20120588 Ver 1_401 Application_20120612

Letter of Transmittal
9751 Inc
9751 Southern Pine Blvd t O
Charlotte NC 28273
(704) 523 -4726
[phone] fax
N C Division of Water Quali
401 Wetlands Unit
JOB NO 1356 12 -009
512 North Salisbury Street
RE Belews Creek Steam Station Proposed Ash Basin
Dam Maintenance
Raleigh, North Carolina, 27604
Nationwide Permit No 3 and 5 Pre Construction Notification Jurisdictional
5
WE ARE SENDING YOU
® Attached
❑ Shop drawings
❑ Prints
❑ Copy of letter
® Report
DATE June 8 2012
JOB NO 1356 12 -009
ATTENTION Ms Karen Higgins
RE Belews Creek Steam Station Proposed Ash Basin
Dam Maintenance
Nationwide Permit No 3 and 5 Pre Construction Notification Jurisdictional
❑ Under separate cover via the following items
❑ Plans ❑ Draft ❑ Specifications
COPIES
DATE
DESCRIPTION
Nationwide Permit No 3 and 5 Pre Construction Notification Jurisdictional
5
682012
Determination
1
682012
$240 00 Check for Minor Impact Processing Fee
THESE ARE TRANSMITTED AS CHECKED BELOW
❑ For approval
❑ As requested
❑ FORBIDS DUE / /_
® For your record
❑ For review and comment ❑
❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS Attached please find the above, for your approval Please let me know if you have questions, Thank you
Dave Homans
SIGN
COPY TO File, USACE, Duke, NC WRC
JUN 13 pp�p I
IF ENCLOSURES ARE NOT AS NOTED PLEASE NOTIFY US AT ONCE a" r
This Letter of Transmittal and the documents accompanying this Letter of Transmittal contain information from S &ME Inc ch nfidential and legally
privileged The information is intended only for use of the individual or entity named on this Letter of Transmittal If you are not the intended recipient you
are hereby notified that any disclosure copying distribution or the taking of any action in reliance on these documents is strictly prohibited
S &ME SFG 001
(Rev 04/04)

June 8 2012
U S Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive Suite 105
Wake Forest North Carolina 27587
Attention Mr John Thomas
N C Division of Water Quality
401 Wetlands Unit
512 North Salisbury Street
Raleigh North Carolina 27604
Attention Ms Karen Higgins
Reference Pre Construction Notification NWP 3 and 5 / WQC 3883 and
Request for Jurisdictional Determination
Proposed Active Ash Basin Dam Maintenance 11 @t ;zk
Duke Energy — Belews Creek Steam Station
Stokes County North Carolina
S &ME Project No 1356 12 009 JUN 1 � 2012
Dear Mr Thomas and Ms Higgins
S &ME Inc (S &ME) is submitting this Pre Construction Notification (PCN) of impacts
to waters of the U S authorized under the Department of the Army Nationwide Permit
(NWP) No 3 (maintenance) and No 5 (scientific measurement devices) and the
corresponding North Carolina Department of Natural Resources Division of Water
Quality (DWQ) 401 Water Quality Certification (WQC) No 3883 along with supporting
documentation for verification of the on site jurisdictional boundaries S &ME has been
retained by Duke Energy (Duke) the applicant for the proposed project to provide
services related to authorization under the NWPs in accordance with the Clean Water
Act
The proposed project will involve permanent fill of 85 linear feet (If) of channel and 0 03
acres of wetland in order to quantify and control water seepage that is occumng through
an earthen dam supporting the active ash basin at Belews Creek Steam Station in Stokes
County North Carolina In support of this PCN please find enclosed the following
9 Figures Site Vicinity / USGS Topographic Map (Figure 1), Approximate Waters
of the U S / Proposed Project Impacts (Figure 2) and Proposed Impact Cross
Section (Figure 3)
SWE INC / 9751 Southern Pine Boulevard / Charlotte NC 28273 5560 / p 704 523 4726 f 704 525 3953 / www smemc corn

Nationwide Permit No 385 /Request for Jurisdictional Determination SBME Project No 1356 12 0009
Duke Energy Belews Creek Active Ash Dam Maintenance June 8, 2012
• Appendix I Pre Construction Notification Form (PCN) and Agent Authorization
Form
• Appendix II Site Photographs
• Appendix III Approved Jurisdictional Determination Form
• Appendix IV USACE Eastern Mountains and Piedmont Wetland and Upland
Determination Forms and
® Appendix V Agency Correspondence
The project site is located along the active ash basin located northwest of Duke s Belews
Creek Steam Station (identified as Tailings Pond on USGS Topographic Mapping
Figure 1) The ash basin is the result of an earthen dam along an un named tributary
flowing north into the Dan River though the active outfall of the basin is located to the
west of the dam During an inspection on January 4 2012 personnel from the North
Carolina Department of Environment and Natural Resources Division of Land Resources
Dam Safety Section (DSS) identified areas of water seeping out of the lower left side
(looking downstream) of the dam near elevation 670 feet side of the dam embankment
and requested that a plan to address the seepage be developed
In order to quantify this seepage and provide surface stabilization S &ME has proposed
the installation of two weirs /flow measurement devices at either end of an existing
concrete lined perennially flowing drainage channel and a third weir /flow measurement
device at the base of a riprap lined ditch that loins the concrete lined drainage channel
along the western edge of the dam The weir /flow measurement device at the eastern end
of the concrete lined drainage will be installed within the footprint of an existing culvert
that is proposed to be replaced and will therefore not result in additional jurisdictional
impacts The approximate locations of the proposed flow measurement devices are
depicted on Figure 2
Within the main project area water seeping through the dam has created wetland
conditions (Wetland A) which is leading to potential localized embankment instability
S &ME has proposed stabilizing this area with riprap underlain by a geotextile which also
requires filling 85 if of the concrete lined drainage directly downslope of the wetland and
adjacent area Please refer to Figure 3 for a cross section and plan view of the proposed
wetland fill area
An area of riprap stabilization is also proposed along an eroding section of the upstream
slope /inner embankment of the active ash basin (See Photo 6 Appendix II)
Modification of this area will not result in jurisdictional impacts as the active ash basin is
a maintained waste treatment system under 33 CFR 3(a)(8) and therefore is not
considered a Jurisdictional water
On April 13 2012 S &ME personnel visited the project site and conducted a delineation
to determine the location of Jurisdictional waters of the U S within the areas to be
repaired and maintained The determination was conducted utilizing currently accepted
2

Nationwide Permit No 3 &5 /Request for Jurisdictional Determination S &ME Project No 1356 12 0009
Duke Energy Belews Creek Active Ash Dam Maintenance June 8 2012
methods as set forth in the 1987 Corps of Engineers Wetlands Delineation Manual
Stream assessments were conducted in accordance with DWQ and USACE guidelines
Results of the determination are depicted on the Approximate Waters of the U S Map
(Figure 2) representative photographs of the project area are included in Appendix II and
the locations of photos are depicted on Figure 2 The jurisdictional status of features in
the vicinity of the proposed impact areas was determined though these features were not
delineated in the field as they were well outside the area of proposed impact
Two concrete lined drainages were observed running generally parallel along the face of
the dam both of which are fed by drilled horizontal drams or finger drains emerging from
the embankment near elevation 670 feet The upper drainage ditch was completely dry at
the time of the field visit and no indications of intermittent flow or connection to the
water table were observed (see Photo 5 Appendix 1I) as such this drainage was
determined to be non jurisdictional
The lower concrete lined drainage channel was filled with water and groundwater
drainage was actively flowing into it from drilled horizontal drains or finger drams
emerging from the embankment (See Photo 2 Appendix I1) Though the highly modified
nature of this channel did not allow it to be affectively assessed using DWQ
Methodology for Identification of Intermittent and Perennial Streams and Their
Origins indicators of perennial flow were observed including the presence of algal mats
and late instar dragonfly nymphs (Amsoptera) which require perennial flow conditions
As this channel exhibits perennial flow is on the exterior of the active ash basin and is
not upstream of a NPDES discharge and would likely persist as a waterway in the
absence of anthropogemc influence S &ME determined it to be a jurisdictional Relatively
Permanent Water (RPW) with a significant nexus to downstream waters
Upslope of the western end of the perennial jurisdictional drain an area was noted where
water was actively seeping out of the embankment and vegetation was dominated by
cattail (Typha lattrfolra) and Sphagnum sp moss (See Photo l Appendix II) The area
appeared to have been historically filled with riprap and large rock making soil sampling
difficult regardless a number of hydric indicators were observed where soil sampling
could be performed including hydrogen sulfide odor (A4) and a muck surface layer
(A10) Though this indicator is specific to mountain regions the steep slope of the dam
surface and the seep like conditions of this area are more consistent with mountain
conditions than Piedmont As such this area was determined to be a jurisdictional
wetland (Wetland A)
Riprap lined ditches (two to the west and one to the east) were observed running the
transversely down the face of the dam near its edges These ditches lacked high water
mark indicators and active flow was not observed within them therefore they were
determined to be non jurisdictional rain fed drainage swales
Downslope of the proposed project areas two Jurisdictional drainages were observed
with wetland fringes at the groin of the dam where dam fill met each natural valley
wall Though these areas were noted as jurisdictional they were not delineated in the
field as they were well outside the proposed project area Additionally tothe downstream
of where the eastern end of the jurisdictional perennial drainage flows into a culvert a
3

Nationwide Permit No 3 &5 /Request for Jurisdictional Determination S &ME Project No 1356 12 0009
Duke Energy Belews Creek Active Ash Dam Maintenance June 8 2012
scrub /shrub wetland (Wetland B) dominated by tag alder (Alnus serrulata) was observed
Though this wetland was delineated in the field it was not surveyed as it was located
outside the proposed impact area
Typical upland areas observed consisted of the steep slopes of the dam (approximately
40% grade) which were vegetated with mowed grasses
Proposed project impacts are indicated on Figures 2 and 3 The area where Wetland A is
emerging from the dike will be stabilized with the addition of riprap resulting In
permanent fill impacts to 0 032 acres of jurisdictional wetland A perforated pipe(s) will
be placed in the jurisdictional concrete lined drainage channel packed around with
coarse aggregate and a layer of sand and then covered with geotextile fabric before
covering the drainage and upslope wetland area with riprap (see Figure 3) A flow
measurement weir /device will be installed upstream of the point where the jurisdictional
ditch flows into the downstream RPW These impacts will result in the permanent fill of
851f of jurisdictional perennially flowing channel A flow measurement weir /device will
also be installed to the non jurisdictional riprap filled ditch adjacent to the jurisdictional
concrete lined channel which will not result in additional jurisdictional impacts
An additional flow measurement weir /device will also be installed within the footprint of
an existing culvert on the eastern end of the jurisdictional drain As the weir /device will
be installed within the footprint of an existing culvert and outside of Wetland B no
additional impacts to jurisdictional waters will be required
An area of riprap stabilization will also be installed along the embankment of the active
ash basin though this will not result to jurisdictional impacts as the active ash basin is a
maintained waste treatment system under 33 CFR 3(a)(8) and therefore not considered a
jurisdictional water
;.. r -
Federally Protected Species
S &ME s consideration of potential protected species habitat began with review of
existing records obtained from federal and state sources The U S Fish & Wildlife
Service (USFWS) list of federally protected species (updated September 22 2010) was
consulted for a listing of protected species documented within Stokes County North
Carolina This review identified three protected species two plants and one animal
Listed flora and fauna and their federal status are identified in Table 1
4

Nationwide Permit No 3 &5 /Request for Jurisdictional Determination S &ME Project No 1356 12 0009
Duke Energy Belews Creek Active Ash Dam Maintenance June 8 2012
Table ll Federaliv Protected Flora and Fauna Sjjmmnry
Species
Federal Rank
County Status
Habitat Present
Pleurobema collina
Endangered
Current
No
James spinymussel
Hehanthus schweinftzu
Schweimtz s sunflower
Endangered
Current
No
Cardamine micranthera
Small anthered bittercress
Endangered
Current
No
As part of the protected species review S &ME also consulted the North Carolina Natural
Heritage Program (NCNHP) Geographic Information Systems (GIS) data layer of
Element Occurrence (EO) for a endangered or threatened species EOs that have been
identified within or near the project area This review found no EOs pertaining to
federally protected species on record within a one mile radius of the project site
Field review indicated that the project area is highly maintained with regular mowing and
has undergone extensive land modification in recent history As such it would not be
expected to present adequate habitat for the aforementioned protected species listed for
the county Drainage features present within the project area are highly modified (i e
concrete lined or filled with riprap) and therefore would not be expected to provide
habitat for James spinymussel
Additionally a scoping letter was sent to the USFWS Asheville Field office on April 26
2012 outlining the proposed project and requesting comments pertaining to protected
species issues USFWS responded with a May 31 2012 letter stating that they had
conducted a review of the proposed project area and no listed protected species or
habitats occur on the proposed site A copy of the May 31 2012 USFWS letter is
included in Appendix V
Trout Protection
The project is located in Stokes County which is designated as a trout county by the
North Carolina Wildlife Resources Commission (WRC) GIS data available from the NC
OneMap website indicated that the nearest trout water is located on the Dan River
approximately 40 river miles upstream of the project area Though the downstream
receiving waters are unlikely to support trout construction of the project is expected to
occur within moratorium established for trout (October 15 to April 15) A scoping letter
requesting comment and coordination was sent to the Western Piedmont Region
Coordinator of WRC on April 26 2012 WRC responded with a May 15 2012 letter
stating that trout are not found in the vicinity of the project and thus the trout moratorium
would not be applicable to the project As the WRC reviews all Nationwide Permit PCNs
for Stokes County a copy of this PCN will be supplied to WRC
Cultural Resources
S &ME reviewed the North Carolina Historical Preservation Office Online GIS Web
Service (HPOWEB) for properties listed or potentially eligible for listing in the National
Register of Historic Places No such properties were identified within the vicinity of the
5

Nationwide Permit No 3 &5 /Request for Jurisdictional Determination S &ME Protect No 1356 12 0009
Duke Energy Belews Creek Active Ash Dam Maintenance June 8 2012
project area In response to a scopmg letter and project location map submitted by
S &ME on April 26 2012 the North Carolina State Historic Preservation Office (SHPO)
responded with a May 8 2012 letter stating that they had conducted a review of the
proposed project area and were not aware of historic resources that would be affected as a
result Accordingly the SHPO had no further comment on the project A copy of the
May 8 2012 SHPO letter is included in Appendix V
This project was designed to only impact the areas where seepage was potentially leading
to instability along the dike Flow measurement devices required to quantify seepage will
be placed either in non jurisdictional areas (in the riprapped ditch) areas that have
already been impacted (within the footprint of the existing culvert) or within areas where
fill was already required as a part of embankment stabilization efforts The project will
not require additional impact to allow for equipment access and no clearing of vegetation
will be required outside of the areas where stabilizing fill will be placed Impacts to
downstream waters will be minimized through the use of stringent erosion and sediment
control measures A separate Erosion and Sediment Control Plan will be prepared for the
proposed construction
Impacts associated with this project have been limited to only the areas required for
stabilization and features that are currently heavily modified (concrete lined or r1prap
filled) The extent of proposed impacts (0 03 acres of wetland and 85 If of perennial
drainage impacts) are well below typical mitigation thresholds As such and based on
our experience with similar projects we do not anticipate that compensatory mitigation
for the proposed project is required
By copy of this correspondence and completed PCN we are requesting your written
concurrence with this request for authorization under NWP No 3 and NWP No 5 If you
have questions or require additional information please feel free to contact David
Homans at 704 523 4726
Sincerely
l
D David Homans
Natural Resources Project Scientist
Senior Review by Jason S Reeves P E
Senior Engineer
Attachments
oey awler
Natural Resources Senior Scientist
cc Western Piedmont Regional Coordinator WRC

tFS_
• Figure 1 - Site Vicinity / USGS Topographic Map
• Figure 2 - Approximate Waters of the U S / Proposed Project
Impacts
Figure 3 — Proposed Impact Cross Section

t o k e s
2
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Belews Creek f
Steam Station 1� `� >I
�y
1.
0 l <1,000 2,000 kA„'� .�:
eL1r* i
Feet � �
�L m
REFERENCE: USGS 2003 BELEWS LAKE [NC] QUAD SHEET
L
THE ABOVE INFORMATION WAS OBTAINED FROM THE USDA GEOSPATIAL DATA GATEWAY. PLEASE
NOTE THIS MAP IS FOR INFORMATIONAL PURPOSES ONLY IT IS NOT MEANT FOR DESIGN, LEGAL, OR
ANYOTHERUSES. THERE ARE NO GUARANTEES ABOUT ITS ACCURACY S &ME, INC. ASSUMES NO
RESPONSIBILITY FOR ANY DECISION MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS . "` ), ^ Approximate Project Location 91
h o
SCALE: 1 = 2,000 SITE VICINITY / FIGURE NO.
DATE: 05 -16 -12 S &ME USGS TOPOGRAPHIC MAP
DRAWN BY DDH Duke Energy Belews Creek Station
'ROJECT NO:
WWW.SMEINC.COM Ash Dike Maintenance
1356 -12 -009 ENGINEERING LICENSE NO F -0176 Stokes County, North Carolina

pxw dW10ZHX0HddH ZOId \6uly. -@d ON Cl ysysMala9 \Z IOZ\LSCL \'0

m
° a III- PLAN VIEW
C 0o -4
Wetland A �,.
0.032 Acres Proposed Fill 4,
rr'? -, ` Perennial Jurisdictional Drain (RPW)
85 LF of Proposed Fill ! Piping
g Cross Section
' C- Proposed Flow Measurement Devices
Proposed Fill Areas
Stream / Ditch Impacts
® Wetland
- - - -- I Drainage Features:
Existing Riprap - - - -- - -�
Stabilization Perennial RPW (Stream)
Jurisdictional Ditch /Drain (RPW)
P
0 30 60 Culvert
Feet — Non- jurisidictional Riprapped Ditch
CROSS SECTION VIEW
A
EXISTING EMBANKMENT FILL
EXISTING RIPRAP
AND BOULDERS
(WETLAND A)
EXISTING CONCRETE DITCH
A'
OPOSED CLASS 8 RIPRAP
PROPOSED ASTM C33 SAND LAYER
(APPROX. 6- INCHES THICK)
PROPOSED GEOTEXTILE FABRIC
EXISTING GRADE
PROPOSED NCDOT 78M COARSE AGGREGATE
(FILLING EXISTING CONCRETE DITCH SECTION
AND VOID SPACE AROUND PIPE)
PROPOSED 6" -12" PERFORATED PIPE
0 4 8 12
Feet
REFERENCE:
PLEASE NOTE DESIGNS DEPICTED ARE FOR CONCEPTUAL PERPOSES. IT IS NOT MEANT FOR BUILD,
LEGAL, ORANY
OTHER USES. THEREARE NO GUARANTEES ABOUT ITS ACCURACY. S &ME, INC.ASSUMES NO RESPONSIBILITY
FOR
ANY DECISION MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
SCALE: 1 11=30'
#S&ME
PROPOSED IMPACT
CROSS SECTION
FIGURE NO
DATE: 05 -09 -12
Duke Energy Belews Creek Station
3
DRAWN BY DDH
WWW.SMEINC.COM
Ash Dike Maintenance
P ROJECT NO:
13S6-1 MOP
I
Stokes County, North Carolina
I ENGINEERING LICENSE NO: F -0176

'APPENDIX 1
Pre - Construction Notification
Agent Authorization Form

o�C)f WA7t,'9 �
y
n
2®120588
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 12
PCN Form —Version 1 3 December 10 2008 Version
Pre - Construction Notification PCN Form
A Applicant Information
1
Processing
1a
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
lb Specify Nationwide Permit (NWP) number 3 and 5 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d
Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification — Regular ❑ Non 404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes ® No
For the record only for Corps Permit
® Yes ❑ No
1f
Is payment into a mitigation bank or in lieu fee program proposed for mitigation
of impacts? If so attach the acceptance letter from mitigation bank or in lieu
fee program
❑ Yes
® No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
Duke Energy Belews Station Ash Basin
2b
County
Stokes
2c
Nearest municipality / town
Walnut Cove
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
N/A
3
Owner Information
3a
Name(s) on Recorded Deed
Duke Energy Corporation
3b
Deed Book and Page No
535/965
3c
Responsible Party (for LLC if
applicable)
N/A
3d
Street address
3195 Pine Hall Road
3e
City state zip
Belews Creek NC 27009 9157
3f
Telephone no
N/A
3g
Fax no
N/A
3h
Email address
N/A
Page 1 of 12
PCN Form —Version 1 3 December 10 2008 Version

4
Applicant information (if different from owner)
4a
Applicant is
® Agent ❑ Other specify
4b
Name
4c
Business name
(if applicable)
4d
Street address
4e
City state zip
4f
Telephone no
4g
Fax no
4h
Email address
5
Agent/Consultant Information (if applicable)
5a
Name
D David Homans
5b
Business name
(if applicable)
SWE Inc
5c
Street address
9751 Southern Pine Blvd
5d
City state zip
Charlotte NC 28273
5e
Telephone no
704 523 -4726
5f
Fax no
704 525 3953
5g
Email address
dhomans @smemc com
Page 2 of 12
PCN Form — Version 1 3 December 10 2008 Version

B
Project Information and Prior Project History
1
Property Identification
1a
Property identification no (tax PIN or parcel ID)
698200642715
lb
Site coordinates (in decimal degrees)
Latitude 36 29732 Longitude 8007611
(DD DDDDDD) ( DD DDDDDD)
1c
Property size
6099 (Ash Dike -15 acres) acres
2
Surface Waters
2a
Name of nearest body of water (stream river etc ) to
Project area drains to an unnamed tributary of the Dan
proposed project
River
2b
Water Quality Classification of nearest receiving water
C
2c
River basin
Upper Dan River (HU 03010103)
3
Project Description
3a
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application
The primary project area is on the outside slope of a maintained earthen berm dike along a coal ash settling basin Water
seepage through the berm emerges through the dike via finger drains which collect in a perennially flowing concrete lined
ditch which drains into two perennial channels located at the groin of the dike where it meets the natural valley walls
Some areas of historic seepage have been repaired with the placement of nprap and large rock seepage has continued
to emerge in an area or rock placement which has resulted in the formation of a wetland (Wetland A) complete with
extensive Sphagnum moss growth
The immediate vicinity is largely made up of forested areas and areas associated with the Belews Creek Power Station
including landfills power generation facilities coal storage and processing areas rail and power line rights of way
3b
List the total estimated acreage of all existing wetlands on the property
0 24 Acres (Wetland A and Wetland B)
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
600 LFof perennial jurisdictional ditch / drain 505 LF of perennial stream at groin of dike and original ground contour
3d
Explain the purpose of the proposed project
At the request of the North Carolina Department of Environment and Natural Resources Division of Land Resources Dam
Safety Section Duke Energy is trying to quantify and control water seepage that is occurring through the earthen dike as
well as increase the stability of the slopes that are supporting the ash basin
3e
Describe the overall project in detail including the type of equipment to be used
Project work is detailed in the attached Figures 2 and 3
The area where Wetland A is emerging from the dike will be stabilized with the addition of nprap A perforated pipe will
be placed in the jurisdictional concrete lined drainage channel packed around with coarse aggregate and a layer of sand
and then covered with geotextde fabric before being covered by the nprap A flow measurement weir will be installed just
upstream of the point where the jurisdictional ditch flows into downstream RPW A flow measurement weir will also be
installed in the non jurisdictional nprap filled ditch adjacent to the jurisdictional concrete lined channel An additional flow
measurement weir will also be installed within the footprint of an existing culvert on the eastern end of the jurisdictional
drain
An area of riprap stabilization will also be installed along the embankment of the active ash basin though this will not
result in jurisdictional impacts as the active ash basin is a maintained waste treatment system under 33 CFR 3(a)(8) and
therefore not considered a jurisdictional water
Equipment likely to be used includes industry standard trackhoes dozers trucks and excavators
Page 3 of 12
PCN Form - Version 1 3 December 10 2008 Version

4
Junsdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past
El Yes El No ®Unknown
Comments Request for verification is included with this
application Potential Jurisdictional features in the project
area were identified by SWE 4/13/2012
4b
If the Corps made the Jurisdictional determination what type
❑ Preliminary ❑ Final
of determination was made
4c
If yes who delineated the Jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
4d
If yes list the dates of the Corps Jurisdictional determinations or State determinations and attach documentation
5
Project History
5a
Have permits or certifications been requested or obtained for
❑ Yes ❑ No ® Unknown
this project (including all prior phases) in the past?
5b
If yes explain in detail according to help file instructions
6
Future Project Plans
6a
Is this a phased project?
❑ Yes ® No
6b
If yes explain
Page 4 of 12
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
1a Which sections were completed below for your project (check all that apply)
® Wetlands ® Streams tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site then complete this question for each wetland area impacted
2a
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ —non 404 other)
(acres)
Temporary T
W1 ®P ❑ T
Rip rap fill
Emergent Seep
❑ Yes
® No
® Corps
® DWQ
0 032
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
0 032
2h Comments
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Fill / Piping
Perennial
Jurisdictional
® PER
INT
® Corps
DWQ
2
85
Drainage
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
85
31 Comments
Page 5 of 12
PCN Form —Version 1 3 December 10 2008 Version

4 Open Water Impacts
If there are proposed impacts to lakes ponds estuaries tributaries sounds the Atlantic Ocean or any other open water of
the U S then individually list all open water impacts below
4a
Open water
impact number —
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c
Type of impact
4d
Waterbody type
4e
Area of impact (acres)
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments No jurisdictional open waters are located within the project area The active ash basin is a waste treatment
system and thus is not considered jurisdictional
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
Pond ID
number
5b
Proposed use or purpose
of pond
5c
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
Page 6 of 12
PCN Form — Version 1 3 December 10 2008 Version

6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ❑ Tar Pamlico ❑ Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
B1 ❑P ❑T
❑Yes
❑ No
B2 ❑P ❑T
El Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments
D Impact Justification and Mitigation
1 Avoidance and Mmimizabon
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
This project was designed to only impact the areas where seepage was potentially leading to instability along the dike Flow
measurement devices required to quantify seepage will be placed either in non jurisdictional areas (in the nprapped ditch)
areas that have already been impacted (within the footprint of the existing culvert) or areas where fill will already be required
as a part of stabilization efforts
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Appropriate sediment and erosion control measures will be utilized during construction Construction equipment access
corridors will not require additional crossings of jurisdictional features
2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U S or Waters of the State?
2b If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c If yes which mitigation option will be used for this
❑ Payment to in lieu fee program
project?
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
Quantity
Page 7 of 12
PCN Form —Version 1 3 December 10 2008 Version

3c Comments
4 Complete if Making a Payment to In lieu Fee Program
4a Approval letter from in lieu fee program is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation stream temperature
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b If yes then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
15
6f Total buffer mitigation required
6g If buffer mitigation is required discuss what type of mitigation is proposed (e g payment to private mitigation bank
permittee responsible riparian buffer restoration payment into an approved in lieu fee fund)
6h Comments
Page 8 of 12
PCN Form — Version 1 3 December 10 2008 Version

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b
If yes then is a diffuse flow plan included? If no explain why
❑Yes El No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
0%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why The proposed project is a maintamance
project which does not generate additional stormwater
2d
If this protect DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
❑ Certified Local Government
2e
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government s jurisdiction is this project?
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 12
PCN Form — Version 1 3 December 10 2008 Version

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
1a Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes ® No
use of public (federal /state) land?
lb If you answered yes to the above does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA /SEPA)?
1c If you answered yes to the above has the document review been finalized by the
State Clearing House? (If so attach a copy of the NEPA or SEPA final approval
letter )
❑ Yes ❑ No
Comments
2 Violations (DWQ Requirement)
2a Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after the fact permit application?
❑ Yes ® No
2c If you answered yes to one or both of the above questions provide an explanation of the violation(s)
3 Cumulative Impacts (DWQ Requirement)
3a Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development which could impact nearby downstream water quality?
3b If you answered yes to the above submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered no provide a short narrative description
The project is not a growth inducing project it is required in order to properly maintain existing features
4 Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non discharge or discharge) of wastewater generated from
the proposed project or available capacity of the subject facility
The proposed project will not generate wastewater
Page 10 of 12
PCN Form — Version 1 3 December 10 2008 Version

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
❑ Raleigh
5c If yes indicate the USFWS Field Office you have contacted
® Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Field review of the project area did not indicate the presence of habitat or endangered species listed for Stokes County
The project area and vicinity are not located in a Designated Critical Habitat Review of Element Occurrences on the
North Carolina Natural Heritage Program Geographic Information Systems (GIS) data available from NC Onemap did not
indicate recorded occurrences of federally listed species in the immediate vicinity of the project area A scoping letter
requesting comment was sent to USFWS Ashville Field Office on April 26 2012 USFWS responded with a May 31
2012 letter stating that they had conducted a review of the proposed project area and no listed protected species or
habitats occur on the proposed site
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http //ocean flondamanne org /efh— coral /ims /viewer htm
The project is located in a designated Trout County GIS data available from NC OneMap indicate that the nearest trout
water is located on the Dan River 40 river miles upstream of the project area A scoping letter requesting comment was sent
to the Western Piedmont Region Coordinator of the North Carolina Wildlife Resource Commission on April 26 2012 WRC
responded with a May 15 2012 letter stating that trout are not found in the vicinity of the project and thus the trout moratorium
would not be applicable to the project
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e g National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
The North Carolina Historical Preservation Office Online GIS Web Service (HPOWEB) indicated that no properties listed
or potentially eligible for listing in the National Register of Historic Places were located within the vicinity of the project
area A scoping letter requesting comment was sent to the State Historic Preservation Office (SHPO) on April 26 2012
In a response dated May 8 2012 SHPO indicated they had no comment on the project
Page 11 of 12
PCN Form —Version 1 3 December 10 2008 Version

8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination? FEMA Floodplain Mapping
D David Homans
Applicant/Agent s Printed Name
6/8/2012
Date
Applicant/Agent s Signature
(Agent s signature is valid only if an authorization letter from the applicant
is provided
Page 12 of 12
PCN Form — Version 1 3 December 10 2008 Version

AGENT AUTHORIZATION FORM
Date C / 7 / I �
Pro)ect Information
S &ME Project Name Belews Creek Active Ash Basin Dam Repairs
Type of Project Natural Resources Services
Location Belews Creek NC
Property Owner /Representative Information
Business Name
Mailing Address
City State Zip Code
Telephone No
Contact
Agent Information
Business Name
Street Address
City State Zip Code
Telephone No
Contact
Duke Energy
3195 Pine Hall Road
Belews Creek North Carolina 27310
336 445 0642
Jay Huntley
S &ME Inc
9751 Southern Pine Boulevard
Charlotte NC 28273
[phone]
Mr D David Homans
Authorization
I on behalf of
(�ontact Signature) 0
Duke Energy hereby authorize
(Name of Landowner or Representative)
S &ME Inc to act as agent for the above mentioned project

APPENDIX 11
• Site Photographs

View of perennially flowing jurisdictional drain in
the vicinity of proposed fill.
r O dry concrete drain.
View of ash pond embankment in the vicinity of
proposed riprap stabilization.
SITE PHOTOGRAPHS
Taken by: DDH
Proposed Active Ash Basin Dam Maintenance
Duke Energy — Belews Creek Steam Station
Checked by: JMBH Stokes County, North Carolina
later d 14 ')010 or ".- ". " nnn I _. —

APPENDIX III
Approved Jurisdictional Determination Form

APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook
SECTION 1 BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD)
B DISTRICT OFFICE FILE NAME AND NUMBER ASHEVILLE FIELD REGULATORY OFFICE
C PROJECT LOCATION AND BACKGROUND INFORMATION DUKE ENERGY BELEWS CREEK ASH DAM
State NORTH CAROLINA County /parish/borough STOKES City
Center coordinates of site (lat/long in degree decimal format) Lai 36 2973 N Long 80 0761 W
Universal Transverse Mercator
Name of nearest waterbody DAN RIVER
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows DAN RIVER
Name of watershed or Hydrologic Unit Code (HUC) UPPER DAN RIVER (03010103)
® Check if map /diagram of review area and/or potential Jurisdictional areas is /are available upon request
❑ Check if other sites (e g offsite mitigation sites disposal sites etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
❑ Office (Desk) Determination Date
® Field Determination Date(s) 4/13/2012
SECTION 11 SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There Are no navigahle waters of the US within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) in the
review area [Required]
❑ Waters subject to the ebb and flow of the tide
❑ Waters are presently used or have been used in the past or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There Are waters of the U S within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area [Required]
1 Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) i
❑ TNWs including territorial seas
❑ Wetlands adjacent to TNWs
® Relatively permanent waterS2 (RPWs) that flow directly or indirectly into TNWs
❑ Non RPWs that flow directly or indirectly into TNWs
® Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
❑ Impoundments of jurisdictional waters
❑ Isolated (interstate or intrastate) waters including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non wetland waters JURISDICTIONAL CONCRETE LiNED DRAINAGE 600 LF PERENNIAL CHANNELS AT
GROIN OF THE DAM 505 LF linear feet 2 FT AND 4 FEET RESPECTIVELY width (ft) and/or acres
Wetlands WETLAND A 0 032 ACRES WETLAND B — 0 21 acres
c Limits (boundaries) of jurisdiction based on 1987 Delineation Manual
Elevation of established OHWM (if known)
2 Non regulated waters /wetlands (check if applicable) 3
® Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional
Explain THE UPPER CONCRETE -LINED DRAINAGE DITCH WAS DRY AND SHOWED NO INDICATION OF
RECEIVING FLOW OTHER THAN STORM DRAINAGE RIPRAP LINED DRAINAGES RUNNING DOWN THE
FACE OF THE DAM DID NOT SHOW INDICATIONS OF RECEIVING GROUNDWATER FLOW OR OTHER
Boxes checked below shall be supported by completing the appropriate sections in Sect on III below
Fo purposes of th s form an RPW s def ed as a tnbutary that s not TNW a d that typ fly flows year ound or has continuous flow at least seasonally
(e g typically 3 months)
Supporting documentation s presented n Section III F

SOURCE OF RELATIVELY PERMANENT DRAINAGE AND THUS LIKELY ONLY ACT AS STORM FLOW
CONDUITS

SECTION 111 CWA ANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW complete
Section III A 1 and Section 111 D 1 only if the aquatic resource is a wetland adjacent to a TNW complete Sections III A 1 and 2
and Section 111 D 1 otherwise see Section III B below
1 TNW
Identify TNW
Summarize rationale supporting determination
2 Wetla nd adjacent to TNW
Summarize rationale supporting conclusion that wetland is adjacent
B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands if any and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met
The agencies will assert jurisdiction over non navigable tributaries of TNWs where the tributaries are relatively permanent
waters (RPWs) i e tributaries that typically flow year round or have continuous flow at least seasonally (e g typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW but has year round
(perennial) flow skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow
skip to Section HI D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water even
though a significant nexus finding is not required as a matter of law
If the waterbody° is not an RPW or a wetland directly abutting an RPW a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines for
analytical purposes the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary or its adjacent wetlands or both If the JD covers a tributary with adjacent wetlands complete Section III B 1 for
the tributary Section III B 2 for any onsite wetlands and Section III BJ for all wetlands adjacent to that tributary both onsite
and offsite The determination whether a significant nexus exists is determined in Section 111 C below
1 Characteristics of non TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size Pick List
Drainage area Pick List
Average annual rainfall inches
Average annual snowfall inches
(u) Physical Characteristics
(a) Relationship with TNW
❑ Tributary flows directly into TNW
❑ Tributary flows through Pick List tributaries before entering TNW
Project waters are Pick List river miles from TNW
Project waters are Pick List river miles from RPW
Project waters are Pick List aerial (straight) miles from TNW
Project waters are Pick List aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain
Identify flow route to TNW5
Note that the I structional Guidebook contains additional information regarding swales ditches washes and erosional features generally and in the and
West
Flow route can be described by identifying e g tributary a which flows through the review area to flow into tributary b wh ch then flows into TNW

Tributary stream order if known
(b) General Tributary Characteristics (check all that apply)
Tnbutary is ❑ Natural
❑ Artificial (man made) Explain
❑ Manipulated (man altered) Explain
Tnbutary properties with respect to top of bank (estimate)
Average width 2 feet
Average depth 5 feet
Average side slopes Pick List
Primary tributary substrate composition (check all that apply)
❑ Silts ❑ Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation Type // cover
❑ Other Explain
Tributary condition/stability [e g highly eroding sloughing banks] Explain
Presence of run/riffle/pool complexes Explain
Tributary geometry Pick List
Tributary gradient (approximate average slope) /
(c) Flow
Tributary provides for Pick List
Estimate average number of flow events in review area/year Pick List
Describe flow regime
Other information on duration and volume
Surface flow is Pick List Characteristics
Subsurface flow Pick List Explain findings
❑ Dye (or other) test performed
Tributary has (check all that apply)
❑ Bed and banks
❑ OHWM6 (check all indicators that apply)
❑ clear natural line impressed on the bank
❑
❑ changes in the character of soil
❑
❑ shelving
❑
❑ vegetation matted down bent or absent
❑
❑ leaf litter disturbed or washed away
❑
❑ sediment deposition
❑
❑ water staining
❑
❑ other (list)
❑ Discontinuous OHWM 7 Explain
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWAjurisdiction (check all that apply)
❑ High Tide Line indicated by ❑ Mean High Water Mark indicated by
❑ oil or scum line along shore objects ❑ survey to available datum
❑ fine shell or debris deposits (foreshore) ❑ physical markings
❑ physical markings /characteristics ❑ vegetation lines /changes in vegetation types
❑ tidal gauges
❑ other (list)
(in) Chemical Charactensttcs
Characterize tributary (e g water color is clear discolored oily film water quality general watershed characteristics etc )
Explain
Identify specific pollutants if known
A natural or man made discontinuity in the OHWM does not necessarily sever jurisdiction (e g where the stream temporarily flows underground or where
the OHWM has been removed by development or agricultu al practices) Where there is a b eak the OHWM that s nrelat d to the waterbody s flow
regime (e g flow over a rock outcrop or through a culvert) the agenc es will look fo nd cators of flow abo a and below the break
Ibid

(iv) Biological Characteristics Channel supports (check all that apply)
❑ Riparian corridor Characteristics (type average width)
❑ Wetland fringe Characteristics
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic /wildlife diversity Explain findings
2 Characteristics of wetlands adjacent to non TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain
Wetland quality Explain
Project wetlands cross or serve as state boundaries Explain
(b) General Flow Relationship with Non TNW
Flow is Pick List Explain
Surface flow is Pick List
Characteristics
Subsurface flow Pick List Explain findings
❑ Dye (or other) test performed
(c) Wetland Adlacency Determination with Non TNW
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain
❑ Ecological connection Explain
❑ Separated by berm/barrier Explain
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW
Project waters are Pick List aerial (straight) miles from TNW
Flow is from Pick List
Estimate approximate location of wetland as within the Pick List floodplam
(u) Chemical Characteristics
Characterize wetland system (e g water color is clear brown oil film on surface water quality general watershed
characteristics etc ) Explain
Identify specific pollutants if known
(i i) Biological Characteristics Wetland supports (check all that apply)
❑ Riparian buffer Characteristics (type average width)
❑ Vegetation type/percent cover Explain
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic /wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis

For each wetland specify the following
Directly abuts9 (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological chemical and physical functions being performed
C SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the now characteristics and functions of the tnbutary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical physical and biological integrity
of a TNW For each of the following situations a significant nexus exists if the tnbutary in combination with all of its adjacent
wetlands has more than a speculative or insubstantial effect on the chemical physical and /or biological integrity of a TNW
Considerations when evaluating significant nexus include but are not limited to the volume duration and frequency of the flow
of water in the tributary and its proximity to a TNW and the functions performed by the tributary and all its adjacent
wetlands It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly the fact an adjacent wetland lies within or
outside of a floodplam is not solely determinative of significant nexus
Draw connections between the features documented and the effects on the TNW as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook Factors to consider include for example
Does the tributary in combination with its adjacent wetlands (if any) have the capacity to carry pollutants or flood waters to
TNWs or to reduce the amount of pollutants or flood waters reaching a TNW9
Does the tributary in combination with its adjacent wetlands (if any) provide habitat and hfecycle support functions for fish and
other species such as feeding nesting spawning or rearing young for species that are present in the TNW9
Does the tributary in combination with its adjacent wetlands (if any) have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs9
Does the tributary in combination with its adjacent wetlands (if any) have other relationships to the physical chemical or
biological integrity of the TNW9
Note the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below
Significant nexus findings for non RPW that has no adjacent wetlands and flows directly or indirectly into TNWs Explain
findings of presence or absence of significant nexus below based on the tributary itself then go to Section III D
2 Significant nexus findings for non RPW and its adjacent wetlands where the non RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below based on the tributary in combination with all of its
adjacent wetlands then go to Section III D
3 Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below based on the tributary in combination with all of its adjacent wetlands then go to
Section 111 D
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY)
1 TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area
❑ TNWs linear feet width (ft) Or acres
❑ Wetlands adjacent to TNWs acres
2 RPWs that flow directly or indirectly into TNWs
® Tributaries of TNWs where tributaries typically flow year round are jurisdictional Provide data and rationale indicating that
tributary is perennial THE LOWER DRAINAGE DITCH APPEARED TO RECEIVE CONSISTENT GROUNDWATER
FLOW FROM FINGER DRAINS EMERGING FROM THE DAM AND AQUATIC FAUNA WHICH HAVE A LIFE
CYCLE REQUIRING PERENNIAL FLOW (DRAGONFLY LARVAE) WERE OBSERVED IN THE DRAINAGE DITCH
DRAINAGES DOWNSTREAM OF THE PERENNIALLY FLOWING DRAINAGE DITCH WERE ASSUMED TO BE
PERENNIAL AS WELL

❑ Tributaries of TNW where tributaries have continuous flow seasonally (e g typically three months each year) are
jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows
seasonally
Provide estimates forjurisdictional waters in the review area (check all that apply)
® Tributary waters JURISDICTIONAL CONCRETE LINED DRAINAGE 600 LF PERENNIAL CHANNELS AT
GROIN OF THE DAM 505 LF linear feet width (ft)
❑ Other non wetland waters acres
identify type(s) of waters
Non RPWse that Flow directly or indirectly into TNWs
❑ Waterbody that is not a TNW or an RPW but flows directly or indirectly into a TNW and it has a significant nexus with a
TNW is jurisdictional Data supporting this conclusion is provided at Section III C
Provide estimates for jurisdictional waters within the review area (check all that apply)
❑ Tributary waters Imear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs
® Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands
® Wetlands directly abutting an RPW where tributaries typically flow year round Provide data and rationale
indicating that tributary is perennial in Section iII D 2 above Provide rationale indicating that wetland is
directly abutting an RPW WETLAND A WAS OBSERVED SEEPING DIRECTLY INTO THE PERENNIAL
CONCRETE LINED DRAINAGE DITCH WETLAND B WAS OBSERVED IN THE FIELD FLOWING INTO
A CULVERT WHICH DRAINED INTO THE EASTERN CHANNEL ALONG THE GROIN OF THE DAM
❑ Wetlands directly abutting an RPW where tributaries typically flow seasonally Provide data indicating that tributary is
seasonal in Section iII B and rationale in Section III D 2 above Provide rationale indicating that wetland is directly
abutting an RPW
Provide acreage estimates for jurisdictional wetlands in the review area acres
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
❑ Wetlands that do not directly abut an RPW but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands have a significant nexus with a TNW are junsidictional Data supporting this
conclusion is provided at Section 111 C
Provide acreage estimates for jurisdictional wetlands in the review area acres
6 Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to such waters and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands have a significant nexus with a TNW are jurisdictional Data supporting this
conclusion is provided at Section III C
Provide estimates forjurisdictional wetlands in the review area acres
7 impoundments of jurisdictional waters 9
As a general rule the impoundment of a jurisdictional tributary remains jurisdictional
❑ Demonstrate that impoundment was created from waters of the U S or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1 6) or
❑ Demonstrate that water is isolated with a nexus to commerce (see E below)
ISOLATED JINTERSTATE OR INTRA STATE] WATERS INCLUDING ISOLATED WETLANDS THE USE
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) to
See Footnote # 3
To complete the analysis refer to the key in Section 111 D 6 of the Instructional Guidebook

❑ which are or could be used by interstate or foreign travelers for recreational or other purposes
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
❑ which are or could be used for industrial purposes by industries in interstate commerce
❑ interstate isolated waters Explain
❑ Other factors Explain
Identify water body and summarize rationale supporting determination
Provide estimates for Jurisdictional waters in the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
❑ Wetlands acres
NON JURISDICTIONAL WATERS INCLUDING WETLANDS (CHECK ALL THAT APPLY)
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
❑ Prior to the Jan 2001 Supreme Court decision in SWANCC the review area would have been regulated based solely on the
Migratory Bird Rule (MBR)
® Waters do not meet the Significant Nexus standard where such a finding is required for Jurisdiction Explain
® Other (explain if not covered above) OTHER DRAINAGE FEATURES OBSERVED ON THE FACE OF THE DAM
WERE DETERMINED NOT TO BE JURISDICTIONAL DUE TO EVIDENCE THAT THEY LACKED FLOW BEYOND
STORM EVENTS THE ACTIVE ASH BASIN ON THE OTHER SIDE OF THE DAM IS A MAINTAINED WASTE
TREATEMENT SYSTEM UNDER 33 CFR3(A)(8) AND IS THEREFORE NOT CONSIDERED TO BE A JURISDICTIONAL
WATER
Provide acreage estimates for non Jurisdictional waters in the review area where the sole potential basis of Jurisdiction is the MBR
factors (i a presence of migratory birds presence of endangered species use of water for irrigated agriculture) using best professional
Judgment (check all that apply)
❑ Non wetland waters (i a rivers streams) linear feet width (ft)
❑ Lakes /ponds acres
❑ Other non wetland waters acres List type of aquatic resource
❑ Wetlands acres
Provide acreage estimates for non Jurisdictional waters in the review area that do not meet the Significant Nexus standard where such
a finding is required for Jurisdiction (check all that apply)
❑ Non wetland waters (i a rivers streams) linear feet width (ft)
❑ Lakes /ponds acres
❑ Other non wetland waters acres List type of aquatic resource
❑ Wetlands acres
SECTION IV DATA SOURCES
SUPPORTING DATA Data reviewed for JD (check all that apply checked items shall be included in case file and where checked
and requested appropriately reference sources below)
® Maps plans plots or plat submitted by or on behalf of the applicant/consultant
® Data sheets prepared/submitted by or on behalf of the applicant/consultant
❑ Office concurs with data sheets/delineation report
❑ Office does not concur with data sheets /delineation report
❑ Data sheets prepared by the Corps
❑ Corps navigable waters study
❑ U S Geological Survey Hydrologic Atlas
❑ USGS NHD data.
❑ USGS 8 and 12 digit 14UC maps
® U S Geological Survey map(s) Cite scale & quad name 2003 BELEWS LAKE
❑ USDA Natural Resources Conservation Service Soil Survey Citation
❑ National wetlands inventory map(s) Cite name
S &ME INC
[NC] 124 000 QUAD SHEET (FIGURE 2)
i Prior to asserting or declining CWA lurisdict on based solely on this category Corps Distr cis w II elevate the act on to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.

❑ State/Local wetland inventory map(s)
❑ FEMA/FIRM maps
❑ 100 year Floodplam Elevation is (National Geodectic Vertical Datum of 1929)
® Photographs ® Aerial (Name & Date) 2010 AERIAL PHOTOGRAPH (SEE FIGURE 2 AND 3)
or ® Other (Name & Date) SITE PHOTOGRAPHS TAKEN 4 13 2012
❑ Previous determination(s) File no and date of response letter
❑ Applicable /supporting case law
❑
App] icable /supportmg scientific Iiterature
❑ Other information (please specify)
B ADDITIONAL COMMENTS TO SUPPORT JD THOUGH THE LOWER DRAINAGE DITCH IS HIGHLY MODIFIED AND OF
ANTHROPOGENIC ORIGIN IT WAS DETERMINED TO BE JURISDICTIONAL FOR THE FOLLOWING REASONS 1) IT
RECEIVES PERENNIAL GROUNDWATER FLOW THROUGH THE DAM 2)IT IS NOT UPSTREAM OF A NPDES PERMITTED
OUTFALL AND THUS NOT EXEMPTED FROM JURISDICTION AS A PART OF A WASTE TREATMENT SYSTEM AND 3) IT
WOULD LIKELY PERSIST AS A PERENNIAL WATERWAY IN THE ABSENCE OF CONTINUED ANTHROPOGENIC
INFLUENCE

APPENDIX V�
• USACE Eastern Mountains and Piedmont Wetland and
Upland Determination Forms

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site Belews Creek Steam Station Ash Pond Dam City /County Stokes Co
Applicant/Owner Duke Energy State NC
Investigator(s) D David Homans Section Township Range
Landform (hillslope terrace etc) hlllSlope Local relief (concave convex none) none
LRR P (CO d bons cons , t 36 297292 80 076132
Subregion (LRR or MLRA) wth lRR N) Lat Long
Sampling Date 4/13/2012
_ Sampling Point Wetland A
_ Slope(/) 40%
Datum
Sod Map Unit Name Udorthents / Dam NWI classification
Are climatic / hydrologic conditions on the site typical for this time of year? Yes ✓ No (If no explain in Remarks )
Are Vegetation ✓ Soil ✓ or Hydrology significantly disturbed? Are Normal Circumstances present? Yes ✓
Are Vegetation Soil ✓ or Hydrology naturally problematic? (If needed explain any answers in Remarks )
No
SUMMARY OF FINDINGS — Attach site map showing sampling point locations transects Important features etc
Hydrophytic Vegetation Present? Yes No Is the Sampled Area
Hydric Soil Present? Yes No within a Wetland? Yes No
Wetland Hydrology Present? Yes v No
Remarks
Wetland is emerging as a seep on the existing maintained earthen dam
Soils are problematic due to their recent placement and their shallowness (recently placed fill atop
nprap and large rock)
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply)
_ Surface Soil Cracks (66)
Surface Water (A1)
_ 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 (B16)
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 (133)
! Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (64)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (D1)
Iron Deposits (135)
_ Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (67)
_ Shallow Aguitard (D3)
_ Water Stained Leaves (69)
_ Microtopographic Relief (D4)
_ Aquatic Fauna (613)
_ FAC Neutral Test (D5)
Field Observations
Surface Water Presents Yes No
Depth (inches)
Water Table Present? Yes No
Depth (inches) surface
Saturation Present? Yes No
Depth (inches) surface
Wetland Hydrology Present? Yes No
includes capillary fringe)
Descnbe Recorded Data (stream gauge monitoring well aerial photos previous inspections) if available
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont — Intenm Version

VEGETATION (Four Strata) — Use scientific names of plants
Sampling Point Wetland A
Remarks (Include photo numbers here or on a separate sheet )
US Army Corps of Engineers Eastern Mountains and Piedmont - Interim Version
Absolute Dominant Indicator
Dominance Test worksheet
Tree Stratum (Plot size )
/ Cover Species? Status
Number of Dominant Species
1
That Are OBL FACW or FAC 2 (A)
2
Total Number of Dominant
3
Species Across All Strata 2 (B)
4
Percent of Dominant Species
5
That Are OBL FACW or FAC 100/ (A/B)
6
Prevalence Index worksheet
7
8
Total / Cover of Multir)ly by
0
OBL species 90 x 1 = 90
= Total Cover
Saoling /Shrub Stratum (Plot size
)
FACW species x 2 =
1
FAC species x 3 =
2
FACU species x4=
3
UPL species x 5 =
4
Column Totals (A) (B)
5
6
= 1
Prevalence Index = B/A -
Hydrophytic Vegetation Indicators
7
8
1 Rapid Test for Hydrophytic Vegetation
9
2 Dominance Test is >50 /
10
3 Prevalence Index is s3 0
0
— 4 Morphological Adaptations' (Provide supporting
Herb Stratum (Plot size )
= Total Cover
data in Remarks or on a separate sheet)
1 Sphagnum sp
70 X OBL
— Problematic Hydrophytic Vegetation (Explain)
2 Typha lattifolla
20 X OBL
3 Festuca sp
10
'Indicators of hydnc sod and wetland hydrology must
be present unless disturbed or problematic
4
Definitions of Four Vegetation Strata
5
6
Tree - Woody plants excluding vines 3 in (7 6 cm) or
more in diameter at breast height (DBH) regardless of
7
height
8
Sapling /Shrub - Woody plants excluding vines less
g
than 3 in DBH and greater than 3 28 It (1 m) tall
10
11
Herb -All herbaceous (non woody) plants regardless
of size and woody plants less than 3 28 It tall
12
= Total Cover
Woody vine - All woody vines greater than 3 28 ft in
Woody Vine Stratum (Plot size
)
height
1
2
3
4
5
Hydrophytic
Vegetation
6
Present? Yes No
= Total Cover
Remarks (Include photo numbers here or on a separate sheet )
US Army Corps of Engineers Eastern Mountains and Piedmont - Interim Version

SOIL Sampling Point Wetland A
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) / Tvae Loc Texture Remarks
02 10 YR 2/1 100% clay mucky
210 10 YR 4/4 100% clay
RM= Reduced Matrix MS= Masked Sand Grains
Hydric Sod Indicators
Histosol (Al)
_ Dark Surface (S7)
Histic Epipedon (A2)
_ Polyvalue Below Surface (S8) (MLRA 147 148)
_ Black Histic (A3)
_ Thin Dark Surface (S9) (MLRA 147 148)
✓ Hydrogen Sulfide (A4)
_ Loamy Gleyed Matrix (172)
Stratified Layers (A5)
_ Depleted Matrix (F3)
2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
_ Depleted Below Dark Surface (A11)
_ Depleted Dark Surface (F7)
Thick Dark Surface (Al2)
_ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N
_ Iron Manganese Masses (F12) (LRR N
MLRA 147 148)
MLRA 136)
Sandy Gleyed Matrix (S4)
_ Umbnc Surface (F13) (MLRA 136 122)
_ Sandy Redox (S5)
_ Piedmont Floodplam Soils (F19) (MLRA 148)
_ Stripped Matrix (S6)
Restrictive Layer (if observed)
Type Riprap / large rock
Depth (inches) 10 inches
in PL =Pore Linina M =Matrx
Indicators for Problematic Hydnc Sc
2 cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147 148)
_ Piedmont Floodplain Soils (F19)
(MLRA 136 147)
_ Red Parent Material (TF2)
Very Shallow Dark Surface (TF12)
_ Other (Explain in Remarks)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present
unless disturbed or problematic
Hydnc Sod Present? Yes V No
Remarks
Most of wetland area was made up of deep Sphagnum moss over riprap
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site Belews Creek Steam Station Ash Pond Dam city/County Stokes Co
Applicant/Owner Duke Energy State NC
investigator(s) D David Homans Section Township Range
Landform (hillslope terrace etc) valley Local relief (concave convex none) convex
Subregion (LRR or MLRA) LRR P Lat 36 29759 Long 80 07425
Ud rthe t / D m
Sampling Date 4/13/2012
_ Sampling Point Wetland B
-Slope(/) 3%
Datum
Sod Map Unit Name O n S a NWI classification
Are climatic / hydrologic conditions on the site typical for this time of year? Yes `� No (If no explain in Remarks )
Are Vegetation Soil or Hydrology significantly disturbed? Are Normal Circumstances present? Yes ✓
Are Vegetation Sod or Hydrology naturally problematic? (If needed explain any answers in Remarks )
No
SUMMARY OF FINDINGS — Attach site map showing sampling point locations transects Important features etc
Hydrophytic Vegetation Present? Yes No
Is the Sampled Area
Hydnc Soil Presents Yes No
within a Wetland? Yes No
Wetland Hydrology Present? Yes No
Remarks
Wetland Is located at a concave area In the valley created at the groin of the dam where dam fill
meets the existing valley walls
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply)
_ Surface Soil Cracks (136)
Surface Water (Al)
_ True Aquatic Plants (1314)
_ Sparsely Vegetated Concave Surface (B8)
High Water Table (A2)
_ Hydrogen Sulfide Odor (Cl)
Drainage Patterns (610)
Saturation (A3)
_ Oxidized Rhizospheres on Living Roots (C3)
Moss Trim Lines (1316)
Water Marks (131)
_ Presence of Reduced Iron (C4)
_ Dry Season Water Table (C2)
Sediment Deposits (132)
_ Recent Iron Reduction in Tilled Sods (C6)
_ Crayfish Burrows (C8)
Drift Deposits (133)
_ Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (64)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (D1)
v Iron Deposits (135)
_ Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (137)
_ Shallow Aquitard (D3)
f Water Stained Leaves (139)
_ Microtopographic Relief (D4)
Aquatic Fauna (613)
_ FAC Neutral Test (D5)
Field Observations
Surface Water Present? Yes No
Depth (inches) 1
Water Table Present? Yes No
Depth (inches) surface
Saturation Present? Yes No
Depth (inches) surface
Wetland Hydrology Present? Yes No
includes capillary fringe)
Describe Recorded Data (stream gauge monitonng well aerial photos previous inspections) if available
Remarks
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

VEGETATION (Four Strata) — Use scientific names of plants
Sampling Point Wetland B
Remarks (Include photo numbers here or on a separate sheet )
Wetland was scrub / shrub dominated
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version
Absolute
Dominant Indicator
Dominance Test worksheet
Tree Stratum (Plot size )
A Cover
Species? Status
Number of Dominant Species
1
That Are OBL FACW or FAC 3 (A)
2
Total Number of Dominant
3
Species Across All Strata 3 (B)
4
Percent of Dominant Species
5
That Are OBL FACW or FAC 100/0 (A/B)
6
Prevalence Index worksheet
7
8
Total / Cover of Multiply by
0
OBL species 25 x 1 = 25
Sapling /Shrub Stratum (Plot size
)
= Total Cover
FACW species 125 x 2 = 250
1 Alnus serrulata
80
X FACW
FAC species 10 x 3 = 30
2 Acer rubrum
5
FAC
FACU species x 4 =
3 Lmodendron tulipifera
5
FAC
UPL species x 5 =
4
Column Totals 160 (A) 305 (B)
5
Prevalence Index = B/A = 19
6
Hydrophytic Vegetation Indicators
7
8
— 1 Rapid Test for Hydrophytic Vegetation
9
2 Dominance Testis >50/
10
3 Prevalence Index is <_3 0'
9Q
= Total Cover
_ 4 Morphological Adaptations (Provide supporting
Herb Stratum (Plot size )
data in Remarks or on a separate sheet)
1 Juncus effusus
30
X FACW
Problematic Hydrophytic Vegetation' (Explain)
2 Woodwardia areolata
25
X OBL
3 Osmunda annamomea
15
FACW
'Indicators of hydnc soil and wetland hydrology must
be present unless disturbed or problematic
4
Definitions of Four Vegetation Strata
5
6
Tree — Woody plants excluding vines 3 in (7 6 cm) or
more in diameter at breast height (DBH) regardless of
7
height
8
Sapling /Shrub — Woody plants excluding vines less
9
than 3 in DBH and greater than 3 28 It (1 m) tall
10
11
Herb —All herbaceous (non woody) plants regardless
of size and woody plants less than 3 28 ft tall
12
60
= Total Cover
Woody vine — All woody vines greater than 3 28 ft in
Woody Vine Stratum (Plot size
)
height
1
2
3
4
5
Hydrophytic
Vegetation
✓
6
Present? Yes No
= Total Cover
Remarks (Include photo numbers here or on a separate sheet )
Wetland was scrub / shrub dominated
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

SOIL
Sampling Point Wetland B
nption (Describe to the depth needed to document the indicator or confirm the absence of indicators )
Depth Matrix Redox Features
(inches) Color (moist) A Color (moist) / Type Loc Texture Remarks
016+ 2 5 YR 4/2 85% 10 YR 4/4 3% C PL sandy clay
'Type C= Concentration D= Depletion RM= Reduced
Hydnc Sod Indicators
Histosol (Al)
_ Histic Epipedon (A2)
Black Histic (A3)
Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
_ Depleted Below Dark Surface (A11)
_ Thick Dark Surface (Al2)
_ Sandy Mucky Mineral (S1) (LRR N
MLRA 147 148)
_ Sandy Gleyed Matrix (S4)
Sandy Redox (S5)
_ Stripped Matrix (S6)
Restrictive Layer (if observed)
Type
Depth (inches)
2Location PL =Pore Lining M =Matrix
Indicators for Problematic Hydric
Dark Surface (S7)
Polyvalue Below Surface (S8) (MLRA 147 148)
Thin Dark Surface (S9) (MLRA 147 148)
_ Loamy Gleyed Matrix (172)
Depleted Matrix (F3)
Redox Dark Surface (F6)
Depleted Dark Surface (F7)
Redox Depressions (F8)
Iron Manganese Masses (F12) (LRR N
MLRA 136)
_ Umbnc Surface (F13) (MLRA 136 122)
Piedmont Floodplain Sods (F19) (MLRA 148)
_ 2 cm Muck (A10) (MLRA 147)
_ Coast Prairie Redox (A16)
(MLRA 147 148)
_ Piedmont Floodplam Sods (F19)
(MLRA 136 147)
Red Parent Material (TF2)
Very Shallow Dark Surface (TF12)
Other (Explain in Remarks)
3Indicators of hydrophybc vegetation and
wetland hydrology must be present
unless disturbed or problematic
Hydnc Sod Present? Yes ✓ No
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site Belews Creek Steam Station Ash Pond Dam City /County Stokes Co
Applicant/Owner Duke Energy State NC
Investigator(s) D David Homans Section Township Range
Landform (hilislope terrace etc) hlllslope Local relief (concave convex none) none
LRR P (cond uons M tent 36 297302 80 076375
Subregion (LRR or MLRA) wth LRR N) Lat Long
Sampling Date 4/13/2012
— Sampling Point Upland A
Slope (/) 40%
Datum
Sod Map Unit Name Udorthents / Dam NWI classification
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no explain in Remarks )
Are Vegetation Sod or Hydrology significantly disturbed? Are Normal Circumstances present? Yes ✓ No
Are Vegetation Sod 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 No
Is the Sampled Area
Hydric Sod Present? Yes No within a Wetland? Yes No ✓
Wetland Hydrology Present? Yes No
Remarks
Upland data point was taken in a typical area on the face of the dam between two riprap lined storm
drainage ditches
HYDROLOGY
Wetland Hydrology Indicators
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required, check all that apply)
_ Surface Sod Cracks (B6)
_ Surface Water (A1) _
True Aquatic Plants (1314)
_ Sparsely Vegetated Concave Surface (68)
_ High Water Table (A2) _
Hydrogen Sulfide Odor (Cl)
— Drainage Patterns (610)
_ Saturation (A3) _
Oxidized Rhizospheres on Living Roots (C3)
_ Moss Trim Lines (B16)
_ Water Marks (B1) _
Presence of Reduced Iron (C4)
_ Dry Season Water Table (C2)
_ Sediment Deposits (B2) _
Recent Iron Reduction in Tilled Sods (C6)
_ Crayfish Burrows (C8)
_ Drift Deposits (B3) _
Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (64) _
Other (Explain in Remarks)
_ Stunted or Stressed Plants (131)
_ Iron Deposits (B5)
_ Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (B7)
_ Shallow Aqwtard (D3)
_ Water Stained Leaves (B9)
_ Microtopographic Relief (D4)
Aquatic Fauna (613)
_ FAC Neutral Test (D5)
Field Observations
Surface Water Present? Yes No
Depth (inches)
Water Table Present? Yes No
Depth (inches)
Saturation Present? Yes No
Depth (inches)
Wetland Hydrology Present? Yes No ✓
includes capillary fringe)
Describe Recorded Data (stream gauge monitoring well aerial photos previous inspections) if available
Remarks
No wetland hydrology was observed
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

VEGETATION (Four Strata) — Use scientific names of plants
Sampling Point Upland A
Remarks (Include photo numbers here or on a separate sheet )
Sample taken in a typical upland area which is regularly maintained through mowing and has been
planted in typical lawn grasses
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version
Absolute Dominant Indicator
Dominance Test worksheet
Tree Stratum (Plot size )
/ Cover Species? Status
Number of Dominant Species
1
That Are OBL FACW or FAC 0 (A)
2
Total Number of Dominant
3
Species Across All Strata 1 (B)
4
Percent of Dominant Species
5
That Are OBL FACW or FAC 0/0 (A/B)
6
Prevalence Index worksheet
7
8
Total A Cover of Multiply by
0 = Total Cover
OBL species 10 x 1 = 10
Sapling /Shrub Stratum (Plot size
)
FACW species x2=
1
FAC species x 3 =
2
FACU species x4=
3
UPL species 90 x5= 450
4
Column Totals 100 (A) 460 (B)
5
Prevalence Index = B/A = 4 6
6
Hydrophytic Vegetation Indicators
7
8
— 1 Rapid Test for Hydrophytic Vegetation
9
— 2 Dominance Test is >50 /
3 Prevalence Index is s3 0'
10
—
0
— 4 Morphological Adaptations' (Provide supporting
= Total Cover
data in Remarks or on a separate sheet)
Herb Stratum (Plot size )
1 Festuca sp
90 X UPL
— Problematic Hydrophytic Vegetation' (Explain)
2 Juncus effusus
10 FACW
3
'Indicators of hydnc sod and wetland hydrology must
be present unless disturbed or problematic
4
Definitions of Four Vegetation Strata
5
6
Tree — Woody plants excluding vines 3 in (7 6 cm) or
more in diameter at breast height (DBH) regardless of
7
height
8
Sapling /Shrub — Woody plants excluding vines less
9
than 3 in DBH and greater than 3 28 ft (1 m) tall
10
11
Herb —All herbaceous (non woody) plants regardless
of size and woody plants less than 3 28 ft tall
12
= Total Cover
Woody vine — All woody vines greater than 3 28 ft in
Woody Vine Stratum (Plot size
)
height
1
2
3
4
5
Hydrophytic
Vegetation
6
Present? Yes No
= Total Cover
Remarks (Include photo numbers here or on a separate sheet )
Sample taken in a typical upland area which is regularly maintained through mowing and has been
planted in typical lawn grasses
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

SOIL
Sampling Point Upland A
Profile Description (Describe to the depth needed to document the indicator or confirm the absence of indicators)
Depth Matrix Redox Features
bnchesl Color (moist) / Color (moist) / TvDe Loc Texture Remarks
016+ 10 YR 4/4 65% 7 5 YR 4/6 35 C M clay loam fill soil (not native)
D= Depletion RM= Reduced Matrix MS= Masked Sand Grains
Hydnc Sod Indicators
Indicators for Problematic Hydnc Sods'
_ Histosol (A1)
^ Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2)
_ Polyvalue Below Surface (S8) (MLRA 147 148)
_ Coast Prairie Redox (A16)
_ Black Histic (A3)
_ Thin Dark Surface (S9) (MLRA 147 148)
(MLRA 147 148)
_ Hydrogen Sulfide (A4)
_ Loamy Gleyed Matrix (F2)
_ Piedmont Floodplain Sods (F19)
_ Stratified Layers (A5)
_ Depleted Matrix (F3)
(MLRA 136 147)
_ 2 cm Muck (A10) (LRR N)
_ Redox Dark Surface (F6)
— Red Parent Material (TF2)
_ Depleted Below Dark Surface (At 1)
_ Depleted Dark Surface (F7)
_ Very Shallow Dark Surface (TF12)
_ Thick Dark Surface (Al2)
_ Redox Depressions (F8)
_ Other (Explain in Remarks)
_ Sandy Mucky Mineral (S1) (LRR N
_ Iron Manganese Masses (F12) (LRR N
MLRA 147 148)
MLRA 136)
_ Sandy Gleyed Matrix (S4)
_ Umbnc Surface (F13) (MLRA 136 122)
3Indicators of hydrophytic vegetation and
_ Sandy Redox (S5)
_ Piedmont Floodplain Sods (F19) (MLRA 148)
wetland hydrology must be present
Stripped Matrix (S6)
unless disturbed or problematic
Restrictive Layer (if observed)
Type
Depth (inches)
Hydnc Sod Present? Yes No V
Remarks
This sample was taken on the face of the earthen dike as such the soils were made up of fill soils
used for the creation of the dike and thus would be considered disturbed
US Army Corps of Engineers Eastern Mountains and Piedmont — Interim Version

jAPPENDIX V
• Agency Correspondence
• North Carolina State Historic Preservation Office
Response Letter (May 8, 2012)
• U S Fish And Wildlife Service Response Letter (May
31, 2012)
• North Carolina Wildlife Resources Commissions
Response Letter (May 15, 2012)

North Carohna Department of Cultural Resources
State Historic Preservation Office
It tmuna %I Bano lclmtns trttc
He c h L I du C r t m
I nd t 1 C, it I SLcrlt to
)effn} I C o Depur) i Lutary
May 8 2012
Dat id Homans
S&ME Inc
9751 Southern Pule Boulevard
Charlotte NC 28273 5560
Off c of %rLh L and 1 It, a n
D on of II ttnc I ctrc
D t d Br(x k 1) r ct
Re ACtiN e Ash Bzsin Dam NI- ntenunce Duke EnergS Belews Creek Steam Station St-A1E 1156 13 009
Stoles Counts ER 12 0707
Dear Mr Homans
Thank you for l our letter of April 36 2013 concenung the aboN e project
We hax e conducted a review of the project and Ire aware of no historic resources which would be affected bl
die project Therefore we hax a no comment on the project as proposed
The above comments are made pursuant to Section 106 of die National Historic Presen ation Act Ind the
Advisory Council on Historic Preservation s Regulations for Comphance with Section 106 codified at 36 CI R
Part 800
Thanl you for 3 our cooperltton and consideration If l ou have question-, concerning the aboN e comment
please contact Renee Gledhill Earlev environmental review coordinator at 919 807 6579 In all future
communication concerning this project, ple i9e cite the above referenced traclung number
Sincerely
I -��
,(R -tmona M Baitos
Loc non. 10) 1_ t J c. St u It I I,h Nt i(()i Mauling Add s 4(i AI Is n (, its It I hh NC 7( ))4(17 T I ph /Fax O19) 81) (5 O /M)7 (5))

FISH AND WILDLIFE SFRVICE
1she�d1k Fi id Office
160 hilicoa �trl.ct
Ashe\ille North Carohna 28801
May 31 2012
Mr David Homans
Ms Crystal Fox
S &ME Inc
9751 Southern Pine Boulevard
Charlotte North Carolina 28273
Dear Mr Homans and Ms Fox
Subject Listed Species Assessment Proposed Duke Energy Active Ash Basin Dam
Maintenance at Belews Creek Steam Station Stokes County North Carolina (S &ME
Project Nos 1356 12 009)
On April 30 2012 we received a letter from you in which you requested our review and
comments Your letter particularly requested information regarding federally listed species that
may occur in the vicinity of the project We have reviewed the information you presented and
are providing the following comments in accordance with the provisions of the Fish and Wildlife
Coordination Act as amended (16 U S C 661 667e) and section 7 of the Endangered Species
Act of 1973 as amended (16 U S C 1531 1543) (Act)
According to your letter NCDENR Division of Land Resources Dam Safety Division has
requested that maintenance repairs be conducted along the face of the existing earthen dike The
maintenance activities will be limited to the face of the dike and will likely involve minor impacts
to wetland seeps and/or drainage ditches Maintenance /repair activities will not involve extensive
tree clearing The purpose of this letter is only to inform you of federally listed species that occur
within the geographical area indicated on the map you sent
Endangered Species According to our records and a review of the information you presented
no listed species or their habitats occur on the site Therefore we believe the requirements under
section 7 of the Act are fulfilled However obligations under section 7 of the Act must be
reconsidered if (1) new information reveals impacts of this identified action that may affect
listed species or critical habitat in a manner not previously considered (2) this action is
subsequently modified in a manner that was not considered in this review or (3) a new species is
listed or critical habitat is determined that may be affected by the identified action
We appreciate the opportunity to provide these comments If we can be of assistance or if you
have any questions please do not hesitate to contact Mr Bryan Tompkins of our staff at

828/258 3939 Ext 240 In any future correspondence concerning this project please reference
our Log Number 4 2 12 160
Sincerely
Or r 112al �r t7c cf
Brian P Cole
Field Supervisor

a
l North Carolina Wildlife Resources Commission I�
Gordon Myers Executive Director
May 15 2012
Mr David Homans
S &ME Inc
9751 Southern Pine Blvd
Charlotte NC 28273 5560
SUBJECT Duke Energy Belews Creek Steam Station Ash Basin Dam Maintenance Stokes County
S &ME Project No s 1356 12 009
Dear Mr Homans
Biologists with the North Carolina Wildlife Resources Commission (WRC) received your April 26 2012
letter in which you inquired about any trout concerns associated with repairs to the ash pond dam at Duke
Energy s Belews Creek Steam Station Comments from the WRC are offered for your consideration
under provisions of the Fish and Wildlife Coordination Act (48 Stat 401 as amended 16 U S C 661 et
seq ) and the National Environmental Policy Act (42 U S C 4332 (2)(c)
Trout are not found in this part of Stoles County and the trout moratorium would not be applicable to any
work here that requires a Nationwide Permit. However there are rare species in the Dan River such as
green floater mussels (Lasmigona subvindis US — FSC and NC Endangered) and bigeye jumprock
(Moxostoma anommum NC — Threatened) that should be considered during project implementation
The WRC reviews all Nationwide Permit applications in Stokes County so please forward the application
for this project to me once it is prepared
Thank you for the opportunity to review and comment on this project Please contact me at (828) 452
0422 extension 24 if you have any questions about these comments
Cordially
;111K
Dave McHenry Mountain Region Coordinator Habitat Conservation Program
Mailing Address Division of Inland Fisheries 1721 Mail Service Center Raleigh NC 27699 1721
Telephone [phone] Fax [phone]