20170204 Ver 1_401 Application_20170217

McGill
A S S O C I A T E S
February 14, 2017
Mr. David Brown
US .Mny Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue. Room 208
Asheville, North Carolina 28801-5006
Dear Mr. Brown:
201 70204
RE: Project Bluebird FRC
Pre -Construction Notification, NWP #39
Rutherford County, North Carolina
On behalf of our client, Andale Inc. FKA, please find the enclosed Pre -Construction Notification
(PCN) application for the referenced project dated February 14, 2017. The purpose of the project is to
construct a security fence and access drive around the perimeter of the campus. A NNW -39 is requested to
complete the proposed work. Please see the attached copy in the PCN application.
Four copies of the PCN application are being provided to the North Carolina Department of
Environmental Quality, Division of Water Resources along with the required fee (see attached check for
$570). One copy of the PCN application is being provided to both the North Carolina Wildlife Resource
Commission and the United States Fish and Wildlife Service. McGill Associates, P.A. is the Authorized
Agent (form included) and should be copied on all project correspondence. Please let us know if you
have any questions or comments.
Sincerely,
MCGILL CIATE , P.A.
Jo . Vilas
Proiram Services Manager- Environmental
cc: NCDEQ - DWR Main Office
Mr. Zan Price -Asheville Regional Office - NCDWR
Ms. Andrea Leslie - North Carolina Wildlife Resources Commission
Mr. Byron Hamstead - United States Fish and Wildlife Service
Mr. John Mailler - Owner Representative
Mr. Matthew Oetting, P.E. - Project Engineer
H:'.Pmjects\2016 PROJECTS\16.01413 SHEEHAN PARTNERS - ProjLct Blue Bird
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Preliminary ORM Data Entry Fields for New Actions
SAW — 2016 - BEGIN DATE [Received Date]:
Prepare file folder ❑ Assign Action ID Number in ORM
1. Project Name [PCN Form A2a]: Project Bluebird FRC
2. Work Type: Private 7 Institutional ❑ Government Commercial
3. Project Description / Purpose [PCN Form 63d and 63e]:
The project proposes construction of a security fence and access roads.
4. Property Owner/ Applicant [PCN Form A3 or A4]: Andale Inc. FKA
5. Agent / Consultant [PCN Form A5 — or ORM Consultant ID Number]: John C. Vllas, McGill Associates, P.A.
6. Related Action ID Number(s) [PCN Form 65b]: SAW -2011-00569
7. Project Location - Coordinates, Street Address, and/or Location Description [PCN Form 61b]:
Latitude: 35.3158 Longitude: - 81.8231
8. Project Location -Tax Parcel ID [PCN Form B1a]: 155800722277, 155800616030, 155800814487
9. Project Location—County [PCN Form A2b]: Rutherford
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Forest City
11. Project Information — Nearest Waterbody [PCN Form 62a]: Second Broad River
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form 62c]: 03050105
Authorization: Section 10 ❑ Section 404 7 Section 10 & 404 ❑
Regulatory Action Type:
Standard Permit
✓ Nationwide Permit # 39
Regional General Permit #
Jurisdictional Determination Request
Pre -Application Request
Unauthorized Activity
Compliance
No Permit Required
Revised 20150602

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 14
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
❑ 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
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
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Project Bluebird FRC
2b.
County:
Rutherford
2c.
Nearest municipality / town:
Forest City
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a. Name(s) on Recorded Deed:
Andale Inc FKA
3b.
Deed Book and Page No.
1013/807
3c.
Responsible Party (for LLC if
applicable):
Jay S. Park
3d. Street address:
1601 Willow Rd
3e.
City, state, zip:
Menlo Park, CA 94025
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 of 14
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Owner
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:
John C. Vilas
5b. Business name
(if applicable):
McGill Associates, P.A.
5c. Street address:
468 New Market Blvd. Ste. B
5d. City, state, zip:
Boone, NC 28607
5e. Telephone no.:
[phone]
5f. Fax no.:
[phone]
5g. Email address:
[e-mail]
Page 2 of 14

B. Project Information and Prior Project History
1. Property Identification
Three tracts make up the Project Site —
la. Property identification no. (tax PIN or parcel ID):
GPIN: 1558007222770000; 1558006160300000;
1558008144870000
1 b. Site coordinates (in decimal degrees):
Latitude: 35.3158 Longitude: - 81.8231
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
152.2 acres (total of three tracts, see Tax Map)
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Second Broad River
proposed project:
2b. Water Quality Classification of nearest receiving water:
WS -V
2c. River basin: map is available at
Broad
hfp://h2o.enr.state.nc.us/admin/maps/
Page 3 of 14
PCN Form — Version 1.3 December 10, 2008 Version

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 Andale Data Center is a communications and proprietary social media facility specializing in data storage. The
Andale site is located in the Town of Forest City of Rutherford County (refer to Location Map). Access to the Andale
site is from Old Caroleen Road south of US Hwy. 74. The facility currently contains 3 large data storage buildings
(FRC -1, FRC -2, FRC -3) with associated parking, drives, accessory structures and site utilities: 6 permanent wet
detention ponds were previously designed and constructed to treat on-site stormwater for the full build -out condition.
Jurisdictional waters within the Project Site include. UT -1 and UT -2 Second Broad River. UT -1 originates from an
existing forested wetland seep on the western edge of the Andale property and flows east towards the currently
developed area. Approximately 540 linear feet below the source this stream loses flow and other characteristics typical
of ]urisdictional streams, most notably, there is a substantial amount of upland vegetation growing in the channel below
this point (see JD report and supporting materials). Below this point UT -1 -Second Broad River is classified as
ephemeral and non -jurisdictional. Approximately 480 linear feet below the source of UT -1 Second Broad River is an
area of riparian wetlands (Unit WA).
UT -2 Second Broad River originates from an existing forested wetland seep on the southern end of the property must to
the west of building FRC -1 From this origin UT -2 flows north through two existing culverts then into an approx. 676
linear foot re-established perennial channel with associated buffer zones plantings etc (Previously permitted in 2011
Action ID. SAW -2011-00569) before reaching its confluence with UT -1.
The Project Site includes a 53 I.f. section of UT -1 Second Broad River and a 61 I.f. section of UT -2 Second Broad
River (refer to Proposed Impacts Map).
Dwarf -flowered heartleaf (DFHL) populations were identified in 2011 during the planning stages for the existing
facilities on the site: DFHL populations were placed into permanent conservation easements following coordination
with USFWS (refer to Overall Existing Conditions Map).
The general land use in the vicinity of the Project is a mixture of residential and farm related activity. US Hwy. 74 is a
major transportation thoroughfare connecting Charlotte and Asheville.
3b. List the total estimated acreage of all existing wetlands on the property:
Within the area of interest for this PCN there is approximately 0. 14 acres— includes Wetland Unit -WA, located in the
Project Site, and a previously delineated wetland at the source of UT -1 Second Broad River (refer to Impacts Map)
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
540 I.f. of intermittent stream channel on UT -1 Second Broad River from its source to the point of non -jurisdiction. 2,270
I.f. of perennial stream channel on UT -2 Second Broad River from its source to its confluence with UT -1.
3d. Explain the purpose of the proposed project:
The purpose of the proposed Project is to construct a high-grade security fence and gravel access road around the
perimeter of the campus.
Page 4 of 14

3e. Describe the overall project in detail, including the type of equipment to be used:
The Applicant proposes to construct an approximately 12.572 Lf. security fence and approximately 8,800 Lf. of 10 foot wide
gravel access drive. The security fence and drive will follow the perimeter of the FRC campus primarily on previously
disturbed areas. The fencing location was designed to avoid wetlands, wooded areas, and conservation areas, however the
crossing of UT -1 and UT -2 were unavoidable. The security fence will not obstruct the flow of the two tributaries.
An approx. 42 If. 30" RCP is proposed for the crossing of UT -1, installed at 6" below the existing streambed to allow for the
development of natural stream substrate and passage of aquatic organisms. An approx. 20 If. rip -rap erosion protection is
proposed around the inlet and outlet section of the CMP. Rip -rap installed within the stream bed will be 'keyed in' to match
existing stream bed elevations (see Plan Sheet C300.3).
Dual, approx. 48 If. 60" RCP and 48" RCP are proposed for the crossing of UT -2. The 60" RCP will be installed at 12" below
the existing streambed to allow for the development of natural stream substrate and passage of aquatic organisms and act as
the main passage for UT -2. The 48" RCP will be installed at existing stream channel elevation to provide for flow during high
water events. An approx. 24 If. ria -rap erosion protection is proposed around the inlet and outlet section of the CMP, with an
additional approx. 10lf. of rip -rap protection along the right stream bank below the outlet end for additional protection. Rip -rap
installed within the stream bed will be 'keyed in' to match existing stream bed elevations (see Plan Sheet C300.4).
Proposed project actions will include temporary and permanent impacts to UT -1 Second Broad River. Stream impact S-1 (42
If. permanent impact) will result from installing the 42 If. 30" RCP. Stream impact S-2 (20 If. temporary impact) will result from
the installation of rip -rap inlet and outlet protection. Proposed project actions will include temporary and permanent impacts to
UT -2 Second Broad River. Stream impact S-3 (51 If. permanent impact) will result from installing the 48 If. 60" and 48" RCPs.
Stream impact S-4 (24 If. temporary impact) will result from the installation of rip -rap inlet and outlet protection. (see Impacts
Map).
A pump -around or other flow diversion technique will be installed at both stream crossing areas prior to construction to ensure
that all work occurs in the dry.
A stainless steel security grate will be mounted within the inlet side of the 30" RCP and within both ends of the 60" RCP and
48" RCP. Security grates will be fastened into place to ensure that damage does not occur during high water events and
maintained regularly to ensure that debris accumulation does not constrict or block flow (see Concrete Culvert Grill Detail).
Following completion of grading, disturbed areas will be stabilized with temporary erosion control seed and over -seeded with
a native seed mix suitable for riparian areas. A fully biodegradable erosion control mat will be installed along the channel
banks_ susceptible to erosive flows, other disturbed areas will be covered with straw mulch.
4. Jurisdictional 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?
Comments: Scott Jones with the U.S. Army Corps of
Engineers met with John C. Vilas of McGill Associates on-
® Yes ❑ No ❑ Unknown
site to perform a jurisdictional verification on June 1, 2015.
Preliminary approval was determined: see attached JD
materials including Rapanos Forms, stream and wetland
datasheets. An earlier delineation was performed in 2011 by
S&ME for the initial development of the site.
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
®Preliminary E] Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): John C. Vilas
Agency/Consultant Company: McGill Associates, P.A.
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Site visit June 1. 2015, no documentation received to date.
Page 5 of 14

S. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
® Yes ❑ No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
During the initial phase of facility development, permanent impacts to 148 linear feet of stream associated with pipe
installation, and temporary impacts to approximately 1,451 linear feet of stream associated with stream daylighting,
restoration, enhancement and relocation work was completed on the site and permitted under NWP #39 and #27 (Action
ID. SAW-2011-00569). Also, in 2015, 0.01 acres of temporary wetland impacts and 36 Lf. of temporary stream impacts
associated with utility line installation was completed on site and permitted under NWP #12 (Action ID. SAW-2011-
00569)•
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Two phases of data center construction have been permitted and completed in the past. The proposed security fence is a
single and complete project. No future work is anticipated associated with the proposed security fence.
Page 6 of 14

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
Excavation
Riparian
❑ Yes
❑ No
❑ Corps
❑ DWQ
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
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/Culvert
UT -1 Second
❑ PER
® Corps
4
42
Broad River
® INT
❑ DWQ
S2 ❑ P ®T
Fill
UT -1 Second
❑ PER
® Corps
4
20
Broad River
® INT
❑ DWQ
S3 ® P ❑ T
Fill/Culvert
UT -2 Second
® PER
® Corps
2
51
Broad River
❑ INT
❑ DWQ
S4 ❑ P ® T
Fill
UT -2 Second
® PER
® Corps
2
24
Broad River
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
137
3i. Comments: Stream impacts at S-1 and S-3 will be permanent fill as culverts totaling 93 Lf. Stream impacts S-2 and S-4 will
be temporary impacts associated with flow diversion, culvert installation, and ria -rap protection totaling 44 Lf. Rip rap will be
'keyed in' within the stream beds to maintain existing stream bed elevations.
Page 7 of 14

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑ PEI T
02 ❑P❑T
03 ❑P
04 ❑P
0. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
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:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse El 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?
131 ❑P❑T
F1 Yes
❑ No
B2 ❑P❑T
L1 Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 8 of 14

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed security fence was desioned to avoid jurisdictional areas and for the crossings of UT -1 and UT -2 to be as
close to perpendicular as practical. Inlet and outlet rip -rap protection will be `keyed in' within the stream beds to match
existing stream bed elevations. Culverts will be countersunk to allow passage of aquatic organisms and maintain natural
stream substrate. No sediment and erosion control measures will be placed in wetlands or streams. Security fence
alignment was designed to avoid impacts to existing dwarf -flowered heartleaf conservation areas and wetlands.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All work in jurisdictional waters will be completed in the dry utilizing a flow diversion technique. Site stabilization work in all
disturbed areas within the Project Site will include use of native seed mixes to ensure native vegetation re-establishment.
Work will be performed during dry site conditions and during normal stream flow.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
® Yes ❑ No
2b. If yes, mitigation is required by (check all that apply):
® DWQ ® Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
®Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type:
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
241 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: See attached letter from NCDMS.
Page 9 of 14
PCN Form — Version 1.3 December 10, 2008 Version

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? If Yes, you will have to fill out this entire form — please
contact the State for more information.
❑ 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
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 10 of 14

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ 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: A stormwater management plan was
completed for the full build -out of the entire project during the 2011 permitting process for the site. No increase in site
imperviousness. Access drive will be gravel.
2d. If this project 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?
Rutherford County
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other: None
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: None
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 11 of 14
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
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.
No known additional development will be generated by the proposed project.
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.
No wastewater associated with the proposed project.
Page 12 of 14
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?
El 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?
U.S. Fish and Wildlife Service (USFWS) Endangered. Threatened, and Federal Species of Concern
hftr)://www.fvvs.gov/raleigh/species/cntylist/rutherford.html
In 2005 a Threatened and Endangered Species Assessment and an informal consultation with USFWS for Hexastylis
naniflora was completed for the entire property prior to initial development activities. All known populations of H. naniflora
were preserved through permanent conservation easements. A survey by McGill Associates. P.A. biologists on 12/15/16
did not find any H. 'naniflora present within the Drowsed project area. Bog turtle supporting habitat was not found in the
project site. Based on USFWS Northern Long -Eared Bat Consultation Areas mapping for Rutherford County, the project
area does not contain any known Northern Long -Eared Bat maternity trees or hibernation sites.
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?
National Oceanic and Atmospheric Administration, National Marine Fisheries Service, Habitat Conservation and
Protection Program. http://www.habitat.noaa.ciov/protection/efh/habitatmapper.html
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?
North Carolina State Historic Preservation Office
hftp://�Cqis.ncdcr.gov/hr)oweb/
The Alexander MFG. Company Mill Village Historic District is the nearest registered national historic place with a distance
of 7.270 -feet from the western edge of the Andale property.
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:
A portion of the proposed project corridor is located in areas of mapped FEMA floodplains. (Zone AE), along the Second
Broad River (see Floodplain Map). Appropriate permits will be acquired through the City of Forest City and/or Rutherford
County. No proposed impacts to waters of the US in the floodplain.
Page 13 of 14

8c. What source(s) did you use to make the floodplain determination?
North Carolina Floodplain Mapping Proaram
http://fris.nc.00v/fds/index.aspx?FIPS=161 &ST=NC&user--General%o20Public
There is approximately 650 linear feet of proposed security fencing and gravel access drive located within the 100 year
floodplain of the Second Broad River (refer to Floodplain Mar)).
John C. Was
Applicant/Agent's Printed Name licant/Agent's Signature
--� (Agent's signature ig valid only if an authorization letter from the applicant
is provided.)
Page 14 of 14
2/14/2017
Date

0mc ill
A S S O C I A T E S
AGENT AUTHO TION FORM
PROJECT NAME: Andale Data Center
PROJECT COUNTY: Rutherford
PROPERTY LEGAL DE RIPTION: Tract 3 PB33 PG39
GPIN: 1558007222770000
MAP BLOCK LOT: 260116
PROPERTY ADDRESS: 404 Social Cirde
Fongft M. NC 28043
Please Print JAV S. PA R K
Property Owner/Rep tative:
(If Representative) T e: VICE- 62 4 $I OENT
The undersigned, regilsttered property owners of the above noted property, do hereby authorize
(Contractor / Agent) (Name of consulting firm)
i
to act on my behalf a � d take all actions necessary for the processing, issuance and acceptance of
this permit or certificaIlon and any and all standard and special conditions attached.
Property Owner's/Rep�resentative's Address (if different than property above):
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledo .
Authorized Signature
Date: J U tj G- , �_ - �D IS Date:
Environmien tal • Planning Finance
McGill A. siliate..•. P.A.• 46X New• Market Blvd. Ste. B, Boune, North Carolina 1X607
Of%ire: (X?X) 386-19111 • Fu.c: [phone]

N
os 0 1 Miles Sources: Esri, HERE, DeLorme, USGS, Intermap, increment P Corp-, NRCAN,
S Esri Japan. METI, Esri China (Hong Kong), Esri (Thailand), TomTom,
Mapmylndia, © OpenStreetMap contributors,-and the GIS User Community
LOCATION MAP ANDALE DATA CENTERMcG1*11
AUG. 2, 2015 RUTHERFORD COUNTY: A S S O C I A T E S
NORTH CAROLINA ENV IRON MENTAL •PLANN ING• FINANCE
468 NEW MARKET BLVD. s"rE. B BOONE, NC 28607 P11: (E28) 386-1920

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TOPOGRAPHIC MAP ANDALE DATA CENTER McG1*11
JUNE 12, 2015 RUTHERFORD COUNTY, NORTH CAROLINA A S S O C I A T E S
ENGINEERING • PLANNING • FINANCE
468 New Market Blvd. Ste. B Boone, NC 28607 [phone]

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Total Value: 566,269,600
Neighborhood Code: I
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Bldg. Value: $24,800
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Total Value: $498,400
Neighborhood Code: 1310
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Neighborhood Desc.: FC IND!GO
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PROJECT BLUEBIRD FRC
S-1 MAP
PROJECT #
OMcGMIMPACT
JANUARY 26, 2017
16.01413
RUTHERFORD COUNTY,
A S S O C I A T E S
NORTH CAROLINA
ENVIRONMENTAL • FINANCE
469 NEW MARKET BLVD. STE B BOONE, NC 2967 PH. (929) 39GI920

PROPOSED SECURITY
FENCING
PROPOSED GRADINGy
PROPOSED ACCESS
ROAD
PROPOSED 60" RCP
48 L.F. @3.13%
INVERT TO BE INSTALLED 12"
BELOW EXISTING STREAM BED
� a
i
2 SECONDOAD RIVER
PROPOSED RIP RAP
PROTECTION
GRAPHIC SCALE
20 0 10 H
PROPOSED RIP RAP
PROTECTION
It:
IMPACT S-2
51' PERMANENT IMPACT:
24' TEMPORARY IMPACTS
PROPOSED 48" RCP
48 L.F. @3.13%
i
I INCH = 20 FEET _ 1
PROJECT BLUEBIRD FRC eMcGMIMPACT S-2 MAP pROJECT#
JANUARY 26, 2017
16.01413 RUTHERFORD COUNTY, A S S o C I A T G S
NORTH CAROLINA ENVIRONMENTAL • FINANCE
468 NEW MARKET HLVU. SIE H H"E, NC 28607 PH. (828) 3861920

FLOODPLAIN MAP
JANUARY 26, 2017
PROJECT #
16.01413
PROJECT BLUEBIRD FRC
RUTHERFORD COUNTY,
NORTH CAROLINA
McGill
ASSOCIATES
ENVIRONMENTAL • FINANCE
468 NEW MARKET BLVD. SIE 8 BOONE, NC 28607 PN. (828) 3861920

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STRUCTURAL ENGINEERS
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PROJECT:
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404 SOCIAL CIRCLE
FOREST CITY, NC
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ALFATECH
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STRUCTURAL ENGINEERS
IP44 T..4 w py■�, a Nene
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PROJECT:
PROJECT BLUEBIRD
FRC
404 SOCIAL CIRCLE
FOREST CITY, NC
DWG. TITLE
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Figure 4 (note that the removable grate is locked in place as an added
security measure).
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Figure 2.
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Figure 3.
Concrete Culvert Grill.
13

35° 19'14'N
35" 1935"N
3 Soil Map—Rutherford County, North Carolina 3
a
w
m m
424200 424300 424400 424500 424600 424700 424800 424900 425000 425100 425200 425300 425400 425500 425600 425700 4258W 425900
3
Map Scale: 1:8,420 if printed on A landscape (11"x8.5") sheet
oelem
N 0 100 200 400 600
N
A0 400 800 1600 2400
Map projection: Web Mercator Comer coordinates: WGS84 Edge tics: UTM Zone 17N WGS84
usDA Natural Resources Web Soil Survey
Conservation Service National Cooperative Soil Survey
426000
3
0
6/12/2015
Page 1 of 3
35° 18'35"N

Soil Map—Rutherford County, North Carolina
MAP LEGEND
MAP INFORMATION
Area of Interest (AOI)
Spoil Area
The soil surveys that comprise your AOI were mapped at 1:24,000.
Area of Interest (AOI)
o. y
Ston Spot
Warning: Soil Map may not be valid at this scale.
Soils
Soil Map unit Polygons
!_.;, Very Stony Spot
Enlargement of maps beyond the scale of mapping can cause
Wet Spot
misunderstanding of the detail of mapping and accuracy of soil line
. 0
Soil Map unit Lines
placement. The maps do not show the small areas of contrasting
13
Soil Map Unit Points
Other
soils that could have been shown at a more detailed scale.
Special Line Features
Special
Point Features
Please rely on the bar scale on each map sheet for map
U
Blowout
Water Features
measurements.
Streams and Canals
Borrow Pit
Source of Map: Natural Resources Conservation Service
Clay Spot
Transportation
Web Soil Survey URL: http:/twebsoilsurvey.nres.usda.gov
+-+-4 Rails
Coordinate System: Web Mercator (EPSG:3857)
Closed Depression
Interstate Highways
Maps from the Web Soil Survey are based on the Web Mercator
Gravel Pit
US Routes
projection, which preserves direction and shape but distorts
distance and area. A projection that preserves area, such as the
„
Gravelly Spot
Major Roads
Albers equal-area conic projection, should be used if more accurate
Landfill
calculations of distance or area are required.
Local Roads
J,,
Lava Flow
Background
This product is generated from the USDA-NRCS certified data as of
the version date(s) listed below.
Marsh or swamp
. Aerial Photography
Soil Survey Area: Rutherford County, North Carolina
Mine or Quarry
Survey Area Data: Version 15, Sep 10, 2014
Miscellaneous Water
Soil map units are labeled (as space allows) for map scales 1:50,000
Perennial Water
or larger.
Rock Outcrop
Date(s) aerial images were photographed: Oct 22, 2010—Apr 30,
Saline Spot
2011
Sandy Spot
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
_t�e.Severely
Eroded Spot
imagery displayed on these maps. As a result, some minor shifting
of map unit boundaries may be evident.
Sinkhole
Slide or Slip
Sodic Spot
USDA Natural Resources Web Soil Survey 6/12/2015
Conservation Service National Cooperative Soil Survey Page 2 of 3

Soil Map—Rutherford County, North Carolina
Map Unit Legend
Rutherford County, North Carolina (NC161)
Map Unit Symbol
Map Unit Name
Acres in AOI
Percent of AOI
BuB
Buncombe loamy sand, 0 to 5
7.1
4.7%
percent slopes, occasionally
flooded
Pb132
Pacolet-Bethlehem complex, 2
8.3
5.6%
to 8 percent slopes,
moderately eroded
PbC2
Pacolet-Bethlehem complex, 8
23.6
15.7%
to 15 percent slopes,
moderately eroded
PbD2
Pacolet-Bethlehem complex,
36.3
24.3%
15 to 25 percent slopes,
moderately eroded
UdC
Udorthents, loamy, 0 to 15
59.4
39.7%
percent slopes
Ur
Urban land
12.1
8.1%
W
Water
2.9
1.9%
Totals for Area of Interest
149.7
100.00/0
SNatural Resources Web Soil Survey 6/12/2015
Conservation Service National Cooperative Soil Survey Page 3 of 3

Mitigation services
ENVIRONMENTAL OUALITV
Jay S. Park
Andale Data Center, FKA
1601 Willow Road
Menlo Park, CA 94025
Project: Project Bluebird FRC
ROY COOPER
MICHAEL S. REGAN
February14, 2017
Expiration of Acceptance: August 14, 2017
County: Rutherford
The purpose of this letter is to notify you that the NCDEQ Division of Mitigation Services (DMS) is willing to accept
payment for compensatory mitigation for impacts associated with the above referenced project as indicated in the
table below. Please note that this decision does not assure that participation in the DMS in -lieu fee mitigation
program will be approved by the permit issuing agencies as mitigation for project impacts. It is the responsibility
of the applicant to contact permitting agencies to determine if payment to the DMS will be approved. You must
also comply with all other state, federal or local government permits, regulations or authorizations associated with
the proposed activity including G.S. § 143-214.11.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not
received a copy of the issued 404 Permit/401 Certification/CAMA permit within this time frame, this
acceptance will expire. It is the applicant's responsibility to send copies of the permits to DMS. Once DMS
receives a copy of the permit(s) an invoice will be issued based on the required mitigation in that permit and
payment must be made prior to conducting the authorized work. The amount of the in -lieu fee to be paid by an
applicant is calculated based upon the Fee Schedule and policies listed on the DMS website.
Based on the information supplied by you in your request to use the DMS, the impacts for which you are
requesting compensatory mitigation credit are summarized in the following table. The amount of mitigation
required and assigned to DMS for this impact is determined by permitting agencies and may exceed the impact
amounts shown below.
Impact
River
Basin
CU Location
(8 -digit HUC)
Stream (feet)
Wetlands (acres) Buffer I
(Sq. Ft.)
Buffer II
(Sq. Ft.)
Cold Cool Warm
Riparian
Non-Ri arian Coastal Marsh
Broad
03050105
1 0 241 0
0
0 0 0
0
Upon receipt of payment, DMS will take responsibility for providing the compensatory mitigation. The mitigation
will be performed in accordance with the In -Lieu Fee Program instrument dated July 28, 2010 and 15A NCAC
02B .0295 as applicable. Thank you for your interest in the DMS in -lieu fee mitigation program. If you have any
questions or need additional information, please contact Kelly Williams at [phone].
cc: Jon Swaim. agent
FOR tAB Stanfill
anagement Supervisor
State of North Carolina Environmental Quality Mitigation Services
1652 Mail Service Center I Raleigh. NC 27699-1652 217 W. Jones Street, Suite 3000
919 707 8976 T

user manuai version za
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 9 any supplementary
measurements were performed. See the NC SAM User Manual forexamples 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 I SITE INFORMATION:
1. Project name (if any): PROJECT BLUEBIRD FRC 2. Date of evaluation: 1-17-2017
3. Applicant/owner name: ANDALE INC, FKA 4. Assessor name/organization: JON SWAIM, MCGILL AS CIATES
5, County: Rutherford 6. Nearest named water body
7. River Basin: Broad on USGS 7.5 -minute quad: 2nd Broad River
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.317273, 81.821678
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): 1 10. Length of assessment reach evaluated (feat): 150,
11. Channel depth from bed (in We, if present) to top of hank (feet): 1.5 r- Unable to assess charm depth.
12. Channel width at lop of bank (feet): 2.5 r r
14. Feature type: t: Perennial flow Intermittent flow r
STREAM RATING INFORMATION:
15, NC SAM Zone: r Mountains (M) Piedmont (P) t' Inner Coastal Plain (1) r Outer Coastal Plain (0)
16. Estimated geomorphic \ J
valley shape (skip for r: a -tip r b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip r Size 1 (< 0.1 mil°) r Size 2 (0.1 to < 0.5 mr) r Size 3 (0.5 to < 5 ml`) r-' Size 4 (>_ 5 miz)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
1E. Were regulatory considerations evaluated? R Yes r- No If Yes, check all that appy to the assessment area.
(-Section 10 water i Classified Trout Waters r- Water Supply Watershed ( r I r II r- III r IV r A
r- Essential Fish Habitat r Primary Nursery Area r- High Quality Watars/Outstanding Resource Waters
r Publicly owned property f NCDWR riparian buffer rule in effect r- Nutrient Sensitive Waters
f- Anadromous fish f 303(d) List r CAMA Area of Environmental Concern (AEC)
1" Documented presence of a federal andlor state listed protected species within the assessment area.
List species:
i Designated Critical Habitat (list species):
19. Are additional stream inlonnallaWsupplementary measurements included In "No ketch" section or attache • Yes No
1. Channel Water -assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
r: A Water throughout assessment reach.
r B No flow, water in pools only.
r C No water In assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
G- A At least 10% of assessment reach In -stream habitat or difle-pool sequence is adversely affected by a flow restriction gr fill to the
point of obstructing flow gLa channel choked with aquatic macrophyles 2f ponded water gl Impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gatesi.
r B Not
3. Feature Pattern - assessment reach metric
r A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
r B Not A.
4. Feature Longitudinal Profile- assessment reach metric
r- 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).
r 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, gablon, rip -rap),
r A < 10% of channel unstable
r: B 10 to 25% of channel unstable
r, C > 25% of channel unstable
8. Streamside Area Interaction - streamakde area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
T A is A Little or no evidence of conditions that adversely affect reference interaction
r B r B Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adve sely affect
reference interaction (examples: limited streamside area access, disruption of food flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching))
C rC Extensive evidence of conditions that adversely affect reference interaction (111119 to no floodplaWintertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream Incision,
disruption of flood flows through streamside area] g_r too much floodplaintintertidal zone access (examples:
impoundments, intensive mosquito ditching)) or floodplainnnterfldal zone unnaturally absent gr assessment reach is a
man-made feature on an Interstream divide
7. Water Quality Stressors -assessment reachlinterticial zone metric

Check all that appy.
A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
r 8 Excessive sedimentation (burying of stream features or intertidal zone)
C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
r D Odor (not including natural sulfide odors)
E Current published or collected data Indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
F Livestock with access to stream or intertidal zone
G Excessive algae in stream or intertidal zone
F H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
r I Other. (explain in "Notes/Sketch" section)
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.
r' A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
r 8 Drought conditions and rainfall exceeding 1 inch within the last 48 hours
r^ C No drought conditions
9 Large or Dangerous Stream - assessment reach metric
r' Yes (- No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamskts Area Ground Surface Condition).
10. Natural In-stmam Habitat Types -assessment reach metric
10s. r; Yes r' 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-rapl, 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)
r A Multiple aquatic macrophytes and aquatic mosses W r F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) E f G Submerged aquatic vegetation
P B Multiple sticks and/or leaf packs and/or emergent in -b r H Low -tide refugia (pools)
vegetationx G r I Sand bottom
I C Multiple snags and logs (including lap trees) r J 5% vertical bank along the marsh
I✓ D 5% undercut banks and/or root mats and/or roots U � - K Little or no habitat
in banks extend to the normal wetted perimeter
I E little or no habitat
REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS
11. Bedform and Substrate - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11 a. r-_ Yes r No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
i✓ A Riffle -run section (evaluate 11c)
t✓ B Pool-gfids section (evaluate 11d)
r C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In dits 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 5 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
(: r I- Bedrock/saprolte
c: r C r- Boulder (256 - 4096 mm)
(' r: (- Cobble (64 - 256 mm)
- r r• (- Gravel (2 - 64 mm)
C' ,: t r Sand (.062 - 2 mm)
,: r' r Silt/day (c 0.062 mm)
r r r' r' r' Detritus
r r. r- r v^ Artificial (rip -rep, concrete. etc.)
11 d r Yes 4 No Are pools filed 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. ! Yes r- No Was an ir"tream aquatic life assessment performed as described in the User Manual?
If No, select one of the billowing reasons and skip to Metric 13. r No Water r, Other:
12b. r: Yes C No Are aquatic organisms present in the assessment reach (look in riffles, pods, Men snags)? If Yes, check
all that apply. If No, skip to Metric 13.
1 >t Numbers over cokxnns refer to 1ndividuais' for size 1 and 2 streams and 'taxa' for size 3 and 4 streams.
r Aduflfrogs
I" Aquatic reptiles
i Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
Beetles (including water pennies)
l% Caddiefly larvae (Trichoptera (r))
F r Asian clam (Corblcula )
r Crustacean(Isopodlamphipod/crayffsh/shrimp)
I Damselfly and dragonfly larvae
r r Dipterans (true flies)
17- Mayfly larvae (Ephemeroptere (E))
F r- Megaloptera (alderly, fishfty, dobsonfly larvae)
i r- Midges/mosquito larvae
F_ r Mosquito fish (Gambusm) or mud minnows (Umbra pygmeea)
r- r Mussels/Clams (not Corbicula )

R Other fish
r fi Salamanders/tadpoles
r r Snails
r l" Stonefly larvae (Piecopters (P))
f r Tipulid larvae
r r WormsAeeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Lek Bank (LB) and the Right Bank (118). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
f'" A 4: A Little or no alteration to water storage capacity over a majority of ft streamside area
(: B r' B Moderate alteration to water storage capacity over a majority of the streamside area
r- C r C Severe atleretlon 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
(- A r A Majority of etreamside area with depressions ableto pond water t 6 inches deep
r' B r B Majority of streamside area with depressions able to pond water 3 to 6 Inches deep
ri C (: C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Welland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
(- Y r Y Are wetlands present in the streamside area?
N (-* N
16. Baseflow, Contributors - assessment reach metric jakip for adze 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
r- A
i C
r- = __
I- E
W F None of the above
17, Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that appy.
r A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
i B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
I✓ C Urban stream (z 24% impervious surface for watershed)
I✓ D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
I- E Assessment reach relocated to valley edge
r- None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider `leaf -on' condition.
(" A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
r B Degraded (example: scattered trees)
r' 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
C A C A r A (- A i 100 -feet wide or extends to the edge of the watershed
B (: B r B r B From 50 to a 100 -feet wide
r C (" C (: C To C From 30 to < 50 -feet wide
r- D r D (' D r' D From 10 to < 30 -Feet wide
r E r- E E r" 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 RS
r A r A Mature forest
r B ( B Non -mature woody vegetation gr modified vegetation structure
C f: C Herbaceous vegetation with or without a strip of trees < 10 feet wide
r- D r D Maintained shrubs
(- E E Little or no vegetation
21. Buffer Streasons - 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).
N none of the following stressors occurs on either bank, check here and skip to Metric 22: ,
Abuts < 30 feel 30-50 feet
LB RB LB RB LB RB
r A r A A r A r A e- A Row crops
r B (-' B (' B (-8 (:B IT B Maintained turf
C r C r C r C r C r C Pasture (no Iivestockyoommercial horticulture
(` D r D r' D (_ D D r- D Pasture (active livestock use)

22. Stem Density - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
A A Medium to high stem density
• B B Low stern density
C r- 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 Duffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10 -feet wide
LB RB
A A The total length of buffer breaks is < 25 percent.
r: B : B The total length of buffer breaks is between 25 and 50 percent.
C C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition - 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
t A A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species. with non-native invasive species absent or sparse,
B 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 gr
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-charactenslic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity - assessment reach metric (skip for all Coastal Plain streams)
25a. r Yes • No Was a conductivity measurement recorded?
If No. select one of the following reasons. � No Water : Other: No Conductivity meter available.
Notes/Sketch:

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name PROJECT BLUEBIRD FRC
Stream Category Mal
Notes of Field Assessment Form (YM)
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 1-17-2017
Assessor Name/Organization SWAIM, MCGILL ASSOCl/
NO
NO
YES
Perennial
NCDWR
Intermittent
USACE/
Function Class Rating Summary
All Streams
(1) Hydrology
MEDIUM
(2) Baseflow
LOW
(2) Flood Flow
HIGH
(3) Streamside Area Attenuation
HIGH
(4) Floodplain Access
HIGH
(4) Wooded Riparian Buffer
MEDIUM
(4) Microtopography
MEDIUM
(3) Stream Stability
MEDIUM
(4) Channel Stability
MEDIUM
(4) Sediment Transport
MEDIUM
(4) Stream Geomorphology
MEDIUM
(2) Stream/Intertidal Zone Interaction
NA
(2) Longitudinal Tidal Flow
NA
(2) Tidal Marsh Stream Stability
NA
(3) Tidal Marsh Channel Stability
NA
(3) Tidal Marsh Stream Geomorphology
NA
(1) Water Quality
LOW
(2) Baseflow
LOW
(2) Streamside Area Vegetation
LOW
(3) Upland Pollutant Filtration
LOW
(3) Thermoregulation
MEDIUM
(2) Indicators of Stressors
NO
(2) Aquatic Life Tolerance
MEDIUM
(2) Intertidal Zone Filtration
NA
(1) Habitat
LOW
(2) In -stream Habitat
LOW
(3) Baseflow
LOW
(3) Substrate
MEDIUM
(3) Stream Stability
MEDIUM
(3) In -stream Habitat
MEDIUM
(2) Stream -side Habitat
LOW
(3) Stream -side Habitat
MEDIUM
(3) Thermoregulation
LOW
(2) Tidal Marsh In -stream Habitat
NA
(3) Flow Restriction
NA
(3) Tidal Marsh Stream Stability
NA
(4) Tidal Marsh Channel Stability
NA
(4) Tidal Marsh Stream Geomorphology
NA
(3) Tidal Marsh In -stream Habitat
NA
(2) Intertidal Zone Habitat
NA
Overall
LOW
NO
NO
YES
Perennial
NCDWR
Intermittent

User alaeYal VeMIOrl A.1
INSTRUCTIONS: Attech 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. ff 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 I SITE INFORMATION:
1. Project name Of any): PROJECT BLUEBIRD FRC 2. Dale of evakiation: 1-17-2017
3. Applcantlowner name: ANDALEINC.FKA 4. Assessor name/organization: JON W IM, MCGILL ASSOCLA
5. County: Rutherford 6. Nearest named water body
7. River Basin: Broad on USGS 7.5 -minute quad: 2nd Broad River
S. Site coon insles (decimal degrees, at lower end of assessment reach): 35.315391, -81.827406
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): 2 10. Length of assessment reach evaluated (feet): 1 MY
11. Channel depth from bed On clots, f present) to top of bank (feel): .8 r- Unable to assess ehanneldepth_
12. Channel width at top of bank (feel): 2 r
14. Feature type: Perennial flow •,-Intermittent flow J
STREAM RATING INFORMATION:
15. NC SAM Zone: r:; Mountains (M) rPiedmonl (P) ';Inner Coastal Plan (1) r",Outer Coastal Plain (0)
16. Estimated geomorphic J
valley shape (skip for ra j ;b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip r., Size 1 (< 0.1 ml`) [ eJ Size 2 (0.1 to < 0.5 mt`) i ,' Size 3 (0.5 to < 5 mi`) [ ; Size 4 (2:5 mi`)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? j. Yes rNo If Yes, check at that appy to the assessment area.
r Section 10 water I- Classified Trout Waters r- Water Supply Watershed ( [;I rII ;III r;IV rv)
F- Essential Fick Habitat r Primary Nursery Area I- High Quakly, WatersfOutstanding Resource Waters
r" Publicly owned property r NCDWR riparian buffer rule in effect F- Nutrient Sensitive Waters
I- Anadromous fish I- 303(4) List r CAMA Area of Environmental Concern (AEC)
r- Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
r Designated C 1cal Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Note ketch section or attached? •,Yes o
1. Channel Water- assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
A Water throughout assessment reach.
+�B No flow, water in pools only.
�C No water in assessment reach.
2, Evidence of Flow Restriction - assessment reach metric
f :A At least 10% of assessment reach in -stream habitat or nffle•poo( sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channelchoked with aquatic macrophyles or ponded water 91impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
�B Not
3. Feature Pattern - assessment reach metric
FA A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
B Not A.
4. Feature Longitudinal Profile - assessment reach metric
�•;A Majority of assessment reach has a substantially altered stream profits (examples: channel down -cutting, existing damming,
over widening, active aggradatkm, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
r!8 Not
S. Signs of Acute 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, rlp-rap).
t ;A < 10% of channel unstable
r-4. B 10 to 25% of channel unstable
rJC > 25% of channel unstable
S. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
FA A Little or no evidence of conditions that adversely affect reference interaction
B •�8 Moderate evidence of conditions (examples: berths, levees, down -cutting, aggradaWn, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood lbws through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching (Muding mosquito dltching1l
i ;C r,C Extensive evidence of conditions that adversely affect reference interaction (little to no floodpianAnterticial zone access
(examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream Incision,
disruption of flood flows through streamskle area) or loo much floodplainAnlerticial zone access [examples:
impoundments, intensive mosquito ditching)) or fbodpiainfntertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reachlintertidal zone metric
Check all that apply.
1- A Discolored water in stream or intertidal zone (milky while, blue, unnatural water discoloration, oil sheen, stream loam)
r- 8 Excessive sedimentation (burying of stream features or intertidal zone)

I C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
r 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 0ne 'Notes/Sketch"
section.
I F Livestock with access to stream or intertidal zone
r -i G Excessive algae In stream or intertidal zone
H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
I Other. (explain in "Notes/Sketch'section)
F J Little to no stressors
S. Recent Weather- watershed metric
For Size 1 or 2 streams, DI drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
r: 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
e- C No drought conditions
9 Large or Dangerous Stream - assessment reach metric
(",Yes r: No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Conditbn),
10. Natural In -stream Habitat Types - assessment reach metric
10a r. Yes r, No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening (for example, rtp-rep), recent dredging, and snagging)
(avaluats for size 4 Coastal Plain streams only, then skip to Metric 12)
10b Check all that occur (occurs ti > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
F- A Multiple aquatic macrophyles and aquatic mosses -40 r F 5% oysters or ober natural hard bottoms
(include INenwrts, lichens, and algal mats) Er G Submerged aquatic vegetation
"+ B Multiple sticks and/or leaf packs and/or emergent to r H Lew -tide rerugia (pools)
vegetation �c o r I Sand bottom
I- C Multiple snags and logs (including lap trees) �L F_ 5% vertical bank along the marsh
re- D 5% undercut banks and/or root mals and/or roots f- Littre or no habitat
in banks extend to the normal wetted perimeter
r- E Lift or no habitat
""""`""•—&&A ---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)
Ila -: Yes ; ",No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Sedform evaluated. Chock the appropriate box(es).
r A Rime -run section (evaluate I Ic)
R 8 PooFgfide section (evaluate 11 d)
i C Natural bedform absent (skip to Metric 12, Aquatic Life)
r_1 rl
r J
Jl"J+
I ld. r,Yes r.; No Are pools filed 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 r: Yes r,No was an in -stream aquatic: sfe assessment performed as described In Bre User Manual?
If No, select one of the following reasons and skip to Metric 13. [;No Water rlOther:
12b. r Yes r.;No Are aquatic organisms present in the assessment reach (look in dries, pools, then snags)? If Yes, deck
all that apply. If No, slip to Metric 13.
i > 1 Numbers over columns refer to "individuals' for size 1 and 2 streams and 'taxa' for size 3 and 4 streams
r r
i r
r r
r �-
r F
F_
r r
r r

13. Streamsids Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and 8 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 R8
FA A Little or no alteration to water storage capacity over a majority of the streamside area
B ',(B Moderate afteration to water storage capacity over a majority of the sfreamaide area
r; C r-jC Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, flit.
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
AA Majority of streamside area with depressions able to pond water i 6 Inches deep
8 B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
t � C VC Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area rrwtrlc (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 orwilhin the
normal wetted perimeter of assessment reach.
LB RB
Z,Y r,Y Are wetlands present in the streamside area?
t.; N r': 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 #W draining to the assessment reach.
+W A Streams and/or springs (urisdictlonal discharges)
F_ 8 Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
r- C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
f- D Evidence of bank seepage or sweating (iron oxidizing bacteria In water indicates seepage)
I- E Stream lied or bank Boll reduced (dig through deposited sediment If present)
f- F None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Mash Streams)
Check all that apply.
V. A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
i- B Obstruction not passing flow during low lbw periods affecting the assessment reach (ex: watertight dam, sediment deposit)
f7 C Urban stream (�! 24% impervious surface for watershed)
r- D Evidence that the siream-side area has been modified resulting in accelerated drainage Into the assessment reach
F E Assessment reach relocated to valley edge
+ F None of the above
16. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
B Degraded (example: scattered trees)
,C Stream shading is gone or largely absent
19. Buffer Width -sVeamside 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
rA A ="A r"A z 1004sal wide gi extends to the edge of the watershed
r -B B i;B B From 50 to<f00feet wide
j;C�,CC C From 30lo<SOfeelwide
D D D D From 10 to < 30 -feel wide
EF
E �E <10 -feet wide gr no trees
20. Buffer Structure - stroamsida area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RS
,A .,A Mature forest
•,8 B Non -mature woody vegetation or modified vegetation structure
,C [ ,C Herbaceous vegetation with or without a strip of trees < 10 feet wide
D rD Maintained shrubs
t",E [-,E Little or no vegetation
21. Buffer Stressors - streamslde 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 feel of stream (30-50 feet).
N none of the following stressors occurs on either bank, check here and skip to Metric 22:
Abuts < 30 feel 30-50 feel
LB RB LB R8 LB RB
EA A A r -,A t;A Raw crops
B B ,B ,B �.,B t,B Maintained turf
N C aC t ;C r;C r,,C Pasture (no 5vestockycommerciai horticulture
D OA
D ,D r4 rD r.D Pasture (active livestock use)
22. Stem Density - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
.,A r.,A Medium to high stem density
,B r.B Low stem density
.1C r;C No wooded riparian buffer or predominantly herbaceous species Qt 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 lac lung vegetation > 10 -feet wide
LB RB
(:rA +A The total length of buffer breaks is < 25 percent.
Z ; B f ' B The total length of buffer breaks is between 25 and 50 percent.
t ;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
r�jA r;A Vegetation is Gose to undisturbed in species present and their proportions, Lower strata composed of native
species, with non-native invasive species absent or sparse.
rB =.;8 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-cutling or Gearing 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.
r�C C Vegetation is severely disturbed in terns 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. t`�'Yes Z:; No Was a conductivity measurement recorded?
If No, select one of the following reasons. (;No Water ':;Other: No Conductivity meter available.

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name PROJECT BLUEBIRD FRC
Stream Category Mbt
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 1-17-2017
Assessor Name/OrganizationSWAIM, MCGILL ASSOCII
NO
NO
YES
Intermittent
USACE/
NCDWR
Function Class Rating Summary
All Streams
Intermittent
(1) Hydrology
MEDIUM
MEDIUM
(2) Baseflow
MEDIUM
MEDIUM
(2) Flood Flow
MEDIUM
MEDIUM
(3) Streamside Area Attenuation
MEDIUM
MEDIUM
(4) Floodplain Access
MEDIUM
MEDIUM
(4) Wooded Riparian Buffer
HIGH
HIGH
(4) Microtopography
NA
NA
(3) Stream Stability
MEDIUM
MEDIUM
(4) Channel Stability
MEDIUM
MEDIUM
(4) Sediment Transport
HIGH
HIGH
(4) Stream Geomorphology
LOW
LOW
(2) Stream/Intertidal Zone Interaction
NA
NA
(2) Longitudinal Tidal Flow
NA
NA
(2) Tidal Marsh Stream Stability
NA
NA
(3) Tidal Marsh Channel Stability
NA
NA
(3) Tidal Marsh Stream Geomorphology
NA
NA
(1) Water Quality
(2) Baseflow
MEDIUM
MEDIUM
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
HIGH
HIGH
(2) Indicators of Stressors
NO
NO
(2) Aquatic Life Tolerance
OMITTED
NA
(2) Intertidal Zone Filtration
NA
NA
(1) Habitat
HIGH
HIGH
(2) In -stream Habitat
HIGH
HIGH
(3) Baseflow
MEDIUM
MEDIUM
(3) Substrate
HIGH
HIGH
(3) Stream Stability
MEDIUM
MEDIUM
(3) In -stream Habitat
MEDIUM
MEDIUM
(2) Stream -side Habitat
HIGH
HIGH
(3) Stream -side Habitat
HIGH
HIGH
(3) Thermoregulation
HIGH
HIGH
(2) Tidal Marsh In -stream Habitat
NA
NA
(3) Flow Restriction
NA
NA
(3) Tidal Marsh Stream Stability
NA
NA
(4) Tidal Marsh Channel Stability
NA
NA
(4) Tidal Marsh Stream Geomorphology
NA
NA
(3) Tidal Marsh In -stream Habitat
NA
NA
(2) Intertidal Zone Habitat
NA
NA
Overall
HIGH

'N(y•TI`AAN' UNIT W -A
UT -2 SECONr,-
BROADRIVER
now
`t IOUSLYDELINEATED
WETLAND AREA
�!' N
GRAPJiIC SCALE 0 75 ]so00,
vV E
1 INCH = 150
S
NCYAM MAP pROJFC'1'/ PROJECT BLUEBIRD FRC eMcGill
JANUARY25.:1117 16.01413 RUTHERFORD COUNTY. A s s u C 1 A 'r e s
NORTH CAROLINA ENVIlt QYN7AL FlNAJiCE

r
U.S. ARMY CORPS OF ENGL,,EERS
WIi..NIlNGTON DISTRICT
Action ID. SAW -2011-00569 County: Rutherford USGS Quad: Forest City
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: Mr. Tot' Furlong
Address: Andale Data Center
1601 S. California Avenue
Palo_ Alto, CA 94304
Size and location of property (water body, road name/nutnber, town, etc.): The proposed Project site is
located on approximately 63 acres on Old Caroleen Road. Just south of US Hwy 74 and bordered to
the northeast by the Second Broad River, southeast of Forest City, in Rutherford County. North
Carolina. 35 31695 N and -81.82550 W.
Description of projects area and activity: This verification authorizes impacts to jurisdictional waters
of the U.S. in association with the construction of the Andale Data Center. The site is a former
industrial facilty site to be redeveloped. Permanent impacts authorized total 148 linear feet of pine
replacement on new location and 1.451 linear feet of stream channel to be re-established/restored
through the removal of existing pipes,, davlighting the stream channels, restoring the Pattern,
dimension and profile to the streams, and the izradineMhayigdplantina of stream banks.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors" 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 39 and 27
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance
with the attached conditions and your submittal plans. Any violation of the attached conditions or deviation
from your submitted plans may subject the permittee to a stop work order, a restoration order and/or
appropriate legal action.
Special Conditions:
1) Populations of the federally endangered hexastylis nanfflora (dwarf flowered heart leaf) have
been identified near the project area. These plants are protected and not to be disturbed by the construction
activities associated with the redevelopment at the site.
2) No work is to occur within the areas identified as Conservation Areas.
This verification will remain valid until the expiration date identified below unless the nationwide authorization
is modified, suspended or revoked If, prior to the expiration date identified below, the nationwide permit
authorization is reissued and/or modified, this verification will remain valid until the expiration date identified
below, provided it complies with all requirements of the modified nationwide permit. If the nationwide permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with
the terms and conditions of the nationwide permit, activities which have commenced (ie., are under construction) or
are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the activity
is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation,
unless discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the
authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality
Certification. You should contact the NC Division of Water Quality (telephone [phone]) to determine
Section 401 requirements.

For activities occurring within th. :venty coastal counties subject to regulation un.. the Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other
required Federal, State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of
Engineers regulatory program, please contact Liz Hair at 828-271-7980.
Corps Regulatory Official —Liz Hair ADate: October 21.201.1
Expiration Date of Verification: March 18.201

r
CCDEE R
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 4, 2011
Mr. Tom Furlong
Andale Data Center
1.601 S. California Avenue
Palo Alto, CA 94304
Subject: 401 Water Quality Certification — Approval
Stormwater Management Plan — Approval
Andale Data Center
DWQ Project # 11-0737
Rutherford County
BRD02 / Second Broad River / 9-41-(12.7) / WS -V
Dear Mr. Furlong:
Dee Freeman
Secretary
The Division of Water Quality has completed the review of your 401 Water Quality Certification application
associated with the subject project listed above.
Approval has been granted to place fill within or otherwise impact 148 feet of streams for the purpose of
industrial development at the subject property. Included in the project is stream restoration work re-establishing
1,451 feet of previously piped stream channels. This approval requires you to follow the conditions listed in
the attached Certification and any additional conditions listed below.
This approval also includes approval of the Stormwater Management Plan.
Project impacts are covered by General Water Quality Certification Numbers 3821 and 3689. These
Certifications allow you to use Nationwide Permits 27 and 39 when issued by the US Army Corps of Engineers
(USACE).. Authorization to proceed with your proposed impacts or to conduct impacts to waters as depicted in
.your application and as authorized by this Certification shall expire upon expiration of the corresponding
USACE Permit Verification. in addition, you should obtain or otherwise comply with any other required
federal, state or local permits before you proceed with your project including (but not limited to) Erosion and
Sediment Control and water supply watershed regulations.
This approval is for the purpose and design that you described in your application. If you change your project,
you must notify us and may be required to submit a new application.
Location: 2090 U.S. Highway 70, Swannanoa, North Carolina 28778
Phone: [phone] FAX: [phone] Customer Service- 1-877-623-6748
Internet www.newaterquak.org
An F("w nnnnrlunily 1 AlBrmativa Arlin FmrJ wor
No,��e Carolina
���a��

Tom Furlong
October 4, 21111
i Page 2 of 3
Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general conditions of
this Certification are met. No other impacts are approved including incidental impacts:
Amount Approved nits Plan Location or Reference
Stream 148 feet Culvert installation
Stream 1,451 feet Channel re-establishment
Additional Conditions
1. Stream Restoration Monitoring
Provide data as described in the Long Term Monitoring Proposal included in the McGill Associates
additional information package dated September 19, 2011.
Stormwater Management Plan Conditions:
The stormwater management system (consisting of 5 wet detention ponds and 1 bioretention basin,
and all associated appurtenances), all stormwater conveyances, and the grading and drainage patterns
depicted on the plans, as approved by this office must be maintained in perpetuity. No changes to the
structural stormwater practices shall be made without written authorization from the Division of
Water Quality. The stormwater management structures shall have maintenance access for the ability
to maintain the structures, and to perform corrective actions.
2. The stormwater easements shall be recorded to provide protection of the structures from potential
alterations by future property owners. Documentation of the easements shall be made within 6
months of completion of the stormwater management system. The Asheville Regional Office —
Surface Water Protection Section shall be notified after completion of the easement documentation.
3. Operation and Maintenance (O&M) Agreements shall be signed and notarized within 6 months after
completion of the stormwater management system. However, Andale Data Center representatives
must comply with the requirements of the O&M Agreements immediately upon completion of the
stormwater management system. Copies of the signed and notarized 0&M Agreements shall be
submitted to the Asheville Regional Office — Surface Water Protection Section.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or stream
impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that you receive
this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150E of the North Carolina
General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-
6714. This certification and its conditions are final and binding unless you ask for a hearing.

Tom Furlong
• October 4, 2011
Page 3 of 3
This letter completes the review of your application by the Division of Water Quality under Section 401 of the
Clean Water Act. If you have any questions, please contact Chuck Cranford in the Asheville Regional Office
at 828-296-4664.
Sincerely,
Coleen H. Sullins, Director
CHS/cbc
Enc: GC3821 and GC3689
Certificate of Completion
Stormwater Management System Plans
cc: USACE Asheville Regulatory Field Office
WBSCP Unit
File Copy
Shad Walters — McGill (e -copy)
S:ISWPiltutherfordWOlANon-DQ1WndelelAMVL.l0.3.1 J.doc

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. SAW -2011-00569 County: Rutherford USGS Quad: NC -FOREST CITY
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: Jay S. Park, Andale Inc., FKA
Address: 1601 Willow Rd.
Menlo, CA 94025
Telephone No.:
of property (water body, road name/number, town, etc.): The proiect is located 404
Description of projects ari
material associated with
Commercial development.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: NW 12
Summary of Authorized Impacts and Required Mitigation
Impact ID # NWP / Open Water (ac)
GP # Temporary Permanent
Wetland (ac) Stream (if)
Temporary Permanent Temporary Permanent
W1 12
0.01
S1 12
36
Impact Totals
0.01 36
Total Loss of Waters of the U.S. (ac)
Total Loss of Waters of the U.S. 1
Required Wetland
Mitigation (ac
Required Stream Mitigation (If)
Additional Remarks and/or Special Permit Conditions
*ALL constructed areas must be returned to pre -construction contours in impacted wetlands and
stream channels. Areas of forested wetland that will be temporarily impacted during construction
must be replanted with native woody vegetation, monitored for success and replanted where
necessary. Any impact deviation to the approved plan must be approved by prior notification from
the Corps before these impacts can occur.
'Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the
attached conditions and your plans submitted on August 17, 2015. Any violation of the attached conditions or
deviation from your submitted plans may subject the permittee to a stop work order, a restoration order and/or
appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization
is modified, suspended or revoked. If, prior to the expiration date identified below, the nationwide permit
authorization is reissued and/or modified, this verification will remain valid until the expiration date identified
below, provided it complies with all requirements of the modified nationwide permit. If the nationwide permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with
the terms and conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or
are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the activity

is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation,
unless discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the
authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality
Certification. You should contact the NC Division of Water Qui ' (telephone [phone]) to determine
Section 401 requirements. You may also visit their website at: httD: } l.nc� web/wg/swj>/ws/webseaye —
For activities occurring within the twenty coastal counties subject to regulation un a Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal Managemea
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other
required Federal, State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of
Engineers regulatory program, please contact William Elliott al 08-271-79
Corps Regulatory Official William Elliott Date: September 30, 2015
Expiration Date of Verification: March 18, 2017
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete the Customer Satisfaction Survey located at our website at
hq://per2.nwp.usace.army.mil/surM.htrnl to complete the survey online.

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above
described project area. This preliminary determination is not an appealable action under the Regulatory
Program Administrative Appeal Process ( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the
permit requirements of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act.
Unless there is a change in the law or our published regulations, this determination may be relied upon for a
period not to exceed five years from the date of this notification.
C. ® There are waters of the US and/or wetlands within the above described project area subject to the permit
requirements of Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the
law or our published regulations, this determination may be relied upon for a period not to exceed five years
from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action.
Please reference jurisdictional determination issued . Action ID
Basis of Jurisdictional Determination:
The site contains wetlands as determined by the 1987 Corps of Engineers Wetland Delineation Manual and the
Interim Regional Supplement to the Corps of Engineers Wetlands Delineation Manual: Eastern Mountain and
Piedmont Region. These wetlands are adjacent to stream channels located on the property that exhibit indicators of
ordinary high water marks. The stream channel on the property is an unnamed tributary to Second Broad River
which flows into the Upper Broad River.
Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for
the particular site identified in this request. The delineation/determination 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 request a certified wetlanddetermination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Appeals Information: (This information applies only to approved jurisdictional determinations as indicated in
B and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object
to this determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331.
Enclosed you will find a request for appeal (RFA) form. If you request to appeal this determination you must
submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room l OM 15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the
criteria for appeal under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of
the date of the NAP. Should you decide to submit an RFA form, it must be received at the above address within 60
days from the Issue Date below.
**It is not necessary to submit an RFA form to the Division Office iVdo ject tothe determination in this
con:espondence.*
Corps Regulatory Official: William Elliott

Issue Date: August 28, 2015
Expiration Date: Five years from Issue Date
Copy Furnished:
John C. Was, McGill Associates, P.A. 468 New Market Blvd. Ste B. Boone, NC 28607

Permit Number: SAW -2011-00569
Permit Type: NW 12
Name of County: Rutherford
Name of Permittee: Jay S. Park, Andale Inc., FKA
Date of Issuance: September 30, 2015
Project Manager: William Elliott
Upon completion of the activity authorized by this permit and any mitigation required by the
permit, sign this certification and return it to the following address:
U.S. Army Corps of Engineers
Attention: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance inspection by an U.S. Army
Corps of Engineers representative. If you fail to comply with this permit you are subject to
permit suspension, modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and conditions of the said permit, and required mitigation was
completed in accordance with the permit conditions.
Signature of Permittee
Date

NOTA=ICATION OF ADMINISTRATIVE APPEAL, OPTIONS AND PROCESS ANIS
REQUEST FOR APPEAL,
---__ ------ --------.__._------
- _------ ---- ----------------_____��—____.-
Applicant: Jay S. Park, Andale Inc., FICA
File Number: SAW -2011- Date: August 28,
00569 2015
Attached is: See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission) A
PROFFERED PERMIT (Standard Permit or Letter ofpermission) B
PF,RMIT DENIAL C _
X APPROVED JURISDICTIONAL DETERMINATION D _
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above
decision. Additional information may be found at
bttp://v,r",w.usace.army.mil/CECW/Pages/reg_materials.aspx or Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for rural
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights
to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request that
the permit be modified accordingly. You must complete Section II of this form and return the form to the district engineer.
Your objections must be received by the district engineer within 60 days of the date of this notice, or you will forfeit your right
to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your objections and may: (a)
modify the permit to address all of your concerns, (b) modify the permit to address some of your objections, or (c) not modify
the permit having determined that the permit should be issued as previously written. After evaluating your objections, the
district engineer will send you a proffered permit for your reconsideration, as indicated in Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights
to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein, you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section 11 of this
form and sending the form to the division engineer. This form must be received by the division engineer within 60 days of the
date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process
by completing Section 11 of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice. ,
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section 11 of this form and sending the form to the division engineer. This form must be received
by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an
approved JD (which may be appealed), by contacting the Corps district for further instruction. Also you may
provide new information for further consideration by the Corps to reevaluate the JD.
SECTION ll - 4QU1 S'E I�QR APPEAL or O13JEC 1TUNS TO AN INITIAL,PROFFE; ED. PERMIT;
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an
initial proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons
or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record. However,
you may provide additional information to clarify the location of information that is already in the administrative record.
POINT OF CONTACT FOR QUESTIONS ORINFORMAT'ION:
If you have questions regarding this decision and/or the appeal
If you only have questions regarding the appeal process you may
process you may contact:
also contact:
William Elliott, Project Manager
Mr.. Jason Steele, Administrative Appeal Review Officer
USACE, Asheville Regulatory Field Office
CESAD-PDO
151 Patton Ave
U.S. Army Corps of Engineers, South Atlantic Division
RM 208
60 Forsyth Street, Room IOMI 5
Asheville, NC 28801
Atlanta, Georgia 30303-8801
828-271-7980
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: William Elliott, 69 Darlington. Avenue,
Wilmington, North Carolina 28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele,
Administrative Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-
8801. Phone: [phone]

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 I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION:
State: NC County/parish/borough: Rutherford City: Forest City
Center coordinates of site (]at/long in degree decimal format): Lat. 35.3164° N, Long. -81.82450 .
Universal Transverse Mercator:
Name of nearest waterbody: Second Broad River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Broad River
Name of watershed or Hydrologic Unit Code (HUC): 03050105
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):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There 1 "navigable waters of the U.S." 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 maybe susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There ye "waters of the US." 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): t
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
Identify (estimate) size of waters of the U.S. in the review area:
Non -wetland waters: 540 linear feet: 3 width (ft) and/or acres.
Wetlands: 0.01 acres.
c. Limits (boundaries) of jurisdiction based on:
Elevation of established OHWM (if known):
Non-regulated waters/wetlands (check if applicable)?
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional
Explain:
' Boxes checked below shall be supported by completing the appropriate sections in Section III below.
' For purposes of this form, an RPW is defined as a tributary that is not a TN W and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
' Supporting documentation is presented in Section III.F.

SECTION III: 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 III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section IH.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
Wetland 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 IH.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.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.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section IH.0 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
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
❑ Tributary flows through tributaries before entering TNW.
Project waters areick List river miles from TNW.
Project waters are ick List river miles from RPW.
Project waters are ick 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:
Tributary stream order, if known:
Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(b) General Tributary Characteristics (check all that apply):
Tributary is: ❑ Natural
❑ Artificial (man-made). Explain:
❑ Manipulated (man -altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes 1 .
Primary tributary substrate composition (check all that apply):
❑ Silts ❑ Sands
❑ Cobbles ❑ Gravel
❑ Bedrock ❑ Vegetation. Type/% cover:
❑ Other. Explain:
❑ Concrete
❑ Muck
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry:
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for:
Estimate average number of flow events in review area/year to"
Describe flow regime:
Other information on duration and volume:
Surface flow is fit. Characteristics:
Subsurface flow 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):
ElW
Discontinuous OHM.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 CWA jurisdiction (check all that apply):
13 High Tide Line indicated by: Q 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):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known
6A 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 agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
']bid.

(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: Explain:
Surface flow is
Characteristics:
Subsurface flow: Pick List. Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Adjacency 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: rick List.
Estimate approximate location of wetland as within the floodplain.
(ii) 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 ]mown:
(iii) 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: Fick List
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/NSize (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary 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 tributary, 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 floodplain 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 TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. 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 IIID: .
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 IIID:
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 III.D: .
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS 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 (fi), Or, acres.
Wetlands adjacent to TNWs: acres.
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: UT -1 Second Broad River has continuous channel bed and bank, exhibits strong channel sinuosity, has
well formed in channel riffle pool structure, excellent channel material sorting, strong presence of base flow conditions,
presence of iron oxidizing bacteria, soil based evidence of high water table, as well as presence of aquatic organisms.
Q 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 for jurisdictional waters in the review area (check all that apply):
Tributary waters: 5401inear feet 3 width (ft).
p Other non -wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss 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: linear feet width (ft).
Other non -wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
IM 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 Unit -WA encloses UT -1 Second Broad River on both sides of the channel and is
located within the tributary's bankfull elevation (OHWM).
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: 0.01 acres.
5. 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 jurisidictional. Data supporting this
conclusion is provided at Section III.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 for jurisdictional 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).
E. ISOLATED [INTERSTATE 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 APPLV):10
k 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:
"See Footnote # 3.
e To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining C WA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.

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.
F. NON -JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
19 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.
C3 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):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., 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.e., 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.e., 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.
A. 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 HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000 Robbinsville, NC USGS topo quad.
USDA Natural Resources Conservation Service Soil Survey. Citation:
National wetlands inventory map(s). Cite name:
State/Local wetland inventory map(s):
FEMA/FIRM maps:
100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ® Aerial (Name & Date): NC ONEMAP DATA EXPLORER -2010.
or ® Other (Name & Date): Field assessment photos -March 16, 2015.
Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature:
Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD: