20181506 Ver 1_401 Application_20181105

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A. Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
®Section 404 Permit El Section 10 Permit
Corps:
1 b.
Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
FED Yes
❑ No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
1 e.
Is this notification solely for the record
For the record only for DWQ 401
For the record only for Corps Permit:
because written approval is not required?
Certification:
❑ Yes ® No
❑ Yes
® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
❑ Yes
® No
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
❑ Yes
® No
below.
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Hampton Inn & Suites — Emergency Stabilization
2b.
County:
Wake County
2c.
Nearest municipality / town:
Town of Cary
2d.
Subdivision name:
N/A
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Quality Oil Company LLC. - PIN#: 0774435681
Buhler Aeroglide Corporation - PIN#: 0774435032
3b.
Deed Book and Page No.
Book: 007164; Page: 00253 - PIN#: 0774435681
Book: 0010000; Page: 00001 - PIN#: 0774435032
3c.
Responsible Party (for LLC if
Rodney Cheek - PIN#: 0774435681
applicable):
Michael Hausfeld — PIN#: 0774435032
3d.
Street address:
1540 Silas Creek Parkway - PIN#: 0774435681
100 Aeroglide Drive - PIN#: 0774435032
3e.
City, state, zip:
Winston Salem, NC 27102 - PIN#: 0774435681
Cary, NC 27511 PIN#: 0774435032
3f.
Telephone no.:
336-408-9303 - PIN#: 0774435681
919-851-2000 - PIN#: 0774435032
3g.
Fax no.:
N/A
3h.
Email address:
[e-mail] - PIN#: 0774435681
[e-mail] - PIN#: 0774435032
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ® Other, specify: Quality Oil Company LLC.
4b.
Name:
Rodney Cheek
4c.
Business name
(if applicable):
Quality Oil Company LLC.
4d. Street address:
1540 Silas Creek Parkway
4e. City, state, zip:
Winston Salem, NC 27102
4f.
Telephone no.:
336-408-9303
4g.
Fax no.:
N/A
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Troy Beasley
5b.
Business name
(if applicable):
WithersRavenel
5c.
Street address:
219 Station Road, Suite 101
5d.
City, state, zip:
Wilmington, NC 28405
5e.
Telephone no.:
910-256-9277
5f.
Fax no..-
o.:5g.
5g.
Email address:
[e-mail]
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B.
Project Information and Prior Project History
1.
Property Identification
PIN#: 0774435681
1a.
Property identification no. (tax PIN or parcel ID):
PIN#: 0774435032
1 b.
Site coordinates (in decimal degrees):
Latitude: 35.792353°N Longitude: - 78.748176°W
(DD.DDDDDD) (-DD.DDDDDD)
± 409 linear project
1c.
Property size:
PIN#: 0774435681 -±3.16 acres
PIN#: 0774435032 - ±10 acres
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to
Richlands Creek
proposed project:
Stream Index: 27-33-11
2b.
Water Quality Classification of nearest receiving water:
C; NSW
2c.
River basin:
Neuse River Basin
HUC: 03020201
3.
Project Description
3a.
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project area consists of an eroded channel, with approximately 15 ft wide wooded fringe adjacent to the Hampton Inn
& Suites parking lot and the rear gravel access driveway to the Bulher-Aeroglide facilty. The general land use in the
vicinity of the project consists primarily of commercial & industrial use.
3b.
List the total estimated acreage of all existing wetlands on the property:
There are no wetlands within the project area.
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
± 409 If within the project area.
3d.
Explain the purpose of the proposed project:
The purpose of the proposed project is to conduct emergency repairs of the failing slopes which has resulted in damage
of the Hampton Inn & Suites parking lot. Currently, the erosion from the stream has resulted in the slope collapsing,
resulting in the failure of the retaining wall along the parking lot, which has destabilized the parking lot and will result in
the parking lot collapsing. Currently a large portion of the parking lot is closed due to risk to public safety from a potential
collapse. If the proposed project is not conducted, the parking lot will collapse, and the erosion and failing banks will
ultimately affect the structural stability of the Hampton Inn & Suites pool, as well as failure of the rear access driveway
into Buhler-Aeroglide.
3e.
Describe the overall project in detail, including the type of equipment to be used:
The overall project consists of installing ±380 If of pipe and a ±29 ft rip -rap dissipator and filling the eroded gully to
adjacent grades in order to stabilize the Hampton Inn & Suites parking lot and rear access driveway. The prosed project
is a response to the erosion that is and will continue to be a threat to adjacent structures. Standard commercial
equipment and techniques will be used to construct the proposed project.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ❑ No El Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
®Preliminary El Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: WithersRavenel
Name (if known): M. Richmond & L. Phillips
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
NCDWR issued a Buffer Determination (RRO #18-343) for the project area on 10/04/2018. A copy of the Buffer
Determination Letter has been provided as an appendix.
Onsite "Waters" were delineated by WithersRavenel on 05/04/2018. A preliminary JD Request and all supporting data will
be included in support of our delineation. WR is not requesting issuance of a JD for this project. A site visit was
conducted by James Lastinger of the USACE on 09/18/2018 to verify jurisdiction and discuss the proposed project.
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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
❑ 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)
Impacts #1
Pipe and rip -rap
UT to Richlands
❑ PER
® Corps
8 ft
409 If
® P ❑ T
stream stabilization
Creek
® INT
® DWQ
3h. Total stream and tributary impacts
409 If
3i. Comments:
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 ❑P❑T
4L 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 of
(acres)
number
pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
5L Total
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

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 ❑ Tar -Pamlico ❑ Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason for impact
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P)
Stream name
mitigation
(square feet)
(square feet)
or Temporary
required?
T
Impact #2
Protection of Existing
UT to Richlands
❑ Yes
20,750 sf
7,600 sf
® P ❑ T
Structures
Creek
® No
6h. Total buffer impacts
20,750 sf
7,600 sf
6i. Comments: The proposed piping of the stream will result in elimination of the riparian buffers along the 409 If of proposed
stream impact. These impacts are necessary for protection of the parking lot and rear access driveway, and therefore are
"Allowable".
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Prior to site plan design, the applicant requested that a detailed wetland delineation be conducted so that impacts to wetlands
and "waters" could be minimized.
The proposed project is in response to the erosion that is currently and will continue to be a threat to adjacent structures.
Therefore, based on the nature of the project, stream impacts could not be avoided. Stream impacts have been minimized by
only piping the portion of the stream adjacent to the parking lot and building in order to protect the existing structures.
The erosion of the stream channel and banks has resulted in failure of the slopes to the point that the retaining wall of the
Hampton Inn & Suites parking lot has failed. Over the course of the last 3 months, the erosion continues to get worse, and the
structure stability of the parking lot is at risk and could potentially collapse. Additionally, there are cracks in the concrete pool
deck, which is adjacent to the gully as well, suggesting that the erosion and failure of the slopes is now affecting the hotel
building itself. At the current rate of erosion, the failure of the slopes will ultimately threaten the Hampton Inn & Suites, as well
as the rear access driveway to the Buhler Aeroglide facility.
The erosion and failure of the slopes has resulted in almost vertical slopes, causing trees to collapse into the gully.
An engineering evaluation of alternative solutions determined that there are no viable alternatives to stabilize the slopes and
protect the existing structures. Specifically, the northern bank of the stream has eroded to the retaining wall. Therefore,
grading and stabilizing the slope cannot be accomplished because there is not enough distance to the existing retaining wall
to grade the slopes back to a stable slope (i.e. 3:1).
Additionally, construction of a new retaining wall to stabilize the slope adjacent to the parking lot was not viable for numerous
reasons. Most notably, the new retaining wall would have to be constructed a minimum of 15 If from the existing retaining wall
in order to install the anchors and backfill, which would have resulted in the stream being within the footprint of the retaining
wall in most places. This would have required the stream to be relocated outside of the retaining wall, and erosion from the
stream could eventually undermine the retaining wall and cause failure.
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

Therefore, the only viable long-term solution for permanently stabilizing the adjacent structures is to pipe the stream and
backfill the eroded gulley.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt fencing will be installed around all disturbed areas to prevent sediment from escaping into adjacent wetlands and waters
during construction. During construction, all equipment will access construction areas from high ground.
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:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
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PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ❑ No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
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 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
Comments: The proposed project consists of piping an eroded channel, which will
❑ Yes ® No
not result in any impervious surface or impede natural diffuse flow.
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
N/A
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
The proposed project consists of piping an eroded channel, which will not result in any impervious surface or impede natural
diffuse flow.
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?
Town of Cary
® Phase II
3b.
Which of the following locally -implemented stormwater management programs
® NSW
❑ USMP
apply (check all that apply):
® Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
® No
use of public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
❑ Yes
❑ No
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The proposed project consists of piping an eroded channel, which will not result in any additional development that could
impact nearby downstream water quality.
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.
N/A
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
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?
WR reviewed the NC Natural Heritage Program database, located at http://www.ncnhp.org/web/nhp/home, as well as NCNHP
GIS data to identify if there were any known occurrences of endangered species on or near the proposed project. The
review of the NHP data did not identify any recent occurrences of federally listed threatened or endangered species or
critical habitat on the subject property or within 1.0 miles of the project. Furthermore, site reviews did not identify any
potential habitat for any federally protected species known to occur in Wake County. Therefore, the proposed project will
have No Effect on federally protected species.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
There are no waters classified as EFH in Wake County.
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?
WR reviewed the NC State Historic Preservation Office's online database, located at: http:Hgis.ncdcr.gov/hi3oweb/, to
determine if there were any known historic or cultural resources within or in the vicinity of the proposed project. The
Aeroglide Corporation Building is HPO Site ID: WA6512 and is in the process of "Determination of Eligibility" (DOE). The
proposed project consists of stabilizing the eroded channel located -375ft from the Aeroglide building, and therefore
should have no effect on the "eligible" structure.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? www.ncfloodmaps.com
Troy Beasley WithersRavenel
-7:7-13-`--
-
Authorized Agent
g
11 /05/ 2018
Date
Applicant/Agent's Signature
Applicant/Agent's Printed Name
(Agent's signature is valid only if an authorization letter from the applicant
is provided.
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version

1/ WithersRavenel
NoOur People. Your Success.
AGENT AUTHORIZATION
QUALITY OIL, LLC

■0 W thersRavenel
■ Our P ople. Your Success_
AUTHORITY FOR APPOINTMENT OF AGENT
The undersigned Owner Rodney Cheek - Quality Oil Company, LLC (Client) does hereby
appoint Withers Rave nel, _Inc as his, her, or it's agent for the purpose of petitioning the
appropriate local, state and federal environmental regulatory agencies (US Army Corps of
Engineers, NC Division of Water Quality, NC Division of Coastal Management, local
municipalities, etc.) for: a) review and approval of the jurisdictional boundaries of onsite
jurisdictional areas (wetlands, surface waters, riparian buffers, etc.) and/or; b) preparation
and submittal of appropriate environmental permit applications/requests for the ±1.78 acre
review area on the ±3.16 acre parcel, Wake County PIN: 0774435681, located at 7329
Chapel Hill Road, Cary, NC 27607.
The Client does hereby authorize that said agent has the authority to do the following acts
on behalf of the owner:
(1) To submit appropriate requests/applications and the required
supplemental materials;
(2) To attend meetings to give representation on behalf of the Client.
(3) To authorize access to subject property for the purpose of
environmental review by appropriate regulatory agencies.
This authorization shall continue in effect until completion of the contracted task or
termination by the Client.
Date: U
Agent's Name, Address & Telephone: Signature of Client:
WithersRavenel, Inc. u?
( me -Print) (Title)
115 MacKenan Drive
Cary, NC 27511 (5ignat e)
Tel. [phone] v S ?r�
Mailing Address
Ws kit-"
City State Zip
Phone: 3� �v r 1343
Email:
115 MacKenan Drive I Cary, NC 27511
919.469.3340 1 f: 919.467.6008 www.wlthersravenel.com I License No. C-0832
Cary { Greensboro Pittsboro I Raleigh I Wilmington

::WithersRavenel
Our People. Your Success.
ACCESS AUTHORIZATION
BUHLER AEROGLIDE CORP

\/ WithersRavenel
,/ Our People. Your Success
AUTHORIZATION FOR PROPERTYAQCESS
The undersigned owner(s), BuhlerAerogiide Corporation, do(es) hereby authorize WithersRavenel, Inc.
to access the ±10 acre parcel, Wake Co. PIN: 0774435032, located at 100 Aeroglide Drive, Cary, NC
27511 for the purpose of environmental regulatory agency review (USArmy Corps of Engineers, NC
Division of Water Quality, NC Division of Coastal Management, US Fish and Wildlife Service, local
Municipalities, etc.) and approvals (i.e. wetland delineation, stream/buffer determination,
environmental permitting, etc.) under the following conditions:
1. WithersRavenel, Inc. will at all times keep dear of obstruction(s) and/or impasse at least one (1)
lane of current property owner(s)' gravel truck road; and
2. WithersRavenel, Inc. agreesto indemnifyand hold harmlesscurrent property owner(s) from any
loss, damage, expense, attorney fees, or liability by reason of property damage or personal
injury of whatsoever nature or kind, arising out of or resulting from the fulfillment of this
authorization. WithersRavenel, Inc. shall maintain commercial general liability, product liability,
and workers compensation insurance sufficient to cover the indemnification requirement
hereunder. WithersRavenel, Inc. shall be responsible for loss or destruction or damage to
property of current property owner(s) caused by the negligence or wrongful acts or omissions
of WithersRavenel, Inc., its employees, agents and subcontractors.
This authorization does not bind the current property owner(s) to financial responsibility for services
rendered on the subject property by WithersRavenel, Inc.
This authorization shall continue in effect until completion/ termination of the project for the subject
property or until otherwise withdrawn by the property owner(s); however in no event shall this
authorization remain valid past 311 December 2018.
Contract Purchaser's Agent Info:
WithersRavenel, Inc.
115 MacKenan Drive
Cary, NC27511
Tel. [phone]
Date: 30th October 2018
Signature of Owner(s):
Michael Hausfeld Head of Manufacturing
Name — Print Title
k - L��e
Signature
100 Aeroglide Drive
Mailing Address
Cary NC 27511
City State Zip
Phone: [phone]
Email: michael.hausfeld(a�buhlergroup.com

::WithersRavenel
Our People. Your Success.
AERIAL PHOTO

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::WithersRavenel
Our People. Your Success.
USGS QUAD

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QUALITY OIL - HAMPTON INN USGS QUAD (2013) - RALEIGH WEST & CARY 10 Engineers I Planners I Surveyors WithersRavenel
CARY WAKE COUNTY NORTH CAROLINA 11 1

GRAPHIC SCALE
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QUALITY OIL - HAMPTON INN USGS QUAD (2013) - RALEIGH WEST & CARY 40 WithersRavenel
m 1/ Engineers I Planners I Surveyors
CARY WAKE COUNTY NORTH CAROLINA

::WithersRavenel
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WAKE CO. SOIL SURVEY

GRAPHIC SCALE
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QUALITY OIL - HAMPTON INN WAKE CO. SOIL SURVEY (1970) - SHEET 47 WithersRavenel
1/ Engineers I Planners I Surveyors
CARY WAKE COUNTY NORTH CAROLINA

::WithersRavenel
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PHOTO DOCUMENTATION

WithersRavenel
Our People. Your Success.
Frame No. 1:
Description: Fallen trees in the eroded channel
Frame No. 2:
Description: Retaining wall for parking lot falling into the eroded channel
Hampton Inn & Suites — Emergency Stabilization
Photographic Record
WR No. 02180837.00
November 2018

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::WithersRavenel
Our People. Your Success.
PRELI M I NARY J D REQU EST

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 7329 Chapel Hill Road
City, State:
Cary, NC
County: Wake County
Parcel Index Number(s) (PIN): 0774435681
B. REQUESTOR INFORMATION
Name: Martin Richmond - WithersRavenel
Mailing Address: 115 MacKenan Drive
Cary, NC 27511
Telephone Number: 919.271.0368
Electronic Mail Address: [e-mail]
Select one:
I am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant'
❑ Interested Buyer or Under Contract to Purchase
❑ Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: Quality Oil Company, LLC
Mailing Address: 1540 Silas Creek Parkway
Winston-Salem, NC 27127
Telephone Number: 336-408-9303
Electronic Mail Address: [e-mail]
I Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION',4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Martin Richmond - WithersRavenel
Print Name
Capacity: ❑ Owner Z Authorized Agent'
09/20/2018
Date
See attached Agent Authorization Form
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑✓ I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a projector perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:
For NCDOT requests following the current NCDOVUSACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
❑✓ I am requesting that the Corps provide a preliminarX JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
❑ I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area ± 1 •78 acres.
❑✓ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates (Decimal Degrees): Latitude:
Longitude
35.792404°N
-78.748424°W
F7A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
■ Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
ul Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Re ug lato!3 -Permit-
Program/Jurisdiction/
Version: May 2017 Page 5

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

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD:
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Martin Richmond — WithersRavenel; 115 MacKenan
Drive, Cary, NC 27511
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: 7329 Chapel Hill Road
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Wake County City: Cary
Center coordinates of site (lat/long in degree decimal format): Lat.: 35.792404°N Long.: -78.748424°W
Universal Transverse Mercator: NAD83
Name of nearest waterbody: Richlands Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
Latitude (decimal
Longitude
Estimated amount of
Type of aquatic
Geographic authority to
Number
degrees)
(decimal degrees)
aquatic resources in
resources (i.e.,
which the aquatic resource
review area (acreage
wetland vs. non-
"may be" subject (i.e.,
and linear feet, if
wetland waters)
Section 404 or Section
a licable
10/404
Stream 1
35.792329°N
-78.747817°W
471 LF
Non -Wetland
Section 404

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

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources below where
indicated for all checked items:
® Maps, plans, plots or plat submitted by or on behalf of the PJD requestor: M.
Richmond
Map:
❑ Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:_
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name: USGS Quad (2013) — Raleigh West & Cary; 1:24K
® Natural Resources Conservation Service Soil Survey. Citation:Wake Co. Soil Survey (1970) — Sheet 47
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
® Photographs: ®Aerial (Name & Date): Aerial - 2017 (NConemap)
or ❑Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily been
verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of Regulatory
staff member completing PJD
J
Martin Richmond - WithersRavenel
Authorized Agent — 09/20/2018
Signature and date of person
requesting PJD (REQUIRED,
unless obtaining the signature
is impracticable)1
1 Districts may establish timeframes for requester to return signed PJD forms. If the requester does not respond within the
established time frame, the district may presume concurrence and no additional follow up is necessary prior to finalizing
an action.

■■ WithersRavenel
,. Our People. Your Success.
Quality Oil - Hampton Inn
WR Proiect No. 02180837.00
Jurisdictional Determination Request Information
Applicant - John Higgins
Quality Oil Company, LLC.
1540 Silas Creek Parkway
Winston-Salem, NC 27127
Property Owner - Same as Applicant
Physical Address - 7329 Chapel Hill Road
Cary, NC 27607
Written Authorization: See attached Agent Authorization form
Nearest Municipality - Cary
County - Wake County
PIN - Wake Co PIN: 0774435681
Drainage Basin - Neuse River Basin
HUC Code: 03020201
Receiving Waters - Richlands Creek
Stream Index: 27-33-11
Classification: Class C; NSW
Decidegrees - 35.792404°N; -78.748424°W
USGS Quad Map - Raleigh West & Cary Quadrangle (2013)
Soils Map - Wake County Soil Survey - Sheet 47
Total Area - ± 1.78 acres
115 MacKenan Drive I Cary, NC 27511
t: 919.469.3340 1 f: 919.467.6008 www.withersravenel.com I License No. C-0832
Cary I Greensboro Pittsboro I Raleigh I Wilmington

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PIN:0774435681
PIN Ext: 000
Real Estate ID: 0030652
Map Name: 0774 14
Owner: QUALITY OIL COMPANY LLC
HIGGINS, JOHN E
Mail Address 1: 1540 SILAS CREEK PKWY
Mail Address 2: WINSTON SALEM NC 27127-
3758
Mail Address 3:
Deed Book: 007164
Deed Page: 00253
Deed Date: 09/27/1996
Deed Acres: 3.16
Building Value: $119,620
Land Value: $1,031,343
Total Value: $1,150,963
Billing Class: Business
Description: WRAY LD
Heat Area: 0
Site Address: 7329 CHAPEL HILL RD
City: CARY
Township: Cary
Year Built: 0
Sale Price: $0
Sale Date:
Use Type:
Design Style:
Land Class: Acre With Improvement, No House
Old Parcel Number: 519-00000-012A
A
0 110 220 440 ft
1 inch = 200 feet
Disclaimer
Maps makes every effort to produce and publish
the most current and accurate information possible.
However, the maps are produced for information purposes,
and are NOT surveys. No warranties, expressed or implied
,are provided for the data therein, its use,or its interpretation

5/3/2018 Google Maps
-r. 77- Wj
https://www.google.com/maps/@35.7922165,-78.7479586,278m/data=!3m 1 ! 1 e3?hl=en 1 /1

GRAPHICI inch 80 ft.
'� a
0 40 80
♦rim- .�
.J
`r��`.!�• i\hY i.Ld! * iii.. �� '7
�- REVIEW AREA
Lul\' `�/ •• '
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GRAPHIC SCALE
0 40 80
I inch 80ft. 7!WIA
::•_--
u •k - 1 m
pr
Ar
STREAM START
�•�.� AT CULVERT '
F
NOTES:
1) DELINEATION PERFORMED BY WR ON 05/04/2018.
2) STREAM LOCATIONS ARE APPROXIMATE, BASED ON GPS LOCATION,
E WAKE CO. GIS DATA AND TOPOGRAPHIC INTERPRETATION. j
3) THERE ARE NO WETLANDS WITHIN THE REVIEW AREA.
QUALITY OIL - HAMPTON INN WETLAND DELINEATION EXHIBIT 1� WithersRavenel
Engineers I Planners I Surveyors
CARY WAKE COUNTY NORTH CAROLINA

GRAPHIC SCALE
o i000 2000
1 inch = 2000 ft.
r
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QUALITY OIL - HAMPTON INN USGS QUAD (2013) - RALEIGH WEST & CARY 10 Engineers I Planners I Surveyors WithersRavenel
CARY WAKE COUNTY NORTH CAROLINA 11 1

GRAPHIC SCALE
0 75 150
1 inch = 150 ft.
/rE POOx
Jor
mdo1v
z
E REVIEW AREA
E
E
E
E
QUALITY OIL - HAMPTON INN USGS QUAD (2013) - RALEIGH WEST & CARY 40 WithersRavenel
m 1/ Engineers I Planners I Surveyors
CARY WAKE COUNTY NORTH CAROLINA

GRAPHIC SCALE
0 75 150
1 inch = 150 ft.
ft
4
a
I
0
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OW
lk*44
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QUALITY OIL - HAMPTON INN WAKE CO. SOIL SURVEY (1970) - SHEET 47 WithersRavenel
1/ Engineers I Planners I Surveyors
CARY WAKE COUNTY NORTH CAROLINA

::WithersRavenel
Our People. Your Success.
NCDWR BUFFER DETERMINATION LETTER

Water Resources
ENVIRONMENTAL QUA4.ITY
October 5, 2018
.John Higgins -Quality Oil Company, LLC.
1510 Silas Creek Parkway
Winston-Salem, NC 27127
ROY COOPER
Gorentor
MICHAEL S. REGAN
Seereutrt
LINDA CULPEPPER
Interim Director
Subject: Buffer Determination Letter
RRO #18-343
Wake Countv
Determination Type:
Buffer
Intermittent/Perennial
® Neuse (15A NCAC 2B .0233)
Stop@ Soil
Survey
❑ Tar -Pamlico (15A NCAC 213.0259)
❑ Intermittent/Perennial Determination (where local buffer
I
ordinances apply)
❑ Jordan 05A NCAC 213 .0267)
Off ro ert X
(governmental and/or interjurisdictional
projects)
Project Name: Quality Oil -Hampton Inn
Address/Location: 7329 Chapel Hill Rd Cary. NC
Streatn(s): Richlands Creek
Determination Date: October 4, 2018 Staff: Gary Kreiser
Stream E/1/P*
Not
Subject
Subject
I
Start@
Stop@ Soil
Survey
USGS
To o
A
I
I X
Subject at culvert
Off ro ert X
*E111P = Ephemertrl/hrtermlue)tt/Perennicil
Explanation: The stream(s) listed above has been located on the most recent published NRCS Soil Survey of Wake
County, North Carolina and/or the most recent copy of the USGS Topographic map at a 1:24,000 scale. Each
stream that is checked "Not Subject" has been determined to not be at least intermittent or is not present. Streams
that are checked "Subject" have been located on the property and possess characteristics that qualify it to be at least
an intermittent stream. "There may be other streams located on the property that do not show up on the maps
referenced above but may be considered jurisdictional according to the US Army Corps of Engineers.
This on-site determination shall expire five (5) years from the date of this letter. Landowners or affected
parties that dispute a determination made by the DWR may request a determination by the Director. An
appeal request must be made within sixty (60) days of date of this letter. A request for a determination by the
Director shall be referred to the Director in writing. If sending via US Postal Service: c/o Karen Higgins;
D IVR — 401 & Buffer Permitting Unit, 1617 Mail Serviee Center; Raleigh, NC 27699-1617. If sending vitt
delivetl, Service (UPS, FetlE.v, etc.): Karen Higgins; DIVR — 401 & Buffer Permitting Unit, 512 N. Salisbury
Street, Raleigh, NC 27604.
Di%ision ofWater Resources. Raleigh Regional Office, Water Quality Operations Section liup:frportal.iicclenr.orgl%vebi%v-cltaps
1628 Mail Service Center. Raleigh. NC 27699-1628 Phone: [phone]
Location: 3800 Barrett Drive, Raleigh, NC 27609 Fax: [phone]

Quality Oil -Hampton Inn
Wake County
October 5, 2018
Page 2 of 2
This determination is final and binding unless, as detailed above, unless an appeal is requested within sixty
(60) days.
This project may require a Section 4041401 Permit for the proposed activity. Any inquiries should be
directed to the US Army Corp of Engineers (Raleigh Regulatory Field Office) at (919)-554-4884.
fyQu haYe._que,�,tiQns,_regarding this determination, please feel free to contact Gasy Kreiser at (919) 7914241. _
Sincerely, -
4r q��i7�
Danny Smith
Supervisor, Water Quality Regional Operations Center
cc: RRO DWR File Copy
Lyle Phillips, Withers Ravenel (electronic copy), 1phllliys(4withersravenel.com

K_'_
18-343: Quality Oil -Hampton Inn, Wake
A: Subject, Not Depicted
County
Q
,.AAtEo Map provided by NCDEQ
Legend:
eDivision of Water Re-
$`
sources
-Approximate Site boundary: Locations are approxi-
mate and are provided
for reference only ::

18-343: Quality Oil -Hampton Inn, Wake County
o Map provided by NCDEQ
Legend:
Division of Water Resources
Locations are approximate
-Approximate Site boundary: ' and ars
and are provided for
reference only

::WithersRavenel
Our People. Your Success.
NCSAM ASSESSMENT FORM

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name Hampton Inn - Emergency Stabilization Date of Evaluation 10/05/2018
Stream Category Pb1 Assessor Name/Organization 1. Richmond/WithersRaven
Notes of Field Assessment Form (Y/N) NO
Presence of regulatory considerations (Y/N) YES
Additional stream information/supplementary measurements included (Y/N) NO
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream) Intermittent
USACE/
NCDWR
Function Class Rating Summary
All Streams
Intermittent
(1) Hydrology
LOW
LOW
(2) Baseflow
MEDIUM
MEDIUM
(2) Flood Flow
LOW
LOW
(3) Streamside Area Attenuation
LOW
LOW
(4) Floodplain Access
LOW
LOW
(4) Wooded Riparian Buffer
LOW
LOW
(4) Microtopography
NA
NA
(3) Stream Stability
LOW
LOW
(4) Channel Stability
LOW
LOW
(4) Sediment Transport
LOW
LOW
(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
LOW
LOW
(2) Baseflow
MEDIUM
MEDIUM
(2) Streamside Area Vegetation
LOW
LOW
(3) Upland Pollutant Filtration
LOW
LOW
(3) Thermoregulation
LOW
LOW
(2) Indicators of Stressors
YES
YES
(2) Aquatic Life Tolerance
HIGH
NA
(2) Intertidal Zone Filtration
NA
NA
(1) Habitat
LOW
LOW
(2) In -stream Habitat
LOW
LOW
(3) Baseflow
MEDIUM
MEDIUM
(3) Substrate
LOW
LOW
(3) Stream Stability
LOW
LOW
(3) In -stream Habitat
LOW
LOW
(2) Stream -side Habitat
LOW
LOW
(3) Stream -side Habitat
LOW
LOW
(3) Thermoregulation
LOW
LOW
(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
LOW
LOW

user manual version z.i
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5 -minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): Hampton Inn - Emergency Stabilization 2. Date of evaluation: 10/05/2018
3. Applicant/owner name: Quality Oil Company, LLC 4. Assessor name/organization: M. Richmond/WithersRavenel
5. County: Wake County 6. Nearest named water body
7. River Basin: Neuse on USGS 7.5 -minute quad: Richlands Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.792357°N; -78.747756°W
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): #2 10. Length of assessment reach evaluated (feet): 250
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 1 it T- Unable to assess channel depth.
12. Channel width at top of bank (feet): 2.5 ft 13. Is assessment reach a swamp stream? r Yes r No
14. Feature type: r Perennial flow f+ Intermittent flow r Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: fes' Mountains (M) f+ Piedmont (P) r Inner Coastal Plain (1) r Outer Coastal Plain (0)
16. Estimated geomorphic \ /
valley shape (skip for r a �`-�� b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip Size 1 (< 0.1 mi`) r Size 2 (0.1 to < 0.5 mi`) r Size 3 (0.5 to < 5 mi`) r Size 4 (>! 5 mit)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? t. Yes r No If Yes, check all that appy to the assessment area.
F Section 10 water T- Classified Trout Waters E- Water Supply Watershed ( r I r II r III r Iv r v)
i- Essential Fish Habitat r Primary Nursery Area T- High Quality Waters/Outstanding Resource Waters
F_ Publicly owned property j NCDWR riparian buffer rule in effect r7 Nutrient Sensitive Waters
T- Anadromous fish T- 303(d) List T- CAMA Area of Environmental Concern (AEC)
r Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
F- Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? r Yes P No
1. Channel Water- assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
is 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
r A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
(: B Not A
3. Feature Pattern - assessment reach metric
A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
B Not A.
4. Feature Longitudinal Profile - assessment reach metric
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).
fes' B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
r A < 10% of channel unstable
r B 10 to 25% of channel unstable
f* C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
r A r 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 adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
P C f: C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reach/intertidal zone metric

Check all that apply.
I- A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
r✓ B Excessive sedimentation (burying of stream features or intertidal zone)
r- 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 the "Notes/Sketch"
section.
r" F Livestock with access to stream or intertidal zone
r G Excessive algae in stream or intertidal zone
r- H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
r- 1 Other: (explain in "Notes/Sketch" section)
F J Little to no stressors
8. Recent Weather -watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
(- A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
C B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
(: C No drought conditions
9 Large or Dangerous Stream - assessment reach metric
r Yes (. No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types - assessment reach metric
10a. t: 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 -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
I- A Multiple aquatic macrophytes and aquatic mosses a N r- F 5% oysters or other natural hard bottoms
(include liverworts, lichens, and algal mats) F m r- G Submerged aquatic vegetation
r- B Multiple sticks and/or leaf packs and/or emergent $ r' a r H Low -tide refugia (pools)
vegetation t `o j I Sand bottom
f- C Multiple snags and logs (including lap trees) r M r- J 5% vertical bank along the marsh
r- D 5% undercut banks and/or root mats and/or roots 02 r K Little or no habitat
in banks extend to the normal wetted perimeter
f✓ 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. rYes (: No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11b. Bedform evaluated. Check the appropriate box(es).
F A Riffle -run section (evaluate 11c)
I- B Pool -glide section (evaluate 11 d)
r C Natural bedform absent (skip to Metric 12, Aquatic Life)
11c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach - whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) _
absent, Raire (R) = present but <- 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
r r r r r Bedrock/saprolite
r r r r r Boulder (256 - 4096 mm)
r r r r r Cobble (64 - 256 mm)
r r r r r Gravel (2 - 64 mm)
r r r r r Sand (.062 - 2 mm)
r r r r f Silt/clay (< 0.062 mm)
r r r r r Detritus
r r r r r Artificial (rip -rap, concrete, etc.)
11d. r Yes r No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. r~ Yes (: No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. r No Water f: Other: no habitat I
12b. (- Yes (: No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
I >1 Numbers over columns refer to "individuals" for size 1 and 2 streams and 'taxa" for size 3 and 4 streams.
r- r Adult frogs
F_ I` Aquatic reptiles
r- r- Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
r- r- Beetles (including water pennies)
I- r Caddisfly larvae (Trichoptera [T])
r- Asian clam (Corbicula )
r r- Crustacean (isopod/amphipod/crayfish/shrimp)
r r Damselfly and dragonfly larvae
F_ [- Dipterans (true flies)
F r- Mayfly larvae (Ephemeroptera [E])
F r- Megaloptera (alderfly, fishfly, dobsonfly larvae)
F r- Midges/mosquito larvae
F I Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
r- r Mussels/Clams (not Corbicula )

F F Other fish
r r Salamanders/tadpoles
i r— Snails
r
r— Stonefly larvae (Plecoptera [P])
F r Tipulid larvae
F_ r" Worms/leeches
13. Streamside Area Ground Surface Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
RB
LB
RB
r" A
r-' A
r A
Little or no alteration to water storage capacity over a majority of the streamside area
r-' B
r B
Moderate alteration to water storage capacity over a majority of the streamside area
(: C
r: C
Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
Maintained shrubs
r+ E
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
r-' A r A Majority of streamside area with depressions able to pond water > 6 inches deep
r-' B I"` B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
r: C r: C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
r-' Y r" Y Are wetlands present in the streamside area?
r: 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 and draining to the assessment reach.
Streams and/or springs (jurisdictional discharges)
Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
Stream bed or bank soil reduced (dig through deposited sediment if present)
None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
r A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
r B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
r- C Urban stream (>_ 24% impervious surface for watershed)
i✓ D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
F E Assessment reach relocated to valley edge
[— F None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
r-' 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
r A I"` A r"' A r"' A > 100 -feet wide or extends to the edge of the watershed
r" B r" B r" B r" B From 50 to < 100 -feet wide
6 C r" C r C r" C From 30 to < 50 -feet wide
r-' D r D r" D r D From 10 to < 30 -feet wide
r: E r: E IT. E G E < 10 -feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB
RB
LB
r" A
r" A
Mature forest
r-' B
r B
Non -mature woody vegetation or modified vegetation structure
r-' C
r C
Herbaceous vegetation with or without a strip of trees < 10 feet wide
r-' D
r D
Maintained shrubs
r+ E
r: E
Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: iv
Abuts < 30 feet 30-50 feet
LB
RB
LB
RB
LB
RB
^ A
r-' A
r-' A
r-' A
r-' A
r-' A
Row crops
^ B
r-' B
r-' B
r-' B
r-' B
r-' B
Maintained turf
C
r" C
r C
r" C
r" C
r" C
Pasture (no livestock)/commercial horticulture
r D
r" D
r D
r" D
r" 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
C A f"' A Medium to high stem density
C B f"' B Low stem density
r" C (: C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)
Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10 -feet wide.
LB RB
r A f"' A The total length of buffer breaks is < 25 percent.
r B r B The total length of buffer breaks is between 25 and 50 percent.
�' C IT. 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 A r A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
r B r B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
{: C r: C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity— assessment reach metric (skip for all Coastal Plain streams)
25a. r Yes IT. No Was a conductivity measurement recorded?
If No, select one of the following reasons. r No Water r Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
r A <46 f"' B 46 to < 67 f"' C 67 to < 79 r D 79 to < 230 f"' E ? 230
Notes/Sketch:

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CURRENT USE: INDUSTRIAL
Hampton Inn & Suites
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\
EXHIBIT
ENVIRONMENTAL IMPACT
PROJECT LOCATION/SITE MAP
WNER
QUALITY OIL COMPANY LLC
1540 Silas Creek Parkway
P.O. Box 2736
Winston Salem, NC 27102.2736
ATTN: Rodney S. Cheek, PE
TEL [phone]
PROPOSED STREAM AND
RIPARIAN BUFFER IMPACT
SHEET 1,2 OF 3
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Engineers I Planners I Surveyors
115 MacKenan Drive Cary, NC 27511 It: 919.469-33401 license #:C-08321 www.withersravenel.com
Sheet No.
1 of 31

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CB 20025
ono RIM C�: 79.31'
INV. 24' RCP IN(2006% 475.06'
INV. OUT(20078): 474.45' CB 20040)
RIM( BC): 476.29'
INV. 24 RCP IN(20025): 471.79'
OUT(20040): 471.67' CB 020051
INV. 24Q
P4 N(20040): 468.42'
EX 24" RCP INV. OUT(20012): 468.29'
EX 24" RCP
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Na. Revision By I DesignerScale Sheet No.
Drawn By Date
WR -3 Hampton Inn & Suites EXHIBIT WithersRavenel
dw 2018.11.01 Quality Oil Company LLC STREAM IMPACT MAP 1 Engineers I Planners I Surveyors 2 Of 3
Checked By Job No.
dw 2180837.00 Town of Cary Wake County North Carolina 115 MacKenan Drive Cary, NC 27511 It: 919.469-33401 license #:C-08321 www.withersravenel.com

CB zoozs�
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INV. 24' RCP IN(20060): 475.06' `
INV. OUT(20078): 474.45' CB IBC
BC,: 476.29'
INV. 24 RCP IN(20025): 471.79'
INV. OUT(20040): 471.67'
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IMPACT 2
PERMANENT BUFFER IMPACT
ZONE 1: 20,750 S.F
ZONE 2:7,600 S.F.
Impact Justification Statement
PRELIMINARY
NOT APPROVED FOR CONSTRUCTION
The purpose of this proposed buffer and stream impact is to install infrastructure
necessary to repair an existing eroded and degraded stream channel and protect
existing building and parking lot infrastructure from damage. Due to the location
of the existing stream, impact avoidance cannot be achieved.
All construction shall be in accordance with the Town of Cary, NCDEQ and
USACOE applicable standards and specifications.
Na. Revision DesignerScale Sheet No.
WR -3
Drawn By Date Hampton Inn & Suites EXHIBIT WithersRavenel
dw 2o,a.,,.o, Quality Oil Company LLC RIPARIAN BUFFER IMPACT MAP 2 Engineers I Planners I Surveyors 3 of 3
Checked By Job No.
dw 2180837 00 Town of Cary Wake County North Carolina 115 MacKenan Drive Cary, NC 27511 It: 919.469-33401 license #:13-08321 www.withersravenel.cOm