frequent
meander
-Very
sinuous
-Braided
channel
Instructions for completioa of worksheet (located otr page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a skeam of the
highest quality.
TotSl Score (from.reverse):
.-1Ei-ii r'. :rt Jl
.*rro* {b*s urm { l:ta&h,,
*
Evaluator's
This channel evaluation form ffitended to be used only as a guide to assist landowners atrd environmerital professionals in
gathering the data requ the United States Army Corps of Engineers to make a preliminary assessment of stream
o,r" 4/Z,v//?, . , ,
particular mitrgatiot'ratio or requirement. Form subject to change -versicn 06/03. To Comment, please call 919-876-8141 x26.
STREA}I QUALTTY ASSESSVIE){T WORKSHEET
#CI{ARACTERISTICS ECOREIGION POINT RANGE
Cc.srtl M 6fifiEtiin
-
t,n€e
),!{lraH&
Prcsenee of flow / pcrsistent pools in stre{m
{oo flow or saturation:0: strong flow: rnax points)0-5 o-4 0-5
')Evidence of past human alteration
(extensive alteratior: ft no alteralion = max poinB)0-5 0-,0-5
J Riparian zcue
lno buffer = 0: contieuous. wide buffer: max poin8)CI-6 a-4 0-,
4 Evidence of autrietrt or chemical dkcharges
(Eitensive dischargex = 0; no discharges = max points)0-5 o-4 0-4
5 Groundwatcr diseharge
(no discharse = O: sorines- seeos. w€tlands. etc. : rnax poirts)0-3 a-4 0-4
6 Prcscncc of tdjacent lloodPlain
(m f,oodoleir = & exteasive floodDlain = nax poir*s)o-4 0-4 o-2
7 Entrcnchmcnt I ftoodPlai* acccss
(deeplv entrenehed = 0; frequeni flooding = max points)0-5 s-4 Q-2
I Prcscrce of tdjacent wetlands
(no wetlands = 0: large adjacent wetlands = Ela{ p!!ts}-0-6 0-4 o*2
9 Channel sirumity
(extensive ctlailnelization = 0: natural mearder = maor poists)0-5 &'4 0*3
t0 Sediment inPut
{extensive deoosition:0: little or no sediment = max points)0-t 0-4 0-4
l1 Size & divcrsity of cbanacl bed substrate
ffire- hmoeenous:0: larse. diverse sizes = max points)r:!S1 ...;!o-4 o-5
FFl,,trl*E
t{€,
t2 Evklente ofchannel iockion or wklening
f&colv incised = 0: stable bed & banks : max @inrs}
0-5 o-4 0-5
r3 P:egeeee ofmaior benk feilurcs
(severe er.osion = 0: no erosioo. stable banls = max points)0-5 0-5 0-t
t4 Root deptb tod densitY oo banlcs
(no visible roots = 0: dense roots throughout = max poitlts)0-3 &-*0-5
l5 Impact by agricullure, livestock, or timber produetioa
{substantial impact =0: no evidence: rnax points)0-5 &-4 0-5
l'.
F,r4
lrT
l6 Prese*ce of riflle-pooUripple-pool eomplexes
(no riffles/ripples or pools : 0; well-developed qqlpo:r{s)-o-3 g-5 0-6
,7 Habitat complexitY
{little or no habitat = 0: &equenl varied habitats = max points}0-6 0-6 o-6
l8 Canopy coverage over streambed
(no shadine veeetalion : 0: continuous caropy = max points)0-5 &-J 0-5
ls Substrate embeddedn css
(deeplv embedded:0: loose structure = max)o-4 o-4
).(,oJ,ox
EI
2A Frescnce of slream invertebrates (see page 4)
{no evidence:0: csnmon, numcrous typ€s : max poinfs)0-4 &-5 o-5
2l Prtserce of amphibirns
(no evidence = 0: commoa, num€roxs types = ma:< points)o-4 0-4 &-4
22 Prescace offish
{no evidence:0: eornmon, numerous types = max points)0*4 &.-4 s*4
23 Evidence of wildlifc use
{no evideflce = 0; abundant widence = max poiris)e-6 s-5 0*5
fo**fq&tsroc*tt lOs .
" II'rc,e clraracteri>tie s arJ n,)t Ais.5sed in coasiai i:riiims
rl IE,t yst {r r Zg( 5 Ll7 *5o
a_.
t.,
NC DWO Stream Identification Form Version 4.11
Date: l..' ;
t ProjecUSite: 1, r.l i'i11,Latitude:y/ 5" 3. - r
Evaluator: ),,',t,,County:Ua /a,, ^n
Longitude; J'{ lo Z;1a!i
Total Pointst , ,-- z/
Stream rs at teast tntermittent ll J \if > 19 or perenntal i> 30*
Stream Determination (circle ong)
Ephemeral lntermittent Perennial
Other ' '.
e.g. Quad Namei
/\ (.
artificial ditches are not rated: see discussions in manual
A. Geomorpholoqv (Subtotal= i Absent Weak Moderate Stro-ng
1u Contrnuity of channel bed and bank 0 1 2 loJ
2. Sinuosity of channel along thalweg 0 1 2
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool sequence 0 1 2
4. Particle size of stream substrate 0 2
5. Active/relict fl oodplain 0 z J
6. Depositional bars or benches U 1 2
7. Recent alluvial deposits 0 2 3
8. Headcuts 0 I J
9. Grade control 0 0.5 15
10. Natural valley 0 0.5 1 15
1 1. Second or greater order channel No=0 Yes = 3.
12. Presence of Baseflow
13. lron oxidizing bacteria
14. Leaf litter
15. Sediment on plants or debris
'16. Organic debris lines or piles
17. Soil-based evidence of high water table?Yes =-f )
18. Fibrous roots in streambed
19. Rooted upland plants in streambed
20. Macrobenthos (note diversity and abundance)
2l Aquatic Mollusks
FACW = 0.75; OBL = 1.5 Other / 0*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
' 1. ,'r-r (,n, (
LtY
, (\\4t
n'1't\)-ttv
Site #_ (indicate on attached nraprUSACE AID#DWQ #
m
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the stream rclch under assessment:\'-t. Applicant's name: -{-2.Evahator'
4. Time of evaluation: /7 ',
5. Name of stream: (r"sbe - 1rant L 6. River a*;n, /€,/ Z,'/rz^
.i.' 'ii*" -(at.u37, Approximate drainage 41sv1 A!,Y:l,' ! .*" :, 6i.(r 3 8. Stream order: "{
IIrWdtfAutt€9. Length ofreach evaluated: f3 "lo.county: ilat*4uttfr. _.--.-_---------
I l. Site coordinates (ifknown): prefer in decimal degrees 12. Subdivision name (if any):
Latitudelex 348723t2)i trl ; i. j: \ i"/ I - 4 ;-t.'"Longitude(ex-77556611): . 7'.,
14. Proposed channel work (ifany):
15. Recent weather conditions:4tJ 1,, f 'k*,
16. Site conditions at time of v
17. $entity any special waterway classifications known:
y' Trout Waters
-Outstanding
Resource Waters
_Section 10 _Tidal Waters Essential Fisheries Habitat
_ Nutrient Sensitive Waters _Water Supply Watershed _(I-ff)
18. Is there a pond or lake located upstream of t)Veualuation point? YES NO [f yes, estimate the water surface area:_
19. Does channel appear on USGS quad ^upl/ @ NO 20. Does channel appear on USDA Soil Survey? @ *O
21. Estimated watershed land use:04 Commercial _12% Industrial _% Agricultural
_ohClearcd I Logged _% Other (
23, Bank height (from bed to top otbar*i): 7, - ,l '
24. Channel slope down center of stream : /-.Flat (0 to 2%)
-Gentle
(2 to 4%7 u{Mod"rut" (4 to l0%)
-Steep
(>10%)
25. Channel sinuosity: Shaisht ./ Occasional bends Frequent meander Verv sinuous Braided channel25. Channel sinuosity: _straight ../bends Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (Iocated otr page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every charaeteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sheam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the steam flows tom a pasture
into a forest), the slream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a sheam of the
highest quality.
This channel evaluation ffi"fi intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data;cffired by the United States Army Corps of f,ugineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particularmitigationratioorrequirement. Formsubjecttochange-version06/03. ToComment,pleasecall 919-876-8441 x26.
_% Residential
CtlyoForested
22. Bankfull width: &
Methodlocationdetermined(circle):;d6TopoSheetortho(Aeriai)Photo/GISotherGISothc,-
13. Location of reach under evalualit((note nearby roads and landmarks and attach map identifing stream(s) location):
STREAII QUALITY,{SSESSNIE).iT WORKSHE ET
#.CIIARACTERISTICS ECOREGIOII* POINT XANGE SC1ORECeslelPfc&lut Mouat&
.lf
l-i(r)
x}{
P{
I Presence of flow / p€rsisient pools in stream
{no flow or saturation = 0: strong flow: max points)0-5 a-4 0 -,5
L
Evidence of past human alteration
(extensive alteration : 0: no alteration : max points)0-6 0-5 0-5
3
Ripariar zone
{no buffet = 0: contisuous- wide buffer: rnax points)0-6 CI-4 0-5
4 Evidence of rutrient or chemical discharges
{extensive disc}urge5 = 0; no discharges = max points)0-5 0*4 0-4
5 Groundw*tcr discharge
(no discharse = Ol sorinss. seeos. w€tlands. etc. = max Doints)
0-3 &-4 g-4
6 Prcsence of edjacent lloodPlain
(rro floo&lain ! {I extensive flmdDlain = max poinl*}a-4 g-4 o-2
7 Entrenchmcnt / floodPlaia access
{deeplv entrenched = 0: Aequeil floodine: max pointsi 0-5 a*4 t-2
8 Pre*ace of adjecent wetlands
(no wetlands = 0: laree adiaceat wetlands = max points)0-6 &-4 0-2
9 Chauncl sinuo*itY
{extensive channelization = 0: natural meander = max points)o-5 0*4 0-3
t0 Sediment inPut
{extensive deposition= 0; little or no sediment = max points)0*s 0-4 *-4
lt Sia & divcrsity ofehsnscl bed substratc
{fine- homoeenous = 0: laree. diverse sizx: rnax points}o-4 0-5
),t't,.Fl3g
t{a
t-t
t
=
lit
l2 Evidence of channel iocision or widcning
fdecstv ineised = 0: siable bed & banks : max roints)o-5 0-4 0-5
l3 Presence of maior bank failurce
{severe erosion = 0; no erosioo, stable banks = max points)o-5 0-5 0-5
t4 R,oot dcpth and density otr benks
{no vigible rosts = 0: dense roots throrrghout = max poiats}0-3 a-4 0-5
l5 Impact by agriculture, livestock, or limbcr produetion
{substantial impacl =0: no evidence = max poinB)0-5 0*4 0-5
l6 Presence of riIIle-pooUripple-pool complexes
{no riffles/riooles or oools : 0: well-developed = max points)0-3 0*5 0--6
t7 Habitat complexity
{little or no habitat = 0: freouenl varied habitats = max points}a-6 0-5 0-6
l8 Canopy coverage over streambed
(no shadin-q vegetation : 0; continuous canopy = max points)0-5 0-5 0-5
ls Substrate embeddedness
(deeplv embedded = 0: loose structure = max)
",i
NAT..:a-4 0-4
(,
htoHa
2A Presence of stream invertebrates (see page 4)
fno evidence:0: common, numerous tYpes = max points)0-4 0-5 0-5
2l Presence of amPhibians
{no eviderre:0: cocmon. numerous tyE€s = mo< points)a-4 0-4 0-4
22 Pre*nce of fish
{no evidence:0: common, aum€rous types : max points)a-4 &-4 $-4
23 Evidence of wildlife use
evidence = 0; abundant evidence: max 0-6 0-5 B-5
tsalFatutsPodlte l0e 1S.,.d@
T$TAL SCORE (al*rerrter oE fitstpg€)
NC DWQ Stream Identification Form Version 4.11
Date: llii, {i",ProjecUsite: tri {i Latitude: f; f '1:
1,,,'
\-lEvaluator: ). ;1. i ."County: ilatqi..tr,;;Longitude: ,J1 ., ,' , i
Total Points:
Sfream ls at least ntermittent . ll '
if > 19 or perennial if > 30" I ' :
Stream Determination (clrcle'one[-
Ephemeral lntermitten(Perenniaf
Other
e.g. Quad Namei
1.4
artificial ditches are not rated; see discussjgns in manual
B.H (5
ll{r i {V\ ;
rJ-. r \'r. l\.1 r ,it,
A. Geomorpholoqy (Subtotal = ' [-''t Absent Weak Moderate Stronq
1u Continuity of channel bed and bank 0 1 2 3:
2 Sinuosity of channel along thalweg 0 1 2 ,J
3. ln-channel structure: ex. riffle-pool, step-pool,n 1 2 a-i
.._9i
4. Particle size of stream substrate 0 1 2 3"i
5 Active/relict fl oodplain 0 1 2 J
6. Depositional bars or benches 0 1 J
7. Recent alluvial deposits 0 2 a
8. Headcuts 0 tl/2 3
9. Grade conirol 0 05 'll 15
10. Natural valley 0 0.5 1.5
1 '1 . Second or greater order channel No=0 Yes
drOloOV (Subtotal =
12. Presence of Baseflow 0 2 n
13. lron oxidizinq bacteria 0l 2*J
14. Leaf litter 15 1 i05,0
15. Sediment on plants or debris 0 0.5 1 15
16. Organic debris lines or piles 0 05 'f 1.5
17. Soil-based evidence of high water table?No =10,Yes=3
C. Bioloqv (Subtotal = : l
18. Fibrous roots in streambed 5 2 1 0
19. Rooted upland plants in streambed 3)2 1 0
20. Macrobenthos lnote diversity and abundance)0 1 2,.J
21 Aquatic Mollusks 0 2 J
22 Fish 0 0.5 1]'1.5
23 Crayfish 0.5 1 1.5
24 Amphibians 0 0.5 I 1.5
25. Alqae 0'0.5 1 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other = 0
-perennial streams may also be identified using othermethods. See p.35 of manual.
Notes:
' \ .r I i
\\r i+ i" '/
\,,:.1t $: I i
7 e '-) 7:, '/* =;)
tc
13. Location of reach under evalualioi-(note nearby roads and landmarks and attach map identifing stream(s) Iocation):
USACE AID#DwQ #Site #_ (indicate on attached map)
re$
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
5. Name of stream: &,5Ae- ,&*,: \ -
6.River basin: N€*J R!,xf
8. Stream order: 3
lo. county: Lt/4 ic.rt4r,.--.-.--------J-
I 1. Site coordinates (if known): prefer in decimal degrees . L2. Subdivision name (if any)
Latitude(ex \48723t2): Q i 3 'u {r"', ''i ,} '.. Longitude (ex -:77 ss66fit: ;ii", "
7, Approximate drainage r:ea:@
9. Length ofreach evalualed: //.( 0'
Method location determined (circl{: 7@ Topo Sheet Ortho (Aerial) Photo/GiS Other GIS Other
13. Location of reach under evaluali66-fnote nearbv roads and landmarks and attach mao identifrin
14. Proposed channel work (ifany): .1 {i ,
l1.lfntify any special waterway classifications known: Section 10
-Tidal
Waters Essential Fisheries Habitat
y'Trout Waters
-Outstanding
Resource Waters
-
Nutrient Sensitive Waters
-Water
Supply Watershed
-(l-lV)f a. l-, ,t ".. u pora *il. Iocated upstream of thpeXaluatron point? YES fr) If yes, estimate the water surface area:
1.9. Does channel appear on USGS quad *unf (9/ NO 20. Does "k .rappear on USDA Soil Survey? @ *
21. Estimated watershed land use:
-%
Residential
-%
Commercial --.1i9 % Industrial 70 %o Agricultwal
15. Recent weather conditi
16. Site conditions at time of visir:
f I o/oForcsted,/
22. Banktull widrh (!-%o
Cleared / Logged _% Other t
23. Bank height (from bed to top of banQ:. 7--"i '
./
24. Channel slope down center of stream : ,_-Flat
(0 to 2o/o) jlGentle (2 to 4o/o)
-Moderate
(4 to l0%) _Steep {>10%)
25. Channel sinuosify:
-straight
\lOceasional bends
-Frequent
meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identilied in the worksheet. Scores should reflect an overall assessment of the sheam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
Evaluator's Signatu !*rf
This channel evalual intended to be used only as a guide to assist landowners and dnvirbhnfental professionals in
gathering the data
quality. The total
by the United States Army Corps of Engineers to make a preliminary assessment of stream
resulting from the completion of this form is subject to USACE approval and does not imply a
li
, fi. )\\ 1 r iri
, ti I
i-I
r\It
particularmitigationratioorrequirement. Formsubjecttochange-versicnC6/03. ToComment,pleasecall 919-876-8441 x26
STREA}T QL ALITY ASSESSNIE\T WORKSHE ET
#CIIARACTERISTICS ECOREGION POINT RANGE
Cmstal Picfuotrt ffsrt b
.l
U
a
3*ttr
I Pres€nce of flow / pcrsistent pools in stream
{oo flow or saturalion = 0r strong flow: max points)0-5 o-4 0-5
2 Eviderce of past bumar alteration
(extensive alteration = 0: no alteration : max points)0-6 0-5 0-5
t Riparian zone
{no buffe,r = 0: contiguous, wide buffer: max points)0 -6 o-4 0-5
4 Evidence of autrient or chemical drscharges
I
fextensive discharges = 0; no discharges = max poinls) I 0-5 0-4 0-4
J Groundwater discharge
{no discharce = 0l $rrines" seeps. w€tlands, etc. = rnax points}0 *3 0-4 0*4
6 Preseuce of adjacent tloodPlain
tao floodplain = S: extensive floodplain = rnax points)0-4 a-4 0-2
7 Entrenchmcnt / floodPlein access
(deeplv entrenched = 0: frequenr flooding : mat points)0-5 o-4 a-7
8 Presecce of adjeeent wetlands
(oo wetlands = 0: Iarse adiacent wetla&ds = max poins)0*6 a-4 0*2
9 Cbannel siouositY
{extensive channelization = 0; natural meander = ma:< points)o-5 0-4 o-3
l0 Scdiment inPut
{extensive deposition= 0; little or no sediment = rnax points)0-5 0-4 *-4
II Sizc & diversity of channcl bed substrate
(fine- homosenous = 0: larse- diverse sizes = max points)$-4 0-5
i'{-Fl-a4
Htl
Et
l.
li
l2 Evidence of channel incisiou or widening
fdecotv incised = 0: stable bed & banks: max poinB)0-5 0-4 0-5
I3 Preseuce ofmsjor balk failores
(severe erosion = 0; no erosioa, stable banks = rnax points)*-5 0-5 0*t
l4 Root depth aod densi$ oD baols
ino visible roots = 0: dense roots throughout = max poinls)0-3 o-4 0-5
t5 lmpatt by agriculture, livestock, or timbcr Productioo
tsubstantial imract:0: no evidence = max poinrs)0-5 0 -4 0-5
r6 Presence of rillle-pooVripple-pool complexes
(no riffleslripoles or pools :6; wsll-developed: max points)0-3 0-5 0-6
l7 Habitat complexitv
{little or no habitat: & fiequent, varied habitats : max points}0-6 0*6 o-6
t8 Canopy covcrage over streambed
(no shadine vegetation = 0: continuous caropy = rnax points)0-5 o-5 o-J
l9 Substrate embeddedness
(deeotv embedded = 0: loose structure = max)
0-4 a-4
r*
o*oF
EI
2A
Presence of stream invertebrates (see page 4)
(no evidence :0: common. numerous types = max points)a-4 0-5 0*5
2l Presence of amPhibiers
(no evidence:0: cwrmon. numerous types = max point$) -
0-4 0-4 0-4
22 Prescnce offish
(no evidence:0: common, numerous types: max poinis)0*4 0-4 a-4
23 f,videnee of wildlife use
(no Evidenee = 0; abundant evidence: max
0-6 0-5 0-5
Totet ?oints Poc$bf?t@,,1&,,I&
TOTAL SCORE (alsc arter or futpga)'|, .., .;..r;.::.:.t.
' fh*;u chari;tcri)ties Jra n.t rssJ\sed tn ;oaslrl strell'ms.
1-qr) 3lCIlot
:.1
NC DWQ Stream ldentification Form Version 4.11
Date: irt ii i ProjecUSite: it I: i,r.,Latitude: O
Evaluator: ;. t) ,t,Counfu: , I r' WA {fl.{:ri Lonqitude: . i
total Points:
Stream ls at least intermittent ,/.i> 19 or perennral if> 30.
Stream Determinafr'on (circle one)
Ephemeral lntermittent Perennial
Other
e g. Quad Namei
A. Geomorpholoqy (Subtotal= ,, 1 Absent Weak Moderate Strong
1" Continuity of channel bed and bank U (2 J
2. Sinuosity of channel along thalweq 0 lT 2 J
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool sequence 0 1 :?)J
4. Particle size of stream substrate 0 J
5. Active/relict fl oodplain 0)1 "2 J
6. Depositional bars or benches 0 1 2 J
7. Recent alluvial deposits 0:1 2 J
8. Headcuts 0 1 t-)
9. Grade control 0 0.5 1-15
10. Natural valley 0 0.5 f')15
1 1. Second or greater order channel No=0 Yes=3
artificial ditches are not rated; see discussions in manual
B
c
oloqv (Subtotal=
'12. Presence of Baseflow 0 1 2 i'a \
'13. lron oxidizing bacteria 0 1 2
14. Leaf litter 15 1 0.5 tt
15. Sediment on plants or debris o 05 1 1.5
16. Organic debris lines or piles 0 0.5 1 1.5
17. Soil-based evidence of high water table?No=0 Yes=3
. Broloqv (Subtotal=
18. Fibrous roots in streambed J 2 1 0
'19. Rooted upland plants in streambed ?2 0
20. Macrobenthos (note diversity and abundance)0 2
21. Aquatic Mollusks U 1 2 J
22. Fish 0 0.5 1 1.5
23. Crayfish 0 0.5 )'1.5
24. Amphibians 0 0.5 I 15
25. Algae 0 U5 1 1.5
26. Wetland plants in streambed I fACW = 0.75; OBL = 1.5 Other = 0*perennial streams rry rt,
r\otes:
Sketch:
trffittl-l,
Provide the
f5 t'^, ',
USACE AID#DWQ #Site #_ (indicate on attached inapr
STREAM QUALITY ASSESSMENT WORKSHEET
following lnformation for the stream reach under assessment:
t-.'1 |
l. Applicant's 2. Evaluator's name: !.. t; ' 'j
3. Date of evaluation: i r ;4. Time of evaluation;
5. Name of stream: Ul "",.1
. t 0'
6. Riverbasin: Mcy' { ,:J<-r
7, Approximate drainage area:
9. Leng1h ofreach evaluated:{oO'
I l. Site coordinates (if known): prefer in decimal degrees
Laritude(ex 348723t2): 'f I 3b s*J . t:,' :' i Longitude (ex --77 5566llr ) L #;.
Method location determined (circle): 1@9-\ Topo Sheet Ortho (Aerial.1 Photo/CiS Other GIS Other
13.Locationofreachunderevaluation(notenearbyroadsandlandmarksandattachmapidenti!ingstream(S)Iocation):-
I:,: i',',,. (' 'i ,._t t:,,,..(r f ,".' I ,.:,. ,:, , ,' ,,- 'i' ,ii i"' ,,'* '' i t"_
14. Proposed channel work (ifany):
15. Recent weather conditi
16. Site conditions at time of visir' 11... ,.'{" l'd, +;
17. ldentify any special waterway classifications known:
-Section
10 _Tidal Waters _Essential Fisheries Habitat
-Trout
Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed _(l-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES ,l(f:if yes, estimate the water surface area:-i- -----
19. Does channel appear on USGS quad map? YES ljO 20. Does channel appear on USDA Soil Survey? YES N0,
21. Estimated watershed land use: % Residential % Commercial % Industrial % Agricultural
% Forested _% Cleared / Logged _% Other (
22. Banktull rvidth:23. Bankheight(fiombedtotop ofbank): l'L' -
24.Channel slopedowncenterofstream:-Flat (0to2o/o)
-Gentle
{2to4%) !{M,oderate(4to10%)
-Steep(>107o)25. Channel sinuosity: JSnuigt t
-Occasional
bends Frequent meander
-Very
sinuous
-Braided
channel
Instructions for completioa of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation. stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sheam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display rnore continuity, and a separate form used to evaluate each
reach. The total score assigned to a sEeam reach must range between 0 and 100, with a score of 100 representing a strearn ofthe
highest quality.
Evaluator's sigont "9.'-, / .'.'-'-*- Date ,' .'' I t .,"
This channcl evalua{ton ldtm is intended to be used only as a guide to assist landowners and environnienial professionals in
gathering the data fre{uired by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to tlSACE approval and does not imply a
particularmitigationratioorrequirement. Formsubjecttochange-version06/03. ToComrnent,pleasecall 919-876-8441 x26.
{.i :"'
ie
STREA}I Q U.\LITY ASSESS NIE).'T W'ORKSHE ET
#CIIARACTERISTICS ECOREGIOIT{ POINT R.A.NGE
ColStI Pkdmort iflwntein
.t<(
U
ed
tlF'&
1
Preseuce of flow I persistent ptols in strerm
(oo flow or saturation :0: strong flow = rnax points)0-5 o-4 0-5
'l Evidence of past human elteration
{extensive alteratioa:0; no alteration = max points)0-6 0-5 0-5
3 Ripariao zone
(no buffer = 0: contiguous, wide buffer: max points)0-6 0-4 0-5
4 Evideoce of nulriert or chemical dise harges
fextensive discharges = 0: no discharges = max points)0-s g*4 0-4
5
Croundwater discharge
(no discharge = 0; sorings" seeps, wetlands, etc. = max points)0:3 s-4 a-4
6 Prcsence of adjacent lloodPlain
e m floodolain = 0: extensive floodDlain = max points)o-4 0*4 o*2
7 Entrenchment I ltroodPlain acces
(deeplv entrenched = 0: frequenl flooding : max points)0-J 6*4 8-2
I Preseace of adjeeent wetlands
{no wetlands = 0: laree adiacent wetlands = max poins}0*6 o*4 o*2
9 Cbannel sinuositY
{extensive charnelization = 0; natural meander = mali poins)0*5 0-{0-3
IO Sediment ioPut
{extensive deoosition= 0: Iittle or no sediment = max points)0-5 0*4 0-4
ll Sizc & diversity of cbanoel bed substrate
{fine- hotnoeenous = 0: laree- diverse sizes = max points)xAr ,,'.::0*4 a-5
ir
,F]
tsata
Farl
l2 Evidence of charnel incision or widening
(detalv incised = 0: stable bed & banks : max points)o-5 0-4 0-5
r3 Presence ofmajor balk failures
{severe erosion = 0: no erosion. stable banks: max points)0-5 0-5 0..5
l4 Root deptb and deasitY oa benks
(no visible roots = & dense roots throughout = max points)0-3 o-4 0-5
l5 Impart by agriculture, livestock, or timbcr prodactioa
{substantial impac!:0; no evidence = max points}0-5 0-4 0-5
l'r
F
E
t6 Presence of rillle-pooUripple-pool complexes
{no riffles/riooles or oools : 0: well-developed = mar points)0-3 0-5 0-6
l7 Habitat comPlexitY
{little or no habitat: 0: fiequent varied habitats = max points)0-6 &-6 o-6
t8 Canopy coverage ovcr streambed
no shadine vesetation : 0: continuous canopy : max points)0 -5 o-5 0-5
l9 Substrate embeddedncss
(deeply embedded = 0; loose structure = max)NA!,.::i:.,0-4 a-4
flr
oJolrE
2A Prcscnce ofstrerm invertebrates (see page 4)
(no evidence :0: ccrnmon. numerous Epes = max points)0-4 0-5 0-5
2t Prcserce of amPbibbrc
(no evidence = 0: common. numerous typ€s = ma< points)0-4 0-4 g-4
7,Prescnce of fislt
{no evidence:0: eommon. rumerous types = max poin&)o*4 s-4 g-4
23 Evidence sf wildlife use
{no er,ridence = 0: abundant evidence: max points)0*6 0-5 0-5
?otelkaF€!d!{€ros :.r00
TOTAL SCORE (also enter on fir$t FgB)
NC DWO Stream ldentification Form Version 4.11
Date:
I f l,', I i',Latitude:$r Jl 3,;
Evaluator:County: t irr,,,"..r,Longitude:? 1 i
Total Points:
Stream is at teast intermittent .. :. {
if > 19 or perennial if > 30-
"lzStream Determination (circle one)
Ephemeral lntermittent Perennial
Other
e.g. Quad Namei
tl- I
A. Geomorphologv (Subtotal = / )Absent Weak Moderate Strong
1" Continuitv of channel bed and bank 0 1
.',2 aJ
2. Sinuosity of channel along thalweg 0 f 2 J
3. ln-channel structure: ex. riffle-pool, step-pool,
ripple-pool sequence 0 1 o 5
4. Particle size of stream substrate 0 1 ))5
5 Active/relict floodplain 0 1 2 J
6. Depositional bars or benches 0.1 2
7. Recent alluvial deposits 0 1 2
8. Headcuts n 1 2
9. Grade control 0 0.5 1 4E
'l0 Natural vallev 0 0.5 1 1.5
'l 1. Second or qreater order channel No=0 Yes=3
artificial ditches are not ratedt see discussions in manual
B
'12. Presence of Baseflow 0 1 2 ta )
13. lron oxidizinq bacteria 0 1 Z^
14. Leaf litter 1.5 1 0.5 0
15. Sediment on plants or debris 0,s 1 1.5
16. Organic debris lines or piles U 0,5'1 1.5
17. Soil-based evidence of high water table?No=0 Yes=3
U. tsioloqv (Subtotal= -.1.- {'-
18. Fibrous roots in streambed J (z 1 0
19. Rooted upland plants in streambed (2\1 0
20. Macrobenthos (note diversity and abundance)0 2 1
21. Aquatic Mollusks :0 1 2 3
22. Fish U,0.5 1 15
23. Cra 0 0.5 i 1.5
24. Amphibians tt 05 1't '1.5
25. Alqae 0 0.5 I 15
26. Wetland plants in streambed FACW=O75; OBL= 1 5 Other=0
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
,):i J-j
m
Provide thc
USACE AID#DWQ #
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the str.am rcach under assessment:
1. Applicant's n*r", e i: L 2. Evaluator's ,u*", ) ' n1* k
7, Approximate drainage arca i Qdft |8. Stream order: I
9. Length ofreach sy71rra1s6' k t 10.Counti: ul/af at q ct
3. Date ot.rulrut;on, f O/ i ', f i 'l 4. Time of evalwtioa:- f C'. ( O
5. Name orro"*r, lr{n*-,ulJ-Tr,L - 6. River a*in, ,r/e
Zg7 52a7ta
Site #_ (indicate on attached rnapr
L,"
12. Subdivision name (if any):
_%o Cleared I Logged _o/o Olher \
23. Bank height (Aom bed to top ofbank;: / '
Latitude (ex 34 872312):Longitude (ex -77 5566n\t-3 t ! t' {'}" f'"n {t '
Mcthod Iocation determined (circle):Topo Sheet Ortho (Aerial) PhotolGIS Ottrer GIS Othtx
\.',' , ', , .!.,.' otr. [",r,'r, , ,:;.,-i .'.1'i *]*zo {tr,/
14. Proposed channel work (ifany):
15. Recent weather conditions: 5o ru'{. (ii t
16. Site conditions at time of visir: .) *" -.
17. Identify any special waterway classifications known:
-Section
10
-Tidal
Waters Essential Fisheries Habitat
Trout Waters _Outstanding Resource Waters
-
Nutrient Sensitive Waters
-Water
Supply Watershed _(I-IV)
18.Isthereapondorlakelocatedupstreamoftheevalua!ionpoint?vpsFoIrves,estimatethewatersurfacearea:-
/ \--,/ ^1"
19. Does channel appear on USGS quad map? YES NQ 20. Does channel appear on USDA Soil Survey? YES .NO r
21. Estimated watershed land use: % Residential % Commercial ;fL % Industrial ?4o/o Ag.'calul:al
I l. Site coordinates (ifknown): prefer in decimal degrees.
r , 7@/olorested
22. Banktull width: I
24. Channel slope down center of stream:
-Flat
(0 to 2o/o)
-Gentle
{Zto 4Yo7 -r/Mod"rur"(4 to l0%)
-Steep
(>10%)
25. Channel sinuosity:
-straight
'/ Occasional bends Frequent meander
-Very
sinuous
-Braided
channel
Instructions for completion of workshect (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment ofthe sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total (frory d(rd,,n,B rr.rl
q bc
Evaluator's Signa Date l3i' t' ;i{ ?
This channel eva is intended to be used only as a guide to assist landowners and'environmental professionals in
gathering the data by the Uuited States Army Corps of Engineers to make a prelimiuary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject ro change - version C6l03. To Comment, please call 919-876-8441 x26.
STREA}I QL ALITY ASSESSNIE\T WORKSHEET
#.CIIARACTERJSTICS ECOREGION POINT RANGE n
Corsltl Pk&qir *Imctiril
J
Ulr.a
€r1
r-F't
I Presence of flow / persistent pools in strerm
(no flow or saturation = 0: stroflg flow : rnax points)0-5 a-4 0-5
..:aa- ..-
z f,vidence of past humar rlteratioD
{exlensive alteration = 0i no alteration = max pollts)
-
a-6 0-5 0-5
J
Riparian zone
{no buffer = 0; contiguous, wide buffer = max points)0-6 8-4 0-5
4 Evklence of Eutriert or chemical dkcharges
{extensive discharges = 0: no discharges = max points)0-5 0-4 0-4
5 Croundwater diseharge
(no discharee = 0: sDrinss" seeps, wetlands, etc. = max poinrsi 0-3 a-4 0*4
6 Prcscoce of adjacent floodPlain
f rro flaodnlain = O: extensive floodolain : max Doints)o-4 a*4 0*?
7 Entrcnchment / lloodPlaia acccss
ideeplv ontrenched = 0; frequent flooding = max points)0-5 0-4 g-z
8 Prescoce of adjecent weflands
(ao wetlands = 0: large adiacent wetlands = max win6)0-6 0-4 o-2
9 Channel siruositY
{extensive channelization = 0: natural rneander = rnax poinE)0-5 0-4 0-3
l0 Sediment ioPul
{extensive deposition= 0: little or no sediment = max points)0-5 q*4 0-4
ll Size & divcrsity of ehanuel bed substrate
{Iine. hornogensus:0; Iarge. diverse sizes = max points)
';xAr 0-4 0-5
i*grt
h{hIha
F{t1
l2 Evilence ofchannel incisiou or widening
{decolv ineised = 0: stable bed & banks : m&r psints}0-5 0-4 0-5
r3 Presence of major benk fnilures
{severe erosion = 0; no erosion, stable banks: max poine)0-5 0-5 0-5
t4 Root depth and density on banks
(no visible roots = 0: dense .oots throughout = max points)0-3 0-4 0-5
l5 Impact by agriculture, livestock, or timber productioa
{substantial imDact:0: no evidence: max poin8)0-.5 a-4 0-5
f-t
F
Fq
-:ra
t6 Presence of riflle-pooVripple-pool compkxes
{no riftles/ripples or Dools:0: well{eveloped: max points 0-3 0-5 0-6
t7 Ilabitat complexity
{little or no habitat = 0: frequent, varied habitats = max points)0-6 0*6 0-6
t8 Canopy coverage over streambed
(no shading vegetation = 0; continuous canopy = max points)0-5 0-5 0-5
l9 Substrate embeddedness
(deeply embedded = 0; loose structue = max)xAt a-4 o*4
rt
o
r.t
rOxf,
2A Preserce ofstrelm invertebrat€s (see page 4)
(no evidence:0: commoo, numerouii typ€s: max poinis)0*4 0*5 o-5
21 Presenee of arnpbibiens
(no evidence = 0; eornmon. numerous types = mar points)0-4 0-4 &-4
22 Presence of fish
{no evidence:0; common, numerous tyP€s = r*ax poinfs)
g-4 o"-4 $-4
ZS
Evidence of wildlife use
{no evidence = 0; abrlndart evidence = max poinlsi 0-6 0-5 8-3
To*rthfursPodblc tffi !r*':rts''
TOTAL SCORE (also c*ter o&fnstirgs)'l
N(] DW tream ntrlrca orm verslon
Date:(,0 iL"iiiu ProjecUsite: ( i ('',,
Evaluator: ,, . /1,:
Li
Gounty: i Longitude: jl6 i:; p.-, #
Total Points:
Stream is at teast intermittent L{t)
if > 19 or Derennial if > 30-
Stream DeterminEtion (circle onq)
Ephemeral lntermittent leren-@
Other
e.g. Quad Name'.
. a1L/ tl)
Sketch.w"r!
Ide ifi
!,5r6i 't( 't
tion F v 4.ll
$ /,,
'artificial ditches are not rated: see discussions in manual
B. Hvdroloqv (Subtotal = {S )
14. Leaf litter
C. Bi ubtotal =
A. Geomoroholoov (Subtotal = '1.1,-Absent Weak Moderate Strong
1" Continuity of channel bed and bank 0 1 2 3.t
2. Sinuosity of channel along thalweg 0 1 2
3. In-channel structure: ex. riffle-pool, step-pool,
rioole-oool sequence
0 1 2 3,',
4. Particle size of stream substrate 0 2
5 Active/relict floodplain 0 1i;2
6. Depositional bars or benches 0 2i
7. Recent alluvial deposits 0 1 2 2
8. Headcuts 0 lt 2 2
9. Grade control 0 0.5 1:1.5
10. Natural valley U 0.5 1 '1.5
1 1. Second or qreater order channel No=0 YesF e,
12. Presence of Baseflow
13. lron oxidizinq bacteria
15. Sediment on plants or debris
16. Orqanlc debris lines or piles
17. Soil-based evidence of high water table?
18. Fibrous roots in streambed
19. Rooted upland plants in streambed
20. Macrobenthos (note diversity and abundance)
21. Aquatic Mollusks
FACW = 0 75; OBL ='1.5r Other = o26. Wetland plants in streambed
"perennial streams may also be identified using other methods. See p. 35 oll4lal'
Notes:
USACE AID#DWQ #
Z@l 5 Ztir *:;
Site #_ (indicate on attached rnapr
m
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the strcam rcach under assessment:
1. Applicant's nu .t l-{'{"'2. Evaluator's name: J "4a14
3. Date of evaluation: ,l -i -. /, r 4.Timeofevaluation: lf Vf
5. Name of stream:" "k*r61 6. River basin: l./e ar' F i v*n
T. Approximate drainage area]?f,/'/ tL''^ {' e, 1 8. Stream arder: L
9. Length ofreach evaluated: F4'l0.County: Ua/a+yi
I l. Site coordinates (if known): prefer in decimal degrees 12, Subdivision name (if any):
Latihrde (ex ,o rrrrtt, I I 3l OL . I i 'i iqi Longitude (ex *'17 5566lti: 3{,.{i'f, . {ir"i*
14. Proposed channel work (ifany):
15. Recent weather conditions:
16. Site conditions at time of visit:
Methodlocationdetermined(circl$:6{{'TopoSheetortho(Aeria1)Photo/GISotherGIS0ther-
13. Location of reach unde.
"rair'raii,5n
(note nearby roads and landmarks and attach map identiling streamlsl location):-
' " '" {'' ('' ,' "' '; l!' :';"' ' "''':' i'';
17. Identifu any special waterway classifications known:
-Section
10
-Tidal
Waters
-_Essential
Fisheries Habitat
_Trout Waters _Outstanding Resource Waters
-
Nukient Sensitive Waters
-Water
Supply Watershed
-(I-N)
,/--',l8.[srhereapondorlakeIocatedupstreamoftheevaluationpoint?YESN9.-lfyes,estimatethewatersurfacearea:-
19. Does channel appear on USGS quad *upZ @S' NO 20. Does channel appear on USDA Soil Survey? ffit UO' --./
21. Estimated watershed iand use: % Residential 0/o Commercial _,!L % Industrial 1p/o Agticaltural
_Yo Cleared I Logged _% Other I
22. Bankfult wid 23. Bank height (from bed to top ottant): /,: I '
24. Channel slope down center of steam:
-Flat
{0 to 2o/o)
-Gentle
(2 to 4%) VlMod"rur"(4 to l0%)
-Steep
(>107o)
25. Channel sinuosity: _straight t/ Occasional bends
-Frequent
meander
-Very
sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse):
,/rl
Evaluator's Si+naturc ,. .- ,= 9a/(" i?i"i ! i ' 4
Thischannel&,t,"ti,tl,ndo*n"..l-od.,ilonmentalprofessionalsin
gathering the data requ'f6d by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total sdore resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change -version 06i03, To Comment, please call 919-876-8441 x26.
}fl vo1orested
*, 4-{' *
b{tl fcomments: lktr{. ut^*,! ,: ,:'i Go:lt- Frd";; h"
STREAT.I QUALITY ASSESSNIE){T WORKSHE ET
*CIIARACTERISTICS ECOREGION POI}TT f,AT.iGE
CmsH *fiffira&'
-l
U}{&xttl-an
I Prescnce of flow / persistent pools in strerm
(m flow or saturation = 0: strong flow: rnax points)0-5 a-4 0-5
2 Evidence of past human alteration
{extersive alteratioil = 0; no alteration = max points)0-6 0-5 0-5
l Riptrian zonc
(no buffer = 0; contiguous, wide bufer: max poinls)0-6 0-4 o-5
4 Evfrleoec of nutrient or ehcraical dkcharges
fextansive discharses = O: no discharges = ma,t poing)0-5 o-4 e-4
s Groundwater diseharge
{no discharse = 0i springr seeps, wetlands, etc- = max points}0-3 a-4 g-4
6 Prescuce of adjaccat lloodPlain a-4 0-4 o*2
7 Entrcnchmcnt I lloodPlain ecccss
(deeptv entrenched = 0; frequenr flooding = ma:t points)0-5 *-4 a-7
I Presence of adjeceut *etlands
(no wetlands = 0: larse adiacent wetlands = max poinB}
-
0-6 a-4 o*z
I C}annel siruositY
(extensive clennelization = 0; natural meander = ma.x poinB)0-5 0-4 o-3
t0 Scdiment inPut
iext€Nlsivs deposition= 0: little or no sediment = max points)0'5 0-4 0-4
11
Size & diversity of chanacl bed substrate
ffine- homoeenous = 0: laree- diverse sizes = max points)0-4 0-5
).
,-lE
FIE,c
t{u.
t?Evitenee of channel ineision or widening
fdEmlv incised = O: stable bed & banks : ma:c foilB)0-5 0-4 0-5
I3 Presence of maior bank failures
{severe erosion = 0; no erosioa, stable banks = max pgilts)0*5 0-5'0*5
,4 Root dcpth and densitY on bauks
fno visible roots = 0; dense roots throughout = llqIqmtsl-0-3 0-4 6-5
l5 Impact by agricnlture, tivestock, or timber produetioa
{substantial impact:0: no eaidence: max points}0-5 0-4 0-5
F
Fr
E
x*a
t6 Presence of riftle-pooUripple-pool complexes
ino riffles/ripoles or pools: f; lvsll-developed : mat points) -
0-3 o-5 0-5
t7 Ilabitat complexitY
(little or no habitat = 0; frequent, varied habitats : maIgollts)-0-6 0-6 0--6
I8 Canopy coverage over streambed
(no shadinq vegetation = 0; continuous caropy = max pq!4q)0-5 0-5 0-5
l9 Substrate embeddedness
fdeeoh embedded = 0: Ioose structure = max)0-4 0-4
}{t,-r::olian.,:
20 Presmcc of strcrat invertebrats (see page 4)
{no evidence :0: eommon, numerous Ep€s : max points)0-4 o-5 0-5
2'Prcsence of amPhibians
(no eviderce = 0: eonmon- nUmerous Wpes = r"nar points)a-4 0-4 &-4
7'Prtscnec of fsh
fno evidence = O: common. mrmerot s types = max pointi)0-4 0-4 t-4
23 Evidenee of wildlife ttse
{noevidence:0: &undant evidence = mat poir*s)0-6 0-5 B-5
',- T&lfa*refo$eila ..,*os:i$r .,ii&.'l:
TOfAt $CORE {atsc,*rrtron fir*tpge}r,i
' firc;e charecteri:tics ate fr-)[ asse>seC in ;oaslai siru:i]Tls
{Igam Identification Form Version 4.ll
Date: la/ ZZ ltq ProjecUSite: ,{,;,Latitude: 3l Si i1.l
Evaluator: J- r'?ql ,-county: lr,/a {a uo^
Total Points:
Stream is at least intermittent
if > 19 or perennial if > 30-
Ll.1 . -'t'Stream DeterminatiSn (circle one)
E ph emeral lnterm ittent, per?ffi-il Other
e.g. Quad Name:
NC DW
.: tt a-i. 7
ditches are not rated; see discussions in manuat
-nlnnrr /Qr rhfntat = {,, \
A. Geomorpholoqy (Subtotat= 7 Absent Weak Moderate Strong1a Continuity of channel bed and bank U 1 2
4. orrruesil.y or cnannet atong tnalweg 0 1 2 .21
3. ln-channel structui@
ripple-pool sequence 0 1 2
2.
i3
4. Particle size of stream substrate 0 1 3
rcr roooptatn 0 1 AtQ J6. Depositional bars or benches 0 1 2 5KecenI ailuvtat oepostts 0 2 28. Headcuts U 1.,2n 5
ttot 0 0.5 1 15'10. Natural valley 0.5 1 '1.5
grearer orqer cnannel
a rtificia I
No=0 Yes = 3.i
. Hydroloqy (Subtotal=
12. Presence of Baseflow U 1 2 fzi'13. Iron oxidizing bacteria o.)1 2 314. Leaf Iitter 1.5 4"''0.5 015. Sediment on plants or debris 0 ,'0.5--1 1.5ro. \Jrgailrc oeofls ilnes or ptles U r 05.1 t.317. Soil-based evidence of hfin watEitable?No=0 Yes =6/
18. Fibrous roots in streambed 2)1 019. Rooted upland plants in streambed J,Y 1 020. Macrobenthos (ngte diversity and abundance)n I ,!2 3AqUdr.ru tvtoilusKS 0)1 2 J22. Fish 0 0.5 n 1.5zJ. ut aryltsn 0 0.5 ,1 1.524. Amphibians 0 0.5 .ti 1525. Algae i0j 0.5 1 1526. Wetland plants in streambed FACW = 0.75; OBL f1 5j Other = O
vrrcrrrdr s.earrs rrlay arso oe roentrfled using other methods. see p. 35 0f manual. !r/
Notes:
Sketch: - a -) (- t^ ^Lb / J'l] i' 2-od iS r_{,./ /_i ,t ,i'-t. t /' . /:,-,.., r; I i*
tri .r I . ,. ,/-t:f."t.'.^' -:.i. ;.7' 1;.i::"- ", ..' .'i.; , ! i;,_. i ..,,0,,,1,
ta
USACE AID#DwQ #
m
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following iaformation for thc stream reech under assessment: rI
l.Applicant's n*, {r'' .. 2.Evaluator's n*n", J r'44{*
3. Date of evaluation: ilj';'.. .;'/ I '/ 4. Time of evaluation: I i'{ ' ,;-?
-
5. Name of st .u-,7, f, J, (e si,, n (<c-,t L
T,Approximatedrainage uea: ."t' i. '; '- .,:',--; 8.Stream order: 2.''
9. Length of reach evaluated: 8o'10. Counw: t+)4 /"2t v1.,
11. Site coordinates (if known): prefer in decima.l degrees
Latirude(ex 348721t2)i *-- ,.' ,t llt]4f
Method location determined (circle): CFF) Topo Sheet Ortho (Aeriat) Photo/GIS Other GIS Othcr
il1(L-1 1 L/.L ar, .-..' {' I | /t +;
14. Proposed channel work (ifany):1 ' J.r*.{u*'.,
15. Recentweatherconditions: 5"ty1'k , 'i.'t , g<ry yl tcrfi
16. Site conditions at time of visir, iu,n , (l ^ n.-.., . / 'i i, , ,.-,
-
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed _(I-IV)
18'Isthereapondorlake[ocatedupstreamoftheevaluationpoint?vesXio-thyes,estimatethewatersurfacearea:-
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
21. Estimated watershed land use: % Residential oZ Commercial -11 % Industrial fuL o/o Agtiatltwal
'"1 1 7, Forestedf-_YoClearcd / Logged _% Other (
22. Banktull width:
.J,)23. Bank height (from bed to top ofbank):' .,, t
24. Channel slope down center of stream: _Flat (0 to 2%) -;Gentte (Zto 4%)
-Moderate
{4 to l\o/d _Steep (>10%)
25. Channel sinuosity: _Straight .. Occasional bends _Frequent meander _Very sinuous _Braided charnel
lnstructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream ofthe
highest quality.
LG;! 5 73 -{.}*
Site #_ (indicate on aftached arapr
1.2. Subdivision name (if any):
Longirude (ex -?7 55661 l ): .i r ' :: ti .i s , . ,-'.':-':
13. Location of reach under evaluatl&r (note nearby roads and landmarks and attach map identif ing stream(s) location):_
Evaluator's Signature
This channel evaluation
gathering the data by the {-inited States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version A6103. To Comment, please call 919-876-8441 x 26 .
,{ri- '/ ,^r, /q / l i l, t
intended to be used orly ut " guiOu to,sirt l"ndo*n... *JIfffiffirfLl professionals in
STREA}T QUALITY ASSESSNIEliT WORKSHEET
#CIIARACTERISTICS ECOREGIOT( POINT RANGE
Comtd neihclil Mqrteb
rI.(
l-a€lt
Htt&
Presence of llow / pcrsistent pools in stream
(oo flow or saturation:0i strong flow: rnax points)0-5 0*4 0-5
a7
:-)_* _
/),
2 Evideaec of past human alteration
(extensive alteratioa :0; no alteration : max points)0-6 0-t 0-5
J
Ripariaa zone
(no buffer = 0: coltiguous, wide buffer: rnax poinls)0-6 a-4 0-5
4 Evideoce ofnutrient or chemical discharges
(extensive discharses = 0: no discharges = max points)0-5 0-4 a*4
5 Groundwater discharge
{no discharse = O; sprinss. seeps, wetlands, etc- = ma,t points)0-3 a-4 o-4
6 Prcscncc of adjaccnt lloodPlair
fno flso&Iain = (h extensive fioodolain = max ooints)
a*4 8*4 0*2
1 Etrtrenchmcnt / lloodPlaia acces
(deeply entrenebed = & fiequem floodirg: max points)0-5 o-4 0-z
8
Presence of adjeeent wef lends
(no wetlands = 0: laree adiacent wetlands = rnax points)0-6 s-4 a-2
9 Channcl siruositY
(extensive channelization = 0: natural meander = max poinh)0-5 &-4 o-3
t0 Scdiment inPut
(extensive deocsition= 0: Iittle or no sediment = max points)B-5 0-4 o-4
ll Size & diversity of channcl bed substrate
(fme-. homopenous = 0: large. diverse sizes = max points)':$ra.0-4 o-- 5
).t(-,F]
He
F,(n
l2 Evirlence of channcl iucisioa or widening
fdeertv incised = 0: stable bed & banks :'max roir8l 0-5 0-4 0-5 J
)13 Preseuce of m*jor bank faihrct
{sever€ erosion:0; no erosion, stable banks = max points} ,o-5 f)-5 s*J
t4 Root dcpth and densitY on baaks
{no visible roots:0: dense roots throughout = max poin*) -
0-3 0-4 0*5
l5 Impa$ by agricultBre, livestoek, sr fimbcr productioo
{zubsantial imgact =0: no evidence: max poina}0-5 &*4 s-5
t<
Ir
l6 Presence of rilfle-pooUripple-poot cornplexes
{no riffleslripples or pools = 0; well-developed: max points)0-3 0-5 0-6
t7 Habitst comPlexitY
(little or no habitat = 0: frequent, varied habitats = max pointsl 0-6 o*6 0-6
l8 Canopy €overage over streambed
{no shadin-g vegetaiion = 0; continuous canopy = max points) -
0*5 o-5 0-5
t9 Substrate embeddednGss
fdeeoh embedded = 0: loose siructute = max)
a-4 q-4
I*t,
LJ
FIoHn
2A Prtseate ofstre*m invertebrat$ (see p4ge 4)
{no evidence:0: co{nslot. numerous types = max points)0-4 0-5 0-5
.)
2l Prescme of rmPhibiaos
(no evidence - 0; csun<r\ numerotls typ€r = m!rypgtntsl-0-4 0-4 8-4
7')Prcserce of fish
{no evidence:0: commoo. num€rous types = rn'ax pointl}*-4 &-4 8*4
Z3
Evidcnce of witdlife uec
(ro widence = 0: abundant evidence = max poirls)0-6 0-5 0-5
T#Srtlt&$?ocih!!t&: ::!sri:,;l,l:'r:{!*!'l
TATAL $CCRE (alrc's*t€r o*! 6ssting$)L
' f hc;; cl:arr;tcr;>tics arc ir,.)t lissJSSed in ;oasilr )irsiims
NCD Stream Identification Form Version 4.11
Date:, .t
ProjecUsite: 1') i .f t" ', ,.,Latitude: (l . j i i, . t;'i
Evaluator: ; ..,;'1" 1.: :"r County: n'Ait.i5r,Longitude: i",_ O* ,$"
Total Points:
Stream is at least intermittent ? -1
if > 19 or perenntal if > 30* i k
Stream Determination (cir-clegne),.
Ephemeral lntermittenti Pere!-il-al_-
Other
e.g. Quad Name:
i--.
A. Geomorpholoqy (Subtotal =Absent Weak Moderate Strong
1'Continuity of channel bed and bank 0 I 3
2. Sinuosity of channel along thalweg 0 1
3. In-channel structure: ex. riffle-pool, step-pool,0 1 d J
4. Particle size of stream substrate 0 1)2 J
5. Active/relict fl oodplain 0 1 3
6. Depositional bars or benches 1,)r 2 J
7. Recent alluvial deposits 0 1,2 3
8. Headcuts 0 2 2
9. Grade control 0 J',5..'1 1.5
10. Natural valley 0 0.5 1.5
1 1. Second or greater order channel No=0 Yes=3
artificial ditches d; see discusslons in manual
B. Hvdroloov (Subtotal = "1 ,( 'l
12. Presence of Baseflow 0 1 2 3i
13. lron oxidizinq bacteria ro)1 2_3
14.Leaf litter 1.5 1 { 0.51 0
15 Sediment on plants or debrrs 0 05,1 1.5
16. Organic debris lines or piles 0 05j 1 1.5
17. Soil-based evidence of high water table?No=0 Yes {3 )
C. Bioloqv (Subtotal =
18. Fibrous roots in streambed 3-,i z-/1 0
19. Rooted upland plants in streambed 2
20. Macrobenthos lnote diversity and abundance)U 2)?
2'1 Aquatic Mollusks r0;2 J
22. Fish 0 0.5)1 1.5
23. Crayfish 0 0.5 1.5
24. Amphibians 0 0.5 1i 't.s
25. Alqae ,d 0.5 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5' Other = 0
*perennial streams mayalso be identified using othermethods. See p.35 of manual
Notes:
, {,;' { _.:{ "i )"a-,ri
-,/
i , r, i l-.
r-. /'I
;,''/';1 o ''-'! ''
USACE AID#DwQ #
^ 11-l{ '
Site #
,! i/1: ' i;';'"'
(indicate on attached inap t
STREAI\{ QUALITY ASSESSMENT WORKSHEf, T
Provide the following information for the strcam rcach under assessment:
1. Applicant's nanrct ttFL 2. Evaluator's name: - ) f'1 r: :"t
3. Date of evaluation: lO / L .: / t i q. Time of evaluation:
5' Name of stream: T'A * ' /*:t'n ka''Lfib {r'/*t;,. ko-rL 6. River basin: //c *' &'n"'
7. Approximate drainage areai i' 1? t " '/ I 8. Stream order:
9. Length ofreach evaluated:10. Counn-: Va taqry,
I l. Site coordinates (if known): prefer in decimal degrees.12, Subdivision name (if any):
Latitude(ex 34872312)i *t gl i\" " ; "-," "1 Longitude(ex -7755661n: "3b {',
Method location determined (circle): (&' Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Orher
r :')..'
13.Locationofreachundereva1uation(notenearbyroadsandlandmarksandattachmapidenti!ingstream(s)location):-
{)'{r,2,- ,oin5 Zff-"} 5 L! "ii ?aei ','utt t;ir,.t: ;tt{:;i ,'"",,,,{ ;,*,."'
t r, l:,'14.Proposedchannelwork(ifany): / LLoo-ttttr^ Lvc.(t,'' i i _
15. Recent weather conditionsi I LQ. (cti'\ , €ealo.q I 'ft tves
-
16. Site conditions at time of visit: '1 :!.oo; ti., i r..,. { {'1r*S
I7. Identifu any special waterway classifications known:
-Section
10
-Tidal
Waters _Essentiai Fisheries Habitat
-Trout
Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed _(I-N)
18. Is ihere a pond or lake located upstream of the evaluation point? YES J@lf yes, estimate the water surface area:-
19. Does channel appear on USGS quad rnap? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
21. Estimated watershed land use:
-%
Residential
-olo
Commercial JZ2Yolndustrial 2+),/o Agtic,llt:u:al
JW YoForested _Yo Cleared I Logged _% Other (
22. Banktull width: { '23, Bank height (from bed to top ofbank): O .- / '
/
24. Channel slope down center of streami/-Flat(0 to 2o/o) l./ Gentle (2to 4o/o)
-Moderate
(4 to 10%) _Steep (>107o)/
25. Channel sinuosity:
-Straight
V Occasional bends Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section, Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display rnore continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a sheam of the
highest quality.
Total Score
'--I.:. '
Evatuator's Signatare ,, .... -t,.' 'L.'.-'-" Drt" I i I i: i I 7"
griOu to tttitt l"ndorrn".. ,ol-ii'ilionmental professionals inThis channel evaluation-
gathering the data reg4ilea by the United States Army Corps of Engineers to make a preliminary assessment of stream
quatity. The total sCflre resuiting from the completion of this form is subject to USACE approval and does not imply a
particularmitigationratioorrequirement. Formsubjecttochange-version06/03. ToComment,pleasecall 919-876-8441 x26.
(from reyerse):
,:t' t' ' t .'
STREA}I QL,{LITY ASSESSNIENT WORKSHE ET
#CIIARACTERISTICS ECOXtr,GION POINT RANGB $congComtalPrkdUouttlqrtih
Ulraq|
)xtst.l-te{
I Presence offlow / pershtent pools in stream
(no flow or saturation:0: strong flow: max points)0-5 0-4 0-5
L Evidence of past human alteration
(extensive alteration :0i no alteralion : max points)0-6 0-5 0-5
3 Ripariao zone
{no buffe,r = 0: contieuous- wide buffer: rnax points}0-6 0-4 0-5
4 Evidencc of nslrient or chemkal discharges
(extensive discharges = 0: no discharges = max poinrs)0-5 0*4 o-4
5 Groundwater discharge
(no discharce = 0: sorinps. seeos. wetlands. etc. = max Doints)
0-3 a-4 o-4
6 Presenee of adjacent {Ioodplain
tao floo&laiin = 0: extensive floodplain = max rointsl a-4 a-4 o-2
7 Ertrenchrncnt / floodplaia access
(deeply entrenched = 0; frequenr flooding = max points)0-J 0-4 a-2
I Preseaee of adjacent *etlands
(no wetlands = 0: laree adiacent wetlands = max points)0-6 a-4 g-2
9 Chaunel sinuosity
(extensive channelizatioa = 0: natural meander = max points)0-5 0-4 0*3
IO Sedimert ioput
fertensive deposition= 0: Iittle or no sediment = max points)0-5 o-4 0-4
ll Sizc & diversity of channel bed substrate
(frne- homosenous: 0: tarse- diverse sizes = max points)xAr,'0-4 0-5
).FhfFlx*
t{t}
F
t{
=
t+a
l2 Evidence of channcl iacisiou or widening
(drcdly incised = 0: stable bed & ba*s : max roiats)0-5 0-4 0-5
I3 Presercc of major benk failurcs
{severe erosion = 0: no erosioa. stable banks: max points)0-5 0-5 s*5
14 Root depth and density oa banks
{no visible roots = O: dense roots throu.shout = max points)0-3 0*4 0-5
l5 Impact by agriculture, livestock, or timber productioo
{substantia} impact =0: no evidence: max points)0-5 0-4 o-5
t6 Presence of rillle-pooUripple-pool compkxes
{no riffles/riooles or pools = 0: well-develooed : max points)0-3 0-5 0-6
l7 Ilabitat eomplexitv
{little or no habitat: 0: frequenl varied habitats = max points)0-6 0-6 0-6
l8 Calopy coverage over streambed
(no shading vegetalion = 0: continuous canopy = rnax points)0-5 0-5 0-5
l9 Substrate embeddedncss
(deeolv embedded = 0: loose structure = max)
o-4 0-4
).
CIor.tol'.tn
2A Presence ofstrelm invertebrat$ (see page 4)
(no evidence = 0: esmmon. numerous typ€s = max points)0-4 o-5 0-5
i
"a.
2l Prcsscce of amphibiens
{ao evidence:0; common, nurerous types = max points) _
0-4 0-4 a-4
2,Prescnce offish
{no evidence:0; conrmon, lrumerous types: rnax points)0-4 o-4 o-4
23 Evidence of wildlife use
(no evidence = 0; abundant evidence - max points)0*6 o-5 0.-5
Ta*.l?ohi&f€6ibi.t&' ,:!$&iiff
TOTAL SCOXE (als* cnter on firstpage)
' fhe-e clraratteri5[i(is nri r,.)t lrss.ssed in coasiai streSrrs
NC DWO Stream ldentilication Form Version 4.ll
Date: {, lr r ProjecUSite: i{N,rq
Evaluator: ,, i'i' r: ;County: Uq luq,,+Lonsitude:tf 0$ So.Xlc2
Total Pointsr n ./
Stream is at teast intermittent \'fi a
i 2 19 or oerennial if > 30. J ' ' ,
Strea m Dete rm i nati o n ( c i rc_1g-o_qgl-.
Ephemeral lntermittent_Perennia! I
Other
e.g. Quad Namei
A. Geomorpholoqv (Subtotal= t Absent Weak Moderate Strong
1" Continuity of channel bed and bank n 1 2
2. Sinuosity of channel along thalweg U 1 2 8)
3. ln-channel structure: ex. riffle-pool, step-pool,
rioole-oool seouence 0 1 9 3
4. Particle size of stream substrate 0 1 2 7a)
5 Active/relict floodplain 0 1 2 J
6. Depositional bars or benches U 1 t)
7. Recent alluvial deposits U 1 CI J
8. Headcuts U 1;2 5
9. Grade control 0 0.5 ,T 't.5
10. Natural valley 0 0.5 r1)1.5
1'1 . Second or qreater order channel No=0 Yes = 3,,
artificial ditches are not rated; see discgssions in manual
B.H
12. Presence of Baseflow 0 1 2 /t
13. lron oxidizinq bacteria {0.,1 2 a
14. Leaf litter 1.5 1 I U.7 0
'15. Sediment on plants or debris 0 05 1 1.5
16. Organic debris lines or piles 0 0.5 1 1.5
17 Soil-based evidence of high water table?No=0.Yes=3
C tsroloqv (Subtotal =
18. Fibrous roots in streambed t;1 0
19. Rooted upland plants in streambed 13,2 1 0
20. Macrobenthos (note diversity and abundance)0 .21
J
21. Aquatic Mollusks d 1 2 J
22. Fish 0 05)1 15
23 Cravfish U 05 1 'l.5
24. Amphibians tl 0.5 t5
25 Alqae /0,05 1 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1 5. Other = 0
"perennial streams may also be identified using other methods. See p. 35 of manual
Notes:
Sketch:
l.-- .1
1, .'
DwQ #
+t ,,.Lr-)'j
Site #_ (indicate on attached nrapi
m
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following informatioa for the strcam rctch under assessment:
USACE AID#
l. Applicant's name;
3. Date of evaluation:
5. Name of stream:
7, Approximate drainage area:
9. Lengh of reach evaluated: {D
2. Evaluator's name:),'. l.,i.
4. Time of evaluation:
6. River basin: il€w R,iu .
8. Stream order: L',
I l. Site coordinates (ifknown): prefer in decimal degrees.12. Subdivision name (if any):
Laritude(ex 348723t2)i q( 3)Longitude (ex -:17 5566l}i 3 b C.r
10. Counw: Uq lqh.,<
J
-1,*r)-
Mcthod location determined (circle): /C Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
[3. Location ofreach under (note nearby roads and landmarks and attach map identiling stream(s) location):
14. Proposed channel work (if aryl: lZ i 't .'' ':-'
15. Recent weather conditions: .P tYL.
t6. Site conditions at time of visir: 7i
21. Estimated watershed land use: ;-i'% Residential 7o Commercial .-l- % Industrial lj % Agricultural
17. Identifu any special waterway classifications kro#or
-section
l0
-Tidal
Waters
-Essential
Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitife Waters _Water Supply Watershed (l-N),',^.l8.Isthereapondorlakelocatedupstreamoft}11valuationpoint?YES@o,[fyes,estimatethewatersurfacearea:-
19. Does channel appear on USGS quad man? ig8 NO 20. Does channel appear on USDA Soil Survey? YES NO
, I \ ToForested-/(.1 _- a
_Yo Cleared / Logged _% Other 1
22. Banktull widrh: ' | - !' 23,. Bank height (from bed to top of bank): i "1-
24. Channel slope down center of stream : /_Flal (0 to 2o/o) V
/
\,/ Gentle (Zto 4%) _Moderate (4 to l0%) _Steep (>10%)
25. Channel sinuosity:
-straight
ilOccasional bends
-Frequent
meander
-Very
sinuous
-Braided
channel
Instructions for completioo of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section, Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream ofthe
highest quality.
Total Score (from reverse ), f0 Comments:
Evaluator's Sigr^to""-:6",
.t
Date IOI I ?,
r-,{
rners aud enviionrhental Drofessionals inThis channel evaluation is'fftended to be used only as a guide to assist landowners atrd en tal professionals in
gathering the data by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particularmitigationratioorroquirement. Formsubjecttochange*version06/03. ToComment,pieasecall 919-876-8441 x26.
STREA}I QUALITY ASSESSNIE).iT \I,ORKSHE ET
#CIIARACTERISTICS ECONEGIONP.()INT RAI{CE
Coastd Pidmoat *IsiEtrir
rl
UFI
?r)
lrlH
Ft'-
Prescnce of llow I persistent pools in strerm
(no flow or saturation = 0: strong flow: max points)0-5 o-4 0-5 .
',
..:._. __
1 Evidence of past human alteration
{extensive alteration = 0; no alteration : max points)a-6 0-5 0-5
J Ripariaa zone
{no buffer = 0; contiauous, wide bufer: max points)0-6 0'4 0-5
4 Evklenee of ruirient or chemical discharges
{extelrsive drscharges = O; no discharges = max points)0-5 0-4 0-4
5 Groundwater discharge
lno discharse = $: sorines- seeos. wetlands- etc. : max poinls)0-3 c-4 0-4
6 Prcsencc of edjaccut lloodPlain
trto ffoodDlaiE = 0: exteEsive floodplain : max points)a-4 o-4 6-2
.,Entrcnthmcut I floodplair eccess
(deeply entrenched = 0; frequent flooding = max points)0-5 0*4 0-2
8 Preseoce of adjaeent wotlatrds
f no wetlands = 0: faree adiacent wetlands = max points)0-6 0-4 a-2
9 Cbauncl sinuosity
{extensive channelization - 0: natural meander = max points}0-5 0-4 0-3
t0 Scdimeot inPut
(extersive deoosition= 0: little or no sediment = max goints)0-5 0-4 0-4
ll Slze & diversity ofehanncl bed substrale
{fine- homoeenous = 0: laree- diverse sizes = max points)Df{{ ,'': I s.-4 0-,
i'f*hlEI*
E!{A)
12 Evidence olchanrel incbioa or widening
{deaolv incised'- 6: stable bed & baoks = max ooints}0-5 0-4 0-5
t3 Pres€rce ofmajor bank failures
{severe erosion = S: no erosioo- stable banks = rnax poin6)0-5 0-t 0-5
l4 Root dtptt and density on baoks
{oo visible roots: 0: dense roots throuehout = max poin8)0-3 8-4 0-5
l5 lmpact by agriculture, livestock, or timber productiot
tsubstantial impact =0: no evidence: max pointsi 0-5 0-4 0-5
f-,
t*
E
r6 Presence of rifile-pooVripple-pool comPhxes
no riftleslriooles or oools: 0: well{evelooed : max Doints 0-3 s-5 0*6
l7 Habitat complexitY
{little or no habitat = 0: freouenl varied habitae : max Doints}
0-6 0*6 0-6
I8 Canogy €overage over streambed
(no shading vegetalio&:0; continuous canopy = max points)0-5 0-5 0-5
19 Srbstrate embeddedness
(deeolv embedded = 0: loose structule = max)I{4:i1.,,0-4 0-4
(,oFtolr.B
20 Preserce ofstream invertebrates (see page 4)
fno wide*ce:0: cornmon. numerous types: max points)a-4 &-5 0-j
zt Presence of amphibians
(ao evidence:0: commoa. numerous tvpes = max points)a*4 0-4 8-4
)7 Presence offish
(no evidence:O: common. numerous Epes = max points)o-4 &-4 o-4
23 Evidenee of wildlife use
(no evidence = 0: abundant evidence: max poinls)0-6 0,5 0-s
?ixrlfafu*rocible tg& ,i&,.r
;TOTAL SCORE (al*r e:-rter eu fixtpage)
'i* .' r?ip
'i
l.- ;""t"^.
--,hj
NC DWQ Stream ldentification Form Version 4.11
Date: lr f ;, :, i I
Evaluator: i .,.1 County: 4fn rn.,,r,Longitude: 1j {{)f ;'l .
Total Points: ^
Stream ls at least intermttent !':"
tf > 19 or Derennral if 2 3O* *i -'
Stream Determind'iion (circle oneL
Ephemeral lntermittent Perenhial
Other
e.g. Quad Namei
A. Geomorpholoov (Subtotal = '(f,"Absent Weak Moderate Strong
1a Continuity of channel bed and bank 0 1 2 (a)
2. Sinuosity of channel along thalweg 0 1 ')2
3. ln-channel structure: ex. riffle-pool, step-pool,
ripole-oool seouence 0 1 2 r'L!t9'
4. Particle size of stream substrate 0 1 2 rt)
5. Active/relict floodplarn 0 ,1 2
6. Depositional bars or benches ,1,2 2
7. Recent alluvial deposits 0 1 2 J
8. Headcuts 0 ll 2 3
9. Grade control 0 0.5 ,i.1.5
10. Natural valley 0 05 1.5
1 '1 . Second or oreater order channel No=0 Yes=3
artificial ditches are not rated: see discussions in manual
B. Hvdroloov (subtotal = q'. HVdroloqv (Subtotal=
12. Presence of Baseflow 0 1 2 ,6,
13. lron oxidizing bacteria IO'I 2 J
'14. Leaf litter 1.5 1 ,,'0.5'0
15. Sediment on plants or debris 0 6.5 1 1.5
16. Organic debris lines or piles 0 05 _1.1.5
17. Soil-based evidence of high water table?No=0 Yes=3
C.
18. Fibrous roots in streambed 5 f 2.,1 0
19. Rooted upland plants in streambed 2 1 0
20. Macrobenthos lnote diversity and abundance)0 1 a J
21 Aquatic Mollusks 0 1 2
22. Fish 0 0.5 1 15
23. Crayfish 0 05 1 1.5
24 Amphibians 0 0.5 1"1 't 5
25. Algae 0 0.5 1 15
26. Wetland plants in streambed FACW = 0.75; OBL = 'l .5 Other = 0.i
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
USACE AID#DWQ #
744; 5 t* i3
Site #_ (indicate on attached nupr
ffi$
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the stream reach under assessment:
,,t,fu't{rl. Applicant's n"rn., ,t""1:-:' .
I o' 'lt{
1 r ,r'1lr ..\ r
7. Approximate drainage uea: 0j,1 . '8. Stream order: L 'J
9. Length of reach eu.luut"d, ' b0'10. County:
I l. Site coordinales (ifknown): prefer in decimal degrees.12. Subdivision name (if any):
,l!
Latitude(cr 34872312): ai 5 Longitude (ex -77 55661 l):. J +e
Method location determined (circle)fopo Sheet Ortho (Aerial) PhotoiGIS Other GIS Othcr
13. Location ofreach under
2. Evaluator's narne:
3. Date of evaluation:- ;; .r ,' : i ' 4. Time of evaluation:
tt-
5. Name osr1r"*nt ,/r,nqn'r,i i j' :i r i" l-r;,'. , 6. River basin:. i'li.
-+-:ciI
j0 i.,;'5 tu.i.{;
14, Proposed channel work (ifany): \ ' ; z:,2 "' ''
15. Reeent weather conditions: 9*'t ( ,,, ^
16. Site conditions at time of visir, j, ".-, 'i)
I7. Identify any special waterway classifications known:
-Section
10
-Tidal
Waters
-Essential
Fisheries Habitat
_Trout Waters Outstanding Resource Waters
-
Nutrient Sensitive Waters
-Water
Supply Watershed (I-IV)
f'.
18. Is there a pond or lake located upstream of the evaluation point? YES .NOi If yes, estimate the water surface area:_
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
21. Estimated watershed land use: ) % Residential oZ Commercial J % Industrial _% Agricultural
Ai--yrForested _%o Cleared / Logged _% Other
22. Banktuli width: t, a '23. Bank height (from bed to top ofbank):,/
24. Channel slope down center of stream : ,-Flat (0 to 2o/o) {Centle (2 to 4o/o)
-Moderate
(4 to 10%)
-Steep
(>lO%)
25. Channel sinuosity:
-straight
t,/ Occasional bends Frequent meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by deterrnining the most appropriate ecoregion based on
location, terrain, vegetation. stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the sffeam reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of i00 representing a stream of the
highest quatiry.
(q
Total Score (from reverse\:_!J- Comments:
Evaluator's Signature
This channel evaluation 6 intei-aeO to be used only as a guide to assist landowners and ehvirohmental professionals in
gathering the data
qualify. The total
by the United States Army Corps of Engineers to make a preliminary assessment of stream
resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation o or requirement. Form subject to change * version 06103. To Comment, please call 919-876-8441 x26
STREAII QUALITY ASSESSNlE){T WORKSHE tlT
#CIIARACTERISTICS ECOREGISN POINT RANCE af,aifitt
Corstd fkfuq.t *tsietrfu
tI
U
w
lr{t-a&
I Presence of llorr I pcrsistent pools in stream
(no flow or satuation = 0: st ong flow: rnax points)0-5 0-4 0-5
z Evidence of past hsman alteration
(extensive alteration : 0; no alteration : max points)a-6 0-5 0-5
t Ripariau zone
(no buffer = 0; contiguous, wide buffer = max poinrs)0-6 o*4 0-5
4 Evidence of uulriett or chemical disthargcs
(extensive discharees -- O; no discharges: max points)0-5 0-4 0-4
5 Groundwater disekarge
(no discharge = 0; sprinss, seeps, w€tlandg etc- = max pointsl 0-3 0-4 0-4
6 Prcseace of adjacent floodPlain
trc ffoodolair = 0; extensive floodplain : max points)0-4 a-4 a-2
7 Entrcnthmeut / Il,oodPlain access
(deerly entrerehed: & frequent flooding = max poiats)0-5 s-4 g-7
I Presence of adjecent wctlaads
tno wetlands = 0: larse adiacent wetlands = max points)o-6 o-4 0-2
9 Chaunel sinuositY
{exteasive channelization : 0: natural rneander = max poinB)0-5 a*4 0-3
t0 Scdiment ioPut
(efiensive deposition= ft little or no sediment = max points)0-5 0*4 0-4
1I Size & diversify ofcbanncl bed substrate
ff,rne- homoeenous = 0: larEe. diverse siz6 = max points)!{Ar 0-4 B-5
Ef
F]!t
Fa
l2 Evidence of channel incisftrn or widening
f&coiv incised = 0: stable bed & banks : max ooin8)o-5 0-4 0-5
r3 Prescace ofmajor bank feilurcs
(severe e.o$ion = 0; no erosion, stable banks: rna,x points) ,s-J 8-3 0-5
t4 Root dcpth end density on baaks
{no visible roots : 0: dense roots throughout = max PoiSq}-0-3 0*4 0-5
l5 Impact by agriculture, livestock, or timber production
(zubstantiat impact:0: no evidence = max points)0-5 0-4 0-5
F
F
lr
t6 Presence of ri{Ile-pool/ripple-poot complexe
(no riffleslripples or pools = 0; well-developed = max points)0-3 0-5 0-6
t7 Habitat complexitY
{little or no habitat = 0; fiequent, varied habitats = max points}0-6 0-6 0-6
18
Caoopy coverage over streambed
(no shadine vesetalion = 0; continuous canopy = max points)0-5 0-5 0-,
l9 Slbstrate embeddedness
(deeolv embedded = 0: loose structure = ma:<)
}IAI 0-4 0-4
)too*ol{f,l
2A Prcsencc ofstream invertebrates (see page 4)
(no evidence = 0: common. numemus types = max points)0 -4 &-5 0-5
21 Prescnce of amPhibians
(no evidence:0; corrmon, nunerous types = 4C4-Pggltsl_-
a-4 o-,4 o-4
,',Prcscrccoffish
ino eviderrce:0: common. numerous Epes: rnax points)0 --4 *,-4 0*4
z3 Evidence of wildlife use
{no evidence = 0: abundan! evidence = max points)0-6 0-5 0--5
ToeIPokS$odtr t@ ..I(iI ,r&t
TCTAL $C$R.E (also entef m *rst gBl r,/ I
' fhere cltarectcr:stius ari nL)t assi:ied in ;oasiai itrtrili.ns
NC DWQ Stream ldentification Form Version 4.11
Date:lb li'V'l 'l proieclsite.$f t,/ / Lr,Latitude: tri :' ':." i i0r'r
Evaluator: )- r,4A1O_County: du {o*o,Longitude: - '' ,"-
TotalPoints: t tr,, /
Stream ls at least ntermfttent 1V ,>
if 2 19 or oerennial if > 30"
Stream Determination (circle one)
Ephemeral lntermittent Perennial
otherffil SZI lae
e.g. Quad Name:
A. Geomorpholoqy (Subtotal= I Absent Weak Moderate Stro_ng
1a Continuity of channel bed and bank 0 1 2 1.1
2. Sinuosity of channel along thalweg 0 ,1,2 3
3. ln-channel structure: ex. riffle-pool, step-pool,0 1 2.
4. Particle size of stream substrate 0 1 2 J
5 Active/relict floodplain 0 1 2 c
6. Depositional bars or benches 0 1 ??
7. Recent alluvial deposits 0 1 2 ,l
8. Headcuts n 1 2 3
9. Grade control 0 0.5 1 15
'10. Natural valley 0 0.5 I 1.5
1 1. Second or oreater order channel No=0 Yes=3
artificial ditches are not rated; see discus,sions in manual
C
B. Hvdroloqv (Subtotal- f
12. Presence of Baseflow U 1 2 ?
'13. lron oxidizinq bacteria 1 2 3
14. Leaf litter '1 5 1 0.5
15. Sediment on plants or debris 0.5 1 1,5
16. Organic debris lines or piles U 05 1 1.5
17. Soil-based evidence of high water table?No=0 Yes=3
-t
18. Fibrous roots in streambed J \e,,
1 0
'1 9 Rooted upland plants in streambed ,'*y 2 1
20. Macrobenthos (note diversity and abundance)0 1 2\J
21. Aquatic Mollusks ,ol 1 2 5
22. Fish 0 '0.5 -I 1.5
23. Crayfish 0 0.5 1 1.5
24 Amphibians 0 0.5 1 1.5
25 Algae /O;0.5 1 1.5
26. Wetland plants in streambed FACW=0.75: OBL= 1 5 Other= 0
"perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
I.]SACE AII}#DwQ #
.na'4 \ \*"t,'
Site #_ (indicate on attached inapr
ffi$
Provide the
STREAM QUALITY ASSESSMENT WORKSHEET
following information for the strcam reach under assessment:
1.Applicant's nu ", -,C l'-L 2. Evaluator's name: .u tL[q t.t
3. Date of evaluation: i'iil.,,, i' / . 4. Time of evaluation:
5.Nameofstream: ,,.,,..1r..* . i: f,, i 6.Riverbasin:
, f .,.
7. Approximale drainage are@ 8. Stream order: -'L
g.Lengthofreachevaluated:- lSl fi.Counry-: v*i4!4n1en
I l. Site coordinates (ifknown): preferin decimal degrees 12. Subdivision name (if any):
Laritude(ex zosrzrrrl Q) i it .; i',t5:,,Longitude (ex -77 55661 1):
Method location determined (circle): ; GP$' Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other-
13. Location of reach unde, eraiualis((note nearby roads and landmarks and attach map identifing riiian(.1 to.utioni'
-)' |',
c/ , -')
17. ldentifr any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (l-N)
1*-'
18. Is there a pond or lake located upstream of the evaluation point? YES (Nq' If yes, estimate the water surface area:-
19. Does channel appear on USGS quad mapZ /{fd5 NO 20. Does channel appear on USDA Soil Survey? lbS r.rO
21. Estimated watershed land use:
-%
RVdential o/o Commercial
-%
Industrial 52y' egricultwal
14. Proposed channel work (ifany):
15. Recent weather conditions: &fi.
a
16. Site conditions at time of visit: {'
flv"Forested _o/" Cleared / Logged _% Other (
22. Banktull *iath,A' j 23. Bank height (from bed to top of bank):
( "-2'l-L
l'
24.Channel slopedowncenterofsaeam: _ Flat(0to2"/o) 1'Centle(zto4yo:)
-Moderate(4to
l0%) _Steep(>10%)
25. Channel sinuosity:
-straight
y'bccasional bends
-Frequent
meander
-Very
sinuous
-Braided
channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality. i r,t._t r
Total Score (from reverse)t-i ',\L,':.r I i.. l,: t' -- rir, i.)- ,J ,. n
Evaluator's Signature Date lo/zY, t',
Ihis channel evaluation form is to be used only as a guide to assist landowners and environmental professionals in
gathering the data required United States Army Corps of Engineers to make a preliminary assessment of stream
quatity. The total scoreftlting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation rado or requirement. Form subject to change - version 06103. To Comment, please call 919-876-8141 x26.
STREA}T Qt ALITY ASSESS}IE){T WORKSHE ET
#CIIARACTERISTICS . COREGIONPOINTR.A.NGE SCOREComtrlPicdnsat*{mnteia
-1
uFi
€A
F'e{
1
Preseuce of flow / pcrsistent pools in str€sm
(no flow or saturation = 0l sfrong flow : max points)0-5 o-4 0-5
2 Evideace of past human alteration
(extensive alteration = 0: no alteration : max points)0-6 0-5 0-5
3 Riparian zone
(no buffer = 0: contiauous. wide buffer: max points)0-6 0-4 0-5
4 Evkleoee ofnutrient or chemical discharges
{extensive discharges = 0; no discharges: max points)0-5 0-4 0-4
5 Grouodwater discharge
{no discharse = O: sorinss. seeos. wetlands, etc- = max points)0 -3 a-4 0-4
6 Prcscnce of adjacent {loodPlaiu
f no floodolair = 0: extensive floodplain : max points)0-4 B-4 0-2
1 Entrenchment I fl,oodPlaia eccess
(&eplv entrenched = 0: &equenl flooding: mat points)0-,o-4 0-2
8 Preseoce of adjacent wetlalds
{no wetlands:0: laree adiacent wetlands = max points)o-5 0-4 a-2
9 Channel siouositY
{ortensive channetization = 0: natural meander = max points}o-5 0-4 0-3
l0 Scdiment input
(extensive deoosition= 0; little or no sediment = max points)0-5 o-4 0-4
il Sizc & divcrsify ofchannel bd sttb$trste
{frne- homosenous - 0: large. diverse siz* = max points)NAT o-4 0-5
i{Hhl*fi
t{a
l2 f,vidence of charnel ineision or widening
fdccolv incised = 0: stable bed & huks : max points)o-5 0-4 0-5
l3 Presc*ce of major baok failures
{severe erosion = 0: no erosioo. stable banks = rnax points}0-5 0-5 0-5
I4 Root dtptb end densitY ol banks
fno visible roots = 0: dense roots throughout = max poirts)0-3 o-4 o-5
l5 Impacf by agriculture, livestock, or limber productioo
tsubstantial impact:0: no evidence = max points)0-5 0*4 0-5
F
h
I
l6 Presence of riflte-pooVripple-pool complexes
(no riffleVripoles or pools:0: well-developed = max pr:ints)0-3 0-5 0-6
l7 Habitat eomPlexitY
{little or no habitat: 0: fiequenl varied habitats = max points}0-6 0-6 0-6
t8 Canopy coverage ovei streambed
(no shadinE vecetation = 0; continuous canopy = max points)0-5 0-5 0-5
l9 Substrate embedddnms
(deeolv embedded = 0: loose structure = max)
i 0-4 0-4
irt,
:IA
Fts
2A Prcsenee ofstream invertebrates (see page 4)
fno evidence:0: cornmon. numerous typ€s = max points)0-4 0-5 0-5 -/
1.2t Preserce of ampbibirns
fno evidence:0: conunon. rumerous types = max points)0-4 0-4 0-4
22 Prescnce offish
{no evidence:0; commor, numerou$ typ€s: nrax points}0-4 A-4 o*4
23 Evidence of wildlife use
(no evidence = 0; abundant evidence = max poinis)0-6 e-5 0-5
Toqf fo&r$foil6k lffi'ifrl
TOTAL SCOR"E (also enter on first pags)
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
projecusire: bL"-< d' A, l/a" lc*,. ciry/county:-. ' ,,
?*1,,r,- ",1..- ln,, i,SamplingDale l''i 1; l!1..br
t--
ApplicanVowner: i' i ,;
lnvestigator(s): ., .,',rr,* /"rri. i.-. ,ttr.",, L Section, Township, Range:
State: ,1:r f Sampling po1n,6{1/i * r'1p
Slope (%): # *"1
Soil Map Unit Name
Are climatic / hydrologic on the site typical for this time of year? Yes
Are Vegetation _. Soil or Hydrology _ significantly disturbed?
Are Vegetation _, Soil or Hydrology _ naturally problematic?
Local relief (concave. convex, none):
1l 3b lrr.ilctl- rons, .jv It4!t :,'-'.1u.'. Datum
NWlclassificatio", Vtll.
No _ (lf no. explain in Remarks.) /
Are "Normal Circumstances" present? yes / No
-
(lf needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
YeS
Yes
Yes
No
No
No s ls the Sampled Area
within a Wetland?Yes /
Remarks:
". t, / ;,'( v.'f i;^.'f !'I i' .,.{ ,tl I f,., {
- ., t
HYDROLOGY
Wetland Hydrology lndicators:
Primarv lndicators (minimum of one is reouired: check all that
Secondarv lndicators (minimum of two requirec
_ Surface Soil Cracks (86)
_ Sparsely Vegetated Concave Surface (88)
_ Drainage Patterns (810)
_ Moss Trim Lines (B16)
_ Dry-Season Water Table (C2)
_ Crayfish Burrows (C8)
_ Saturation Visible on Aerial lmagery (C9)
_ Stunted or Stressed Plants (D1)
_ Geomorphic Position (D2)
_ Shallow Aquitard (D3)
_ Microtopographic Relief (D4)
FAC-Neutral Test (D5)
Surface Water (A1)
High Water Table (A2)
Saturation (A3)
Water Marks (81)
Sediment Deposits (82)
Drift Deposits (B3)
Algal Mat or Crust (84)
lron Deposits (85)
lnundation Visible on Aerial lmagery (87)
Water-Stained Leaves (B9)
Aquatic Fauna (813)
True Aquatic Plants (B14)
Hydrogen Sulfide Odor (C1)
Oxidized Rhizospheres on Living Roots (C3)
Presence of Reduced lron (C4)
Recent lron Reduction in Tilled Soils (C6)
Thin Muck Surface (C7)
Other (Explain in Remarks)
Field Observations:
Surface Water Present? Yes _
Water Table Present? Yes _
Saturation Present? Yes
(includes caoillarv frinoe)
No Wetland Hydrology Present? Yes
-
*" /
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
1Vo t'11ts'';'i c''il
!^ it, ill
I
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point:
Tree Stratum (Plot size: ) % Cover Soecies? Status1 ()^ rt- J i^: br. .:i:'- Y f4CUz. A, l- L ':!'. '.1- ' y Fr/c
3 ?- t 1at,r'
o ,/. -]-;?- {4!,
5
6
Dominance Test worksheet:
Number of Dominant Species -t
That Are OBL, FACW, br FAC: ? 6)
Total Number of Dominant I
Species Across All Strata: P tel
Percent of Dominant Species ,.; '; .,)
^That Are OBL, FACW, or FAC: * ,, ' .' (A/B)
----1-->-:------
lV 0=TotatCover
50% of total cover: 5 / 20% of total cover: ' i'
Saolinq/Shrub Stratum (Plot size: )
t {'; ( i' ;', i.r, - I
2. 1_t,.: t r I i! .,:,{.., la
3. ?r ," ,- * , / {ers t)4e, !
o -----:-
5.
6.
F4c
f4crr
F4 Lq
f4(kt
v
v.
M
Multiplv by:
OBLspecies x1=_
FACW species x2 = _
FACspecies x3=_
FACUspecies x4=_
UPLspecies x5=_
Column Totals: _ (A) _ (B)
Prevalence lndex = B/A =
Prevalence lndex worksheel
Total 7" Cover of:
Herb Stratum fPlot size: )
'l v'r : t'i "' ',1
2
3
7
o
--
t' ^ \'u = Total cover-
5070 of total cover: 'l'j --Mof total cover: ?
Hydrophynic Vegetation lndicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
_ 3 - Prevalence Index is <3.01
_ 4 - Morphological Adaptationsl (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetationr (Explain)
'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
7
R
o
,, o,
11
i,")I r' = Total Cover
50%oftotalcover' i zoy.oftotalcover, l.-
Woody Vine Stratum (Plot size: _ )'1 !
a t /, r... /,.4z. !\ !., I
c'! ./
4. -/'
6
50%oftotar rou"r, --.1].%or;#i::::l"t
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, Iess
than 3 in. DBH and greater than or equal to 3.28 ft (j
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3,28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
HydrophyticVegetation I ^/Present? Yes _ No Y=
Remarks: (lnclude photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
'soI
Sampting eoint, 6lril' r'i''
ProfileDescription:(DescribetothedePthneededtodocumenttheindicatororconfirmtheabseniffi
Depth Matrix Redox Features(inches) Color (moist) o/o Color (moist) % Tvoe' Loc2 Texture Remarks
0 - t t 'tl\( 'itt ,1i.) )
. .- '- , ) t-'- /( t,, t\ v'/i
t ll'tR'4 /-)
lType: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.2location: PL=Pore Linino- M=Matrix
Hydric Soil lndicators: lndicators for problematic Hyaric soitsl
_ Histosot (A1) _ Dark Surface (S7) _ zcm Muck (A10) (MLRA 147)
_ HisticEpipedon(A2) _ potyvatueBelowSurface(S8) (MLRA147,148) _ CoasrprairieRedox(4.16)
_ BlackHistic(A3) _ ThinDarkSurface(S9) (MLRA147,14Bt (MLRA147, 148)
_ Hydrogen Sutfide (A4) _ Loamy Gteyed Marrix (F2) _ piedmont Ftoodptain Soils (F19)
-
srrarified Layers (A5) _ Depleted Marrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N) _ Redox Dark Surface (F6) _ very Shailow Dark Surface (TF12)
-
Depleted Below Dark Surface (A1 1) _ Depleted Dark Surface (F7) _ Other (Explain in Remarks)
_ Thick Dark Surface (A12) _ Redox Depressions (F8)
-
Sandy Mucky Mineral (S1) (LRR N, _ tron-Manganese Masses (Fl2) (LRR N,
MLRA 147,148) MLRA 136)
-
Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122) 'lndicarors of hydrophytic vegetation and
-
Sandy Redox (S5)
-
Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ Stripped Matrix (56) Red parent Material (F21) (MLRA 127 , 147\ unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):Hydric Soil Present? Yes
-
*" l/
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Proiecusite: f l . , (", r,{" , i,r'. i. ,, r'u
OOO,,.unrO*
lnvestigator(s):,.),,'n.lr.
Landform (hillslope, terrace, etc.)
Subregion (LRR or ML ur,,{[ 1
Soil Map Unit Name
A ' gt
fia iJ- r '. .l
Are climatic / hydrologic conditions on the site typical for this time of year? Yes
Are Vegetation _, Soil or Hydrology _ significantly disturbed?
Are Vegetation _, Soil or Hydrology _ naturally problematic?
stle: NL Sampling Poinr:g/ L'/ /*b4l'
Section, Township, Range:
Local relief (concave, convex, none): (o.lLA/L' Slope (%): O'2-
rong, -jt ji. (?.:l(l? oatr*
,., Y!classification:
No _ (lf no, explain in Remarks.)
Are "Normal Circumstances" present? Vut ,/ No
-
(lf needed, explain any answers in Remarks.)
city/County: L)at fiqr, Sampling ,ur"' 1o/ Z Z / / y
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
KetTlart(a
Yes
Yes
Yes
-V,-7
No
No
No
ls the Sampled Area
n ithin a Wetland?
s"l .:i, i,{ ,.,.r,/ tl"^'+,,,,3 0,". fI,, r-
HYDROLOGY
Wetland Hydrology lndicators: Secondary lndicators (minimum of two required)
Primary lndicators (minimum of one is required; check all that apBly) _ Surface Soil Cracks (86)
_ Surface Water (A1) _ True Aquatic Plants (814) _ Sparsely Vegetated Concave Surface (88)
_.High Water Table (A2) _ Hydrogen Sulfide Odor (C1) _ Drainage Patterns (810)
-rzl Saturation (A3) -,/ OxidizeO Rhizospheres on Living Roots (C3)
-
Moss Trim Lines (816)
_ Water Marks (B1) _ Presence of Reduced lron (C4) _ lry-Season Water Table (C2)
-
Sediment Deposits (82)
-
Recent lron Reduction in Tilled Soils (C6) vlCrayfisn Bunows (C8)
_ Drift Deposits (B3) _ Thin Muck Surface (C7) _ Saturation Visible on Aerial lmagery (C9)
_ Algal Mat or Crust (84) _ Other (Explain in Remarks) _ ,tunted or Stressed Plants (Dl)
-
lron Deposits (85) Z1eomorphic Position (D2)
_ lnundation Visible on Aerial lmagery (87) _ Shallow Aquitard (D3)
_ Water-Stained Leaves (B9) _ Microtopographic Relief (D4)
_ Aquatic Fauna (813) _ FAc-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes - No '/ DeDth (inches):
water Table present? v"t-7. *o - D"otn (in.h.r),-F-
saturarion presenr? v"t-7 *o
-
o"ptt 1in.n"r1
-]il
(includes caoillarv frinoe)
Wetland Hydrology Present? ,", ,/ No-
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks:
S w'f',,^
,f-{,,,, .1". :
i",: r I ''
I
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2,0
Tree Stratum (Plot size: )rC
I
1.
Absolute Dominant lndicator
o/" Cover Species? Status
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC:
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL. FACW. or FAC:
(A)
2.
3,
4.
(B)
5 ';{(A/B)
o
7
= Total Cover
50% of total cover: _ 20% of total cover:
obt-
2.
3.
4.
5.
6.
7.
8.
9.
Hydroph)rtic Vegetation lndicators:
_ J - Rapid Test for Hvdrophytic Vegetation-,/t/ 2 - Dominance fest is >50%
-
-r-
. r) =TotalCover ,
3 - Prevalence Index is <3.0
4 - Morphological Adaptationsr (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetationr (Explain)
50%of roral ,ouur, -l ,f-^ozori"t.i..r"."'S
1 -
{'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic,
Definitions of Four
7.
8.
9.
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
I Sapling/Shrub - Woody plants, excluding vines, less
I than 3 in. DBH and greater than or equal to 3.28 ft (1
1 m) tall.
11 Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
50% of total cover:
*_ElU Zo"/" ot
= Total Cover -
tolalcover'?4
Woody Vine Stratum (Plot size
1
2
3
4
5
Hydrophytic
Vegetation
Present?v"' /no= Total Cover
507o of total cover:20% of total cover:
Prevalence lndex worksheet:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:_ (A) _ (B)
Remarks: (lnclude photo numbers here or on a separate sheet.)
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point B( '"1I -v't\"
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
SOtL
lt
Sampling Point ( ( ul -'*Y
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
DeDth Matrix Redox Features(inihes) Colo(moist) % Color (moist) % Tvoe Loc2 Texture Remarks
i Ji 0i tt -/:.a'1',,) ?.{yp t ; * /r,'i. l*sa t"12 'tti i:'.j
9*r -iVKq-@ ?"{tF 7t ?.o L zq {i.y i*,,,
fi- t'.( la'i tl 1/r 1f f yR qA lit * A sil,i- i,-.q.*.
'Tvoe: C=Concentration, D=Deoletion, RM=Reduced Matrix, MS=Masked Sand Grains 'Location: PL=Pore Lininq, M=Matrix.
Hydric Soil lndicators: lndicators for Problematic Hydric Soils":
-
Histosol (A1) _ Dark Surface (S7)
-
2 cnl Muck (A10) (MLRA 147)
_ Histic Epipedon (A2) _ Polyvalue Below Surface (S8) (MLRA 147, 148) _ Coast Prairie Redox (416)
_ Black Histic (A3) _ Thin Dark Surface (Sg) (MLRA 147,1481 (MLRA 147, 148)
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2) _ Piedmont Floodplain Soils (F19)
-
srrarified Layers (A5) ;zloepteteo Matrix (F3) (MLRA 136, 147)
_2cmMuck(A10) (LRRN) _ RedoxDarkSurface(F6) _ VeryShallowDarkSurface(TF12)
_ Depleted Below Dark Surface (A11) _ Depleted Dark Surface (F7) _ Other (Explain in Remarks)
_ Thick Dark Surface (A12) _ Redox Depressions (FB)
-
Sandy Mucky Mineral (S1) (LRR N, _ lron-Manganese Masses (F12) (LRR N,
MLRA 147,148) MLRA 136)
-
SandyGleyedMatrix(S4)
-
UmbricSurface(F13) (MLRA136, 122) slndicatorsof hydrophyticvegetationand
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ Stripped Matrix (56) _ Red Parent Material (F21) (MLRA 127,14-ll unless disturbed or problematic.
stractive Layer (if observed):
Type
Depth (inches):HydricsoilPresent? ves / No-
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2,0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Projecusite: ciry/county:
trj " Sampting out" l)i':: /i\,' "- i., r ll-tiApplicanUOwner, -i]'-l-- , State: 17 L Sampting point..16F ;-,i i.' -1"
r,ftlnvestigator(s):..];..J.'..li.,.,lr.ll.rrSeCtion,ToWnShip,Range:
'r- i
Landform (hillslope, terrace, etc.): ,.: l! .,r ,., l.Local relief (concave, convex, none): 1.:-
subregion (LRR or MLRA), LrL,t ii ar, 5 i l;; li 'i'', !'l Lonq: 'O :t -i.tLtr-'
.1,' ! i.') .. t
Soil Map unit Name: Sqi ,nOOk I oA ,- L*$ 't, .\iri. .- NWt ctassification: '[":,
Slope (%): " ''
Datum:_
'rt, \
Are climatic / hydrologic conditions on the site typical for this time of year? ves ./'" No
-
(lf no, explain in Remarks.) /,Are Vegetation
-,
Soil or Hydrology
-
significantly disturbed? Are "Normal Circumstances" present? yes y' No _
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
Yes
Yes
Yes
"/-----/-V,,
No
No
No
ls the Sampled Area
within a Wetland?Yes ,,/ No
Remarks:
l'
HYDROLOGY
Wetland Hydrology lndicators: Sb
Primary lndicators (minimum of one is required; check all that apoly) _ Surface Soil Cracks (86)
-
Surface Water (A1)
-
True Aquatic Plants (814)
-
Sparsely vegetated Concave Surface (B8)
. Hioh Water Table (A2) _ Hydrogen Sulfide Odor (C1) _ Drainage patterns (B'10)---7r/ Saturation (A3) _ Oxidized Rhizospheres on Living Roots (C3) _ Moss Trim Lines (816)
-
Water Marks (81)
-
Presence of Reduced lron (C4) _piy-season Water Table (C2)
-
Sediment Deposits (B2) _ Recent lron Reduction in Tilled Soits (C6) _y! Crayfish Burrows (C8)
-
Drift Deposits (83)
-
Thin Muck Surface (C7)
-
Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (84) _ Other (Explain in Remarks) _, Stunted or Stressed plants (D1)
-
lron Deposits (85) -7
ceomorphic position (D2)
-
lnundation Visible on Aerial lmagery (B7) _ shallow Aquitard (D3)
_ Water-Srained Leaves (89) _ Microtopographic Relief (D4)
_ Aquatic Fauna (813) _ FAc-Neutral Test (D5)
Field Observations:
Surface Water Present?
Water Table Present?
Saturation Present?
[includes caoillarv frinoe)
Yes
Yes
Yes
No
No
No
_ Depth (inches):
_ Depth (inches):
wettand Hydrotogy present? ,.. / No-
l-lescrlbe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
), "."..! tt'..'l i l:^ i
_ ,/. t./..14 il.. I't
!-:y'/
US Army Corps of Enqineers Eastern Mountains and Piedmont - Version 2.0
VEGETATION (Four Strata) - Use scientific names of plants.Sampling u 7.
Tree Stratum (Plot size:
1.
Absolute Dominant lndicator
o/o Cover Soecies? Status
2.
3.
4.
5.
Saolino/Shrub Stratum
1.
= Total Cover
50% oftotal cover: _ 20% oftotal cover
(Plot size: )
_ 1 - Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
_ 3 - Prevalence lndex is <3.01
_ 4 - Morpholoqical Adaptations- (Provide supporting-// data in Remarks or on a separate sheet)
v Problematic HydrophyticVegetation' (Explain)
'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
2.
3.
4.
5
o
1
= Total Cover
507o of total cover:20% of total cover:_
)
4
6
t,!L
It"
Y {,iruiv--V- f{LtJ--F- ---=-
7
8
9
10
'11
50% of total ,ou"r, {{ --ii7o/" of ,orul cou.r, 'L..*'i
l(O = Totar cover
-1?Oo/^ of tntal cover' ' L Q'
Woody Vine Stratum (Plot size:-*:--'l1.
2.
3.
4.
5.
= Total Cover
20% of total cover:50% of total cover:
Number of Dominant Species
That Are OBL, FACW, or FAC:
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL, FACW. or FAC:
I
'o'L ,,,
FACWspecies - x2=
FACUspecies _ x4=
UPL species
Column Totals:
Prevalence lndex = B/A =
Tree - Woody plants, excluding vines, 3 in, (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (l
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3,28 ft in
or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
I
SOIL Sampling po,m,K ^t'
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features(inihes) Colo(rois0 % Texture Remarks
c -t1 h Y t( uz r() 1,r y(t it 'o c l'lL- f " .,, .' , 10r,,,
/t!- t', {r'!P-"n 7i 7,i iri irr 7, C, 'ltl u,,l ,. ,.',./ t*n
,r*, a=a..*"n.u... o=*r.*=*"*r*r*r,r,-, rt=*r* =-uno "rrrt **,**r=*" *ao, n *"*
Hyarlc Soi--Oicaiors: lndicators for Problematic Hydric Soils3:
-
Histosol (A1)
-
Dark Surface (S7)
-
2 cm Muck (A10) (MLRA 147)
_ HisticEpipedon(A2) _ PolyvalueBeiowSurface(S8) (MLRA147,148)
-
CoastPrairieRedox(416)
-
Black Histic (A3)
-
Thin Dark Surface (Sg) (MLRA 147,1481 (MLRA 147, 148)
_ Hydrogen Sulfide (A4) _ L/,amy Gleyed Matrix (F2) _ Piedmont Floodplain Soils (F19)
-
Strarified Layers (A5) -sl Depleted Matrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A.10) (LRR N) _ Redox Dark Surface (F6) _ Very Shallow Dark Surface (TF12)
_ Depleted Below Dark Surface (A11) _ Depleted Dark Surface (F7)
-
Other (Explain in Remarks)
_ Thick Dark Surface (A12) _ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N,
-
lron-Manganese Masses (F12) (LRR N,
MLRA 147.148) MLRA 136)
_ Sandy Gleyed Matrix (S4)
-
Umbric Surface (F13) (MLRA 136, 12?l 3lndicators of hydrophytic vegetation and
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ StrippedMatrix(56) _ RedParentMaterial (F21)(MLRA127,147) unlessdisturbedorproblematic.
Restrictive Layer (if observed):
Type:
Depth (inches):Hydric Soil Present? Yes _ No _
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
ProjecUSite:City/County:l-/.. .' " .
/. /'
Sampling Date:ryZ : /' i
Applicanuowner' f, tt srae: i4/- Sampting pornt,{r' ;/ ,. 1
Investigaror(s): ) .#+ r,Section, Township, Range
Landform (hillslope, terrace, etc.): j Local relief (concave, convex, none): i). ', ,'Slope (%): --
1*,
Subregion (LRR or MLRA)
Soil Map gn;, N1uru 54,! ,t 6 ,v. L"g NWI classification: f .- '' I I
Are climatic / hydrologic conditions on the site typical for this time of year? yes No (lf no. exolain in Remarks.)
Are vegetation
-,
Soil or Hydrology
-
significantly disturbed? Are "Normal Circumstances" present? ves L./No _
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks,)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
ls the Sampled Area
within a Wetland?
^/ /)/q,. tt t';'.,.; ,/ , i 4:',
:!;,1t+ ({ -,,.
HYDROLOGY
Wetland Hydrology lndicators:
Primary lndicators (minimum of one is required; check all that applv) _ Surface Soil Cracks (86)
_ Surface Water (A1)
Hioh Water Table (A2)
J Saturation (A3)
_ Water Marks (81)
_ Sediment Deposits (82)
Drift Deoosits (B3)
_ Algal Mat or Crust (84)
_ lron Deposits (B5)
_ lnundation Visible on Aerial lmagery (B7)
_ Water-Stained Leaves (89)
Aouatic Fauna (813)
_ True Aquatic Plants (814)_ Sparsely Vegetated Concave Surface (Bg)
-;tyUrogen
Sulfide Odor (C1) _ Drainage patterns (BtO)
! OxidizeA Rhizospheres on Living Roots (C3) _ Moss Trim Lines (816)
_ Presence of Reduced lron (C4)_ Dry-Season Water Table (CZ)
-
Recent lron Reduction in Tilled Soils (C6) llcrayfish Burrows (C8)
_ Thin Muck Surface (C7)
_ Other (Explain in Remarks)
_ Saturation Visible on Aerial lmagery (C9)
_ Stunted or Stressed Plants (Dl)
_ Geomorphic Position (D2)
_ Shallow Aquitard (D3)
_ Microtopographic Relief (D4)
_ FAc-Neutral Test (D5)
Surface Water Present? Yes
-
frf o f,/
Water Table Present? yes ,/ .. No
Saturation Present? vu=-Z *o
-(includes capillarv frinoe)
Depth (inches):_
Depth (inches): i
/1
Depth (inches): 'f,r /
Wetland Hydrology Present? Ves t/ No
DeScribeRecordedData(Streamgauge,monitoringwell,aerialp@
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
,,
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point
' 50% of total cover: _
(Plot size: )
= Total Cover
ZOYo of lolal cover:_
Absolute Dominant lndicator
o/" Couer Species? Status
j"
,(:
Y. o&L--T- oil
4
5
6
7
E( =Totat cover
50% of totat ,ouur, / 7 , f- zo"t" of total corert t /
1.
2
3.
4.
5.
6.
7.
L
9,
1.
2.
3.
4.
5.
10
11
7oyJ{ rJ,
io f,l,
iO ,!i
f,4t tu
F4c
-ErS_y
,-. =-l3S= Total cover- ,
50% ot total cover: J t-. ) -Mir total cover: ? J
Hydrophytic
Vegetation
Present?v.t { No= Total Cover
50% of total cover: _ zOVo of lolal cover:_
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC:
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL, FACW. or FAC:
Prevalence lndex worksheet:
Total % Cover of: Multiply by:
FACWspecies _ x2=
FACUspecies _ x4=
UPL species
Column Totals:
Hydroph)rtic Vegetation lndicators:
z4 - Rapid Test for Hydrophytic Vegetation
y' 2 - Dominance Test is >507"
-
3 - Prevalence lndex is s3.01
-
4 - Morphological Adaptationsr (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetationr (Explain)
'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in, DBH and greater than or equal to 3.28 ft (1
m) tall,
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
(lnclude photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
Sampling Point:SOIL
/
profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators')
Depth Matrix Redox Features-
Colo(mois0 % coror frroisl z --- rvpE=- Lpi- Texture
h i,l T J!_ , ,, t,t i{, Zo _S_ }+_ adyLzr
h - !t, n YL {rt 'i t 7 -i',,1( 'tifi
__--i_Zo C ,f4 I,nl yn',t'.., ,**,
t-Me: L=L ,,**r=O*S=MaskedSandGrains. 2location: PL=PoreLinirlg-fU-wlallx.
Hydric Soil lndicators: lndicators for Problematic Hydric Soils3:
_ Histosol (A1) _ Dark Surface (S7)
-
2 cm Muck (A10) (MLRA 147)
_ Hisric Epipedon (A2) _ Polyvalue Below Surface (S8) (MLRA 147,148)
-
Coast Prairie Redox (A16)
_ Black Hisric (A3) _ Thin Dark Surface (s9) (MLRA 147,148) (MLRA 147, 148)
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2)
-
Piedmont Floodplain Soils (F19)
-
Stratified Layers (A5) -/loeptetea Matrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N) _ Redox Dark Surface (F6)
-
Very Shallow Dark Surface (TF12)
_ Depleted Below Dark Surface (A11) _ Depleted Dark Surface (F7)
-
Other (Explain in Remarks)
-
Thick Dark Surface (A12)
-
Redox Depressions (F8)
-
Sandy Mucky Mineral (S1) (LRR N,
-
lron-Manganese Masses (F12) (LRR N,
MLRA 147, 148) MLRA 135)
_ Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122) 'lndicators of hydrophytic vegetation and
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ Stripped Matrix (56) _ Red Parent Material (F21) (MLRA 127,1471 unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):Hvdric Soil Present? Yes No
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2,0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
'1/ ,. / ' IProjecusite: Pllt i' .i.tt , -" {t..- city/county: ,'"".:t,.*, samptingDate: ,r ':i1 .;,',"
\-': t' t' dr ' -- ," (. sampling Point: l - 'Applicanuownel i: i" State: /r/
Investigator(s):Sectron, Township, Range
Landform(hillslope,terrace,etc.): T !1,i,,^ Local relief (concave,convex,none): i'.{.'. r' Slope(%): J,,,
subresion(LRRor MLRN, LLI-,,^/. .' tut b{ .7i, Z'.l0b9 tons, ib , i::i,.:':r{A ,arum:
soit MapunirName: /!ilt.*r,!', .: t.;,- ,n r!:,, i" . , ., : .{h4,t*, .,urr,,,.u*, --P-!__
Are climatic / hydrologic conditions on the site typical for this time of year? Ves l./ No _ (tf no. explain in Remarks.)
Are Vegetation
-,
Soil or Hydrology
-
significantly disturbed? Are "Normal Circumstances'' present? ves l./ No _
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks,)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
Sampled Area
a Wetland?Yes
',: .:
Remarks:17 ,/I / r)...( ., /6t . . // i.. f
I
-/-.,
i,,
ft ""
HYDROLOGY
Wetland Hydrology lndicators:secon@
/ Surface Water (At)True Aquatic Plants (814)
Hydrogen Sulfide Odor (C1)
Oxidized Rhizospheres on Living Roots (C3)
Presence of Reduced lron (C4)
Recent lron Reduction in Tilled Soils (CG)
Thin Muck Surface (C7)
Other (Explain in Remarks)
_ Surface Soil Cracks (86)
_ Sparsely Vegetated Concave Surface (B8)
_ Drainage Patterns (810)
_ Moss Trim Lines (816)
_ Dry-Season Water Table (C2)
_1/Crayfish Bunows (C8)
_ Saturation Visible on Aerial lmagery (C9)
_ Stunted or Stressed Plants (D1)
_ Geomorphic Position (D2)
_ Shallow Aquitard (D3)
_ Microtopographic Relief (D4)
_ FAc-Neutral Test (D5)
_ High Water Table (A2)
-V:'Saturation (A3)
_ Water Marks (81)
_ Sediment Deposits (82)
Drift Deoosits (83)
_ Algal Mat or Crust (84)
_ lron Deposits (85)
lnundation Visible on Aerial lmaqery (B7)
Water-Stained Leaves (89)
Aquatic Fauna (813)
Frelcl Observations:
Surface Water Present? yes / No
-
Depth (inches):-
Water Table Present? Ves r.,r No _ Depth (incnes): ! ..
Saturation Present? Yes "./ No _ Depth (inches):_
(includes caoillarv frinoe)
Wetland Hydrology Present? Yes 3_ No_
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), rf ,vailable
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point:
Tree Stratum (Plot size:
1.
Absolute Dominant lndicator
7o Cover Species? Status
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC:
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL, FACW, or FAC:
I (A)
2.
3.
4.
5.
6.
7.
/L (B)
(A/B)
Prevalence lndex worksheet:
= Total Cover
Total 7" Cover of:Multiply by:
x1=50% of total cover 20% of total cover:OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:
Saplino/Shrub Stratum (Plot size: )Li,,; { ogL
x2=
x3=
x4=
x5=
(A)
2
3
4
5
6
7
8
o
(B)
Prevalence lndex = B/A =
'l c/ = Toial Cover
Hydrophlrtic Vegetation lndicators:
1'- Rapid Test for Hydrophytic Vegetation
-,/_g' 2 - Dominance Test is >50%
-
3 - Prevalence lndex is <3.01
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic HydrophyticVegetationr (Explain)
5o7o of total cover: n'A -l-oolo of totul .ou"r, q
Herb Stratum (Plot saze t1 -.s i.,
-n
ir)
1ii Alt/ /,./\< t'\I
$
^,
.---------i-
i.*"
i '/ r
.flttJ2. '-' i: ,' '
3. ''; '' /,',i? ' )
a L/isl,q ttrcr,llqk
5.
A
1
c
q
10
Eils
lndicators of hydric soil and wetland hydrology musl
be present, unless disturbed or problematic.
Woody Vine Stratum
50% of total cover
(Plot size:
I 7-f'= Torat Cover. /-
t I , f zo% .f totut cor"r, i.j
)
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants. excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3,28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
1
= Total Cover
Hydroph)rtic
Vegetation
Present?,/
50% oftotal cover: _ 2Oo/o of lotal cover:_
Remarks: (lncl on here or on a separate sheel
US Army Corps of Enqineers Eastern lvlountains and Piedmont - Version 2.0
/
a
SOIL Sampling eoinl 6R V b' ',11;,
I
Profile Des
Depth
(inches)
ATu '"'
9:T-
!2 '.)
: (Describe to the depth needed to doiument thelnd-i-cator or
RM=Reduced Matrix. MS=
Hydric Soil lndicators:
_ Histosol (A1)
_ Histic Epipedon (A2)
_ Black Histic (A3)
_ Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
_ 2 cm Muck (A10) (LRR N)
lndicators for Problematic Hydric Soils3:
_ Depleted Below Dark Surface (A11)
_ Thick Dark Surface (A12)
_ Sandy Mucky Minerat (S1) (LRR N,
MLRA 147, 148)
_.Sandy Gteyed Matrix (S4)
4! Sanay Redox (S5)
_ Stripped Marrix (56)
_ Dark Surface (S7)
_ Polyvalue Belorr,r Surface (S8) (MLRA 147,1481
_ Thin Dark Surface (Sg) (MLRA 147,1481
_ Loamy Gleyed Matrix (F2)
_ Depleted Marrix (F3)
_ Redox Dark Surface (F6)
_ Depleted Dark Surface (F7)
_ Redox Depressions (F8)
_ lron-Manganese Masses (F12) (LRR N,
MLRA 136)
_ Umbric Surface (Fl3) (MLRA 136, lZZl
_ Piedmont Floodplain Soils (Ft9) (MLRA 148)
_ Red Parent Material (F21) (MLRA 127,1471
_ 2cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147, 148)
_ Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
_ Very Shallow Dark Surface (TFi 2)
_ Other (Explain in Remarks)
3lndicators of hydrophyic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? yes No
US Army Corps of Engineers Eastern Mountains and piedmont - Version 2.0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
ProjecVSite Ri ,,, t" t City/County Va l*ri.+..
,^ / t- /O/ ri;.Sampling Dale: / / !-.) I t'
ApplicanUOwner M e sampting point [/1 :,'l b 'u4/
Section, Township, Range:
Landform (hillslope, terrace, etc.): h:ll ;!Locaf relief (concave, convex, none): t/AV- Slope (%): {-)
Subresion(LRRoTMLRN, l.e('N ' tli.,?l 3V ?o,:':;'{ tons,-,'t" \i tC1.Li'i Darum:-
soilrvrapunitName: A<i.- (Lrri^^ h@.r,,, o ,',','"r **,.,urI-.uuon,--.i[l-
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No _ (lf no, explain in Remarks.)
Are Vegetation
-,
Soil or Hydrology
-
significantly disturbed? Are "Normal Circumstances" present? Ves bZ No
-
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
No r/,
Noy'
No \^/
ls the Sampled Area
within a Wetland?Yes
,ll
No
/:' i) ,i '"{
HYDROLOGY
Wetland Hydrology lndicators: Secondary lndicators (minimum of two required)
Primary lndicators (minimum of one is reouired; check all that apply) _ Surface Soil Cracks (86)
_ Surface Water (A1)
_ High Water Table (A2)
_ Saturation (A3)
_ Water Marks (81)
_ Sediment Deposits (82)
_ Drift Deposits (83)
_ Algal Mat or Crust (84)
_ lron Deposits (B5)
_ lnundation Visible on Aerial lmagery (B7)
_ Water-Stained Leaves (Bg)
_ Aquatic Fauna (813)
True Aquatic Plants (814)
Hydrogen Sulfide Odor (Cl)
Oxidized Rhizospheres on Living Roots (C3)
Presence of Reduced lron (C4)
Recent lron Reduction in Tilled Soils (C6)
Thin Muck Surface (C7)
Other (Explain in Remarks)
_ Sparsely Vegetated Concave Surface (B8)
_ Drainage Patterns (B10)
_ Moss Trim Lines (B16)
_ Dry-Season Water Table (C2)
_ Crayfish Burrows (C8)
_ Saturation Visible on Aerial lmagery (C9)
_ Stunted or Stressed Plants (D1)
_ Geomorphic Position (D2)
_ Shallow Aquitard (D3)
_ Microtopographic Relief (D4)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes _ No _ Depth (inches):_
Water Table Present? Yes _ No _ Depth (inches):_
Saturation Present? Yes_ No_ Depth (inches):_
(includes caoillarv frinoe)
Wetland Hydrology Present? Yes
-
*, /
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
KEMATKS:
ll-r,ll-r,l i '"'f'lr!''"',
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
r/EGETATION (Four Strata) - Use scientific names of plants.Sampling Point
Saoling/Shrub Stratum (Plot size: )t Fq I , ;q /qJii. ls 1':
z. /0r,.:.t i'f , t,. r
3. i' ,,t t - /404/,t,t4 .r
4
Dominance Test worksheet:
b ,,,
Definitions of Four
Tree - Woody plants, excluding vines, 3 in, (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) rall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3,28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
%o Cover Soecies? Statu<"#* -"t: -#: Number of Dominant Species)) f rtL 4 ] That Are oBL, FACW, or FAC:-:l- I -1.- 'l
-. -..-- I l-otat Number oi Domtnant.':) _ ,'-r I t { '1 | Species Across All Strata:
(A)o
- I Percent of Dominant Species 0 (A/B)- I Tnat Are OBL, FACW. or FAC:
--;l-; = Total Cover
50% of total cover: 20% of total cover:
Y {,ftq-T- FAL^y L|/L
5.
6.
7.
8.
9.-q"n- =4", a*., ^
50% of total ,orur, 'lC --ffi" or total cover: '?)
)
t+'.4 i:" y fuIh
1
10
11
8.
9,
2.
3.
4.
E
, lL = Total cover. /,/
50% of total cover: 14 20% of total cover'. lr,'l
Woodv Vine Stratum (Plot size:
1.
= Total Cover
Hydrophytic
Vegetation
Present?Yes No L
50% of total cover 20% of total cover:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:
Hydrophlrtic Vegetation lndicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
-
3 - Prevalence lndex is s3,0r
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
JOIL
/
Sampling Point,.DrA l"'fu' Wl
Depth Matrix Redox Features(inines] Cdq-'rlotg = % Texture Remarks, ' '1 7r\l 7'% n) /*. -
ProfileDescription:(DescribetothedePthneededtodocumentihe
rType: c=concentration, D=Depletion, RM=Reduced Matrix, MS=Masked sand Grains 2l ocation' Pl =Pnre lininn I\r=il/latriv
Hydric Soil lndicators:
_ Histosol (A1)
_ Histic Epipedon (A2)
_ Black Histic (A3)
_ Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
_ 2 cm Muck (A10) (LRR N)
_ Depleted Below Dark Surface (Ait)
_ Thick Dark Surface (A12)
_ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Matrix (S4)
Sandv Redox (S5)
_ Stripoed Matrix (56)
Dark Surface (S7)
Polyvalue Belorv Surface (SB) (MLRA 147, 148)
Thin Dark Surface (S9) (MLRA 147, 148)
Loamy Gleyed Matrix (F2)
Depleted Matrix (F3)
Redox Dark Surface (F6)
Depleted Dark Surface (F7)
Redox Depressions (F8)
lron-Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (Fl3) (MLRA 136, 122)
Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127,147)
lndicators for Problematic Hydric Soils3:
_ 2cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147. 148)
_ Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
_ Very Shallow Dark Surface (TF12)
_ Other (Explain in Remarks)
'lndicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
strictive Layer (if observed):
Type:
Depth (inches):Hydric Soil Present? Yes No
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
ProiecUSite:t l ,, " { n ,' *'''7' f5 ;.,-.,r,City/County h./" lnrnrr,sampling oarc' J'l" i '
ApplicanUOwner t-" j-sulrc, M(- SamplingPoint: "S2"".'. I ,,' '., - (
Investigator(s)Section. Township, Range
Landform (hillslope, terrace, etc.):,'.:- Local relief (concave, convex, none): bOf9:-u* Slope (%): .:
Subregion (LRR or MLR$: ,Ql .3 ;', 'cA :;':'":" long, 'l k ,''' :-',,' Darum:_
Soil i/ap Unit Name:NWI classificatio n, '; 2ra
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No _ (lf no, explain in Remarks.)
Are Vegetation
-,
Soil or Hydrology
-
significantly disturbed? Are "Normal Circumstances" present? Ves 1../ No
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks.)
HYDROLOGY
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
Renlarks.
ls the Sampled Area , ,/'
within a Wetland? Yes l/ No
re Sampled Area , ./'
rin a Wetland? Yes l/ No
.t
fc i rrta;r, | .li(t,;..._. , ATrrr* I
I
. .,f - /.'t'
No-
No-
No-
t.tt,t!. i
4,, i (: k{
!a
Wetland Hydrology lndicators: Secondary lndicators (minimum of two required)
Primary lndicators (minimum of one is reouired; check all that aoply) _ Surface Soil Cracks (86)
_ Turface Water (A1) True Aquatic Plants (B14) _ Sparsely Vegetated Concave Surface (88)
-/_! VEh Water Table (A2) _ Hydrogen Sulfide Odor (C1) _ Drainage Patterns (B10)
--rZlSaturation (A3) /OxraizeO Rhizospheres on Living Roots (C3)
-
Moss Trim Lines (816)
_ Water Marks (B1) _ Presence of Reduced lron (C4) _.Dry-Season Water Table (C2)
-
Sediment Deposits (82)
-
Recent lron Reduction in Tilled Soils (C6) y( Craynsn Bunows (C8)
_ Drift Deposits (83) _ Thin Muck Surface (C7) _ Saturation Visible on Aerial lmagery (C9)
_ Algal Mat or Crust (B4) _ Other (Explain in Remarks) _ Stunted or Stressed Plants (D1)
_ lron Deposits (85) _ Geomorphic Position (D2)
_ lnundation Visible on Aerial lmagery (87) _ Shallow Aquitard (D3)
_ Water-Stained Leaves (Bg) _ Microtopographic Relief (D4)
_ Aquatic Fauna (813) _ FAC-Neutral Test (D5)
Field Observations: ./
Surface Water Present? Yes No / Depth (inches):
water Table presenr? y"t7-, *o
-
o"ptn 1tn.n"r;, i I "-----J
Saturation Present? Ves / No
-
Depth (inches), *'t
(includes capillarv frinqe)
Wetland Hydrology Present?
"at
,/No-
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:,tl/,. . I r.,.rf /t"^n { t,1 I f f"{,,frltt {lS
Llav io
"
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC;
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL, FACW, or FAC:
Prevalence hrdex workstleefi
Total o% Cover of:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals
Multiplv bv:
x1=
x2=
x3=
><4=
x5=
(A)
J?,t
'l"t
(A)
(B)
(A/B)
(B)
Prevalence Index = B/A =
Hydrophlnic Vegetation lndicators :
-
7f napiO Test for Hydrophytic Vegetation
-t\l 2 - Dominance Test is >50olo
3 - Prevalence lndex is <3.0r
_ 4 - Morphological Adaptationsr (Provide supporting
data in Remarks or on a separate sheet)
-
Problematic Hydrophytic Vegetationr (Explain)
llndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic,
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants. excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3,28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
h
Hydrophytic
Vegetation
Present?
Lt
i
Absolute Dominant lndicator
TreeStratum (Plotsize: _) o/oCover Soecies? Status
1
L"
. .'/L-.
6,/
a./
= Total Cover
50% of total cover: _ 20% of total cover:_
Saolino/Shrub Stratum (Plot size: )
1-
2. ,r'/'
r_ .r'
^lc/
7./
8.'
= Total Cover
50% of total cover: _ 20% of total cover:_
Herb Stratum .(Plot size: ) , .. -. I1 [ . . q/vr 1<,,< 4.t / t'4 L, -77- -T -s. ill ...,. ,;....1, ' ,,r lV !:.-.t Lt
_lt'5 lnr';t " ';'-:,.-,,,-.-- :' 'l' ;,'li,.
c./
1
o_
1n
11
/ .. -+=,=,::lu, r?!", -t z.50% of total cover: l? :: 20% of total cover:__:z_
Woody Vine Stratum (Plot size: _ )
1.
z .-
c/
,/a,/
./5. ,"
-=,*",
a-".
50%o of total cover:
-
20%a ol lolal cover:-
tt t /f 1; t ' I /
!,.t,! i , t,4 o// )lt t,,,. ,
lt
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point: W tt) ''l ' ',,;{'-
Eastern Mountains and Piedmont - Version 2.0US Army Corps of Engineers
SOIL
t'
i
I
I
Profi|eDescription:(Describetothedepthneeded
'Tvpe: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains 2location: PL=Pore Lininq, M=Matrix.
Hydric Soil lndicators:
_ Histosol (A1)
Histic EoiDedon (A2)
_ Black Histic (A3)
_ Hydrogen Sulfide (Aa)
Stratified Lavers (A5)
_ 2cm lt/uck (A10) (LRR N)
_ Depleted Below Dark Surface (A1 1)
_ Thick Dark Surface (A12)
_ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Marrix (S4)
_ Sandy Redox (S5)
_ stripped Marrix (s6)
_ Dark Surface (S7)
_ Polyvalue Below Surface (S8) (MLRA 147,148)
_ Thin Dark Surface (Sg) (MLRA 147,148)
_ Loamy Gleyed Matrix (F2)
X oepteted Marrix (F3)
_ Redox Dark Surface (F6)
_ Depleted Dark Surface (F7)
_ Redox Depressions (F8)
_ lron-Manganese Masses (Fl2) (LRR N,
MLRA 136)
_ Umbric Surface (Fl3) (MLRA 136, 1221
_ Piedmont Floodplain Soils (F19) (MLRA 148)
_ Red Parent Material (F21) (MLRA 127,147)
lndicators for Problematic Hydric Soils3:
_ 2 cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147, 148)
_ Piedmont Floodplain Soils (Fl9)
(MLRA 136, 147)
_ Very Shallow Dark Surface (TF12)
_ Other (Explain in Remarks)
'lndicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
strictive Layer (if observed):
Type:
Depth (inches):HydricSoilPresent? ,". ,/ No-
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
WETLAND DETERMINATION
/: i :t. iIt
DATA FORM - Eastern Mountains and Piedmont Region\/r, - ,-l- /
city/county: samptingour. lOlZ4f/'tProjecUSite
ApplicanUOwner
Section, Township, Range
Landform (hillslope, terrace, etc.):
Subregion (LRR or tntAelt L(
Local relief (concave,
: '"I :.-)
conve
Long:JJ
x, none): C:, t-, u1.- Slope (%)
Datum:
Soil Map Unit Name -: to NWI classificatio ", i){}'(
Are climatic / hydrologic conditions on the site typical for this time of year? Yes y' No _ (lf no, explain in Remarks.) ,/.
Are Vegetation
-,
Soil or Hydrology _ significantly disturbed? Are "Normal Circumstances" present? ves y' No
Are Vegetation _, Soil or Hydrology _ naturally problematic?(lf needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, amportant features, etc.
Hydrophytic Vegetation Present?Yes
Yes
Yes
No
No
No
ls the Sampled Area
within a Wetland?Yes V NoHydric Soil Present?
Wetland Hydrology Present?
I::i
HYDROLOGY
Wetland Hydrology lndicators: Secondary lndicators (minimum of two reouired)
Primary lndicators (minimum of one is reouired; check all that aoply) _ Surface Soil Cracks (86)
_ Surface Water (A1)
_ High Water Table (A2)
_ Saturation (A3)
_ Water Marks (B1)
_ Sediment Deposits (B2)
_ Drift Deposits (B3)
_ Algal Mat or Crust (B4)
_ lron Deposits (B5)
_ lnundation Visible on Aerial lmagery (B7)
_ Water-Stained Leaves (B9)
_ Aquatic Fauna (B13)
_ True Aquatic Plants (B14)
_,Hydrogen Sulfide Odor (Cl)
I OxiAizea Rhizospheres on Living Roots (C3)--Y-
_ Presence of Reduced lron (C4)
_ Recent lron Reduction in Tilled Soils (C6)
_ Thin Muck Surface (C7)
_ Other (Explain in Remarks)
_ Sparsely Vegetated Concave Surface (88)
_ Drainaqe Patterns (810)
_ Moss Trim Lines (B16)
_ Dry-Season Water Table (C2)
_ Crayfish Burrows (C8)
_ Saturation Visible on Aerial lmagery (Cg)
_ Stunted or Stressed Plants (Dl)
-i;-'Geomorphic Position (D2)
_ Shallow Aquitard (D3)
_ Microtopographic Relief (D4)
_ FAc-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes _ No
Water Table Present? Yes _ No
Saturation Present? Yes No
(includes caoillarv frinoe)
J oeorn(inches):-7/o"uwir.h"r),-
--7 o.pn(,n.n.rl,-Wetland Hydrology Present?Yes Y No
llescribe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
Tree Stratum (Plot size:
1.
2.
Absolute Dominant lndicator
7o Cover Species? Status
3
4
5
6
7
2
3
4
5
6
1
3
4.
5.
Sapling/Shrub Stratum
1
Herb Stratum (Plot size:- -< t l'-.I ij;l .:\a .:.
50% of total cover
= Total Cover
20olo of total cover
= Total Cover
zoo/n of total cover:
Y
v---:-t-
)
N
&:
,l/I--J-
= Total Cover
50% of total cover: _ 20% of total cover
(Plot size: )
Hydrophlrtic
_ i - Rapid Test For Hydrophytic Vegetation-/V 2 - Dominance Test is >50%
_ 3 - Prevalence lndex is <3.0r
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetationr (Explain)
'lndicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic,
our Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
50% of total cover:
=)
.TilJJ
Y'+{-
0bL'
Woodv Vine Stratum
- ( l9t = Torat couer 4/)
50% of total cover: / J 20% of total cover: #'
(Plot size: .. )
Number of Dominant Species
That Are OBL, FACW, or FAC:
Total Number of Dominant
Species Across All Strata:
Percent of Dominant Species
That Are OBL, FACW, or FAC:
t t t.1 l.hk u'j eftuat
Prevalence lndex worksheet:
OBL species
FACW species
FAC species
FACU species
UPL species
Column Totals:
Prevalence lndex = B/A =
Hydrophytic /'Vegetation , /Present? Yes V No
numbers here or on a separate sheet.)
VEGETATION (Four Strata) - Use scientific names of plants.Sampling Point:'lx'Z tt4 -v-L( {
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
SOIL
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features(inihes) Color (!noist) o/o Color (moist) o/o Tvpe' Loc2 Texture Remarks
rTvoe: C=Concentration. D=Deoletion. RM=Reduced Matrix. MS=Masked Sand Grains. 2location: PL=Pore Linino. M=Matrix
Hydric Soil lndicators: lndicators for Problematic Hydric Soils':
_ Histosol (A1) _ Dark Surface (S7) _ zcm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2) _ Polyvalue Below Surface (SB) (MLRA 147,1481 _ Coast Prairie Redox (416)
-
Black Histic (A3)
-
tln Dark Surface (S9) (MLRA 147, 148) (MLRA 147, 148)
-
Hydrogen Sulfide (A4) -y(tourry Gleyed Matrix (F2)
-
Piedmont Floodplain Soils (F19)
_ srrarified Layers (A5) _ Depleted Marrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N) _ Redox Dark Surface (F6) _ Very Shallow Dark Surface (TF1 2)
_ Depleted Below Dark Surface (A1 I) _ Depleted Dark Surface (F7) _ Other (Explain in Remarks)
_ Thick Dark Surface (A12) _ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N, _ lron-Manganese Masses (F12) (LRR N,
MLRA 147, 148) MLRA 136)
-
Sandy cleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122] 'lndicators of hydrophytic vegetation and
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ Stripped Matrix (56) _ Red Parent Material (F21) (MLRA 127,147) unless disturbed or problematic.
Restricti
Type:
ve Layer (if observed):
Depth (inches):Hydric Soil Present?,". ,/: No-
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0
National Park Service
U.S. Department of the Interior
Categorical Exclusion Form
Blue Ridge Parkway
Date: 06/11/2014
Project: PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F from MP 275 to 292
PEPC Project Number: 45186
Project Description: •
PRA-BLRI ~F24, Recondition Parkway from MP 276.4 to MP 291.9
Scope of Work: This contract work will repair areas of serious damage and renew the entire surface.
Completing this work will ensure visitor safety and prolong the life as part of a cost-effective plan. Project
will resurface Parkway Section 2F (from MP 276.4 (Bridge over US Route 421) to MP 291.9 (Bridge over
US 321). Project will consist of pavement rehabilitation of approx. 15.5 miles of mainline roadway,
including pavement rehabilitation of overlooks, parking areas, developed areas, spurs and access roads, as
funding allows. Full-depth reclamation (FDR) (pavement pulverization followed by aggregate
stabilization and mill and overlay) and/or pavement patching and reconstruction and wedge and leveling
course may be required In addition, all necessary safety and drainage improvements will be made and the
centerline will be striped. Evaluate and correct pavement markings for sight distances and passing zones.
Evaluate to reconstruct bridge approaches within project area. If funding permits, curb '
resetting/replacement and sidewalk repairs in overlooks and ramps will completed.
Project will be completed under one lane traffic control. No work will be permitted on Parkway mainline
motor road during the month of October 2015 or 2016.
PRA-BLRI 2F25, Repairs to US Route 421 Bridge, Milepost276.3
Scope of Work: The existing bridge (091P) at MP 276.35, in Watauga County, NC, was constructed in
2001. The concrete overlay has extensive and severe cracking and has de-laminated from the concrete
bridge deck slab, allowing moisture to be trapped between the wearing course and deck. In addition, the
drainage system at the approach next to northern abutment is insufficient and is causing approach
pavement to settle, damaging the existing stone masonry on the wingwalls. The purpose of this project is
to replace existing concrete deck overlay with High Performance Concrete (HPC) reinforced with fiber
optic stands and improve drainage system at north approach by adding an inlet at the low point,
connecting it with a pipe culvert to an existing inlet, installing an underdrain next to the north approach
slab, and reconstructing the settled pavement as needed. Work will also include repair and cleaning of the
drainage chute above the northwest retaining wall and sealing the vertical joint between the retaining wall
and the wingwall.
Due to the compressed design time, design will proceed directly to 95% and the resolution meeting for
the 95 % design will be at project site. The Parkway will be closed for the duration of construction; it is
planned that construction will occur in April and May of 2015. The Parkway will be reopened prior to
Memorial Day, 2015. Parkway traffic will be detoured onto existing state roads as under NPS-BLRI
WMS(1) project.
Plans, specifications, estimates, and contracts will be administered by FHW A Project oversight and
supervision will be provided by the DSC.
Categorical Exclusion Form -PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F from MP
275 to 292 -PEPC ID: 45186
Page 1 of 2
Project Locations:
Location
County:
District:
Geo. Marker:
Mitigation(s):
Wilkes, Ashe, Watauga
Highlands
275 -291.9 (Milepost)
State:
Section:
Other:
NC
2F
• Any work that impacts areas outside the existing road surface shall need to be identified so park
biologists can survey for impacts to the plants and animals found there. The Contractor shall limit
equipment storage only to Parkway approved road side locations.
• If project is accessed via motor road, vendor shall have to stay within existing bridge/road load
limitations. The contractor shall use the US 421 access ramp as the closest connect point for
materials and equipment delivery.
• Existing overlook parking areas within the project area shall be used for staging. Overlooks shall
be closed while being used as a staging area. Consecutive use of overlooks within the project area
shall not be allowed.
• The contractor shall submit aminimal of four (4) color samples of Silica Fume HP concrete to the
NPS for approval.
• Curbing that is removed and replaced shall require consultation with the Park Cultural Resource
Specialist
• Disturbed areas shall be restored to original grade and reseeded according to the park's current
seeding specifications once paving has been completed.
• The Parkway can be closed under detour to complete the construction of the HP concrete
overlay, rather than allow the contractor to construct the overlay with a center joint
• Construction debris will be disposed of at an approved landfill or other off-site approved area.
Describe the category used to exclude action from further NEPA analysis and indicate the number
of the category (see Section 3-4 of D0-12):
C.9 Repair, resurfacing, striping, installation of traffic control devices, repair/replacement of guardrails,
etc., on existing roads.
On the basis of the environmental impact information in the statutory compliance file, with which I
am familiar, I am categorically excluding the described project from further NEPA analysis. No
exceptional circumstances (e.g. all boxes in the ESF are marked "no") or conditions in Section 3-6
apply, and the action is fully described in Section 3-4 of 00-12.
Park Superintendent
Suzette Molling
NPS Contact Person
199 Hemphill Knob Road
Address
Date
Environmental Protection Specialist
Tit1e
828/348-3432
Phone number
Categorical Exclusion Form -PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F from MP
275 to 292 -PEPC ID: 45186
Page 2 of 2
National Park Service
U.S. Department of the Interior
Blue Ridge Parkway
Date: 06/19/2014
L7617
Letter of Compliance Completion
Memorandum
To: Project Leader, Michael Molting
From: Environmental Protection Specialist
Subject: NEPA and NHPA Clearance: PRA-BLRI 2F24/2F25 -Repave/Repair Mainline
Road Section 2F from MP 275 to 292 (PIN 45186)
The Resource Stewardship Division has reviewed the proposed project and completed its
environmental assessment documentation, and we have determined that there:
• Will not be any adverse effects on threatened, endangered, or rare species and/or their
critical habitat.
• Will not be any adverse effects on historical, cultural, or archeological resources.
• Will not be serious or long-term undesirable environmental or visual effects.
The subject proposed project, therefore, is now cleared for all NEPA and NHPA compliance
requirements as presented above. Project implementation can commence.
For the proposed project actions to be within compliance requirements during construction
and/or project implementation, the following mitigations must be adhered to:
• Any work that impacts areas outside the existing road surface shall need to be identified
so park biologists can survey for impacts to the plants and animals found there. The
Contractor shall limit equipment storage only to Parkway approved road side locations.
• If project is accessed via motor road, vendor shall have to stay within existing
bridge/road load limitations. The contractor shall use the US 421 access ramp as the
closest connect point for materials and equipment delivery.
• Existing overlook parking areas within the project area shall be used for staging.
Overlooks shall be closed while being used as a staging area. Consecutive use of
overlooks within the project area shall not be allowed.
• The contractor shall submit a minimal of four ( 4) color samples of Silica Fume HP
concrete to the NPS for approval.
• Curbing that is removed and replaced shall require consultation with the Park Cultural
Resource Specialist.
Letter of Compliance Completion -PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F
from MP 275 to 292 -PEPC ID: 45186
Page 1 of 2
• Disturbed areas shall be restored to original grade and reseeded according to the park's
current seeding specifications once paving has been completed.
• The Parkway can be closed under detour to complete the construction of the HP
concrete overlay, rather than allow the contractor to construct the overlay with a center
joint.
• Construction debris will be disposed of at an approved landfill or other off-site approved
area.
For complete compliance information see PEPC Project 45186. If you have any questions, please
let me know.
cc: Dennis Atkins
Roy Jones
Debra Flowers
David Anderson
Dave Bauer
Monika Mayr
Steven.Kidd
Jackie Holt
Bambi Teague
Bob Cherry
Lillian McElrath
Susan Gonshor
Tina White
Kathy Tustanowski
Laura Nelson
Mark Woods
Wesley Greene
Larry Hultquist, DSC-T
Andy Otten, DSC-T
Y anina Kirtley, FHW A
Letter of Compliance Completion -PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F
from MP 275 to 292 -PEPC ID: 45186
Page 2 of 2
Assessment of Effect Form - PRA-BLRI 2F24/2F25 - Repave/Repair Mainline Road Section 2F from MP
275 to 292 - PEPC ID: 45186
Page 1 of 4
National Park Service
U.S. Department of the Interior
Blue Ridge Parkway
Date: 06/11/2014
ASSESSMENT OF ACTIONS HAVING AN EFFECT ON
HISTORIC PROPERTIES
A. DESCRIPTION OF UNDERTAKING
1. Park: Blue Ridge Parkway

2. Project Description:
Project Name: PRA-BLRI 2F24/2F25 - Repave/Repair Mainline Road Section 2F from MP 275 to
292

Prepared by: Steven Kidd Date Prepared: 05/16/2013 Telephone: [phone]

PEPC Project Number: 45186

Locations:
Describe project:
PRA-BLRI 2F24, Recondition Parkway from MP 276.4 to MP 291.9
Scope of Work: This contract work will repair areas of serious damage and renew the entire surface.
Completing this work will ensure visitor safety and prolong the life as part of a cost-effective plan.
Project will resurface Parkway Section 2F (from MP 276.4 (Bridge over US Route 421) to MP 291.9
(Bridge over US 321). Project will consist of pavement rehabilitation of approx. 15.5 miles of
mainline roadway, including pavement rehabilitation of overlooks, parking areas, developed areas,
spurs and access roads, as funding allows. Full-depth reclamation (FDR) (pavement pulverization
followed by aggregate stabilization and mill and overlay) and/or pavement patching and
reconstruction and wedge and leveling course may be required. In addition, all necessary safety and
drainage improvements will be made and the centerline will be striped. Evaluate and correct
pavement markings for sight distances and passing zones. Evaluate to reconstruct bridge approaches
within project area. If funding permits, curb resetting/replacement and sidewalk repairs in overlooks
and ramps will completed.

Project will be completed under one lane traffic control. No work will be permitted on Parkway
mainline motor road during the month of October 2015 or 2016.

PRA-BLRI 2F25, Repairs to US Route 421 Bridge, Milepost 276.3
Scope of Work: The existing bridge (091P) at MP 276.35, in Watauga County, NC, was constructed
in 2001. The concrete overlay has extensive and severe cracking and has de-laminated from the
concrete bridge deck slab, allowing moisture to be trapped between the wearing course and deck. In
addition, the drainage system at the approach next to northern abutment is insufficient and is
causing approach pavement to settle, damaging the existing stone masonry on the wingwalls. The
purpose of this project is to replace existing concrete deck overlay with High Performance Concrete
(HPC) reinforced with fiber optic stands and improve drainage system at north approach by adding
an inlet at the low point, connecting it with a pipe culvert to an existing inlet, installing an underdrain
next to the north approach slab, and reconstructing the settled pavement as needed. Work will also
include repair and cleaning of the drainage chute above the northwest retaining wall and sealing the
vertical joint between the retaining wall and the wingwall.

Assessment of Effect Form - PRA-BLRI 2F24/2F25 - Repave/Repair Mainline Road Section 2F from MP
275 to 292 - PEPC ID: 45186
Page 2 of 4
Due to the compressed design time, design will proceed directly to 95% and the resolution meeting
for the 95% design will be at project site. The Parkway will be closed for the duration of
construction; it is planned that construction will occur in April and May of 2015. The Parkway will
be reopened prior to Memorial Day, 2015. Parkway traffic will be detoured onto existing state roads
as under NPS-BLRI WMS(1) project.

Plans, specifications, estimates, and contracts will be administered by FHWA. Project oversight and
supervision will be provided by the DSC.

Area of potential effects (as defined in 36 CFR 800.16[d])
3. Has the area of potential effects been surveyed to identify historic properties?
No
X Yes

Source or reference: Dr. Ian Firth’s Draft 1993 Historic Resource Study/2005 Draft National
Historic Landmark Nomination.
4. Potentially Affected Resource(s):

Archeological Resources Notes: Previously disturbed road bed.

Historical Structures/Resources Affected:

Name and number(s): Roadway Prism, Section 2-F Asset 4622
Location: MP 276.4 - 292.0
NR status: 5 - Found eligible for 106 purposes through consultation with the SHPO

5. The proposed action will: (check as many as apply)
No Destroy, remove, or alter features/elements from a historic structure
Yes Replace historic features/elements in kind
No Add non-historic features/elements to a historic structure
No Alter or remove features/elements of a historic setting or environment (inc. terrain)
No
Add non-historic features/elements (inc. visual, audible, or atmospheric) to a historic
setting or cultural landscape
No Disturb, destroy, or make archeological resources inaccessible
No Disturb, destroy, or make ethnographic resources inaccessible
No Potentially affect presently unidentified cultural resources
No
Begin or contribute to deterioration of historic features, terrain, setting, landscape
elements, or archeological or ethnographic resources
No Involve a real property transaction (exchange, sale, or lease of land or structures)

B. REVIEWS BY CULTURAL RESOURCE SPECIALISTS
The park 106 coordinator requested review by the park's cultural resource specialist/advisors as
indicated by check-off boxes or as follows:

[ X ] 106 Advisor
Name: Tommy Jones
Date: 05/29/2013
Check if project does not involve ground disturbance [ ]
Assessment of Effect: No Potential to Cause Effect No Historic Properties
Assessment of Effect Form - PRA-BLRI 2F24/2F25 - Repave/Repair Mainline Road Section 2F from MP
275 to 292 - PEPC ID: 45186
Page 3 of 4
Affected X No Adverse Effect Adverse Effect X Streamlined Review
Recommendations for conditions or stipulations:
Doc Method: Streamlined Review (PA)
Streamlined Activity:
3. Repair/Resurfacing/Removal of Existing, Roads, Trails and Parking Areas

[ X ] Archeologist
Name: Steven Kidd
Date: 05/16/2013
Comments: No adverse effect.
Check if project does not involve ground disturbance [ ]
Assessment of Effect: No Potential to Cause Effect No Historic Properties
Affected X No Adverse Effect Adverse Effect X Streamlined Review
Recommendations for conditions or stipulations:
Doc Method: Streamlined Review (PA)
Streamlined Activity:
3. Repair/Resurfacing/Removal of Existing, Roads, Trails and Parking Areas

[ X ] Curator
Name: Jackie Holt
Date: 01/17/2013
Check if project does not involve ground disturbance [ ]
Assessment of Effect: No Potential to Cause Effect No Historic Properties
Affected X No Adverse Effect Adverse Effect Streamlined Review
Recommendations for conditions or stipulations:

[ X ] Landscape Historian
Name: Beth Byrd
Date: 05/28/2013
Check if project does not involve ground disturbance [ ]
Assessment of Effect: No Potential to Cause Effect No Historic Properties
Affected X No Adverse Effect Adverse Effect X Streamlined Review
Recommendations for conditions or stipulations:
Doc Method: Streamlined Review (PA)
Streamlined Activity:
3. Repair/Resurfacing/Removal of Existing, Roads, Trails and Parking Areas

C. PARK SECTION 106 COORDINATOR'S REVIEW AND RECOMMENDATIONS
1. Assessment of Effect:
No Potential to Cause Effects
No Historic Properties Affected
X No Adverse Effect
Adverse Effect

2. Documentation Method:
[ ] A. STANDARD 36 CFR PART 800 CONSULTATION
Further consultation under 36 CFR Part 800 is needed.
[ X ] B. STREAMLINED REVIEW UNDER THE 2008 SERVICEWIDE PROGRAMMATIC AGREEMENT
(PA)
The above action meets all conditions for a streamlined review under section Ill of the 2008
Servicewide PA for Section 106 compliance.
APPLICABLE STREAMLINED REVIEW Criteria
3. Repair/Resurfacing/Removal of Existing, Roads, Trails and Parking Areas.
3. Additional Consulting Parties Information:
Additional Consulting Parties: No
4. Stipulations and Conditions:
Following are listed any stipulations or conditions necessary to ensure that the assessment of
effect above is consistent with 36 CFR Part 800 criteria of effect or to avoid or reduce potential
adverse effects.
All original curbing at overlooks will be removed and reset. No new curbing will be used.
5. Mitigations/Treatment Measures:
Measures to prevent or minimize loss or impairment of historic/prehistoric properties:
(Remember that setting, location, and use may be relevant.)
• Assessment of Effect -Cultural Landscapes -Curbing that is removed and replaced shall
require consultation with the Park Cultural Resource Specialist.
Recommended by Park Section 106 coordinator:
Name: Steven Kidd Title: Park Section 106 Coordinator
D. SUPERINTENDENT'S APPROVAL
The proposed work conforms to the NPS Management Policies and Cultural Resource Management
Guideline, and I have reviewed and approve the recommendations, stipulations, or conditions
noted in Section C of this form.
Signature of Park Superintendent ~ Date: ______ _
Assessment of Effect Form -PRA-BLRI 2F24/2F25 -Repave/Repair Mainline Road Section 2F from MP
275 to 292 -PEPC ID: 45186
Page 4 of 4