20241033 Ver 1_ePCN Application_20240730

i DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?
Yes No
Is this project a public transportation project?*
Yes No
Change only If needed.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned Version# *
20241033 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Washington Regional Office - [phone]
Information for Initial Review
la. Name of project:
Goldsboro Raw Water Intake Screen Emergency Replacement
la. Who is the Primary Contact?*
Keven Duerr
1b. Primary Contact Email: *
[e-mail]
Date Submitted
7/30/2024
Nearest Body of Water
Neuse River
Basin
Nauss
Water Classification
WS-IV: NSW. CA
Site Coordinates
Latitude: Longitude:
35.3744767-78.0345234
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Wayne
Is this a NCDMS Project
Yes No
What amount is owed?*
$240.00
$323.00
Select Project Reviewer*
Robert Tankard:robert.tankard
1c. Primary Contact Phone:*
[phone]
$570.00
$767.00
Is this project a public transportation project?*
Yes No

1a. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
1f. Is this an after -the -fact permit application? *
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
City of Goldsboro
2b. Deed book and page no.:
DB833, PG800
2c. Contact Person:
Richard Hamilton
2d.Address
Street Address
Stevens Mill Road
Address Line 2
P.O. Box A
City
State / Province / Region
Goldsboro
NC
Postal / Zip Code
Country
57533-9701
United States

2e. Telephone Number:
[phone]
2g. Email Address:'
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Keven Duerr
4b. Business Name:
Hazen and Sawyer
4c. Address
Street Address
4011 Westchase Blvd., Suite 500
Address Line 2
City
Raleigh
Postal / Zip Code
27607
4d. Telephone Number:
[phone]
4f. Email Address:"`
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Goldsboro
2. Project Identification
2f. Fax Number:
State / Province / Region
NC
Country
United States
4e. Fax Number:
2a. Property Identification Number:
2b. Property size:
2589737401
37 acres
2c. Project Address
Street Address
Stevens Mill Road
Address Line 2
City
State / Province / Region
Goldsboro
NC
Postal / Zip Code
Country
United States
3. Surface Waters
3a. Name of the nearest body of water to proposed project: "
Neuse River
3b. Water Resources Classification of nearest receiving water:
WS-IV; NSW, CA
3c. What river basin(s) is your project located in?*
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030202011705
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:
Please refer to the attached Additional Information section.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
a

4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
1,065
4h. Explain the purpose of the proposed project:"
Please refer to the attached Additional Information section.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Please refer to the attached Additional Information section.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Keven Duerr
Agency/Consultant Company: Hazen and Sawyer
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
u
F
S1
3a. Reason for impact (?)
Dredging
3b.lmpact type*
Permanent
3c. Type of impact*
Other
3d. S. name*
Neuse River
3e. Stream Type*
?)
Perennial
3f. Type of
Jurisdiction*
Both
3g. S. width
27
Average (feet)
3h. Impact
length*
58
(linear feet)
Erosion and Sediment
Tem ora
P rYCOntr01
Other
Neuse River ::IPerennial
::]
Both
t;;J�:]_
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
58 46
3i. Total stream and ditch impacts:
104
3j. Comments:
Neuse River is approximately 115 feet wide at the project location. Project encroachment will not exceed 85 feet from the left bank.
E. Impact Justification and Mitigation O
1. Avoidance and Minimization

la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Please refer to the attached Additional Information section.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Please refer to the attached Additional Information section.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts will not exceed threshold to require mitigation. Minimal environmental effects will result from project implementation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the INC Riparian Buffer Protection Rules?
Yes No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated Stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes No
Comments:*
This project does not meet the minimum criteria to trigger the preparation of a SEPA document. The project does not involve funds, federal lands, or
federal agency involvement other than authorization under Section 404 of the Clean Water Act.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality? *
Yes No
3b. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
n

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?"`
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
Yes No
What Federal Agency is involved?
National Marine Fisheries Service
5e. Is this a DOT project located within Division's 1-8?
Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
Unknown
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Please refer to the attached Additional Information section.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
Hazen reviewed the Essential Fish Habitat Mapper for the Mid -Atlantic region provided through NOAA Fisheries website to determine potential impacts
to Essential Fish Habitat anticipated by the proposed project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Please refer to the attached Additional Information section.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
Yes No
8b. If yes, explain how project meets FEMA requirements:
No new structures or permanent fill material will be placed within the floodway.
8c. What source(s) did you use to make the floodplain determination?"
FEMA National Flood Hazard Layer Viewer of FIRM Panel 3720258800K, effective date June 19, 2018.
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
20240730_Goldsboro PCN Attachments.pdf 6.62MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:

• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction' subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Keven Duerr
Signature
&46�;,r 06"t t
Date
7/30/2024