23-142 Ver 1_Buffer and/or Stream Determination_20230502

DocuSign Envelope ID: C6814387-E6DB-456C-9B4D-B31A06217354
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
JD Lewis Facility, LLC
Attn: David West
(via email: info(a(a)jd-Lewis-center.com)
NORTH CAROLINA
Environmental Quality
May 2, 2023
Subject: Buffer Determination Letter
NBRRO# 23-142
Wake County
Determination Type
Buffer
Intermittent/Perennial
® Neuse (15A NCAC 2B .0714)
❑ Tar -Pamlico (15A NCAC 2B .0734)
❑ Intermittent/Perennial Determination (where local
buffer ordinances apply)
❑ Jordan (15A NCAC 2B .0267) (governmental
and/or interjurisdictional projects)
Project Name: Fertile Ground Grocery Store
Address/Location
Stream(s):
2245 Garner Road, Raleigh, NC (Approx: 35.74868,-78.63032)
UT to Walnut Creek
Determination Date: 4/27/2023
Staff: Zach Thomas, Tyler Clark,
Kevin Fowler, Mike Hall
Feature
E/I/Ptt>
Not cZ�
Subject
Start @
Stop @
Soil
USGS
Subject
Survey
To o
Pond 1
NP
X
X
X
Flag
Flag
Stream SA
I
X
(Approx: 35.7489,
(Approx: 35.7488,
X
-78.6298)
-78.6291
Stream SC
P
X
Throughout
X
X
(1) E = Ephemeral, I = Intermittent, P = Perennial, NP = Not Present, N/A=Not Applicable, NE=Not Evaluated
(2) Refers to State riparian buffer rules only. Stream, wetland, or pond impacts are still subject to applicable water
quality standards and permitting requirements.
Explanation: The stream(s)/pond(s) listed above has been located on the most recent published NRCS Soil Survey
of Wake County, North Carolina and/or the most recent copy of the USGS Topographic map at a 1: 24,000 scale.
Each feature that is checked "Not Subject" has been determined to not be an intermittent stream, perennial stream, a
pond connected to a stream feature, or the feature is determined not to be present. Stream features that are checked
"Subject" have been located on the property and possess characteristics that qualify them to be subject to the buffer
rules. There may be other streams located on the property that are not depicted on the maps referenced above and
are therefore not subject to the buffer rules. However, if the stream features are present on the tract they are subject
�_
Noan.cnaou D EQI.
.
Oepa�hnml N EnWrunmenlal Oual�
North Carolina Department of Environmental Quality I Division of Water Resources I Raleigh Regional Office
3800 Barrett Drive 11628 Mail Service Center I Raleigh, North Carolina 27699-1628
919.791.4200

DocuSign Envelope ID: C6814387-E6DB-456C-9B4D-B31A06217354
23-142: Fertile Ground Grocery Store
Wake County
5/2/2023
Page 2 of 2
to all other applicable North Carolina stream standards and permitting requirements as outlined in 15A NCAC 02B,
and may be considered jurisdictional according to the US Army Corps of Engineers.
This on -site determination shall expire five (5) years from the date of this letter. Landowners or affected
parties that dispute a determination made by the DWR may request a determination by the Director. An
appeal request must be made within sixty (60) days of date of this letter. A request for a determination by the
Director shall be referred to the Director in writing. If sending via US Postal Service: c/o Stephanie Goss;
DWR — 401 & Buffer Permitting Unit, 1617 Mail Service Center; Raleigh, NC 276 99-1617. If sending via
delivery service (UPS, FedEx, etc.): Paul Wojoski; DWR — 401 & Buffer Permitting Unit; 512 N. Salisbury
Street, Raleigh, NC 27604.
This determination is final and binding unless, as detailed above, an appeal is requested within sixty (60)
days.
This project may require a Section 404/401 Permit for the proposed activity. Any inquiries should be
directed to the US Army Corp of Engineers (Raleigh Regulatory Field Office) at (919)-554-4884.
If you have questions regarding this determination, please feel free to contact Zach Thomas at [phone].
Sincerely,
ocu Signed by:
E�D
ale t,SSa, f.
2916E6AB32144F...
Vanessa Manuel, Assistant Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: Rob Crowther, NV5 Engineers and Consultants (via email: [e-mail])
Laserfiche
e�_
Noan.cnaou D EQI.
.
Oepa�hnml N EnWrunmenlal Oual�
North Carolina Department of Environmental Quality I Division of Water Resources I Raleigh Regional Office
3800 Barrett Drive 11628 Mail Service Center I Raleigh, North Carolina 27699-1628
919.791.4200

DocuSign Envelope ID: C6814387-E6DB-456C-9B4D-B31A06217354
DWR# 23-142
Fertile Ground Grocery Store
Wake County
3 _
y � I
Stream SA:
Legend:
-Approximate Site Boundary:
-Approximate Start/Stop Point
Subject between flags
(approx. 35.7489,-78.6298
to 35.7488,-78.6291)
Intermittent
sT'�Ecr. Map provided by NCDEQ
tJV' Division of Water Resources
y
Locations are approximate
and are provided for refer-
. ence only ::
a�
C ec
Stream SC:
Subject
Perennial

DocuSign Envelope ID: C6814387-E6DB-456C-9B4D-B31A06217354
DWR# 23-142
Fertile Ground Grocery Store
Wake County
- I I
I -
I ,
nUTL- ILI
Legend:
-Approximate Site Boundary:
-Approximate Start/Stop Point
I
Not Present
�aSTAT�� Map provided by NCDEQ
K,nYo.ny
Division of Water Resources
Locations are approximate
and are provided for refer-
ence only
Stream SC:
Subject -
Perennial

Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Information
ID# 23-142 Version
County Wake
Project Name Fertile Ground Grocery Store
Click here to log in to see the project information submitted.
Contact Emails
Staff Determination
Is the review for this project completed?
Yes - Review Complete No Review Required
Document Uploads
Determination Letter
File Upload Date of Letter
PDF only 5/2/2023
More Information Received
File Upload Received Date
PDF only
Please attach review documents here. PDF only
Staff notes or comments:
Issued 5/2/23
Folder Path \DWR - Wetlands Program\Determinations\Raleigh Regional Office\23-142

Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Name:*
Is this a transportation project?*
Is this request for a mitigation site?
What type of request is this?*
Owner Information
Name on the Recorded Deed:
Responsible Party :
Fertile Ground Grocery Store
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
JD Lewis Facility LLC
David West
(for LLC, Corporations, businness, agency, etc.)
Telephone Number:
Email Address: * [e-mail]
How would you like to received your determination?*
IF Stream Determination
Stream
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * Agent Authorization Form
203.21 KB
FertileGroundGrocery_20230320_Signe...
PDF only
Agent/Consultant Information
How would you like to receive your
determination letter?*
Name of Agent: *
Company Name:*
Email Address: *
n
USPS
Email
Rob Crowther
NV5 Engineers and Consultants
[e-mail]

Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:
Site Information
Nearest Highway/Street: * Garner Road
Nearest Town: * Raleigh
Nearest Named Stream:* Walnut Creek
River Basin: * Neuse
County: *
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Click the upload button or drag and drop files here to attach document
FertileGround_Buffer_Figure1.pdf 1.43MB
Pdf file type only
TOPO map look up: https://viewer.nationalmap.gov/basic/
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.
Click the upload button or drag and drop files here to attach document
FertileGround_Buffer Figure2.pdf 844.79KB
Pdf file type only
Soil Survey Link: https://www.nres.usda.gov/wps/portal/nres/surveylist/soils/survey/state/?stateld=NC
Latitude and Longitude
Please provide the Latitude and Longitude for physical location for the determination that. If you have a physical
address you can look up the Latitude and Longitude by typing in an address or filling out the information
manually.
Choose below how you would like to Address Lookup
provide this information. Manually
Latitude: 35.74868
Longitude:-78.63032
Misc attachments: FertileGround_PJD_Request_20230331... 10.52MB
pdf or kmz file types only
By digitally signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
I intend to electronically sign and submit the "Determination Request' form."
Signature
Date Submitted: 3/31/2023
Initial Review RRO
D# * 23-142
Do you want to send this for review? Yes No
Select Reviewer: * Zachary Thomas:[e-mail]
Select Regional Office: * Raleigh Regional Office - [phone]

AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By the Current Landowner/Client
Property Owner: JD Lewis Facility LLC Client: Andre Johnson, Andre Johnson
Architects
Property Address: 2245 Garner Road, Raleigh, NC 27610
Parcel PIN(s): 1702977558, 1702973663, 1702973573, 1702973474
Project Name/Description: Fertile Ground Community Grocery Store
Date: March 3, 2023
US Army Corps of Engineers, Wilmington District
Raleigh Regulatory Field Office
Re: Stream and Wetlands Related Consulting
To Whom It May Concern:
I, David West , current property owner, hereby authorize NV5, Inc., retained by
Andre Johnson Architects, the client, to act as agent to the client in the verification process of
stream and wetland delineations and buffer determinations, to furnish upon request supplemental
information in support of applications, etc. from this day forward, the Yd day of March 2023.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only
for government officials to enter the property when accompanied by NV5, Inc. staff. You
should call NV5, Inc. to arrange a site meeting prior to visiting the site.
David West
Print Property Owner's Name
Andre L. Johnson
Print Client's Name
'D
Property Owner's Signature
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March 31, 2023
Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
RE: Preliminary Jurisdictional Determination & Buffer Determination
To Whom It May Concern,
NV5 Engineers and Consultants, Inc. (NV5) has been retained by Andre Johnson Architects to provide
environmental services, including stream and wetland delineations and regulatory coordination, for a 10-
acre study area consisting of four parcels (PIN(s): 1702977558, 1702973663, 1702973573, 1702973474)
located at 2245 Garner Road in Raleigh, NC in Wake County (Figure 1). The purpose of this letter is to
request a preliminary jurisdictional determination for the resources identified on Figures 2-4.
Streams and wetlands on the referenced properties were delineated using the US Army Corps of
Engineers (USACE) Regional Supplement to the Corps of Engineers Wetland Delineation Manual:
Eastern Mountains and Piedmont Region (Version 2.0) and the North Carolina Division of Water Quality
(NCDWQ) Methodology for Identification of Intermittent and Perennial Streams and Their Origins
(Version 4.11). On -site investigations took place on February 23, 2023, during "Normal' conditions
(Antecedent Precipitation Tool Score = 11).
Included with the attached information, NV5 has completed USACE wetland determination data sheets,
North Carolina Division of Water Resources (NCDWR) stream rating forms, North Carolina Wetland
Assessment Method (NCWAM) forms, and North Carolina Stream Assessment Method (NCSAM) forms.
Approximately 549 linear feet of perennial stream, 270 linear feet of intermittent stream and 0.006 acre of
wetland were identified as potentially jurisdictional waters of the U.S. on the site.
In a separate correspondence we have requested that features be evaluated by the North Carolina
Department of Environmental Quality (NCDEQ) for applicability to the Neuse River riparian buffer rules.
Should you have any questions about the information provided, or like to coordinate a site visit, please
contact me at Rob.Crowther&NV5.com or [phone].
Sincerely,
�.l 6LW
Robert Crowther, PWS
Environmental Services Project Manager
NV5 Engineers and Consultants, Inc.
CC:
DEQ Raleigh Regional Office
3300 Regency Parkway #100 1 Cary, NC 27518 1 www.NV5.com I Office 919.836.4800 1 Fax [phone]
CONSTRUCTION QUALITY ASSURANCE - INFRASTRUCTURE - ENERGY - PROGRAM MANAGEMENT - ENVIRONMENTAL

urisdictional Determination Reauest
U5 Army Corps
of Engineers.
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http:llwww.saw.usace.gM.mil/Missions/Re ulatoiyPennitProaam/Contact/Coun!yLocator.aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
INSTRUCTIONS:
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: (252) 975 -13 99
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USAGE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 2245 Garner Road
City, State:
County:
Raleigh, NC
Wake
Parcel Index Number(s) (PIN): 170297(7558,3663,3573,3474
B. REQUESTOR INFORMATION
Name: Robert Crowther - NV5. Inc.
Mailing Address: 3300 Regency Parkway, Suite 100
Telephone Number:
Electronic Mail Address:
Select one:
✓❑
Cary, NC 27518
[phone]
[e-mail]
I am the current property owner.
I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: JD Lewis Facility LLC
Mailing Address: 715 Bakewell Street
Covington, KY 41011-1227
Telephone Number: N/A
Electronic Mail Address: N/A
' Must provide completed Agent Authorization Form/Letter.
Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION'J
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Robert Crowther - NV5, Inc.
Print Name
Capacity: ❑ Owner Z Authorized Agents
03/22/2023
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a projector perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑✓ I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
A Corps JD is required in order obtain my local/state authorization.
❑ I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
I believe that the site may be comprised entirely of dry land.
❑ Other:
For NCDOT requests following the current NCDOVUSACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
❑✓ I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
❑ I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 45-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 10,0 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates (Decimal Degrees): Latitude:
Longitude: -78.6304
zA legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than I I x 17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Welland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Welland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
• Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
Welland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www,saw.usace.an-nv.mil/Missions/Re,(zulatory-Pen-nit-
Pro,(zrain/Jurisdiction/
Version: May 2017 Page 5

Jurisdictional Determination Request
✓❑ Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Form'
✓❑ Vicinity Map
❑✓ Aerial Photograph
❑ USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
zLandscape Photos (if taken)
0 NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
FJ Other Assessment Forms
' www.saw.usace.anny.mil/Portals/59/does/regulatory/re does/JD/RGL 08-02 App_A_Prelim_JD_Form fi11ab1e.pdf
a Please see http://www.saw.usace.army.mil/Missions/Re ug latory-Pennit-Prograin/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and maybe made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Rob Crowther, 3300 Regency Parkway, suite 100, Cary, NC 27518
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Wake County City: Raleigh
Center coordinates of site (lat/long in degree decimal format):
Lat.: 35.7488 Long.:-78.6304
Universal Transverse Mercator: NAD 83
Name of nearest waterbody: Walnut Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
■❑ Field Determination. Date(s): February 23, 2023
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
{decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
SA
35.7488
-78.6293
226 Linear Feet
Non -wetland Water
Section 404/401
SB
35.7488
-78.6296
44 Linear Feet
Non -Wetland Water
Section 404/401
SC
35.7486
-78.6288
549 Linear Feet
Non -wetland Water
Section 404/401
WA
35.7488
-78.6294
0.006 Acres
Wetland
Section 404/401

1 ) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a
Nationwide General Permit (NWP) or other general permit verification requiring "pre -
construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) the
applicant has the right to request an individual permit rather than accepting the terms
and conditions of the NWP or other general permit authorization; (4) the applicant can
accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has
determined to be necessary; (5) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps permit
authorization based on a PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives any challenge to such jurisdiction in any administrative or judicial compliance
or enforcement action, or in any administrative appeal or in any Federal court; and (7)
whether the applicant elects to use either an AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, a proffered individual permit (and all terms
and conditions contained therein), or individual permit denial can be administratively
appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be"waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Vicinity Map
FEW Data sheets prepared/submitted by or on behalf of the PJD requestor.
F-1 Office concurs with data sheets/delineation report.
F-1 Office does not concur with data sheets/delineation report. Rationale:
F-] Data sheets prepared by the Corps:
F-] Corps navigable waters' study:
F-1 U.S. Geological Survey Hydrologic Atlas:
F-] USGS NHD data.
F-] USGS 8 and 12 digit HUC maps.
FE-] U.S. Geological Survey map(s). Cite scale & quad name: Lake Wheeler 1:24,000
FEW Natural Resources Conservation Service Soil Survey. Citation: NRCS, NCDOT Project ATLAS
F-] National wetlands inventory map(s). Cite name:
F-1 State/local wetland inventory map(s):
F-] FEMA/FIRM maps:
F-] 1 00-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
* Photographs: FE-] Aerial (Name & Date): NC 2021 Statewide Aerial Photography
or F-] Other (Name & Date):
F-1 Previous determination (s). File no. and date of response letter:
FO-1 Other information (please specify): Site Photographs
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later Ourisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
A&I-eW &-,mwe4P 03/31/2023
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
1 Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By the Current Landowner/Client
Property Owner: JD Lewis Facility LLC Client: Andre Johnson, Andre Johnson
Architects
Property Address: 2245 Garner Road, Raleigh, NC 27610
Parcel PIN(s): 1702977558, 1702973663, 1702973573, 1702973474
Project Name/Description: Fertile Ground Community Grocery Store
Date: March 3, 2023
US Army Corps of Engineers, Wilmington District
Raleigh Regulatory Field Office
Re: Stream and Wetlands Related Consulting
To Whom It May Concern:
I, David West , current property owner, hereby authorize NV5, Inc., retained by
Andre Johnson Architects, the client, to act as agent to the client in the verification process of
stream and wetland delineations and buffer determinations, to furnish upon request supplemental
information in support of applications, etc. from this day forward, the Yd day of March 2023.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only
for government officials to enter the property when accompanied by NV5, Inc. staff. You
should call NV5, Inc. to arrange a site meeting prior to visiting the site.
David West
Print Property Owner's Name
Andre L. Johnson
Print Client's Name
'D
Property Owner's Signature
C ie is tore

3/21/23, 11:43 AM
Account Summary - 0328922
Home Wake County Real Estate Data
EMW Account Summary
PW Real Estate ID 0328922 PIN # 1702977558
W-P" Location Address Property Description
COUNTY 2245 GARNER RD L02 GARNER ROAD YMCA SUB BM2003-01073
Pin/Parcel History. New Search
N0RTII CAROLiNA Account I ounginga I Lana i veeds I Notes I males I Photos I Tax Bill I Map
iMaps
Tax Bills
Account
Search
Property Owner
Owner's Mailing Address
Property Location Address
JD LEWIS FACILITY LLC
715 BAKEWELL ST
2245 GARNER RD
(Use the Deeds link to view any additional owners)
COVINGTON KY 41011-1227
RALEIGH NC 27610.4609
Administrative Data
Transfer Information
Assessed Value
Old Map #
606--
Map/Scale
170208
Deed Date
12/3/2010
Land Value Assessed $492,100
VCS
EWRA001
Book & Page
14183 1863
Bldg. Value Assessed $1,525,163
City
RALEIGH
Revenue Stamps
2234.00
Fire District
Pkg Sale Date
12/3/2010
Township
ST. MARYS
Pkg Sale Price
$1,018,600
Tax Relief
Land Class
COMMERCL
Land Sale Date
ETJ
RA
Land Sale Price
Land Use Value
Spec Dist(s)
Use Value Deferment
Zoning
R-10
Improvement Summary
Historic Deferment
History ID 1
Total Deferred Value
History ID 2
Total Units
0
Acreage
9.25
Recycle Units
0
Permit Date
Apt/SC Sqft
Use/Hist/Tax Relief
Permit #
Heated Area
17,030
Assessed
Total Value Assessed" $2,017,263
"Wake County assessed building and land values reflect the market value as of January 1, 2020, which is the date of the last
county -wide revaluation. Any inflation, deflation or other economic changes occurring after this date does not affect the
assessed value of the property and cannot be lawfully considered when reviewing the value for adjustment.
The January 1, 2020 values will remain in effect until the next county -wide revaluation. Until that time, any real estate
accounts created or new construction built is assessed according to the 2020 Schedule of Values.
For questions regarding the information displayed on this site, please contact the Department of Tax Administration
at [e-mail] or call 919-856-5400.
hftps://services.wakegov.com/realestate/Account.asp?id=0328922 1 /1

3/21/23, 11:46 AM
Account Summary - 0328923
Home Wake County Real Estate Data
EMW Account Summary
PW Real Estate ID 0328923 PIN # 1702973663
W-P" Location Address Property Description
COUNTY 2303 GARNER RD L03 GARNER ROAD YMCA SUB BM2003-01073
Pin/Parcel History. New Search
N0RTII CAROLiNA Account I ounginga I Lana i veeds I Notes I males I Photos I Tax Bill I Map
iMaps
Tax Bills
Account
Search
Property Owner
Owner's Mailing Address
Property Location Address
JD LEWIS FACILITY LLC
715 BAKEWELL ST
2303 GARNER RD
(Use the Deeds link to view any additional owners)
COVINGTON KY 41011-1227
RALEIGH NC 27610.4611
Administrative Data
Transfer Information
Assessed Value
Old Map #
606--
Map/Scale
170208
Deed Date
12/3/2010
Land Value Assessed $35,100
VCS
16RA900
Book & Page
14183 1863
Bldg. Value Assessed
City
RALEIGH
Revenue Stamps
2234.00
Fire District
Pkg Sale Date
12/3/2010
Township
ST. MARYS
Pkg Sale Price
$36,500
Tax Relief
Land Class
VACANT
Land Sale Date
ETJ
RA
Land Sale Price
Land Use Value
Spec Dist(s)
Use Value Deferment
Zoning
R-10
Improvement Summary
Historic Deferment
History ID 1
Total Deferred Value
History ID 2
Total Units
0
Acreage
-22
Recycle Units
0
Permit Date
1/6/2011
Apt/SC Sqft
Use/Hist/Tax Relief
Permit #
0000090213
Heated Area
Assessed
Total Value Assessed" $35,100
"Wake County assessed building and land values reflect the market value as of January 1, 2020, which is the date of the last
county -wide revaluation. Any inflation, deflation or other economic changes occurring after this date does not affect the
assessed value of the property and cannot be lawfully considered when reviewing the value for adjustment.
The January 1, 2020 values will remain in effect until the next county -wide revaluation. Until that time, any real estate
accounts created or new construction built is assessed according to the 2020 Schedule of Values.
For questions regarding the information displayed on this site, please contact the Department of Tax Administration
at [e-mail] or call 919-856-5400.
hftps://services.wakegov.com/realestate/Account.asp?id=0328923 1 /1

3/21/23, 11:49AM
Account Summary - 0328924
Home Wake County Real Estate Data
EMW Account Summary
PW Real Estate ID 0328924 PIN # 1702973573
W-P" Location Address Property Description
COUNTY 2307 GARNER RD L04 GARNER ROAD YMCA SUB BM2003-01073
Pin/Parcel History. New Search
N0RTII CAROLiNA Account I ounginga I Lana i veeds I Notes I males I Photos I Tax Bill I Map
iMaps
Tax Bills
Account
Search
Property Owner
Owner's Mailing Address
Property Location Address
JD LEWIS FACILITY LLC
715 BAKEWELL ST
2307 GARNER RD
(Use the Deeds link to view any additional owners)
COVINGTON KY 41011-1227
RALEIGH NC 27610.4611
Administrative Data
Transfer Information
Assessed Value
Old Map #
606--
Map/Scale
170208
Deed Date
12/3/2010
Land Value Assessed $35,100
VCS
16RA900
Book & Page
14183 1863
Bldg. Value Assessed
City
RALEIGH
Revenue Stamps
2234.00
Fire District
Pkg Sale Date
12/3/2010
Township
ST. MARYS
Pkg Sale Price
$44,200
Tax Relief
Land Class
VACANT
Land Sale Date
ETJ
RA
Land Sale Price
Land Use Value
Spec Dist(s)
Use Value Deferment
Zoning
R-10
Improvement Summary
Historic Deferment
History ID 1
Total Deferred Value
History ID 2
Total Units
0
Acreage
-23
Recycle Units
0
Permit Date
1/6/2011
Apt/SC Sqft
Use/Hist/Tax Relief
Permit #
0000090212
Heated Area
Assessed
Total Value Assessed" $35,100
"Wake County assessed building and land values reflect the market value as of January 1, 2020, which is the date of the last
county -wide revaluation. Any inflation, deflation or other economic changes occurring after this date does not affect the
assessed value of the property and cannot be lawfully considered when reviewing the value for adjustment.
The January 1, 2020 values will remain in effect until the next county -wide revaluation. Until that time, any real estate
accounts created or new construction built is assessed according to the 2020 Schedule of Values.
For questions regarding the information displayed on this site, please contact the Department of Tax Administration
at [e-mail] or call 919-856-5400.
hftps://services.wakegov.com/realestate/Account.asp?id=0328924 1 /1

3/21/23, 11:51 AM
Account Summary - 0328925
Home Wake County Real Estate Data
EMW Account Summary
PW Real Estate ID 0328925 PIN # 1702973474
W-P" Location Address Property Description
COUNTY 2311 GARNER RD L05 GARNER ROAD YMCA SUB BM2003-01073
Pin/Parcel History. New Search
N0RTII CAROLiNA Account I ounginga I Lana i veeds I Notes I males I Photos I Tax Bill I Map
iMaps
Tax Bills
Account
Search
Property Owner
Owner's Mailing Address
Property Location Address
JD LEWIS FACILITY LLC
715 BAKEWELL ST
2311 GARNER RD
(Use the Deeds link to view any additional owners)
COVINGTON KY 41011-1227
RALEIGH NC 27610.4611
Administrative Data
Transfer Information
Assessed Value
Old Map #
606--
Map/Scale
170208
Deed Date
12/3/2010
Land Value Assessed $35,100
VCS
16RA900
Book & Page
14183 1863
Bldg. Value Assessed
City
RALEIGH
Revenue Stamps
2234.00
Fire District
Pkg Sale Date
Township
ST. MARYS
Pkg Sale Price
Tax Relief
Land Class
VACANT
Land Sale Date
12/3/2010
ETJ
RA
Land Sale Price
$17,700
Land Use Value
Spec Dist(s)
Use Value Deferment
Zoning
R-10
Improvement Summary
Historic Deferment
History ID 1
Total Deferred Value
History ID 2
Total Units
0
Acreage
-20
Recycle Units
0
Permit Date
10/4/2007
Apt/SC Sqft
Use/Hist/Tax Relief
Permit #
0000070347
Heated Area
Assessed
Total Value Assessed" $35,100
"Wake County assessed building and land values reflect the market value as of January 1, 2020, which is the date of the last
county -wide revaluation. Any inflation, deflation or other economic changes occurring after this date does not affect the
assessed value of the property and cannot be lawfully considered when reviewing the value for adjustment.
The January 1, 2020 values will remain in effect until the next county -wide revaluation. Until that time, any real estate
accounts created or new construction built is assessed according to the 2020 Schedule of Values.
For questions regarding the information displayed on this site, please contact the Department of Tax Administration
at [e-mail] or call 919-856-5400.
hftps://services.wakegov.com/realestate/Account.asp?id=0328925 1 /1

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Fertile Ground
Grocery Store
N V 5 Wake County, NC
0 0.5 1 Figure 1: Project
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Figure Date: March 21, 2023

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NC DWQ Stream Identification Form Version 4.11 1SA
Date: 02/23/2023
Project/Site: Fertile Ground Grocery
Latitude: 35.74884
Evaluator:R. Crowther, NV5 County: Wake
Longitude:-78.629301
Total Points:
Other:
Stream is at least intermittent if
�g Stream Determination:
e.g. Quad Name:
>19 or perennial if >30
Intermittent
A. Geomorphology (Subtotal =5.5 )
Absent
Weak
Moderate
Strong
SCORE
1a. Continuous bed and bank
0
1
2
3
1
2. Sinuosity of channel along thalweg
0
1
2
3
1
3. In -Channel structure: ex. riffle -pool, step -pool, ripple-
ool se uence
0
1
2
3
0
4. Particle size of stream substrate
0
1
2
3
1
5. Active/relic flood lain
0
1
2
3
0
6. Depositional bars or benches
0
1
2
3
0
7. Recent alluvial deposits
0
1
2
3
1
8. Headcuts
0
1
2
3
1
9. Grade controls
0
0.5
1
1.5
0
10. Natural valley
0
0.5
1
1.5
0.5
11. Second or greater order channel
No - 0
Yes - 3
0
a artificial ditches are not rated; see discussions in manual.
B. Hydrology (Subtotal =8.5)
Absent
Weak
Moderate
Strong
SCORE
12. Presence of Baseflow
0
1
2
3
2
13. Iron oxidizing bacteria
0
1
2
3
2
14. Leaflitter
1.5
1
0.5
0
1
15. Sediment on plants or debris
0
0.5
1
1.5
0.5
16. Organic debris lines or piles
0
0.5
1
1.5
0
17. Soil -based evidence of high water table?
No = 0
Yes = 3
3
C. Biology Subtotal = 5
Absent
Weak
Moderate
Strong
SCORE
18. Fibrous roots in streambed
3
2
1
0
2
19. Rooted upland plants in streambed
3
2
1
0
3
20. Macrobenthos note diversity and abundance
0
1
2
3
0
21. Aquatic Mollusks
0
1
2
3
0
22. Fish
0
0.5
1
1.5
0
23. Crayfish
0
0.5
1
1.5
0
24. Amphibians
0
0.5
1
1.5
0
25. Algae
0
0.5
1
1.5
0
26. Wetland plants in streambed
FACW=0.75; OBL=1.5 Other=0
0
.perennial stream may also be identified using other methods. See p.35 of manual.
Notes:
Bank Height feet
0.5
Bankfull Width feet
3
Water Depth inches
2
Channel Substrate
Silt
Velocity:
low
Clarity:
lightly Turbid
Sketch:

NC SAM FIELD ASSESSMENT FORM
user rvianuai version d.,i
USACE AID #: NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic quadrangle,
and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same property, identify and
number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User Manual for detailed descriptions
and explanations of requested information. Record in the "Notes/Sketch" section if supplementary measurements were performed. See the
NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT/SITE INFORMATION:
1. Project name (if any): Fertile Ground 2. Date of evaluation: 2/23/2023
3. Applicant/owner name: Andre Johnson Architects 4. Assessor name/organization: Rob Crowther, NV5, Inc.
5. County: Wake 6. Nearest named water body
7. River basin: Neuse on USGS 7.5-minute quad: Walnut Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.748840,-78.629301
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SA 10. Length of assessment reach evaluated (feet): 50
11. Channel depth from bed (in riffle, if present) to top of bank (feet): <1 ❑Unable to assess channel depth.
12. Channel width at top of bank (feet): 2-4 13. Is assessment reach a swamp steam? ❑Yes ❑No
14. Feature type: ❑Perennial flow ®Intermittent flow ❑Tidal Marsh Stream
STREAM CATEGORY INFORMATION:
15. NC SAM Zone: ❑ Mountains (M) ® Piedmont (P) ❑ Inner Coastal Plain (1) ❑ Outer Coastal Plain (0)
16. Estimated geomorphic ®A El
valley shape (skip for
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip ®Size 1 (< 0.1 mil) ❑Size 2 (0.1 to < 0.5 mil) ❑Size 3 (0.5 to < 5 mil) ❑Size 4 (>_ 5 mil)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? ®Yes ❑No If Yes, check all that apply to the assessment area.
❑Section 10 water ❑Classified Trout Waters ❑Water Supply Watershed (❑l ❑II ❑III ❑IV ❑V)
❑Essential Fish Habitat ❑Primary Nursery Area ❑ High Quality Waters/Outstanding Resource Waters
❑Publicly owned property ®NCDWR Riparian buffer rule in effect ❑Nutrient Sensitive Waters
❑Anadromous fish ❑303(d) List ❑CAMA Area of Environmental Concern (AEC)
❑Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
❑Designated Critical Habitat (list species)
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? ❑Yes ®No
1. Channel Water— assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
®A Water throughout assessment reach.
❑B No flow, water in pools only.
❑C No water in assessment reach.
2. Evidence of Flow Restriction — assessment reach metric
❑A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is severely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impoundment on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates, debris jams,
beaver dams).
®B Not
3. Feature Pattern — assessment reach metric
❑A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
®B Not
4. Feature Longitudinal Profile — assessment reach metric
®A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming, over
widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of these
disturbances).
❑B Not
5. Signs of Active Instability — assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
❑A < 10% of channel unstable
❑B 10 to 25% of channel unstable
®C > 25% of channel unstable

6. Streamside Area Interaction — streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
❑A ❑A
Little or no evidence of conditions that adversely affect reference interaction
®B ®B
Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area, leaky
or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
❑C ❑C
Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision, disruption
of flood flows through streamside area] or too much floodplain/intertidal zone access [examples: impoundments, intensive
mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a man-made feature on an
interstream divide
Water Quality Stressors — assessment reach/intertidal zone metric
Check all that apply.
❑A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
❑B Excessive sedimentation (burying of stream features or intertidal zone)
❑C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
❑D Odor (not including natural sulfide odors)
❑E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in "Notes/Sketch"
section.
❑F Livestock with access to stream or intertidal zone
❑G Excessive algae in stream or intertidal zone
❑H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc)
❑I Other: (explain in "Notes/Sketch" section)
®J Little to no stressors
8. Recent Weather — watershed metric (skip for Tidal Marsh Streams)
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a drought.
❑A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
❑B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
®C No drought conditions
9. Large or Dangerous Stream — assessment reach metric
❑Yes ®No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. ❑Yes ❑No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for Size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
❑A Multiple aquatic macrophytes and aquatic mosses F, W ❑F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) 2 E ❑G Submerged aquatic vegetation
®B Multiple sticks and/or leaf packs and/or emergent o w ❑H Low -tide refugia (pools)
vegetation Y U)C ❑I Sand bottom
❑C Multiple snags and logs (including lap trees) r ❑J 5% vertical bank along the marsh
❑D 5% undercut banks and/or root mats and/or roots ❑K Little or no habitat
in banks extend to the normal wetted perimeter
❑E Little or no habitat
*********************************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate —assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11a. ❑Yes ®No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
®A Riffle -run section (evaluate 11c)
®B Pool -glide section (evaluate 11d)
❑C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffle sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged. Check
at least one box in each row (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams). Not Present (NP) = absent, Rare
(R) = present but < 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative percentages
should not exceed 100% for each assessment reach.
NP R C A P
® ❑ ❑ ❑ ❑ Bedrock/saprolite
® ❑ ❑ ❑ ❑ Boulder (256 — 4096 mm)
® ❑ ❑ ❑ ❑ Cobble (64 — 256 mm)
® ❑ ❑ ❑ ❑ Gravel (2 — 64 mm)
❑ ❑ ❑ ❑ ® Sand (.062 — 2 mm)
❑ ❑ ® ❑ ❑ Silt/clay (< 0.062 mm)
❑ ❑ ® ❑ ❑ Detritus
❑ ® ❑ ❑ ❑ Artificial (rip -rap, concrete, etc.)
11d. ❑Yes ®No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)

12
Aquatic Life — assessment reach metric (skip for Tidal Marsh Streams)
12a. ®Yes ❑No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. ❑No Water ❑Other:
12b. ❑Yes ®No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check all that
apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for Size 1 and 2 streams and "taxa" for Size 3 and 4 streams.
❑ ❑Adult frogs
❑ ❑Aquatic reptiles
❑ ❑Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
❑ ❑Beetles
❑ ❑Caddisfly larvae (T)
❑ ❑Asian clam (Corbicula)
❑ ❑Crustacean (isopod/amphipod/crayfish/shrimp)
❑ ❑Damselfly and dragonfly larvae
❑ ❑Dipterans
❑ ❑Mayfly larvae (E)
❑ ❑Megaloptera (alderfly, fishfly, dobsonfly larvae)
❑ ❑Midges/mosquito larvae
❑ ❑Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
❑ ❑Mussels/Clams (not Corbicula)
❑ ❑Other fish
❑ ❑ Sala manders/tad poles
❑ ❑Snails
❑ ❑Stonefly larvae (P)
❑ ❑Tipulid larvae
❑ ❑Worms/leeches
13. Streamside Area Ground Surface Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and upland runoff.
LB RB
®A ®A Little or no alteration to water storage capacity over a majority of the streamside area
❑B ❑B Moderate alteration to water storage capacity over a majority of the streamside area
❑C ❑C Severe alteration to water storage capacity over a majority of the streamside area (examples: ditches, fill, soil compaction,
livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
❑A ❑A Majority of streamside area with depressions able to pond water >_ 6 inches deep
❑B ❑B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
®C ®C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the normal
wetted perimeter of assessment reach.
LB RB
❑Y ®Y Are wetlands present in the streamside area?
ON ❑N
16. Baseflow Contributors — assessment reach metric (skip for Size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
®A Streams and/or springs (jurisdictional discharges)
❑B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
❑C Obstruction passing flow during low -flow periods within the assessment area (beaver dam, leaky dam, bottom -release dam, weir)
❑D Evidence of bank seepage or sweating (iron in water indicates seepage)
®E Stream bed or bank soil reduced (dig through deposited sediment if present)
❑F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
❑A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
❑B Obstruction not passing flow during low -flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
❑C Urban stream (>_ 24% impervious surface for watershed)
❑D Evidence that the streamside area has been modified resulting in accelerated drainage into the assessment reach
❑E Assessment reach relocated to valley edge
OF None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
❑A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
®B Degraded (example: scattered trees)
❑C Stream shading is gone or largely absent

19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top of bank out
to the first break.
Vegetated Wooded
LB RB LB RB
®A ®A ®A ®A >_ 100 feet wide or extends to the edge of the watershed
❑B ❑B ❑B ❑B From 50 to < 100 feet wide
❑C ❑C ❑C ❑C From 30 to < 50 feet wide
❑D ❑D ❑D ❑D From 10 to < 30 feet wide
❑E ❑E ❑E ❑E < 10 feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
®A ®A Mature forest
❑B ❑B Non -mature woody vegetation or modified vegetation structure
❑C ❑C Herbaceous vegetation with or without a strip of trees < 10 feet wide
❑D ❑D Maintained shrubs
❑E ❑E Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but is
within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22:
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
❑A ❑A ❑A ❑A ❑A ❑A Row crops
❑B ❑B ❑B ❑B ❑B ❑B Maintained turf
❑C ❑C ❑C ❑C ❑C ❑C Pasture (no livestock)/commercial horticulture
❑D ❑D ❑D ❑D ❑D ❑D Pasture (active livestock use)
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
®A ®A Medium to high stem density
❑B ❑B Low stem density
❑C ❑C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10 feet wide.
LB RB
®A ®A The total length of buffer breaks is < 25 percent.
❑B ❑B The total length of buffer breaks is between 25 and 50 percent.
❑C ❑C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes to
assessment reach habitat.
LB RB
❑A ❑A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native species,
with non-native invasive species absent or sparse.
®B ®B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
❑C ❑C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. ❑Yes ®No Was conductivity measurement recorded?
If No, select one of the following reasons. ❑No Water ❑Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
❑A < 46 ❑B 46 to < 67 ❑C 67 to < 79 ❑D 79 to < 230 ❑E >_ 230
Notes/Sketch

Draft NIC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Fertile Ground Date of Assessment 2/23/2023
Stream Category Pal Assessor Name/Organization Rob Crowther, NV5, Inc.
Notes of Field Assessment Form (Y/N)
NO
Presence of regulatory considerations (Y/N)
YES
Additional stream information/supplementary measurements included (Y/N)
NO
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Intermittent
USACE/
NCDWR
Function Class Rating Summary
All Streams
Intermittent
(1) Hydrology
MEDIUM
MEDIUM
(2) Baseflow
HIGH
HIGH
(2) Flood Flow
MEDIUM
MEDIUM
(3) Streamside Area Attenuation
HIGH
HIGH
(4) Floodplain Access
MEDIUM
MEDIUM
(4) Wooded Riparian Buffer
HIGH
HIGH
(4) Microtopography
HIGH
HIGH
(3) Stream Stability
LOW
LOW
(4) Channel Stability
LOW
LOW
(4) Sediment Transport
LOW
LOW
(4) Stream Geomorphology
MEDIUM
MEDIUM
(2) Stream/Intertidal Zone Interaction
NA
NA
(2) Longitudinal Tidal Flow
NA
NA
(2) Tidal Marsh Stream Stability
NA
NA
(3) Tidal Marsh Channel Stability
NA
NA
(3) Tidal Marsh Stream Geomorphology
NA
NA
(1) Water Quality
MEDIUM
MEDIUM
(2) Baseflow
HIGH
HIGH
(2) Streamside Area Vegetation
HIGH
HIGH
(3) Upland Pollutant Filtration
HIGH
HIGH
(3) Thermoregulation
MEDIUM
MEDIUM
(2) Indicators of Stressors
NO
NO
(2) Aquatic Life Tolerance
LOW
NA
(2) Intertidal Zone Filtration
NA
NA
(1) Habitat
LOW
HIGH
(2) In -stream Habitat
LOW
MEDIUM
(3) Baseflow
HIGH
HIGH
(3) Substrate
LOW
LOW
(3) Stream Stability
LOW
LOW
(3) In -stream Habitat
LOW
HIGH
(2) Stream -side Habitat
HIGH
HIGH
(3) Stream -side Habitat
HIGH
HIGH
(3) Thermoregulation
HIGH
HIGH
(2) Tidal Marsh In -stream Habitat
NA
NA
(3) Flow Restriction
NA
NA
(3) Tidal Marsh Stream Stability
NA
NA
(4) Tidal Marsh Channel Stability
NA
NA
(4) Tidal Marsh Stream Geomorphology
NA
NA
(3) Tidal Marsh In -stream Habitat
NA
NA
(2) Intertidal Zone
NA
NA
Overall
MEDIUM
MEDIUM

NC DWQ Stream Identification Form Version 4.11 1SB
Date: 02/23/2023
Project/Site: Fertile Ground Grocery
Latitude: 35.7488
Evaluator:R. Crowther, NV5 County: Wake
Longitude:-78.6296
Total Points:
Other:
Stream is at least intermittent if
�g Stream Determination:
e.g. Quad Name:
>19 or perennial if >30
Intermittent
A. Geomorphology (Subtotal =5.5 )
Absent
Weak
Moderate
Strong
SCORE
1a. Continuous bed and bank
0
1
2
3
1
2. Sinuosity of channel along thalweg
0
1
2
3
1
3. In -Channel structure: ex. riffle -pool, step -pool, ripple-
ool se uence
0
1
2
3
0
4. Particle size of stream substrate
0
1
2
3
1
5. Active/relic flood lain
0
1
2
3
0
6. Depositional bars or benches
0
1
2
3
0
7. Recent alluvial deposits
0
1
2
3
1
8. Headcuts
0
1
2
3
1
9. Grade controls
0
0.5
1
1.5
0
10. Natural valley
0
0.5
1
1.5
0.5
11. Second or greater order channel
No - 0
Yes - 3
0
a artificial ditches are not rated; see discussions in manual.
B. Hydrology (Subtotal =8.5)
Absent
Weak
Moderate
Strong
SCORE
12. Presence of Baseflow
0
1
2
3
2
13. Iron oxidizing bacteria
0
1
2
3
2
14. Leaflitter
1.5
1
0.5
0
1
15. Sediment on plants or debris
0
0.5
1
1.5
0.5
16. Organic debris lines or piles
0
0.5
1
1.5
0
17. Soil -based evidence of high water table?
No = 0
Yes = 3
3
C. Biology Subtotal = 5
Absent
Weak
Moderate
Strong
SCORE
18. Fibrous roots in streambed
3
2
1
0
2
19. Rooted upland plants in streambed
3
2
1
0
3
20. Macrobenthos note diversity and abundance
0
1
2
3
0
21. Aquatic Mollusks
0
1
2
3
0
22. Fish
0
0.5
1
1.5
0
23. Crayfish
0
0.5
1
1.5
0
24. Amphibians
0
0.5
1
1.5
0
25. Algae
0
0.5
1
1.5
0
26. Wetland plants in streambed
FACW=0.75; OBL=1.5 Other=0
0
.perennial stream may also be identified using other methods. See p.35 of manual.
Notes:
Bank Height feet
0.5
Bankfull Width feet
3
Water Depth inches
2
Channel Substrate
Silt
Velocity:
low
Clarity:
lightly Turbid
Sketch:

NC SAM FIELD ASSESSMENT FORM
user rvianuai version d.,i
USACE AID #: NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic quadrangle,
and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same property, identify and
number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User Manual for detailed descriptions
and explanations of requested information. Record in the "Notes/Sketch" section if supplementary measurements were performed. See the
NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT/SITE INFORMATION:
1. Project name (if any): Fertile Ground 2. Date of evaluation: 2/23/2023
3. Applicant/owner name: Andre Johnson Architects 4. Assessor name/organization: Rob Crowther, NV5, Inc.
5. County: Wake 6. Nearest named water body
7. River basin: Neuse on USGS 7.5-minute quad: Walnut Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.7488,-78.6295
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SIB 10. Length of assessment reach evaluated (feet): 50
11. Channel depth from bed (in riffle, if present) to top of bank (feet): <1 ❑Unable to assess channel depth.
12. Channel width at top of bank (feet): 2-4 13. Is assessment reach a swamp steam? ❑Yes ❑No
14. Feature type: ❑Perennial flow ®Intermittent flow ❑Tidal Marsh Stream
STREAM CATEGORY INFORMATION:
15. NC SAM Zone: ❑ Mountains (M) ® Piedmont (P) ❑ Inner Coastal Plain (1) ❑ Outer Coastal Plain (0)
16. Estimated geomorphic ®A El
valley shape (skip for
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip ®Size 1 (< 0.1 mi2) ❑Size 2 (0.1 to < 0.5 mil) ❑Size 3 (0.5 to < 5 mil) ❑Size 4 (>_ 5 mil)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? ®Yes ❑No If Yes, check all that apply to the assessment area.
❑Section 10 water ❑Classified Trout Waters ❑Water Supply Watershed (❑l ❑II ❑III ❑IV ❑V)
❑Essential Fish Habitat ❑Primary Nursery Area ❑ High Quality Waters/Outstanding Resource Waters
❑Publicly owned property ®NCDWR Riparian buffer rule in effect ❑Nutrient Sensitive Waters
❑Anadromous fish ❑303(d) List ❑CAMA Area of Environmental Concern (AEC)
❑Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
❑Designated Critical Habitat (list species)
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? ❑Yes ®No
1. Channel Water— assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
®A Water throughout assessment reach.
❑B No flow, water in pools only.
❑C No water in assessment reach.
2. Evidence of Flow Restriction — assessment reach metric
❑A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is severely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impoundment on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates, debris jams,
beaver dams).
®B Not
3. Feature Pattern — assessment reach metric
❑A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
®B Not
4. Feature Longitudinal Profile — assessment reach metric
®A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming, over
widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of these
disturbances).
❑B Not
5. Signs of Active Instability — assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
❑A < 10% of channel unstable
❑B 10 to 25% of channel unstable
®C > 25% of channel unstable

6. Streamside Area Interaction — streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
❑A ❑A
Little or no evidence of conditions that adversely affect reference interaction
®B ®B
Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area, leaky
or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
❑C ❑C
Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision, disruption
of flood flows through streamside area] or too much floodplain/intertidal zone access [examples: impoundments, intensive
mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a man-made feature on an
interstream divide
Water Quality Stressors — assessment reach/intertidal zone metric
Check all that apply.
❑A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
❑B Excessive sedimentation (burying of stream features or intertidal zone)
❑C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
❑D Odor (not including natural sulfide odors)
❑E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in "Notes/Sketch"
section.
❑F Livestock with access to stream or intertidal zone
❑G Excessive algae in stream or intertidal zone
❑H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc)
❑I Other: (explain in "Notes/Sketch" section)
®J Little to no stressors
8. Recent Weather — watershed metric (skip for Tidal Marsh Streams)
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a drought.
❑A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
❑B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
®C No drought conditions
9. Large or Dangerous Stream — assessment reach metric
❑Yes ®No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types — assessment reach metric
10a. ❑Yes ❑No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for Size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
❑A Multiple aquatic macrophytes and aquatic mosses F, W ❑F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) 2 E ❑G Submerged aquatic vegetation
®B Multiple sticks and/or leaf packs and/or emergent o w ❑H Low -tide refugia (pools)
vegetation Y U)C ❑I Sand bottom
❑C Multiple snags and logs (including lap trees) r ❑J 5% vertical bank along the marsh
❑D 5% undercut banks and/or root mats and/or roots ❑K Little or no habitat
in banks extend to the normal wetted perimeter
❑E Little or no habitat
*********************************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate —assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11a. ❑Yes ®No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
®A Riffle -run section (evaluate 11c)
®B Pool -glide section (evaluate 11d)
❑C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffle sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged. Check
at least one box in each row (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams). Not Present (NP) = absent, Rare
(R) = present but < 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative percentages
should not exceed 100% for each assessment reach.
NP R C A P
® ❑ ❑ ❑ ❑ Bedrock/saprolite
® ❑ ❑ ❑ ❑ Boulder (256 — 4096 mm)
® ❑ ❑ ❑ ❑ Cobble (64 — 256 mm)
® ❑ ❑ ❑ ❑ Gravel (2 — 64 mm)
❑ ❑ ❑ ❑ ® Sand (.062 — 2 mm)
❑ ❑ ® ❑ ❑ Silt/clay (< 0.062 mm)
❑ ❑ ® ❑ ❑ Detritus
❑ ® ❑ ❑ ❑ Artificial (rip -rap, concrete, etc.)
11d. ❑Yes ®No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)

12
Aquatic Life — assessment reach metric (skip for Tidal Marsh Streams)
12a. ®Yes ❑No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. ❑No Water ❑Other:
12b. ❑Yes ®No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check all that
apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for Size 1 and 2 streams and "taxa" for Size 3 and 4 streams.
❑ ❑Adult frogs
❑ ❑Aquatic reptiles
❑ ❑Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
❑ ❑Beetles
❑ ❑Caddisfly larvae (T)
❑ ❑Asian clam (Corbicula)
❑ ❑Crustacean (isopod/amphipod/crayfish/shrimp)
❑ ❑Damselfly and dragonfly larvae
❑ ❑Dipterans
❑ ❑Mayfly larvae (E)
❑ ❑Megaloptera (alderfly, fishfly, dobsonfly larvae)
❑ ❑Midges/mosquito larvae
❑ ❑Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
❑ ❑Mussels/Clams (not Corbicula)
❑ ❑Other fish
❑ ❑ Sala manders/tad poles
❑ ❑Snails
❑ ❑Stonefly larvae (P)
❑ ❑Tipulid larvae
❑ ❑Worms/leeches
13. Streamside Area Ground Surface Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and upland runoff.
LB RB
®A ®A Little or no alteration to water storage capacity over a majority of the streamside area
❑B ❑B Moderate alteration to water storage capacity over a majority of the streamside area
❑C ❑C Severe alteration to water storage capacity over a majority of the streamside area (examples: ditches, fill, soil compaction,
livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
❑A ❑A Majority of streamside area with depressions able to pond water >_ 6 inches deep
❑B ❑B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
®C ®C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the normal
wetted perimeter of assessment reach.
LB RB
❑Y ®Y Are wetlands present in the streamside area?
ON ❑N
16. Baseflow Contributors — assessment reach metric (skip for Size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
®A Streams and/or springs (jurisdictional discharges)
❑B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
❑C Obstruction passing flow during low -flow periods within the assessment area (beaver dam, leaky dam, bottom -release dam, weir)
❑D Evidence of bank seepage or sweating (iron in water indicates seepage)
®E Stream bed or bank soil reduced (dig through deposited sediment if present)
❑F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
❑A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
❑B Obstruction not passing flow during low -flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
❑C Urban stream (>_ 24% impervious surface for watershed)
❑D Evidence that the streamside area has been modified resulting in accelerated drainage into the assessment reach
❑E Assessment reach relocated to valley edge
OF None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
❑A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
®B Degraded (example: scattered trees)
❑C Stream shading is gone or largely absent

19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top of bank out
to the first break.
Vegetated Wooded
LB RB LB RB
®A ®A ®A ®A >_ 100 feet wide or extends to the edge of the watershed
❑B ❑B ❑B ❑B From 50 to < 100 feet wide
❑C ❑C ❑C ❑C From 30 to < 50 feet wide
❑D ❑D ❑D ❑D From 10 to < 30 feet wide
❑E ❑E ❑E ❑E < 10 feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
®A ®A Mature forest
❑B ❑B Non -mature woody vegetation or modified vegetation structure
❑C ❑C Herbaceous vegetation with or without a strip of trees < 10 feet wide
❑D ❑D Maintained shrubs
❑E ❑E Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but is
within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22:
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
❑A ❑A ❑A ❑A ❑A ❑A Row crops
❑B ❑B ❑B ❑B ❑B ❑B Maintained turf
❑C ❑C ❑C ❑C ❑C ❑C Pasture (no livestock)/commercial horticulture
❑D ❑D ❑D ❑D ❑D ❑D Pasture (active livestock use)
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
®A ®A Medium to high stem density
❑B ❑B Low stem density
❑C ❑C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10 feet wide.
LB RB
®A ®A The total length of buffer breaks is < 25 percent.
❑B ❑B The total length of buffer breaks is between 25 and 50 percent.
❑C ❑C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes to
assessment reach habitat.
LB RB
❑A ❑A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native species,
with non-native invasive species absent or sparse.
®B ®B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
❑C ❑C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. ❑Yes ®No Was conductivity measurement recorded?
If No, select one of the following reasons. ❑No Water ❑Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
❑A < 46 ❑B 46 to < 67 ❑C 67 to < 79 ❑D 79 to < 230 ❑E >_ 230
Notes/Sketch

Draft NIC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Fertile Ground Date of Assessment 2/23/2023
Stream Category Pal Assessor Name/Organization Rob Crowther, NV5, Inc.
Notes of Field Assessment Form (Y/N)
NO
Presence of regulatory considerations (Y/N)
YES
Additional stream information/supplementary measurements included (Y/N)
NO
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Intermittent
USACE/
NCDWR
Function Class Rating Summary
All Streams
Intermittent
(1) Hydrology
MEDIUM
MEDIUM
(2) Baseflow
HIGH
HIGH
(2) Flood Flow
MEDIUM
MEDIUM
(3) Streamside Area Attenuation
HIGH
HIGH
(4) Floodplain Access
MEDIUM
MEDIUM
(4) Wooded Riparian Buffer
HIGH
HIGH
(4) Microtopography
HIGH
HIGH
(3) Stream Stability
LOW
LOW
(4) Channel Stability
LOW
LOW
(4) Sediment Transport
LOW
LOW
(4) Stream Geomorphology
MEDIUM
MEDIUM
(2) Stream/Intertidal Zone Interaction
NA
NA
(2) Longitudinal Tidal Flow
NA
NA
(2) Tidal Marsh Stream Stability
NA
NA
(3) Tidal Marsh Channel Stability
NA
NA
(3) Tidal Marsh Stream Geomorphology
NA
NA
(1) Water Quality
MEDIUM
MEDIUM
(2) Baseflow
HIGH
HIGH
(2) Streamside Area Vegetation
HIGH
HIGH
(3) Upland Pollutant Filtration
HIGH
HIGH
(3) Thermoregulation
MEDIUM
MEDIUM
(2) Indicators of Stressors
NO
NO
(2) Aquatic Life Tolerance
LOW
NA
(2) Intertidal Zone Filtration
NA
NA
(1) Habitat
LOW
HIGH
(2) In -stream Habitat
LOW
MEDIUM
(3) Baseflow
HIGH
HIGH
(3) Substrate
LOW
LOW
(3) Stream Stability
LOW
LOW
(3) In -stream Habitat
LOW
HIGH
(2) Stream -side Habitat
HIGH
HIGH
(3) Stream -side Habitat
HIGH
HIGH
(3) Thermoregulation
HIGH
HIGH
(2) Tidal Marsh In -stream Habitat
NA
NA
(3) Flow Restriction
NA
NA
(3) Tidal Marsh Stream Stability
NA
NA
(4) Tidal Marsh Channel Stability
NA
NA
(4) Tidal Marsh Stream Geomorphology
NA
NA
(3) Tidal Marsh In -stream Habitat
NA
NA
(2) Intertidal Zone
NA
NA
Overall
MEDIUM
MEDIUM

U.S. Army Corps of Engineers OMB Control #. 0710-xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT.•
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR335-15, paragraph5-2a)
Project/Site: Fertile Ground Grocery Store City/County: Wake Sampling Date: 02/23/23
Applicant/Owner: Andre Johnson Architects State: NC Sampling Point: WA Wei
Investigator(s): Rob Crowther, Annie Welch, NV5 Section, Township, Range:
Landform (hillside, terrace, etc.): Crenulation Local relief (concave, convex, none): Concave Slope (%): 0-2
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 35.7488 Long:-78.6294 Datum: NAD 83
Soil Map Unit Name: ChA - Chewacla and Wehadkee Soils NWI classification: PFO
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two reouired)
Primary Indicators (minimum of one is reouired; check all that apply)
_Surface Soil Cracks (136)
_Surface Water (Al) _True
Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
X High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
—Drainage Patterns (1310)
X Saturation (A3) _Oxidized
Rhizospheres on Living Roots (C3)
_Moss Trim Lines (1316)
—Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) _Other
(Explain in Remarks)
_Stunted or Stressed Plants (D1)
—Iron Deposits (135)
X Geomorphic Position (D2)
—Inundation Visible on Aerial Imagery (137)
—Shallow Aquitard (D3)
—Water-Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
X Depth (inches):
Water Table Present? Yes X No
Depth (inches): 10
Saturation Present? Yes X No
Depth (inches): 8
Wetland
Hydrology Present? Yes X No
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: WA Wet
Tree Stratum (Plot size: 10, x 10, )
1.
2.
3.
4.
5.
6.
7.
50% of total cover:
Saolino/Shrub Stratum (Plot size: 10, x 10, )
1. Ligustrum sinense
2.
3.
4.
5.
6.
7.
8.
9.
50% of total cover: 1
Herb Stratum (Plot size: 10, x 10, )
1. Nyssa sylvatica
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
50% of total cover: 3
Woody Vine Stratum (Plot size: 10, x 10, )
1.
2.
3.
4.
5.
Absolute Dominant Indicatc
% Cover Species? Status
_=Total Cover
20% of total cover:
2 No FACU
= I Vial vV 1
20% of total cover: 1
5 Yes FAC
J =1 V-1 VV 1
20% of total cover: 1
=Total Cover
50% of total cover: 20% of total cover:
Remarks: (Include photo numbers here or on a separate sheet.)
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC:
1 (A)
Total Number of Dominant
Species Across All Strata:
1 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC:
100.0% (A/B)
Prevalence Index worksheet:
Total % Cover of:
Multiply by:
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals: (A) (B)
Prevalence Index = B/A =
_ 1 - Rapid Test for Hydrophytic Vegetation
X 2 - Dominance Test is >50%
_3 Prevalence Index is:s3.0'
4 Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators 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
height.
Hydrophytic
Vegetation
Present? Yes X No
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: WA Wet
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture Remarks
0-4 10YR 3/2 85 7.5YR 4/6 15 C M Loamy/Clayey Prominent redox concentrations
4-12 10YR 3/2 75 7.5YR 4/6 25 C M Loamy/Clayey Prominent redox concentrations
'Type: C=Concentration, D=Depletion,
Hydric Soil Indicators:
_ Histosol (Al)
_ Histic Epipedon (A2)
—Black Histic (A3)
—Hydrogen Sulfide (A4)
—Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
_ Depleted Below Dark Surface (At 1;
_Thick Dark Surface (At 2)
_Sandy Mucky Mineral (S1)
_Sandy Gleyed Matrix (S4)
—Sandy Redox (S5)
_Stripped Matrix (S6)
Dark Surface (S7)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
RM=Reduced Matrix, MS=Masked Sand Grains
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_Thin Dark Surface (S9) (MLRA 147, 148)
—Loamy Mucky Mineral (F1) (MLRA 136)
—Loamy Gleyed Matrix (F2)
—Depleted Matrix (F3)
X Redox Dark Surface (F6)
—Depleted Dark Surface (F7)
_ Redox Depressions (F8)
—Iron-Manganese Masses (F12) (LRR N,
MLRA 136)
_ Umbric Surface (F13) (MLRA 122, 136)
—Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147, 148)
2Location: PL=Pore Lining, M=Matrix
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
_Coast Prairie Redox (At6)
(MLRA 147, 148)
—Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
—Red Parent Material (F21)
(outside MLRA 127, 147, 148)
_Very Shallow Dark Surface (F22)
Other (Explain in Remarks)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes X No
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

U.S. Army Corps of Engineers OMB Control #. 0710-xxxx, Exp: Pending
WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region Requirement Control Symbol EXEMPT.•
See ERDC/EL TR-07-24; the proponent agency is CECW-CO-R (Authority: AR335-15, paragraph5-2a)
Project/Site: Fertile Ground Grocery Store City/County: Wake Sampling Date: 02/23/23
Applicant/Owner: Andre Johnson Architects State: NC Sampling Point: WA Up
Investigator(s): Rob Crowther, Annie Welch, NV5 Section, Township, Range:
Landform (hillside, terrace, etc.): Hillside Local relief (concave, convex, none): None Slope (%): 2-5
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 35.7488 Long:-78.6294 Datum: NAD 83
Soil Map Unit Name: ChA - Chewacla and Wehadkee Soils NWI classification: N/A
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two reouired)
Primary Indicators (minimum of one is reouired; check all that apply)
_Surface Soil Cracks (136)
_Surface Water (Al) _True
Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
—High Water Table (A2) —Hydrogen
Sulfide Odor (Cl)
—Drainage Patterns (1310)
_Saturation (A3) _Oxidized
Rhizospheres on Living Roots (C3)
_Moss Trim Lines (1316)
—Water Marks (131) —Presence
of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (132) _Recent
Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_Drift Deposits (133) _Thin
Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (134) _Other
(Explain in Remarks)
_Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
—Inundation Visible on Aerial Imagery (137)
—Shallow Aquitard (D3)
—Water-Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
X Depth (inches):
Water Table Present? Yes No
X Depth (inches):
Saturation Present? Yes No
X Depth (inches):
Wetland
Hydrology Present? Yes No X
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: WA Up
Tree Stratum (Plot size: 30' R )
1. Quercus alba
2. Nyssa sylvatica
3. Platanus occidentalis
4. Pinus taeda
5.
6.
7.
50% of total cover: 23
Saolino/Shrub Stratum (Plot size: 15' R )
1. Ligustrum sinense
2. Nyssa sylvatica
3.
4.
5.
6.
7.
8.
9.
50% of total cover: 13
Herb Stratum (Plot size: 5' R )
1. Polystichum acrostichoides
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
50% of total cover: 3
Woody Vine Stratum (Plot size: 30' R )
1. Hedera helix
2. Smilax rotundifolia
3.
4.
5.
Absolute
Dominant
Indicato
% Cover
Species?
Status
10
Yes
FACU
15
Yes
FAC
10
Yes
FACW
10
Yes
FAC
45 =Total Cover
20% of total cover: 9
20 Yes FACU
5 Yes FAC
LO = I Vldl UUVCI
20% of total cover: 5
5 Yes FACU
O = I Vldl UUVCI
20% of total cover: 1
2 No FACU
2 No FAC
4 =Total Cover
50% of total cover: 2 20% of total cover: 1
Remarks: (Include photo numbers here or on a separate sheet.)
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: 4 (A)
Total Number of Dominant
Species Across All Strata: 7 (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: 57.1% (A/B)
Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
UPL species x 5 =
Column Totals: (A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
X 2 - Dominance Test is >50%
_3 Prevalence Index is:53.0'
4 Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators 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
height.
Hydrophytic
Vegetation
Present? Yes X No
ENG FORM 6116-4-SG, JUL 2018
Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: WA Up
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture Remarks
0-5 10YR 3/4 100 Loamy/Clayey
5-12 7.5YR 4/6 100 Loamy/Clayey
'Type: C=Concentration, D=Depletion,
Hydric Soil Indicators:
_ Histosol (Al)
_ Histic Epipedon (A2)
—Black Histic (A3)
—Hydrogen Sulfide (A4)
—Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
_Depleted Below Dark Surface (A11;
_Thick Dark Surface (Al 2)
_Sandy Mucky Mineral (S1)
_Sandy Gleyed Matrix (S4)
—Sandy Redox (S5)
—Stripped Matrix (S6)
Dark Surface (S7)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
RM=Reduced Matrix, MS=Masked Sand Grains
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_Thin Dark Surface (S9) (MLRA 147, 148)
—Loamy Mucky Mineral (F1) (MLRA 136)
—Loamy Gleyed Matrix (F2)
—Depleted Matrix (F3)
_ Redox Dark Surface (F6)
—Depleted Dark Surface (F7)
_ Redox Depressions (F8)
—Iron-Manganese Masses (F12) (LRR N,
MLRA 136)
_ Umbric Surface (F13) (MLRA 122, 136)
—Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147, 148)
2Location: PL=Pore Lining, M=Matrix
Indicators for Problematic Hydric Soils3:
2 cm Muck (A10) (MLRA 147)
_Coast Prairie Redox (A16)
(MLRA 147, 148)
—Piedmont Floodplain Soils (F19)
(MLRA 136, 147)
—Red Parent Material (F21)
(outside MLRA 127, 147, 148)
_Very Shallow Dark Surface (F22)
Other (Explain in Remarks)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes No X
ENG FORM 6116-4-SG, JUL 2018 Eastern Mountains and Piedmont — Version 2.0

NC WAM FIELD ASSESSMENT FORM
Accompanies user Manual Version b.0
USACE AID #
NCDWR#
Project Name
Fertile Ground
Date of Evaluation
2/23/2023
Applicant/Owner Name
Andre Johnson Architects
Wetland Site Name
WA
Wetland Type
Headwater Forest
Assessor Name/Organization
Rob Crowther, NV5, Inc.
Level III Ecoregion
Piedmont
Nearest Named Water Body
Walnut Creek
River Basin
Neuse
USGS 8-Digit Catalogue Unit
03020201
County
Wake
NCDWR Region
Raleigh
F— Yes M No
Precipitation within 48 hrs?
Latitude/Longitude (deci-degrees)
35.748862.-78.629474
Evidence of stressors affecting the assessment area (may not be within the assessment area)
Please circle and/or make note on the last page if evidence of stressors is apparent. Consider departure from reference, if appropriate, in
recent past (for instance, within 10 years). Noteworthy stressors include, but are not limited to the following.
• Hydrological modifications (examples: ditches, dams, beaver dams, dikes, berms, ponds, etc.)
• Surface and sub -surface discharges into the wetland (examples: discharges containing obvious pollutants, presence of nearby septic
tanks, underground storage tanks (USTs), hog lagoons, etc.)
• Signs of vegetation stress (examples: vegetation mortality, insect damage, disease, storm damage, salt intrusion, etc.)
• Habitat/plant community alteration (examples: mowing, clear -cutting, exotics, etc.)
Is the assessment area intensively managed? ® Yes ❑ No
Regulatory Considerations - Were regulatory considerations evaluated? ®Yes ❑No If Yes, check all that apply to the assessment area.
❑ Anadromous fish
❑ Federally protected species or State endangered or threatened species
® NCDWR riparian buffer rule in effect
❑ Abuts a Primary Nursery Area (PNA)
❑ Publicly owned property
❑ N.C. Division of Coastal Management Area of Environmental Concern (AEC) (including buffer)
❑ Abuts a stream with a NCDWQ classification of SA or supplemental classifications of HQW, ORW, or Trout
❑ Designated NCNHP reference community
❑ Abuts a 303(d)-listed stream or a tributary to a 303(d)-listed stream
What type of natural stream is associated with the wetland, if any? (check all that apply)
❑ Blackwater
® Brownwater
❑ Tidal (if tidal, check one of the following boxes) ❑ Lunar ❑ Wind ❑ Both
Is the assessment area on a coastal island? ❑ Yes ® No
Is the assessment area's surface water storage capacity or duration substantially altered by beaver? ❑ Yes ® No
Does the assessment area experience overbank flooding during normal rainfall conditions? ❑ Yes ® No
1. Ground Surface Condition/Vegetation Condition —assessment area condition metric
Check a box in each column. Consider alteration to the ground surface (GS) in the assessment area and vegetation structure (VS) in the
assessment area. Compare to reference wetland if applicable (see User Manual). If a reference is not applicable, then rate the assessment
area based on evidence an effect.
GS VS
®A ®A Not severely altered
❑B ❑B Severely altered over a majority of the assessment area (ground surface alteration examples: vehicle tracks, excessive
sedimentation, fire -plow lanes, skidder tracks, bedding, fill, soil compaction, obvious pollutants) (vegetation structure
alteration examples: mechanical disturbance, herbicides, salt intrusion [where appropriate], exotic species, grazing, less
diversity [if appropriate], hydrologic alteration)
Surface and Sub -Surface Storage Capacity and Duration — assessment area condition metric
Check a box in each column. Consider surface storage capacity and duration (Surf) and sub -surface storage capacity and duration (Sub).
Consider both increase and decrease in hydrology. A ditch <_ 1 foot deep is considered to affect surface water only, while a ditch > 1 foot
deep is expected to affect both surface and sub -surface water. Consider tidal flooding regime, if applicable.
Surf Sub
❑A ®A Water storage capacity and duration are not altered.
❑B ❑B Water storage capacity or duration are altered, but not substantially (typically, not sufficient to change vegetation).
®C ❑C Water storage capacity or duration are substantially altered (typically, alteration sufficient to result in vegetation change)
(examples: draining, flooding, soil compaction, filling, excessive sedimentation, underground utility lines).
Water Storage/Surface Relief — assessment area/wetland type condition metric (skip for all marshes)
Check a box in each column. Select the appropriate storage for the assessment area (AA) and the wetland type (WT).
AA WT
3a. ❑A ❑A Majority of wetland with depressions able to pond water > 1 deep
❑B ❑B Majority of wetland with depressions able to pond water 6 inches to 1 foot deep
❑C ❑C Majority of wetland with depressions able to pond water 3 to 6 inches deep
®D ®D Depressions able to pond water < 3 inches deep
3b. ❑A Evidence that maximum depth of inundation is greater than 2 feet
❑B Evidence that maximum depth of inundation is between 1 and 2 feet
®C Evidence that maximum depth of inundation is less than 1 foot

4. Soil Texture/Structure — assessment area condition metric (skip for all marshes)
Check a box from each of the three soil property groups below. Dig soil profile in the dominant assessment area landscape feature.
Make soil observations within the top 12 inches. Use most recent National Technical Committee for Hydric Soils guidance for regional
indicators.
4a. ❑A Sandy soil
®B Loamy or clayey soils exhibiting redoximorphic features (concentrations, depletions, or rhizospheres)
❑C Loamy or clayey soils not exhibiting redoximorphic features
❑D Loamy or clayey gleyed soil
❑E Histosol or histic epipedon
4b. ®A Soil ribbon < 1 inch
❑B Soil ribbon >_ 1 inch
4c. ®A No peat or muck presence
❑B A peat or muck presence
5. Discharge into Wetland — opportunity metric
Check a box in each column. Consider surface pollutants or discharges (Surf) and sub -surface pollutants or discharges (Sub). Examples
of sub -surface discharges include presence of nearby septic tank, underground storage tank (UST), etc.
Surf Sub
®A ®A Little or no evidence of pollutants or discharges entering the assessment area
❑B ❑B Noticeable evidence of pollutants or discharges entering the wetland and stressing, but not overwhelming the
treatment capacity of the assessment area
❑C ❑C Noticeable evidence of pollutants or discharges (pathogen, particulate, or soluble) entering the assessment area and
potentially overwhelming the treatment capacity of the wetland (water discoloration, dead vegetation, excessive
sedimentation, odor)
6. Land Use — opportunity metric (skip for non -riparian wetlands)
Check all that apply (at least one box in each column). Evaluation involves a GIS effort with field adjustment. Consider sources draining
to assessment area within entire upstream watershed (WS), within 5 miles and within the watershed draining to the assessment area (5M),
and within 2 miles and within the watershed draining to the assessment area (2M).
WS 5M 2M
®A ®A ®A > 10% impervious surfaces
❑B ❑B ❑B Confined animal operations (or other local, concentrated source of pollutants
❑C ❑C ❑C >_ 20% coverage of pasture
❑D ❑D ❑D >_ 20% coverage of agricultural land (regularly plowed land)
❑E ®E ❑E >_ 20% coverage of maintained grass/herb
❑F ❑F ❑F >_ 20% coverage of clear-cut land
❑G ❑G ❑G Little or no opportunity to improve water quality. Lack of opportunity may result from little or no disturbance in
the watershed or hydrologic alterations that prevent drainage and/or overbank flow from affecting the
assessment area.
7. Wetland Acting as Vegetated Buffer —assessment area/wetland complex condition metric (skip for non -riparian wetlands)
7a. Is assessment area within 50 feet of a tributary or other open water?
®Yes ❑No If Yes, continue to 7b. If No, skip to Metric 8.
Wetland buffer need only be present on one side of the water body. Make buffer judgment based on the average width of wetland.
Record a note if a portion of the buffer has been removed or disturbed.
7b. How much of the first 50 feet from the bank is wetland? (Wetland buffer need only be present on one side of the .water body. Make
buffer judgment based on the average width of wetland. Record a note if a portion of the buffer has been removed or disturbed.)
❑A >_ 50 feet
❑B From 30 to < 50 feet
❑C From 15 to < 30 feet
®D From 5 to < 15 feet
❑E < 5 feet or buffer bypassed by ditches
7c. Tributary width. If the tributary is anastomosed, combine widths of channels/braids for a total width.
®<_ 15-feet wide ❑> 15-feet wide ❑ Other open water (no tributary present)
7d. Do roots of assessment area vegetation extend into the bank of the tributary/open water?
❑Yes ®No
7e. Is stream or other open water sheltered or exposed?
®Sheltered — adjacent open water with width < 2500 feet and no regular boat traffic.
❑Exposed — adjacent open water with width >_ 2500 feet or regular boat traffic.
8. Wetland Width at the Assessment Area — wetland type/wetland complex condition metric (evaluate WT for all marshes and
Estuarine Woody Wetland only; evaluate WC for Bottomland Hardwood Forest, Headwater Forest, and Riverine Swamp Forest
only)
Check a box in each column for riverine wetlands only. Select the average width for the wetland type at the assessment area (WT) and
the wetland complex at the assessment area (WC). See User Manual for WT and WC boundaries.
WT WC
❑A ❑A >_ 100 feet
❑B ❑B From 80 to < 100 feet
❑C ❑C From 50 to < 80 feet
❑D ❑D From 40 to < 50 feet
❑E ❑E From 30 to < 40 feet
❑F ❑F From 15 to < 30 feet
®G ®G From 5 to < 15 feet
❑H ❑H < 5 feet

9. Inundation Duration — assessment area condition metric (skip for non -riparian wetlands)
Answer for assessment area dominant landform.
❑A Evidence of short -duration inundation (< 7 consecutive days)
®B Evidence of saturation, without evidence of inundation
❑C Evidence of long -duration inundation or very long -duration inundation (7 to 30 consecutive days or more)
10. Indicators of Deposition — assessment area condition metric (skip for non -riparian wetlands and all marshes)
Consider recent deposition only (no plant growth since deposition).
®A Sediment deposition is not excessive, but at approximately natural levels.
❑B Sediment deposition is excessive, but not overwhelming the wetland.
❑C Sediment deposition is excessive and is overwhelming the wetland.
11. Wetland Size — wetland type/wetland complex condition metric
Check a box in each column. Involves a GIS effort with field adjustment. This metric evaluates three aspects of the wetland area: the
size of the wetland type (WT), the size of the wetland complex (WC), and the size of the forested wetland (FW) (if applicable, see User
Manual). See the User Manual for boundaries of these evaluation areas. If assessment area is clear-cut, select "K" for the FW column.
WT WC FW (if applicable)
❑A ❑A ❑A >_ 500 acres
❑B ❑B ❑B From 100 to < 500 acres
❑C ❑C ❑C From 50 to < 100 acres
❑D ❑D ❑D From 25 to < 50 acres
❑E ❑E ❑E From 10 to < 25 acres
❑F ❑F ❑F From 5 to < 10 acres
❑G ❑G ❑G From 1 to < 5 acres
❑H ❑H ❑H From 0.5 to < 1 acre
❑I ❑I ❑I From 0.1 to < 0.5 acre
❑J ❑J ❑J From 0.01 to < 0.1 acre
®K ®K ®K < 0.01 acre or assessment area is clear-cut
12. Wetland Intactness — wetland type condition metric (evaluate for Pocosins only)
❑A Pocosin is the full extent (>_ 90%) of its natural landscape size.
❑B Pocosin type is < 90% of the full extent of its natural landscape size.
13. Connectivity to Other Natural Areas — landscape condition metric
13a. Check appropriate box(es) (a box may be checked in each column). Involves a GIS effort with field adjustment. This metric
evaluates whether the wetland is well connected (Well) and/or loosely connected (Loosely) to the landscape patch, the contiguous
naturally vegetated area and open water (if appropriate). Boundaries are formed by four -lane roads, regularly maintained utility line
corridors the width of a four -lane road or wider, urban landscapes, maintained fields (pasture and agriculture), or open water > 300
feet wide.
Well Loosely
❑A
❑A
>_ 500 acres
❑B
❑B
From 100 to < 500 acres
❑C
❑C
From 50 to < 100 acres
❑D
®D
From 10 to < 50 acres
®E
❑E
< 10 acres
❑F
❑F
Wetland type has a poor or no connection to other natural habitats
13b. Evaluate for marshes only.
❑Yes ❑No Wetland type has a surface hydrology connection to open waters/stream or tidal wetlands.
14. Edge Effect — wetland type condition metric (skip for all marshes and Estuarine Woody Wetland)
May involve a GIS effort with field adjustment. Estimate distance from wetland type boundary to artificial edges. Artificial edges include
non -forested areas >_ 40 feet wide such as fields, development, roads, regularly maintained utility line corridors, and clear -cuts. Consider
the eight main points of the compass. Artificial edge occurs within 150 feet in how many directions? If the assessment area is clear cut,
select option "C."
®A 0
❑ B 1 to 4
❑C 5to8
15. Vegetative Composition — assessment area condition metric (skip for all marshes and Pine Flat)
❑A Vegetation is close to reference condition in species present and their proportions. Lower strata composed of appropriate
species, with exotic plants absent or sparse within the assessment area.
❑B Vegetation is different from reference condition in species diversity or proportions, but still largely composed of native species
characteristic of the wetland type. This may include communities of weedy native species that develop after clearcutting or clearing.
It also includes communities with exotics present, but not dominant, over a large portion of the expected strata.
®C Vegetation severely altered from reference in composition, or expected species are unnaturally absent (planted stands of non -
characteristic species or at least one stratum inappropriately composed of a single species), or exotic species are dominant in at
least one stratum.
16. Vegetative Diversity — assessment area condition metric (evaluate for Non -tidal Freshwater Marsh only)
❑A Vegetation diversity is high and is composed primarily of native species (< 10% cover of exotics).
®B Vegetation diversity is low or has > 10% to 50% cover of exotics.
❑C Vegetation is dominated by exotic species (> 50 % cover of exotics).

17. Vegetative Structure — assessment area/wetland type condition metric
17a. Is vegetation present?
®Yes ❑No If Yes, continue to 17b. If No, skip to Metric 18.
17b. Evaluate percent coverage of assessment area vegetation for all marshes only. Skip to 17c for non -marsh wetlands.
❑A >_ 25% coverage of vegetation
❑B < 25% coverage of vegetation
17c. Check a box in each column for each stratum. Evaluate this portion of the metric for non -marsh wetlands. Consider
structure in airspace above the assessment area (AA) and the wetland type (WT) separately.
TAA WT
o ❑A ❑A Canopy closed, or nearly closed, with natural gaps associated with natural processes
m ®B ®B Canopy present, but opened more than natural gaps
U ❑C ❑C Canopy sparse or absent
T
o ❑A
❑A
Dense mid-story/sapling layer
❑B
❑B
Moderate density mid-story/sapling layer
®C
®C
Mid-story/sapling layer sparse or absent
- ❑A
❑A
Dense shrub layer
Moderate density layer
1E ❑B
❑B
shrub
U) ®C
®C
Shrub layer sparse or absent
-0 ❑A
❑A
Dense herb layer
_ ❑B
❑B
Moderate density herb layer
®C
®C
Herb layer sparse or absent
18. Snags — wetland type condition metric (skip for all marshes)
❑A Large snags (more than one) are visible (> 12 inches DBH, or large relative to species present and landscape stability).
®B Not
19. Diameter Class Distribution — wetland type condition metric (skip for all marshes)
❑A Majority of canopy trees have stems > 6 inches in diameter at breast height (DBH); many large trees (> 12 inches DBH) are
present.
❑B Majority of canopy trees have stems between 6 and 12 inches DBH, few are > 12 inch DBH.
®C Majority of canopy trees are < 6 inches DBH or no trees.
20. Large Woody Debris — wetland type condition metric (skip for all marshes)
Include both natural debris and man -placed natural debris.
❑A Large logs (more than one) are visible (> 12 inches in diameter, or large relative to species present and landscape stability).
®B Not
21. Vegetation/Open Water Dispersion — wetland type/open water condition metric (evaluate for Non -Tidal Freshwater Marsh only)
Select the figure that best describes the amount of interspersion between vegetation and open water in the growing season. Patterned
areas indicate vegetated areas, while solid white areas indicate open water.
❑A ❑B ❑C ❑D
22
Hydrologic Connectivity — assessment area condition metric (evaluate for riparian wetlands and Salt/Brackish Marsh only)
Examples of activities that may severely alter hydrologic connectivity include intensive ditching, fill, sedimentation, channelization, diversion,
man-made berms, beaver dams, and stream incision. Documentation required if evaluated as B, C, or D.
®A Overbank and overland flow are not severely altered in the assessment area.
❑B Overbank flow is severely altered in the assessment area.
❑C Overland flow is severely altered in the assessment area.
❑D Both overbank and overland flow are severely altered in the assessment area.
Notes

NC WAM Wetland Rating Sheet
Accompanies User Manual Version 5.0
Wetland Site Name WA
Wetland Type Headwater Forest
Date of Assessment 2/23/2023
Rob Crowther, NV5,
Assessor Name/Organization Inc.
Notes on Field Assessment Form (Y/N) NO
Presence of regulatory considerations (Y/N) YES
Wetland is intensively managed (Y/N)
Assessment area is located within 50 feet of a natural tributary or other open water (Y/N) YES
Assessment area is substantially altered by beaver (Y/N) NO
Assessment area experiences overbank flooding during normal rainfall conditions (Y/N) NO
Assessment area is on a coastal island (Y/N) NO
Sub -function Ratina Summa
Function Sub -function Metrics Rating
Hydrology Surface Storage and Retention Condition LOW
Sub -surface Storage and
Retention Condition HIGH
Water Quality Pathogen Change
Condition
HIGH
Condition/Opportunity
HIGH
Opportunity Presence
(Y/N)
YES
Particulate Change
Condition
HIGH
Condition/Opportunity
NA
Opportunity Presence
(Y/N)
NA
Soluble Change
Condition
MEDIUM
Condition/Opportunity
HIGH
Opportunity Presence
(Y/N)
YES
Physical Change
Condition
LOW
Condition/Opportunity
LOW
Opportunity Presence
(Y/N)
YES
Pollution Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence
(Y/N)
NA
Habitat Physical Structure
Condition
LOW
Landscape Patch Structure
Condition
LOW
Vegetation Composition
Condition
LOW
Function Ratina Summa
Function
Metrics
Rating
Hydrology
Condition
MEDIUM
Water Quality
Condition
HIGH
Condition/Opportunity
HIGH
Opportunity Presence (Y/N)
YES
Habitat
Condition
LOW
Overall Wetland Rating MEDIUM