20170899 Ver 1_NCDOT_I-4729A_Polk_ Permit Application_20170724

Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name TIP I-4729A Improvements to the I-26/US 74 Interchan,�e in Columbus, Polk Co., NC
2. Name of Property Owner/Applicant: NC Department of Transportation
3. Name of Consultant/Agent: N/A
*Agent authorization needs to be attached.
4. Related/Previous Action ID number(s): N/A
5. Site Address: N/A
6. Subdivision Name: N/A
7. City: Columbus
8. County: Polk
9. Lat: 35.24990° N Long: -82.20820 ° W (Approx. Project Center)
10. Quadrangle Name: Mill Sprin�(35082-C2-TF-024�
11. Waterway: Horse Creek (C)
12. Watershed: U�er Broad River (03050105)
13. Requested Action:
Nationwide Permit #
X General Permit # 31
_ Jurisdictional Determination Request
_ Pre-Application Request
The following information will be completed by Corps office:
: �
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose:
Site/Waters Name:
Keywords:

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
July 22, 2017
Ms. Lori Beckwith
U.S. Army Corps of Engineers
NCDOT Regulatory Project Manager
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
JAMES H. TROGDON, III
SECRETARY
Subject: Application for Section 404 Regional General Permit 198200031 and Section 401
Water Quality Certification for the proposed improvements to the I-26/iJS 74
interchange in Columbus, Polk County, NC. TIP No. I-4729A. Debit $570 from WBS
34243.1.3
Dear Ms. Beckwith:
The North Carolina Department of Transportation (NCDOT) proposes improvements to the I-26/iJS 74
interchange in Columbus, Polk County, NC. The State Transportation Improvement Program (STIP)
Project I-4729A is intended to provide direct ramp connections from I-26 West Bound (WB) to US 74
East Bound (EB) and from US 74 WB to I-26 EB. The culvert in Horse Creek that currently connects
US-74 WB to I-26 EB was constructed in 1975. Proposed permanent impacts to jurisdictional areas
(Horse Creek) total 1,283 linear feet (1 fl of stream and temporary impacts to 55 lf of streams.
Please fnd enclosed copies of the Pre-Construction Notification (PCN), Stormwater Management Plan,
permit drawings, erosion control plan for temporary dewatering (full set available if needed), stream
relocation plan set, Division of Mitigation Services acceptance letter, and other supporting information to
assist in your evaluation. The Categorical Exclusion (CE) was completed on June 20, 2017 and
distributed shortly thereafter.
This project contract let date is currently scheduled for September 19, 2017.
In Polk County, there are four species that have federal status. White Irisette (Sisyrinchium dichotomum)
is listed as endangered. Northern Long-Eared Bat (Myotis septentrionalis), Dwarf-flowered Heartleaf
(Hexastylis naniflora), and Small Whorled Pogonia (Isotria medeoloides) are listed as threatened. Habitat
for these four species was found within the project study area. Surveys were conducted.
White Irisette, endemic to the upper Piedmont of North and South Carolina, is generally found on the
southeast to southwest aspect of gentle to very steep, mid-elevation mountain slopes in thin-canopied,
dry-mesic Basic Oak Hickory Forests that are mature, successional, or recently logged. Occurrences are
also found in open, disturbed sites such as clearings, woodland edges, roadside embankments, and power
line rights-of-way. Known populations occur at elevations between 1,312 and 3,280 feet above mean sea
level. The perennial herb prefers rich, basic soils, probably weathered from amphibolite, which are
intermittently saturated with rain but well drained. The species occurs in a variety of soils, including the
MailingAddress: Telephone: [phone] Location:
NC DEPARTMENT OF TRANSPORTATION Fax: [phone] NC DEPARTMENT OF TRANSPORTATION
Div[sioN 14 Customer Service: 1-877-368-4968 Divlsiorr 14
253 WEss�xRo.aD 253 WEssTExRonD
Sv[,vn NC 287'79 Website: www.ncdot.gov SY[,va NC 28779

I-4729A Page 2 July 22, 2017
Polk County
Ashe-Cleveland association; the Evard-Cowee complex; and Brevard, Cowee, Fannin, Greenlee, and
Hayesville series. It may grow on shallow soil sites where down slope runoff removed the usual deep
litter, humus, or mineral soil layers. Partial shade to direct sun is preferred, and some form of disturbance
(e.g., mowing, clearing, grazing, periodic fire) is necessary to maintain its relatively open habitat. A
review of the May 2017 NCNHP database indicated the nearest White Irisette record is approximately
one mile (0.97 mile) northwest of the I-4729A project study area, on Skyuka Mountain Road. Surveys by
Three Oaks biologists were conducted on May10, 2017. No White Irisette was found within the I-4729A
study area, but blue-eyed grass (Sisyrinchium atlanticum) was observed. Since the nearest White Irisette
population is approximately a mile from I-4729A, the biological conclusion for I-4729A is No Effect.
In North Carolina, the Northern Long-eared Bat (NLEB) occurs in the mountains, with scattered recards
in the Piedmont and Coastal Plain. In western North Carolina, NLEB spend winter hibernating in caves
and mines. During the summer, NLEB roost singly or in colonies underneath bark, in cavities, or in
crevices of both live and dead trees (typically >3 inches dbh). Males and non-reproductive females may
also roost in cooler places, like caves and mines. This bat has also been found, rarely, roosting in
structures like barns and sheds, under eaves of buildings, behind window shutters, in bridges, and in bat
houses. Foraging occurs on forested hillsides and ridges, and occasionally over forest clearings, over
water, and along tree-lined corridors. Mature forests may be an important habitat type for foraging. A
survey conducted on June 14, 2017 in the NC 108 Bridge over I-26 found no NLEB. Also, there currently
are no identified NLEB maternity roost sites or hibernacula known in Polk County. Therefore, the project
will have No Effect on this species.
Dwarf-flowered Heartleaf is endemic to the western Piedmont and foothills of North and South Carolina.
This herbaceous evergreen is found in moist to rather dry forests along bluffs; boggy areas next to streams
and creek heads; and adjacent hillsides, slopes, and ravines. Requiring acidic, sandy loam soils, the
species is found in soil series such as Pacolet, Madison, and Musella, among others. Occurrences are
generally found on a north facing slope. Undisturbed natural communities such as Piedmont/Coastal Plain
Heath Bluff, Dry-Mesic Oak Hickory Forest, and Mesic Mixed Hardwood Forest hold the most viable
occurrences. However, less viable remnant occurrences are found in disturbed habitats, including logged,
grazed, mown, and residentiaUcommercial developed lands; areas converted to pasture, orchards, and tree
plantations; roadside rights-of-way; and on upland slopes surrounding manmade ponds or lakes. A
review of the May 2017 NCNHP database on May 31, 2017, indicated there are no Dwarf-flowered
Heartleaf records within a mile of the project study area for either I- 4729A or B. Surveys by Three Oaks
biologists were conducted on Apri14, 2017 within the I-4729A study area and no plants were found.
Therefore, this project will have No Effect on dwarf-flowered heartleaf for I-4729A.
Small Whorled Pogonia occurs in young as well as maturing (second to third successional growth) mixed-
deciduous or mixed-deciduous/coniferous forests. It does not appear to exhibit strong affinities for a
particular aspect, soil type, or underlying geologic substrate. In North Carolina, the perennial archid is
typically found in open, dry deciduous woods and is often associated with white pine and rhododendron.
The species may also be found on dry, rocky, wooded slopes; moist slopes; ravines lacking stream
channels; or slope bases near braided channels of vernal streams. The orchid, often limited by shade,
requires small light gaps or canopy breaks, and typically grows under canopies that are relatively open or
near features like logging roads or streams that create long persisting breaks in the forest canopy.
USFWS lists Small Whorled Pogonia as "probable/potential" for occurring in Polk County. Suitable
habitat for Small Whorled Pogonia is present within the study area. A review of the May 2017 NCNHP
database indicated no known Small Whorled Pogonia occurrences within 1.0 mile of the project study
area. Surveys by Three Oaks biologists were conducted on May10, 2017; no plants were found within the
study area for I-4729A. Therefore, the I-4729A project will have No Effect on Small Whorled Pogonia.

I-4729A
Polk County
Page 3 July 22, 2017
The NCDOT Human Environment Unit reviewed the project and determined that there are no historic
architectural properties that would be affected and surveys for archaeological resources were not
necessary (reports attached).
Impacts to Waters of the United States
Horse Creek (DWQ Class: C) is shown on topographic maps as a perennial stream and has a defined
channel. Horse Creek flows from the project study area about 1.9 river miles (RM) into North Pacolet
River, which then flows 22 RM to the Pacolet River, which then flows 50 RM to the Broad River. The
project is located in the Upper Broad River basin (Hydrologic Unit 03050105). The North Pacolet River,
Pacolet River, and Broad River meet the definition of Traditional Navigable Waters. For these reasons,
we believe Horse Creek and its UTs are Relatively Permanent Waters and under the jurisdiction of the
U.S. Army Corps of Engineers. The project will result in impacts to waters of the United States as listed
in the table below:
Site No. Station Existing proposed Condition Net Impacts
Condition linear feet
1 Horse Creek Bank Stabilization 6
10+06 — RP E-RT
Horse Creek 2@10'x7' x 350' RCBC and 1,220*
2 Roadwa Fill (742 will be relocated
15+09 to 29-66-RP F- Horse Creek Bank Stabilization/Benches 57
Horse Creek Tem ora Dewaterin 55
*There will be a net loss of 478 lf of stream channel associated with the RCBC and channel relocation.
See below far discussion of channel design considerations and channel length loss.
Mitigation
Approval for compensatory mitigation was requested for all combined permanent stream impacts totaling
1,2201inear feet of mitigation credit. Division of Mitigation Services (DMS) committed to implementing
sufficient compensatory stream mitigation credits to offset the impacts associated with this project as
determined by the regulatory agencies in accordance with the In-Lieu Fee Instrument dated July 28, 2010.
An approval letter was received from DMS on July 11, 2017 for this project.
The stream channel realignment was designed using natural techniques and aligned to maintain or provide
at least a 30' wide vegetated buffer between the new fill slope and proposed top of bank. However, a
much wider vegetated buffer is proposed along most of the left descending bank. The stream channel
relocation and culvert combined will reduce the length of stream channel, but it should be noted that the
reduction is attributed to what appears to be an overly sinuous and unstable pattern in the upper portion of
the impact reach. While the NCSAM rating for the stream resulted in a"Medium" determination for the
stream, the channel is incised/entrenched (streamside area interaction was rated as extensively adversely
affected - NCSAM #6) and failing banks and fallen trees become even more prevalent with distance
upstream. Bank stability improves downstream within the impact reach where the existing channel also
becomes much less sinuous. For these reasons, the proposed channel design should constitute an
improvement of the existing channel morphometry.
Regulatory Approvals
Section 404: It is anticipated that all improvements to the I-26/US 74 interchange will be authorized
under Section 404 Regional General Pernut (RGP) No. 198200031 in accordance with Section 404 of the
Clean Water Act (33 U.S.C. 1344). Comments from the NC Wildlife Resources Commission are
requested for your consideration.

I-4729A
Polk County
Page 4 July 22, 2017
Section 401: It is anticipated that 401 General Certification number 4088 will apply to this project.
NCDOT is requesting written concurrence from the North Carolina Department of Environmental
Quality, Division of Water Resources.
Thank you for your assistance with this project. If you have any questions or need additional information,
please contact Dave McHenry at d�mchenry(a),ncdot. o�v or [phone].
Sincerely,
DocuSigned by:
L� /n� �� 7/22/2017
..,r.,�l l%4
86673FBE42E5415...
Dave McHenry
Division 14 Environmental Officer
Enclosures
cc: Ms. Amy Chapman, Division of Water Resources, DEQ, Raleigh
Ms. Kristie Lynn Carpenter, Division of Water Resources, DEQ, Raleigh
Mr. Kevin Barnett, Division of Water Resources, DEQ, Asheville
Ms. Marella Buncick, Biologist, US Fish & Wildlife Service, Asheville
Mrs. Marla Chambers, Western NCDOT Coordinator, NCWRC
Mr. Kenneth McDowell, PE, Division 14 DDC, NCDOT
Mr. Dave Wilver, PE, Senior Project Manager, Parsons Engineering
Mr. Reid Whitehead, Area Roadside Environmental Engineer, BCDOT

� � O��F WAT�'9QG Office Use Only:
�,�, � � � Corps action ID no.
o t DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. A licant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number: 31
1c. Has the NWP or GP number been verified by the Corps? � Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
� 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit:
because written approval is not required? Certification:
❑ Yes � No ❑ Yes � No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation � Yes ❑ No
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Improvements to the I-26/US 74 Interchange
2b. County: Polk
2c. Nearest municipality / town: Columbia
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state I-4729A
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if Dave McHenry, Division 14 Environmental Officer for Division 14 Engineer
applicable):
3d. Street address: 253 Webster Road
3e. City, state, zip: Sylva, NC 28779
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: N/A
5b. Business name N/A
(if applicable):
5c. Street address: N/A
5d. City, state, zip: N/A
5e. Telephone no.: N/A
5f. Fax no.: N/A
5g. Email address: N/A
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): Multiple, see attached plans
1b. Site coordinates (in decimal degrees): Latitude 35.24990 Longitude: -82.20820
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 270 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Horse Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Broad (HUC 03050105)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project study area is comprised of forested areas (pine-oak/heath, mesic mixed hardwood, montane oak-hickory, and
Piedmont alluvial forest) as well as maintained roadway, commercial, and residential areas. There are several additional
jurisdictional features associated with the subject project other than Horse Creek, mostly unnamed tributaries (UT) to
Horse Creek and several small wetlands.
3b. List the total estimated acreage of all existing wetlands on the property:
<0.011 acre
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
— 5,572 LF of stream within the project boundaries (less within Prelim. JD request area south of US 74)
3d. Explain the purpose of the proposed project:
To improve the configuration of the I-26/US 74 interchange area so that all traffic movements are directly accommodated
by "freeway-to-freeway" ramps, and that heavy through-truck traffic between I-26 and US 74 is not forced to mix with local
traffic on NC 108.
3e. Describe the overall project in detail, including the type of equipment to be used:
NCDOT proposes to construct improvements to the I-26/US 74 interchange in Columbus, NC in Polk County. The project will
provide direct ramp connections from I-26 westbound (WB) to US 74 eastbound (EB), and from US 74 WB to I-26 EB. The
proposed design will provide freeway-to-freeway ramp connections that will eliminate the need for interstate traffic to travel
through the two partial roundabouts on NC 108.
A new culvert, approximately 350 feet in length, will be constructed to convey Horse Creek underneath the new I-26 WB to US
74 EB ramp. In addition to the culvert, the new ramp will require that approximately 742 feet of Horse Creek, just east of NC
108, be relocated. This stream relocation will be done using natural channel design.
A new bridge will be constructed to allow for a new ramp between US 74 WB and I-26 EB. This new bridge will span existing I-
26 and the ramp will provide direct ramp-taramp connection between US 74 WB and I-26EB, as well as handle the traffic exiting
US 74 WB to access NC 108. The existing US 74 EB to I-26 EB/NC 108 ramp will be shifted approximately 165 feet to the west
to provide the necessary spacing for the new US 74 WB to I-26 EB ramp.
In the vicinity of the interchange, US 74 EB will continue to have two lanes on the I-26 East exit ramp to NC 108/US 74 East,
dropping to one lane prior to the I-26 West/NC 108 merge onto US 74 East. However, due to the length of the ramp and the
need to safely maintain a passing zone, pavement for two lanes will be retained and striped for two lanes, dropping to one lane
(dropping the right lane) prior to the merge point west of the three-lane bridge over Houston Road.
Erosion and sedimentation control measures will be installed. Surface water will be diverted around the construction area.
Equipment to be used includes a track hoe, dump truck, paving equipment, pumps, and various hand tools, possibly a crane to
move construction material such as reinforced bars of steel, and concrete buckets to place concrete. See stream relocation
plan for more details.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / � Yes ❑ No ❑ Unknown
project (including all prior phases) in the past.
Comments: N/A
4b. If the Corps made the jurisdictional determination, what type
of determination was made? � Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Three Oaks Engineering
Name (if known): Chris Sheats Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
March 20, 2017
5. Project History
5a. Have permits or certifications been requested or obtained for � Yes � No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
N/A
6. Future Project Plans
6a. Is this a phased project? � Yes ❑ No
6b. If yes, explain.
There are plans to widen NC 108 (West Mills Street) from the St. Luke's Hospital entrance to Walker Street (STIP No. I-
4729B). The interchange (STIP No. I-4729A) is being accelerated to accomodate an expected influx in traffic to the
region for the Federation Equestre Internationale (FEI) World Equestrian Games, which will be held at the nearby Tryon
International Equestrian Center in September, 2018.
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands � Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary (T)
W 1❑ P❑ T ❑ Yes ❑ Corps �
❑ No ❑ DWQ
2g. Total wetland impacts 0
2h. Comments: N/A
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 � P❑ T Bank Stabilization Horse Creek � PER � Corps g_12 6
❑ INT � DWQ
S2 � P❑ T 2@10'x7' RCBC/ Horse Creek � PER � Corps g_12 1220*
Roadway FIII ❑ INT � DWQ
S2 � P❑ T Bank Horse Creek � PER � Corps g_12 57
Stabilization/Benches ❑ INT � DWQ
S2 ❑ P� T Temp. Dewatering Horse Creek � PER � Corps g_12 55
Structures ❑ INT � DWQ
3h. Total Permanent Stream and Tributary Impacts 1283
3i. Comments: *Of the 1,283 If of permanent stream impacts, 742 If will involve relocating the channel of Horse Creek using
natural stream design. The culvert and reduced channel length from the relocation will result in a loss of 478 If of stream.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody type Area of impact (acres)
- Permanent
(P) or
Tem ora T
01 ❑P❑T
4f. Total open water impacts
4g. Comments: No open water impacts
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments: There are no ponds created for this project
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar-Pamlico � Other: Jordan Lake
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number — Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) for impact Stream name mitigation (square feet) (square feet)
or Temporary required?
T
B1 ❑P❑T ❑Yes
❑ No
B2 ❑P❑T ❑Yes
❑ No
6h. Total buffer impacts
6i. Comments: N/A
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The alignment of Ramp E(I-26 WB to US 74 EB) was revised from its original concept in order to minimize impacts to Horse
Creek and to avoid the relocation of two businesses near where the ramp tied back in with US 74 EB.
Stream impacts associated with the relocation of Horse Creek will be minimized through the use of natural channel design
standards for the relocated portion of the stream. The new culvert will be countersunk and base-flow maintained in one cell to
promote fish passage and channel stability.
1.5:1 fill slopes are utilized along sections of the Ramp E alignment, to limit the length of channel realignment and reduce
impacts to Horse Creek. Further, 2:1 fill slopes are used in the remaining high fill areas to reduce or eliminate impacts to
adjacent parcels and surface waters. The 2@10'x7' RCBC has been designed with a low flow barrel, to maintain the natural
channel width and flow depth through the culvert. Natural channel design has been utilized for the channel realignment
downstream of the culvert. The proposed channel realignment will maintain the existing channels width and flow depth while
incorporating features to promote habitat for fish and wildlife and channel stability. A rip rap energy dissipator basin will be
used at the storm drain system outlet (14+00 -RP_E- Rt), in the Horse Creek floodplain, to reduce peak flow velocities to
Horse Creek and promote diffuse flow.
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction will take place within the existing right-of-way. Erosion and sedimentation BMPs will be installed prior to
construction. Water will be diverted around the work area to prevent sedimentation of downstream aquatic resources.
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of surface waters,
restrictions against the staging of equipment in or adjacent to waters of the US and coordination (including a pre-construction
meeting) with the Division Environmental Supervisor. See attached a relocation plan, which includes plans for how all
temporary fills and structures will be removed and how the area will be restored to pre-project conditions. Also see attached a
sediment and erosion control plan.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for � Yes ❑ No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ❑ DWQ � Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this project? � Payment to in-lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. � Yes
4b. Stream mitigation requested: 1,220 LF
4c. If using stream mitigation, stream temperature: ❑ warm � cool ❑cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
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PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ❑ Yes � No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3(2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified � Yes � No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: The proposed structure will be a double 11' by 7' reinforced concrete ❑ Yes ❑ No
box culvert. There is a slight increase in impervious surface but treatment is not
required.
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? N/A %
2b. Does this project require a Stormwater Management Plan? � Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Plan is attached.
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Columbia, NC
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a. Which of the following state-implemented stormwater management programs apply � ORW
(check all that apply): ❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? � Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met? � Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the � Yes ❑ No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 26 .0200)?
2b. Is this an after-the-fact permit application? ❑ Yes � No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in � Yes � No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The project will not alter traffic capacity or travel patterns, reduce travel time, affect access to properties in the area, or
open areas for development or redevelopment. Due to its minimal transportation impact-causing activities, this project
will neither influence nearby land uses nor stimulate growth. Therefore, a detailed indirect and cumulative effects study
will not be necessary.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
It is not anticipated that this project will generate any wastewater as it is a roadway project.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or � Yes � No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act � Yes ❑ No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
� Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The North Carolina Natural Heritage Database was checked for records of threatened and endangered species. The
database lists four species for Polk County that have federal status. White Irisette (Sisyrinchium dichotomum) is listed as
endangered. Northern Long-Eared Bat (Myotis septentrionalis), DwarF-flowered Heartleaf (Hexastylis naniflora), and
Small whorled pogonia (Isotria medeoloides) are listed as threatened. Habitat for these four species was found within the
project study area. Survyes were conducted during appropriate survey windows for each of the four species. No
individuals were found in the vicinity of the project area. The project with have No Effect on any of the four species.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes � No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
This project takes place in Polk County, which is not near any coastal or tidal habitat that would support EFH (i.e. salt
marshes, oyster reefs, etc.).
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 � Yes � No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
This project was submitted to the North Carolina Department of Transportation's Human Environment Unit for review. It
was determined that no survey was required for archaeological resources in a letter dated March 24, 2017. A review of
historical architecture on March 17, 2017 found one property within the study area that required an assessment of effects.
The J.G. Hughes House (PL0009) is the only site of significance near the project and it was determined that the project
would not affect this site. No other historical properties will be affected by this project.
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: An MOA will be obtained.
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
DocuSigned by:
Mr. Dave McHenry 7/�2/2017
A IicanUA ent's Printed Name ���
PP g 86673FBE42E5415...
Applicant/AgenYs Signature Date
(AgenYs signature is valid only if an authorization letter from the
a licant is rovided.
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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I-26/US 74/NC 108
Interchange Improvements
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Date�
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Scale� 0 250 500 Feet
l i I
Job No.�
16-020
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Name: MILL SPRING Location: 035°14' 33.35" N 082°12' 32.67" W NAD 27
Date: 7/11 /2017 Gaption: I-4729A
Scale: 1 inch equals 2000 feet I-26-US 74 Interchange
Polk County
Copyright (C) 1997, Maptech, Inc.

Project Tracking No. (Inteinal Use�
17-03-0009
HISTORIC ARCHITECTURE AND LANDSCAPES
NO HISTORIC PROPERTIES PRESENT OR AFFECTED FORM
This form only pertains to Historic Architecture and Landscapes for this project. It
is not valid for Archaeological Resources. You must consult separately with the
Archaeology Group.
PROJECT INFORMATION
Project No: I-4729 County: Polk
WBS No.: 34243.1.3 Document PCE
T e:
Fed. Aid No: IMS-26-1(66)36 Funding: ❑ State � Federal
Federal � Yes ❑ No Permit
Permit s : Type(s):
Prolect Description:
Improvements to the I-26/US 74 Interchange in the Town of Columbus.
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
� There are no National Register-listed or Study Listed properties within the project's area of
potential effects.
� There are no properties less than fifty years old which are considered to meet Criteria
Consideration G within the project's area of potential effects.
❑ There are no properties within the project's area of potential effects.
� There are properties over fifty years old within the area of potential effects, but they do not
meet the criteria for listing on the National Register.
� There are no historic properties present or affected by this project. (Attach any notes or
documents as needed.)
Date of field visit:
Descrintion of review activities, results, �nd conclusions:
Review of HPO quad maps, HPO GIS information, historic designations roster, and indexes was
undertaken on March 17, 2017. Based on this review, there is one National Register listed
property within the Area of Potential Effects, which is defined as the study area on the following
map. The J.G. Hughes House (PL0009) required an assessment of effects. Preliminary plans
were reviewed on May 10, 2017, it and was determined that the property was well outside of the
proposed work and would not be affected by this project. The interchange work ends before the
I-74 Bridge over Houston Road, approximately 1,200 feet from the house, while the actual ramp
will be located even farther from the property (approximately half a mile). All other properties
over fifty years of age are unremarkable and not eligible for NR listing based on Google street
view imagery. There are no properties potentially eligible for National Register listing, and the
National Register listed J.G. Hughes House will not be affected by this project. If design plans
change, additional review will be required.
Hisloric Architecture and Landscapes NO HISTORIC PROPERT/F,S PRESENT OR AFFECTED form for Mirror Transportation Projects as Qualifred rn the 2007
Programma(ic Agreemenl.
Page 1 af 7

Map(s)
Historic
SUPPORT DOCUMENTATION
❑Previous Survey Info. ❑Photos ❑Correspondence ❑Design Plans
FINDING BY N
and Landscapes —
NCDOT Architectural Historian
ARCHITECTURAL HISTORIAN
PROPERTIES PRESENT OF AFFECTED
�
Date
Historic Archilecture ai�d Landscapes NO HIS'!'ORIC PROPFX7IF,S NRLSCNT OR AFFEC7F.D fa•m for Minor �ranspa�lation Projects as Qualifred in Ihe 2007
Progrannna�ic Agreemen(.
Page 2 of 7

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AEh'IAL MAP County POLK
NORTHCAROLiNADEPARTMENT INTERCHANGEIMPROVEMENTS FI UC@
. OF TRANSPORTATION I-261US 741NC 1081NTERCHANGE oN: �4 STIP� ±4729 g
DIVISION OF HIGHWAYS I�
.� PROJECTDEVELQPMENTAND TOWN O�COLUMBUS WBS: 34243.1.3 3
'A ENVIRONMENTALANALYSISUNIT POLKCOUtriTY
STIP PROJECT I-0729 Date: MARCH 2O17 I
Hism�•ic Archr(ec�iu�e rn�d Laru(scupes NO H/STORIC' PROPF.R77/:S PIUiSIsNT OR A!•7�%C7'GD joi�m Jor rLfinor 77misporrnriwi l'rojecrs n.s Qualified ii� d�e 2007
I'rogrnmmuric Agrecn�enf.
Page 3 of 7

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Buig M�afts Bircl'e [�:ys: view of th� interchange.
Historic Archilechu�e nnd LancLscnpes NO HlSl'OIUC PROPERTIGS PRE,SL'NT OR Al�7�7iC%7iD J'o�•m fo�� A/inor T�•nnspa•�a�ion Projec�s ns OrtnliJied in die 1007
Progrnnuualic Agveeuieitl.
Page 7 of 7

Project Tracking No.:
17-03-0009
•oQ�`�-�. NO ARCHAEOLOGICAL SURVEY REQUIRED FORM �
�,<'.�; � ,.: �; �.�
This form only pertains to ARCHAEOLOGICAL RESOURCES for this project. It is not ��',, ' o
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�s o�i �� valid for Historic Architecture and Landscapes. You must consult separately with the �`8
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'�,`.�:!� r°� Historic A rc hitecture an d Lan dscapes Group. �� i ( Q�
PROJECT INFORMATION
Project No: I-4729 County: Polk
WBS No: 34343.1.3 Document: PCE
F.A. No: NA Funding: � State ❑ Federal
Federal Permit Required? � Yes ❑ No Permit Type: NWP# 3 or 14
Project Description:
The project calls for construction improvements to the I-26/US 74 interchange (TIP I-4729) in Polk
County. The archaeological Area of Potential Effects (APE) for the project is defined as approximate
1.15 mile (1.85 km) long corridor along I-26 and an approximate 0. 78 mile (1.25 km) long corridor along
US 74. The APE includes existing ramps and newly proposed ramps. The APE extends approximately
100 feet (30.48 m) from the edge of pavement on either side and covers all areas between existing and
proposed roads/ramps. APE extends slightly further to the west for 250 feet (76.20 m) in one section in
order to encompass proposed ramp realignment. In all, the APE comprised 136 acres.
SUMMARY OF CULTURAL RESOURCES REVIEW
Brief description of review activities, results of review, and conclusions:
The proposed improvements to the I-26/US 74 interchange (TIP I-4729) are located on the west side of
Columbus in southwestern Polk County, North Carolina. The project area is plotted on the northern edge
of the Landrum USGS 7.5' topographic quadrangle (Figure 1).
A map review and site file search was conducted at the Office of State Archaeology (OSA) on March 23,
2017. No previously recorded archaeological sites have been identified within the APE or in the
surrounding vicinity. According to the North Carolina State Historic Preservation Office online data base
(HPOWEB 2017), there are no known historic architectural resources within the APE that may yield
intact archaeological deposits. Topographic maps, USDA soil survey maps, aerial photographs (NC One
Map), historic maps (North Carolina maps website), and Google Street View application were examined
for information on environmental and cultural variables that may have contributed to prehistoric or
historic settlement within the project limits and to assess the level of ground disturbance.
The APE is situated mostly within the Horse Creek drainageway and floodplain with portions of the
roadways extending onto side slopes (Figure 2). Horse Creek and at least one of its tributaries are crossed
by US 74 and I-26. The stream channels were modified during pervious construction of the roads and the
interchange. Horse Creek flows south and is part of the Broad drainage basin. The area is a mix of
commercial and residential properties to the east and southwest and forested properties to the north,
northwest, and southeast. Commercial properties and urban development are heaviest along NC 108 in
the southern portion of the APE. Overall, disturbance is severe and includes large areas of cut and fill
associated with past road construction. Soil erosion is also reported along the side slopes.
The APE according to the USDA soil survey for Polk County consists almost entirely of Udorthents loam
(Ud) (see Figure 2). This series is where the natural soils have been altered by earth moving activities or
"No ARCHAEOLOGYSURVEYREQUIRED "form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
1 of 6

Project Tracking No.:
17-03-0009
covered by fill. It is highly disturbed and unlikely to yield significant and intact archaeological resources
within the construction limits. Chewacla loam (ChA) makes up the floodplain and once covered a much
wider area prior to the roads. It is somewhat poorly drained, nearly level, and subject to occasional
flooding. Due to persistent wetness, this series is not suited for early settlement activities. Other soils
found to a lesser degree along the periphery of the APE include the Fannin-Cowee complex (FaE) and
Madison sandy clay loam (MaC2; MaD2). These series are on side slopes and are considered well
drained. Slope is generally over 15 percent except for the MaC2 variant, which is at 8 to 15 percent. Soil
erosion is also moderate to severe on the Madison series especially if the surface is exposed. Generally,
this series is unlikely to contain intact deposits due to erosion. Also, slope of 15 percent or more is not
usually tested as it is doubtful to yield significant archaeological sites.
The records at OSA show that no surveys have been conducted in the general vicinity of the current
project. OSA has also carried out very few reviews. As a result, no known sites are in the area. Further
data is needed in the region, but the current project will not provide any useful information towards the
prehistoric or early historic periods due to prior ground disturbance.
The earliest map in which an approximate location for the project area can be found is on the 1889 USGS
Saluda topographic map (Figure 3). The map illustrates an early alignment for a road similar to NC 108,
but the road on this map falls well south of the project area. The later 1907 USGS Saluda map clearly
depicts no roads or features within the current project area (Figure 4). The 1923 soil survey map,
however, shows a more modern alignment for NC 108 through the southern portion of the APE, but
US 74 is still not established. (Figure 5). It is not until the late 1960s that highway maps begin to display
US 74 and I-26. Due to a lack of historic features, it seems very unlikely that any significant deposits
associated with historic structure will be encountered.
Brief Explanation of why the available information provides a reliable basis for reasonably predicting
that there are no unidentified historic properties in the APE:
The defined archaeological APE for the proposed improvements to the I-26/L7S 74 interchange (TIP
I-4729) in Polk County is unlikely to impact intact and significant archaeological deposits. This is
primarily due previous ground disturbance from the construction of I-26 and US 74 and urban
development. In those areas along the margins of the APE, steep side slopes and/or soil erosion make it
unlikely for significant deposits to be encountered. In addition, the map review identified no historic
structures within the APE. As long as impacts to the subsurface occur within the defined APE, no further
archaeological work is recommended for the proposed improvements to the interchange. If design plans
change and work should affect subsurface areas beyond the defined APE, further archaeological
consultation might be necessary.
SUPPORT DOCUMENTATION
See attached: � Map(s) ❑ Previous Survey Info
❑ Photocopy of County Survey Notes
FINDING B NCDOT ARCHAEOLOGIST
NO ARCHAEOLOGYSURVEYREQUIRED
"_ /
C. Damon Jones
�.cyz��r.�zyar:�x��.��ze���r��
❑ Photos ❑Correspondence
Other: images of historic maps
3/24/17
Date
"No ARCHAEOLOGYSURVEYREQUIRED "form for Minor Transportation Projects as Qualified in the 2007 Programmatic Agreement.
2 of 6

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En vironmental
Quality
ROY COtaPER
`�,__,.��.,.
Mr. Dave McHenry
NCDOT Division 14 Environmental Specialist
North Carolina Department of Transportation
253 Webster Road
Sylva, North Carolina 28779
Dear Mr. McHenry:
July 11, 2017
Subject: Mitigation Acceptance Letter:
Division 14 Project, TIP I-4729A, I-26 / US 74 Interchange Improvement, Polk County; WBS Element
34243.1.4
The purpose of this letter is to notify you that the Division of Mitigation Services (DMS) will provide the
compensatory stream mitigation for the subject project. Based on the information received on July 11, 2017, the impacts
are located in CU 03050105 of the Broad River basin in the Southem Piedmont (3P) Eco-Region, and are as follows:
Broad
03050105
SP
Impacts (feedacres)
Stream
Cold Cool Warm Riparian
0 1,220.0 0 ` 0
Wetlands
Non- Coastal
Rinarian Marsh
n
Buffer (Sq. Ft.)
Zone 1 u Zone 2
0
DMS commits to implementing sufficient compensatory stream mitigation credits to offset the impacts associated
with this project as detemuned by the regulatory agencies in accordance with the In-Lieu Fee Instrument dated July 28,
2010. If the above referenced impact amounts are revised, then this mitigation acceptance letter will no longer be valid and
a new mitigation acceptance letter will be required from DMS.
If you have any questions or need additional information, please contact Ms. Beth Harmon at 919-707-8420.
Sincerely,
Jam��. I�. Stanfill
Credit Management Supervisor
cc: Ms. Lori Beckwith, USACE — Asheville Regulatory Field Office
Mr. Kenneth McDowell, P.E., Division 14
Ms. Linda Fitzpatrick, NCDOT — PDEA
Mr. David Wilver, P.E., Farsons Engineering
Mr. Craig Young, P.E., Three Oaks Engineering
File: I-4729A — I-26 / US 74 Interchange Improvements — Division 14
s�'�'`Nothing Compares�-._
5tate of Narth Carolina I Environmentai Quality
217 West Jones Street I 1601 Mai[ Service Center I Raleigh. North Carolina 27699 1b01
919 707 8600

NC SAM FIELD ASSESSMENT RESULTS
Accompanies User Manual Version 2.1
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): I-4729
3. Applicant/owner name: NCDOT
5. County: Polk
7. River basin: Broad
2. Date of evaluation: 3-10-17
4. Assessor name/orqanization: Beckwith
Nearest named water body
on USGS 7.5-minute quad: Horse Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach):
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): 10. Length of assessment reach evaluated (feet): 60
11. Channel depth from bed (in rifFle, if present) to top of bank (feet): 5 ❑Unable to assess channel depth.
12. Channel width at top of bank (feet): 17 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 (I) ❑ Outer Coastal Plain (0)
16. Estimated geomorphic �A ���
valley shape (skip for
Tidal Marsh Stream): (more sinuous stream, flatter valley slope)
❑B
(less sinuous stream, steeper valley slope)
17. Watershed size: (skip ❑Size 1(< 0.1 mi2) ❑Size 2(0.1 to < 0.5 mi2) ❑Size 3(0.5 to < 5 mi2) �Size 4(>_ 5 mi2)
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 (❑I ❑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/supplementarv measurements included in "Notes/Sketch" section or attached? �JYes I-lNo
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 A
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 A
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 A
5. Signs of Active Instability — assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down-cutting (head-cut), active widening, and artificial hardening (such as concrete, gabion, rip-rap).
�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 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) F� ❑G Submerged aquatic vegetation
❑B Multiple sticks and/or leaf packs and/or emergent o�' ❑H Low-tide refugia (pools)
vegetation Y L ❑I Sand bottom
❑C Multiple snags and logs (including lap trees) L� ❑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)
11c. 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)
❑ ❑ ❑ � ❑ SilUclay (< 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
❑ ❑Salamanders/tadpoles
❑ �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?
�N �N
16. Baseflow Contributors — assessment reach metric (skip for Size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
❑A Streams and/or springs Qurisdictional 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
❑F 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 NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name I-4729 Date of Assessment 3-10-17
Stream Category Pa4 Assessor Name/Organization Beckwith
Notes of Field Assessment Form (Y/N) NO
Presence of regulatory considerations (Y/N) NO
Additional stream information/supplementary measurements included (Y/N) YES
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream) Perennial
Function Class Rating Summary
(1) Hydrology
(2) Baseflow
(2) Flood Flow
(3) Streamside Area Attenuation
(4) Floodplain Access
(4) Wooded Riparian Buffer
(4) Microtopography
(3) Stream Stability
(4) Channel Stability
(4) Sediment Transport
(4) Stream Geomorphology
(2) Stream/Intertidal Zone Interaction
(2) Longitudinal Tidal Flow
(2) Tidal Marsh Stream Stability
(3) Tidal Marsh Channel Stability
Tidal Marsh Stream Geomorpho
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
(1) Habitat
(2) In-stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In-stream Habitat
(2) Stream-side Habitat
(3) Stream-side Habitat
(3) Thermoregulation
(2) Tidal Marsh In-stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In-stream Habitat
(2) Intertidal Zone
Overall
U SAC E/
All Streams
MEDIUM
HIGH
MEDIUM
LOW
LOW
MEDIUM
LOW
HIGH
HIGH
LOW
HIGH
NA
NA
NA
NA
NA
HIGH
HIGH
HIGH
HIGH
HIGH
NO
HIGH
NA
LOW
LOW
HIGH
LOW
HIGH
LOW
HIGH
MEDIUM
HIGH
NA
NA
NA
NA
NA
NA
NA
MEDIUM
NCDWR
Intermittent