20200260 Ver 1_BR-0124 CE_20200218

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Type I and II Ground Disturbing Categorical Exclusion Action
Classification Form
Project No.
WBS Element
BR-0124
48833.1.1
Federal Project No. N/A
A. Project Description:
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge No.
960166 on SR 1745 (Shumate Mountain Road) over the West Prong of Roaring River in
Wilkes County (Refer to Figure 1).
Built in 1977, Bridge No. 960166 has two 8 to 9-foot travel lanes, is approximately 136 feet in
length, with a steel deck on I-beam construction. Bridge No. 960166 has a posted single
vehicle weight limit of 26 tons and a truck tractor semitrailer weight limit of 31 tons. The
existing right of way along SR 1745 (Shumate Mountain Road) is 60 feet. The project is
scheduled for Right of Way (ROW) in August 2019 and Let in May 2020. Minor ROW
acquisition is anticipated.
The project proposes replacing the existing bridge with an approximately 30-foot wide structure
out to out with two 10-foot travel lanes and three-foot, eleven inch shoulders. The proposed
three -span bridge would be approximately 143 feet in length with a proposed right of way width
of up to 80 feet. Improvements to SR 1746 (Middle Fork Road) include raising the profile to tie
into SR 1745 (Shumate Mountain Road). In addition, there will be approximately 172 feet of
improvements along SR 1746 (Middle Fork Road), to allow for guardrail placement at the
intersection. The total length of the project is approximately 635 feet.
The proposed bridge would not be posted with weight restrictions and will be designed to meet
the legal load rating. The bridge replacement would be constructed in place using an off -site
detour. SR 1745 (Shumate Mountain Road) is classified as a Local Route with a 55-mile per
hour posted speed limit and 45-mile per hour design speed. The speed limit will be lowered to
45-miles per hour upon completion of the new bridge.
B. Description of Need and Purpose:
The replacement of Bridge No. 960166 is part of the Growing Rural Economy and Agriculture
through Transportation and Technology Enhancement or Replacement in North Carolina
(GREATTER-NC) Project under the United States Department of Transportation's 2018 Better
Utilizing Investments to Leverage Development (BUILD) Grant program. The purpose of the
grant and this bridge replacement project is to provide transportation infrastructure to support
economic development and improve physical and digital connectivity in rural communities in
North Carolina. The posted weight restriction on Bridge No. 960166 prohibits large or heavy
vehicles, typically used in transporting agricultural and manufactured products, from using the
bridge. Vehicles above the posted weight must detour 3.9 miles to avoid the bridge.
Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Replacing the existing bridge will eliminate posted weight limits by providing a safe crossing for
all legal loads and will make accommodations for broadband installation in order to support
economic competitiveness.
NCDOT Structures Management Unit records indicate Bridge No. 960166 has a sufficiency
rating of 67.52 out of a possible 100 and has a posted weight limit. The proposed project will be
designed to meet the legal load rating.
C. Categorical Exclusion Action Classification:
❑X TYPE I A
D. Proposed Improvements:
28. Bridge rehabilitation, reconstruction, or replacement or the construction of grade
separation to replace existing at -grade railroad crossings, if the actions meet the
constraints in 23 CFR 771.117(e)(1-6).
E. Special Project Information:
Anticipated Permit or Consultation Requirements: A Nationwide Permit (NWP)
No. 3- Maintenance, NWP No.14- Linear Transportation Projects, and/or NWP No. 23-
Approved Categorical Exclusion will likely be applicable. The US Army Corps of Engineers
(USACE) holds the final discretion as to what permit will be required to authorize project
construction. A Section 404 permit is required and a Section 401 Water Quality Certification
(WQC) from the North Carolina Division of Water Resources (NCDWR) is needed.
Floodplain: West Prong of Roaring River, which crosses under Bridge No. 960166, is in a
FEMA Zone AE Floodplain. The Hydraulics Unit will coordinate with the NC Floodplain Mapping
Program (FMP) regarding applicability of NCDOT'S Memorandum of Agreement, or approval of
a Conditional Letter of Map Revision (CLOMR) and subsequent final Letter of Map Revision
(LOMR). See Section H for project commitments.
Historic and Archaeological Resources: In compliance with NCDOT's Programmatic
Agreement with the State Historic Preservation office, NCDOT Human Environment Section
completed a No Survey Required form for Historic Architecture and Landscapes on 10/18/2018
and for Archaeological Resources on 7/24/2019.
Agricultural Land Use: Agricultural land use, primarily livestock, was identified surrounding
the project area using aerial imagery and confirmed during the April 2019 site visit. Farming
operations in the vicinity of the bridge may be temporarily affected during construction by
losing direct access and by using the approximately 6.7 mile off -site detour. Minor right of way
acquisition will also be required for the project. Coordination with the agricultural landowners
temporarily impacted by the off -site detour and by right of way acquisition should occur
throughout the project. See Section I, Project Commitments.
Environmental Commitments: Project commitments are located at the end of the checklist in
Section I.
2 Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Estimated Costs (FY 2020): The estimated costs are as follows:
Utility** $79,800
R/W* $4,913
Contt.** $1,995,000
Total $2,079,713
Sources: *NCDOT Right of Way Appraisal Unit, July 2019
** Connect GREATTER Rural Bridge Program- Bridges Budget Sources and Uses, Accessed June 11, 2019.
https://con nect. ncdot.gov/resources/G REATTER-Ru ral-Bridge-Program/Documents/05%20 N C DOT%2OB ridges%20 Budget%2OSources%20and%2OUses. xlsx
Estimated Traffic:
Average Daily Traffic (ADT) 2016* 470 vehicles per day (vpd)
Average Daily Traffic (ADT) 2040 940 vpd
Source: * NCDOT Traffic Review Sheet, 2018
Crashes: NCDOT's Safety Planning Group completed a planning level query of bridge crash
counts from 1/1/2013 to 12/31/2017. Over the five-year study period, zero crashes were
reported within a 500 feet distance of Bridge No. 960166 on SR 1745 (Shumate Mountain
Road).
Pedestrian and Bicycle Accommodations: There are no existing bike or pedestrian facilities
on Bridge No. 960166 along SR 1745 (Shumate Mountain Road). However, SR 1745 is
identified as part of the Cabin Creek Bicycle Loop, a feature in Wilkes County bicycle network.
The proposed three-foot, six-inch high railing is considered bike safe. A Start of Study letter was
sent to NCDOT Bicycle & Pedestrian Division; no comments were received.
Design Exceptions: A design exception is not required for this project.
Alternative Analysis:
No Build — The no build alternative would not meet the requirements of the GREATTER-NC
Project, and thus is not a viable option.
Rehabilitation — Rehabilitation would not meet the requirements of the GREATTER-NC
Project, and thus is not a viable option.
Onsite Detour — An offsite detour was determined acceptable.
New Alignment — A new alignment option for SR 1745 (Shumate Mountain Road), is not
preferred as the existing alignment has been deemed acceptable.
Replace Bridge in Place with Offsite Detour (Preferred Alternative) — The detour route
is approximately 3.9 miles long and follows SR 1745 (Shumate Mountain Road), SR 1730
(Dehart Community Center Road), and SR 1002 (Traphill Road) and will be required for the
duration of construction.
Agency Comments: Input forms were sent to the Wilkes County EMS Director, Wilkes County
Planning Director, and the Wilkes County Schools Director of Transportation in February and
April of 2019.
3 Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
The Schools Transportation Director indicated that three school busses make six daily trips
across the bridge (approximately 7:00 AM and 3:00 PM) and there would be a high impact to the
Wilkes School System if the bridge was closed for up to a year, as the project study area is used
as a bus turnaround for stops on Adams Road and SR 1746 (Middle Fork Road). A low level of
impact was noted from the Wilkes County Planning Director if the bridge was closed for up to a
year. No response was received from Wilkes County EMS.
Response: An approximately 3.9-mile long offsite detour is required for the duration of
construction. The detour will utilize SR 1745 (Shumate Mountain Road), SR 1730 (Dehart
Community Center Road), and SR 1002 (Traphill Road). Continued coordination with County
EMS and Schools will take place prior to construction; see Section 1, Project Commitments.
Agency Start of Study notifications were sent to the USACE, Federal Highway Administration
(FHWA), NC Wildlife Resources Commission (NC WRC), U.S. Fish and Wildlife Service
(USFWS), NC Department of Environmental Quality — Division of Water Resources (NC
DEQ- DWR), and NC Division of Parks and Recreation (NC DPR) in May 2019, and to the
Eastern Band of Cherokee Indians, Cherokee Nation of Oklahoma, and United
Keetoowah Band of Cherokee Indians in July of 2019. Start of Study notification were also
sent to NCDOT Division 11 and NCDOT Preconstruction contacts in May 2019.
General comments provided by USFWS regarding the project included recommendations for
erosion and sediment control, Northern long-eared bat (NLEB), migratory birds, and replacing
structures that cross rivers and streams. Project -specific comments regarding the potential for
the Brook Floater (Alasmidonta varicosa) to occur in the study area were provided.
Response: The NLEB has been assessed by the NCDOT Biological Surveys Group, and the
nearest NLEB hibernacula record is 42 miles west of the project and no known NLEB roost trees
occur within 150 feet of the project area. The requested preliminary plans were provided to
USFWS on 7124119. NCDOT Environmental Analysis Unit (NCDOT EAU) confirmed that no
action regarding the Brook Floater is required at this time.
NC DWR provided general project comments regarding 401 Water Quality Certification, erosion
and sediment control BMPs, and mitigation for impacts to waters of the U.S. are also included in
the response.
USACE and NC DPR had no specific comments regarding the proposed actions. No response
was received by FHWA, NC WRC, Eastern Band of Cherokee Indians, Cherokee Nation of
Oklahoma, and United Keetoowah Band of Cherokee Indians.
Public Involvement: A landowner notification letter was sent on 2/7/2019 to property owners
adjacent to the bridge to inform them of representatives being present on their property for
surveys. No comments have been received to date.
Prior to ROW, newsletters will be sent out by STV on behalf of NCDOT to the properties
affected by the project to inform them of the project and the offsite detour, as noted in Section
I, Project Commitments.
4 Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
F. Project Impact Criteria Checklists:
Type I & II - Ground Disturbing Actions
FHWA APPROVAL ACTIVITIES THRESHOLD CRITERIA
If any of questions 1-7 are marked "yes" then the CE will require FHWA approval.
Yes
No
1
Does the project require formal consultation with U.S. Fish and Wildlife
❑
Service (USFWS) or National Marine Fisheries Service (NMFS)?
2
Does the project result in impacts subject to the conditions of the Bald and
❑
❑X
Golden Eagle Protection Act (BGPA)?
3
Does the project generate substantial controversy or public opposition, for any
❑
reason, following appropriate public involvement?
4
Does the project cause disproportionately high and adverse impacts relative to
❑
❑X
low-income and/or minority populations?
5
Does the project involve a residential or commercial displacement, or a
❑
substantial amount of right of way acquisition?
6
Does the project require an Individual Section 4(f) approval?
❑
❑X
Does the project include adverse effects that cannot be resolved with a
7
Memorandum of Agreement (MOA) under Section 106 of the National Historic
❑
Preservation Act (NHPA) or have an adverse effect on a National Historic
Landmark (NHL)?
If any of questions 8 through 31 are marked "yes" then additional information will be required for those
questions in Section G.
Other Considerations
Yes
No
Does the project result in a finding of "may affect not likely to adversely affect"
8
for listed species, or designated critical habitat under Section 7 of the
❑
0
Endangered Species Act (ESA)?
9
Is the project located in anadromous fish spawning waters?
❑
0
Does the project impact waters classified as Outstanding Resource Water
10
(ORW), High Quality Water (HQW), Water Supply Watershed Critical Areas,
❑
0
303(d) listed impaired water bodies, buffer rules, or Submerged Aquatic
Vegetation (SAV)?
11
Does the project impact waters of the United States in any of the designated
❑
0
mountain trout streams?
12
Does the project require a U.S. Army Corps of Engineers (USACE) Individual
❑
0
Section 404 Permit?
13
Will the project require an easement from a Federal Energy Regulatory
❑
z
Commission (FERC) licensed facility?
14
Does the project include a Section 106 of the NHPA effects determination
❑
0
other than a no effect, including archaeological remains?
Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Other Considerations
Yes
No
15
Does the project involve hazardous materials and/or landfills?
❑X
❑
Does the project require work encroaching and adversely affecting a
16
regulatory floodway or work affecting the base floodplain (100-year flood)
❑
elevations of a water course or lake, pursuant to Executive Order 11988 and
23 CFR 650 subpart A?
Is the project in a Coastal Area Management Act (CAMA) county and
❑
17
substantially affects the coastal zone and/or any Area of Environmental
Concern (AEC)?
18
Does the project require a U.S. Coast Guard (USCG) permit?
❑
❑X
19
Does the project involve construction activities in, across, or adjacent to a
❑
designated Wild and Scenic River present within the project area?
20
Does the project involve Coastal Barrier Resources Act (CBRA) resources?
❑
0
21
Does the project impact federal lands (e.g. U.S. Forest Service (USFS),
❑
USFWS, etc.) or Tribal Lands?
22
Does the project involve any changes in access control?
❑
0
23
Does the project have a permanent adverse effect on local traffic patterns or
❑
community cohesiveness?
24
Will maintenance of traffic cause substantial disruption?
❑
0
Is the project inconsistent with the STIP or the Metropolitan Planning
25
Organization's (MPO's) Transportation Improvement Program (TIP) (where
❑
❑
applicable)?
Not Applicable
Does the project require the acquisition of lands under the protection of
Section 6(f) of the Land and Water Conservation Act, the Federal Aid in Fish
26
Restoration Act, the Federal Aid in Wildlife Restoration Act, Tennessee Valley
❑
Authority (TVA), or other unique areas or special lands that were acquired in
fee or easement with public -use money and have deed restrictions or
covenants on the property?
27
Does the project involve Federal Emergency Management Agency (FEMA)
❑
buyout properties under the Hazard Mitigation Grant Program (HMGP)?
28
Does the project include a de minimis or programmatic Section 4(f)?
❑
❑X
29
Is the project considered a Type I under the NCDOT's Noise Policy?
❑
0
30
Is there prime or important farmland soil impacted by this project as defined by
❑
the Farmland Protection Policy Act FPPA ?
31
Are there other issues that arose during the project development process that
❑
affected the project decision?
Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
G. Additional Documentation as Required from Section F
Response to Question 1: NCDOT has determined that the proposed action will not require
separate consultation on the grounds that the proposed action is consistent with the final
Section 4(d) rule, codified at 50 C.F.R. § 17.40(o) and effective February 16, 2016. NCDOT
may presume its determination is informed by best available information and consider Section
7 responsibilities fulfilled for NLEB.
Response to Question 15: NCDOT Geotechnical Engineering Unit project scoping comments
indicated the presence of an underground storage tank (UST) within the project study area. A
Phase I environmental site assessment completed in July 2019 indicates one (1) site of low
concern was found within the proposed study area on SR1002 (Traphill Road). Site of concern
identified in the Phase I report should be reviewed by the GeoEnvironmental Section once the
Final Right of Way plans are complete to determine if Phase II Investigations and Right of Way
Recommendations are necessary prior to right of way acquisition. See Section I, Project
Commitments.
Response to Question 16: This project involves construction activities on or adjacent to
FEMA-regulated stream(s). Therefore, the Division shall submit sealed as -built construction
plans to the Hydraulics Unit upon completion of project construction, certifying that the
drainage structure(s) and roadway embankment that are located within the 100-year floodplain
were built as shown in the construction plans, both horizontally and vertically.
The Hydraulics Unit will coordinate with the NC Floodplain Mapping Program (FMP) to
determine the status of the project with regard to applicability of NCDOT'S Memorandum of
Agreement, or approval of a Conditional Letter of Map Revision (CLOMR) and subsequent final
Letter of Map Revision (LOMR).
Response to Question 30: Prime and Important Farmland Soils, as defined by the Farmland
Protection Policy Act (FPPA), are located within the project study area (25-foot buffer from the
slope stakes). The Prime and Important Farmland Soil found within the footprint are
designated as either "Farmland of Statewide Importance", "Prime Farmland", or "Prime
Farmland if drained and either protected from flooding or not frequently flooded during the
growing season".
A Natural Resource Conservation Service (NRCS) Farmland Conversion Impact Rating was
completed for this project, and a total score of 44 out of 160 points was calculated for the BR-
0124 project site. Since the total points calculated in part VI of the NRCS Farmlands
Conversion Form AD-1006 for BR-0124 was less than 60, and the total points of the NRCS
Farmlands Conversion Form AD-1006 is less than 160, no mitigation for farmland loss is
required for the project in accordance with FPPA.
7 Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
H. Categorical Exclusion Approval
Project No. BR-0124
WBS Element 48833.1.1
Federal Project No. N/A
Prepared By:
DocuSigned by:
8/23/2019 � saff
Date'—Ekbetb46cott, El, STV Engineers Inc.
Prepared For: North Carolina Department of Transportation
Reviewed By:
DocuSigned by:
8/30/2019 F, 44,'A
Date i pF684, 4arris, III, PE, Environmental Analysis Unit
North Carolina Department of Transportation
If all of the threshold questions (1 through 7) of
0 Approved Section F are answered "no," NCDOT approves this
Categorical Exclusion.
If any of the threshold questions (1 through 7) of
❑ Certified Section F are answered "yes," NCDOT certifies this
Categorical Exclusion.
DocuSigned by:
8/23/2019
Date �—"V9fffoPrgtsher, PE, Structures Management Unit
North Carolina Department of Transportation
FHWA Approved: For Projects Certified by NCDOT (above), FHWA signature
required.
N/A
Date John F. Sullivan, III, PE, Division Administrator
Federal Highway Administration
8 Updated 8/23/2019

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
I. Project Commitments
Wilkes County
Bridge No. 960166 on SR 1745 (Shumate Mountain Road) over West Prong of Roaring
River
WBS No. 48833.1.1
Project No. BR-0124
NCDOT Hydraulics Unit
FEMA Coordination
The Hydraulics Unit will coordinate with the NC Floodplain Mapping Program (FMP), to
determine status of project with regard to applicability of NCDOT'S Memorandum of
Agreement, or approval of a Conditional Letter of Map Revision (CLOMR) and
subsequent final Letter of Map Revision (LOMR).
This project involves construction activities on or adjacent to FEMA-regulated stream(s).
Therefore, the Division shall submit sealed as -built construction plans to the Hydraulics
Unit upon completion of project construction, certifying that the drainage structure(s)
and roadway embankment that are located within the 100-year floodplain were built as
shown in the construction plans, both horizontally and vertically.
NCDOT GeoEnvironmental Section
Phase I Report
Site of concern identified in the Phase I report should be reviewed by the
GeoEnviron mental Section once the Final Right of Way plans are complete to
determine if Phase II Investigations and Right of Way Recommendations are necessary
prior to right of way acquisition.
NCDOT Structures Management Unit
Public Involvement Newsletter
Prior to ROW, newsletters will be sent out on behalf of NCDOT to the properties
affected by the project to inform them of the project and the offsite detour.
NCDOT Division 11
Agricultural Land Use
Continued coordination should occur through the right of way phase with the owners of
the agricultural lands that are temporarily impacted by the off -site detour.
NCDOT Division 11
Schools and Emergency Services
NCDOT should coordinate with Wilkes County Schools (Eric Barker, 336-667-1126) and
Wilkes County Emergency Services (Timothy Pennington, 336-651-7363) at least one
month prior to construction.

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
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THIS PROJECT IS NOT WITHIN ANY
MUNICIPAL BOUNDARIES.
CLEARING ON THIS PROJECT SHALL BE PERFORMED
TO THE LIMITS ESTABLISHED BY METHOD _
STATE OF NORTH ('.-lROI.,['7:-\
DIVISION OF Hl'""HWAYS
WILI<ES CO UNTY
Z LOCATION: BRIDGE #166 OVER WEST PRONG ROARING RIVER
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O111 SR 1745 (SHUMATE MOUNTAIN RD)
44 TYPE OF WORK: GRADING, DRAINAGE, PAVING, & STRUCTURE
A.
STATE
STATE PROJECT REFERENCE NO.
SHEET
NO.
TOTAL
SHEETS
N.C.
BR-0124
I
STATE PROJ. NO.
F. A. PROD. NO.
DESCRIPTION
67124.1.1
P.E.
INCOMPLETE PLANS
DO NO°l[C' tTSE FOR R // W ACQUISITION
DOCUMENT NOT CONSIDERED FINAL
UNLESS ALL SIGNATURES COMPLETED
GRAPHIC SCALES
50 25 0 50 100
DESIGN DATA
ADT 2016 = 470
ADT 2040 = N /A
D H V = N / A
D = N / A
T = N /A
V = 45 MPH
FUNC. CLASSIFICATION:
LOCAL
SUB REGIONAL TIER
PROJECT LENGTH
',
LENGTH OF ROADWAY TIP PROJECT BR-0124 = 0.093 MILES
—
LENGTH OF STRUCTURE TIP PROJECT BR-0124 — 0.027 MILES
TOTAL LENGTH OF TIP PROJECT BR-0124 = 0.120 MILES
PLANS PREPARED FOR THE NCDOT BY.
STV Engineers, Inc.
STV 100 900 West Trade St., Suite 715
NCaL enseNNum8be0r2F-0991
HYDRAULICS
ENGINEER
P.E.
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1-1411
PLANS
50 25 0 50 100
2018 STANDARD SPECIFICATIONS
NIKKI T. HONEYCUTT, PE
RIGHT OF WAY DATE:
AUGUST 29, 2019
ROADWAY
DESIGN
ENGINEER
P.E.
PROJECT ENGINEER
BHUPESH R. JOSHI, EIT
PROFILE (HORIZONTAL)
5 2.5 0 5 10
I
LETTING DATE:
MAY 2212020
NCDOT CONTACT: TIERRE PETERSON, PE
Structures Management Unit
PROJECT DESIGNER
so
PROFILE (VERTICAL)
SIGNATURE:

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
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DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Project Tracking No.
18-09-0086
NO ARCHAEOLOGICAL SURVEY REQUIRED FORM �'
This form only pertains to ARCHAEOLOGICAL RESOURCES for this project. It is not o
p
valid for Historic Architecture and Landscapes. You must consult separately with the
Historic Architecture and Landscapes Group.'4p
PROJECT INFORMATION
Project No: BR-0124
WBS No: 67124
Federal Aid No:
Federal Permit Required?
County:
Document
Funding
® Yes ❑ No
Wilkes
Federal Categorical Exclusion
® State ❑ Federal
Permit USACE
Type:
Project Description:
Replace Bridge 166 on SR 1745 (Shumate Mountain Rd.) over the West Prong Roaring River in
Wilkes County. The Area of Potential Effects (A.P.E.) is approximately 295 meters (968 ft.) long
and 114 meters (375 ft.) wide at its widest point (approximately 4 acres). The A.P.E. includes land
along SR 1745 and SR 1746 (Middle Fork Rd.). The project is State -funded and will require
Federal permits. Easements will be required.
NOTE: A survey was recommended for this project on 2/15/2019. The original submittal included
a large study area (21 acres) that included land along SR 1745 and SR 1002 (Traphill Rd.), as well
as Bridge 138 on SR 1002 over the Roaring River. The recommendation was changed to no survey
required when a much -reduced A.P.E. (from 21 to 4 acres) was submitted in June 2019. The
smaller A.P.E. did not include the two archaeological potential areas that had been identified in
the larger study area.
SUMMARY OF CULTURAL RESOURCES REVIEW
Brief description of review activities, results of review, and conclusions:
The review included an examination of a topographic map, the Wilkes County web soil survey, an
aerial photograph, and records about previously recorded sites, previous archaeological surveys,
and previous environmental reviews at the North Carolina Office of State Archaeology (OSA) in
Raleigh. Also, a reconnaissance of the project was conducted on 1/8/2019. Bridge 166 is oriented
northwest -southeast but is considered north -south for this review.
The topographic map (Traphill) shows the A.P.E. is located in a wide stream valley. The West
Prong Roaring River joins the Middle Prong Roaring River a short distance east of Bridge 166.
The landforms in the A.P.E. appear to be floodplain and ridges along the West Prong and the
Middle Prong Roaring River. The southwest quadrant of Bridge 166 appears to be a floodplain.
The northwest quadrant appears to be a floodplain. The northeast quadrant appears to be a ridge
toe. SR 1746 joins SR 1745 in this quadrant. The southeast quadrant is a narrow floodplain
between SR 1745 and the Roaring River. (It is called the Roaring River south of the confluence
of the West Fork and Middle Fork.)
The Wilkes County soil survey shows two main soil types in the A.P.E. These include Pfafftown
fine sandy loam (1-6% slopes), rarely -flooded, and Ronda loamy sand (0-5% slopes), occasionally
"No ARCHAEOLOGYSURVEYREQUIRED"form for Minor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
1 of 10

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Project Tracking No.
18-09-0086
flooded. Pfafftown fine sandy loam is a well -drained soil found on stream terraces. Ronda loamy
sand is an excessively drained soil found on natural levees on floodplains.
The aerial photograph shows the land use in the A.P.E. is a mix of wooded and cleared land. The
southwest quadrant 166 is cleared (pasture?). The northwest quadrant is wooded next to the road
and cleared (pasture?) away from the road. The northeast quadrant is wooded. The southeast
quadrant is a narrow, wooded strip between SR 1745 and the Roaring River.
A reconnaissance of the original study area was conducted by NCDOT archaeologist Caleb Smith
on 1/8/2019. The reconnaissance found that the landforms in the northwest and southwest
quadrants (of the larger study area) have potential for archaeological sites. The northeast and
southeast quadrants have a low potential for archaeological sites.
The southwest quadrant is a narrow strip of level land that extends along the west side of SR 1745
from the bridge south to SR 1002. It is currently used as horse pasture. It overlooks the floodplain
in the southeast quadrant, and appeared to have potential for archaeological sites. The reduced
A.P.E. includes only a narrow strip along the west side of SR 1745. The southeast quadrant is a
narrow strip of floodplain between SR 1745 and the Roaring River. There is a small parking lot
(for a boat ramp?) located along SR 1002. The landform appears to be flood -prone and poorly -
drained. The land elevation is well below the road, and there are several flood channels visible.
The northeast quadrant is a slope up from the Middle Fork to SR 1746, and then a sloped ridge.
This area is wooded. The reduced A.P.E. includes more land in this quadrant than did the large
study area. Visual inspection of the land along both sides of SR 1746 did not identify any areas
with potential for archaeological sites. The northwest quadrant is a gently -sloped terrace or ridge
toe. A large drainage (ditch?) runs along the west side of SR 1745. The land along the west side
of the drainage appears to have a moderate to high potential for archaeological sites. However,
the reduced A.P.E. includes only a narrow strip along the west side of SR 1745, which is occupied
by the drainage ditch. The terrace/ridge toe is not included in the A.P.E.
Brief Explanation of why the available information provides a reliable basis for reasonably
predicting that there are no unidentified historic properties in the APE:
An archaeological survey (of parts of the large study area) was recommended on 2/15/2019. The
reduced A.P.E. provided in June 2019 does not include the two sections of the study area that were
considered to have potential for archaeological sites. Therefore, no survey is recommended.
SUPPORT DOCUMENTATION
See attached: ® Map(s) ❑ Previous Survey Info
❑ Photocopy of County Survey Notes
FINDING BY NCDOT ARCHAEOLOGIST
NO ARCHAEOLOGY SUR VEY REQ UIRED
Caleb Smith
NCDOT ARCHAEOLOGIST II
® Photos El Correspondence
Other:
7/24/2019
Date
"No ARCHAEOLOGY SURVEY REQUIRED "formfor Minor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
2of10

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
Project Tracking No. (Internal Use)
18-09-0086
�r
1 HISTORIC ARCHICTECTURE AND LANDSCAPES
NO SURVEY REQUIRED 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:
BR-0124
County:
Wilkes
WBS No.:
67124.1.1
Document
Type:
MCC
Fed. Aid No:
Funding:
® State ❑ Federal
Federal
Permits :
® Yes ❑ No
Permit
Typ e s
USACE
Project Description:
Replace Bridge No. 166 on SR 1745 (Shumate Mountain Rd) over West Prong Roaring River
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
Description of review activities, results, and conclusions. -
Review of HPO quad maps, relevant background reports, historic designations roster, and
indexes was undertaken on October 18, 2018. Based on this review there are no NR, DE, LL, SL
or SS in the Area of Potential Effects (APE). There are three structures over 50 years of age.
None of these rise to the level of significance or architecturally integrity to warrant further
evaluation. No Survey is required at this time.
Why the available information provides a reliable basis for reasonably predicting that there
are no unidentified siQnifrcant historic architectural or landscape resources in the project
area: Using HPO GIS website and county tax data provides reliable information regarding the structures
in the APE. These combined utilities are considered valid for the purposes of determining the likelihood
of historic resources being present.
SUPPORT DOCUMENTATION
®Map(s) ❑Previous Survey Info. ❑Photos ❑Correspondence ❑Design Plans
FINDING BY NCDOT ARCHITECTURAL HISTORIAN
Historic Architecture and Landscapes -- NO SURVEY REQUIRED
NCDOT Architectural Hi
Date
Hisrwic Architecture and Landscapes NO SURVh''Y Rl,QUlkG'D jonn fnr Mirror I' ansporrarion Projects as {)ualified m Fhe 2007 ProRramnuvic Agreenrarf.
Page 1 of 4

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
�SYAI'f.y�,
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
Date: June 11, 2019
MEMORANDUM TO: File
JAMES H. TROGDON, III
SECRETARY
From: Marissa Lenoce, Transportation Planner, STV Engineers,
Inc
SUBJECT:
NRCS Farmland Conversion Impact Rating Bridge No.
960166 on SR 1745 over West Prong of Roaring River
Wilkes County, NC
WBS 48833.1.1, Project No. BR-0124
The Farmland Protection Policy Act of 1981 (7 CFR Part 658) (FPPA) requires an assessment of
the potential impacts of land acquisition and construction activities in prime, unique, and local or
statewide importance as defined by the US Natural Resource Conservation Service (NRCS). This
memo is to document the completion and results of the NRCS Farmland Conservation Impact
Rating process for Project BR-0124 consistent with FPPA.
Project Description
BR-0124 proposes to replace Bridge No. 960166 on SR 1745 (Shumate Mountain Road) over
West Prong of Roaring River in Wilkes County. The project proposes replacing the existing
bridge with an approximately 30-foot wide structure with two 10-foot travel lanes. The
proposed bridge would be approximately 143 feet in length and the proposed right of way 80
feet. The total length of the project is approximately 635 feet.
Applicability
Project BR-0124 is subject to the provisions of FPPA for the following reasons:
• It is a federally funded project.
• It is not within a municipality, urbanized area, or urban built-up area.
• Prime farmlands of statewide importance are found within the project area.
• The land is not in water storage or used for national defense purposes.
Mailing Address: Telephone: [phone]
NC DEPARTMENT OF TRANSPORTATION Fax: [phone]
Structures Management Unit Website: www.ncdot.gov
1581 Mail Service Center
Raleigh, NC 27699-1581

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
NRCS Farmland Figure
In accordance with guidance provided by NCDOT Community Studies, the farmland figure was
created to display the project location and a one -mile buffer over a layer displaying prime
farmland, farmland of statewide importance, and Farmland of Local Importance in the vicinity
of the project. A project footprint was created to include a 25-foot buffer from the slope stakes.
The NRCS farmland figure is attached to this memo.
Completion of Part VI of the NRCS Form AD-1006
Part VI (Site Assessment Criteria) of the NRCS Form AD-1006 was completed for this project.
Points allotted for each criterium and reasoning are provided below.
1. Area in Non -urban Use: 13 out of 15 points. Estimated using aerial
photography; approximately 80% of the land within the 1-mile buffer is non -
urban.
2. Perimeter in Non -urban Use: 10 out of 10 points. Estimated using aerial
photography; more than approximately 90% borders on land in non -urban use.
3. Percent of Site Being Farmed: 6 out of 20 points. Estimated using aerial
photography; approximately 30% of the site is being farmed.
4. Protection Provided by State and Local Government: 0 out of 20 points. The site is
not designated as a Voluntary Agriculture District (VAD) or Enhanced Voluntary
Agriculture District (EVAD).
5. Distance from Urban Built-up Area: 5 out of 15 points. Determined using aerial
photography; site is within 1.0 mile of North Wilkes High School and New
Covenant Baptist Church.
6. Distance to Urban Support Services: 0 out of 15 points. Services exist within '/z mile
of the project site.
7. Size of Present Farm Unit Compared to Average: 0 out of 10 points. The farm units
are more than 50% below the average size farm unit in Wilkes County (114 acres).
8. Creation of Non-farmable Farmland: 0 out of 10 points. This project will have
no implications on remaining farmable land.
9. Availability of Farm Support Services: 0 out of 5 points. No farm support
services were identified within the site.
10. On -Farm Investments: 10 out of 20 points. Some on -farm investments including
barns, storage buildings, and waterways were identified using aerial imagery.
11. Effects of Conversion on Farm Support Services: 0 out of 10 points. No significant
reduction in demand for farm support services would occur as a result from the
project.
12. Compatibility with Existing Agricultural Use: 0 out of 10 points. The project is
compatible with existing agricultural use.
Result of Site Assessment Criteria
The sum of the points assigned in part VI of the NRCS form AD-1006 for BR-0124 is 44.
Summary
Because the total of the points assigned in part VI of the NRCS form AD-1006 for BR-0124 is
less than 60 and therefore the total points of the NRCS Farmlands Conversion Form AD-1006 is
less than 160, no mitigation for farmland loss is required for the project in accordance with
FPPA.

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDFO
Sources
US Census. Census of Agriculture. 2012. County Data. North Carolina. Wilkes County. Accessed
6/14/2019.
(htws://www.nass.usda.gov/Publications/AgCensus/2012/Full ReportNolume 1, Chapter 2 County Level/North Carolina/st37 2
001 OOl.pdfhtips://www.nass.usda.gov/Publications/AgCensus/2012/Online Resources/County Profiles/North Carohna/cp37097.pd
f)
Wilkes County. GIS Application. Wilkes County, NC. Accessed 6/14/2019.
(htWs://gis.wilkescounty.net/main/#)
Legal Information Institute. Section 658.5- Criteria. Accessed 6/14/2019.
(htWs://www.law.comell.edu/cfr/text/7/658.5)
Attachments
NRCS Farmland figure
Cc: Harrison Marshall and Herman Huang, NCDOT Community Studies

DocuSign Envelope ID: B236DB41-3F7D-4E91-9D86-BEFC199BCDF0
1�
a
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West Prong Roaring River
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11
STIP BR-0124
Bridge No. 960166 Replacement
over West Prong of
Roaring River
Wilkes County
NCDOT Division 11
July 2019
NCRS Farmland Figure
Sources: Wilkes County GIs Department,
NC One Map & Google Earth

Appendix A

M:Mn
MEMORANDUM
DATE: 9/6/2019
TO: File
FROM: STV Engineers Inc.
SUBJECT: BR-0124 CE
Documentation
FILE NUMBER: 4019918
PROJECT/PROP. NO.: BR-0124
CLIENT:
NCDOT Structures
Management Unit
The following documents were used in the preparation of the Categorical Exclusion for BR-0124.
- Historic Architecture and Landscapes No Survey Required Form (10/18/2018)
- Archaeological Survey Required Form (02/15/2019)
- No Archaeological Survey Required Form (07/24/2019)
- Local School Input (02/20/2019)
- Local Planner Input (02/20/2019)
- Natural Resource Technical Report (06/2019)
- Landowner Notification (02/07/2019)
- Section 7 survey results for the Northern Long-eared Bat (03/25/2019)
- Preliminary Jurisdictional Determination Package (PJD) (06/06/2019)
- Farmland Conversion Memo (06/11/2019)
- Demographic Memo (05/03/2019)
- Certification of Financial Contribution BUILD Grant Application (07/19/2018)
- Field Scoping Meeting Worksheet (04/17/2019)
- Structure Safety Report (01/13/2017)
- Right of Way Cost Estimate (07/08/2019)
- NCDOT Bridges Budget and Sources Used (2018)
- NCDOT Bridge Crash Count (2018)
- Bridge Traffic Review Sheet (10/02/2018)
- Geo-Environmental Pre-Scoping Comments (06/07/2019)
- NCDOT Study Hydraulics Pre-Scoping Comments (05/08/2019)
- Hydraulics Unit Pre -Design Report (Pre-Scoping) (03/25/2019)
- FEMA Flood Insurance Study (12/03/2009)
- NCDOT Rail Pre-Scoping Comments (05/10/2019)
- North Carolina Division of Parks and Recreation (DPR) Pre-Scoping Comments (05/10/2019)
- US Fish and Wildlife Pre-Scoping Comments (05/23/2019)

M:on
MEMORANDUM
PAGE 2 OF 2
- NC Wildlife Resource Commission Pre-Scoping Comments (08/22/2019)
- Screening Checklist (accessed 07/2019)
- Pre -Screening Worksheet (05/21/2018)
- Pre -Screening Summary (08/30/2018)
- Environmental Pre -Screening Checklist (05/14/2019)
- Division Resource Map (accessed 07/2019)

Project Tracking No. (Internal Use)
18-09-0086
ORHISTORIC ARCHICTECTURE AND LANDSCAPES
J rr NO SURVEY REQUIRED 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:
BR-0124
County:
Wilkes
WBS No.:
67124.1.1
Document
Type:
MCC
Fed Aid No:
Funding:
® State ❑ Federal
Federal
Permits :
® Yes ❑ No
Permit
T e s :
USACE
Project Description:
Replace Bridge No. 166 on SR 1745 (Shumate Mountain Rd) over West Prong Roaring River
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
Description of review activities, results, and conclusions:
Review of HPO quad maps, relevant background reports, historic designations roster, and
indexes was undertaken on October 18, 2018. Based on this review there are no NR, DE, LL, SL
or SS in the Area of Potential Effects (APE). There are three structures over 50 years of age.
None of these rise to the level of significance or architecturally integrity to warrant further
evaluation. No Survey is required at this time.
Why the available information Provides a reliable basis for reasonably predictinz that there
are no unidentified sieniricant historic architectural or landscape resources in the proiect
area: Using HPO GIS website and county tax data provides reliable information regarding the structures
in the APE. These combined utilities are considered valid for the purposes of determining the likelihood
of historic resources being present.
SUPPORT DOCUMENTATION
®Map(s) ❑Previous Survey Info. ®Photos ❑Correspondence ❑Design Plans
FINDING BY NCDOT ARCHITECTURAL HISTORIAN
Historic Architecture and Landscapes -- NO SURVEY REQUIRED
NCDOT Architectural Hi
Date
Historic Architecture and l andscapes NO SURYF,Y REQUIRE!] form for Mirror Transporiarion Projects as Qxvltfred in the 2007 Programrnalic Agreement.
Page 1 of 4

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Page 2 of 4

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Page 4 of 4

�J
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WILKES
C.Q U N T Y
Project Study Area
stP
USGS Topo Quad - Traphill
FBR-0124

Project Tracking No.:
18-09-0086
oo ARCHAEOLOGICAL SURVEY REQUIRED FORM
^ This form only pertains to ARCHAEOLOGICAL RESOURCES for this project. It is not
valid for Historic Architecture and Landscapes. You must consult separately with the`,
�•,._ Historic Architecture and Landscapes Group.
PROJECT INFORMATION
Project No.
WBS No.
F.A. No:
BR-0124
67124
Federal Permit Required?
County: Wilkes
Document: Federal Categorical Exclusion
Funding: ® State ❑ Federal
® Yes ❑ No Permit Type: USACE
Project Description: Replace Bridge 166 on SR 1745 (Shumate Mountain Rd.) over the West
Prong Roaring River in Wilkes County. The Area of Potential Effects (A.P.E.) is approximately
690 meters (2,264 ft.) long and 114 meters (375 ft.) wide. The A.P.E. includes approximately
392 meters (1,286 ft.) along SR 1002 (Traphill Rd.) (including Bridge 138) and 298 meters (978
ft.) along SR 1745 (Shumate Mountain Rd.). The project is State -funded and will require
Federal permits. Easements will be required.
SUMMARY OF ARCHAEOLOGICAL RESOURCES REVIEW: SURVEYREQUIRED
Brief description of review activities, results of review, and conclusions:
The review included an examination of a topographic map, the Wilkes County web soil survey, an
aerial photograph, and records about previously recorded sites, previous archaeological surveys,
and previous envrionmental reviews at the North Carolina Office of State Archaeology (OSA) in
Raleigh. Also, a reconnaissance of the project was conducted on 1/8/2019. Bridge 166 is oriented
northwest -southeast but is considered north -south for this review. Bridge 138 is oriented
northeast -southwest but is considered east -west for this review.
The topographic map (Traphill) shows the A.P.E. is located in a wide stream valley. The West
Prong Roaring River joins the Middle Prong Roaring River a short distance east of Bridge 166.
SR 1745 intersects with SR 1002 approximately 150 meters (492 ft.) southeast of the bridge. The
A.P.E. includes land along SR 1002 including Bridge 138. The landforms in the A.P.E. appear to
be floodplain and ridges along the West Prong and the Middle Prong Roaring River. The
topographic map shows several structures located in the A.P.E. along the south side of SR 1002.
The southwest quadrant of Bridge 138 appears to be in a drainage valley. The southeast quadrant
of Bridge 138 looks like a narrow strip between SR 1002 and the Middle Prong, and two structures
are shown there. The northeast quadrant of Bridge 138 appears to be a narrow floodplain along
the Middle Prong and a ridge toe. The northwest quadrant of Bridge 138 appears to be a floodplain.
The southwest quadrant of Bridge 166 (also the northwest quadrant of Bridge 138) appears to be
a floodplain. The northwest quadrant of Bridge 166 appears to be a floodplain. The northeast
quadrant of Bridge 166 appears to be a ridge toe. SR 1746 joins SR 1745 in this quadrant. the
southeast quadrant of Bridge 166 is a narrow floodplain between SR 1745 and the Middle Fork
Roaring River.
`ARCHAEOLOGICAL SUR VEY REQUIRED "formfor Minor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
1 of I 1

Project Tracking No.:
18-09-0086
The Wilkes County soil survey shows several soil types in the A.P.E. These include Danripple
sandy clay loam (2-8% and 8-15% slopes), moderately -eroded, Rhodhiss fine sandy loam (15-25%
and 25-60% slopes), Pfafftown fine sandy loam (1-6% slopes), rarely -flooded, and Ronda loamy
sand (0-5% slopes), occasionally flooded. Danripple sandy clay loam is a well -drained soil found
on slopes on stream terraces. Rhodhiss fine sandy loam is a well -drained soil found on ridge side -
slopes. Pfafftown fine sandy loam is a well -drained soil found on stream terraces. Ronda loamy
sand is an excessively drained soil found on natural levees on floodplains.
The aerial photograph shows the land use in the A.P.E. is a mix of wooded, cleared, and developed
land. The northeast, southeast and southwest quadrants of Bridge 138 are occupied by houses and
commercial development. The eastern part of the northwest quadrant (also the southwest quadrant
of Bridge 166) is cleared (pasture?). There is a trailer home and pond in the western part. The
northwest quadrant of Bridge 166 is wooded next to the road and cleared (pasture?) away from the
road. The northeast quadrant is wooded. The southeast quadrant is a narrow wooded strip between
SR 1745 and the Middle Prong Roaring River.
A reconnaissance of the A.P.E. was conducted by NCDOT archaeologist Caleb Smith on 1/8/2019.
The reconnaissance found that the landforms in the northwest and southwest quadrants of Bridge
166 have some potential for archaeological sites. The other quadrants of Bridge 166 and Bridge
138 have low potential for archaeological sites.
The southwest quadrant of Bridge 138 is a narrow strip of flat land next to the bridge, and then a
slope up to a ridge. A house occupies most of the flat land along the Middle Fork. The southeast
quadrant of bridge 138 is a narrow strip of sloped land between SR 1002 and the Middle Fork. It
is occupied by an automotive repair shop. The northeast quadrant of Bridge 138 is a slope up to a
ridge. There is a house located on the ridge.
The southwest quadrant of Bridge 166 (also the northwest quadrant of Bridge 138) is a gently- to
moderately -sloped ridge toe from the bridge south to SR 1002. It is currently used as pasture. The
landform appears to have some potential for archaeological sites. The soil on this landform is
described as well -drained Ronda loamy sand. The southeast quadrant of Bridge 166 is a narrow
strip (40-50 meters [ 131-164 ft.] wide) of level floodplain between SR 1745 and the Middle Fork.
There is a small parking lot (for a boat ramp?) located along SR 1002. The landform in this
quadrant appears to be unstable and poorly -drained. The land elevation is well below the road,
and there are several flood chutes visible. The northeast quadrant is a slope up to SR 1746 (Middle
Fork Rd.), and then a sloped ridge. It is wooded. The northwest quadrant is a level
terrace/floodplain. A large drainage (ditch?) runs along the west side of SR 1745. The land along
the west side of the drainage is a level terrace currently used as pasture. This landform appears to
have some potential for archaeological sites. The soil in this part is described as Ronda loamy
sand and Pfafftown fine sandy loam.
Recommend survey of the level, well -drained landforms in the northwest and southwest quadrants
of Bridge 166. No survey is recommended for the other quadrants of Bridge 166 and Bridge 138.
We can complete these investigations using one of the Archaeology Team's on -call firms, or if
Division 11 would like to manage and complete the survey they can use a NCDOT prequalified
archaeologist under contract with one of Division's on -call firms. We can provide a scope of
work for the Division to use, but we do need to know within seven days which path the Division
`ARCHAEOLOGICAL SURVEY REQUIRED "form for Manor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
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Project Tracking No.:
18-09-0086
plans to follow. All products produced by the Division's consultant will need to be submitted to
the Archaeology Team for review, acceptance, and submittal to the Office of State Archaeology
as per the Programmatic Agreement. We would be happy to discuss this approach with you.
SUPPORT DOCUMENTATION
See attached: ® Map(s) ❑ Previous Survey Info ® Photos ❑Correspondence
❑ Photocopy of County Survey Notes Other:
FINDING BY NCDOT ARCHAEOLOGIST — SURVEY REQUIRED
Caleb Smith
NCDOT ARCHAEOLOGIST
5/10/2019
Proposed fieldwork completion date
2/15/2019
Date
`ARCHAEOLOGICAL SURVEY REQUIRED "form for Minor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
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Project Tracking No.:
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Project Tracking No.
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oo NO ARCHAEOLOGICAL SURVEY REQUIRED FORM
This form only pertains to ARCHAEOLOGICAL RESOURCES for this project. It is not o
o g b; 97. valid for Historic Architecture and Landscapes. You must consult separately with the
�•,._ Historic Architecture and Landscapes Group.'4p
PROJECT INFORMATION
Project No: BR-0124
WBS No: 67124
Federal Aid No:
Federal Permit Required?
County:
Document
Funding
® Yes ❑ No
Wilkes
Federal Categorical Exclusion
® State ❑ Federal
Permit USACE
Type:
Project Description:
Replace Bridge 166 on SR 1745 (Shumate Mountain Rd.) over the West Prong Roaring River in
Wilkes County. The Area of Potential Effects (A.P.E.) is approximately 295 meters (968 ft.) long
and 114 meters (375 ft.) wide at its widest point (approximately 4 acres). The A.P.E. includes land
along SR 1745 and SR 1746 (Middle Fork Rd.). The project is State -funded and will require
Federal permits. Easements will be required.
NOTE: A survey was recommended for this project on 2/15/2019. The original submittal included
a large study area (21 acres) that included land along SR 1745 and SR 1002 (Traphill Rd.), as well
as Bridge 138 on SR 1002 over the Roaring River. The recommendation was changed to no survey
required when a much -reduced A.P.E. (from 21 to 4 acres) was submitted in June 2019. The
smaller A.P.E. did not include the two archaeological potential areas that had been identified in
the larger study area.
SUMMARY OF CULTURAL RESOURCES REVIEW
Brief description of review activities, results of review, and conclusions:
The review included an examination of a topographic map, the Wilkes County web soil survey, an
aerial photograph, and records about previously recorded sites, previous archaeological surveys,
and previous environmental reviews at the North Carolina Office of State Archaeology (OSA) in
Raleigh. Also, a reconnaissance of the project was conducted on 1/8/2019. Bridge 166 is oriented
northwest -southeast but is considered north -south for this review.
The topographic map (Traphill) shows the A.P.E. is located in a wide stream valley. The West
Prong Roaring River joins the Middle Prong Roaring River a short distance east of Bridge 166.
The landforms in the A.P.E. appear to be floodplain and ridges along the West Prong and the
Middle Prong Roaring River. The southwest quadrant of Bridge 166 appears to be a floodplain.
The northwest quadrant appears to be a floodplain. The northeast quadrant appears to be a ridge
toe. SR 1746 joins SR 1745 in this quadrant. The southeast quadrant is a narrow floodplain
between SR 1745 and the Roaring River. (It is called the Roaring River south of the confluence
of the West Fork and Middle Fork.)
The Wilkes County soil survey shows two main soil types in the A.P.E. These include Pfafftown
fine sandy loam (1-6% slopes), rarely -flooded, and Ronda loamy sand (0-5% slopes), occasionally
"No ARCHAEOLOGY SURVEY REQUIRED "formfor Minor Transportation Projects as Qualified in the 2015 Programmatic Agreement.
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Project Tracking No.
18-09-0086
flooded. Pfafftown fine sandy loam is a well -drained soil found on stream terraces. Ronda loamy
sand is an excessively drained soil found on natural levees on floodplains.
The aerial photograph shows the land use in the A.P.E. is a mix of wooded and cleared land. The
southwest quadrant 166 is cleared (pasture?). The northwest quadrant is wooded next to the road
and cleared (pasture?) away from the road. The northeast quadrant is wooded. The southeast
quadrant is a narrow, wooded strip between SR 1745 and the Roaring River.
A reconnaissance of the original study area was conducted by NCDOT archaeologist Caleb Smith
on 1/8/2019. The reconnaissance found that the landforms in the northwest and southwest
quadrants (of the larger study area) have potential for archaeological sites. The northeast and
southeast quadrants have a low potential for archaeological sites.
The southwest quadrant is a narrow strip of level land that extends along the west side of SR 1745
from the bridge south to SR 1002. It is currently used as horse pasture. It overlooks the floodplain
in the southeast quadrant, and appeared to have potential for archaeological sites. The reduced
A.P.E. includes only a narrow strip along the west side of SR 1745. The southeast quadrant is a
narrow strip of floodplain between SR 1745 and the Roaring River. There is a small parking lot
(for a boat ramp?) located along SR 1002. The landform appears to be flood -prone and poorly -
drained. The land elevation is well below the road, and there are several flood channels visible.
The northeast quadrant is a slope up from the Middle Fork to SR 1746, and then a sloped ridge.
This area is wooded. The reduced A.P.E. includes more land in this quadrant than did the large
study area. Visual inspection of the land along both sides of SR 1746 did not identify any areas
with potential for archaeological sites. The northwest quadrant is a gently -sloped terrace or ridge
toe. A large drainage (ditch?) runs along the west side of SR 1745. The land along the west side
of the drainage appears to have a moderate to high potential for archaeological sites. However,
the reduced A.P.E. includes only a narrow strip along the west side of SR 1745, which is occupied
by the drainage ditch. The terrace/ridge toe is not included in the A.P.E.
Brief Explanation of why the available information provides a reliable basis for reasonably
predicting that there are no unidentified historic properties in the APE:
An archaeological survey (of parts of the large study area) was recommended on 2/15/2019. The
reduced A.P.E. provided in June 2019 does not include the two sections of the study area that were
considered to have potential for archaeological sites. Therefore, no survey is recommended.
SUPPORT DOCUMENTATION
See attached: ® Map(s) ❑ Previous Survey Info
❑ Photocopy of County Survey Notes
FINDING BY NCDOT ARCHAEOLOGIST
NO ARCHAEOLOGY SUR VEY REQ UIRED
Caleb Smith
NCDOT ARCHAEOLOGIST II
® Photos El Correspondence
Other:
7/24/2019
Date
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Area 2018 Study
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Figure 3: Southeast view of the southeast quadrant.
Figure 4: Northwest view of the southeast quadrant.
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10 of 10

NC Department of Transportation Community Studies Group, Human Environment Section
Local Schools Input Form for
STIP Project BR-0124 COMMUNITY IMPACT ASSESSMENT
Contact Information
Interviewee Name: Eric Barker Date: February 20, 2019
Title/Position: Transportation Director Phone Number: [phone]
Organization/Agency: Wilkes County Schools
Email: [e-mail] Completed Via: ® Email ❑ Phone
Interview Information/Instructions
If completed by phone:
Interviewed By (Name/Organization):
If completed by email:
Using the project information and map below, please respond to the following questions by typing your answers in
the space provided. Then save (using the Save As command) this file with a new file name for your records and e-
mail the new file back to the original sender. If you would prefer to complete a hard copy of this form, please send all
sheets to the following address or fax number:
Elizabeth Scott
STV Incorporated
1600 Perimeter Park Drive, Suite 225
Morrisville, North Carolina 27560
[e-mail]
Fax: [phone]
Project Information
Y �+
4.
Replacement of Bridge 960166 on SR 1745
(Shumate Mountain Road) over West Prong of
Roaring River.
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Check all questions that apply and provide a detailed explanation of your response in the
Check if item
I
field
provided.
is applicable
1.
How many school buses [cross the bridge/pass through the corridor] per day (total # of daily
buses, total # daily of trips)?
X❑
3 Buses. 6 Trips.
2.
Is the corridor used by carpool traffic or pedestrians to access local schools? If yes, please describe
the location and time(s) of day.
X❑
Yes, carpool. Estimate 7:00am and 3:00pm
3.
[Applicable if schools are located in or near the project area] Are there any Safe Routes to School
plans in place at schools in the vicinity of the project?
X❑
No
4.
Based on your knowledge of the project area, do you have any concerns with the
condition/capacity of potential detour routes or the location of resources along these routes with
respect to school traffic?
X❑
Yes. Bus Turnaround for Stops from Adams Rd to Middle Fork Rd.
5.
Are there any future time periods or events that you know of where bridge or road closure or
reduction in number of lanes for construction would be of particular concern?
X❑
No
6.
Rate the overall impact on school transportation if the bridge or roadway were closed or at reduced capacity for
up to a year:
❑ No Impact ❑ Low Impact ❑ Moderate Impact X ❑ High Impact
7.
Are road names referenced by the names locals would use?
X❑
Yes.
8.
Is there anyone else you feel should be contacted regarding this project (i.e. local officials or
stakeholders)?
X❑
Yes. Wilkes Transportation Authority (WTA)
9.
Are there any other concerns you have regarding the potential impact of this project on school
transportation services or any additional comments? Please be as specific as possible.
❑

NC Department of Transportation Community Studies Group, Human Environment Section
Local Planner Input Form for
STIP Project BR-0124 COMMUNITY IMPACT ASSESSMENT
Contact Information
Interviewee Name: Eddie Barnes Date: February 20, 2019
Title/Position: Director Phone Number: [phone]
Organization/Agency: Wilkes County Planning Department
Email: [e-mail] Completed Via: ❑ Email ❑ Phone
Interview Information/Instructions
If completed by phone:
Interviewed By (Name/Organization):
If completed by email:
Using the project information and map below, please respond to the following questions by typing your answers in the
space provided. Then save (using the Save As command) this file with a new file name for your records and e-mail the
new file back to the original sender. If you would prefer to complete a hard copy of this form, please send all sheets to
the address or fax number below:
Elizabeth Scott
STV Incorporated
1600 Perimeter Park Drive, Suite 225
Morrisville, North Carolina 27560
[e-mail]
Fax: [phone]
Project Information
A
r Q
Replacement of Bridge 960166 on SR
1745 (Shumate Mountain Road) over
West Prong of Roaring River.
u .. ..,
�9 w ®� r
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Check those questions that apply and provide a detailed explanation of your response
Check if item is
in the field provided.
applicable
Growth and Development
1. Are there any known plans for development in the vicinity of the project? ❑
NO
2. Are there any adopted plans for growth or economic development that could directly affect or
be affected by this project? ❑
NO
3. Are there plans to extend water/sewer lines or to build any new facilities, such as fire stations,
schools, or other facilities, in the vicinity of the project? El
NO
4. Are there any specific business and/or economic resources present in the project area, such as
business parks, distribution centers, manufacturing facilities, etc.? ❑
NO
Special Populations
5. Are you aware of any minority, low-income or limited English proficiency (LEP) populations/
communities in the vicinity of the project? If so, please provide the locations of these
populations in the area. [If yes, proceed to Question 6. If no, skip to Question 7.]
NO
6. Are there specific community resources or services that are used by minority, low-income or
LEP populations in the vicinity of the project? How is the project likely to affect minority and ❑
low-income populations?
NO
7. Are there any tribal groups connected with land, religious, ethnic or other special populations
with different mobility needs or outreach needs in the project area?
NO
8. Who should we contact to discuss outreach needs for any special populations? Please provide
input on community leader contacts, media sources or other ways to reach these populations. ❑
WILKES COUNTY SOCIAL SERVICES, WILKES COUNTY HEALTH DEPT. WILKES COUNTY SCHOOLS
Access, Accessibility, and Mobility
9. Is there pedestrian or bicycle activity/traffic or transit use along the project? If so, please
describe multimodal activity in the project area. ❑
NO
10. Are there any existing access, accessibility, or mobility concerns or any barriers to non -auto
travel in the area? Please consider all modes.
❑
NO
11. Are there any adopted plans for pedestrian, greenway, bicycle, or transit facilities in the area?
For each plan, please provide a description of how the plan applies to the project area, the
title of the plan, its year of adoption, and the current status of its implementation.
NO

Agricultural Operations
12. Are you aware of any active agricultural operations in the vicinity of the project? If so, please
describe these operations (e.g. size, ownership, crops, years farmed, suppliers, customers,
❑
value to the community). (If yes, answer Question 12. If no, skip to Question 13.1
NO
13. Are farm support services —such as farm suppliers, equipment dealers, processing and storage
facilities, and farmer's markets —located in the vicinity of the project? If so, please describe
these services (e.g. type, location).
❑
NO
14. Does the project lie within a VAD or EVAD district, or are you aware of any land with other
farmland protections (plans, tax districts or credits, trust, agricultural zoning, deed
restrictions)? If so, please describe the nature and location of these areas and properties.
❑
NO
Other Notable Features
15. Are there any recreational properties within the project area that were purchased or
improved with Land and Water Conservation Act funds?
❑
NO
16. Are there any other specific notable community resources or issues in the project area? (e.g.
socio-economic resources, recreational resources, community safety concerns, cohesive
neighborhoods, areas in decline) If so, please describe.
❑
NO
Detours and Closures
17. Are there any future time periods or events that you know of where road or bridge closure or
reduction in number of lanes for construction would be of particular concern?
❑
NO
18. [If applicable] Based on your knowledge of the project area, do you have any concerns with
the condition/capacity of potential detour routes, or the location of resources along these
Elroutes?
NO
19. Rate the overall impact on local planning objectives if the bridge or roadway were closed or at reduced capacity
for up to a year:
❑ Positive Impact ❑ No Impact X ❑ Low Impact ❑ Moderate Impact ❑ High Impact
Closing Questions
20. Are road names referenced by the names locals would use?
❑
YES
21. Is there anyone else you feel should be contacted regarding this project (i.e. local officials or
takeholders)?
❑
WILKES COOLINTY SCHOOLS
22. Do you have any additional comments about this project?
❑
NO

NATURAL RESOURCES TECHNICAL REPORT
Replacement of Bridge No. 960166 on SR 1745 (Shumate Mountain Road) over
West Prong Roaring River
Wilkes County, North Carolina
STIP No. BR-0124
WBS Element No. 67124.3.1
THE NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
Environmental Coordination and Permitting
June 2019

TABLE OF CONTENTS
1.0 INTRODUCTION.......................................................................................................1
2.0 METHODOLOGY.....................................................................................................1
3.0 TERRESTRIAL COMMUNITIES...........................................................................1
4.0 PROTECTED SPECIES............................................................................................2
4.1 Endangered Species Act Protected Species.......................................................... 2
4.2 Bald and Golden Eagle Protection Act................................................................. 3
5.0 WATER RESOURCES..............................................................................................3
6.0 REGULATORY CONSIDERATIONS....................................................................5
6.1 Clean Water Act Waters of the U.S...................................................................... 5
6.2 Construction Moratoria......................................................................................... 6
6.3 N.C. River Basin Buffer Rules............................................................................... 6
6.4 Rivers and Harbors Act Section 10 Navigable Waters ....................................... 6
7.0 REFERENCES............................................................................................................7
Appendix A Figures
Figure 1. Vicinity Map
Figure 2. Project Study Area Map
Figure 3. Jurisdictional Features Map
Figure 4. Terrestrial Communities Map
Appendix B Qualifications of Contributors
Appendix C Protected Species Survey Reports
LIST OF TABLES
Table 1. Coverage of terrestrial communities in the study area..................................1
Table 2. ESA federally protected species listed for Wilkes County ............................ 2
Table 3. Potential streams in the study area.................................................................. 4
Table 4. Potential surface waters in the study area ...................................................... 4
Table 5. Characteristics of potential jurisdictional streams in the study area........... 5
Table 6. Characteristics of potential jurisdictional wetlands in the study area......... 5

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N.C.
1.0 INTRODUCTION
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge
No. 960166 on SR 1745 (Shumate Mountain Road) over West Prong Roaring River in
Wilkes County, North Carolina (STIP No. BR-0124; Figures 1 and 2). The following
Natural Resources Technical Report (NRTR) has been prepared to assist in the
preparation of a federally -funded Categorical Exclusion (CE), which will be prepared in
accordance with the National Environmental Policy Act (NEPA).
2.0 METHODOLOGY
All work was conducted in accordance with the NCDOT Environmental Coordination
and Permitting's (ECAP) Preparing Natural Resources Technical Reports Procedure and
the latest NRTR Template (November 2017). Field work was conducted on January 9,
2019. Potential jurisdictional areas identified in the study area have not been verified by
the United States Army Corps of Engineers (USACE) or the North Carolina Division of
Water Resources (NCDWR). It is anticipated that the USACE will cover the potential
features associated with this project under a Preliminary Jurisdictional Determination
(PJD). The principal personnel contributing to the field work and document are provided
in Appendix B.
3.0 TERRESTRIAL COMMUNITIES
Three terrestrial communities were identified in the study area. Figure 4 shows the
location and extent of these terrestrial communities. Terrestrial community data are
presented in the context of total coverage of each type within the study area (Table 1).
Table 1. Coverage of terrestrial communities in the study area
Community
Dominant Species (Scientific name)
Coverage
ac.
Broomsedge (Andropogon virginicus)
Maintained/Disturbed
Multiflora rose (Rosa multiflora)
15.9
Sweet m Li uidambar s raci ua
American sycamore (Platanus
Piedmont Alluvial Forest
occidentalis)
1.5
Boxelder (Acer negundo)
Chinese privet Li ustrum sinense
Dry-Mesic Oak -Hickory
White oak (Quercus alba)
Forest (Piedmont Subtype)
Sourwood (Oxydendrum arboreum)
3.4
Cranefly orchid Ti ularia discolor
Total
20.8
June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N.C.
4.0 PROTECTED SPECIES
4.1 Endangered Species Act Protected Species
As of June 27, 2018, the United States Fish and Wildlife (USFWS) lists three federally
protected species, under the Endangered Species Act (ESA), for Wilkes County (Table
2). For each species, a discussion of the presence or absence of habitat is included below
along with the Biological Conclusion rendered based on survey results in the study area.
Table 2. ESA federally protected species listed for Wilkes County
Scientific Name
Common Name
Federal
Habitat
Biological
Status
Present
Conclusion
Glyptemys muhlenbergii
Bog turtle
T(S/A)
No
Not Required
Myotis septentrionalis
Northern long-eared bat
T
Yes
Meets 4(d)
rule
Bombus affinis*
Rusty -patched bumble
E
---$
N/A$
bee RPBB
Note: E — Endangered; T — Threatened; T(S/A) - Threatened due to similarity of appearance
* - Historic record (the species was last observed in the county more than 50 years ago)
$ The USFWS does not and will not require surveys for RPBB in North Carolina because USFWS assumes
the state is unoccupied by RPBB
Bog turtle
USFWS Recommended Survey Window: April 1 — October 1 (visual surveys); April 1-
June 15 (optimal for breeding/nesting); May 1-June 30 (trapping surveys)
Biological Conclusion: Not Required
Species listed as threatened due to similarity of appearance do not require Section
7 consultation with the USFWS. Moreover, suitable habitat (open, spring -fed,
emergent wetlands) is not present within the study area. A review of the April
2019 North Carolina Natural Heritage Program (NCNHP) database indicates no
known bog turtle occurrences within 1.0 mile of the study area.
Northern long-eared bat (NLEB)
USFWS Optimal Survey Window: June 1 — August 15
Biological Conclusion: Meets 4(d) rule
This species has been assessed by the NCDOT — Biological Surveys Group
(BSG). NCDOT has determined that the proposed action does not require
separate consultation on the grounds that the proposed action is consistent with
the final Section 4(d) rule, codified at 50 C.F.R. § 17.40(o) and effective February
16, 2016. NCDOT may presume its determination is informed by best available
information and consider Section 7 responsibilities fulfilled for NLEB.
2 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N. C.
Rusty -patched bumble bee (RPBB)
USFWS Recommended Survey Window: early -June — mid -August
Biological Conclusion: N/A
The USFWS lists RPBB as a historic record for Wilkes County, North Carolina.
Additionally, the USFWS does not and will not require surveys for RPBB in
North Carolina because USFWS assumes the state is unoccupied by RPBB.
Therefore, surveys for this species are not needed. A review of the April 2019
NCNHP database indicates no known occurrences of this species within 1.0 mile
of the study area.
4.2 Bald and Golden Eagle Protection Act
The bald eagle is protected under the Bald and Golden Eagle Protection Act and enforced
by the USFWS. Habitat for the bald eagle primarily consists of mature forests in
proximity to large bodies of open water for foraging. Large dominant trees are utilized
for nesting sites, typically within 1.0 mile of open water.
A desktop-GIS assessment of the study area, as well as the area within a 1.13-mile radius
of the project limits, was performed on January 5, 2019 using the most currently -
available orthoimagery. Water bodies large and sufficiently open enough to be
considered potential feeding sources were identified. Since foraging habitat was present
within the review area, a survey of the study area and the area within 660 feet of the
project limits was performed by Three Oaks staff on January 9, 2019. No nests or
individuals were observed. A review of the April 2019 NCNHP database revealed no
known occurrences of this species within 1.0 mile of the study area. Due to the lack of
habitat, known occurrences, and minimal impact anticipated, it has been determined that
this project will not affect this species.
5.0 WATER RESOURCES
The study area is part of the Yadkin — Pee Dee River Basin (U.S. Geological Survey
[USGS] Hydrologic Unit [HUC] 03040101). Eight potential streams were identified in
the study area (Table 3). The locations of each stream are shown on Figures 3 and 4.
3 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N.C.
Table 3. Potential streams in the study area
NCDWR
Best Usage
Bank
Bankfull
Depth
Stream Name
Map ID
Index
Classification
Height
width
(in.)
Number
(ft.)
(ft.)
Middle Prong
Middle Prong
12-46-2-(6)
C
4-8
40-60
8-48
Roaring River
Roaring River
West Prong Roaring
West Prong
12-46-1-(5)
C
4-8
40-60
8-48
River
Roaring River
Unnamed Tributary
(UT) to Middle
SA
12-46-2-(6)
C
1-2
1-2
2-10
Prong Roaring River
UT to West Prong
SB
12-46-1-(5)
C
0-1
1-1.5
1-3
Roaring River
UT to West Prong
SC
12-46-1-(5)
C
3-6
3-6
4-10
Roaring River
UT to West Prong
SD
12-46-1-(5)
C
2-3
2-3
0-2
Roaring River
UT to West Prong
SE
12-46-1-(5)
C
4-6
3-4
0-3
Roaring River
UT to West Prong
SF
12-46-1-(5)
C
4-6
3-4
0-3
Roaring River
There are no Outstanding Resource Waters (ORW), High Quality Waters (HQW), or
water supply watersheds (WS-I or WS-II) within the study area or within 1.0 mile
downstream of the study area. The project is located within a USACE-designated trout
watershed; however, the North Carolina Wildlife Resources Commission (NCWRC) does
not identify any trout waters within the study area or within 1.0 mile downstream of the
study area. The North Carolina 2016 Final 303(d) list of impaired waters identifies no
impaired waters within the study area or within 1.0 mile downstream of the study area.
One potential surface water (i.e., ponds, tributaries, or basins) was identified within the
study area (Table 4). The location of this surface water is shown on Figures 3 and 4.
Table 4. Potential surface waters in the study area
Surface Water
Map ID of
Acreage (ac.)
Connection
PA
SB
0.09
4 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N.C.
6.0 REGULATORY CONSIDERATIONS
6.1 Clean Water Act Waters of the U.S.
Eight potential jurisdictional streams were identified in the study area (Table 5). The
locations of these streams are shown on Figures 3 and 4. NCDWR stream identification
forms and North Carolina Stream Assessment Method (NCSAM) forms are included in a
separate PJD Package. All potential jurisdictional streams in the study area have been
designated as cool water streams for the purposes of stream mitigation.
Table 5. Characteristics of potential jurisdictional streams in the study area
Map ID
Length
(ft.)
Classification
Compensatory
Mitigation Required
River Basin
Buffer
Middle Prong
Roaring River
565
Perennial
Yes
Not Subject
West Prong
Roaring River
457
Perennial
Yes
Not Subject
SA
407
Perennial
Yes
Not Subject
SB
114
Intermittent
Undetermined
Not Subject
SC
696
Perennial
Yes
Not Subject
SD
63
Intermittent
Undetermined
Not Subject
SE
50
Intermittent
Undetermined
Not Subject
SF
31
Intermittent
Undetermined
Not Subject
Total
2,383
Two potential jurisdictional wetlands were identified within the study area (Table 6).
The locations of these wetlands are shown on Figures 3 and 4. All wetlands in the study
area are located within the Yadkin — Pee Dee River Basin (USGS HUC 03040101).
USACE wetland determination forms and North Carolina Wetland Assessment Method
(NCWAM) forms for each site are included in a separate PJD Package.
Table 6. Characteristics of potential jurisdictional wetlands in the study area
Map ID
NCWAM Classification
NCWAM
Rating
Hydrologic
Classification
Area (ac.) in
Study Area
WA
Non -tidal Freshwater Marsh
Medium
Riparian
0.01
WB
Non -tidal Freshwater Marsh
Medium
Riparian
0.01
Total
0.02
5 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N. C.
6.2 Construction Moratoria
The project is within a USAGE -designated trout watershed; however, the NCWRC does
not identify any trout waters within or within 1.0 mile downstream of the study area. The
potential for trout -related in -water moratoria will be determined when comments from
USACE and NCWRC are received. No bat -related moratoria are anticipated for this
project.
6.3 N.C. River Basin Buffer Rules
This project is located in the Yadkin Pee — Dee River Basin (USGS HUC 03040101).
Potential jurisdictional features within the study area are not subject to streamside
riparian zones protected under provisions administered by the North Carolina Department
of Environmental Quality (NCDEQ).
6.4 Rivers and Harbors Act Section 10 Navigable Waters
The USACE has not designated any waters in the study area as Navigable Waters under
Section 10 of the Rivers and Harbors Act.
6 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N. C.
7.0 REFERENCES
Environmental Laboratory. 1987. Corps of Engineers Wetlands Delineation Manual.
Technical Report Y-87-1, U. S. Army Engineer Waterways Experiment Station.
Vicksburg, Mississippi.
Environmental Laboratory. 1992. Clarification and Interpretation of the 1987 Manual,
memorandum from Major General Arthur E. Williams.
North Carolina Department of Environment and Natural Resources (NCDENR) -
Division of Water Resources. 2018. Final 2016 North Carolina 303(d) List.
https:Hfiles.nc.gov/ncdeq/Water%20Qualit /Planning/TMDL/303d/2016/2016 NC Category 5 3
03 d_list.pdf
North Carolina Natural Heritage Program (NCNHP). 2018. Natural Heritage Data
Explorer [Web Application]. NCDNCR, Raleigh, NC.
http://ncnhde.natureserve.org. (Accessed: April 30, 2019).
North Carolina Stream Functional Assessment Team. North Carolina Stream Assessment
Method (NCSAM) User Manual [Version 2.1]. 2012. PDF Document.
North Carolina Wetland Functional Assessment Team. North Carolina Wetland
Assessment Method (NCWAM) User Manual [Version 5]. 2016. PDF
Document. (Accessed: Accessed: January 7, 2019).
North Carolina Wildlife Resources Commission. (NCWRC) Bog Turtle Fact Sheet.
2018. https://www.ncwildlife.org/Leaming/Species/Reptiles/Bog-Turtle
Schafale, M.P. 2012. Guide to the Natural Communities of North Carolina: Fourth
Approximation. North Carolina Natural Heritage Program, North Carolina
Department of Environmental Quality (NCDEQ). Raleigh, North Carolina. 208
pp.
United States Army Corps of Engineers. 2012. Regional Supplement to the Corps of
Engineers Wetland Delineation Manual: Eastern Mountains and Piedmont Region
Version 2.0, ed. J. F. Berkowitz, J. S. Wakeley, R. W. Lichvar, C. V. Noble.
ERDC/EL TR-12-9. Vicksburg, MS: U.S. Army Engineer Research and
Development Center.
United States Department of Agriculture (USDA), Natural Resources Conservation
Service (MRCS). 1997. Soil Survey of Wilkes County, North Carolina.
United States Department of Agriculture (USDA), Natural Resources Conservation
Service (MRCS). 2018. Field Indicators of Hydric Soils in the United States,
Version 8.2. L.M. Vasilas, G.W. Hurt, and J.F. Berkowitz (eds.). USDA, NRCS,
in cooperation with the National Technical Committee for Hydric Soils.
7 June 2019

Natural Resources Technical Report STIP No. BR-0124, Wilkes County, N. C.
United States Fish and Wildlife Service. (USFWS) 2018. Bog Turtle.
hLtps://www.fws.gov/northeast/nyfo/es/bogturtle.htm
United States Fish and Wildlife Service. (USFWS) 2016. Northern long-eared bat — what
it means for your project.
hllp://www.fws.gov/asheville/htmis/project_review/NLEB_ in WNC.html.
United States Fish and Wildlife Service (USFWS) 2017. Northern long-eared bat — what
it means for your project. https://www.fws.gov/raleigh/NLEB RFO.html.
United States Fish and Wildlife Service. (USFWS) Northern long-eared bat (Myotis
septentrionalis). https:Hecos.fws. og v/ecp0/profile/speciesProfile?spcode=AOJE.
United States Fish and Wildlife Service (USFWS). Threatened and Endangered Species
in North Carolina: Wilkes County. Updated June 27, 2018.
https://www.fws.gov/raleigh/species/cntylist/wilkes.html.
United States Geological Survey (USGS). 2016. Traphill, North Carolina, Topographic
Quadrangle (7.5-minute series).
Weakley, Alan S. (Working Draft of May 21, 2015). Flora of the Southern and Mid -
Atlantic States. University of North Carolina Herbarium (NCU), North Carolina
Botanical Garden. Chapel Hill, NC. 1,320 pp.
8 June 2019

Appendix A
Figures

*1EfR! Prepared For:
oipo hp
4`jJ�4731'i1:Yy �tl�v, � 44
T flF P�
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.
over West Prong Roaring River
STIP No. BR-0124
Project Vicinity Map
Wilkes County, North Carolina
Date.
JUNE 2019
Scale:
0 200 400 Feet
Job No.:
18-025
rawn y:
IChecked By
CMR
I JSM
Figure

Est Proriq- Roarinq R
'L v
CI
i
USGS The National Map: National Boundaries Dataset, 3DEP
�
CoV�
Elevation Program, Geographic Names Information System, National
Hydrography Dataset, National Land Cover Database, National
Structures Dataset, and National Transportation Dataset; USGS Global
Ecosystems; U.S. Census Bureau TIGER/Line data; USFS Road Data;
Natural Earth Data; U.S. Department of State Humanitarian Information
Unit; and NOAA National Centers for Environmental Information, U.S.
Coastal Relief Model. Data refreshed October 2018.
Prepared For:
oer
o i
a
ap
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.;
over West Prong Roaring River
STIP No. BR-0124
Topographic Map
Wilkes County, North Carolina
Date:
APRIL 2019
Scale:
0 200 400 Feet
i
Job No.:
18-025
rawn y:
Checked By
CMR I
JSM
Figure

*1�IEfR! Prepared For:
oowohp y9
R' x
9yj�„� t�c�a T flF P�
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.
over West Prong Roaring River
STIP No. BR-0124
Jurisdictional Features Map
Wilkes County, North Carolina
Date.
JUNE 2019
Scale:
0 100 200 Feet
i
Job No.:
18-025
Drawn By.
Checked By
CMR
I JSM
Figure

�r��� Prepared For:
ii ��t aHrN �
o hp y9
owo
OF
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.
over West Prong Roaring River
STIP No. BR-0124
Terrestrial Communities Map
Wilkes County, North Carolina
Date.
JUNE 2019
Scale:
0 100 200 Feet
Job No.:
18-025
Drawn By.
Checked By
CMR
I JSM
Figure

Appendix B
Qualifications of Contributors
Principal
Investigator Nathan Howell
Education: B.S. Fisheries, Wildlife, and Conservation Biology, North Carolina
State University, 2013
M.S. Plant and Microbial Biology, North Carolina State
University, 2015
Experience: Environmental Scientist, Three Oaks Engineering, 2015-Present
Responsibilities: Wetland and stream delineations, natural community assessment,
T&E surveys, document preparation/review
Investigator: Mary Frazer
Education: M.E.M. (Master of Environmental Management), Resource
Ecology, Duke University, 1991
B.S. Zoology, University of Wisconsin, 1988
Experience: Environmental Specialist, Three Oaks Engineering, July 2015-
present
Environmental Program Consultant, NCDOT, 2000-2015
Environmental Specialist, Wisconsin Coastal Management
Program, 1996-2000
Water Regulation Specialist, Wisconsin Department of Natural
Resources, 1994-1996
Biologist, Soil and Environmental Consultants, 1992-1994
Responsibilities: Wetland and stream delineations, natural community assessment,
T&E surveys, GPS
Investigator: Lillian Lovingood
Education: B.S. Environmental Studies: Ecology and Environmental Biology,
UNC-Asheville, 2016
Experience: Environmental Scientist, Three Oaks Engineering, December
2018-Present
Aquatic Conservation Technician, NCWRC, March 2018-
November 2018
Responsibilities: Document preparation/review
Investigator James Mason
Education: B.A. Biology, Colby College, 2000
M.S. Biology/Ecology, UNC-Charlotte, 2004
Experience: Environmental Senior Scientist, Three Oaks Engineering, April
2018-Present
Environmental Program Consultant, NCDOT, 2006-2018
Responsibilities: Document preparation/review

Investigator: Evan Morgan
Education: B.S. Environmental Science, Virginia Tech, 2014
Experience: Environmental Scientist, Three Oaks Engineering, 2015-Present
Responsibilities: Wetland and stream delineations, T&E assessments
Investigator: Cary Rowells
Education: Coursework, Civil Engineering, Wake technical Community
College
Coursework, Geology, University of North Carolina at Wilmington
Experience: GIS Analyst, Three Oaks Engineering, 2015-Present
GIS analyst, Michael Baker Engineering, 2002-2015
Analytical Surveys, Inc., CADD Technician/GIS Technician/GIS
Project Coordinator, 1989-2002
Responsibilities: GIS Mapping, Microstation
Investigator: Lizzy Stokes -Cawley
Education: B.S. Conservation Biology, St. Lawrence University, 2011
M.E.M. Water Resources, Duke University, 2016
Experience: Environmental Scientist, Three Oaks Engineering, April 2017-
Present
Responsibilities: Wetland and stream delineations, T&E Assessments, GPS

Appendix C
Protected Species Survey Reports

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
February 7, 2019
Dear Landowner:
JAMES H. TROGDON, III
SECRETARY
The N.C. Department of Transportation (Department) is constantly working to provide -better and
safer transportation facilities for public uses in North Carolina. The effects that these proposed
facilities have on the human and natural environment are of great concern to the Department and
must be adequately described in environmental documents. As part of this process, the Department
is obligated to identify and document environmental resources so that they can be avoided or impacts
reduced. Streams and wetlands are two of the resources that must be identified during the review
process. The Department has begun planning studies for the proposed replacement of Bridge 166 on
Shady Mountain Road (S.R. 1745) over West Prong Roaring River in Wilkes County as TIP Project
BR-0124.
Over the next several months, representatives of the Department including engineers, surveyors,
geologists, and biologists as well as the U.S. Army Corps of Engineers, Wilmington District,
Regulatory Division, may be present on your property. They will be collecting data that will be used
to design the project and conducting or verifying the limits of streams and wetlands pursuant to
Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. These
representatives will be wearing highly reflective safety vests, have picture ID badges, and will be
hanging various colors of flagging, or ribbons, on trees and shrubs to identify the limits of streams
and wetlands, if present, on the property. This flagging does not indicate the final location of a
proposed transportation project, but it is very important in our environmental review process. Please
do not disturb this flagging.
Please note that if the U.S. Army Corps of Engineers has already issued a Jurisdictional
Determination on your property confirming the presence of streams and/or wetlands, or if you have
general questions or comments about the project, contact David Stutts at [e-mail] or (919)
707-6442.
If you call, please mention NCDOT project number BR-0124.
Thank you for your cooperation.
Sincerely,
Cam& Z�)'ar
�d2 Philip S. Harris III, P.E., C.P.M.
(/ Environmental Analysis Unit Head
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
ENVIRONMENTAL ANALYSIS UNIT
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
Telephone: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.gov
Physical Address:
1000 BIRCH RIDGE DRIVE
NCDOT CENTURY CENTER
BUILDING A
RALEIGH NC 27610

ySAT(
14� l V
ESTADO DE CAROLINA DEL NORTE
DEPARTMENTO DE TRANSPORTE
Roy COOPER
GOBERNADOR
7 de Febrero de 2019
Estimado propietario:
JAMES H. TROGDON, III
SECRETARIO
El Departamento de Transporte de Carolina del Norte (Departamento) trabaja constantemente para
ofrecer mejores y mas seguras instalaciones de transporte para el use pAblico en Carolina del Norte.
Los efectos que estas instalaciones propuestas tienen sobre el medio ambiente representan una gran
preocupaci6npara el Departamento y deben ser descritas adecuadamente en documentos ambientales.
Como parte de este proceso, el Departamento esta obligado a identificar y documentar recursos
ambientales con el fin de evitar o reducir los impactos. Los arroyos y los humedales son dos de los
recursos que deben ser identificados durante el proceso de revisi6n. El Departamento ha comenzado
los estudios de planeaci6n relacionados con su propuesta de Puente No. 166 Puente 166 en Shady
Mountain Road (S.R. 1745) sobre el Rio West Roble Rovering en el Condado de Wilkes como
identificado como Proyecto TIP BR-0124.
Durante los pr6ximos meses, es posible que representantes del Departamento, asi como del Cuerpo
de Ingenieros del Ej6rcito de los Estados Unidos del Distrito de Wilmington, pertenecientes a la
Divisi6n Regulatoria, se presenten en su propiedad con el prop6sito de conducir o verificar los limites
de cuerpos de agua y humedales de conformidad con la Secci6n 404 del Acta de Agua Limpia y/o la
Secci6n 10 del Acta de Rios y Puertos de 1899. Estos representantes vestiran chalecos de seguridad
altamente brillantes, llevaran credenciales de identificaci6n con fotografia y estaran colgando
banderines o listones de varios colores en arboles y arbustos para identificar los limites de arroyos y
humedales que existan en la propiedad. Este mapeo no significa que en la zona se contemple un
posible proyecto de transporte, pero es muy importante en nuestro proceso de analisis ambiental. Por
favor no retire dichos banderines o listones.
Por favor tome en cuenta que si el Cuerpo de Ingenieros del Ej6rcito de los EE.UU. ha emitido una
Determinaci6n Jurisdiccional en su propiedad confirmando la presencia de arroyos y/o humedales, o
si tiene preguntas o comentarios relacionados con el proyecto, por favor flame a la Linea Directa en
Espanol del NCDOT al 1-800-481-6494 o contacte al gerente del proyecto del NCDOT David Stuffs
at [e-mail] or [phone].
Cuando flame, por favor mencione el Proyecto TIP BR-0124 del NCDOT.
Gracias por su cooperaci6n.
Atentamente,
CaA& 7�).4yote"
,&Philip S. Harris III, P.E., C.P.M.
(/ Titular de la Unidad de Analisis Ambiental
Direccion de correo:
NC DEPARTMENT OF TRANSPORTATION
ENVIRONMENTAL ANALYSIS UNIT
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
Telefono: [phone]
Servicio a clientes: 1-877-368-4968
Sitio web: www.ncdot.gov
Direccion fascia:
1000 BIRCH RIDGE ROAD
NCDOT CENTURY CENTER
BUILDING A
RALEIGH NC 27610

bcc: Division Engineer
Jamille Robbins
Division ROW Agent
County Sheriff / City Police (if in municipality)
USACE Representative
Primary Project Contact (from letter)
L&S Area Locating Engineer
File

Roy COOPER
GOVERNOR
WO
FROM
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES H. TROGDON, III
SECRETARY
March 25, 2019
Heaven Manning
Environmental Coordination & Permitting Group Western, EAU
Melissa Miller, Environmental Program Consultant
Biological Surveys Group, EAU
SUBJECT: Section 7 survey results for the northern long-eared bat (Myotis
septentrionalis) associated with the replacement of Bridge No. 166 over
West Prong Roaring River on SR 1745 in Wilkes County, TIP No. BR-0124.
The North Carolina Department of Transportation (NCDOT, Division 11) proposes to
replace Bridge No. 166 over West Prong Roaring River on SR 1745 in Wilkes County, TIP
No. BR-0124. The existing bridge is a three span structure with steel plank deck, steel I -
beams, timber end walls and metal guard rails. The overall length of the structure is 136
feet.
Northern long-eared bat
The project to replace Bridge No. 166 has been reviewed for effects on the northern long-
eared bat (NLEB). As of May 4, 2015, NLEB is listed by the U.S. Fish and Wildlife Service
(USFWS) as "Threatened" under the Endangered Species Act of 1973. As of March 25, 2019,
NLEB is listed by USFWS (http://www.fws.gov/raleigh/speciesIcntylist/nc counties.html)
as "current" in Wilkes County. USFWS also established a final rule under the authority of
section 4(d) of the Endangered Species Act that provides measures for the conservation of
NLEB. The USFWS has tailored the final 4(d) rule to prohibit the take of NLEB from certain
activities within areas where they are in decline. This incidental take protection applies
only to known NLEB occupied maternity roost trees and known NLEB hibernacula.
Effective February 16, 2016, incidental take resulting from tree removal is prohibited if it 1)
occurs within a 1/4 mile radius of known NLEB hibernacula; or 2) cuts or destroys known
occupied maternity roost trees or any other trees within a 150-foot radius from the known
maternity tree during the pup season (June 1-July 31).
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT &
ENVIRONMENTAL ANALYSIS UNIT
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
TELEPHONE: [phone]
FAX• 919-212-5785
WEBSITE:NCDOT.GOV
Location:
CENTURY CENTER, BUILDING A
1020 BIRCH RIDGE DRIVE
RALEIGH NC 27610

According to the North Carolina Natural Heritage Program (NHP) Biotics Database, most
recently updated January 2019, the nearest NLEB hibernacula record is 42 miles west of
the project and no known NLEB roost trees occur within 150 feet of the project area.
NCDOT has also reviewed the USFWS Asheville Field office website
(http://www.fws.gov/asheville/htmis/project review/NLEB in WNC.html) for consistency
with NHP records. This project is located entirely outside of the red highlighted areas (12-
digit HUC) that the USFWS Asheville Field Office has determined to be representative of an
area that may require consultation.
For the proposed action, NCDOT has committed to the conservation measures listed below:
1) No alterations of a known hibernacula entrance or interior environment if it impairs
an essential behavioral pattern, including sheltering northern long-eared bats
(January 1 through December 31);
2) No tree removal within a 0.25 mile radius of a known hibernacula (January 1
through December 31); and
3) No cutting or destroying a known, occupied maternity roost tree, or any other trees
within a 150-foot radius from the known, occupied maternity tree during the period
from June 1 through and including July 31.
NCDOT has determined that the proposed action does not require separate
consultation on the grounds that the proposed action is consistent with the final
Section 4(d) rule, codified at 50 C.F.R. § 17.40(o) and effective February 16, 2016. NCDOT
may presume its determination is informed by best available information and consider
Section 7 responsibilities fulfilled for NLEB.
If you need any additional information, please contact Melissa Miller at 919-707-6127.

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
June 6, 2019
U.S. Army Corps of Engineers
ATTN: Steven Kichefski
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
JAMES H. TROGDON, III
SECRETARY
SUBJECT: Preliminary Jurisdictional Determination Package for the following Natural
Resources Technical Report: STIP No. BR-0124: Replace Bridge No. 960166 on SR
1745 (Shumate Mountain Road) over the West Prong Roaring River in Wilkes County,
North Carolina.
Mr. Kichefski,
The North Carolina Department of Transportation (NCDOT) proposes the replacement of Bridge No.
960166 on SR 1745 (Shumate Mountain Road) over the West Prong Roaring River in Wilkes County,
North Carolina. Below and attached are a brief description of the project, figures depicting all features,
and appropriate forms.
On January 9, 2019, Three Oaks Engineering (Three Oaks) staff members Nathan Howell, Evan
Morgan, Mary Frazer, and Lizzy Stokes -Cawley conducted a site investigation (Figure 1). Eleven
potential jurisdictional features (eight streams, two wetlands, and one pond) were identified within the
study area (Tables 1-4; Figures 2-3).
North Carolina Division of Water Resources (NCDWR) Stream Identification forms are included for
each potential stream where jurisdictionality was in question. North Carolina Stream Assessment
Method (NCSAM) forms were completed for streams that exhibited degraded conditions. United States
Army Corps of Engineers (USACE) wetland determination forms and North Carolina Wetland
Assessment Method (NCWAM) forms are included for each wetland. Please see the following PJD
Package:
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
ENVIRONMENTAL COORDINATION AND
PERMITTING
1598 MAIL SERVICE CENTER
RALEIGH, NC 27699-1598
Telephone: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.gov
Location:
CENTURY CENTER, BUILDING A
1000 BIRCH RIDGE DRIVE
RALEIGH, NC 27610

Table 1. Potential jurisdictional streams in the study area
NCDWR
Best Usage
Stream Name
Map ID
Index
Classification
Number
Middle Prong Roaring River
Middle Prong Roaring
12-46-2-(6)
C
River
West Prong Roaring River
West Prong Roaring
1 2-46-1-(5)
C
River
Unnamed Tributary (UT) to
SA
12-46-2-(6)
C
Middle Prong Roaring River
UT to West Prong Roaring River
SB
12-46-1- 5
C
UT to West Prong Roaring River
Sc
12-46-1- 5
C
UT to West Prong Roaring River
SD
12-46-1- 5
C
UT to West Prong Roaring River
SE
12-46-1- 5
C
UT to West Prong Roaring River
SF
12-46-1- 5
C
Table 2. Characteristics of potential jurisdictional streams in the study area
Compensatory
Map ID
Length
Classification
NCSAM Rating
Mitigation
River Basin
Buffer
Required
Middle Prong
565
Perennial
*
Yes
Not Subject
Roaring River
West Prong
457
Perennial
*
Yes
Not Subject
Roaring River
SA
407
Perennial
*
Yes
Not Subject
SB
114
Intermittent
Low/Low
Undetermined
Not Subject
Sc
696
Perennial
*
Yes
Not Subject
SD
63
Intermittent
Low/Low. .
Undetermined
Not Subject
in field only)'
SE
50
Intermittent
*
Undetermined
Not Subject
SF
31
Intermittent
*
Undetermined
Not Subject
Total
2,383
* NCSAM forms were not completed due to a lack of degraded conditions that would result in lower mitigation ratios.
1 This NCSAM Rating is only for the portion of Stream SD within the field. The wooded portion was assumed to require 2:1
mitigation.
Table 3. Characteristics of potential .jurisdictional wetlands in the study area
Map ID
NCWAM Classification
NCWAM
Ratio
Hydrologic
Classification
Area (ac.)
WA
Non -tidal Freshwater Marsh
Medium
Riparian
0.01
WB
Non -tidal Freshwater Marsh
Medium
Riparian
0.01
Total
0.02

Table 4. Potential surface waters in the study area
Map ID of
Surface Water
Acreage (ac.)
Connection
PA
SB
0.09
If you have any questions, require additional information, or would like to schedule a site visit, please
contact me at [phone] or by email at [e-mail]. This is a request for concurrence
with our assessment. We appreciate your assistance on this project.
Sincerely,
Ron Johnson
North Carolina Department of Transportation
Environmental Analysis Unit
Cc: Dave Wanucha, NCDWR

Appendix A
Figures

*1EfR! Prepared For:
oipo hp
4`jJ�4731'i1:Yy �tl�v, � 44
T flF P�
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.
over West Prong Roaring River
STIP No. BR-0124
Project Vicinity Map
Wilkes County, North Carolina
Date.
JUNE 2019
Scale:
0 200 400 Feet
Job No.:
18-025
rawn y:
IChecked By
CMR
I JSM
Figure

Inset 2
Sc
SD
SF
[SE
SCi r \
SD
River
West Prong
Roaring River
WB
USG - The National Map:
National�oundaries Dataset,
3DEP Elevation Program,
1�
P
r 000
�r
WB rn �-•
Ir,
.I Sc
See Inset 2
SB
L—
PA]
SA
;Inset 1
WA
le-00" ; 4 =
SA USGS The National Map:
National Boundaries Dataset,
3DEP Elevation Program,
Prepared For:
�E tiuhrk �,.
r
s'\4s
r�
Legend
Project Study Area
Potential Wetland Waters of the U.S.
Potential Non -Wetland Waters of the U.S. (Pond)
Potential Non -Wetland Waters of the U.S. (Stream)
Culvert
Intermittent
Perennial
See Inset 1
SA
o,
Middle Prong
Roaring River
USGS The National Map: National Boundaries Dataset, 3DEP
Elevation Program, Geographic Names Information System, National
Hydrography Dataset, National Land Cover Database, National
Structures Dataset, and National Transportation Dataset; USGS Global
Ecosystems; U.S. Census Bureau TIGER/Line data; USFS Road Data;
Natural Earth Data; U.S. Department of State Humanitarian Information
Unit; and NOAA National Centers for Environmental Information, U.S.
Coastal Relief Model. Data refreshed October 2018.
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.)
over West Prong Roaring River
STIP No. BR-0124
Topographic Map
Wilkes County, North Carolina
Date:
JUNE 2019
Scale:
0 100 200 Feet
Job No.:
18-025
yawn By:
Checked By
CMR
JSM
Figure

*1�IEfR! Prepared For:
oowohp y9
R' x
9yj�„� t�c�a T flF P�
Replacement of Bridge No. 166
on SR 1745 (Shumate Mountain Rd.
over West Prong Roaring River
STIP No. BR-0124
Jurisdictional Features Map
Wilkes County, North Carolina
Date.
JUNE 2019
Scale:
0 100 200 Feet
i
Job No.:
18-025
Drawn By.
Checked By
CMR
I JSM
Figure

Appendix B
Stream and Wetland Data Forms

V
NC DWQ Stream Identification Form Version 4.11
Date:
projecusite: e.
Latitude:
Evaluator: ya'lr^ 0 fA C' V'1
County: k_-c5
Longitude.
Total points.,
Stream isatleast inte►mittent
if;> 19 or o ennialita 3o" 3�
Stream Determination (circle one)
Ephemeral Intermitte rennial
p
Other
g.g. Quad Name:
ff-�91 e
A. Geomorphology Subtotal = Ig
Absent
Weak
Moderate
Strong
1a' Continuity of channel bed and bank
0
1
2
2. Sinuosity of channel along thalweg
0
1
3
3_ In -channel structure: ex. riffle -pool, step -pool,
ripple -pool sequence
0
1
,•-,
3
4. Particle size of stream substrate
0
_
2
3
5. Activelrelict floodplain
0
1
2
3
S. Depositionaf bars or benches
0
2
3
7, Recent alluvial deposits
0
1
2
3
S. Headcuts
0
1
2
3
9. Grade control
0
0,5
1
1.5
10. Natural valley
0
0.5
U
1.5
11. Second or greater order channel
a
No = 0
Yes = 3
arnn0we arLwes are not rated; see discussions in menual
B. Hydrology Subtotal =
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
1
2
3
14. Leaf fitter
C1.5
1
0.5
0
15. Sediment on plants or debris
0
0.5
1
1.5
16. Organic debris lines or piles
0
0_5
1.5
17. Soil -based evidence of high water table?
No = 0
Yes = 3
k,. Biology (Subtotal = _ 7. )
I & Fibrous roots in streambed
2
1
0
19. Rooted upland plants in streambed
2
f
0
20. Macrobenthos (note diversity and abundance)
0
1
2
3
21. Aquatic Mollusks
1
2
3
22. Fish
0.5
1
1.5
23. Crayfish
1 0.5
1
1.5
24. Amphibians
0
0.5
1
1.5
25. Algae
0
07
1
1.5
26. Wetland plants in streambed
FAGW = 0.75; OBL = 1.5 other -
"perennial streams may also be identified using other methods. $ee p, 35ofmanual.
Notes: c I
Sketch: �� r�o re_
{%� 04
1" 1�
Bank Height (ft): /' z
Bankfull width (ft). 7-
Water depth (in): Z,- I D
Channel substrate - Clay It, Sand, Grave, ❑bbie,
Bedrock
Veloaty - fast, erate low
Clarity le lightly turbid, turbid
rJ

5-b-
NC DWQ Stream Identification Farm Version 4.11
Baba; f
I I !Z_0I � Prsojec#Blte;
6R-- U + � Latitude: 3�, 212�DSo
Evaluator: V G n M QVr t �� County- ,. tY- U i kt rj Longitude: --d1. �9ra�i y 1'7 j
Total points:
sfam is at least intermittent Stream in Cirde one) Other
.a z 19 or erenniat itz 30• Z �� Ephemeral n erBanial a.g. Quad Name: l�rx " 11
A. Ceomo halo 11 Subtotal = �
Absent
1° Continuity of channel bed and bank
0
2 Sinuosity o#channel along t#talweg
0
3. In -channel structure: ex. riffle -pool, step -pool,
n le ool S uence
0
4. Particle size of stream substrate
S. Activelrelict Aoodplain
0
6. 13epositionaI tars or benches
0
T Recent alluvial deposits
0
$. 1 iPadCutS
9. Grade control
10. Natural van y
0
U
11. Second or greater order channel
atft;iai dltehas are rmt rated; see disou"ons in manual
i3. H drology (Subtotal = V.
12. Pfesettce of Baseflow
0
13. Iron oxidizina bacteria
14. Leaf litter
1 5
It). Sediment on plants or debris
0
Ifi, Organic debris fines or eiles
0
17. Soil -teased evidence of high water table?
C. 8 Acl subtotal =
18, Fibrous roots in streamed
3
19, booted upland plarits in streambed
3
20. Macrobenthos (RD* diversity and abundance)
21. Aquatic Mollusks
22. Fish
23. Crayfish
24. Amphibians
25. Algae
0
26 Wetland Plants in streambed
'perennial stm$ms may also be iderfified using other methods. See P. 35 of man"
i n e 7!■Ip,(f J�l.►nf
Lei
gtfp � OL��-
Sketch: r44# 4heo.'n�,}
�� C
3
3
3
3
3
3
1-5
1.5
3
3
0
1_5
1.5
CV 1
0
2 1
a
1 2
3
1 2
3
0.5 1
1.5
0.5 1
1.5
0.5 1
1.5
0.5 1
1-5
FACW = 0-75; OBL = 1.5 her = 0
al.
1►K' NSIr. ► t J_ rd.r
di L 4
410'o-_ "'Ic.
Bank Height (ftp } — 1
Bankfull width (ftl: 1-1.5
Water depth (in): 1-3
Channel substrate -Clay, 11t, Sand ravel, Cobble, Bedrock
velodty —fast moderate slow
Clarity—rdear, ightly turbid, turbid

I
M
NC DWQ Stream Identification Form Version 4,11
Daft: 1 �G I Projecusfte: -59 _ o l Z Latitude: 3(o r 1
Bvalua#ar: �I/ Cou _._.__ Longitude,
•�-•' 1...+ �(b.+ �1-- . IT.+f}' L—V r.'n►6CI "' - arj►r yy �,�+1J
-01
Total Paints: Stream Determination (circle one !� 2?Y f1
Stream is of Least jnrermltrepf � t f l7tttier Ufa _
f9 or erennial if � 3D' Epfieme n nmitt erennial e.g Quea Neme. T r rf-fl
A. [ieoMo hol Subtotal -61i�;)
1' Continulty of channel bed and bank
Absent,
0
Weak
1
Moderate
2
str
3
2. Sinuosity of channel along thalweg ---
3. In -channel structure: ex riffle -pool, step -pool,
�Rple:2ool sequence
0
0
2"
Z
�- 3 —
3
4. Particle size of stream substrate
0
1
2
3
5. Acme/relict floodplain
1
2
3
6, Deposttional bars or benches
f
2
3
T Recent alluvial deposJts
0
2
3
8. heBldCuts
0
i
2
3
9. Grade control
It
10. Natural valley
0
0.5
1
1 5
i 1. 5eaarad or greater order channel
No, 0
Yes = 3
w1:Fk1;5tu inmanuai
B. Hydrology {Subtotal w t
i2. Presence of Baseflow
D
i
3
13. Iron oxidizing bacteria
0
14. Leaf litter
1.5
1
0.5
0
15. Sediment on plants or debris
" fl 5
16. Organic debris lines or piles
0
5
1
1 5
11. Soil-trased evidence of high water table?
Na = 0
Ye =
6. rldrous roots in streambed
3
2
1
0
19. Rooted upland plants in strearnbed
" 3
2
1
0
crB a os i;nofe diverslty and ab indanoe)
0
1
2 -
3
21. Aquatic Mollusks
1
2
3
22. Fish —
0.5
1
1.5
23 Grayish
0.5
0.5
1
1
1.5
1.5...-__
--
24. Amphibians
25. Algae
05
_ FACW = 0.75; DBL. = 1.5 Othe = 0
2F Wetla nd plants in streambed —
'perennial strears may also be ide tfied using other methods. See p_ 35 of manual
Notes: ��— sue; _fir
Sketch:�5r�/e j
In
Bank Height tft]:
Bankfull width lft]; Z-25
Water depth [in42,Silt
Channel substra Sand, Gravel obble.
sedrock
Velocity • fast, moderate
Clari tle ightlyturbid, turbid

00* sf-
NC DWQ Stream Identification Feria Versinn A. t 1
Date: A
Latitude:
Evaluator: /
^rCLn l.'l/`J6II 4o�i
Gang:
_��.
Longidlde:
_
Total
isPoints:as
Sf1vl►arrrlsafFaastl►rfermFi7enr
Stream Getermi 'on circle one
Other
fl a 19 arereniva! ►f a 30,
l herrlera ntsrmltten Perennial
p
e.g Quad Name:"�i-���,iit
A. Geomor hot Subtotal =
1` Continuity of channel bed and bank
Absent
0
Weak
1
Moderate
2
Strong
3
2. Sinuosity of channel along thahaeg _
0
, 4
2
2
-" 3
3
3. In -channel structure: ex riffle -pool, step -pool,
rile ool sequence
-- —Q
4. Particle size of stream substrate
0
(
2
3
5. Activefrelict tloodplain
0
i
2
3
6_ De}�ositbnal bars or benches
0
3
7• Repent alluvial deposits
0
2
3
8. Headcuts
0
�-
i
q 5
2
1
3
1 5-
9. Grade control
10. Natural valley
0
0.5
1
11, Second or greater order channel
s_
No_4 0
Yes = 3
emu, �� wa�u ans m manual
B. Hydrology (Subtota f = ---!f -5)
12. Presence of i3aseflow
0
1
2
3
xidizin hsderia
�Leaf
0
1
2
3
itter
�1.6 .>
1
0-5
0
15. Sediment on plants or debris
D
rp 5�
1
15
16. Organic debris lines or piles
0
1
1.5
17. Soil -based evidence of high er table?
Na = t}
Yes 3
— r IWFWWV Lvuv[VLal — (O 1
us roots in strearnbed
3
2
1
0
ted upland plants in streambed
3
1
0
r8 en os (note diversity and abundanoej �
0
1
2
3
tic Mollusks
-0
1
2
3
rWetlend
fish
_
0.5 _
_ O.S _
0 5 �Y
FACW = 0.75: 0131- = 1.5
1
1
1 -
Cthe - 0
1.5
1.5 -
1.55
___.� ---- -.
hibians
_.._.. _ _
__�—
and plants in streambed
_
'perennial, strew s rney also be idepri5ed using other methods. 5se p. 35 of manual
��
Not es: r; '� �,'� )�,��
Sketch: re
lrsGs— �S
N0-t-5- 0
10
Bank Height {ft}:
Bankfull width (ft)._?
Water depth (inl: 0 -_
Channel substrate - Cla . Slat Sand Grwvel. obble,
Bedrock
Velocity - Fast, moderat el 11
Ciari a lightly turbid, turbid

SF
NC DWQ Stream Identification Form Ve.rcinn a. I I
Die: A `� J�
Pro*MrW: --
Latitude:
A, �.�j
, oL�
qq
Evaluator: �+. � �s� God�'•+���
County:
l.onSitud
--
Total Points:
SYrearn Is at onfd10W f►it? 3 tr'
ft x f 9 or e►enrrial !! a 30 ` `� �
Stream l7eterrnin circle one)
E hsmera rm *nt erenniat
P
Other
a.p Quad Narne: � l r
�rq � ,
A. Geomorphology ( Subtotal
Absent
Weak
Moderate
Strong
1" Continulky of channel bed and bank
---
0
1
2
i 3
2. Sinuosity of channel "ng thalweg
0
-- 2_.
_ 3
3. In -channel structure: ex riffie-pool, step -pool,
d le ool sequence
0
2
3
4. Particle size of stream substrate
0
2
3
5. Acfivelreiict floodplain
,�: 0
1
2
3
6. Deposidonai bars or benches
`Q!'
1
2
3
7. Recent alluvial deposits
0
1
2
3
8. Headcuts
- 0
i 1
2
3
9. Grade control
0
:5
1
1.5
1[}_ Natural
11. Second or greater order channel
a_
Nn = t]
Yeses
o,unc.OMI uivaless at[y nut ra[@atSCI Mons In rranual
B. Hydrology (subtotal = $;CS 1
12. Presence of Baseflow
0
1
2
3
13. iron oxidizing bacteria
0
'1
2
3
14, Leaf litter
ii.5_T
0.5
0
15, Sediment on plants or debris
0
0.5
1
1 5
16. Organic debris lines or piles
0
ids
1
1-5
17. Soil based evidence of high water table?
Igo = 0
Ye = 3
�.. urV VVY �QULAUteal -- ilk _ )
Li 18. Fibrous roots in streambed
-3
2-
1
0
19- Rooted upland plants in streambed
3
2
1
0
o a os note diversity and abundance)
0
1
2
3
tic Mollusks
��',
1
2
3
223Crayrish
i �/
0.5
1
1.5
y -
0.5
— 0.5
1ibians'
1
1 --
1.5
-
1.5
25_ Algae
05 - —
26 Wetland plants in strearnbed
_
FACW = 0.75: OBL = 1.5 Other 0
_
`perennial stree rs may also be i Ufled using other methods. Seep. 35 of manual_-
fY LVO
Sketch: , �, - re 3
rl��t
_ Bank Height [fti;
Bankrull width (ft):3
Water depth (in),b
Channel 5ub5t1rate •`ay. Silt, Sand, Gravel, bble,
Bedrock
V00city - Wt, ear moderat�
Clafity ightly NMI turbid

Accompanies user manual version z.-i
USACE AID #: NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any 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): BR-0124 2. Date of evaluation: 1/9/2019
3. Applicant/owner name: NCDOT 4. Assessor name/organization: E. Morgan - Three Oaks
5. County: Wilkes 6. Nearest named water body
7. River Basin: Yadkin-PeeDee on USGS 7.5-minute quad: West Prong Roaring River
8. Site coordinates (decimal degrees, at lower end of assessment reach): 36.29240517,-81.09684191
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SB 10. Length of assessment reach evaluated (feet): 90
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 2-4 F Unable to assess channel depth.
12. Channel width at top of bank (feet): 2-8 13. Is assessment reach a swamp stream? �` Yes r No
14. Feature type: r Perennial flow C: Intermittent flow r Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: C' Mountains (M) C: Piedmont (P) C' Inner Coastal Plain (1) C' Outer Coastal Plain (0)
16. Estimated geomorphic J'
valley shape (skip for r a C: b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip % Size 1 (< 0.1 miZ) r Size 2 (0.1 to < 0.5 miZ) r Size 3 (0.5 to < 5 mil) r Size 4 (>- 5 miZ)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? 6- Yes (_ No If Yes, check all that appy to the assessment area.
F Section 10 water FIClassified Trout Waters F Water Supply Watershed ( C' I C' II C' III C' IV (' V)
F Essential Fish Habitat F Primary Nursery Area F High Quality Waters/Outstanding Resource Waters
F Publicly owned property F NCDWR riparian buffer rule in effect F Nutrient Sensitive Waters
F Anadromous fish F 303(d) List F CAMA Area of Environmental Concern (AEC)
F Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
F Designated Critical Habitat (list species):
19. Are additional stream information/supplementaryinformation/supplementary measurements included in "Notes/Sketch" section or attached? C' Yes C: No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
C: A Water throughout assessment reach.
C' B No flow, water in pools only.
C' C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
C: A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
C' 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).
C: 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).
C' 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).
C A < 10% of channel unstable
B 10 to 25% of channel unstable
C' 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 C' A Little or no evidence of conditions that adversely affect reference interaction
C: B C: 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 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

7. Water Quality Stressors — assessment reach/intertidal zone metric
Check all that apply.
F A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
F B Excessive sedimentation (burying of stream features or intertidal zone)
F C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
F D Odor (not including natural sulfide odors)
F E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
FIF Livestock with access to stream or intertidal zone
F G Excessive algae in stream or intertidal zone
F H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
F I Other: (explain in "Notes/Sketch" section)
F J Little to no stressors
8. Recent Weather —watershed metric
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 (a 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)
F A Multiple aquatic macrophytes and aquatic mosses --a E F F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) H M F G Submerged aquatic vegetation
F B Multiple sticks and/or leaf packs and/or emergent o cn F H Low -tide refugia (pools)
vegetation s o F I Sand bottom
F C Multiple snags and logs (including lap trees) m F J 5% vertical bank along the marsh
F D 5% undercut banks and/or root mats and/or roots V F K Little or no habitat
in banks extend to the normal wetted perimeter
FIE 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)
11 a. r 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).
FIA Riffle -run section (evaluate 11c)
FIB Pool -glide section (evaluate 11d)
F_ C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles 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 s 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)
r r (a r r Silt/clay (< 0.062 mm)
Detritus
Artificial (rip -rap, concrete, etc.)
11d. r 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 Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. ii Yes i` 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. i' Yes (a 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.
F F Adult frogs
F F Aquatic reptiles
F F Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
F F Beetles (including water pennies)
F F Caddisfly larvae (Trichoptera [T])
F F Asian clam (Corbicula )
F F Crustacean (isopod/amphipod/crayfish/shrimp)
F F Damselfly and dragonfly larvae
F F Dipterans (true flies)
F F Mayfly larvae (Ephemeroptera [E])
F F Megaloptera (alderfly, fishily, dobsonfly larvae)
F F Midges/mosquito larvae
F F Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
F F Mussels/Clams (not Corbicula )
F F Other fish
F F Salamanders/tadpoles
F F Snails
F F Stonefly larvae (Plecoptera [P])
F F Tipulid larvae
F F 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
G B
G B
Moderate alteration to water storage capacity over a majority of the streamside area
C
r C
Severe alteration to water storage capacity over a majority of the streamside area (examples include: 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
i` A C` A Majority of streamside area with depressions able to pond water >_ 6 inches deep
G B Ci B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
(` C 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
i` Y C` Y Are wetlands present in the streamside area?
f+'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.
F A Streams and/or springs (jurisdictional discharges)
FIB Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
F C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
FID Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
FIE Stream bed or bank soil reduced (dig through deposited sediment if present)
F F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
F A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
F B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
F C Urban stream G! 24% impervious surface for watershed)
FAD Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
F E Assessment reach relocated to valley edge
F F None of the above
I B. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
C` A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
C` B Degraded (example: scattered trees)
C: 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
G A G A
C` A i` A
>: 100-feet wide or extends to the edge of the watershed
(` B r B
r B r B
From 50 to < 100-feet wide
r C r C
r C r C
From 30 to < 50-feet wide
r D (_ D
(o- D C` D
From 10 to < 30-feet wide
r E r E
r E G 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
C' A A Mature forest
G B B Non -mature woody vegetation or modified vegetation structure
C' C C: C Herbaceous vegetation with or without a strip of trees < 10 feet wide
C` D` D Maintained shrubs
C' 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: F
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
A C'A A CA C'A C'A Row crops
C` B r B C` B C` B C` B C` B Maintained turf
C' C C' C C' C i' C C' C C' C Pasture (no livestock)/commercial horticulture
C: D C: D C: D G D C: D C: 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
C' A C' A Medium to high stem density
C: B r B Low stem density
(— C 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
C: A C: A The total length of buffer breaks is < 25 percent.
r B r B The total length of buffer breaks is between 25 and 50 percent.
r C C` C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of 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
C' A C' 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.
r B C` 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 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. C` Yes C: No Was a conductivity measurement recorded?
If No, select one of the following reasons. C' No Water C' Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
f— A <46 f— B 46 to < 67 r C 67 to < 79 r D 79 to < 230 r E >> 230
Notes/Sketch:

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name BR-0124
Stream Category Pb1
Notes of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Date of Evaluation 1/9/2019
Assessor Name/Organization E. Morgan - Three Oaks
NO
NO
NO
Function Class Rating Summary
USACE/
All Streams
NCDWR
Intermittent
(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
(3) Tidal Marsh Stream Geomorphology
LOW
MEDIUM
LOW
LOW
MEDIUM
LOW
NA
LOW
MEDIUM
LOW
MEDIUM
NA
NA
NA
NA
NA
LOW
MEDIUM
LOW
LOW
MEDIUM
LOW
NA
LOW
MEDIUM
LOW
MEDIUM
NA
NA
NA
NA
NA
(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
LOW
MEDIUM
LOW
LOW
LOW
YES
HIGH
NA
LOW
MEDIUM
LOW
LOW
LOW
YES
NA
NA
(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 Habitat
LOW
LOW
MEDIUM
LOW
MEDIUM
LOW
LOW
LOW
LOW
NA
NA
NA
NA
NA
NA
NA
LOW
LOW
MEDIUM
LOW
MEDIUM
LOW
LOW
LOW
LOW
NA
NA
NA
NA
NA
NA
NA
Overall
LOW
LOW

Accompanies user manual version z.-i
USACE AID #: NCDWR #:
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any 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): BR-0124 2. Date of evaluation: 1/9/2019
3. Applicant/owner name: NCDOT 4. Assessor name/organization: E. Morgan - Three Oaks
5. County: Wilkes 6. Nearest named water body
7. River Basin: Yadkin-PeeDee on USGS 7.5-minute quad: West Prong Roaring River
8. Site coordinates (decimal degrees, at lower end of assessment reach): 36.294714,-81.098354
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SD -in field only 10. Length of assessment reach evaluated (feet): 30
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 2-4 F Unable to assess channel depth.
12. Channel width at top of bank (feet): 2-4 13. Is assessment reach a swamp stream? (' Yes No
14. Feature type: (' Perennial flow Intermittent flow (' Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: C' Mountains (M) Ci Piedmont (P)` Inner Coastal Plain (1) (` Outer Coastal Plain (0)
16. Estimated geomorphic J'
valley shape (skip for a C: b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip (i Size 1 (< 0.1 miZ) (' Size 2 (0.1 to < 0.5 miZ) f -Size 3 (0.5 to < 5 mil) (' Size 4 (>- 5 miZ)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? (i Yes (' No If Yes, check all that appy to the assessment area.
F Section 10 water F-1 Classified Trout Waters F Water Supply Watershed ( C I (` II C III (` IV C V)
F Essential Fish Habitat F Primary Nursery Area F High Quality Waters/Outstanding Resource Waters
F Publicly owned property F NCDWR riparian buffer rule in effect F Nutrient Sensitive Waters
F Anadromous fish F 303(d) List F CAMA Area of Environmental Concern (AEC)
F Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
F Designated Critical Habitat (list species):
m
in
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
(- A Water throughout assessment reach.
C B No flow, water in pools only.
C C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
C A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
fi 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).
C. 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).
C 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
(i 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
C A C A
Little or no evidence of conditions that adversely affect reference interaction
(F 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 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

7. Water Quality Stressors — assessment reach/intertidal zone metric
Check all that apply.
F A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
F B Excessive sedimentation (burying of stream features or intertidal zone)
F C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
F D Odor (not including natural sulfide odors)
F E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
F-I F Livestock with access to stream or intertidal zone
F G Excessive algae in stream or intertidal zone
F H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
F I Other: (explain in "Notes/Sketch" section)
FI J Little to no stressors
8. Recent Weather —watershed metric
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.
C A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
C 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
C Yes C*- 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. C Yes C 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)
F A Multiple aquatic macrophytes and aquatic mosses m N F F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) P m F G Submerged aquatic vegetation
F B Multiple sticks and/or leaf packs and/or emergent o cn F H Low -tide refugia (pools)
vegetation 0 s o F I Sand bottom
F C Multiple snags and logs (including lap trees) 12 F J 5% vertical bank along the marsh
F D 5% undercut banks and/or root mats and/or roots V F K Little or no habitat
in banks extend to the normal wetted perimeter
FIE 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)
11 a. C 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).
FI A Riffle -run section (evaluate 11 c)
F1 B Pool -glide section (evaluate 11 d)
F_ C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles 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 s 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
C' (' C Bedrock/saprolite
(— Boulder (256 — 4096 mm)
C (_0 C C C Cobble (64 — 256 mm)
C C. Gravel (2 — 64 mm)
C Sand (.062 — 2 mm)
(— Silt/clay (< 0.062 mm)
C C_0 C C C Detritus
C C C C.. Artificial (rip -rap, concrete, etc.)
11d. C4 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 Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. C: 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 C Other:
12b. C: Yes C' 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.
F F Adult frogs
F F Aquatic reptiles
F F Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
F F Beetles (including water pennies)
F F Caddisfly larvae (Trichoptera [T])
F F Asian clam (Corbicula )
F F1 Crustacean (isopod/amphipod/crayfish/shrimp)
F F Damselfly and dragonfly larvae
F F Dipterans (true flies)
F F Mayfly larvae (Ephemeroptera [E])
F F Megaloptera (alderfly, fishfly, dobsonfly larvae)
F F Midges/mosquito larvae
F F Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
F F Mussels/Clams (not Corbicula )
F F Other fish
F F Salamanders/tadpoles
F F Snails
F F Stonefly larvae (Plecoptera [P])
F F Tipulid larvae
F F 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
C A
C A
Little or no alteration to water storage capacity over a majority of the streamside area
Ci B
C: B
Moderate alteration to water storage capacity over a majority of the streamside area
C
C. C
Severe alteration to water storage capacity over a majority of the streamside area (examples include: 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
C A C A Majority of streamside area with depressions able to pond water >_ 6 inches deep
f B C B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
C—a C Ce 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
C Y r Y Are wetlands present in the streamside area?
(-a N G 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.
F A Streams and/or springs (jurisdictional discharges)
F-I B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
F C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
F-I D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
FIE Stream bed or bank soil reduced (dig through deposited sediment if present)
F F None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
F A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
F B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
F_ C Urban stream (>- 24% impervious surface for watershed)
FI D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
F E Assessment reach relocated to valley edge
F F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
C A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
C" 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
Ci A CJ A
C A C A
>- 100-feet wide or extends to the edge of the watershed
C B r B
C B C B
From 50 to < 100-feet wide
C. C C.. C
Cam. C C.. C
From 30 to < 50-feet wide
C. D C.. D
C D C D
From 10 to < 30-feet wide
C E C E
C: E C: 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 C" B Non -mature woody vegetation or modified vegetation structure
(—a C Ca C Herbaceous vegetation with or without a strip of trees < 10 feet wide
C. D C.. D Maintained shrubs
C E C 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: F
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
(� A Co— A (F A (- A Ci A (� A Row crops
C B r B C B C B C B C B Maintained turf
C. C Cam. C Cam. C Cam. C C.. C C.. C Pasture (no livestock)/commercial horticulture
(— D C D (' D (— D C' 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
C' A C' A Medium to high stem density
(' B C' B Low stem density
(—a C Ca- 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
(F A G A The total length of buffer breaks is < 25 percent.
C B C B The total length of buffer breaks is between 25 and 50 percent.
C. C C C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of 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
C A C 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.
C' B C' 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. C. Yes (F No Was a conductivity measurement recorded?
If No, select one of the following reasons. (— No Water C Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
C' A <46 f B 46 to < 67 C` C 67 to < 79 C` D 79 to < 230 f— E >> 230
Notes/Sketch:

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name BR-0124
Stream Category Pb1
Notes of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Date of Evaluation 1/9/2019
Assessor Name/Organization E. Morgan - Three Oaks
NO
NO
NO
Function Class Rating Summary
USACE/
All Streams
NCDWR
Intermittent
(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
(3) Tidal Marsh Stream Geomorphology
LOW
MEDIUM
LOW
LOW
MEDIUM
LOW
NA
LOW
MEDIUM
LOW
LOW
NA
NA
NA
NA
NA
LOW
MEDIUM
LOW
LOW
MEDIUM
LOW
NA
LOW
MEDIUM
LOW
LOW
NA
NA
NA
NA
NA
(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
LOW
MEDIUM
LOW
LOW
LOW
NO
LOW
NA
LOW
MEDIUM
LOW
LOW
LOW
NO
NA
NA
(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 Habitat
LOW
LOW
MEDIUM
LOW
MEDIUM
LOW
LOW
LOW
LOW
NA
NA
NA
NA
NA
NA
NA
LOW
LOW
MEDIUM
LOW
MEDIUM
LOW
LOW
LOW
LOW
NA
NA
NA
NA
NA
NA
NA
Overall
LOW
LOW

WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region
Project/Site: BR-0124 City/County: Hays/Wilkes Sampling Date: 1/9/2019
Applicant/Owner: NCDOT State: NC Sampling Point: wAMBwET
Investigator(s): E. Morgan, N. Howell - Three Oaks Section, Township, Range: ---
Landform (hillside, terrace, etc.): floodplain Local relief (concave, convex, none): concave Slope (%): 0-2
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 36.294722 Long:-81.098218 Datum: NAD 83
Soil Map Unit Name: See below NWI classification: PEM
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks:
Soils: Ronda loamy sand, 0 to 5 percent slopes, occasionally flooded (RyB) (WA); Pfafftown fine sandy loam, 1 to 6 percent slopes, rarely flooded
(PaB) (WB). Both wetlands appear to be floodplain benches that have converted to small, PEM wetlands. Point taken in WB.
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply)
_Surface Soil Cracks (B6)
_Surface Water (Al)
_True Aquatic Plants (B14)
_Sparsely Vegetated Concave Surface (B8)
X High Water Table (A2)
—Hydrogen Sulfide Odor (Cl)
—Drainage Patterns (B10)
X Saturation (A3)
_Oxidized Rhizospheres on Living Roots (C3)
_Moss Trim Lines (1316)
—Water Marks (B1)
—Presence of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (B2)
_Recent Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_ Drift Deposits (B3)
_Thin Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (B4)
_Other (Explain in Remarks)
_Stunted or Stressed Plants (D1)
_ Iron Deposits (135)
X Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (137)
—Shallow Aquitard (D3)
—Water-Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
X FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes
No X Depth (inches): 0
Water Table Present? Yes X
No Depth (inches): 6
Saturation Present? Yes X
No Depth (inches): 0
Wetland Hydrology Present? Yes X No
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: WA/WB WET
Tree Stratum (Plot size:
Within wetland)
% Cover Species?
Status
Dominance Test worksheet:
1. Absent
Number of Dominant Species
2.
That Are OBL, FACW, or FAC: 3 (A)
3.
Total Number of Dominant
4.
Species Across All Strata: 4 (B)
5.
Percent of Dominant Species
6.
That Are OBL, FACW, or FAC: 75.0% (A/B)
7.
Prevalence Index worksheet:
=Total Cover
Total % Cover of: Multiply by:
50% of total cover:
20% of total cover:
OBL species 8 x 1 = 8
Sapling/Shrub Stratum (Plot size: Within wetland)
FACW species 15 x 2 = 30
1. Ligustrum sinense
5 Yes
FACU
FAC species 0 x 3 = 0
2.
FACU species 5 x 4 = 20
3.
UPL species 0 x 5 = 0
4.
Column Totals: 28 (A) 58 (B)
5.
Prevalence Index = B/A = 2.07
6.
Hydrophytic Vegetation Indicators:
7.
_ 1 - Rapid Test for Hydrophytic Vegetation
8.
X 2 - Dominance Test is >50%
9.
X 3 - Prevalence Index is 53.0'
5 =Total Cover
4 - Morphological Adaptations' (Provide supporting
50% of total cover: 3
20% of total cover:
1
data in Remarks or on a separate sheet)
Herb Stratum (Plot size:
Within wetland)
Problematic Hydrophytic Vegetation' (Explain)
1. Juncus effusus
10 Yes
FACW
'Indicators of hydric soil and wetland hydrology must be
2. Carex lurida
8 Yes
OBL
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
3. Impatiens capensis 5 Yes FACW
4.
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
5.
more in diameter at breast height (DBH), regardless of
6
height.
7•
Sapling/Shrub - Woody plants, excluding vines, less
8,
than 3 in. DBH and greater than or equal to 3.28 ft (1
9
m) tall.
10.
Herb - All herbaceous (non -woody) plants, regardless
11.
of size, and woody plants less than 3.28 ft tall.
23 =Total Cover
Woody Vine - All woody vines greater than 3.28 ft in
50% of total cover: 12
20% of total cover:
5
height.
Woody Vine Stratum (Plot size: Within wetland )
1. Absent
2.
3.
4.
5.
Hydrophytic
=Total Cover
Vegetation
50% of total cover:
20% of total cover:
Present? Yes X No
Remarks: (Include photo numbers here or on a separate sheet.)
Ligustrum only on edge; majority of wetlands herbaceous -dominant
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: iNA/WB WEl
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type' Loc2 Texture Remarks
0-12 10YR 4/2 90 10YR 4/4 10 C M Loamy/Clayey Distinct redox concentrations
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Indicators for Problematic Hydric Soils3:
_ Histosol (Al)
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_ 2 cm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2)
—Thin Dark Surface (S9) (MLRA 147, 148)
—Coast Prairie Redox (Al6)
_ Black Histic (A3)
—Loamy Mucky Mineral (F1) (MLRA 136)
(MLRA 147, 148)
_ Hydrogen Sulfide (A4)
—Loamy Gleyed Matrix (F2)
—Piedmont Floodplain Soils (F19)
_ Stratified Layers (A5)
X Depleted Matrix (F3)
(MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
_ Red Parent Material (F21)
_ Depleted Below Dark Surface (Al 1)
—Depleted Dark Surface (F7)
(outside MLRA 127, 147, 148)
—Thick Dark Surface (Al2)
_ Redox Depressions (F8)
—Very Shallow Dark Surface (F22)
—Sandy Mucky Mineral (S1)
_ Iron -Manganese Masses (F12) (LRR N,
—Other (Explain in Remarks)
_ Sandy Gleyed Matrix (S4)
MLRA 136)
_ Sandy Redox (S5)
_ Umbric Surface (F13) (MLRA 122, 136)
3Indicators of hydrophytic vegetation and
—Stripped Matrix (S6)
—Piedmont Floodplain Soils (F19) (MLRA 148)
wetland hydrology must be present,
Dark Surface (S7)
Red Parent Material (F21) (MLRA 127, 147, 148)
unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present? Yes X No
Remarks:
This data sheet is revised from Eastern Mountains and Piedmont Regional Supplement Version 2.0 to include the NRCS Field Indicators of Hydric
Soils, Version 8.0, 2016.
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

WETLAND DETERMINATION DATA SHEET — Eastern Mountains and Piedmont Region
Project/Site: BR-0124 City/County: Hays/Wilkes Sampling Date: 1/9/2019
Applicant/Owner: NCDOT State: NC Sampling Point: WANVB UPL
Investigator(s): N. Howell - Three Oaks Section, Township, Range: ---
Landform (hillside, terrace, etc.): hillslope Local relief (concave, convex, none): none Slope (%): 2-4
Subregion (LRR or MLRA): LRR P, MLRA 136 Lat: 36.29450 Long:-81.09789 Datum: NAD 83
Soil Map Unit Name: Pfafftown fine sandy loam, 1 to 6 percent slopes, rarely flooded (PaB) NW I classification: Upland
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No Is the Sampled Area
Hydric Soil Present? Yes No X within a Wetland? Yes No X
Wetland Hydrology Present? Yes No X
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply)
_Surface Soil Cracks (B6)
_Surface Water (Al)
_True Aquatic Plants (B14)
_Sparsely Vegetated Concave Surface (B8)
_ High Water Table (A2)
—Hydrogen Sulfide Odor (Cl)
—Drainage Patterns (B10)
_Saturation (A3)
_Oxidized Rhizospheres on Living Roots (C3)
_Moss Trim Lines (1316)
—Water Marks (B1)
—Presence of Reduced Iron (C4)
_ Dry -Season Water Table (C2)
_Sediment Deposits (B2)
_Recent Iron Reduction in Tilled Soils (C6)
_Crayfish Burrows (C8)
_ Drift Deposits (B3)
_Thin Muck Surface (C7)
_Saturation Visible on Aerial Imagery (C9)
_Algal Mat or Crust (B4)
_Other (Explain in Remarks)
_Stunted or Stressed Plants (D1)
_Iron Deposits (135)
_Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (137)
—Shallow Aquitard (D3)
—Water-Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes
No X Depth (inches): 0
Water Table Present? Yes
No X Depth (inches): >12
Saturation Present? Yes
No X Depth (inches): >12
Wetland Hydrology Present? Yes No X
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point: WA/WB UPL
ADs01ute uominant
inaicator
Tree Stratum (Plot size: 30 ft )
% Cover Species?
Status
Dominance Test worksheet:
1. Platanus occidentalis
15
Yes
FACW
Number of Dominant Species
2. Acer rubrum
10
Yes
FAC
That Are OBL, FACW, or FAC: 4 (A)
3.
Total Number of Dominant
4.
Species Across All Strata: 6 (B)
5.
Percent of Dominant Species
6.
That Are OBL, FACW, or FAC: 66.7% (A/B)
7.
Prevalence Index worksheet:
25
=Total Cover
Total % Cover of: Multiply by:
50% of total cover:
13
20% of total cover:
5
OBL species 0 x 1 = 0
Sapling/Shrub Stratum (Plot size: 30 ft
)
FACW species 15 x 2 = 30
1. Ligustrum sinense
15
Yes
FACU
FAC species 23 x 3 = 69
2. Acer negundo
8
Yes
FAC
FACU species 25 x 4 = 100
3.
UPL species 0 x 5 = 0
4.
Column Totals: 63 (A) 199 (B)
5.
Prevalence Index = B/A = 3.16
6.
Hydrophytic Vegetation Indicators:
7.
1 - Rapid Test for Hydrophytic Vegetation
8.
X 2 - Dominance Test is >50%
9.
- Prevalence Index is 53.0'
23
=Total Cover
-3
4 - Morphological Adaptations' (Provide supporting
50% of total cover:
12
20% of total cover:
5
data in Remarks or on a separate sheet)
Herb Stratum (Plot size: 30 ft )
Problematic Hydrophytic Vegetation' (Explain)
1. Polystichum acrostichoides
10
Yes
FACU
'Indicators of hydric soil and wetland hydrology must be
2.
present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
3.
4.
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
5.
more in diameter at breast height (DBH), regardless of
6
height.
7•
Sapling/Shrub - Woody plants, excluding vines, less
8,
than 3 in. DBH and greater than or equal to 3.28 ft (1
9
m) tall.
10.
Herb - All herbaceous (non -woody) plants, regardless
11.
of size, and woody plants less than 3.28 ft tall.
10
=Total Cover
Woody Vine - All woody vines greater than 3.28 ft in
50% of total cover:
5
20% of total cover:
2
height.
Woody Vine Stratum (Plot size: 30 ft )
1. Smilax rotundifolia
5
Yes
FAC
2.
3.
4.
5.
Hydrophytic
5
=Total Cover
Vegetation
50% of total cover:
3
20% of total cover:
1
Present? Yes X No
Remarks: (Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0

SOIL Sampling Point: WA/WB UPL
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix
Redox Features
(inches) Color (moist) %
Color (moist) % Type' Loc2
Texture Remarks
0-4 10YR 4/4 100
Loamy/Clayey
4-12 10YR 4/3 90
10YR 4/4 10 C M
Loamy/Clayey Faint redox concentrations
'Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains.
2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators:
Indicators for Problematic Hydric Soils3:
_ Histosol (Al)
_ Polyvalue Below Surface (S8) (MLRA 147, 148) _ 2 cm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2)
—Thin Dark Surface (S9) (MLRA 147, 148) —Coast Prairie Redox (A16)
_ Black Histic (A3)
—Loamy Mucky Mineral (F1) (MLRA 136) (MLRA 147, 148)
_ Hydrogen Sulfide (A4)
—Loamy Gleyed Matrix (F2)
—Piedmont Floodplain Soils (F19)
_ Stratified Layers (A5)
—Depleted Matrix (F3)
(MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
_ Red Parent Material (F21)
_ Depleted Below Dark Surface (A11)
—Depleted Dark Surface (F7)
(outside MLRA 127, 147, 148)
—Thick Dark Surface (Al2)
_ Redox Depressions (F8)
—Very Shallow Dark Surface (F22)
—Sandy Mucky Mineral (S1)
_ Iron -Manganese Masses (F12) (LRR N,
—Other (Explain in Remarks)
_ Sandy Gleyed Matrix (S4)
MLRA 136)
_ Sandy Redox (S5)
_ Umbric Surface (F13) (MLRA 122, 136)
3Indicators of hydrophytic vegetation and
—Stripped Matrix (S6)
—Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
Dark Surface (S7)
Red Parent Material (F21) (MLRA 127,
147, 148) unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric Soil Present? Yes No X
Remarks:
This data sheet is revised from Eastern Mountains and Piedmont Regional Supplement Version 2.0 to include the NRCS Field Indicators of Hydric
Soils, Version 8.0, 2016.
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

NC WAM WETLAND ASSESSMENT FORM
Accompanies User Manual Version 5
USACE AID#: NCDWR #:
Project Name BR-0124 Date of Evaluation 1/9/2019
Applicant/Owner Name NCDOT Wetland Site Name WA/WB
Wetland Type Non -Tidal Freshwater Marsh Assessor Name/Organization Nathan Howell - Three Oaks Engineering
Level III Ecoregion Piedmont Nearest Named Water Body West Prong/Middle Prong Roaring River
River Basin Yadkin-PeeDee USGS 8-Digit Catalogue Unit 03040101
County Wilkes NCDWR Region Winston-Salem
C' Yes C: No Precipitation within 48 hrs? Latitude/Longitude (deci-degrees) 36.294722,-81.098218
Evidence of stressors affecting the assessment area (may not be within the assessment area)
Please circle and/or make note on last page if evidence of stressors is apparent. Consider departure from reference, if
appropriate, in recent past (for instance, approximately within 10 years). Noteworthy stressors include, but are not limited
to the following.
• Hydrological modifications (examples: ditches, dams, beaver dams, dikes, berms, ponds, etc.)
• Surface and sub -surface discharges into the wetland (examples: discharges containing obvious pollutants, presence of nearby
septic tanks, underground storage tanks (USTs), hog lagoons, etc.)
• Signs of vegetation stress (examples: vegetation mortality, insect damage, disease, storm damage, salt intrusion, etc.)
• Habitat/plant community alteration (examples: mowing, clear -cutting, exotics, etc.)
Is the assessment area intensively managed? i Yes (: No
Regulatory Considerations - Were regulatory considerations evaluated? Ci Yes ( No If Yes, check all that apply to the assessment area.
F Anadromous fish
F Federally protected species or State endangered or threatened species
F NCDWR riparian buffer rule in effect
F Abuts a Primary Nursery Area (PNA)
F Publicly owned property
F N.C. Division of Coastal Management Area of Environmental Concern (AEC) (including buffer)
F Abuts a stream with a NCDWQ classification of SA or supplemental classifications of HQW, ORW, or Trout
F Designated NCNHP reference community
F Abuts a 303(d)-listed stream or a tributary to a 303(d)-listed stream
What type of natural stream is associated with the wetland, if any? (check all that apply)
C' Blackwater
C: Brownwater
F Tidal (if tidal, check one of the following boxes) (' Lunar (' Wind (' Both
Is the assessment area on a coastal island? i Yes (: No
Is the assessment area's surface water storage capacity or duration substantially altered by beaver? (' Yes (: No
Does the assessment area experience overbank flooding during normal rainfall conditions? (' Yes C: No
Ground Surface Condition/Vegetation Condition — assessment area condition metric
Check a box in each column. Consider alteration to the ground surface (GS) in the assessment area and vegetation structure
(VS) in the assessment area. Compare to reference wetland if applicable (see User Manual). If a reference is not applicable,
then rate the assessment area based on evidence of an effect.
GS VS
Ci A C: A Not severely altered
i B Ci B Severely altered over a majority of the assessment area (ground surface alteration examples: vehicle tracks, excessive
sedimentation, fire -plow lanes, skidder tracks, bedding, fill, soil compaction, obvious pollutants) (vegetation structure
alteration examples: mechanical disturbance, herbicides, salt intrusion [where appropriate], exotic species, grazing,
less diversity [if appropriate], hydrologic alteration)
2. Surface and Sub -Surface Storage Capacity and Duration — assessment area condition metric
Check a box in each column. Consider surface storage capacity and duration (Surf) and sub -surface storage capacity and
duration (Sub). Consider both increase and decrease in hydrology. A ditch s 1 foot deep is considered to affect surface water only,
while a ditch > 1 foot deep is expected to affect both surface and sub -surface water. Consider tidal flooding regime, if applicable.
Surf Sub
Ci A C: A Water storage capacity and duration are not altered.
r B (' B Water storage capacity or duration are altered, but not substantially (typically, not sufficient to change vegetation).
C' C C' C Water storage capacity or duration are substantially altered (typically, alteration sufficient to result in vegetation
change) (examples: draining, flooding, soil compaction, filling, excessive sedimentation, underground utility lines).
3. Water Storage/Surface Relief — assessment area/wetland type condition metric (skip for all marshes)
Check a box in each column for each group below. Select the appropriate storage for the assessment area (AA) and the wetland
type (WT).
AA WT
3a. i A C' A Majority of wetland with depressions able to pond water > 1 foot deep
i' B (' B Majority of wetland with depressions able to pond water 6 inches to 1 foot deep
is C (: C Majority of wetland with depressions able to pond water 3 to 6 inches deep
C" D C" D Depressions able to pond water < 3 inches deep
3b. C� A Evidence that maximum depth of inundation is greater than 2 feet
C' B Evidence that maximum depth of inundation is between 1 and 2 feet
C: C Evidence that maximum depth of inundation is less than 1 foot

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

9. Inundation Duration — assessment area condition metric (skip for non -riparian wetlands)
Answer for assessment area dominant landform.
r A Evidence of short -duration inundation (< 7 consecutive days)
(: B Evidence of saturation, without evidence of inundation
r C Evidence of long -duration inundation or very long -duration inundation (7 to 30 consecutive days or more)
10. Indicators of Deposition —assessment area condition metric (skip for non -riparian wetlands and all marshes)
Consider recent deposition only (no plant growth since deposition).
r A Sediment deposition is not excessive, but at approximately natural levels.
(: B Sediment deposition is excessive, but not overwhelming the wetland.
r C Sediment deposition is excessive and is overwhelming the wetland.
11. Wetland Size — wetland type/wetland complex condition metric
Check a box in each column. Involves a GIS effort with field adjustment. This metric evaluates three aspects of the wetland area: the
size of the wetland type (WT), the size of the wetland complex (WC), and the size of the forested wetland (FW) (if applicable, see User
Manual). See the User Manual for boundaries of these evaluation areas. If assessment area is clear-cut, select "K" for the FW column.
WT WC FW (if applicable)
C' A C` A C` A >_ 500 acres
C— B C' B C' B From 100 to < 500 acres
C' C C` C C C From 50 to < 100 acres
C' D C' D C' D From 25 to < 50 acres
C' E C' E C E From 10 to < 25 acres
C' F C` F C` F From 5 to < 10 acres
C' G r G C' G From 1 to < 5 acres
f— H C` H C H From 0.5 to < 1 acre
C' I C' I C I From 0.1 to < 0.5 acre
f: J R J f+ J From 0.01 to < 0.1 acre
C' K C` K C` K < 0.01 acre or assessment area is clear-cut
12. Wetland Intactness — wetland type condition metric (evaluate for Pocosins only)
C` A Pocosin is the full extent (>_ 90%) of its natural landscape size.
C' B Pocosin is < 90% of the full extent of its natural landscape size.
13. Connectivity to Other Natural Areas — landscape condition metric
13a. Check appropriate box(es) (a box may be checked in each column). Involves a GIS effort with field adjustment. This
evaluates whether the wetland is well connected (Well) and/or loosely connected (Loosely) to the landscape patch, the contiguous
metric naturally vegetated area and open water (if appropriate). Boundaries are formed by four -lane roads, regularly maintained utility
line corridors the width of a four -lane road or wider, urban landscapes, fields (pasture open and agriculture), or water > 300 feet wide.
Well Loosely
C' A R A >_ 500 acres
(` B r B From 100 to < 500 acres
ti C C' C From 50 to < 100 acres
C' D C D From 10 to < 50 acres
C` E C' E < 10 acres
C F C` F Wetland type has a poor or no connection to other natural habitats
13b. Evaluate for marshes only.
0 Yes C` No Wetland type has a surface hydrology connection to open waters/stream or tidal wetlands.
14. Edge Effect — wetland type condition metric (skip for all marshes and Estuarine Woody Wetland)
May involve a GIS effort with field adjustment. Estimate distance from wetland type boundary to artificial edges. Artificial edges include
non -forested areas >_ 40 feet wide such as fields, development, roads, regularly maintained utility line corridors and clear -cuts. Consider
the eight main points of the compass. Artificial edge occurs within 150 feet in how many directiions? If the assessment area is clear-cut,
select option "C."
C' A 0
re 1to4
C`C 5to8
15. Vegetative Composition — assessment area condition metric (skip for all marshes and Pine Flat)
f— A Vegetation is close to reference condition in species present and their proportions. Lower strata composed of appropriate
species, with exotic plants absent or sparse within the assessment area.
C0— B Vegetation is different from reference condition in species diversity or proportions, but still largely composed of native species
characteristic of the wetland type. This may include communities of weedy native species that develop after clearcutting or
clearing. It also includes communities with exotics present, but not dominant, over a large portion of the expected strata.
C` C Vegetation severely altered from reference in composition, or expected species are unnaturally absent (planted stands of non -
characteristic species or at least one stratum inappropriately composed of a single species), or exotic species are dominant in
at least one stratum.
16. Vegetative Diversity — assessment area condition metric (evaluate for Non -tidal Freshwater Marsh only)
r A Vegetation diversity is high and is composed primarily of native species (<10% cover of exotics).
C� B Vegetation diversity is low or has > 10% to 50% cover of exotics.
C` C Vegetation is dominated by exotic species (>50% cover of exotics).

17. Vegetative Structure — assessment area/wetland type condition metric
17a. Is vegetation present?
4 Yes (.7 No If Yes, continue to 17b. If No, skip to Metric 18.
17b. Evaluate percent coverage of assessment area vegetation for all marshes only. Skip to 17c for non -marsh wetlands.
ti A >_ 25% coverage of vegetation
C" B < 25% coverage of vegetation
17c. Check a box in each column for each stratum. Evaluate this portion of the metric for non -marsh wetlands. Consider structure
in airspace above the assessment area (AA) and the wetland type (WT) separately.
AA WT
Q (` A (' A Canopy closed, or nearly closed, with natural gaps associated with natural processes
C: B C B Canopy present, but opened more than natural gaps
U (" C (` C Canopy sparse or absent
o (` A { A Dense mid-story/sapling layer
a
(' B t' B Moderate density mid-story/sapling layer
{^ C f~ C Mid-story/sapling layer sparse or absent
(— A (' A Dense shrub layer
r (' B
C"` B
Moderate density shrub layer
(' C
( C
Shrub layer sparse or absent
(` A
(` A
Dense herb layer
(` B
(` B
Moderate density herb layer
(' C
(' C
Herb layer sparse or absent
18. Snags — wetland type condition metric (skip for all marshes)
rc - A Large snags (more than one) are visible (> 12-inches DBH, or large relative to species present and landscape stability).
fi B Not A
19. Diameter Class Distribution — wetland type condition metric (skip for all marshes)
f� A Majority of canopy trees have stems > 6 inches in diameter at breast height (DBH); many large trees (> 12 inches DBH) are
present.
dy B Majority of canopy trees have stems between 6 and 12 inches DBH, few are > 12-inch DBH.
Co— C Majority of canopy trees are < 6 inches DBH or no trees.
20. Large Woody Debris — wetland type condition metric (skip for all marshes)
Include both natural debris and man -placed natural debris.
(" A Large logs (more than one) are visible (> 12 inches in diameter, or large relative to species present and landscape stability).
4r B Not A
21. Vegetation/Open Water Dispersion — wetland type/open water condition metric (evaluate for Non -Tidal Freshwater
Marsh only)
Select the figure that best describes the amount of interspersion between vegetation and open water in the growing season. Patterned
areas indicate vegetated areas, while solid white areas indicate open water.
C` /A' t B C � :a D
- %r� •v -� -`.. ,r�r Vie. R'; .r
22. Hydrologic Connectivity — assessment area condition metric (evaluate for riparian wetlands and Salt/Brackish Marsh only)
Examples of activities that may severely alter hydrologic connectivity include intensive ditching, fill, sedimentation, channelization,
diversion, man-made berms, beaver dams, and stream incision. Documentation required if evaluated as B, C, or D.
ii A Overbank and overland flow are not severely altered in the assessment area.
$ B Overbank flow is severely altered in the assessment area.
( C Overland flow is severely altered in the assessment area.
D Both overbank and overland flow are severely altered in the assessment area.
Notes

NC WAM Wetland Rating Sheet
Accompanies User Manual
Version 5.0
Wetland Site Name WA/WB
Date
1/9/2019
Wetland Type Non -Tidal Freshwater Marsh
Assessor Name/Organization
Howell - Three Oaks Eng
Notes on Field Assessment Form (Y/N)
NO
Presence of regulatory considerations (Y/N)
NO
Wetland is intensively managed (Y/N)
NO
Assessment area is located within 50 feet of a natural tributary or other open water (Y/N)
YES
Assessment area is substantially altered by beaver (Y/N)
NO
Assessment area experiences overbank flooding during normal rainfall conditions
(Y/N)
NO
Assessment area is on a coastal island (Y/N)
NO
Sub -function Rating Summary
Function Sub -function
Metrics
Rating
Hydrology Surface Storage and Retention
Condition
NA
Sub -Surface Storage and Retention
Condition
NA
Water Quality Pathogen Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence? (Y/N)
NA
Particulate Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence? (Y/N)
NA
Soluble Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence? (Y/N)
NA
Physical Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence? (Y/N)
NA
Pollution Change
Condition
NA
Condition/Opportunity
NA
Opportunity Presence? (Y/N)
NA
Habitat Physical Structure
Condition
MEDIUM
Landscape Patch Structure
Condition
LOW
Vegetation Composition
Condition
MEDIUM
Function Rating Summary
Function Metrics/Notes
Rating
Hydrology Condition
MEDIUM
Water Quality Condition
MEDIUM
Condition/Opportunity
HIGH
Opportunity Presence? (Y/N)
YES
Habitat Condition
MEDIUM
Overall Wetland Rating MEDIUM

Appendix C
JD Request Form
PJD Form

urisdictional Determination Reauest
US Army Corps
of Engineers
Wilminglan 6istHcf
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www. saw.usace. army.mil/Missions/Re izulatoiyPermitProgram/Contact/CouniyLocator. aWx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
INSTRUCTIONS:
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: (910) 251-46 10
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: Multiple Parcels
City, State: Hays, NC
County: Wilkes
Parcel Index Number(s) (PIN): Multiple PIN's
B. REQUESTOR INFORMATION
Name: Ron Johnson
Mailing Address: 1598 Mail Service Center
Raleigh, NC 27699-1598
Telephone Number: [phone]
Electronic Mail Address: rgjohnson1 [e-mail]
Select one:
❑ I am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant'
❑ Interested Buyer or Under Contract to Purchase
❑ Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: Multiple Property Owners
Mailing Address:
Telephone Number:
Electronic Mail Address:
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION',4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Print Name
Capacity: ❑ Owner ❑ Authorized Agents
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
✓❑ I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑ I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
I intend to construct/develop a projector perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
❑ A Corps JD is required in order obtain my local/state authorization.
❑ I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:
For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
❑✓ I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
❑ I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 20.8 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
❑✓ Project Coordinates (Decimal Degrees): Latitude:
Longitude
36.293641
-81.095546
❑� A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than l 1x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Pro,gram/Jurisdiction/
Version: May 2017 Page 5

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

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 06/06/2019
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Ron Johnson, 1598 Mail Service Center, Raleigh, NC 27699-1598
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Wilkes City: Hays
Center coordinates of site (lat/long in degree decimal format):
Lat.: 36.293641 Long.:-81.095546
Universal Transverse Mercator: 17
Name of nearest waterbody: West Prong/Middle Prong Roaring River
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
SEE
ATTACHED
LIST

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

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
❑■ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: Vicinity Map, Topo Map, Jurisdictional Features Map
Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
USGS NHD data.
USGS 8 and 12 digit HUC maps.
Geological Survey map(s). Cite scale & quad name: 1:24,000 2016 Traphill, NC
Natural Resources Conservation Service Soil Survey. Citation: 1997 Wilkes County Soil Survey
❑ National wetlands inventory map(s). Cite name:
State/local wetland inventory map(s):
FEMA/FIRM maps:
❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
❑ Photographs: ❑ Aerial (Name & Date):
or ❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
' Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

Three Oaks aquatic resources in the review area which "may be" subject to regulatory jurisdiction
Estimated amount
Geographic
Site
of aquatic
Type of aquatic
authority to which
Latitude
Longitude
Number
resource in review
resource
the aquatic resource
area (If. & ac.)
"ma be" subject
Middle
Prong
36.293886
-81.095459
565 linear feet
Non -wetland-
Section 404
Roaring
Perennial Stream
River
West Prong
Non -wetland -
Roaring
36.294220
-81.096761
457 linear feet
Section 404
River
Perennial Stream
SA
36.293199
-81.095191
407 linear feet
Non -wetland-
Section 404
Perennial Stream
SB
36.292405
-81.096841
114 linear feet
Non -wetland-
Section 404
Intermittent Stream
SC
36.294462
-81.096774
696 linear feet
Non -wetland-
Section 404
Perennial Stream
Non -wetland-
SD
36.294714
-81.098354
63 linear feet
Intermittent Stream
Section 404
SE
36.295148
-81.098807
50 linear feet
Non -wetland-
Section 404
Intermittent Stream
Non -wetland-
SF
36.295089
-81.098580
31 linear feet
Intermittent Stream
Section 404
WA
36.293213
-81.095138
1 0.01 acre
Wetland
Section 404
WB
36.294722
-81.098218
0.01 acre
Wetland
Section 404
PA
36.292914
-81.096849
0.09 acre
Non -wetland — Pond
Section 404

r ,
STATE OF NORTH CAROUrNA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
Date:
MEMORANDUM TO
From:
SUBJECT:
JAws H. TROGDON, III
SECRETARY
June 11, 2019
File
Marissa Lenoce, Transportation Planner, STV Engineers,
Inc
NRCS Farmland Conversion Impact Rating Bridge No.
960166 on SR 1745 over West Prong of Roaring River
Wilkes County, NC
WBS 67124.1.1, Project No. BR-0124
The Farmland Protection Policy Act of 1981 (7 CFR Part 658) (FPPA) requires an assessment of
the potential impacts of land acquisition and construction activities in prime, unique, and local or
statewide importance as defined by the US Natural Resource Conservation Service (NRCS). This
memo is to document the completion and results of the NRCS Farmland Conservation Impact
Rating process for Project BR-0124 consistent with FPPA.
Project Description
BR-0124 proposes to replace Bridge No. 960166 on SR 1745 (Shumate Mountain Road) over
West Prong of Roaring River in Wilkes County. The project proposes replacing the existing
bridge with an approximately 30-foot wide structure with two 10-foot travel lanes. The
proposed bridge would be approximately 140 feet in length and the proposed right of way 80
feet. The total length of the project is approximately 634 feet.
Applicability
Project BR-0124 is subject to the provisions of FPPA for the following reasons:
• It is a federally funded project.
• It is not within a municipality, urbanized area, or urban built-up area.
• Prime farmlands of statewide importance are found within the project area.
• The land is not in water storage or used for national defense purposes.
Mailing Address: Telephone: [phone]
NC DEPARTMENT OF TRANSPORTATION Fax: [phone]
Structures Management Unit Website: www.ncdot.gov
1581 Mail Service Center
Raleigh, NC 27699-1581

NRCS Farmland Figure
In accordance with guidance provided by NCDOT Community Studies, the farmland figure was
created to display the project location and a one -mile buffer over a layer displaying prime
farmland, farmland of statewide importance, and Farmland of Local Importance in the vicinity
of the project. A project footprint was created to include a 25-foot buffer from the slope stakes.
The NRCS farmland figure is attached to this memo.
Completion of Part VI of the NRCS Form AD-1006
Part VI (Site Assessment Criteria) of the NRCS Form AD-1006 was completed for this project.
Points allotted for each criterium and reasoning are provided below.
1. Area in Non -urban Use: 13 out of 15 points. Estimated using aerial
photography; approximately 80% of the land within the 1-mile buffer is non -
urban.
2. Perimeter in Non -urban Use: 10 out of 10 points. Estimated using aerial
photography; more than approximately 90% borders on land in non -urban use.
3. Percent of Site Being Farmed: 6 out of 20 points. Estimated using aerial
photography; approximately 30% of the site is being farmed.
4. Protection Provided by State and Local Government: 0 out of 20 points. The site is
not designated as a Voluntary Agriculture District (VAD) or Enhanced Voluntary
Agriculture District (EVAD).
5. Distance from Urban Built-up Area: 5 out of 15 points. Determined using aerial
photography; site is within 1.0 mile of North Wilkes High School and New
Covenant Baptist Church.
6. Distance to Urban Support Services: 0 out of 15 points. Services exist within 1/2 mile
of the project site.
7. Size of Present Farm Unit Compared to Average: 0 out of 10 points. The farm units
are more than 50% below the average size farm unit in Wilkes County (114 acres).
8. Creation of Non-farmable Farmland: 0 out of 10 points. This project will have
no implications on remaining farmable land.
9. Availability of Farm Support Services: 0 out of 5 points. No farm support
services were identified within the site.
10. On -Farm Investments: 10 out of 20 points. Some on -farm investments including
barns, storage buildings, and waterways were identified using aerial imagery.
11. Effects of Conversion on Farm Support Services: 0 out of 10 points. No significant
reduction in demand for farm support services would occur as a result from the
project.
12. Compatibility with Existing Agricultural Use: 0 out of 10 points. The project is
compatible with existing agricultural use.
Result of Site Assessment Criteria
The sum of the points assigned in part VI of the NRCS form AD-1006 for BR-0124 is 44.
Summary
Because the total of the points assigned in part VI of the NRCS form AD-1006 for BR-0124 is
less than 60 and therefore the total points of the NRCS Farmlands Conversion Form AD-1006 is
less than 160, no mitigation for farmland loss is required for the project in accordance with
FPPA.

Sources
US Census. Census of Agriculture. 2012. County Data. North Carolina. Wilkes County. Accessed
6/14/2019.
(https://www.na,s.usda.gov/Publications/AgCensus/2012/Full Report/Volume 1, Chapter 2 County Level/North Carolina/st37 2
001 OOl.pdf Ms://www.nass.usda.gov/Publications/AgCensus/2012/Online Resources/County Profiles/North Carolina/cp37097.pd
fl
Wilkes County. GIS Application. Wilkes County, NC. Accessed 6/14/2019.
(hgps://gis.wilkescounty.net/main/#)
Legal Information Institute. Section 658.5- Criteria. Accessed 6/14/2019.
(htti)s://www.law.comell.edu/cfr/text/7/658.5)
Attachments
NRCS Farmland figure
Cc: Harrison Marshall and Herman Huang, NCDOT Community Studies

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NC One Map & Google Earth

Demographic Memorandum
Bridge No. 960166 on SR 1745 (Shumate Mountain Road)
Over West Prong of Roaring River
Wilkes County, North Carolina
In order to evaluate whether there are Environmental Justice (EJ) or Limited English Proficiency (LEP) populations in the
vicinity of Bridge No. 960166, the 2019 NCDOT Demographic Tool was used. A Direct Community Impact Area (DCIA) had
been developed for the project, and in accordance with NCDOT guidance, the US Census Block Groups that encompass
the DCIA make up the Demographic Study Area (DSA). The DSA is the analysis area used in this memorandum. Census
Tract 9602, Block Group 3, Census Tract 9603, and Block Group 1, Census Tract 9604 make up the DSA.
Environmental Justice
Minority populations include all races that are non-White, and include Hispanic populations that are White. Two NCDOT
thresholds are used to identify the presence of minority populations. These thresholds are any Block Group where 50% or
more of the population is minority (or a majority minority), or any Block Group with a minority population at least 10
percentage points higher than the county average.
As shown in Table 1, there are no Census Tract Block Groups with minority populations that are greater than 50%. Census
Tract 9604, Block Group 1 has a minority population of 22.6%, which exceeds the threshold of at least 10 percentage
points higher than the percentage in Wilkes County (12.1%).
Table 1: Minority Population
Geography
Total
Population
White, Non -Hispanic
Minority Population*
Meets
Thresholds
#
%
#
%
50%
10% over
County
CT 9602, BG 3
1,581
1,524
96.4%
57
3.6%
No
No
CT 9603, BG 1
1,166
1,143
98.0%
23
2.0%
No
No
CT 9604, BG 1
1,266
980
77.4%
286
22.6%
No
Yes
DSA
4,013
3,647
90.9%
366
9.1%
No
N/A
Wilkes County
68,525
60,214
87.9%
8,311
12.1%
North Carolina
10,052,564
6,397,460
63.6%
3,655,104
36.4%
* Minority population includes all races that are Non -White and Hispanic populations that are also White.
Source: US Census Bureau, American Community Survey 5-year Estimates (2013-2017), Table B03002, "Hispanic or Latino Origin by Race."
NCDOT uses poverty as an indicator of low-income. Two NCDOT thresholds are used to identify the presence of low-
income populations. These thresholds are any Block Group where the percentage of the population in any of the poverty
categories — Below Poverty Level, Very Poor or Near Poor equals or exceeds 25% of the total population of the Block
Group, or any Block Group where the percentage of the population in any of the poverty categories exceeds the county
average by five percentage points or more.
As shown in Table 2, one Block Group (Census Tract 9604, Block Group 1) exceeds the NCDOT poverty threshold, by
exceeding 25% of the population in that Block Group and two Block Groups (Census Tract 9602, Block Group 3 and Census
Tract 9604, Block Group 1) exceed the county average by five percentage points or more.
05/03/2019 DEMOGRAPHIC MEMORANDUM

Table 2: Poverty Status
Between 100% and
Below Poverty
Under 50% of
Meets
Population for
149% of Poverty
Level
Poverty Level
Thresholds
whom Poverty
Level
Geography
Status is
5%
Determined
#
%
#
%
#
%
25%
over
County
CT 9602, BG 3
1,581
378
23.9%
219
13.9%
148
9.4%
No
Yes
CT 9603, BG 1
1,166
248
21.3%
-
0.0%
182
15.6%
No
No
CT 9604, BG 1
1,266
464
36.7%
57
4.5%
81
6.4%
Yes
Yes
DSA
4,013
1,090
27.2%
276
6.9%
411
10.2%
Yes
N/A
Wilkes County
67,318
14,040
20.9%
4,830
7.2%
8,984
13.3%
North Carolina
9,783,738
1,579,871
16.1%
688,118
7.0%
1,016,581
10.4%
Source: US Census Bureau, American Community Survey 5-year Estimates (2013-2017), Table C17002, "Ratio of Income to Poverty Level in the Past
12 Months."
Census data indicates a notable presence of populations meeting the criteria for Environmental Justice (minority and low-
income) within the DSA, but no low-income communities were observed within the Direct Community Impact Area (DCIA)
during the field visit or were noted by local planners.
Limited English-speaking Populations (LEP)
The US Department of Justice Safe Harbor threshold for LEP is met when there is a language group that speaks English less
than very well and that either has 1,000 adults or makes up 5% of the aggregate DSA population (with at least 50 adults).
NCDOT's threshold for language assistance is more than 50 adults of a Block Group's population within a language group
who speaks English less than very well.
As shown in Table 3, Census data does not indicate Limited English Proficiency (LEP) populations meeting the US
Department of Justice LEP Safe Harbor threshold or a notable presence within the DSA.
Table 3: Limited English Proficiency
GeographyPopulation,
Total Adult
18 years
and older
Primary Language Group of Persons Who Speak English Less than
Very Well
Meets
Thresholds
Spanish
Other Indo-
Euro
Asian/Pacific
Other
#
%
#
%
#
%
#
%
LEP
LA
CT 9602, BG 3
1,228
16
1.3%
-
0.0%
-
0.0%
-
0.0%
N/A
No
CT 9603, BG 1
1,017
-
0.0%
-
0.0%
-
0.0%
-
0.0%
N/A
No
CT 9604, BG 1
862
33
3.8%
-
0.0%
-
0.0%
-
0.0%
N/A
No
DSA
1 3,107
1 49
1 1.6%
-1
0.0%
1 -1
0.0%
1 -1
0.0%
No
I N/A
Wilkes County
54,064
1,385
2.6%
31
0.1%
91
0.2%
250
0.5%
North Carolina
7,762,882
274,705
3.5%
39,930
0.5%
58,782
0.8%
14,471
0.2%
Source: US Census Bureau, American Community Survey 5-year Estimates (2013-2017), Table B16004, "Age by Language Spoken
at Home by Ability to Speak English for the Population 5 Years and Over."
05/03/2019 DEMOGRAPHIC MEMORANDUM 2

Bj46
Longbottom Rd
State Rd 17:
N
�CID
ALLEGHANY
COUNTY
/u
�SRURY
COUNTY
Legend
Direct Community CT 9602 BG 3
Wilkes County, , NC
Bridge No. 960166 Replacement
over West Prong of
10
Q
Impact Area (DCIA) CT 9603 BG 1
*
Roaring River
Wilkes County
Project Study Area 0 CT 9604 BG 1
t6
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NcvoT Division 11
421
April2019
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STV 1Q0
Demographics
Ma p
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Sources: Wilkes County GIs Department,
NC One Map, NC HPO GIs Portal,
& Google Earth

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
July 19, 2018
Secretary Elaine Chao
U.S. Department of Transportation
1200 New Jersey Avenue, SE
Washington, DC, 20590
JAMES H. TROGDON, III
SECRETARY
Subject: Certification of Financial Contribution BUILD Grant Application: Growing
Rural Economy and Agriculture through Transportation & Technology
Enhancement or Replacement in North Carolina (GREATTER-NC) Project
Dear Secretary Chao:
The North Carolina Department of Transportation wishes to express its full support for
the Growing Rural Economy and Agriculture through Transportation & Technology
Enhancement or Replacement in North Carolina Project (GREATTER-NC) project under
the United States Department of Transportation's 2018 Better Utilizing Investments to
Leverage Development (BUILD) program. This project represents much -needed
infrastructure and technology improvements to several economically depressed rural
counties in eastern and western North Carolina, as reflected in our mission statement:
"Connecting people, products and places safely and efficiently with
customer focus, accountability and environmental sensitivity to enhance
the economy and vitality of North Carolina. "
As demonstrated in the project narrative and letters of support, the project will
reconstruct seventy-seven (77) rural bridges located in 17 of the most rural and
economically depressed counties across the state, potentially adding broadband capability
to a number of the structures as they are rebuilt. In addition, nineteen (19) of these
bridges include weight restrictions that result in large or heavy vehicles having to detour
to avoid crossing them. The GREATTER-NC Project directly addresses the dual
challenge of improving physical and digital connectivity in North Carolina's rural
communities while providing additional safety improvements, reducing travel times and
improving freight connectivity and rural communications infrastructure.
Afading Address:
NC DEPARTMENT OF TRANSPORTATION
FINANCIAL MANAGEMENT DIVISION
1514 MAIL SERVICE CENTER
RALEIGH, NC 27699
Telephone: [phone]
Fax: [phone]
Cusronrer Service: 1-877-368-4968
JV sile: www.nedot.gov
Location:
1 SOUTH WILMINGTON STREET
RALEIGH, NC 27601

Secretary Elaine Chao
Page 2 of 2
July 19, 2018
To that end, the NCDOT will fund the GREATTER-NC project in the amount of at. least
$94,100,000 towards a successful BUILD grant from the state funded North Carolina
Highway Trust Fund.
Thank you for your consideration of the GREATTER-NC for the 2018 BUILD
Discretionary Grant Program. If NCDOT can be of any further assistance, please do not
hesitate to contact me at [phone] or via e-mail at [e-mail].
Sincerely,
L4&
Evan Rodewald
Chief Financial Officer

5/11/12
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
FIELD SCOPING MEETING WORKSHEET
Return with Comments to Division by (Two weeks prior to FSM)
TIP No.: BR-0124 FIELD REVIEW MEETING DATE: 04/17/2019
DIVISION: 11 LOCATION: 36.29425,-81.09683
COUNTY: Wilkes
ROUTE (US / NC / SR): SR 1745
PROJECT DESCRIPTION: Replace bridge No. 960166 over West Prong Roaring River
FUNCTIONAL CLASSIFICATION: Local
TIER: Sub- Regional
MPO / RPO AREA:
MUNICIPALITY:
ATTFWDFRSN NAMF, (PRTNT) PHONF, No F,-MATT.
DIVISION CONSTRUCTION ENGINEER
AREA BRIDGE CONSTRUCTION
ENGINEER
DIVISION BRIDGE PROGRAM
MANAGER
Joe Laws
DIVISION UTILITY COORDINATOR
Sunil Singh
DIVISION ENVIRONMENTAL OFFICER
DIVISION RIGHT OF WAY
REPRESENTATIVE
HYDRAULICS REPRESENTATIVE
PDEA REPRESENTATIVE
NEU REPRESENTATIVE
GEOTECHNICAL REPRESENTATIVE
Shiping Yang
STRUCTURE DESIGN
REPRESENTATIVE
ROADWAY DESIGN REPRESENTATIVE
LOCATION AND SURVEYS
REPRESENTATIVE
WORK ZONE TRAFFIC CONTROL
REPRESENTATIVE
STV Attendees: Kevin Bailey, Shirshant Sharma, Brandon Phillips, Laura Braunfeld, Michelle Lopez
1

5/11/12
DIVISION (COMPLETED BY DIVISION STAFF AND SENT WITH THE FSM LETTER)
EXISTING FEATURES
FEATURE BRIDGED: West Prong Roaring River
(BRIDGE / CULVERT) LENGTH 136 (FT.) DECK WIDTH (OUT TO OUT) 24.167 (FT.)
WATER DEPTH: 2 (FT.) HEIGHT BED -TO -CROWN: 15.5 (FT.)
PRIOR SURVEY DATE: POSTED: SV TTST:
STRUCTURE TYPE: Steel deck on I -beams
SPAN TYPE: Steel deck
SUFFICIENCY RATING: 67.52
POSTED SPEED LIMIT IN PROJECT VICINITY: 55 (MPH / STATUTORY 55MPH)
DETOUR: OFF -SITE YES ON -SITE NO STAGE CONSTRUCTION NO
IF DETOUR IS OFF -SITE, PROVIDE DESCRIPTION OF DETOUR ROUTE SR 1745 to SR 1730 to SR 1002
APPROXIMATE LENGTH OF DETOUR? 6.7 ( MILES )
IMPROVEMENTS NEEDED TO ROAD ON DETOUR? NO
IMPROVEMENTS NEEDED TO BRIDGES ON DETOUR? NO
ARE BRIDGES ON DETOUR CURRENTLY PROGRAMMED ON TIP? N/A COMMENTS:
ARE THERE EMS, SCHOOL, OR BUSINESS ACCESS ISSUES? YES COMMENTS: Schools have high impact
ARE THERE ANY RAILROAD CROSSINGS ON DETOUR? NO COMMENTS:
SHOULD WORK ZONE PEDESTRIAN ACCESS BE MAINTAINED DURING CONSTRUCTION? NO
REASONS:
IMPACT RATING TO UTILITIES LOW
OVERHEAD UTILITY LINES YES IN CONFLICT YES
POWER TRANSMISSION LINES NO IN CONFLICT NO
TELEPHONE / CABLE LINES YES IN CONFLICT YES
FIBER OPTIC YES IN CONFLICT YES
WATER NO IN CONFLICT NO
SEWER NO IN CONFLCIT NO
NATURAL GAS NO IN CONFLICT NO
OTHER N/A IN CONFLICT N/A
BASED ON THE PAST HISTORY NEAR THIS PROJECT SITE, WHAT IS THE ESTIMATED TIME REQUIRED TO
COMPLETE UTILITY ADJUSTMENTS 4-5 MONTHS
IS THERE ANY FUTURE UTILITY CONSTRUCTION ANTICIPATED IN THE PROJECT AREA Future Fiber
IS A FEMA BUY-OUT PROPERTY BEING IMPACTED NO
2

5/11/12
HYDRAULICS UNIT (COMPLETED BY HYDRAULICS UNIT STAFF PRIOR TO THE FSM)
WILL THIS PROJECT REQUIRE A FEMA PERMIT? YES
IS THERE UNUSUAL SCOUR POTENTIAL? NO IS PROTECTION NEEDED? YES
ARE BANKS STABLE? Yes IS PROTECTION NEEDED? Yes
DOES STREAM CARRY APPRECIABLE AMOUNT OF LARGE DEBRIS? No
WILL THE PLACEMENT OF BENTS IN THE WATER BE ALLOWED N/A COMMENTS
WERE HYDRAULIC ALTERNATIVES BESIDES A BRIDGE CONSIDERED No COMMENTS
POSSIBLE SPAN LAYOUT: 40 FT +/- — 60 FT — 40 FT +/- (140 FT to 160 FT TOTAL)
GEOTECHNICAL UNIT (COMPLETED BY GEOTECHNICAL UNIT PRIOR TO THE FSM)
EXISTING FOUNDATION REPORTS? No IF SO, ATTACH.
KNOWN GEOLOGICAL FEATURES IN AREA WHICH MAY AFFECT DESIGN No
ARE PERMITS NEEDED FOR INVESTIGATIVE WORK AT SITE No COMMENTS:
ARE THERE ANY HISTORICAL AND / OR VIBRATION SENSITIVE STRUCTURES NEAR BY No COMMENTS:
ARE THERE ANY KNOWN LANDFILLS AND / OR GEOENVIRONMENTAL HAZARD SITES AT OR WITHIN CLOSE
PROXIMITY TO THE PROJECT SITE No COMMENTS: verify with Cyrus Parker
DEPTH OF WEATHERED ROCK OR ROCK BELOW STREAMBED TBD (FT.)
ARE ANY IMPACTS ANTCIPATED TO NATURAL SPRINGS OR ARTESIAN WELLS No COMMENTS:
POSSIBLE FOUNDATION TYPE: EB Piles, Int. Bent Drilled Shafts
3

5/11/12
PD & EA AND NEU UNIT (COMPLETED BY PDEA STAFF PRIOR TO THE FSM)
TRAFFIC FORECAST (AS PREPARED BY TRANSPORTATION PLANNING BRANCH AND PROVIDED BY PDEA)
Accident History:
-L- BASE YEAR (2016) ANNUAL AVERAGE DAILY TRAFFIC 470
% TRUCKS/DUALS
-L- DESIGN YEAR (20 ) ANNUAL AVERAGE DAILY TRAFFIC
% TRUCKS/DUALS
SHOW -Y-LINE TRAFFIC IF APPLICABLE FOR BRIDGES OVER / UNDER.
-Y- BASE YEAR (20 ) ANNUAL AVERAGE DAILY TRAFFIC
% TRUCKS/DUALS
-Y- DESIGN YEAR (20 ) ANNUAL AVERAGE DAILY TRAFFIC
% TRUCKS/DUALS
TRAFFIC SAFETY (AS PREPARED BY THE TRAFFIC SAFETY UNIT AND PROVIDED
BY PDEA)
OPERATING SPEED: 55 MPH
CRASH RATE:
WETLANDS AT SITE Yes COMMENTS: One wetlend identified during field work within the project study area.
KNOWN ENDANGERED SPECIES POPULATIONS IN AREA No COMMENTS:
TROUT OR TVA COUNTY Yes COMMENTS: Within USACE Trout Watershed, closest WRC water (Hatchery Supported)
over 3 river miles upstream
CAMA COUNTY No PRIMARY NURSERY AREA No
MORATORIA No IF YES -DURATION
COMMENTS:
IS WATER FEATURE CLASSIFIED AS A WILD AND SCENIC RIVER No COMMENTS:
WHAT IS THE WATER QUALITY CLASSIFICATION FOR THIS PROJECT: Class C, West Prong and Middle Prong Roaring
River
WILL A COAST GUARD PERMIT BE REQUIRED No COMMENTS:
IS THE PROJECT SITE IN OR NEAR ANY OF THE FOLLOWING:
NATIONAL FOREST No
WILDLIFE REFUGE No
STATE, COUNTY, OR LOCAL PARK No
AIRPORT No
A LAKE FOR RECREATION OR POWER GENERATION No
WATER SUPPLY RESERVOIR No
NUTRIENT SENSITIVE WATERS No
PUBLIC USE BOAT RAMP No
CEMETARIES No
WILL A FEDERAL ENERGY REGULATORY COMMISSION PERMIT BE REQUIRED No
IS THE PROJECT AREA KNOWN FOR POTENTIAL INDIAN, COLONIAL, OR OTHER ARCHAEOLOGICAL SITES
Yes
KNOWN OR POTENTIAL HISTORIC PROPERTIES IN THE AREA No
IS THE BRIDGE STRUCTURE ITSELF, OR ANY PART THEREOF, CONSIDERED HISTORIC No
WILL THE PROJECT IMPACT A CHURCH, COMMUNITY CENTER, OR OTHER PUBLIC FACILITY No
IS THIS PROJECT ON A STATEWIDE BICYCLE ROUTE OR A LOCAL NON -MARKED BICYCLE ROUTE None (verify Bike
Route sign)
4

5/11/12
ANY CLARIFICATION OR COMMENTS ON ITEMS ABOVE: Archaeology Survey required
ROADWAY DESIGN UNIT (COMPLETED BY ROADWAY DESIGN UNIT PRIOR TO FSM)
ALIGNMENT: EXISTING HORIZONTAL Fair
EXISTING VERTICAL Fair
POSSIBLE DESIGN STANDARDS Subregional Tier
POSSIBLE DESIGN SPEED 45 (MPH)
POSSIBLE DESIGN EXCEPTIONS Possibly COMMENT
APPROXIMATE PROJECT LENGTH 850 (FT) NUMBER AND WIDTH OF LANES 2/ 10 ft
SHOULD THIS PROJECT HAVE CURB AND GUTTER OR SHOULDER APPROACHES Shoulders
COMMENT
TOTAL SHOULDER WIDTH 3 (FT) PAVED SHOULDER WIDTH 0 (FT)
CLEAR ROADWAY ON STRUCTURE 27 (FT)
WILL EXISTING DRIVEWAYS, BUSINESS ACCESS, -Y- LINES OR RAMPS NEED TO BE RELOCATED No
COMMENTS:
IS THERE ADDITIONAL RIGHT OF WAY / PERMANENT EASEMENTS / TEMPORARY EASEMENTS ANTICIPATED FOR
CONSTRUCTION Yes COMMENT
ARE ANY RETAINING WALLS ANTICIPATED No
IS THERE A POSSIBILITY OF RELOCATEES No IF SO, DESCRIBE
ADDITIONAL COMMENTS: Hold north side edge and widen to the south
Hold western end of existing bridge end bent location and lengthen to the east
STRUCTURE DESIGN UNIT (COMPLETED BY THE STRUCTURE DESIGN UNIT PRIOR TO THE FSM)
POSSIBLE SUPERSTRUCTURE:
TYPE: 21" or 24" Cored Slab
NUMBER OF SPANS 3 LENGTH OF SPANS 40 to 60 (FT)
WILL RAILROAD INVOLVEMENT BE REQUIRED No
WILL STRUCTURE REQUIRE DESIGN FOR VESSEL IMPACT OR FENDER SYSTEM No
DESCRIPTION:
ARE ANY RETAINING WALLS ANTICIPATED No
5

5/11/12
CONSTRUCTABILITY AND ACCESS (DISCUSSED AT THE FSM BY DIVISION BRIDGE MANAGER)
METHOD OF ACCESS: Road closure, Off -site detour
TOP -DOWN Yes
(WORK BRIDGE / CAUSEWAY) PROPOSED LOCATION RELATIVE TO EXISTING STRUCTURE: N/A
PROPOSED LENGTH (FT) WIDTH (FT)
MATERIAL AND EQUIPMENT ACCESS TO SITE:
TRACTOR -TRAILER ACCESS Yes BARGE ACCESS No HEAVY EQUIPMENT ACCESS Yes
POSTED ROADS AND POSTED BRIDGES IN VICINITY THAT MAY AFFECT ACCESS Possible
ARE CONSTRUCTION STAGING AREAS AVAILABLE NEAR SITE Yes
ANY ANTICIPATED AREAS OF TEMPORARY SHORING REQUIRED No
ADDITIONAL COMMENTS: Staging on road
ITEMS TO BE DISCUSSED / RESOLVED AT FSM BY ATTENDEES
LIST ALTERNATIVES TO BE STUDIED BY ROADWAY DESIGN:
1) Look to hold north side and widen to the south
2) Look to hold existing EB location to the western end of the bridge
3) Channel improvements needed in northwest quadrant of the bridge
DESCRIBE ANY DISCUSSION REGARDING HOW THE ALTERNATIVES WERE DECIDED UPON, WHY CERTAIN
ALTERANTIVES WERE REJECTED, AND IF AN ALTERNATIVE WAS SELECTED, WHY.
Due to improvements needed to channel in northwest quadrant, look to hold western end of existing bridge and north side of
road.
CHECK ONE
TYPE OF ENVIRONMENTAL DOCUMENT (CHECK ONE)
CATIGORICAL EXCLUSION (CE)
PROGRAMMATIC CATIGORICAL EXCLUSION (PCE) ❑
THE OPTIMUM LET DATE FOR THIS PROJECT IS: Spring/Summer 2020
ADDITIONAL COMMENTS AND/OR UNRESOLVED ISSUES TO BE ADDRESSED: verify Bike Route sign
6

ok quprrr c NC DEPARTMENT OF TRANSPORTATION ATTENTION: CHANGE IN STRUCTURE DATA.
0�a
DIVISION OF HIGHWAYS
STRUCTURE MANAGEMENT UNIT
Q
a
OF s
Structure Safety Report
Routine Element Inspection - Contract
COUNTY: WILKES STRUCTURE NUMBER: 960166 FREQUENCY: 24 MONTHS
FACILITY CARRIED: SR1745 MILE POST:
LOCATION: 50 FT.E.JCT.SR1746
FEATURE INTERSECTED: WEST PRONG ROARING RIVER
LATITUDE: 36' 17' 39.27" LONGITUDE: 81 ° 5' 48.49"
SUPERSTRUCTURE: STEEL PLANK FLOOR ON I -BEAMS
SUBSTRUCTURE: E.BTS:TIM.CAPS/TIM. PILES; BTS:TIM.CAPS/TIM.POST&CONC.SIILLS
1 @ 454"; 1 @ 45'; 1 @ 45'-4"
SPANS: 1 @ 45-4; 1 @ 45'; 1 @ 45'-4
❑FRACTURE CRITICAL ❑TEMPORARY SHORING ❑SCOUR CRITICAL ❑SCOUR PLAN OF ACTION
PRESENT CONDITION: Fair INSPECTION DATE: 01/13/2017
POSTED SV: 26 POSTED TTST: 31
OTHER SIGNS PRESENT: (4) DELINEATORS, (2) WEIGHT LIMIT
Sign noticed
Number
issued for
Required
NO
WEIGHT LIMIT
0
NO
DELINEATORS
0
NO
NARROW BRIDGE
0
NO
ONE LANE BRIDGE
0
NO
LOW CLEARANCE
0
DIRECTION OF W E
INSPECTION
DIRECTION NO PLANS
MATCHES PLANS
LOOKING EAST.
INSPECTED BY SIGNATURE ASSISTED BY Aaron Stroud
Raghuveer Surapaneni r

Structure Element Scoring
Structure Number: 960166
Inspection Date 1/13/2017
Element
Number
Parent
Number
Element Name
Location
Total
Quantity
Level
Quantity
Level
Quantity
Level
Quantity
Level
Quantity
30
0
Steel Deck Corrugated/Orthotropic/Etc.
Deck
3280
3005
230
45
0
107
0
Steel Open Girder/Beam
Beam
1370
1345
25
0
0
515
107
Steel Protective Coating
Beam
7380
7340
0
40
0
206
0
Timber Column
Piles and Columns
20
11
7
2
0
216
0
Timber Abutment
Abutments
60
60
0
0
0
235
0
Timber Pier Cap
Caps
104
70
34
0
0
316
0
Other Bearings
Bearing Device
60
34
24
2
0
515
316
Steel Protective Coating
Bearing Device
180
114
0
64
2
330
0
Metal Bridge Railing
Bridge Rail
274
0
274
0
0
515
330
Steel Protective Coating
Bridge Rail
816
0
0
816
0
510
10
lWearing Surface
lWearing Surfaces
13256
13238
118
10
10

Summary of Maintenance Needs
Maintenance By Defect
Structure Number: 960166
Inspection Date: 01/13/2017
MMS
Code
Element Name
Defect Name
Recommended Quantity
71
3328
Steel Deck Corrugated/Orthotropic/Etc.
Corrosion
45 Square Feet
3344
Timber Column
Decay/Section Loss
2 Each
3344
Timber Column
Check/Shake
7 Each
3344
Timber Column
Spiit/Delamination (Timber)
2 Each
3344
Timber Pier Cap
Check/Shake
8 Feet
3344
Timber Pier Cap
Split/Delamination (Timber)
5 Feet
3344
Timber Pier Cap
Damage
21 Feet
3334
Other Bearings
Corrosion
2 Each
2816
Wearing Surface
I Crack (Wearing Surface)
18 Square Feet
3342
Steel Protective Coating
Effectiveness (Steel Protective Coatings)
922 Square Feet

Element Structure Maintenance Quantities
Structure Number: 960166
Inspection Date 01/13/2017
Location
MMS
Code
Description
Maint
Quantity
Total
Quantity
Severe
Quantity
Poor
Quantity
Fair
Quantity
Good
Quantity
Abutments
3346
Maintenance of Timber Bulkheads or Wingwalls
0
60
0
0
0
60
Beam
3314
Maintenance Steel Superstructure Components
0
1370
0
0
25
1345
Beam
3342
Clean and Paint Steel
40
7380
0
40
0
7340
Bearing Device
3334
Bridge Bearing
2
60
0
2
24
34
Bearing Device
3342
Clean and Paint Steel
66
180
2
64
0
114
Bridge Rail
3322
Maintenance of Steel Bridge Rail
0
274
0
0
274
0
Bridge Rail
3342
Clean and Paint Steel
816
816
0
816
0
0
Caps
3344
Maintenance To Timber Substrcutre
34
104
0
0
34
70
Deck
3328
Maintenance of Steel Plank Bridge Floor
45
3280
0
45
230
3005
Piles and Columns
3344
Maintenance To Timber Substrcutre
11
20
0
2
7
11
Baring Surfaces
2816
Asphalt Surface Repair
18
3256
0
0
18
3238

Element Condition and Maintenance Data
Structure Number: 960166 Inspection Date: 01/13/2017
Span 1 Deck
Steel Deck Corrugated
Element Total CS1 CS2 CS3 CS4
Number Element Name Qty Qty Qty Qty Qty
30 Steel Deck Corrugated/Orthotropic/Etc. 1,096 971 80 45 0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
30 Corrosion HEAVY CORROSION WITH THROUGH THICKNESS 3 45 45 Square Feet
SECTION LOSS IN RIGHT SIDE END ANGLE.
30 Corrosion MODERATE TO HEAVY CORROSION IN STEEL DECK IN 2 80 Square Feet
ISOLATED AREAS FOR APPROXIMATELY 10% OF TOTAL
DECK AREA.
General Comments
Span 1
Plate Girder
Element
Number
107
515
Element Name
Steel Open Girder/Beam
Steel Protective Coating
Beam 2
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
44
2
0
0 Feet
246
244
0
2
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE CORROSION IN TOP FLANGE AT BENT 1. 2 2 Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1. 3 2 2 Square Feet
Protective Coatings)
General Comments
Span 1
Plate Girder
Element
Number
107
515
Element Name
Steel Open Girder/Beam
Steel Protective Coating
Beam 3
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
44
2
0
0 Feet
246
244
0
2
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE CORROSION IN TOP FLANGE AT BENT 1. 2 2 Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1. 3 2 2 Square Feet
Protective Coatings)
General Comments
Span 1
Plate Girder
Element
Number
107
515
Element Name
Steel Open Girder/Beam
Steel Protective Coating
Beam 4
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
44
2
0
0 Feet
246
244
0
2
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE CORROSION IN TOP FLANGE AT BENT 1. 2 2 Feet

Structure Number: 960166 Inspection Date: 01/13/2017
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1. 3 2 2 Square Feet
Protective Coatings)
General Comments
Span 1 Beam 5
Plate Girder
Element Total
CS1
CS2
CS3
CS4
Number Element Name Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam 46
44
2
0
0
Feet
515 Steel Protective Coating 246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion 2 FT OF MODERATE CORROSION IN TOP FLANGE AT
2
2
Feet
BENT 1.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 1 Beam 6
Plate Girder
Element Total
CS1
CS2
CS3
CS4
Number Element Name Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam 46
44
2
0
0
Feet
515 Steel Protective Coating 246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE CORROSION IN TOP FLANGE AT BENT 1.
2
2
Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 1 Beam 7
Plate Girder
Element Total
CS1
CS2
CS3
CS4
Number Element Name Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam 46
44
2
0
0
Feet
515 Steel Protective Coating 246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE CORROSION IN TOP FLANGE AT BENT 1.
2
2
Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1.
3
2
2 Square Feet
Protective Coatings)
General Comments

Structure Number:
960166
Span 1
Steel Rail
Element
Number
Element Name
330
Metal Bridge Railing
515
Steel Protective Coating
Left Bridge Rail
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
0
46
0
0 Feet
136
0
0
136
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH. 2 46 Square Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON BRIDGE RAIL. 3 136 136 Square Feet
Protective Coatings)
General Comments
Span 1 Right Bridge Rail
Steel Rail
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
330 Metal Bridge Railing
46
0
46
0
0
Feet
515 Steel Protective Coating
136
0
0
136
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH.
2
46
Square Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ON BRIDGE RAIL.
3
136
136
Square Feet
Protective Coatings)
General Comments
Span 1 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 1 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)

Structure Number: 960166
Inspection Date: 01/13/2017
General Comments
Span 1
Other Bearing
Element
Number Element Name
316 Other Bearings
515 Steel Protective Coating
Near Bearing
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
2
0
1
0 Square Feet
Element
Number Defect Type Defect Description
316 Corrosion CORROSION OF ANCHOR BOLTS AT END BENT 1,
ANCHOR BOLTS MISSING NUTS.
515 Effectiveness (Steel PAINT INEFFECTIVE ON ANCHOR BOLT.
Protective Coatings)
CS
2
3
CS Qty
1
1
Maint
Qty
Each
1 Square Feet
General Comments
Span 1 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
ivumoer -- -- -- ------..�.._..
316 Corrosion SURFACE RUST ON BEARING PLATE.
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
Protective Coatings)
General Comments
Span 1 Near Bearing
Other Bearing
Element
Number Element Name
316 Other Bearings
515 Steel Protective Coating
in
CS CS Qty Qty t
2 1 Each
3 3 3 Square Feet
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
0
1
0 Each
3
2
0
0
1 Square Feet
Element
Number Defect Type Defect Description
316 Corrosion HEAVY CORROSION WITH SECTION LOSS IN ANCHOR
BOLTS.
515 Effectiveness (Steel PAINT FAILED ON ANCHOR BOLT.
Protective Coatings)
CS
3
4
CS Qty
1
1
Maint
Qty
1 Each
1 Square Feet
General Comments
Span 1
Far Bearing
Other Bearing
Element
Total CS1
CS2
CS3
CS4
Number Element Name
Qty Qty
Qty
Qty
Qty
316 Other Bearings
1 0
1
0
0
Each
515 Steel Protective Coating
3 0
0
3
0
Square Feet
Element
Maint
Number Defect Type
Defect Description
CS
CS Qty
Qty

Structure Number: 960166
Inspection Date: 01/13/2017
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 1 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
2
0
1
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion MODERATE CORROSION IN ANCHOR BOLTS AT END
2
1
Each
BENT 1.
515 Effectiveness (Steel PAINT INEFFECTIVE ON ANCHOR BOLT.
3
1
1 Square Feet
Protective Coatings)
General Comments
Span 1 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 1 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
2
0
1
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion CORROSION OF ANCHOR BOLT ON NORTH FACE OF
2
1
Each
BEARING.
515 Effectiveness (Steel PAINT INEFFECTIVE ON ANCHOR BOLT.
3
1
1 Square Feet
Protective Coatings)
General Comments

Structure Number: 960166
Span 1
Other Bearing
Element
Number Element Name
316 Other Bearings
515 Steel Protective Coating
Far Bearing
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
316 Corrosion SURFACE RUST ON BEARING PLATE. 2 1 Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE. 3 3 3 Square Feet
Protective Coatings)
General Comments
Span 1 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
2
0
1
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion MODERATE CORROSION IN SOUTH ANCHOR BOLT AT
2
1
Each
END BENT 1.
515 Effectiveness (Steel PAINT INEFFECTIVE ON ANCHOR BOLT.
3
1
1 Square Feet
Protective Coatings)
General Comments
Span 2 Deck
Steel Deck Corrugated
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
30 Steel Deck Corrugated/Orthotropic/Etc.
1,088
988
100
0
0
Square Feet
Element
Number Defect Type Defect Description
30 Corrosion MODERATE TO HEAVY CORROSION IN STEEL DECK IN
ISOLATED AREAS FOR APPROXIMATELY 10% OF TOTAL
DECK AREA.
CS
2
CS Qty
100
Maint
Qty
Square Feet
General Comments
Span 2 Beam 2
Plate Girder
Element Total CS1
CS2
CS3
CS4
Number Element Name Qty Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam 45 44
1
0
0 Feet
515 Steel Protective Coating 246 244
0
2
0 Square Feet
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION IN TOP 2 1 Feet
FLANGE AT BENT 1.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1. 3 2 2 Square Feet
Protective Coatings)
General Comments

Structure Number: 960166
Inspection Date: 01/13/2017
Span 2 Beam 3
Plate Girder
Element
Total CS1
CS2
CS3
CS4
Number Element Name
Qty Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45 44
1
0
0 Feet
515 Steel Protective Coating
246 244
0
2
0 Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION IN TOP
2
1
Feet
FLANGE AT BENT 1.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 1.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 2 Beam 4
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45
43
2
0
0 Feet
515 Steel Protective Coating
246
242
0
4
0 Square Feet
Number ueieci i ype ueieci uescnpuon k,a ka Wiy Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION IN TOP 2 1 Feet
FLANGE AT BENT 1.
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP 2 1 Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BOTH INTERIOR 3 4 4 Square Feet
Protective Coatings) BENTS.
General Comments
Span 2 Beam 5
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45
43
2
0
0 Feet
515 Steel Protective Coating
246
242
0
4
0 Square Feet
Element
Maint
Number
Defect Type
Defect Description
CS CS Qty Qty
107
Corrosion
MODERATE TO HEAVY SURFACE CORROSION IN TOP
2 1 Feet
FLANGE AT BENT 1.
107
Corrosion
MODERATE TO HEAVY SURFACE CORROSION ON TOP
2 1 Feet
FLANGES AT BENT 2.
515
Effectiveness (Steel
PAINT INEFFECTIVE ON TOP FLANGE AT BOTH INTERIOR
3 4 4 Square Feet
Protective Coatings)
BENTS.
General Comments

Structure Number: 960166
Inspection Date: 01/13/2017
Span 2 Beam 6
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45
44
1
0
0
Feet
515 Steel Protective Coating
246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP
2
1
Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT
BENT 2.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 2 Beam 7
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45
44
1
0
0
Feet
515 Steel Protective Coating
246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP
2
1
Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT
BENT 2.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 2 Beam 8
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
45
45
0
0
0
Feet
515 Steel Protective Coating
246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT
BENT 2.
3
2
2 Square Feet
Protective Coatings)
General Comments
Span 2 Wearing Surface
Asphalt Wearing Surface
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
510 Wearing Surface
1,080
1,062
18
0
0
Square Feet
Element
Number Defect Type Defect Description
CS
CS Qty
Qty
Qty
510 Crack (Wearing TRANSVERSE CRACKS UP TO 1/16 IN, EASTBOUND
2
18
18
Square Feet
Surface) TRAVEL LANE AT BENT 2.
General Comments

Structure Number:
960166
Span 2
Steel Rail
Element
Number
Element Name
330
Metal Bridge Railing
515
Steel Protective Coating
Left Bridge Rail
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
45
0
45
0
0 Feet
136
0
0
136
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH. 2 45 Square Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ALONG ENTIRE LENGTH. 3 136 136 Square Feet
Protective Coatings)
General Comments
Span 2 Right Bridge Rail
Steel Rail
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
330 Metal Bridge Railing
45
0
45
0
0
Feet
515 Steel Protective Coating
136
0
0
136
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH.
2
45
Square Feet
515 Effectiveness (Steel PAINT INEFFECTIVE ALONG LENGTH OF RAIL.
3
136
136
Square Feet
Protective Coatings)
General Comments
Span 2 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 2 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)

Structure Number: 960166
General Comments
Span 2
Other Bearing
Element
Number
316
515
Element Name
Other Bearings
Steel Protective Coating
Near Bearing
Number �VIUUL IYYU �UIUUL �U�UIINLIUII
316 Corrosion SURFACE RUST ON BEARING PLATE.
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
Protective Coatings)
General Comments
Span 2
Other Bearing
Element
Number
316
515
Element Name
Other Bearings
Steel Protective Coating
Far Bearing
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
in
CS CS Qty Qty t
2 1 Each
3 3 3 Square Feet
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
316 Corrosion SURFACE RUST ON BEARING PLATE. 2 1 Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE. 3 3 3 Square Feet
Protective Coatings)
General Comments
Span 2
Other Bearing
Element
Number
316
515
Element Name
Other Bearings
Steel Protective Coating
Near Bearing
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
316 Corrosion SURFACE RUST ON BEARING PLATE. 2 1 Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE. 3 3 3 Square Feet
Protective Coatings)
General Comments
Span 2
Other Bearing
Element
Number
316
515
Element Name
Other Bearings
Steel Protective Coating
Far Bearing
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty

Structure Number: 960166
Inspection Date: 01/13/2017
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 2 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 2 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 2 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments

Structure Number: 960166
Inspection Date: 01/13/2017
Span 3
Deck
Steel Deck Corrugated
Element
Total CS1
CS2
CS3
CS4
Number
Element Name Qty Qty
Qty
Qty
Qty
30 Steel Deck
Corrugated/Orthotropic/Etc. 1,096 1,046
50
0
0 Square Feet
Element
Maint
Number Defect Type
Defect Description
CS
CS Qty
Qty
30 Corrosion
MODERATE TO HEAVY CORROSION IN STEEL DECK IN
2
50
Square Feet
ISOLATED AREAS FOR APPROXIMATELY 5% OF TOTAL
DECK AREA.
General Comments
Span 3 Beam 4
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
46
45
1
0
0 Feet
515 Steel Protective Coating
246
244
0
2
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP 2 1 Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 2. 3 2 2 Square Feet
Protective Coatings)
General Comments
Span 3 Beam 5
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
46
45
1
0
0 Feet
515 Steel Protective Coating
246
244
0
2
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP 2 1 Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 2. 3 2 2 Square Feet
Protective Coatings)
General Comments
Span 3 Beam 6
Plate Girder
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
107 Steel Open Girder/Beam
46
45
1
0
0
Feet
515 Steel Protective Coating
246
244
0
2
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON
TOP
2
1
Feet
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 2.
3
2
2 Square Feet
Protective Coatings)
General Comments

Structure Number: 960166
Inspection Date: 01/13/2017
Span 3
Plate Girder
Element
Number Element Name
107 Steel Open Girder/Beam
515 Steel Protective Coating
Beam 7
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
45
1
0
0 Feet
246
244
0
2
0 Square Feet
Number �cicui i yyu vcicUL vUaUI INuvn
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 2.
Protective Coatings)
General Comments
Span 3 Beam 8
Plate Girder
Element
Number Element Name
107 Steel Open Girder/Beam
515 Steel Protective Coating
Maint
CS CS Qty Qty
2 1 Feet
3 2 2 Square Feet
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
45
1
0
0 Feet
246
244
0
2
0 Square Feet
Number yyc vw IIYuvii
107 Corrosion MODERATE TO HEAVY SURFACE CORROSION ON TOP
FLANGES AT BENT 2.
515 Effectiveness (Steel PAINT INEFFECTIVE ON TOP FLANGE AT BENT 2.
Protective Coatings)
General Comments
Span 3
Left Bridge Rail
Steel Rail
Element
Number
330
Element Name
Metal Bridge Railing
Steel Protective Coating
Maint
CS CS Qty Qty
2 1 Feet
3 2 2 Square Feet
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
0
46
0
0 Feet
136
0
0
136
0 Square Feet
Number vV]c�L iyNc —ci vca�iiNuvii
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH.
515 Effectiveness (Steel PROTECTIVE COATING INEFFECTIVE ALONG ENTIRE
Protective Coatings) LENGTH OF RAIL.
General Comments
Span 3 Right Bridge Rail
Steel Rail
Element
Number Element Name
330 Metal Bridge Railing
515 Steel Protective Coating
Element
Number Defect Type Defect Description
330 Corrosion SURFACE RUST ALONG ENTIRE LENGTH.
Maint
CS CS Qty Qty
2 46 Square Feet
3 136 136 Square Feet
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
46
0
46
0
0
Feet
136
0
0
136
0
Square Feet
in t
CS
CS Qty
Qty
2
46
Square Feet

Structure Number: 960166 Inspection Date: 01/13/2017
515 Effectiveness (Steel PROTECTIVE COATING INEFFECTIVE ALONG ENTIRE 3 136 136 Square Feet
Protective Coatings) LENGTH OF RAIL.
General Comments
Span 3 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 3 Far Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
0
1
0
Each
515 Steel Protective Coating
3
2
0
0
1
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion HEAVY CORROSION AND SECTION LOSS
IN ANCHOR
3
1
1 Each
BOLT AT END BENT 2.
515 Effectiveness (Steel PAINT FAILED ON ANCHOR BOLT.
4
1
1 Square Feet
Protective Coatings)
General Comments
Span 3 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments

Structure Number: 960166
Span 3
Other Bearing
Element
Number Element Name
316 Other Bearings
515 Steel Protective Coating
Near Bearing
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
3
0
0
3
0 Square Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
316 Corrosion SURFACE RUST ON BEARING PLATE. 2 1 Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE. 3 3 3 Square Feet
Protective Coatings)
General Comments
Span 3 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
Span 3 Near Bearing
Other Bearing
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
316 Other Bearings
1
0
1
0
0
Each
515 Steel Protective Coating
3
0
0
3
0
Square Feet
Element
Maint
Number Defect Type Defect Description
CS
CS Qty
Qty
316 Corrosion SURFACE RUST ON BEARING PLATE.
2
1
Each
515 Effectiveness (Steel PAINT INEFFECTIVE ON BEARING PLATE.
3
3
3 Square Feet
Protective Coatings)
General Comments
End Bent 1 Timber Pier Cap 1
Timber Pier Cap
Element
Total
CS1
CS2
CS3
CS4
Number Element Name
Qty
Qty
Qty
Qty
Qty
235 Timber Pier Cap
26
24
2
0
0
Feet
Element
Number Defect Type Defect Description
CS
CS Qty
Qty
Qty
235 Damage HEAVY DEBRIS BUILDUP ON TOP OF PILE CAP, BAY 5.
2
1
1 Feet
235 Split/Delamination 1 FT HORIZONTAL SPLIT UP TO 1/8 IN, EAST FACE OF
PILE
2
1
1 Feet
(Timber) CAP ABOVE PILE 4.
General Comments

Structure Number: 960166
End Bent 1 Timber Column 3
Timber Column
Element
Number Element Name
206 Timber Column
206 Check/Shake VERTICAL CHECKS THROUGHOUT.
General Comments
Bent 1 Timber Column 2
Timber Column
Element
Number Element Name
206 Timber Column
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
Maint
CS CS Qty Qty
2 1 1 Each
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
206 Check/Shake CHECKS IN BRACE BEGINNING AT BASE OF PILE 2 2 1 Each
BETWEEN PILES 2 AND 3.
206 Check/Shake CHECKS THROUGHOUT PILE. 2 1 1 Each
General Comments
Bent 1 Timber Column 3
Timber Column
Element Total CS1 CS2 CS3 CS4
Number Element Name Qty Qty Qty Qty Qty
206 Timber Column 1 0 1 0 0 Each
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
206 Check/Shake CHECKS THROUGHOUT PILE. 2 1 1 Each
General Comments
Bent 1 Timber Column 5
Timber Column
Element
Number Element Name
206 Timber Column
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
206 Decay/Section Loss DECAY IN TOP END OF BRACE BEGINNING AT BASE OF 2 1 1 Each
PILE 2.
General Comments

Structure Number: 960166
End Bent 2
Timber Pier Cap
Element
Number Element Name
235 Timber Pier Cap
Number "VJUU` ' YPU
235 Damage
General Comments
Timber Pier Cap 1
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
26
6
20
0
0 Feet
Maint
Defect Description CS CS Qty Qty
DEBRIS BUILDUP ON TOP OF CAP IN ALL BAYS. 2 20 20 Feet
Bent 2
Timber Pier Cap
Element
Number Element Name
235 Timber Pier Cap
Timber Pier Cap 1
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
26
14
12
0
0 Feet
Element Maint
Number Defect Type Defect Description CS CS Qty Qty
235 Check/Shake LONGITUDINAL CHECKS IN BOTTOM FACE BETWEEN 2 8 8 Feet
PILES 4 AND 5.
235 Split/Delamination 4 FT X 3 IN WIDE X 2 IN DEEP DELAMINATION IN BOTTOM 2 4 4 Feet
(Timber) OF PILE CAP BETWEEN PILES 3 AND 4.
General Comments
Bent 2
Timber Column 1
Timber Column
Element
Total CS1
CS2
CS3
CS4
Number
Element Name Qty Qty
Qty
Qty
Qty
206 Timber
Column 1 0
0
1
0 Each
Element
Maint
Number Defect Type
Defect Description
CS
CS Qty
Qty
206 Split/Delamination
3 FT HIGH X 6 IN WIDE DELAMINATION, NORTH FACE OF
3
1
1 Each
(Timber)
PILE NEAR BASE.
206 Check/Shake
VERTICAL CHECKS THROUGHOUT BASE OF PILE.
2
1 Each
General Comments
Bent 2
Timber Column 2
Timber Column
Element
Total CS1
CS2 CS3
CS4
Number
Element Name Qty Qty
Qty Qty
Qty
206 Timber
Column 1 0
0 1
0 Each
Element
Maint
Number Defect Type
Defect Description
CS CS Qty
Qty
206 Split/Delamination
3 FT HIGH X 6 IN WIDE DELAMINATION, NORTHEAST FACE
3 1
1 Each
(Timber)
OF COLUMN AT MIDHEIGHT.
General Comments

Structure Number: 960166
Bent 2 Timber Column 3
Timber Column
Element
Number Element Name
206 Timber Column
Numoer
206 Decay/Section Loss VERTICAL CHECKS THROUGHOUT PILE.
General Comments
Bent 2 Timber Column 4
Timber Column
Element
Number Element Name
206 Timber Column
Element
Number Defect Type
206 Check/Shake
General Comments
Bent 2
Timber Column
Element
Inspection Date: 01/13/2017
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
in
CS CS Qty Qty t
2 1 1 Each
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
Maint
Defect Description CS CS Qty Qty
VERTICAL CHECKS THROUGHOUT PILE. 2 1 1 Each
Number Element Name
206 Timber Column
Element
Number Defect Type
206 Check/Shake
General Comments
Timber Column 5
Total
CS1
CS2
CS3
CS4
Qty
Qty
Qty
Qty
Qty
1
0
1
0
0 Each
Maint
Defect Description CS CS Qty Qty
FULL HEIGHT VERTICAL CHECKS THROUGHOUT PILE. 2 1 1 Each

Elements Verfied
Location
Name
Component
Element Name
Amount
Span 1
Deck
Steel Deck Corrugated
Steel Deck Corrugated/Orthotropic/Etc.
1096
Span 1
Beam 1
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 2
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 3
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 4
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 5
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 6
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 7
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 8
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 9
Plate Girder
Steel Open Girder/Beam
46
Span 1
Beam 10
Plate Girder
Steel Open Girder/Beam
46
Span 1
Left Bridge Rail
Steel Rail
Metal Bridge Railing
46
Span 1
Right Bridge Rail
Steel Rail
Metal Bridge Railing
46
Span 1
Wearing Surface
Asphalt Wearing Surface
Wearing Surface
1088
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Far Bearing
Other Bearing
Other Bearings
1
Span 1
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Deck
Steel Deck Corrugated
Steel Deck Corrugated/Orthotropic/Etc.
1088
Span 2
Beam 1
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 2
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 3
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 4
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 5
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 6
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 7
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 8
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 9
Plate Girder
Steel Open Girder/Beam
45
Span 2
Beam 10
Plate Girder
Steel Open Girder/Beam
45

Elements Verfied
Location
Name
Component
Element Name
Amount
Span 2
Left Bridge Rail
Steel Rail
Metal Bridge Railing
45
Span 2
Right Bridge Rail
Steel Rail
Metal Bridge Railing
45
Span 2
Wearing Surface
Asphalt Wearing Surface
Wearing Surface
1080
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 2
Near Bearing
Other Bearing
Other Bearings
1
Span 2
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Deck
Steel Deck Corrugated
Steel Deck Corrugated/Orthotropic/Etc.
1096
Span 3
Beam 1
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 2
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 3
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 4
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 5
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 6
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 7
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 8
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 9
Plate Girder
Steel Open Girder/Beam
46
Span 3
Beam 10
Plate Girder
Steel Open Girder/Beam
46
Span 3
Left Bridge Rail
Steel Rail
Metal Bridge Railing
46
Span 3
Right Bridge Rail
Steel Rail
Metal Bridge Railing
46
Span 3
Wearing Surface
Asphalt Wearing Surface
Wearing Surface
1088
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1

Elements Verfied
Location
Name
Component
Element Name
Amount
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Far Bearing
Other Bearing
Other Bearings
1
Span 3
Near Bearing
Other Bearing
Other Bearings
1
Bent 1
Timber Pier Cap
Timber Pier Cap
26
Bent 1
Timber Column
Timber Column
1
Bent 1
Timber Column
Timber Column
1
Bent 1
Timber Column
Timber Column
1
Bent 1
Timber Column
Timber Column
1
Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Pier Cap
Timber Pier Cap
26
End Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Column
Timber Pile
1
End Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Column
Timber Column
1
End Bent 1
Timber Abutment
Timber Abutment
30
Bent 2
Timber Pier Cap
Timber Pier Cap
26
Bent 2
Timber Column
Timber Column
1
Bent 2
Timber Column
Timber Column
1
Bent 2
Timber Column
Timber Column
1
Bent 2
Timber Column
Timber Column
1
Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Pier Cap
Timber Pier Cap
26
End Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Column
Timber Pile
1
End Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Column
Timber Column
1
End Bent 2
Timber Column
Timber Pile
1
End Bent 2
Timber Abutment
Timber Abutment
30

National Bridge and NC Inspection Items
Structure Number: 960166 Inspection Date: 01/13/2017
National Bridge Inventory Items
Item
Grade Scale
Grade
Item 58: Deck
0 - 9, N
6
Item 59: Superstructure
0-9, N
6
Item 60: Substructure
0-9, N
6
Item 61: Channel and Channel Protection
0 - 9 , N
7
Item 62: Culvert
0 - 9 , N
N
Item 71: Waterway Adequacy
0 - 9 , N
7
Item 72: Approach Roadway Alignment
0 - 9, N
8
Note: If NBI Inspection Item is not present, code NBI item with "N"
NC SMU Inspection Items
Item
Grade Scale
Grade
Maint. Qty.
Maint. Code
Deck Debris
G, F, P, or C
F
3262
3376
Drainage System
G, F, P, or C
F
48
3332
Utilities
G, F, P, or C
Slope Protection
G, F, P, or C
G
0
3352
Scour
G, F, P, or C
G
Wingwall
G, F, P, or C
G
0
3350
Field Scour Evaluation
L
Drift
G, F, P, or C
G
0
3366
Fender System
G, F, P, or C
Movable Span Machinery
G, F, P, or C
Response to Live Load
G, F, P, or C
G
Estimated Remaining Life
0 - 100 Years
16
Superstructure Paint Code
U
Note: If NC SMU Insepction Item is not present, leave NC SMU item blank
Inspection Information
Item
Grade Scale
Grade
Regulatory Sign Noticed Issued
YES/NO
N
Priority Maintenance Request Submitted
YES/NO
N
Inspection Time
Hours
6
Traffic Control Time
Hours
0
Snooper Time
Hours
0
Ladder Used
YES/NO
N
Bucket Truck Used
YES/NO
N
Boat Used
YES/NO
N
Other Equipment Used
YES/NO
N

National Bridge and NC SMU Inspection Item Details
Structure Number: 960166 Inspection Date: 01/13/2017
Item Superstructure - Item 59 Grade 6 Maint Code Qty. 0
Details PAINT PEELING ON DIAPHRAGMS IN SPAN 2 AND 3.
Item Deck Debris Grade F Maint Code 3376 Qty. 3262
Details DEBRIS THROUGHOUT BOTH GUTTERLINES.
Item Drainage System Grade F Maint Code 3332 Qty. 48
Details LEAKAGE THROUGH WEARING SURFACE AT BENTS.

Structure: 960166 County: WILKES Date: 01/13/2017 Condition Photos
FULL WIDTH TRANSVERSE CRACKS UP TO 1/8 IN, WEST APPROACH.
HEAVY DECK DEBRIS, SPAN 1 LEFT GUTTERLINE. TYPICAL ALL SPANS LEFT GUTTERLINE.

Structure: 960166 County: WILKES Date: 01/13/2017 Condition Photos
End Bent 1 Cap 1: HEAVY DEBRIS BUILDUP ON TOP OF PILE CAP, BAY 5.
APPROXIMATELY 10% OF TOTAL DECK AREA.

Structure: 960166 County: WILKES
Date: 01/13/2017 Condition Photos
End Bent 1 Cap 1: 1 FT HORIZONTAL SPLIT UP TO 1/8 IN. EAST FACE OF PILE CAP ABOVE PILE 4.
Span 1 Deck: HEAVY CORROSION WITH THROUGH THICKNESS SECTION LOSS IN RIGHT SIDE END ANGLE.

Structure: 960166 County: WILKES Date: 01/13/2017 Condition Photos
End Bent 1 Pile 3: CHECKS THROUGHOUT PILE.
Bent 1 Pile 3: CHECKS THROUGHOUT PILE.

Structure: 960166 County: WILKES Date: 01/13/2017 Condition Photos
Bent 1 Pile 2: CHECKS IN BRACE BEGINNING AT BASE OF PILE 2 BETWEEN PILES 2 AND 3.
Span 1 Beam 5: 2 FT OF MODERATE CORROSION IN TOP FLANGE AT BENT 1

Structure: 960166 County: WILKES
Date: 01/13/2017 Condition Photos
Bent 2 Pile 2: 3 FT HIGH X 6 IN WIDE DELAMINATION, NORTHEAST FACE OF COLUMN AT MIDHEIGHT.
Bent 2 Cap 1: 4 FT X 3 IN WIDE X 2 IN DEEP DELAMINATION IN BOTTOM OF PILE CAP BETWEEN PILES 3
AND 4.

Structure: 960166 County: WILKES Date: 01/13/2017 Condition Photos
Span 3 Beam 4 Far Bearing: HEAVY CORROSION AND SECTION LOSS IN ANCHOR BOLT AT END BENT 2.
gyp,, i
Span 3 Left Bridge Rail: SURFACE RUST ALONG ENTIRE LENGTH.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
LOOKING EAST.
LOAD POSTING AT SOUTHWEST CORNER.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
w ,
tc J
0y�
r
r
RIGHT BRIDGE RAIL.
LEFT BRIDGE RAIL.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
UPSTREAM/SOUTH PROFILE.
DOWNSTREAM/NORTH PROFILE.

Structure: 960166
County: WILKES
Date: 01 /13/2017
Structure Photos
JOINT A
D BENT 1, LOOKING SOUTH. NOTE NEW ASPHALT PATCH SINCE PREVIOUS II
TOP OF DECK, LOOKING EAST.
CTION.

Structure: 960166 County: WILKES
Date: 01/13/2017 Structure Photos
JOINT AT BENT 1, LOOKING NORTH. NOTE NEW ASPHALT PATCH SINCE PREVIOUS INSPECTION.
4_
LOOKING DOWNSTREAM/NORTH FROM SPAN 2.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
1Y f 11
_r_ �f¢�� .sue. � _ -- - `'• 1 �
741
it
LOOKING UPSTREAM/SOUTH FROM SPAN 2.
JOINT AT BENT 2, NOTE NEW ASPHALT PATCH SINCE PREVIOUS INSPECTION.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
.r�
JOINT AT END BENT 2 LOOKING NORTH.
LOAD POSTING SIGN, NORTHEAST CORNER.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
LOOKING WEST.
SOUTHWEST WINGWALL.

Structure: 960166 County: WILKES
Date: 01/13/2017 Structure Photos
dt•y�E r
END BENT 1.
BEARING ASSEMBLY, BEAM 4, END BENT 1.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
INTERMEDIATE DIAPHRAGM, BAY 4, SPAN 1.
BENT 1 PROFILE, LOOKING EAST.

Structure: 960166 County: WILKES
Date: 01/13/2017 Structure Photos
SUPERSTRUCTURE UNDERSIDE, SPAN 2, LOOKING EAST.
00
BENT 2 PROFILE, LOOKING EAST.

Structure: 960166 County: WILKES
Date: 01/13/2017 Structure Photos
rnow
_..
-
ow
�r
SINCE PREVIOUS INSPECTION, NEW SECTION OF STEEL DECKING INSTALLED AT BENT 1 OVER BEAMS
4,5,6 AND BOLTED TO BEAM TOP FLANGES.
NORTHWEST WINGWALL.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
LOOKING DOWNSTREAM/NORTH FROM BELOW BRIDGE.
LOOKING UPSTREAM/SOUTH FROM BELOW BRIDGE.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
END BENT 2.
SLOPE PROTECTION AT END BENT 2.

Structure: 960166 County: WILKES
Date: 01/13/2017 Structure Photos
FENCE BELOW SPAN 3.
SOUTHEAST WINGWALL.

Structure: 960166 County: WILKES Date: 01/13/2017 Structure Photos
NORTHEAST WINGWALL.

NATIONAL BRIDGE INVENTORY-------- STRUCTURE INVENTORY AND APPRAISAL Run Date: 09/25/2017
IDENTIFICATION
(1) STATE NAME -NORTH CAROLINA BRIDGE
960166
SUFFICIENCY RATING =
68.53
(8) STRUCTURE NUMBER(FEDERAL) 000000001930166
STATUS = Not Deficient
(5) INVENTORY ROUTE (ON/UNDER) - ON
31017450
(2) STATE HIGHWAY DEPARTMENT DISTRICT
3
CLASSIFICATION
CODE
(3) COUNTY CODE 193 (4) PLACE CODE
0
(112)NBIS BRIDGE SYSTEM -
YES
(6) FEATURE INTERSECTED - WEST PRONG ROARING RIVER
(104)HIGHWAY SYSTEM Is not on NHS
0
(7) FACILITY CARRIED SR1745
(26) FUNCTIONAL CLASS - Local
09
(9) LOCATION 50 FT.E.JCT.SR1746
(100)STRAHNET HIGHWAY- Not a STRAHNET Route
0
(11)MILEPOINT
0
(101)PARALLEL STRUCTURE- No Parallel Structure
N
(16)LAT 36° 17' 39.27" (17)LONG 81° 5' 48.49"
(102)DIRECTION OF TRAFFIC - 2-way Traffic
2
(98)BORDER BRIDGE STATE CODE PCT SHARE
(103)TEMPORARY STRUCTURE -
(99)BORDER BRIDGE STRUCTURE NO
(110)DESIGNATED NATIONAL NETWORK - Not on the National Network
0
(20) TOLL On Free Road
3
STRUCTURE TYPE AND MATERIAL
(31) MAINTAIN - State Highway Agency
01
(43) STRUCTURE TYPE MAIN: Steel
(22) OWNER - State Highway Agency
01
TYPE- Stringer Mutlibeam or Girder
CODE 302
(37) HISTORICAL SIGNIFICANCE - Not Eligible
5
(44) STRUCTURE TYPE APPR :
TYPE-
CODE 000
CONDITION
CODE
(45) NUMBER OF SPANS IN MAIN UNIT
3
(58) DECK
6
(46) NUMBER OF APPROACH SPANS
(59) SUPERSTRUCTURE
6
(107)DECK STRUCTURE TYPE - 6
CODE
(60) SUBSTRUCTURE
6
(108)WEARING SURFACE / PROTECTIVE SYSTEM:
(61) CHANNEL & CHANNEL PROTECTION
7
(A) TYPE OF WEARING SURFACE -
CODE
(62) CULVERTS
N
(B) TYPE OF MEMBRANE -
CODE
LOAD RATING AND POSTING
CODE
(C) TYPE OF DECK PROTECTION -
CODE
(31) DESIGN LOAD Unknown
0
(63) OPERATING RATING METHOD - Load Factor
1
AGE AND SERVICE
(64) OPERATING RATING - HS-19
35
(27) YEAR BUILT
1977
(65) INVENTORY RATING METHOD - Load Factor
1
(106)YEAR RECONSTRUCTED
(66) INVENTORY RATING - HS-12
21
(42) TYPE OF SERVICE: ON - Highway
(70) BRIDGE POSTING - Posting Required
4
UNDER - Waterway
CODE 15
(41) STRUCTURE OPEN, POSTED ,OR CLOSED
P
(28) LANES: ON STRUCTURE 2 UNDER STRUCTURE
0
DESCRIPTION - Posted for Load
(29) AVERAGE DAILY TRAFFIC
370
APPRAISAL
CODE
(30) YEAR OF ADT 2012 (109) TRUCK ADT PCT
6%
(67) STRUCTURAL EVALUATION
5
(19) BYPASS OR DETOUR LENGTH
8 MI
(68) DECK GEOMETRY
5
GEOMETRIC DATA
(69) UNDERCLEARANCES,VERTI & HORIZ
N
(48) LENGTH OF MAXIMUM SPAN
45 FT
(71) WATERWAY ADEQUACY
7
(49) STRUCTURE LENGTH
136 FT
(72) APPROACH ROADWAY ALIGNMENT
8
(50)CURB OR SIDEWALK: LEFT .1 FT RIGHT
.1 FT
(36) TRAFFIC SAFETY FEATURES
0000
(51) BRIDGE ROADWAY WIDTH CURB TO CURB
24 FT
(113)SCOUR CRITICAL BRIDGES
8
(52) DECK WIDTH OUT TO OUT
24.167 FT
PROPOSED IMPROVEMENTS
(32) APPROACH ROADWAY WIDTH (W/SHOULDERS)
20 FT
(75) TYPE OF WORK - CODE
(33) BRIDGE MEDIAN - No Median
CODE 0
(76) LENGTH OF STRUCTURE IMPROVEMENT
(34) SKEW 0° (35) STRUCTURE FLARED
0
(94) BRIDGE IMPROVEMENT COST
(10) INVENTORY ROUTE MIN VERT CLEAR
999.9 FT
(95) ROADWAY IMPROVEMENT COST
(47) INVENTORY ROUTE TOTAL HORIZ CLEAR
24 FT
(96) TOTAL PROJECT COST
(53) MIN VERT CLEAR OVER BRIDGE RDWY
999.9 FT
(97) YEAR OF IMPROVEMENT COST ESTIMATE
(54) MIN VERT UNDERCLEAR REF Not a Highway or Railroad
0 FT
(114)FUTURE ADT 740 (115) YEAR FUTURE ADT
2025
(55) MIN LAT UNDERCLEAR RT REF Not a Highway or Railroad
000 FT
(56) MIN LAT UNDERCLEAR LT REF -
000 FT
INSPECTIONS
(90) INSPECTION DATE 01/13/2017
NAVIGATION DATA
(92) CRITICAL FEATURE INSPECTION: (93) CFI DATE
(38) NAVIGATION CONTROL - No Navigational Control
CODE 0
A) FRACTURE CRIT DETAIL - NO A)
(111)PIER PROTECTION -
CODE
B) UNDERWATER INSP - NO B)
(39) NAVIGATION VERTICAL CLEARANCE
0
C) OTHER SPECIAL INSP NO C)
(116)VERT - LIFT BRIDGE NAV MIN VERT CLEAR
FT
SCOUR
(40) NAVIGATION HORIZONTAL CLEARANCE
0 FT

BRIDGE MANAGEMENT UNIT
DATA ON EXISTING STRUCTURE Run Date: 09/25/2017
COUNTY: DIVISION: DISTRICT: STRUCTURE NUMBER: LENGTH:
WILKES 11 3 960166 136
FEET
ROUTE CARRIED: FEATURE INTERSECTED :
SR1745 WEST PRONG ROARING RIVER
LOCATED: BRIDGE NAME:
50 FT.E.JCT.SR1746 CITY:
FUNC. CLASS : SYST.ON : SYST.UNDER : ADT & YR : RAIL TYPE:
09 NFA NFA 370 2012 LT 233 RT 233
BUILT: BY: PROJ : FED.AID PROJ : DESIGN LOAD:
1977 BMU Unknown
REHAB: BY: PROJ: ALIGNMENT: SKEW: LANES:
TAN 90 ON 2 UNDER
0
NAVIGATION: HT. CRN. TO BED: WATER DEPTH:
VC 0 FT HC 0 FT 20 FT 1
FT
SUPERSTRUCTURE: STEEL PLANK FLOOR ON I -BEAMS
SUBSTRUCTURE: E.BTS:TIM.CAPS/TIM.PILES;BTS:TIM.CAPS/TIM.POST&CONC.SILLS
SPANS: 1 @ 45'-4; 1 @ 45; 1 @ 45'-4
BEAMS OR GIRDERS: 10 LINES 21 I -BEAMS @ 2'-6.75 CENTERS
FLOOR: ENCROACHMENT: DECK (OUT TO OUT) :
STL.PLK/4.5 24.167 FT
AWS
CLEAR ROADWAY: BETWEEN RAILS: SIDEWALK OR CURB:
24 FT 24.25 FT LT .1 FT RT
.1 FT
VERT.CL.OVER :
999.9 FT
INV.RTG.: OPE.RTG.: CONTR.MEMBER : POSTED:
HS-12 HS-19 int bm SV 26 TTST 31 DATE 05/07/2009
SYSTEM: GREEN LINE ROUTE:
Secondary S.R. Route N
UNDER ROUTES AND CLEARANCES
REMARKS:

Structure Data Worksheet
Spans
County: WILKES Structure No: 960166 Date: 01/13/2017 Inspected By: IRS
Span No
Span
Length
Bearing to
Bearing
Comments
1
45'-4"
44'-4"
NBIS LENGTH = 135'-8"
2
45'-0"
44'-7"
3
45'-4"
44'-4"

Stream Bed Soundings
(See next sheet for profile sketch)
Bridge No: 960166 County: WILKES Date: 01/13/2017 By: IRS
Record sounding from top of rail. Other location if needed:
Distance from Highwater Mark to top of rail: Location of Highwater Mark:
DOWNSTREAM
UPSTREAM
Distance
(Station) (ft)
Sounding
(ft)
Description
Distance
(Station) (ft)
Sounding
(ft)
Description
0
2
TOP OF WING
0.3
4.3
Top of Cap
0.31
8.9
FACE OF END BENT
0.31
8.8
FACE OF END BENT
10
9.9
31
14.7
35
16.2
45.3
19.2
BENT 1, TOP OF FOOTING
45.3
20.4
BENT 1, TOP OF FOOTING
45.31
21.5
WSWE
68
21.6
88
21.1
WSWE
90.3
18.4
BENT 2, TOP OF FOOTING
90.3
19.5
BENT 2, TOP OF FOOTING
105
15.5
129
6.3
135.29
6.3
FACE OF END BENT 2.
135.29
6.3
FACE OF END BENT 2.

Bridge: 960166 County WILKES Date: 01/13/2017
STREAMBED PROFILE (Downstream)
Top of Rail = 0 FT (Sounding)
Water Surface ■ 1 /4/2007 ■ 1 /2012009 ■ 1 /1812011 ❑ 1 /9/2013 ■ 1 /20/2015 171 1 /1312017
0
4
8
IL
12
U7 18
20
24 _
0 20 40 60 80 100 120 140
Distance (FT)

Bridge Inspection Field Sketch
STEEL PLANK
8 1f4"
2 5/8" X 10" DIAPH. MID -SPAN
31811
1 /211
VERIFIED 111311 7 BY RS
Title
Description
TS
SUPER
Eldd a No: 9 Q16fi
Drawn By: K�CI
Date:Q11Q9/2013 File Name:S012�6001299
Deck Width/Out to Out 24.167ft
Wearing Surface {].375ft
Between Rails
24.25Qft
Median Width
Curb Height
0.667 ft
Median Height
Top Rail to Deck/Wearing Surface
2.083ft
Left Guardrail
Measurements for Span #
1
SPAI112 & 3 SIMILAR
Deck Thickness
Tap of Rail to bottom of Beam
0.167
4.5Qi1
Left dverhang
Right Overhang
0.542
0.542
Beam No
Beam Type � Spacing
Comments
1
Steel I Beam 2.562
_

Bridge Inspection Field Sketch
SR 1745
_ LOOKING NORTH
Roadway 18ft Wide 2 Paved Lanes Looking East
Left Shoulder Oft Wide 1ft Paved aft Unpaved
Right Shoulder 3.5ft Wide 1ft Paved 2.5ft Unpaved
�Left Guardrail
Right Guardrail
MODIFIED 1 /13/17 BY IRS
Title Description
APRW APPROACH ROADWWAY
Bridge No; 960166 Drawee By: G.R.R. Date=0110412007 File Narne:E0130001510

Bridge Inspection Field Sketch
Abutment #
1
Abutment
2 similar
Cap -Beam Type Woad or Steel)
Wide
0.98ft High
Gap Size
25ft Long

?
Bridge Inspection Field Sketch
?
Bent # 1
Bent 2 similar
Cap -Beam Type Woad or Steel)
Gap Size
251t Long
�0.98ft Wide
0.98tt High
Left Overhang
1.5ft
Lt Cap/Beam Overhang
1.254tt
1.333ft
Right Overhang
1.5ft Rt Cap/Beam Overhang
Sill -Spread
Sill Size

REQUEST FOR R/W COST ESTIMATE / RELOCATION EIS
COST ESTIMATE REQUEST ❑ RELOCATION EIS REPORT
NEW REQUEST: ® UPDATE REQUEST:❑ REVISION REQUEST:❑
Update to Estimate Revision to Estimate
Revision No.:
DATE RECEIVED: 06 18 19 DATE ASSIGNED: 06 19 19 # of Alternates Requested: 1
DATE DUE: 07 17 19
DESCRIPTION: Replace bridge # 960166 on SR 1745 (Shumate Mountain Rd) over West Prong of
IP No.: BR-0124 Roaring River
WBS ELEMENT: 67124.1.1 COUNTY: Wilkes DIV: 11 APPRAISAL OFFICE: 3
REQUESTOR: Marissa Lenoce, Elizabeth Scott, Kevin Bailey DEPT: STV Engineers
TYPE OF PLANS: HEARING MAPS❑ I LOCATION MAP❑ I AERIAL❑ I VICINITY❑ I PRELIMINARY❑ I CONCEPTUAL❑
** Based on past project historical data, the land and damage figures have been adjusted to include condemnation
and administrative increases that occur during settlement of all parcels.**
APPRAISER: Tommy Nance COMPLETED: 07108119 # of Alternates Completed: 1
TYPE OF ACCESS:
NONE:®
IMITED: ❑
PARTIAL:❑
ULL: ❑
ESTIMATED NO. OF PARCELS:
2
RESIDENTIAL RELOCATEES:
-
$ -
BUSINESS RELOCATEES:
-
$ -
GRAVES:
-
$ -
CHURCH / NON — PROFIT:
-
$ -
MISC:
-
$ -
SIGNS:
-
$ -
LAND, IMPROVEMENTS, & DAMAGES:
$ 3,413
ACQUISTION:
$ 1,500
TOTAL ESTIMATED R/W COST: $ 4,913
** THIS IS A COST ESTIMATE AND NOT TO BE USED AS AN APPRAISAL **
NOTES:
Page 1 of 1

Sources and Uses of Funds for the GREATTER-NC Program
Summary
Design
ROW
Utilities
Construction
Total
960166
Non-federal sources
$ 34,960
$ 13,984
$ 13,984
$ 349,604
$ 412,532
BUILD
$ 164,540
$ 65,816
$ 65,816
$ 1,645,396
$ 1,941,568
Other federal
$ -
$ -
$ -
$ -
$ -
2,354,100

STR_No Total Total Injury Fatal A_Inj B_Inj C_Inj PDO Unk AADT (2016) Truck%
960166 0 0 0 0 0 0 0 0 470 6%
Crash Reduction
Crash Reduction
- Total Injury
- Total Crashes
Crashes (K,A,B,C)
0
0

TIP:
County:
Bridge Number and Location:
Reviewer:
Date:
Base Year:
Base Year AADT Estimate
Is the bridge location modeled with an approved model?
Historic AADT Location:
Comments:
Class Data
Result:
B R-0124
Wilkes
BRIDGE 960166 ON SR1745 OVER WEST PRONG ROARING RI
Keith Dixon
10/2/2018
2016
470
No
SR 1745 W OF SR 1746
2016
290
2015
2014
240
2013
2012
340
2011
2010
320
2009
2008
310
2007
N/A
Assume Minimum Design Standards

Roy COOPER
GOVERNOR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
6/7/2019
MEMORANDUM TO: Marissa Lenoce
Planner STV Inc.
JAMES H. TROGDON, III
SECRETARY
FROM: Gordon Box, PG Docu ft„W b,.
GeoEnvironmental Project Manager
GeoEnvironmental Section
Geotechnical Engineering Unit OOA9A702E9�B479...
TIP NO:
BR-0124
WBS:
67124.1.1
COUNTY:
WILKES
DIVISION
11
DESCRIPTION:
Bridge Number 960166 on SR1745 over West Prong Roaring River
SUBJECT: Pre-Scoping Comments
The GeoEnvironmental Section performed a records search of readily available information for the given
project study area to identify known and potential sites of concern. One (1) UST facility was identified within
the project area. Refer to the attached table and figure for a list of sites of concern and their anticipated
impacts.
A detailed Phase I study of the preferred alternative should be performed to field verify the hazardous waste
sites and identify unknown sites. This detailed Phase I study should be included in the environmental
document.
cc:
Kevin Fischer, PE, Assistant State Structures Engineer - PEF Coordination, Program Management & Field
Ops.
John Pilipchuk, LG, PE, State Geotechnical Engineer
Brian Hanks, PE, State Structures Engineers
Dale Burton, PE, PLS, State Locations and Surveys Engineer
Carl Barclay, PE, State Utilities Manager
Trent Beaver, PE, Division Construction Engineer
Daneil Miles, Division Right of Way Agent
Eric Williams, PE, Geotechnical Regional Manager
Kevin Miller, PG, Regional Geological Engineer
Heather Fulghum, State Negotiator
row-notifykncdot. gov
roadwaydesi gnkncdot. gov
hydraulics notify&ncdot.gov
File
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
GEOTECHNICAL ENGINEERING UNIT
1589 MAIL SERVICE CENTER
RALEIGH NC 27699-1589
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.eov
Location:
CENTURY CENTER COMPLEX
ENTRANCE B-2
1020 BIRCH RIDGE DRIVE
RALEIGH NC

GeoEnvironmental Pre-Scoping Comments
T.I.P.#: BR-0124
Page 2 of 4

GeoEnvironmental Pre-Scoping Comments
T.I.P.#: BR-0124
Page 3 of 4
Table
USTs, Landfills & Other Potentially Contaminated Sites of Concern
Site #
Type
Location
UST Facility
ID #
Property Name
Property Owner
Anticipated Impact
Anticipated
Risk
Comments
1
UST
3984 TRAPHILL
NA
Garage
WILES, KIM,
USTs, hydraulic lifts,
Low
This parcel has a
RD, HAYS, NC
4042
and/or petroleum and/or
building with three bay
TRAPHILL RD,
solvent impacted soil
doors that may have
HAYS, NC
and/or groundwater.
hydraulic lifts with in
ground components.
Automobile service has
likely been performed
on site. The building
may have been a former
gas station - USTs may
be present. Multiple
salvage automobiles are
also on site, per Google
Streetview.

GeoEnvironmental Pre-Scoping Comments
T.I.P.#: BR-0124
Page 4 of 4
WILKES
COUNTY
USGS Topo Quad - iraphill
0 500 1,000 2,000
Feet

BR-0124 (960166)
• A PDR is available. Please let me know if a copy needs to be
provided. The summary of the PDR is listed below:
o West Prong Roaring River
■ Class C
■ Yadkin Pee -Dee River Basin
■ DA z 23.0 mil (FEMA)
■ Limited Detailed Study
• Possible Structures Impacted: Some structures are
impacted but by the Middle Prong River
floodplain.
• RS = 344
• Q 100 = 11127 cfs

Cover
Page
Hydraulics Unit Pre -Design Report (Pre-Scoping) for Structure #: 960166
County: Wilkes I Stream: I WEST PRONG ROARING RIVER
Assigned to: STV ENGINEERS, INC.
Date: 03/25/2019
Road #: SR 1745 Road Name: SHUMATE MTN. RD
Division: 11 1 Location: 50 FT. E,JCT.SR 1746
Latitude: 36.29425 Longitude:-81.09683 Decimal degrees, a min of 5 decimal
Prepared By MANOHAR SEETHARAMU
Hydro Reviewer:
Project Type:
txisvng biruciure
Structure Type Steel Deck/I Beams Yr Built: 1977
Span Arrangement: 1@45'-4, 1@45', 1@454 I CAL (ft): 136.0 Skew: 90 Abutment Type: I Vertical -Timber
Number of Barrels: I @ Span (ft): x Rise (ft):
Bed to Crown (ft): 15.5 Clear Roadway (ft): 24.0
ADT: 470 Year ADT: 2016 I Scour Code (item113)
Water Depth (ft) 2•0 Superstructure Depth: 2'
: I Prior Survey Completed: Survey Date:
Drainage Area: 123.0 I Sq. Mi. Drainage Area Source: USGS Stream Stats I Roadway Overtops at Q100: No
Discharge Method: USGS Regression Equations USGS Region: 1- Piedmont Stream Gage Number(if applicable): 02112120
Q10 (cfs): 1,600.0 Q25 (cfs): 2,100.0 Q50 (cfs): 2,400.0 Q100 (cfs): 2,700.0 QBFE (cfs): 11,127.0
Structure in Flood Hazard Zone Yes Panel #: 3982 Panel Date: 03/02/2009 Type of FIS: LIMITED Date of FIS: 12/03/2009
r_...-_.Y­_1
Quad Map: TRAPHILL, NC
River Basin: Yadkin -Pee Dee Buffer Rule: N/A
Primary Stream Classification
Other Stream Classification
❑ Class B ❑1 Class C
❑ SA
❑ SB
❑ Anadromous Fish
❑ Area of Environmental Concern
❑ SC ❑ SWL
❑ WL
❑ WS 1
❑ CAMA County
❑ Federal Wild & Scenic Rivers
❑ WS 11 ❑ WS III
❑ WS IV
❑ WS V
❑ HSB Requried
❑ NC Natural & Scenic Rivers
Supplemental Stream Classification
❑ Impaired [303d]
❑ Primary Nursery Area
❑ FWS ❑ HQW
❑ NSW
❑ ORW
❑ TVA
❑ Designated Shellfish Harvesting Area
❑ Sw ❑ Tr
❑ UWL
❑ w/in 0.5mi. of CA
❑ Designated Public Mountain Trout Waters
— Up/Down Stream Features
Upstream Feature:
Location: CONFLUENCE WITH CANE CREEK
Structure #: Route:
Latitude: Longitude:
Prior Survey Completed:= Survey Date:
Structure Type:
Span Arrangement:
Number of Barrels: @ Span (ft)
Bed to Crown (ft): = Year Built:
Downstream Feature:
Structure Type:
Location: CONFLUENCE WITH MIDDLE PRONG ROARING CR
Span Arrangement:
Structure #: Route:
Number of Barrels: @ Span (ft):
Latitude: Longitude:
Prior Survey Completed:= Survey Date: Bed to Crown (ft) Year Built: _
— Preliminary Structure Estimate [Office Estimate]
Structure Type: TBD Skew:
160 LF OAL. Maintain existing low chord. Span arrangement to be discussed at Field Review Meeting.
Dimensions/Spans:
Notes
OAL (ft):
x Rise (ft):
OAL (ft):0
x Rise (ft):
itream Index: 1246-1-(5)
rev.20160922

1746 a 1p R 012 4 ROARING
1736 1748
F
Eart I/ .
I aA 1730
3' 40
Sh",,, 1_45
1.46
1744
\� h18�0
e2
Bridge otion (960166) 174
170 e <�
M
1770 1002
I \ '4761
w 1954
� s
p2
>
o
2000' 0' 2000'
1953
69
2153 a
o,Pc
oyPc�
�h
1953
1746
1952
1747
1
tt
0
1002
90
1736
cQ�
Dockery
1952

STV
CLIENT "-VcDpl
MADE BY
CHECKED BY
PROJECT NO.
PROJECT Cep —
O" 1.<'
0I221 E;
SUBJECT
DATE
DATE
REVISION
SHEET NO.
C7 /19// 2

I
A�
t
Lim
d
L�
C m
W O m
A mm z
-i
Ti ,3
a � o
"I m W
O
A
2
a X
I m
m p
m
m
e.
�+ a
o� z�� p
2 �
m zp
m
z
p

2/25/2019 StreamStats
StreamStats Report
Region ID: NC
Workspace ID: NC20190225164546641000
Clicked Point (Latitude, Longitude): 36.29432,-81.09676
Time: 2019-02-25 11:46:00 -0500
effe rs.on
: Airpti t e
- III
88
r d?n,'N}' AJN
PULIHEAD
k
Iiy`
1
MOUNTAIN
pays
iAirport
Basin Characteristics
Parameter Code Parameter Description
MUQNTAI
hi
.o�
Thurmond
Value Unit
Pleasant Hill
https://streamstats.usgs.gov/ss/ 1 /4

2/25/2019 StreamStats
Parameter Code Parameter Description
DRNAREA
Area that drains to a point on a stream
PCTREG1
Percentage of drainage area located in Region 1
PCTREG2
Percentage of drainage area located in Region 2
PCTREG3
Percentage of drainage area located in Region 3
PCTREG4
Percentage of drainage area located in Region 4
PCTREG5
Percentage of drainage area located in Region 5
LC061MP
Percentage of impervious area determined from NLCD 2006 impervious dataset
Peak-FloW Statistics Parameters [86 Percent (19.8 square miles) Peak Southeast US over 1 sgmi 2009 51581
Parameter Code
Parameter Name
DRNAREA
Drainage Area
PCTREG1
Percent Area in Region 1
PCTREG2
Percent Area in Region 2
PCTREG3
Percent Area in Region 3
PCTREG4
Percent Area in Region 4
PCTREG5
Percent Area in Region 5
Value Units
Value Unit
23 square miles
13.791 percent
86.209 percent
0 percent
0 percent
0 percent
0.17 percent
Min Limit Max Limit
23
square miles
1
9000
13.791
percent
0
100
86.209
percent
0
100
0
percent
0
100
0
percent
0
100
0
percent
0
100
Peak-FloW Statistics Disclaimers [86 Percent (19.8 square miles) Peak Southeast US over 1 sgmi200951581
Weighted flows were not calculated. Users should be careful to evaluate the applicability of the provided estimates. Percentage of area falls
outside where region is undefined. Whole estimates have been provided using available regional equations.
Peak-FloW Statistics Flow Report [86 Percent (19.8 square miles) Peak Southeast US over 1 sgmi 2009 51581
https://streamstats.usgs.gov/ss/ 2/4

2/25/2019
StreamStats
PII: Prediction Interval -Lower, Plu: Prediction Interval -Upper, SEp: Standard Error of Prediction, SE: Standard
Error (other -- see
report)
Statistic
Value
Unit
PII
Plu
SEp
2 Year Peak Flood
1250
ft"3/s
722
2180
34.5
5 Year Peak Flood
2180
ft"3/s
1260
3760
34
10 Year Peak Flood
2880
ft^3/s
1640
5050
35.1
25 Year Peak Flood
3820
ft^3/s
2100
6950
37.5
50 Year Peak Flood
4520
ft^3/s
2400
8490
39.6
100 Year Peak Flood
5330
ft^3/s
2740
10400
41.9
200 Year Peak Flood
6040
ft"3/s
3000
12200
44.3
500 Year Peak Flood
7140
ft"3/s
3380
15100
47.7
Peak -Flow Statistics Citations
Weaver, J.C., Feaster, T.D., and Gotvald, A.J.,2009, Magnitude and frequency of rural floods in the Southeastern United
States, through 2006-Volume 2, North Carolina: U.S. Geological Survey Scientific Investigations Report 2009-5158, 111 p.
(http://pubs.usgs.gov/sir/2009/5158/)
USGS Data Disclaimer: Unless otherwise stated, all data, metadata and related materials are considered to satisfy the quality standards relative to the purpose for
which the data were collected. Although these data and associated metadata have been reviewed for accuracy and completeness and approved for release by the U.S.
Geological Survey (USGS), no warranty expressed or implied is made regarding the display or utility of the data for other purposes, nor on all computer systems, nor
shall the act of distribution constitute any such warranty.
USGS Software Disclaimer: This software has been approved for release by the U.S. Geological Survey (USGS). Although the software has been subjected to rigorous
review, the USGS reserves the right to update the software as needed pursuant to further analysis and review. No warranty, expressed or implied, is made by the USGS
or the U.S. Government as to the functionality of the software and related material nor shall the fact of release constitute any such warranty. Furthermore, the software
is released on condition that neither the USGS nor the U.S. Government shall be held liable for any damages resulting from its authorized or unauthorized use.
USGS Product Names Disclaimer: Any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the U.S. Government.
Application Version: 4.3.0
https:Hstreamstats.usgs.gov/ss/ 3/4

2/25/2019
StreamStats
https:Hstreamstats.usgs.gov/ss/ 4/4

FLOOD INSURANCE STUDY
FEDERAL EMERGENCY MANAGEMENT AGENCY
A Report of Flood Hazards in
WILKES COUNTY, NORTH
CAROLINA AND
INCORPORATED AREAS
Community Name
Community
Number
TOWN OF ELKIN
370225
TOWN OF NORTH WILKESBORO
370257
TOWN OF RONDA
370258
TOWN OF WILKESBORO
370259
WILKES COUNTY
370256
FEMA'S CGGPERATING WRCMNIMMALIARMNE.
EFFECTIVE: 3/2/2009
REVISED: 12/3/2009
Federal Emergency Management Agency
State of North Carolina
Flood Insurance Study Number
37193CV000
www.fema.gov and www.ncfloodmaps.com

Table 13 - Summary of Discharges
Flooding Source
I Discharges (cfs)
Location
Drainage Area
(square miles)
10% Annual
Chance
2% Annual
Chance
1 % Annual
Chance
0.2% Annual
Chance
Approximately 0.4 mile downstream of Falls Road (SR 1108)
5.29
4434
Approximately 175 feet upstream of Falls Road (SR 1108)
4.91
4236
Approximately 0.7 mile upstream of Falls Road SR 1108
4.49
4004
Approximately 1.2 miles upstream of Falls Road (SR 1108)
14.01
1
1
13730
West Prong Moravian Creek Tributary 1
At the confluence with West Prong Moravian Creek
2.84
3007
West Prong Roaring River
At the confluence with Middle Prong Roaring River
23.04
11127
Approximately 0.5 mile upstream of the confluence with Middle Prong Roaring River
22.75
11040
Approximately 1.0 mile downstream of the confluence of Cane Creek
21.36
10611
Approximately 775 feet upstream of the confluence of Cane Creek
14.31
8263
Approximately 100 feet upstream of Shumate Mountain Road (SR 1745)
14.06
8169
Approximately 0.5 mile downstream of first Cabin Creek Road SR 1730 crossing
13.59
8000
Approximately 1,170 feet upstream of first Cabin Creek Road (SR 1730) crossing
12.41
7556
Approximately 1,840 feet downstream of second Cabin Creek Road crossing
12.31
7521
Approximately 0.4 mile upstream of second Cabin Creek Road crossing
10.68
6882
Approximately 0.5 mile downstream of the confluence of Gambill Creek
9.98
6595
Approximately 25 feet upstream of the confluence of Gambill Creek
7.65
5585
Approximately 960 feet downstream of State Road 1731
6.35
4972
Approximately 1,500 feet upstream of State Road 1731
5.88
4739
Approximately 0.8 mile upstream of State Road 1731
5.70
4647
Approximately 1.6 miles upstream of State Road 1731
4.29
3890
Approximately 1.9 miles upstream of State Road 1731
4.05
3755
Approximately 2.2 miles upstream of State Road 1731
3.80
13609
West Swan Creek
At the confluence with Swan Creek
5.40
2136
Approximately 100 feet upstream of Bagley Springs Road SR 2311
5.23
2094
Approximately 0.5 mile upstream of Bagley Springs Road (SR 2311)
4.88
2006
Approximatel 0.7 mile upstream of Bagley Springs Road SR 2311
4.51
1911
Approximately 1.1 miles upstream of Bagley Springs Road (SR 2311)
4.38
1874
Approximately 1.4 miles upstream of Bagley Springs Road SR 2311
4.16
1816
Approximately 1.8 miles upstream of Bagley Springs Road (SR 2311)
3.88
1738
Whites Creek
At the confluence with Yadkin River
3.41
3374
Approximately 0.5 mile upstream of the confluence with Yadkin River
3.09
3167
Approximately 1,425 feet downstream of NC Highway 268
2.60
2848
Approximately 0.4 mile upstream of NC Highway 268
2.20
2564
Approximately 0.8 mile upstream of NC Highway 268
11.71
1
1
12193
Yadkin River
At the Wilkes/Surry/ Yakin County boundary
829.75
26600
48300
62100
113700
Approximately 25 feet upstream of the confluence of Little Elkin Creek
811.10
26400
48000
61700
113000
Approximately 25 feet upstream of the confluence of Swan Creek
797.98
25600
46300
59400
110200
Approximately 25 feet upstream of the confluence of Yadkin River Tributary 15
787.87
25000
44900
57700
108100
Approximately 25 feet upstream of the confluence of Big Bugaboo Creek
1763.61
123600
141800
153700
1103000
Flood Insurance Study Report: WILKES COUNTY, NORTH CAROLINA AND INCORPORATED AREAS
Effective Date: March 2, 2009 Page 31 of 167

Table 17 - Limited Detailed Flood Hazard Data
Cross Section
Stream Station
Flood Discharge (cfs)
1 % Annual Chance Water-
Non -Encroachment Width (feet)
Surface Elevation (feet NAVD
Left/Right from Stream
88)
Centerline
003
334.0
3007.0
1077.3
14.0 / 119.0
005
464.0
3007.0
1078.4
14.0 / 101.0
009
888.0
3007.0
1083.7
106.0 / 14.0
012
1168.0
3007.0
1086.2
155.0 / 14.0
015
1533.0
3007.0
1088.7
63.0 / 14.0
017
1742.0
3007.0
1091.4
53.0 / 65.0
020
12006.0
3007.0
1093.4
20.0 / 68.0
023
2287.0
3007.0
1097.0
85.0 / 30.0
024
2449.0
3007.0
1100.1
60.0 / 19.0
West Prong Roaring River
002
221.0
11127.0
1090.51
30.0 / 95.0
003
256.0
11127.0
1090.51
29.0 / 74.0
003
328.0
11127.0
1090.51
41.0 / 38.0
004
363.0
11127.0
1090.51
44.0 / 35.0
008
750.0
11127.0
1090.51
28.0 / 35.0
015
1500.0
11127.0
1093.8
44.0 / 65.0
023
2250.0
11127.0
1096.0
91.0 / 28.0
030
3000.0
11040.0
1099.7
19.0 / 75.0
037
3702.0
11040.0
1106.3
131.0 / 31.0
045
4500.0
11040.0
1108.0
46.0 / 149.0
053
5250.0
11040.0
1109.6
67.0 / 37.0
060
5964.0
11040.0
1117.1
53.0 / 58.0
068
6750.0
11040.0
1124.0
21.0 / 46.0
075
7500.0
11040.0
1128.0
95.0 / 35.0
081
8084.0
11040.0
1131.6
51.0 / 33.0
083
8262.0
11040.0
1134.9
75.0 / 40.0
090
9012.0
10611.0
1136.8
97.0 / 25.0
093
9328.0
10611.0
1137.9
37.0 / 90.0
095
9487.0
10611.0
1138.6
35.0 / 96.0
098
9762.0
10611.0
1139.3
49.0 / 50.0
105
10498.0
10611.0
1143.0
40.0 / 59.0
113
11262.0
10611.0
1149.5
19.0 / 146.0
116
11607.0
10611.0
1151.8
50.0 / 66.0
120
11961.0
10611.0
1155.8
54.0 / 29.0
121
12099.0
10611.0
1158.6
56.0 / 29.0
123
12314.0
10611.0
1159.8
92A / 22.0
128
12762.0
10611.0
1162.1
100.0 / 29.0
135
13512.0
10611.0
1166.3
32.0 / 65.0
143
14262.0
10611.0
1173.3
34.0 / 114.0
146
14647.0
10611.0
1174.2
16.0 / 87.0
150
15012.0
8263.0
1175.1
25.0 / 53.0
154
15351.0
8263.0
1178.2
40.0 / 35.0
157
15674.0
8263.0
1181.9
35.0 / 17.0
163
16293.0
8263.0
1188.6
21.0 / 34.0
169
16853.0
8263.0
1194.9
43.0 / 53.0
Flood Insurance Study Report: WILKES COUNTY, NORTH CAROLINA AND INCORPORATED AREAS
Effective Date: March 2, 2009 Page 148 of 167

1380000 FEET 1400000 FEET
940000 FEET 81 °6'0"W 81 °5'30"W 81 °5'0"W 81 °4'30"W 81 °4'0"W 81 °3'30"W 81 °3'0"W 81 °2'30"W 940000 FEET
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9
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j6�Fo'��� ,� pis East Prong G`���a
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C�°�e ti�aQ�6 �2° 1p42• �o�,yg
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36°16'0"N
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�� moo'` River ,ti
920000 FEET v tit iiiiiii920000 FEET
81 °6'0"W 81 °5'30"W 81 °5'0"W 81 °4'30"W 81 °4'0"W 81 °3'30"W 81 °3'0"W 81 °2'30"W
1380000 FEET 1400000 FEET
j
F€i COOPERATING 1W
TECHNICALPAMEfi
This digital Flood Insurance Rate Map (FIRM) was produced through a unique
cooperative partnership between the State of North Carolina and the Federal
Emergency Management Agency (FEMA). The State of North Carolina has
implemented a long term approach to floodplain management to decrease the
costs associated with flooding. This is demonstrated by the State's commitment
to map flood hazard areas at the local level. As a part of this effort, the State of
North Carolina has joined in a Cooperating Technical State agreement with
FEMA to produce and maintain this digital FIRM.
FLOOD HAZARD INFORMATION NOTES TO USERS SCALE
SEE FIS REPORT FOR ZONE DESCRIPTIONS AND INDEX MAP
THE INFORMATION DEPICTED ON THIS MAP AND SUPPORTING
DOCUMENTATION ARE ALSO AVAILABLE IN DIGITAL FORMAT AT
HTTP://FRIS.NC.GOV/FRIS
Without Base Flood Elevation (BFE)
Zone A,V, A99
With BFE or Depth zone Al AO, AH, VE, AR
SPECIAL FLOOD Regulatory Floodway
HAZARD AREAS
JILL
0.2% Annual Chance Flood Hazard, Areas
of 1% Annual Chance Flood with Average
Depth Less Than One Foot or With Drainage
Areas of Less Than One Square Mile zone x
Future Conditions 1% Annual
Chance Flood Hazard zone x
OTHER AREAS OF Area with Reduced Flood Risk due to Levee
FLOOD HAZARD See Notes zone x
OTHER Areas Determined to be Outside the
AREAS 0.2% Annual Chance Floodplain zone x
------------- Channel, Culvert, or Storm Sewer
Accredited or Provisionally Accredited
GENERAL Levee, Dike, or Floodwall
STRUCTURES l l l l l l l l l l l l l Non -accredited Levee, Dike, or Floodwall
BM5510 X North Carolina Geodetic Survey bench mark
BM55100 National Geodetic Survey bench mark
BM5510<8> Contractor Est. NCFMP Survey bench mark
0�2 i-8-2— Cross Sections with 1% Annual Chance
Water Surface Elevation (BFE)
- - - - - Coastal Transect
--- --- Coastal Transect Baseline
Profile Baseline
Hydrographic Feature
OTHER Limit of Study
FEATURES Jurisdiction Boundary
For information and questions about this map, available products associated with this FIRM including
historic versions of this FIRM, how to order products or the National Flood Insurance Program in general,
please call the FEMA Map Information eXchange at 1-877-FEMA-MAP (1-877-336-2627) or visit the FEMA Map
Service Center website at http://msc.fema.gov. An accompanying Flood Insurance Study report, Letter of Map
Revision (LOMR) or Letter of Map Amendment (LOMA) revising portions of this panel, and digital versions of this
FIRM may be available. Visit the North Carolina Floodplain Mapping Program website at http://www.ncfloodmaps.c(
or contact the FEMA Map Service Center.
Communities annexing land on adjacent FIRM panels must obtain a current copy of the adjacent panel as well as
the current FIRM Index. These may be ordered directly from the Map Service Center at the number listed above.
For community and countywide map dates refer to the Flood Insurance Study report for this jurisdiction.
To determine if flood insurance is available in the community, contact your Insurance agent or call the National
Flood Insurance Program at 1-800-638-6620.
Base map information shown on this FIRM was provided in digital format by the North Carolina Floodplain
Mapping Program (NCFMP). The source of this information can be determined from the metadata available in the
digital FLOOD database and in the Technical Support Data Notebook (TSDN).
ACCREDITED LEVEE NOTES TO USERS: If an accredited levee note appears on this panel check with your local
community to obtain more information, such as the estimated level of protection provided (which may exceed the
1-percent-annual-chance level) and Emergency Action Plan, on the levee systems) shown as providing protection.
To mitigate flood risk in residual risk areas, property owners and residents are encouraged to consider flood
insurance and floodproofing or other protective measures. For more information on flood insurance, interested
parties should visit the FEMA Website at http://www.fema.gov/business/nfip/index.shtm.
PROVISIONALLY ACCREDITED LEVEE NOTES TO USERS: If a Provisionally Accredited Levee (PAL) note
appears on this panel, check with your local community to obtain more information, such as the estimated level of
protection provided (which may exceed the 1-percent-annual-chance level) and Emergency Action Plan, on the
levee systems) shown as providing protection. To maintain accreditation, the levee owner or community is
required to submit the data and documentation necessary to comply with Section 65.10 of the NFIP regulations.
If the community or owner does not provide the necessary data and documentation or if the data and documentation
provided indicates the levee system does not comply with Section 65.10 requirements, FEMA will revise the flood
hazard and risk information for this area to reflect de -accreditation of the levee system. To mitigate flood risk in
residual risk areas, property owners and residents are encouraged to consider flood insurance and floodproofing
or other protective measures. For more information on flood insurance, interested parties should visit the FEMA
Website at http://www.fema.gov/business/nfip/index.shtm.
LIMIT OF MODERATE WAVE ACTION NOTES TO USERS: For some coastal flooding zones the AE Zone
category has been divided by a Limit of Moderate Wave Action (LiMWA). The LiMWA represents the approximate
landward limit of the 1.5-foot breaking wave. The effects of wave hazards between the VE Zone and the LiMWA
(or between the shoreline and the LiMWA for areas where VE Zones are not identified) will be similar to, but less
severe than those in the VE Zone.
Limit of Moderate Wave Action (LiMWA)
COASTAL BARRIER RESOURCES SYSTEM (CBRS) NOTE
This map may include approximate boundaries of the CBRS for informational purposes only. Flood insurance is not
available within CBRS areas for structures that are newly built or substantially improved on or after the date(s)
indicated on the map. For more information see http://www.fws.gov/habitatconservation/coastal_barrier.html, the
FIS Report, or call the U.S. Fish and Wildlife Service Customer Service Center at 1-800-344-WILD.
CBRS Area Otherwise Protected Area
Map Projection:
North Carolina State Plane Projection Feet (Zone 3200)
Datum: NAD 1983 (Horizontal), NAVD 1988 (Vertical)
1 inch = 1,000 feet 1:12,000
0 500 1,000 2,000
Feet
Meters
0 150 300 600
PANEL LOCATOR
ASHE COUNTY
ALLEGHANY COUNTY
SURRYCOUNTY
3966 1 3986 11 4906
'3904 3924 1 3944 1 3964 1 3984 1 4904 1 4924 1`4944
IJ H
3902 3922 3942 3962 3982 4902 4922
2980 1 3900 1 3920 1 3940 1 3960 1 3980
2888 1 3808 1 3828
3807
3817
3827
3837
3847
3857
3867
3877
1
--2846
2866
2886
3886
4806
4826
4846
3806
3816
3826
3836
3846
3856
3866
3876
CALDWELL COUNTY
ALEXANDER COUNTY
IREDELL COUNTY
NORTH CAROLINA FLOODPLAIN MAPPING PROGRAM
NATIONAL FLOOD INSURANCE PROGRAM
cc FLOOD INSURANCE RATE MAP
NORTH CAROLINA a4w
0
L.0 p
PANEL 3902
CL
FEMA
cc Panel Contains:
G COMMUNITY CID PANEL SUFFIX
WILKES COUNTY 370256 3982 J
0
0
cc
a
0
Z
MAP NUMBER
3710398200J
MAP REVISED
3/2/2009

West Prong Roaring River Limited Detail Study Plan: Floodway Run 2/25/2019
Shumate Mountain Rd (WPRR) TORStructure ID: LDS_WPRR_01Approxi
.15
08
T 048 7
.08
1120
Legend
--
-----
-
-
WS 100 FW
- ------
..... ........ ...... ..
- -- -----
-- - - -
-
- --
-year
........ ..........
.......:.....
..
............
------
■
Ground
1110
Ineff
.............
. - - -
.. .. - -
- .. ....... -
- - - - ...............
-- ..
Bank Sta
-------------------->------
-------
-
----'--- - - -- -----
- - - - -
- - - - ---
---- - - --
-
- -
Encroachment
1100
c
m
1090
------- >.-...
- -- - - - - -- --
I I I
-
w
1080
......
...............:...
.. .. ... ... ... ...............
- -
- - -
- -
1070
-
-
..
-
-
1060
4500
4600 4700 4800 4900 5000 5100
5200
Station (ft)

Cashmore, Blake A.
From: Harris, James B <[e-mail]>
Sent: Friday, May 10, 2019 2:13 PM
To: Lenoce, Marissa A.
Subject: RE: [External] Start of Study Notification: Bridge No. 960166 in Wilkes County
**This e-mail is from outside STV**
Marissa —
Rail Division does not have any comments since no rail is involved on the project. Thank you. - - Jim
James B. Harris, PE
State Railroad Coordination Engineer
Rail Division
North Carolina Department of Transportation
919 707 4707 office
[e-mail]
1 South Wilmington Street
1553 Mail Service Center
Raleigh, NC 27699-1553
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Lenoce, Marissa A. <[e-mail]>
Sent: Friday, May 03, 2019 12:35 PM
Cc: 4019918 <[e-mail]>; Scott, Elizabeth S. <[e-mail]>
Subject: [External] Start of Study Notification: Bridge No. 960166 in Wilkes County
External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
[e-mail]
Good afternoon,
STV Inc., under contract with the Structures Management Unit, is starting the project development,
environmental and engineering studies for the replacement of the following:
Bridge No. 960166 in Wilkes County.
The current project schedule is for right of way in 2019 and construction in 2020.
1

NCDOT is starting the project development, environmental and engineering studies for the replacement of
Bridge No. 960166 on SR 1745 (Shumate Mountain Road), over West Prong of Roaring River in Wilkes
County. The project vicinity map is attached.
A Field Scoping Meeting took place on April 17, 2019.
We would appreciate any information you might have that would be helpful in evaluating potential
environmental impacts of the project, including recommendation of alternates to be studied. Your comments
may be used in the preparation of an environmental document, in accordance with the State or National
Environmental Policy Act.
Please respond by June 3rd so that your input can be used in the scoping of this project. If you have no
comment at this time, then a response is not required.
If you have any questions concerning this project, please contact me at Marissa.Lenoce(c�r�,stvinc.com.
Thank you,
Marissa Lenoce
Marissa Lenoce
Planner
STV 17125 Ambassador Road, Suite 200, Baltimore, Maryland 21244
(p) 410-281-2859
(cell) 410-404-0426
Marissa. Lenocena,stvinc. com
This e-mail address is being protected from spambots. You need JavaScript enabled to view it I www.stvinc.com
K T '_ loo
Please consider the environment before printing this e-mail.
Redesigned and rebuilt: visit our new website at www.stvinc.com
lFh' I I l.k avw; 5to+e
ago
The information contained in this electronic message is intended only for the use of the individual or entity to which it is
addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient, you are informed that any dissemination, copying or
disclosure of the material contained herein, in whole or in part, is strictly prohibited. If you have received this
transmission in error, please notify STV and purge this message.
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

NORT" CAROLINA
STATE PARK
Division of Parks and Recreation
NC Department of Natural and Cultural Resources
Governor Roy Cooper
May 10, 2019
Marissa Lenoce
Planner
STV
7125 Ambassador Road, Suite 200
Baltimore, Maryland 21244
Ms. Lenoce,
Secretary Susi H. Hamilton
I have reviewed NCDOT project B-960166 Bridge Replacement in Wilkes County. Based on the
proposed project the North Carolina Division of Parks and Recreation (DPR) has no objections or
comments.
Please feel free to contact this office if you have any questions or comments.
Sincerely,
Mike Peveler
Environmental Review Coordinator
North Carolina Division of Parks and Recreation
[phone] / [e-mail]
Dwayne Patterson, Director
NC Division of Parks and Recreation
1615 MSC - Raleigh, NC 27699-1615
919.707.9300 / ncparks.gov
NORTH CAROLINA STATE PARKS
/11a" Wort

SST l3fi � � F18II & AXAM6
CE
[united States Department of the Interior --
FISH AND WILDLIFE SERVICE
QG►+ 3'$''$ Asheville Field Office'��-.„r"�
160 Zillicoa street Suite #S
Asheville, North Carolina 28801
May 23, 2019
Marissa Lenoce
STVinc.
7125 Ambassador Road,
Suite 200
Baltimore, Maryland 21244
Subject: Division 11 Bridge Replacement Projects
Dear Ms. Lenoce,
Can May 3, 2019 we received your letters requesting our comments on four North Carolina
Department of Transportation (NCDOT) Division 11 bridge scopings for proposed design -build
bridge replacement projects. We submit the following comments and recommendations in
accordance with the provisions of Section 7 of the Endangered Species Act of 1973, as amended
(16 U.S.C. §§1531-1543); the Fish and Wildlife Coordination Act, as amended (16 U.S.C.
§§661-667e); the Clean Water Act (33 U.S.C. §1251 et seq.); the Migratory Bird Treaty Act (16
U.S.C. §§703-712); and the National Environmental Policy Act (42 U.S.C. §4321 et seq.).
General Recommendations for Replacing Structures that Cross Rivers and Streams
We generally recommend the use of clear -spanning bridge structures designed, at a minimum, to
accommodate the active channel width. Use of culverts is discouraged. Properly sized spanning
structures will provide for the passage of aquatic species and accommodate the movement of
debris and bed material. Furthermore, spanning structures usually: (1) can be constructed with
minimal in -stream impacts, (2) do not require stream -channel realignment, and (3) retain the
natural streambed conditions; and the horizontal and vertical clearances may be designed to
allow for human and wildlife passage beneath the structures.
If possible, bridge supports (bents) should not be placed in the streams. Bents can collect debris
during flood events, resulting in the scouring of bridge foundations. In -stream bents can also
result in hydrologic changes, such as bed scour or deposition, which may adversely affect
in -stream habitat. Deck drains of the spanning structures should not discharge directly into the
streams; instead, they should drain through a vegetated area before entering the streams.
Removal of vegetation in riparian areas should be minimized. Armoring of the bank with riprap
should be minimized, The reseeding of disturbed areas should be performed promptly after
grading, and seed mixes should consist of native vegetation in order to prevent the spread of
invasive plant species. New structures should be constructed without the use of in -stream
causeways or work pads whenever possible. When causeways are necessary, using the largest
washed stone practicable for the application will prevent unnecessary damage to in -stream

habitat and will facilitate complete removal. We recommend that all equipment be refueled and
receive maintenance outside of the floodplain. Refueling and maintenance should take place in
designated refueling sites that are provisioned to quickly contain any spills of fuel, lubricants,
and other fluids.
Erosion and Sedimentation Control
Construction activities near streams, rivers, and lakes have the potential to cause water pollution
and stream degradation if measures to control site runoff are not properly installed and
maintained. In order to effectively reduce erosion and sedimentation impacts, best management
practices specific to the extent and type of construction should be designed and installed during
land -disturbing activities and should be maintained until the project is complete and appropriate
stormwater conveyances and vegetation are reestablished on the site.
A complete design manual, which provides extensive details and procedures for developing
site -specific plans to control erosion and sediment and is consistent with the requirements of the
North Carolina Sedimentation and Pollution Control Act and Administrative Rules, is available
at: http://portal.ncdenr.org/web/Ir/publications. For maximum benefits to water quality and bank
stabilization, riparian areas should be forested; however, if the areas are maintained in grass, they
should not be mowed. We recommend planting disturbed areas with native riparian species.
The U.S. Fish and Wildlife Service can provide information on potential sources of plant
material upon request.
Northern Long-eared Bat
Suitable summer roosting habitat may be present in the project area for the federally threatened
northern long-eared bat (Myotis septentrionalis). However, the final 4(d) rule (effective as of
February 16, 2016), exempts incidental take of northern long-eared bat associated with activities
that occur greater than 0.25 miles from a known hibernation site, and greater than 150 feet from
a known, occupied maternity roost during the pup season (June 1 — July 31). Based on the
information provided, the project would occur at a location where any incidental take that may
result from associated activities is exempt under the 4(d) rule. Your project will likely include
tree clearing. Although not required, we encourage you to conduct any associated tree
clearing activities outside the pup season (June 1 to July 31) and/or active season (April 1 to
October 31) to reduce the chance of impacting unidentified maternity roosts.
Migratory Birds
The MBTA (16 §U.S.C. 703-712) prohibits the intentional taking, killing, possession,
transportation, and importation of migratory birds, their eggs, parts, and nests, except when
specifically authorized by the Department of the Interior. To avoid impacts to migratory birds,
we recommend conducting.a visual inspection of any migratory bird nesting habitat within the
project area during the migratory bird nesting season of March through September and avoiding
impacting the nests during the migratory bird nesting season. If birds are discovered nesting near
the project area during years prior to the proposed construction date, we recommend that you and
the NCDOT, in consultation with US Fish and Wildlife Service, develop measures to discourage
birds from establishing nests within the project area by means that will not result in the take of
birds or eggs; or avoid construction activities during the nesting period.
2

The attached table summarizes our comments for the proposed projects. Included in the table is
the USFWS file number that will aid us in referencing the appropriate file in the future. Please
include this number in any future. correspondence. If you have questions about these comments
please contact Ms. Claire Ellwanger of our staff at 828/258-3939, Ext. 235.
K
Sincerely,
2je�t Mizzi
Field Supervisor
Electronic copies to:
Mr. Kevin Hining, Division 1 I Environmental Officer, North Carolina Department of
Transportation, 801 Statesville Road, North Wilkesboro, NC 28659
Ms. Marla J. Chambers, Western NCDOT Permit Coordinator, North Carolina Wildlife
Resources Commission, 12275 Swift Road, Oakboro, NC 28129
Bridge #
County
USFWS Comments
USFWS File #
Brook Floater (Alasmidonta varicose), a federally At Risk
Species (ARS), is present in the project area. Contact
USFWS and North Carolina Wildlife Resources Commission
(NCWRC) when plans are available. Request Design
960663
Wilkes
standards for sensitive watersheds (DSSW).
19-235
960667
Wilkes
general recommendations
19-263
980189
1 Yadkin
general recommendations
19-237
Brook Floater (Alasmidonta varicose), an ARS, is present in
the project area. Contact USFWS and NCWRC when plans
960166
Wilkes
are available. Request DSSW.
19-238 .

2
North Carolina Wildlife Resources Commission
Gordon Myers, Executive Director
August 22, 2019
MEMORANDUM
TO: Heaven Manning
Environmental Analysis Unit, NC Department of Transportation
FROM: Marla Chambers, Western NCDOT Coordinators
Habitat Conservation Program, NCWRC
SUBJECT: Scoping review of 6 proposed NCDOT bridge replacement projects in Surry,
Wilkes, and Yadkin Counties.
North Carolina Department of Transportation has requested comments from the North Carolina
Wildlife Resources Commission regarding impacts to fish and wildlife resources resulting from
the subject project. Staff biologists have reviewed the information provided. The following
preliminary comments are provided in accordance with the provisions of the state and federal
Environmental Policy Acts (G.S. 11 3A- lthrough 113-10; 1 NCAC 25 and 42 U.S.C. 4332(2)(c),
respectively), the Clean Water Act of 1977 (33 U.S.C. 466 et seq.) and the Fish and Wildlife
Coordination Act (48 Stat. 401, as amended; 16 U.S.C. 661-667d), as applicable.
Our standard recommendations for bridge replacement projects of this scope are as follows:
We generally prefer spanning structures. Spanning structures usually do not require work
within the stream and do not require stream channel realignment. The horizontal and
vertical clearances provided by bridges allows for human and wildlife passage beneath
the structure, does not block fish passage, and does not block navigation by canoeists and
boaters.
2. Bridge deck drains should not discharge directly into the stream.
3. Live concrete should not be allowed to contact the water in or entering into the stream.
Mailing Address: Habitat Conservation • 1721 Mail Service Center • Raleigh, NC 27699-1721
Telephone: [phone] • Fax: [phone]

6 BRIDGE PROJECTS
SURRY, WILKES & YADKIN CO.'S PAGE 2 AUGUST 22, 2019
4. If possible, bridge supports (bents) should not be placed in the stream.
5. If temporary access roads or detours are constructed, they should be removed back to
original ground elevations immediately upon the completion of the project. Disturbed
areas should be seeded or mulched to stabilize the soil and native tree species should be
planted with a spacing of not more than 10'x10'. If possible, when using temporary
structures, the area should be cleared but not grubbed. Clearing the area with chain saws,
mowers, Bush Hogs, or other mechanized equipment and leaving the stumps and root mat
intact, allows the area to revegetate naturally and minimizes disturbed soil.
6. A clear bank (riprap free) area of at least 10 feet should remain on each side of the stream
underneath the bridge.
7. In trout waters, the Commission reviews all U.S. Army Corps of Engineers nationwide
and general `404' permits. We have the option of requesting additional measures to
protect trout and trout habitat and we can recommend that the project require an
individual `404' permit.
In streams that contain threatened or endangered species, Mr. Logan Williams with the
NCDOT - ONE should be notified. Special measures to protect these sensitive species
may be required. NCDOT should also contact the U.S. Fish and Wildlife Service for
information on requirements of the Endangered Species Act as it relates to the project.
9. In streams that are used by anadromous fish, the NCDOT official policy entitled "Stream
Crossing Guidelines for Anadromous Fish Passage" (May 12, 1997) should be followed.
10. In areas with significant fisheries for sunfish, seasonal exclusions may also be
recommended.
11. Sedimentation and erosion control measures sufficient to protect aquatic resources must
be implemented prior to any ground disturbing activities. Structures should be maintained
regularly, especially following rainfall events.
12. Temporary or permanent herbaceous vegetation should be planted on all bare soil within
15 days of ground disturbing activities to provide long-term erosion control.
13. All work in or adjacent to stream waters should be conducted in a dry work area. Sandbags,
rock berms, cofferdams, or other diversion structures should be used where possible to
prevent excavation in flowing water.
14. Heavy equipment should be operated from the bank rather than in stream channels in order to
minimize sedimentation and reduce the likelihood of introducing other pollutants into
streams.

6 BRIDGE PROJECTS
SURRY, WILKES & YADKIN CO.'S PAGE 3 AUGUST 22, 2019
15. Only clean, sediment -free rock should be used as temporary fill (causeways), and should be
removed without excessive disturbance of the natural stream bottom when construction is
completed.
16. During subsurface investigations, equipment should be inspected daily and maintained to
prevent contamination of surface waters from leaking fuels, lubricants, hydraulic fluids, or
other toxic materials.
17. If culvert installation is being considered, conduct subsurface investigations prior to structure
design to determine design options and constraints and to ensure that wildlife passage issues
are addressed.
If corrugated metal pipe arches, reinforced concrete pipes, or concrete box culverts are used:
1. The culvert must be designed to allow for aquatic life and fish passage. Generally, the
culvert or pipe invert should be buried at least 1 foot below the natural streambed
(measured from the natural thalweg depth). If multiple barrels are required, barrels other
than the base flow barrel should be placed on or near stream bankfull or flood plain bench
elevation (similar to Lyonsfield design). These should be reconnected to flood plain
benches as appropriate. This may be accomplished by utilizing sills on the upstream end
to restrict or divert flow to the base flow barrel. Silled barrels should be filled with
sediment so as not to cause noxious or mosquito breeding conditions. Sufficient water
depth should be provided in the base flow barrel during low flows to accommodate fish
movement. If culverts are longer than 40-50 linear feet, alternating or notched baffles
should be installed in a manner that mimics existing stream pattern. This should enhance
aquatic life passage: 1) by depositing sediments in the barrel, 2) by maintaining channel
depth and flow regimes and 3) by providing resting places for fish and other aquatic
organisms. In essence, the base flow barrel should provide a continuum of water depth
and channel width without substantial modifications of velocity.
2. If multiple pipes or cells are used, at least one pipe or box should be designed to remain
dry during normal flows to allow for wildlife passage.
3. Culverts or pipes should be situated along the existing channel alignment whenever
possible to avoid channel realignment. Widening the stream channel must be avoided.
Stream channel widening at the inlet or outlet end of structures typically decreases water
velocity causing sediment deposition that requires increased maintenance and disrupts
aquatic life passage.
4. Riprap should not be placed in the active thalweg channel or placed in the streambed in a
manner that precludes aquatic life passage. Bioengineering boulders or structures should
be professionally designed, sized, and installed.
In most cases, we prefer the replacement of the existing structure at the same location with road
closure. If road closure is not feasible, a temporary detour should be designed and located to
avoid wetland impacts, minimize the need for clearing and to avoid destabilizing stream banks.

6 BRIDGE PROJECTS
SURRY, WILKES & YADKIN CO.'S PAGE 4 AUGUST 22, 2019
If the structure will be on a new alignment, the old structure should be removed and the approach
fills removed from the 100-year floodplain. Approach fills should be removed down to the
natural ground elevation. The area should be stabilized with grass and planted with native tree
species. Tall fescue should not be used in riparian areas. If the area that is reclaimed was
previously wetlands, NCDOT should restore the area to wetlands. If successful, the site may be
used as wetland mitigation for the subject project or other projects in the watershed.
Project specific comments:
BR-0123 Surry County, Bridge No. 318 over an unnamed tributary of South Fork Mitchell River
on SR 1319 (Abe Mayes Road). Significant trout resources are not expected; therefore, we are
not requesting a trout moratorium for this project. Brook Floaters (Alasmidonta varicosa),
Federal Species of Concern and State Endangered, occur downstream in the Mitchell River.
Stringent sedimentation and erosion control measures and standard recommendations should
apply.
2. BR-0124 Wilkes County, Bridge No. 166 over West Prong Roaring River on SR 1745 (Shumate
Mountain Road). Significant trout resources are not expected; therefore, we are not requesting a
trout moratorium for this project. Brook Floaters (Alasmidonta varicosa), Federal Species of
Concern and State Endangered, occur just downstream in Middle Prong Roaring River. Sediment
and erosion control measures should adhere to the Design Standards in Sensitive Watersheds.
3. BR-0125 Wilkes County, Bridge No. 663 over East Prong Roaring River on SR 1002 (Traphill
Road). Significant trout resources are not expected; therefore, we are not requesting a trout
moratorium for this project. Brook Floaters (Alasmidonta varicosa), Federal Species of Concern
and State Endangered, occur in the project vicinity. Sediment and erosion control measures
should adhere to the Design Standards in Sensitive Watersheds.
4. BR-0126 Wilkes County, Bridge No. 667 over Sparks Creek on SR 1749 (Austin Traphill Road).
Significant trout resources are not expected; therefore, we are not requesting a trout moratorium.
Standard recommendations should apply.
5. BR-0127 Yadkin County, Bridge No. 189 over an unnamed tributary of South Deep Creek on SR
1325 (Mountain View Church Road) Significant trout resources are not expected; therefore, we
are not requesting a trout moratorium. Standard recommendations should apply.
6. BR-0108 Wilkes County, Bridge No. 4 over Little Hunting Creek on SR 2418 (Windy Gap
Road). Significant trout resources are not expected; therefore, we are not requesting a trout
moratorium. Standard recommendations should apply.
We request that NCDOT routinely minimize adverse impacts to fish and wildlife resources in the
vicinity of bridge replacements. The NCDOT should install and maintain sedimentation control
measures throughout the life of the project and prevent wet concrete from contacting water in or
entering into these streams. Replacement of bridges with spanning structures of some type, as
opposed to pipe or box culverts, is recommended in most cases. Spanning structures allow

6 BRIDGE PROJECTS
SURRY, WILKES & YADKIN CO.'S PAGE 5 AUGUST 22, 2019
wildlife passage along streambanks, reducing habitat fragmentation and vehicle related mortality
at highway crossings.
If you need further assistance or information on NCWRC concerns regarding bridge
replacements, please contact me at marla.chamberskncwildlife.org or [phone]. Thank
you for the opportunity to review and comment on this project.
Cc:
Carla Dagnino, NCDOT
Marissa Lenoce, STV Inc.
Kevin Hining, NCDOT

NCDOT Feasibility Studies Unit Bridge 960166
`fir,.
SCREENING CHECKLIST
BRIDGE ID: 960166 FACILITY: SR1745 OVER WEST PRONG ROARING DIVISION: 11
RIVER
YEAR BUILT: 1977 ' COUNTY: WILKES POSTED (SV/TTST): 26/31
COST ESTIMATE: $2,625,000
uvs r KUL.1 rUrvs: me ronowmgquesuons are oaseaon me cc cnecKrrsrs ror i rrc ianrr ii nrrr rrs Hnswereac!, rrli('soon m me space
provided basedon available data. Include qualitative discussion as appropriate.
Does the project require formal consultation with U.S. Fish and Wildlife Service (USFWS) or National Marine
Fisheries Service (NMFS)?
A Natural Resources Technical Report (NRTR) must be prepared during projectdevelopment before this question can be fully answered.
Review the current USFWS Endangered and Threatened Species and Species of Concern by County forNorth Carolina and note
species or designated critical habitat listed in the county(s).
AS OF JUNE 27, 2018, THE USFWS LISTS THE RUSTY -PATCHED BUMBLE BEE AS ENDANGERED
AND THE NORTHERN LONG-EARED BAT AS THREATENED WITHIN WILKES COUNTY.
THE BOG TURTLE IS LISTED AS THREATENED DUE TO SIMILARITY OF APPEARANCE WITH
ANOTHER LISTED SPECIES AND IS LISTED FOR ITS PROTECTION. HOWEVER, THE BOG TURTLE IS
NOT BIOLOGICALLY ENDANGERED OR THREATENED AND IS NOT SUBJECT TO SECTION 7
CONSULTATION.
A CHECK OF THE CURRENT NC NHP DATABASE SHOWED NO OCCURRENCES OF FEDERALLY
ENDANGERED OR THREATENED SPECIES WITHIN 1 MILE OF THE PROPOSED PROJECT.
Does the project result in impacts subject to the conditions of the Bald and Golden Eagle Protection Act
(BGPA)?
t , : ; rust be prepared during project development before this question can be fully answered. Review the current USFWS
Endangered and Threatened Species and Species of Concern by County for North Carolina and note if BGPA species are listedin the
county(s).
THE USFWS LIST FOR WILKES COUNTY DOES NOT INCLUDE THE BALD EAGLE. THE NCNHP
DATABASE DOES NOT SHOW ANY OCCURRENCES WITHIN 1 MILE OF THE PROPOSED PROJECT.
Does the project generate substantial controversy or public opposition, for any reason, following appropriate
public involvement?
Review tine appropriate G I i, ioruocunyi)tationofpublicinvolventnt m the u yi- uevelopnL-ni ar;u any cotaieijts ieiateu to the project.
7 no
Does the project cause disproportionately high and adverse impacts relative to low-income and/or minority
populations?
This question will require additional evaluation during projectdevelopment. Using the NCDOT Dernograghic Tool, note the total
population, as well as ainority and low-income populations forthe county and each Census Block Group in which the projectis located.
Also note any observations based on review of aerialphotography.
THE PROJECT DEMOGRAPHIC STUDY AREA (DSA) CONTAINS PORTIONS OF 2 BLOCK GROUPS.
THE MINORITY POPULATION OF THE DSA IS 1.1%. THIS COMPARES TOA MINORITY POPULATION
OF 11.7% FOR WILKES COUNTY. THE POVERTY RATE FOR THE DSA IS 11.10/0. WILKES COUNTY'S
POVERTY RATE IS 14.30/a
THERE IS NO EVIDENCE OF LOW INCOME HOUSING IN THE VICINITY OF THE PROJECT VISIBLE ON
AERIAL IMAGERY.

NCDOT Feasibility Studies Unit Bridge 960166 >
5 , Does the project involve a residential or commercial displacement, or a substantial amount of right of way
10
11
acquisition?
Provide a count of potential residential and corr+-srrial displacements.
THERE ARE NO RESIDENTIAL OR COMMERCIAL STRUCTURES WITHIN THE PROJECT STUDY
AREA.
Does the project require an Individual Section 4(f) approval?
This question will require additional evaluation during project developmem. lAt this tirre, note the presence of properties that may be
subject to Section 4(f), including historic resources, parks. and wildlife/waterfowl refuges. Note those within the proposed right of way, as
well as within 1,000'ofthe project.
ACCORDING TO THE NC SHPO GIS DATABASE, THERE ARE NO NC SHPO RESOURCES WITHIN
1,000 FEET OF THE PROJECT.
THERE ARE NO PARKS OR WILDLIFE REFUGES WITHIN 1,000 FEET OF THE PROPOSED ROW.
Does the project include adverse effects that cannot be resolved with a Memorandum of Agreement (MOA)
under Section 106 of the National Historic Preser\iation Act (NHPA) or have an adverse effect on a National
Historic Landmark (NHL)?
This question will require additunal evaluation during projectdeveloprrent. Review NC State Historic Preservation Office GIS data and
note the presence of historic properties within the proposed right of way, as well as within 1.000'of the project. Note: this site does not
include archaeological resources.
ACCORDING TO THE NC SHPO GIS DATABASE, THERE ARE NO NC SHPO RESOURCES WITHIN
1,000 FEET OF THE PROJECT.
Does the project result in a finding of "may affect not likely to adversely affect" for listed species, or
designated critical habitat under Section 7 of the Endangered Species Act (ESA)?
/-A NRTR ared during prufeci a&veroprrent oeuvre this question can be fui"y answerea. Heierto Question#1 above.
SEE #1 ABOVE
Is the project located in anadromous fish spawning waters?
Review the
os to deterrrrne ifthe
ject is within 1,000'ofthese areas
THERE ARE NO ANADROMOUS FISH SPAWNING WATERS WITHIN 1,000 FEET OF THE PROJECT.
Does the project impact waters classified as Outstanding Resource Water (ORW), High Quality Water
(HQW ), Water Supply Watershed Critical Areas, 303(d) listed impaired water bodies, buffer rules, or
Submerged Aquatic Vegetation (SAV)?
Deternine Me NCDEQ Surface Water Classification otany wateis within 1,00U of theprojecl, and note if anyhave a WS"(Water
Supply) classification orsupplerrental classification of ORWorHQW. Check the current 303 d list for303(d) listed waters within 1,000
feet of the project. Review the Division Resource Map to detemine if the project is within a watershed subject to bufferrules.
NONE OF THE WATERS WITHIN 1,000 FEET OF THE PROJECT ARE WITHIN WATER SUPPLY
WATERSHEDS OR CLASSIFIED AS ORW, HQW, OR LISTED ON THE FINAL 2014 303(D) LIST.
STATE BUFFER RULES DO NOT APPLY WITHIN THE YADKIN PEE-DEE RIVER BASIN, WHERE THE
PROJECT IS LOCATED.
THERE IS NO MAPPED SAV WITHIN 1,000 FEET OF THE PROJECT.
Does the project impactwaters of the United States in any of the designated mountain trout streams?
Trout counties are identified on the PDEA Agency Merger Contact Map, and trout waters are identified by "T✓'classification in their
NCDEQ Surface Water Classification (see Question #10 above). Detc -tne if project is within 1000'ofa trout stream
THERE ARE NO NCDEQ CLASSIFIED TROUT STREAMS OR DESIGNATED PUBLIC MOUNTAIN
TROUT WATERS WITHIN 1,000 FEET OF THE PROJECT.
12 Does the project require a U.S. Army Corps of Engineers (USACE) Individual Section 404 Permit?
i rus qu(�s,iai vloi iequuc aou'hior;ar U 'Oi bJNUN ciurrng prcJGGi ceveicparunt. Usmn , uuncepto ai,.resrgn ngnt of way watsand
National Wet/andInventory (NWI) mapping, calculatepotentia/ irrpacts to waters of the U.S. Note irrpacts to wetlands to the nearest 0.1
acre and to streams to the nearest 10 feet.
81

.4NCDOT Feasibility Studies Unit Bridge 960166 ;.
THERE ARE NO MAPPED NWI WETLANDS WITHIN THE PROJECT LIMITS.
BASED ON NHD FLOWLINES, THE PROJECT WOULD IMPACT APPROXIMATELY200 FEET OF
FRESHWATER STREAMS.
13 Will the project require an easementfrom a Federal Energy Regulatory Commission (FERC) licensed facility?
Review the Division Resource Map to determne if the project is within 1,000'ofa FERC licensed facilii
THERE ARE NO FERC LICENSED FACILITIES WITHIN 1,000 FEET OF THE PROJECT.
Does the project include a Section 106 of the NHPA effects determination other than a no effect, including
archaeological remains?
This question will require additional evaluation during projectdeveloprrent. Refer to Question# 7above.
SEE #7 ABOVE
Does the project involve hazardous materials and/or landfills?
Note any potential hazardous properties based on review of aerial photography orfromNC OneMap data.
THERE ARE NO HAZARDOUS MATERIALS OR LANDFILLS WITHIN 1,000 FEET OF THE PROJECT.
16 Does the project require work encroaching and adversely affecting a regulatory floodway or work affecting the
base floodplain (100-year flood) elevations of a water course or lake, pursuant to Executive Order 11988 and
23 CFR 650 subpart A?
Hevie vv NCFloodmaias data to detemrne whetherrUte piejeci stay encroach on aoybase (100-year) fioodpiait and/orreguiaioty
floodway.
THE PROJECT ROW LIMITS OCCUR WITHIN THE 100-YEAR FLOODPLAIN.
17 Is the project in a Coastal Area Management Act (CAMA) county and substantially affects the coastal zone
and/or any Area of Environmental Concern (AEC)?
A NRTR trust be prepared during project development before this question can be fully answered Review the Division Resource Map to
determne if the project is within a CAMA county.
W I LKES COUNTY IS NOT A CAMA COUNTY.
18 1 Does the project require a U.S. Coast Guard (USCG) permit?
Review NCDOT's USCG Stream Coordination Map to determine if the projectinpacts a navigable waterway that may require
coordination and permitting with the USCG.
THERE ARE NO NAVIGABLE WATERS WITHIN THE VICINITY OF THE PROJECT.
19 Does the ro'ect involve construction activities in across or ad'acentto a desi nated Wild and Scenic River
P 1 J g
present within the project area?
Review the Division Resource Map io aeierrrine if the project is within 1,000'ofa WiIdand Scenic Rrver.
THERE ARE NO WILD AND SCENIC RIVIRS WITHIN 1,000 FEET OF THE PROJECT.
20 Does the project involve Coastal Barrier Resources Act (CBRA) resources?
Review the Division Resource Map to determne if the project is within a CBRA area.
THERE ARE NO CBRA AREAS WITHIN THE VICINITY OF THE PROJECT.
21
Does the project impactfederal lands (e.g. U.S. Forest Service (USFS), USFWS, etc.) or Tribal Lands?
Review the Division Resource Map to determne if the project is within federal lands.
THERE ARE NO FEDERAL LANDS WITHIN THE VICINITY OF THE PROJECT.
22
Does the project involve any changes in access control?
Note if the project is proposing change in control ofaccess.
NO
82

NCDOT Feasibility Studies Unit Bridge 960166 ;.
es UUes Me prU1ecL nave a perrnanenL aUverse eiieGL Un rocar Llariic Pauerns Ur cUrnrnuniLy c�nesrveness r
Iills quesirOnwrllrequileacldrlionaievaivaironduoogprojectoevelopnent.Aithistm,Worechangesuiiraiiicpatternsandany
reduction in access to conwunity resources.
NO
Will maintenance of traffic cause substantial disruption?
24
Note if an offsite detouris recorrrnended.
ALL PROPOSED IMPROVEMENTS AND CONSTRUCTION WOULD BE COMPLETED IN A MANNER TO
MINIMIZE DETOURS AND IMPACTS TO TRAFFIC. AN OFFSITE DETOUR COULD BE USED WITHOUT
SUBSTANTIALLY IMPACTING TRAFFIC PATTERNS AND ACCESS.
25
Is the project inconsistent with the STIP or the Metropolitan Planning Organization's (MPO's) Transportation
Improvement Program (TIP) (where applicable)?
This question will be evaluatedduring project development.
N/A
Does the project require the acquisition of lands under the protection of Section 6(f) of the Land and Water
26
Conservation Act, the Federal Aid in Fish Restoration Act, the Federal Aid in Wildlife Restoration Act,
Tennessee Valley Authority (TVA), or other unique areas or special lands that were acquired in fee or
easement with public -use money and have deed restrictions or covenants on the property?
A list of resources using funds provide through Section 6(f) of the Land and Water Conservation Fund (LWCF) is available at http://waso-
Iwcf.ncrc.nps.gov/publiclndex.cfm Review the Division Resource Map to determine if the projectcrosses a TVA area. tfparcel data is
available, use best available inforrretionto determine ifanyofthese situations exist.
THERE ARE NO UNIQUE AREAS OR SPECIAL LANDS THAT WERE ACQUIRED IN FEE OR
EASEMENT WITH PUBLIC USE MONEY WITHIN THE VICINITY OF THE PROJECT.
27
Does the project involve Federal Emergency Management Agency (FEMA) buyout properties under the
Hazard Mitigation Grant Program (HMGP)?
This question will require additional evaluation during project development. Referto Question#16 above, andif the project is within a
flood zone, review property data for locally-ownedproperty (county ormunicipality) within the flood zone and note. If parcel data is
available, detemine if anypropertyin the floodzone is govemment owned.
THE PROJECT ROW LIMITS OCCUR WITHIN THE 100-YEAR FLOODPLAIN. THERE ARE NO FEMA
BUYOUT PROPERTIES WITHIN THE VICINITY OF THE PROJECT.
28
Does the project include a de minimis or programmatic Section 4(f)?
This question will require additional evaluation during project development. Referto Question#6 above.
SEE #6 ABOVE
29 Is the project considered a Type I under the NCDOTs Noise Policy?
Review NGDO 1 s Traffic Noise Policy (pages 2-3) to detemine the level of noise analysis that may be required. Provide responses for
each funding scenario noting the level of environmental documentation.
IF THE PROJECT IS FEDERALLY FUNDED
Is the project a Type I project?
NO
IF THE PROJECT IS STATE FUNDED
Is the project on an interstate orfull control of access US route and does it involve adding additional through lanes? W1ll the project
require a state EA orEIS?
THE PROJECT IS NOT ON AN INTERSTATE OR FULL CONTROL OF ACCESS US ROUTE.
Is there prime or important farmland soil impacted by this project as defined by the Farmland Protection
30
Policy Act (FPPA)?
This question will be evaluated during project development.
N/A
83

NCDOT Feasibility Studies Unit Bridge 960166 4
31 Are there other issues that may affect project decisions?
I Note any otherissues that shouldbe considered during proiectdevelo,
INS I KUGHUNS: I he tollowing questions are based on the Gt Checklist for I YI't 111 projects. Answer each question in the space provided
based on available data. Include qualitative discussion as appropriate.
32 Is a project -level analysis for direct, indirect, or cumulative effects required based on the NCDOT community
studies screening tool?
This question will be evaluated during proiect development.
NIA
Is a project level air quality Mobile Source Air Toxics (MSAT) analysis required?
Note if existing orprojected traffic volumes on the project are greater than 140,000 vpd.
NO
84

2023 SMU Bridge Pro ram — Pre -Screening Worksheet
Bridge
#: 960166 BUILD Grant
County: Wilkes Division: 11
Project Description: Bridge on SR 1745 over West Prong Roaring River
1.
Is an off -site detour available? Yes
a. Describe Route: SR 1745 to SR 1730 to SR 1002
b. Approximate Length: 3.9 miles
c. Off -Site Detour Improvement Required: No
d. Other Considerations (seasonal, special events, etc): No
2.
What project alternates are to be considered?
a. Replace in place only: No
b. Realignment: Yes
c. Widening: Yes
d. Phased construction: No
e. Accelerated bridge construction: No
3.
Does the project warrant detailed traffic forecasting and analysis due to the following?
a. Current ADT: 470
b. Current or anticipated peak hour delays: No
c. Future traffic increases due to growth or land use changes: No
4.
Describe existing or anticipated utility conflicts within or around the project area and
the potential impacts to project construction:
a. Water & Sewer: No
b. Power: No
c. Telecommunication: Yes
d. Gas: No
e. Cable TV: No
f. Other:
5.
Do significant environmental or cultural resources exist in the project area: No
6.
Are there unique constructability concerns with the project(s), such as access, staging,
phasing, etc.? No
7.
Other project constraints or special considerations: None
5/21/18

NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
STRUCTURES MANAGEMENT UNIT — 5 YEAR BRIDGE PROGRAM
PRE-SCREENING SUMMARY
2023 SMU Bridge Program — Pre -Screening Worksheet
STIP #: BR-0124 Bridge #: 960166 BUILD Grant Div./County: 11/Wilkes
Project Description: Bridge on SR-1745 over West Prong Roaring River
PRE-SCREENING DETERMINATION
Anticipated Project Development Duration: Potential 2-year project delivery to Letting.
Specific constraints/issues affecting duration: Off -site detour is feasible. In addition to
replace -in -place, Division recommends realignment be evaluated. Low ADT; traffic
forecast and capacity analysis is not warranted. Aerial utilities present but minimal
coordination/relocation anticipated.
General Project Context: see attached preliminar Study Area Ma
Existing typical section: Two Lane shoulder
Facility classification: Local Rural
Posted speed: 55 mph
Existing right-of-way est.: 60' via GIS
Adjacent properties: Wooded land in the NW quadrant. Roaring River is parallel to SR
1745 in the SE quadrant. Agricultural fields in the SW and NW quadrants.
Existing improvements proximate to project: None
Surrounding community: Residential Rural
Topography: Rollin
Current ADT / Source: 470 / 2016 NCDOT AADT Web Ma
Utilities observed: Power, telephone, run aerial on poles along the SW side of the project.
Overhead utilities cross the road diagonally 230' SE of the bridge.
Power — Duke Energy, Phone — Wilkes Communications, Cable TV — Time Warner
Cable, Water — Blue Ridge Water Association
Other concerns: Bridge #960138 is 500 feet SE of the project on SR 1002 (Traphill RD.).
It is not functionally deficient but is listed as Structurally Obsolete. SR 1746 intersects
SR 1745 75' NW of the bridge and SR 1002 intersects SR 1745 400' SE of the bridge.
8/30/2018

NEPA /SEPA Planning: see Environmental Pre -Screening Checklist
Cultural Resource: ECBI County. ETRACS request submitted: Responses pending
Natural Resource: No known occurrence of T&E species in study area. T&E species listed
for Wilkes County include Bog turtle, Northern long-eared bat, Rusty -patched bumble
bee
FERC Permit: No
Coast Guard Permit: No
Community Impacts: In Progress
Other Concerns: None
Hydrologic / Hydraulic Assessment:
River/Stream Crossing: Yes
Name: North Prong
Roaring River
FEMA Regulated: Yes
FEMA Model Type: Limited Detail - Available
River Basin: Yadkin Pee -Dee
I Buffers: None
WATER QUALITY DWR Surface Water Classification Map): indicate all that apply
H W: No
ORW: No
Trout: No
WSWS: No
Name: 12-46-1- 5
Critical Area: No
Other Concerns:
Division Consultation: see attached worksheet
General Summary: Division advises off -site detour is feasible via SR 1730 and SR 1002,
approximately 3.9 miles. Division recommends realignment also be considered for
project and requests a wider bridge structure (likely per current design standards). Low
ADT.
Specific Utilities Considerations: Minimal. Aerial power is present on south side of project
but has good offset. UG telecom with aerial stream crossing appears to be located on the
south side adjacent to bridge; would require relocation.
Other Concerns:
Utility Section Consultation:
Major Utilities Considerations: None
Other Concerns:
8/30/2018

5-YEAR BRIDGE PROGRAM
ENVIRONMENTAL PRE-SCREENING CHECKLIST
STIP #: BR-0124 COUNTY: Wilkes DIVISION: 11 FUNDING:
State ® Federal ❑
DESCRIPTION: Bridge 166 on SR-1745 over West Prong Roaring River
ADJACENT STIP PROJECTS: None
Cultural Resources
1
Is the project located in a listed National Register Historic District?
No
2
Are there other listed National Register properties or state Study List properties in the project
study area?
No
3
Does the project potentially impact tribal lands?
Located in ECBI County
4
Did the project ETRACS request determine a survey was needed for one or more potential
historic resources?
Response
Natural Resources
1
Are there NWI wetlands in the project study area?
No
2
Does the bridge cross anadromous fish waters?
No
3
Does the bridge cross waters classified as Outstanding Resource Water (ORW), High Quality
Water (HQW), Water Supply Watershed Critical Areas; 303(d) listed impaired waters, or
submerged aquatic vegetation (SAV)?
No
4
Does the bridge cross a designated Wild and Scenic River?
No
5
Does the bridge cross designated mountain trout streams?
No
6
Is the project in a Coastal Area Management Act (CAMA) county?
No
7
Does the project involve Coastal Barrier Resource Act (CBRA) resources?

No
8
What federal ME species are listed (USFWS or NMFS) for the county where the project is
located?
Bog turtle, Northern long-eared bat, Rusty -patched bumble bee
9
Are there known occurrences of protected species in the project study area?
No
10
Does the project study area include lands within the 100-year flood zone?
Yes
FERC/Coast Guard
1
Does the project cross known Federal Energy Regulatory Commission (FERC)-regulated waters?
No
2
Does the project cross US Coast Guard navigable waters?
No
Community Impacts
1
Is the project located in a Census block group with low-income or minority populations?
Yes — Low Income
2
Is there a limited English proficiency or language assistance population in the Census block
group?
No
3
Are there any parks in the project study area? If yes, are there any Section 4(f) concerns
(federal prolects only)?
No
4
Are there prime and important farmlands in the project study area (federal prolects only)?
Yes: DpB2 = all areas are prime farmland; DpC2 = farmland of statewide importance; and PaB =
all areas are prime farmland
5
Is the project located along a designated bicycle route?
No
Other
1
Is the project located within or adjacent to publicly -owned lands or known lands restricted by
conservation easements (i.e., DMS, NCDCT, CWMTF)?
No
2
Are there any known Section 6(f) resources?
No
3
Are there known hazardous materials or landfills in the project study area?
No

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