20200099 Ver 1_PCN Form Submission (4)_20200121

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
6 Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200099
Is a payment required for this project?*
r No payment required
6 Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a. Name of project:
Replacement of failed pipe on HWY 21, nr Thurmond, Wilkes County, NC
1a. Who is the Primary Contact?*
Kevin Hiring
1b. Primary Contact Email:*
[e-mail]
Date Submitted
1/21/2020
Nearest Body of Water
LFF to Elkin Creek
Basin
Yadkin-PeeDee
Water Classification
WS-II, HOW
Site Coordinates
Latitude: Longitude:
36.356165-80.907476
A. Processing Information
County (or Counties) where the project is located:
Wilkes
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
IT Yes r No
(NCDOT only) T.I.P. or state project number:
WBS # (1)
11511.1097800
1a. Type (a) of approval sought from the Corps:
Version#*
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone:*
[phone]
U

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
V Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
801 Statesville HWY
Address Line 2
city
North Wilkesboro
Fbstal / Zip Code
28659
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rovince / Region
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Thurmond
2. Project ctct Identification
2a. Property Identification Number: 2b. Property size:
2c. Project Address
Street Address
Address Line 2
(Sty State / Province / Pegion
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Elkin Creek
3b. Water Resources Classification of nearest receiving water:*
WS-II, HQW
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401010604
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
NCDOT is replacing a failed pipe. The pipe has broke and collapsed at several locations due to high water related to hurricane events.
The project is being paid for by Federal hurricane reclamation funds. General land use is a mix of residential, wooded, and field/farmland.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
HWY 21 pipe replacement map.pdf 199.28KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
4f. List the total estimated acreage of all existing wetlands on the property:
< 1/4 acre
4g. List the total estimated linear feet of all existing streams on the property:
250
4h. Explain the purpose of the proposed project:*
NCDOT is replacing a 174' long 66" CMP pipe that is currently cracked and collapsed. Due to heavy traffic and the depth of fill over the pipe, NCDOT is planning to bore and jack the
new pipe in place, since closing the road is not a viable option. The new pipe will be slightly longer (185' in length) and larger diameter (72") to better handle high flows, which is in part
why the old pipe failed. The new pipe will also be of steel, welded construction, making it stronger.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
See attached detail and description of project
4j. Please upload project drawings for the proposed project.
HWY 21 maintenance pipe replacement.pdf 131.72KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No 6 Unknown
Comments:

5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Kevin Hining and Heath Slaughter
Agency/Consultant Company: NCDOT
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r 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?
none
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries r Buffers
r- Open Waters r Pond Construction
3. Stream Impacts
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* �name* 3e. Stream Type * 3f. Type of 3g. S. width * �3h. Impact
(?) Jurisdiction* length*
i1
e replacement Permanent Fill UT of Elkin Creek Perennial Both 3 91 pipe P Average (feet) (lir�rfeet)
3i. Total jurisdictional ditch impact in square feet
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
91 0
3i. Total stream and ditch impacts:
91
3j. Comments:
The 91' of permanent impacts consists of 80' of existing channel that will be filled and replaced and 11' of additional pipe Iength.Temporary impacts
from dewatering will occur within the area upstream of the existing pipe that will be permanently impacted, so they were not broken out seperately.
E. Impact Justification and Mitigation U
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The existing pipe is perched and the existing stream below the pipe outlet is entrenched with vertical eroding banks and overwide. The proposed
design will correct these issues and leave the stream in much better shape. The proposed permanent impacts are a result of the new alignment of the
proposed pipe. The pipe has to be laid on a different alignment since the old pipe will be left in place until the new one is installed. The additional
length of pipe is to account for the new skew of the new pipe, which was necessary so that the bore pit can be constructed completely outside of the
existing stream channel. This will reduce potential sediment impacts during construction.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The bore and jack operation will allow us to put in a new pipe with minimal excavation of the existing fill.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:

The project has been designed and Will be constructed in a manner that avoids and minimizes adverse effects to the stream. Furthermore, the proposed impacts are necessary to
improve the eAsting stream condition at the inlet and outlet of the pipe, and improve aquatic passage. The portions of the stream impacted are the minimum necessary to reconnect the
epsting stream to the new pipe alignment.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r 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)? *
r Yes r No
Comments:
no document required
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)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
We are replacing a failed roadway pipe, and no other development will occur at the project site.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r NIA
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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No C' Unknown
What Federal Agency is involved?
FHWA
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No

5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Natural Heritage program and visual observation. All trees that are to be removed will be removed during the late winter, which is a time of year that
NLEB will not be utiliang the trees for habitat.
Consultation Documentation Upload
project _report _hwy_21 pipe_replacement_22599_22599.pdf 766.79KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA
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?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC State Historic Preservation Office GIS data layer.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
Flood Risk Information System - https://fris.nc.gov/fris/Home.aspx?ST=NC
Miscellaneous v
Comments
I have attached several pictures of the site, showing the existing condition of the pipe.
I've also attached an overview plan sheet that shows the entire project area and access roads to get to the pipe, and the location of the two other jurisdictional features at the project
site - small wetland near pipe inlet and spring head near pipe outlet. These areas will be surrounded with orange fencing to showthat they are environmentally sensitive areas. No
impacts will occur to these two jurisdictional features.
Miscellaneous attachments not previously requested.
HWY 21 pipe replacement photos.pdf
US21 pipe replacement overview plan sheet.pdf
1.33MB
1.9MB
Signature U
W By checking the box and signing below, I certify that:
• 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:
Kevin Hining
Signature
Date
1/21/2020