20200782 Ver 1_Old PCN_20200612

S&ME, INC. / 9751 Southern Pine Blvd / Charlotte, NC 28273 /p 704.523.4726 f 704.525.3953 / www.smeinc.com
December 21, 2017
U.S. Army Corps of Engineers
Washington Regulatory Field Office
2407 West Fifth Street Washington, NC 27889
Attention:Ms. Rachel Capito
NC Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention:Ms. Jennifer Burdette
Reference: Pre-Construction Notification: NWP No. 18/WQC No. 4139
PNG Line 204 – Gum Branch Road Project
Jacksonville, North Carolina
S&ME Project No. 7435-17-012
Dear Ms. Capito:
On behalf of Piedmont Natural Gas (PNG), S&ME, Inc. (S&ME) hereby submits this Pre-Construction
Notification (PCN) for temporary and permanent impacts to waters of the U.S. in accordance with
Nationwide Permit (NWP) No. 18 and the corresponding North Carolina Water Quality Certification (WQC)
No. 4139. PNG, the project sponsor, will be considered the applicant. The project entails construction of
a launcher/receiver station associated with one of their existing natural gas pipelines in Onslow County,
N.C.
In support of this application, please find enclosed the following:
•Figures: Site Vicinity Exhibit (Figure 1), USGS Topographic Exhibit (Figure 2), Onslow County Soils
Exhibit (Figures 3) and an Approximate Waters of the US Exhibit (Figure 4)
•Appendix I: Preliminary Jurisdictional Delineation Information
•Appendix II: Site Photographs
•Appendix III: Completed Pre-Construction Notification (PCN) and Agent Authorization Form
•Appendix IV: Impact Drawing
•Appendix V: Agency Scoping Information
•Appendix VI: Restoration Plan
A copy of this PCN is being provided to the N.C. Division of Water Resources as a courtesy. The project as
proposed should comply with the relevant conditions of General Water Quality Certification No. 4139,
and as such, does not require pre-construction written approval.
Pre-Construction Notification S&ME Project No. 7435-17-012
PNG Line 204 Gum Branch Road Project December 21, 2017
2
The activities described in this submittal will result in both temporary and permanent wetland impacts.
The temporary impacts (0.044 acre) are limited to herbaceous wetlands located within PNG’s existing,
maintained easement. The permanent impacts (0.053 acre) will occur from clearing and placement of fill
material within a forested wetland. Cumulatively, both the temporary and permanent impacts do not
exceed 0.10 acre.
♦General Project Information
PNG is planning to construct a “Launcher/Receiver” facility adjacent to the Line 204 natural gas
transmission pipeline and mainline valve station on the south side of Gum Branch Road in Jacksonville,
Onslow County, North Carolina (34.804616°N, -77.442841°W). The location of the project area is depicted
on the attached Site Vicinity Exhibit (Figure 1), the appropriate portion of the 1978 Jacksonville North, NC
USGS Topographic Map (Figure 2), and an Onslow County Soils Exhibit (Figure 3).
The purpose of the new facility is to accommodate the insertion and retrieval of an in-line inspection
device (ILID). Operation and maintenance of PNG’s pipeline system is subject to extensive state and
federal regulations and requirements. At the Federal level, these regulations fall under the Department of
Transportation (DOT). As a result of current Federal DOT requirements, all pipeline owners, including
PNG, are required to inspect and assess the safety and integrity of transmission pipelines on an ongoing
basis through the use of specific pipeline assessment tools. One of the assessment tools required by DOT
is the use of an ILID. Such devices physically travel through the pipeline, continuously taking
measurements and recording data that allow the pipeline to be assessed in terms of its structural integrity
and to identify any areas that require further inspection, assessment, and potential repair or remediation.
To make Line 204 compatible with the use of an ILID and meet DOT inspection and assessment
requirements, PNG plans to construct the new aboveground facility that will accommodate the ILID’s
insertion into and removal from the pipeline. The station will consist of a gravel pad and some
aboveground piping. The gravel pad is necessary to accommodate the vehicular access and equipment
staging that is necessary during ILI operations, and will be surrounded by a new chainlink fence.
♦Existing Environment
The project area is located within the Coastal Plain Physiographic Province of North Carolina. Topography
in the area is generally flat, but slopes very gradually to the east and an off-site stream. The northern
portion of the project area contains the existing Line 204 natural gas transmission easement and an
aboveground mainline valve. The remainder of the project area is vegetated with approximately 8-10
year-old trees – primarily loblolly pine (Pinus taeda) and sweetgum (Liquidambar styraciflua).
On April 12, 2017, S&ME personnel visited the proposed project site to delineate jurisdictional surface
waters located therein. We followed the procedures set forth in the 1987 USACE Wetlands Delineation
Manual. Conditions were documented using USACE Routine Wetland Determination Data Forms, as
appropriate. Two similar wetland areas (WA and WB), both classified as headwater wetlands based on NC
Wetland Assessment Methodology, were identified within the project area (Figure 4). Portions of WA and
WB that are located within the regularly-maintained gasline easement are vegetated with herbaceous
species such as soft rush (Juncus effuses) and shallow sedge (Carex lurida). Overstory species observed
within the forested areas included sweetgum, loblolly pine and red maple (Acer rubrum). Herbaceous
species included shallow sedge, soft rush, netted chain fern (Woodwardia areolate) and cinnamon fern
(Osmunda cinnomoea).
Pre-Construction Notification S&ME Project No. 7435-17-012
PNG Line 204 Gum Branch Road Project December 21, 2017
3
Soils within the wetland area were hydric and exhibited a depleted matrix. Hydrologic indicators included
areas of shallow standing water, water-stained leaves and drainage patterns. A Request for Preliminary
Jurisdictional Determination is included in Appendix I,and photographs of conditions at the site are
included in Appendix II.
♦Description of the Proposed Work and Impacts
A gravel access road will be constructed over a portion of Wetland A located within PNG’s existing Line
204 easement. The road will be 20 feet wide and appropriately culverted such that the normal flow and
circulation patterns of the wetland are not otherwise inhibited. The station site will consist of a gravel pad
and some above ground piping that will serve to insert and retrieve the ILID device. The gravel pad was
sized to safely accommodate the vehicular access and equipment staging that is necessary during ILID
operations, and to avoid a 50-foot stream buffer associated with an off-site tributary. A chain link fence
will be constructed around the pad.
Table 1: Summary of Stream and Wetland Impacts
Wetland ID
Proposed Impact
Temporary Permanent
Square Feet Acre Square Feet Acre
WA 740 0.017 292 0.007
WB 1,172 0.027 2,019 0.046
TOTAL:1,912 0.044 2,311 0.053
As indicated, the project will result in permanent impacts to 2,311 square feet (0.053 acre) of wetlands
through placement of clean earthen fill material and gravel. Approximately 1,912 square feet (0.044 acre)
of wetland located within PNG’s existing Line 204 easement may be temporarily impacted during
construction operations. The permanent wetland impacts associated with the proposed project will result
from grading and placement of fill material sufficient to provide a level surface and accommodate
construction of the new facility and access road. Following construction, temporarily disturbed wetlands
within the existing easement will be restored to their original grade and contour and seeded with a native
wetland seed mix.
The completed PCN Form and Agent Authorization Form are included in Appendix III. A drawing that
depicts the proposed disturbance limits and impacts to the wetlands is included on Sheet 01 by RLS Land
Surveying, Inc., and the locations of the piping and launcher/receiver are shown on Drawing No. PNG-M-
204-0001045, both in Appendix IV.
♦Protected Species
To comply with applicable sections of the Endangered Species Act (ESA) of 1973 (16 USC 1531-1543),
S&ME conducted a search of the North Carolina Natural Heritage Program (NCNHP) database to identify
element occurrences (EOs) of such species listed as potentially occurring near the project site. A report
generated from the findings of the NCNHP database review (Appendix V) indicated that there are no
documented occurrences of federally-protected species within one mile of the project area. S&ME also
Pre-Construction Notification S&ME Project No. 7435-17-012
PNG Line 204 Gum Branch Road Project December 21, 2017
4
reviewed the relevant U.S. Fish and Wildlife Service (USFWS) species descriptions pursuant to
identification of potentially suitable habitat within the project area. Review of the NCNHP database
identified the following documented occurrences of federally-protected species in Onslow County:
Table 2: Federally-Protected Species Summary
T (S/A) = Threatened due to Similarity of Appearance, BGPA = Bald and Golden Eagle Protection Act, E = Endangered, T= Threatened
Scoping letters detailing the proposed project were also provided to the FWS and the NC Wildlife
Resources Commission (WRC) on November 1, 2017. The FWS responded with a November 30, 2017
letter stating that, based on their review of the proposed project, it appears that federally-protected
species or their critical habitat will not be affected, and that requirements of Section 7(a)(2) of the ESA
have been satisfied. No response from WRC was received.
Field assessments for the presence of federally-protected terrestrial species listed in Table 2 were also
conducted by S&ME in April and August 2017. Given that the site does not contain waterbodies,
assessment for the aquatic species listed above was not conducted. Suitable habitat for the terrestrial
species identified in Table 2 was not observed on-site.
Copies of the FWS letter and NCNHP database report is included in Appendix V.
♦Historic Resources
Projects requiring a federal permit must also comply with Section 106 of the National Historic
Preservation Act (NHPA) of 1966. Review of the NC State Historic Preservation Office (SHPO) GIS
database indicated that the nearest site listed or eligible for listing on the National Register of Historic
Places is located over three miles from the project site. It is our understanding that the USACE will
complete coordination with SHPO prior to issuance of the requested permit.
Scientific Name Common Name Federal Status County Status
Alligator mississippiensis American Alligator T (S/A)Current
Haliaeetus leucocephalus Bald Eagle BGPA Current
Chelonia mydas Green Sea Turtle T Current
Eretmochelys imbricata Hawksbill Sea Turtle E Historic
Lepidochelys kempii Kemp’s Ridley Sea Turtle E Current
Dermochelys coriacea Leatherback Sea Turtle E Current
Caretta caretta Loggerhead Sea Turtle T Current
Charadrius melodus Piping Plover T Current
Picoides borealis Red-cockaded Woodpecker E Current
Calidris canutus rufa Red Knot T Current
Trichechus manatus West Indian Manatee E Current
Thalictrum cooleyi Colley’s meadowrue E Current
Carex lutea Golden sedge E Current
Lindera melissifolia Pondberry E Current
Lysimachia asperulaefolia Rough-leaved loosestrife E Current
Amaranthus pumilis Seabeach amaranth T Current
Pre-Construction Notification S&ME Project No. 7435-17-012
PNG Line 204 Gum Branch Road Project December 21, 2017
5
♦Avoidance and Minimization
The project area has been limited to the minimum amount considered necessary to safely accommodate
the new station and all of the support equipment that will be required during the ILID events. A proposed
flaring site (a gas-venting operation required prior to the ILID event) was originally planned for a 100-foot
x 100-foot area adjacent to the current project area. The proposed flare site would have resulted in
additional wetland impacts, but was eliminated. Impacts have been minimized by PNG’s use of an
existing easement and a formerly disturbed area, limiting impacts to forested wetlands, and by use of
appropriate sediment and erosion control measures during construction. Following construction,
temporarily disturbed wetlands within the existing easement will be restored to their original grade and
contour and seeded with a native wetland seed mix (Appendix VI).
The project will result in a loss of 0.053 acre wetlands. The remaining 0.044 acre of wetland impacts are
temporary. Mitigation has been provided by avoidance and minimization procedures implemented
during the design phase of the proposed project. Because the project will not result in impacts to greater
than 0.10 acre of wetlands, we do not anticipate that compensatory mitigation will be required.
♦Closing
Thank you for your review of this PCN. If you have questions or need additional information, please feel
free to contact us at 704.523.4726.
Sincerely,
S&ME
Joey Lawler, P.W.S.
Project Manager
Senior Review by Christopher J.L. Stahl, P.E.
Cc:
•Jeff Smith - RLS
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SCALE:
DATE:
PROJECT NUMBER
FIGURE NO.
11 " = 3,000 '
12-20-17
7435-17-012PNG LINE 204 GUM BRANCH ROAD SITEJACKSONVILLE, NCDrawing Path: Q:\7435\17\012 Line 204 Retrofit\GumBranch\1-Vicinity.mxd plotted by JLawler 12-20-20170 1 2 Miles
SITE VICINITY EXHIBIT
³
REFERENCE:GIS BASE LAYERS WERE OBTAINED FROM ESRI, RLS AND/OR COUNTY GIS DATA. THIS MAPIS FOR INFO RMATIONAL PURPOSES ONLY. ALL FEATURE LOCATIONS DISPLAYED AREAPPROXIMATED, AND NOT BASED ON CIVIL SURVEY INFORMATION, UNLESS STATEDOTHERWISE.
1978 JACKSOVIL LE NO RTH, NC USG S TOPOGRAPHIC MAP
GUM BRANCHMAYNAR DCopyright:© 2013 National Geographic Society, i-cubedProject Are a
SCALE:
DATE:
PROJECT NUMBER
FIGURE NO.
21 " = 300 '
12-20-17
7435-17-012PNG LINE 204 GUM BRANCH ROAD SITEJACKSONVILLE, NCDrawing Path: Q:\7435\17\012 Line 204 Retrofit\GumBranch\2-Topo.mxd plotted by JLawler 12-20-20170 100 200(FE ET)
USGS TOPOGRAPHIC MAP EXHIBIT
³
REFERENCE:GIS BASE LAYERS WERE OBTAINED FROM ESRI, RLS AND/OR COUNTY GIS DATA. THIS MAPIS FOR INFO RMATIONAL PURPOSES ONLY. ALL FEATURE LOCATIONS DISPLAYED AREAPPROXIMATED, AND NOT BASED ON CIVIL SURVEY INFORMATION, UNLESS STATEDOTHERWISE.
1978 JACKSOVIL LE NO RTH, NC USG S TOPOGRAPHIC MAP
GUM BRANCHMAYNARD
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SCALE:
DATE:
PROJECT NUMBER
FIGURE NO.
31 " = 200 '
12-20-17
7435-17-012PNG LINE 204 GUM BRANCH ROAD SITEJACKSONVILLE, NCDrawing Path: Q:\7435\17\012 Line 204 Retrofit\GumBranch\3-Soils.mxd plotted by JLawler 12-20-20170 100 200(FE ET)
ONSLOW COUNTY SOILS EXHIBIT
³
REFERENCE:GIS BASE LAYERS WERE OBTAINED FROM ESRI, RLS AND/OR COUNTY GIS DATA. THIS MAPIS FOR INFO RMATIONAL PURPOSES ONLY. ALL FEATURE LOCATIONS DISPLAYED AREAPPROXIMATED, AND NOT BASED ON CIVIL SURVEY INFORMATION, UNLESS STATEDOTHERWISE.
WA - 0.02 ACREWB - 0.07 ACREGUM BRANCH
NC OneMap, NC Center for Geographic Information and Analysis, NC 911Board
Project Are a
Existing Easemen ts
Existing Gas L ine
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Contours
SCALE:
DATE:
PROJECT NUMBER
FIGURE NO.
41 " = 40 '
12-20-17
7435-17-012PNG LINE 204 GUM BRANCH ROAD SITEJACKSONVILLE, NCDrawing Path: Q:\7435\17\012 Line 204 Retrofit\GumBranch\4 - Aerial - REV.mxd plotted by JLawler 12-20-20170 50 100(FE ET)
APPROXIMATE WATERS OF THE US ³REFERENCE:GIS BASE LAYERS WERE OBTAINED FROM ESRI, RLS AND/OR COUNTY GIS DATA. THIS MAPIS FOR INFO RMATIONAL PURPOSES ONLY. ALL FEATURE LOCATIONS DISPLAYED AREAPPROXIMATED. JURISDICTIONAL BOUNDARIES HAVE NOT BEEN VERIFIED BY THE USACE,AND ARE NOT BASED ON CIVIL SURVEY INFORMATION, UNLESS STATED OTHERWISE.
Appendix I
Preliminary Jurisdictional Delineation Information
Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD)
FORM BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD:12/21/2017
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Joey Lawler of S&ME, Inc.
9751 Southern Pine Blvd., Charlotte, NC 28273
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Onslow Co. City: Jacksonville
Center coordinates of site (lat/long in degree decimal format):
Lat.: 34.804430° Long.: -77.443181°
Universal Transverse Mercator: NAD83
Name of nearest waterbody: UT to New River
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALTHAT APPLY): Office (Desk)
☐ Determination. Date:
☐ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH “MAY BE” SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e.,
wetland vs. non-
wetland waters)
Geographic authority
to which the aquatic
resource “may be”
subject (i.e., Section
404 or Section 10/404)
WA 34.804793° -77.443276° 0.02 ac Wetland Section 404
WB 34.804519° -77.443051° 0.07 ac 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 finds that there “may be” waters of the U.S. and/or that there “may be”
navigable waters of the U.S. on the subject review area, and identifies all aquatic
features in the review area that could be affected by the proposed activity, based on
the following information:
SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply - checked items should
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: 1978 Jacksonville North, NC USGS
topographic quadrangle, 1:24,000 scale.
USDA Natural Resources Conservation Service Soil Survey. Citation: 1992 USDA-SCS published
Soil Survey of Onslow County, North Carolina.
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): 2016 NCOneMap aerial orthoimagery layer.
or Other (Name & Date): Site photos taken April 2017.
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 Signature and date of
Regulatory Project Manager person requesting preliminary JD
(REQUIRED) (REQUIRED, unless obtaining the signature is
impracticable)1
1 Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not
respond within the established time frame, the district may presume concurrence and no additional follow up
is necessary prior to finalizing an action.
Jurisdictional Determination Request
Version: May 2017 Page 1

This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www.saw.usace.army.mil/Missions/RegulatoryPermitProgram/Contact/CountyLocator.aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.

ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]

RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]

WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]

INSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D – PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Jurisdictional Determination Request
Version: May 2017 Page 2
A. PARCEL INFORMATION
Street Address: _______________________________________________
City, State: _______________________________________________
County:
Parcel Index Number(s) (PIN):
B. REQUESTOR INFORMATION
Name:
Mailing Address:
_________________________________________
Telephone Number: _________________________________________
Electronic Mail Address: ________________________________________
Select one:
I am the current property owner.
I am an Authorized Agent or Environmental Consultant1
Interested Buyer or Under Contract to Purchase
Other, please explain. ________________________________________
__________________________________________________________
C. PROPERTY OWNER INFORMATION2
Name:
Mailing Address:
Telephone Number:
Electronic Mail Address:
_______________________________________________________________________________________________________________________
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Jurisdictional Determination Request
Version: May 2017 Page 3

D. PROPERTY ACCESS CERTIFICATION3,4

By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.

Print Name
Capacity: Owner Authorized Agent5

Date

Signature

E. REASON FOR JD REQUEST: (Check as many as applicable)

I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a project or 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 project or 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 project or 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:___________________________________________________________________
_______________________________________________________________________
3 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 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).
Jurisdictional Determination Request
Version: May 2017 Page 4

F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)

I am requesting that the Corps provide a preliminary JD for the property identified herein.

A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be “waters of the United States” or “navigable waters of the United States”on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional “waters of
the United States”. PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
“preliminary” in the sense that an approved JD can be requested at any time. PJDs do
not expire.

I am requesting that the Corps provide an approved JD for the property identified herein.

An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional “waters of the United States” or “navigable waters of the United
States” are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other “affected
party” (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).

I am unclear as to which JD I would like to request and require additional information
to inform my decision.

G. ALL REQUESTS

Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.

Size of Property or Review Area acres.

The property boundary (or review area boundary) is clearly physically marked on the site.

Jurisdictional Determination Request
Version: May 2017 Page 5

H. REQUESTS FROM CONSULTANTS

Project Coordinates (Decimal Degrees): Latitude: ______________________
Longitude: ______________________

A 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.

Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)

____________________________________________________________________________
6 Please refer to the guidance document titled “Survey Standards for Jurisdictional Determinations” to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Jurisdiction/
Jurisdictional Determination Request
Version: May 2017 Page 6

Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form7 and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Form8

Vicinity Map

Aerial Photograph

USGS Topographic Map

Soil Survey Map

Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)

Landscape Photos (if taken)

NCSAM and/or NCWAM Assessment Forms and Rating Sheets

NC Division of Water Resources Stream Identification Forms

Other Assessment Forms

_____________________________________________________________________________
7 www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/JD/RGL_08-02_App_A_Prelim_JD_Form_fillable.pdf
8 Please see http://www.saw.usace.army.mil/Missions/Regulatory-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.
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
WETLAND DETERMINATION DATA FORM – Atlantic and Gulf Coastal Plain Region

Project/Site: City/County: Sampling Date:
Applicant/Owner: State: Sampling Point:
Investigator(s): Section, Township, Range:
Landform (hillslope, terrace, etc.): Local relief (concave, convex, none): Slope (%):
Subregion (LRR or MLRA): Lat: Long: Datum:
Soil Map Unit Name: NWI classification:
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed? Are “Normal Circumstances” present? Yes No
Are Vegetation , Soil , or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS – Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No
Hydric Soil Present? Yes No
Wetland Hydrology Present? Yes No
Is the Sampled Area
within a Wetland? Yes No
Remarks:

HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply) Surface Soil Cracks (B6)
Surface Water (A1) Aquatic Fauna (B13) Sparsely Vegetated Concave Surface (B8)
High Water Table (A2) Marl Deposits (B15) (LRR U) Drainage Patterns (B10)
Saturation (A3) Hydrogen Sulfide Odor (C1) Moss Trim Lines (B16)
Water Marks (B1) Oxidized Rhizospheres along Living Roots (C3) Dry-Season Water Table (C2)
Sediment Deposits (B2) Presence of Reduced Iron (C4) Crayfish Burrows (C8)
Drift Deposits (B3) Recent Iron Reduction in Tilled Soils (C6) Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (B4) Thin Muck Surface (C7) Geomorphic Position (D2)
Iron Deposits (B5) Other (Explain in Remarks) Shallow Aquitard (D3)
Inundation Visible on Aerial Imagery (B7) FAC-Neutral Test (D5)
Water-Stained Leaves (B9) Sphagnum moss (D8) (LRR T, U)
Field Observations:
Surface Water Present? Yes No Depth (inches):
Water Table Present? Yes No Depth (inches):
Saturation Present? Yes No Depth (inches):
(includes capillary fringe)

Wetland Hydrology Present? Yes No
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:

Remarks:

US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
VEGETATION (Four Strata) – Use scientific names of plants. Sampling Point:
Absolute Dominant Indicator
Tree Stratum (Plot size: ) % Cover Species? Status
1.
2.
3.
4.
5.
6.
7.
8.
= Total Cover
50% of total cover: 20% of total cover:
Sapling/Shrub Stratum (Plot size: )
1.
2.
3.
4.
5.
6.
7.
8.
= Total Cover
50% of total cover: 20% of total cover:
Herb Stratum (Plot size: )
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
= Total Cover
50% of total cover: 20% of total cover:
Woody Vine Stratum (Plot size: )
1.
2.
3.
4.
5.
= Total Cover
50% of total cover: 20% of total cover:
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: (A)

Total Number of Dominant
Species Across All Strata: (B)

Percent of Dominant Species
That Are OBL, FACW, or FAC: (A/B)

Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
UPL species x 5 =
Column Totals: (A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
1 - Rapid Test for Hydrophytic Vegetation
2 - Dominance Test is >50%
3 - Prevalence Index is ≤3.01
Problematic Hydrophytic Vegetation1 (Explain)

1Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:

Tree – Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.

Sapling/Shrub – Woody plants, excluding vines, less
than 3 in. DBH and greater than 3.28 ft (1 m) tall.

Herb – All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.

Woody vine – All woody vines greater than 3.28 ft in
height.

Hydrophytic
Vegetation
Present? Yes No

Remarks: (If observed, list morphological adaptations below).
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
SOIL Sampling Point:
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type1 Loc2 Texture Remarks

1Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains. 2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators: (Applicable to all LRRs, unless otherwise noted.) Indicators for Problematic Hydric Soils3:
Histosol (A1) Polyvalue Below Surface (S8) (LRR S, T, U) 1 cm Muck (A9) (LRR O)
Histic Epipedon (A2) Thin Dark Surface (S9) (LRR S, T, U) 2 cm Muck (A10) (LRR S)
Black Histic (A3) Loamy Mucky Mineral (F1) (LRR O) Reduced Vertic (F18) (outside MLRA 150A,B)
Hydrogen Sulfide (A4) Loamy Gleyed Matrix (F2) Piedmont Floodplain Soils (F19) (LRR P, S, T)
Stratified Layers (A5) Depleted Matrix (F3) Anomalous Bright Loamy Soils (F20)
Organic Bodies (A6) (LRR P, T, U) Redox Dark Surface (F6) (MLRA 153B)
5 cm Mucky Mineral (A7) (LRR P, T, U) Depleted Dark Surface (F7) Red Parent Material (TF2)
Muck Presence (A8) (LRR U) Redox Depressions (F8) Very Shallow Dark Surface (TF12)
1 cm Muck (A9) (LRR P, T) Marl (F10) (LRR U) Other (Explain in Remarks)
Depleted Below Dark Surface (A11) Depleted Ochric (F11) (MLRA 151)
Thick Dark Surface (A12) Iron-Manganese Masses (F12) (LRR O, P, T) 3Indicators of hydrophytic vegetation and
Coast Prairie Redox (A16) (MLRA 150A) Umbric Surface (F13) (LRR P, T, U) wetland hydrology must be present,
Sandy Mucky Mineral (S1) (LRR O, S) Delta Ochric (F17) (MLRA 151) unless disturbed or problematic.
Sandy Gleyed Matrix (S4) Reduced Vertic (F18) (MLRA 150A, 150B)
Sandy Redox (S5) Piedmont Floodplain Soils (F19) (MLRA 149A)
Stripped Matrix (S6) Anomalous Bright Loamy Soils (F20) (MLRA 149A, 153C, 153D)
Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type:
Depth (inches):

Hydric Soil Present? Yes No
Remarks:

US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
WETLAND DETERMINATION DATA FORM – Atlantic and Gulf Coastal Plain Region

Project/Site: City/County: Sampling Date:
Applicant/Owner: State: Sampling Point:
Investigator(s): Section, Township, Range:
Landform (hillslope, terrace, etc.): Local relief (concave, convex, none): Slope (%):
Subregion (LRR or MLRA): Lat: Long: Datum:
Soil Map Unit Name: NWI classification:
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed? Are “Normal Circumstances” present? Yes No
Are Vegetation , Soil , or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS – Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No
Hydric Soil Present? Yes No
Wetland Hydrology Present? Yes No
Is the Sampled Area
within a Wetland? Yes No
Remarks:

HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply) Surface Soil Cracks (B6)
Surface Water (A1) Aquatic Fauna (B13) Sparsely Vegetated Concave Surface (B8)
High Water Table (A2) Marl Deposits (B15) (LRR U) Drainage Patterns (B10)
Saturation (A3) Hydrogen Sulfide Odor (C1) Moss Trim Lines (B16)
Water Marks (B1) Oxidized Rhizospheres along Living Roots (C3) Dry-Season Water Table (C2)
Sediment Deposits (B2) Presence of Reduced Iron (C4) Crayfish Burrows (C8)
Drift Deposits (B3) Recent Iron Reduction in Tilled Soils (C6) Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (B4) Thin Muck Surface (C7) Geomorphic Position (D2)
Iron Deposits (B5) Other (Explain in Remarks) Shallow Aquitard (D3)
Inundation Visible on Aerial Imagery (B7) FAC-Neutral Test (D5)
Water-Stained Leaves (B9) Sphagnum moss (D8) (LRR T, U)
Field Observations:
Surface Water Present? Yes No Depth (inches):
Water Table Present? Yes No Depth (inches):
Saturation Present? Yes No Depth (inches):
(includes capillary fringe)

Wetland Hydrology Present? Yes No
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:

Remarks:

US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
VEGETATION (Four Strata) – Use scientific names of plants. Sampling Point:
Absolute Dominant Indicator
Tree Stratum (Plot size: ) % Cover Species? Status
1.
2.
3.
4.
5.
6.
7.
8.
= Total Cover
50% of total cover: 20% of total cover:
Sapling/Shrub Stratum (Plot size: )
1.
2.
3.
4.
5.
6.
7.
8.
= Total Cover
50% of total cover: 20% of total cover:
Herb Stratum (Plot size: )
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
= Total Cover
50% of total cover: 20% of total cover:
Woody Vine Stratum (Plot size: )
1.
2.
3.
4.
5.
= Total Cover
50% of total cover: 20% of total cover:
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: (A)

Total Number of Dominant
Species Across All Strata: (B)

Percent of Dominant Species
That Are OBL, FACW, or FAC: (A/B)

Prevalence Index worksheet:
Total % Cover of: Multiply by:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
UPL species x 5 =
Column Totals: (A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
1 - Rapid Test for Hydrophytic Vegetation
2 - Dominance Test is >50%
3 - Prevalence Index is ≤3.01
Problematic Hydrophytic Vegetation1 (Explain)

1Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:

Tree – Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.

Sapling/Shrub – Woody plants, excluding vines, less
than 3 in. DBH and greater than 3.28 ft (1 m) tall.

Herb – All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.

Woody vine – All woody vines greater than 3.28 ft in
height.

Hydrophytic
Vegetation
Present? Yes No

Remarks: (If observed, list morphological adaptations below).
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region – Version 2.0
SOIL Sampling Point:
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type1 Loc2 Texture Remarks

1Type: C=Concentration, D=Depletion, RM=Reduced Matrix, MS=Masked Sand Grains. 2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators: (Applicable to all LRRs, unless otherwise noted.) Indicators for Problematic Hydric Soils3:
Histosol (A1) Polyvalue Below Surface (S8) (LRR S, T, U) 1 cm Muck (A9) (LRR O)
Histic Epipedon (A2) Thin Dark Surface (S9) (LRR S, T, U) 2 cm Muck (A10) (LRR S)
Black Histic (A3) Loamy Mucky Mineral (F1) (LRR O) Reduced Vertic (F18) (outside MLRA 150A,B)
Hydrogen Sulfide (A4) Loamy Gleyed Matrix (F2) Piedmont Floodplain Soils (F19) (LRR P, S, T)
Stratified Layers (A5) Depleted Matrix (F3) Anomalous Bright Loamy Soils (F20)
Organic Bodies (A6) (LRR P, T, U) Redox Dark Surface (F6) (MLRA 153B)
5 cm Mucky Mineral (A7) (LRR P, T, U) Depleted Dark Surface (F7) Red Parent Material (TF2)
Muck Presence (A8) (LRR U) Redox Depressions (F8) Very Shallow Dark Surface (TF12)
1 cm Muck (A9) (LRR P, T) Marl (F10) (LRR U) Other (Explain in Remarks)
Depleted Below Dark Surface (A11) Depleted Ochric (F11) (MLRA 151)
Thick Dark Surface (A12) Iron-Manganese Masses (F12) (LRR O, P, T) 3Indicators of hydrophytic vegetation and
Coast Prairie Redox (A16) (MLRA 150A) Umbric Surface (F13) (LRR P, T, U) wetland hydrology must be present,
Sandy Mucky Mineral (S1) (LRR O, S) Delta Ochric (F17) (MLRA 151) unless disturbed or problematic.
Sandy Gleyed Matrix (S4) Reduced Vertic (F18) (MLRA 150A, 150B)
Sandy Redox (S5) Piedmont Floodplain Soils (F19) (MLRA 149A)
Stripped Matrix (S6) Anomalous Bright Loamy Soils (F20) (MLRA 149A, 153C, 153D)
Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type:
Depth (inches):

Hydric Soil Present? Yes No
Remarks:

Appendix II
Site Photographs

SITE PHOTOGRAPHS
Line 204 - Gum Branch Road Project
Jacksonville, Onslow County, North Carolina
S&ME Project No. 7435-17-012
Taken by: W. Cole Date Taken: 4/10/2017

1 View from northwest corner of the site looking south toward
Duke Energy site. 2 View of typical wooded upland area within the site.

3 View of site from southwest corner of the site looking east.

4 View of existing mainline valve in easement.

SITE PHOTOGRAPHS
Line 204 - Gum Branch Road Project
Jacksonville, Onslow County, North Carolina
S&ME Project No. 7435-17-012
Taken by: W. Cole Date Taken: 4/10/2017

5 View of WA within existing easement at proposed access road
location. 6 Second view of WB at location of proposed access road crossing.

7 View of WB near location of proposed L&R station. 8 Second view of WB near location of proposed L&R Station.
Appendix III
Completed PCN and Agent Authorization Form
Page 1 of 12
PCN Form – Version 1.3 December 10, 2008 Version
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:Section 404 Permit Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 18 or General Permit (GP) number: 4092
1c. Has the NWP or GP number been verified by the Corps?Yes No
1d. Type(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
Yes No
For the record only for Corps Permit:
Yes No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
Yes No
1g. Is the project located in any of NC’s twenty coastal counties. If yes, answer 1h
below.
Yes No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?Yes No
2. Project Information
2a. Name of project:Line 204 – Gum Branch Road Project
2b. County:Onslow
2c. Nearest municipality / town:Jacksonville
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed:Easement: Piedmont Natural Gas / Parcel: Carolina Power & Light (Duke Energy)
3b. Deed Book and Page No.408, 575
3c. Responsible Party (for LLC if
applicable):
3d. Street address:PO Box 1551
3e. City, state, zip:Raleigh, NC 27602
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.3 Dec 10 2008
Page 2 of 12
4. Applicant Information (if different from owner)
4a. Applicant is:Agent Other, specify: Utility Company
4b. Name:Sanu Odugbesan
4c. Business name
(if applicable):Piedmont Natural Gas (Duke Energy)
4d. Street address:4720 Piedmont Row Drive
4e. City, state, zip:Charlotte, NC 28210
4f. Telephone no.:704.731.4246
4g. Fax no.:
4h. Email address:[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:Joseph Lawler
5b. Business name
(if applicable):S&ME, Inc.
5c. Street address:9751 Southern Pine Blvd.
5d. City, state, zip:Charlotte, NC 28273
5e. Telephone no.:704-523-4726
5f. Fax no.:
5g. Email address:[e-mail]
Page 3 of 12
PCN Form – Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):436811672221
1b. Site coordinates (in decimal degrees):Latitude: Longitude
34.804430 (DD.DDDDDD) -77.443181 (-DD.DDDDDD)
1c. Property size:0.83 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:UT to New River
2b. Water Quality Classification of nearest receiving water:C; NSW
2c. River basin: map is available at
http://h2o.enr.state.nc.us/admin/maps/03020302 – New River
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:
Topography in the area is generally flat, but slopes very gradually to the east and an off-site stream. The northern portion
of the project area contains the existing Line 204 natural gas transmission easement and an aboveground mainline valve.
The remainder of the project area is vegetated with approximately 8-10 year-old trees – primarily loblolly pine (Pinus
taeda) and sweetgum (Liquidambar styraciflua). Utility substations and overhead powerlines are located near the site.
The larger vicinity consists of a mixture of open land, forested areas, residential and commercial development.
3b. List the total estimated acreage of all existing wetlands on the property:
0.097
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
No streams are located on-site
3d. Explain the purpose of the proposed project:
To construct a launcher and receiver station and access road. See cover letter for additional details.
3e. Describe the overall project in detail, including the type of equipment to be used:
A gravel access road will be constructed over a portion of Wetland A located within PNG’s existing Line 204 easement.
The road will be 20 feet wide and appropriately culverted such that the normal flow and circulation patterns of the wetland
are not otherwise inhibited. The station site will consist of a gravel pad and some above ground piping that will serve to
insert and retrieve the ILID device. The gravel pad was sized to safely accommodate the vehicular access and
equipment staging that is necessary during ILID operations, and to avoid a 50-foot stream buffer associated with an off-
site tributary. A chain link fence will be constructed around the pad. Industry-standard construction equipment will be
used.
Page 4 of 12
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:
Yes No Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Request for Pre-JD is submitted as part of this application.
5. 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.
N/A
6. Future Project Plans
6a. Is this a phased project?Yes No
6b. If yes, explain.
N/A
Page 5 of 12
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.
Wetland
impact number
– Permanent
(P) or
Temporary (T)
2b.
Type of impact
2c.
Type of wetland
(if known)
2d.
Forested
2e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404, other)
2f.
Area of
impact
(acres)
W1 P T Fill in WA PEM Yes
No
Corps
DWQ 0.007
W2 P T Temporary Disturbance
in WA PEM Yes
No
Corps
DWQ 0.017
W3 P T Fill in forested portion
of WB PFO Yes
No
Corps
DWQ 0.046
W4 P T
Temporary Disturbance
in emergent portion of
WB
PEM Yes
No
Corps
DWQ 0.027
W5 P T Yes
No
Corps
DWQ
W6 P T Yes
No
Corps
DWQ
2g. Total wetland impacts 0.097
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.
Stream impact
number -
Permanent (P)
or Temporary
(T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial
(PER) or
intermittent
(INT)?
3e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404,
other)
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P T PER
INT
Corps
DWQ
S2 P T PER
INT
Corps
DWQ
S3 P T PER
INT
Corps
DWQ
S4 P T PER
INT
Corps
DWQ
S5 P T PER
INT
Corps
DWQ
S6 P T PER
INT
Corps
DWQ
3h.Total stream and tributary impacts
3i. Comments: No stream impacts will occur as a result of this project.
Page 6 of 12
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact
number –
Permanent
(P) or
Temporary
(T)
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
O1 P
T
O2 P
T
O3 P
T
O4 P
T
4f. Total open water impacts
4g. Comments: To impacts to open waters will not occur as a result of this project.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose of
pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments: No impacts to ponds or lakes are anticipated as a result of this project.
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:
Page 7 of 12
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.
Project is in which protected basin?
Neuse Tar-Pamlico Other:
Catawba Randleman
6b.
Buffer impact
number –
Permanent
(P) or
Temporary
(T)
6c.
Reason
for
impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1 impact
(square feet)
6g.
Zone 2 impact
(square feet)
B1 P
T
Yes
No
B2 P
T
Yes
No
B3 P
T
Yes
No
6h.Total buffer impacts
6i. Comments: Riparian buffers will not be impacted.
Page 8 of 12
PCN Form – Version 1.3 December 10, 2008 Version
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 new station site was designed to disturb the minimum amount of area considered necessary to safely accommodate
the new station and all of the support equipment that will be required during the ILID events. A proposed flaring site (a
gas-venting operation required prior to the ILID event) was originally planned for a 100-foot x 100-foot area adjacent to
the current project area. The proposed flare site would have resulted in additional wetland impacts, but was eliminated.
Impacts have been minimized by PNG’s use of an existing easement and a formerly disturbed area, limiting impacts to
forested wetlands, and by use of appropriate sediment and erosion control measures during construction.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Impacts will be minimized by clear demarcation of construction limits, a pre-construction meeting, and use of appropriate
sediment and erosion control measures during construction.Following construction, temporarily disturbed wetlands within
the existing easement will be restored to their original grade and contour and seeded with a native wetland seed mix.
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: N/A
3b. Credits Purchased (attach receipt and letter)Type Quantity
3c. Comments: N/A
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: N/A
Page 9 of 12
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.
N/A
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: N/A
Page 10 of 12
PCN Form – Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?Yes No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Project does not encroach upon protected riparian buffers Yes No
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: N/A
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
N/A
2e. Who will be responsible for the review of the Stormwater Management Plan?
Certified Local Government
DWQ Stormwater Program
DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government’s jurisdiction is this project?
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
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 11 of 12
PCN Form – Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land?Yes No
1b. If you answered “yes” to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Yes No
1c. If you answered “yes” to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
Comments:
Yes No
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,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
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): N/A
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
additional development, which could impact nearby downstream water quality?Yes No
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.
N/A
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 12 of 12
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.Raleigh
Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
See attached letter from the USFWS
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://www.habitat.noaa.gov/protection/efh/efhmapper/
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
http://www.hpo.ncdcr.gov/
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: N/A
8c. What source(s) did you use to make the floodplain determination?
Nap No. 3720436800J, Panel 4368
Joey Lawler
Applicant/Agent's Printed Name
_______________________________
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
12.21.2017
Date
AGENT AUTHORIZATION FORM
Date:
Project information
S&ME Project Name: Line 204 / 243 Sites
Type of Project: Natural Gas Pipeline ILI Project
Location: Multiple Eastern NC Counties
Property owner/Kep information
Business Name: Piedmont Natural Gas (PNG)
Mailing Address: 4720 Piedmont Row Drive
City, State, Zip Code: Charlotte, NC 28210
Telephone No. —7D4 T 3 � L-( Z [ f�
Contact: Sanu Odugbesan, Project.En&ee -AAr
Aaent Information
Business Name:
S&ME, Inc.
Street Address:
9751 Southern Pine Blvd
City, State, Zip:
Charlotte, NC 28273
Telephone No.
704.523.4726
Contact:
Joey Lawler, PWS
Authorization: I a `"'' C^ V.— Qj�f�Lcnehalf of PNG, hereb��Y
authorize S&ME, Inc. to submit information to the US Army Corps of Engineers
(USACE) and/or the NC Division of Water Resources (DWR), pursuant to
obtaining necessary environmental permits for the project referenced above, If
applicable, this also authorizes the USACE/DWR to access the project area (PNG
easement) with prior notification for the purposes of conducting site
assessment/confirming the accuracy of the deline caries.
Signature:
S&ME, INC / 9751 Southern Pine Blvd / p 704.523A726 f 704 525.3953 / wwwsmeinc.com

Appendix IV
Impact Drawing
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WETLAND PERMANENT IMPACT AREA - 2,311 SF/0.053 AC
WETLAND TEMPORARY IMPACT AREA - 1,912 SF/0.044 AC
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WETLAND A (891AC
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LINE TABLE
LINE
BEARING
LENGTH
L1
N37018'56"E
5.97'
L2
N46038'33"E
7.08'
L3
N64055'18"W
20.26'
L4
S58052'52"W
10.50'
L5
S46011'45"W
4.01,
L6
N64046'01"W
16.84'
L7
N46038'33"E
19.35'
L8
N64030'46"W
25.08'
L9
S58052'52"W
21.45'
L10
N46038'33"E
13.48'
L11
S82020'22"E
27.30'
L12
S09054'13"E
5.46'
L13
S52001'30"W
13,46'
WETLAND "B"
LINE TABLE
LINE
BEARING
LENGTH
L14
358052'52"W
5.31'
L15
N31001'43"E
21.92'
L16
429023'24"W
18.05'
L17
N56025'43"W
27.63'
L18
N31009'11"E
13.57'
L19
S67013'11"E
21.13'
L20
S60041'00"E
26.66'
L21
320043'14"W
48.92'
L22
N64046'01"W
13.11'
L23
320043'14"W
4.48'
L24
302009'17"W
43.92'
L25
S10048'17"E
6.35'
L26
S10048'17"E
18.09'
LINE TABLE
LINE
BEARING
LENGTH
L27
S10034'47"E
6.35'
L28
S76018'43"W
8.21'
L29
S25013'59"W
17.27'
L31
N12059'13"W
23.41'
L32
N03020'31"W
22.18'
L33
N46047'39"W
12.65'
L34
N46047'39"W
12.48'
SITE
�Q
%r
VICINITY
MAP (NOT TO SCALE)
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N�6°18'43,, N. 387,426.97 Qy \ �A \\ �o
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GENERAL NOTES �11111 I I II///
----------- EASEMENT LEGEND COMPUTED POINT I HEREBY CERTIFY THAT A SURVEY WAS MADE UNDER MY
REBAR FOUND 1 BY OPEN CUT. TION THROUGH JURISDICTION BOUNDARY \\\�\\ �`, CARO///��i/ SUPERVISION AND THAT THE WETLANDS SHOWN HEREON
SUBJECT BOUNDARY LINE (SURVEYED)
SUBJECT BOUNDARY LINE (NOT SURVEYED)
ADJOINER BOUNDARY LINE (SURVEYED)
ADJOINER BOUNDARY LINE (NOT SURVEYED) DB DEED BOOK
G G GAS LINE PB PLAT BOOK
-OHIJ 0HU- OVERHEAD UTILITIES PG PAGE
SD SD STORM DRAIN LINE R/WRIGHT-OF-WAY
• TREE LINE E/P EDGE OF PAVEMENT
-O O CHAIN LINK C&GCURB AND GUTTER
�0
0
O
w w /
w � �
w w
O /
w w w /
/
y w /
w w w 4' CHAINLINK FENCE j
PROPOSED UTILITY
STATION SITE
EAS
EMENT AREA
PIN:436811672221
CAROLINA POWER &
D.B. 2788 PG. 814
/ D.B. 408 PG. 575
/ P.B. 61 PG. 2
/
/
L
OREFLECTS THE DELINEATION EVIDENCE PROVIDED BY S&ME
8642 WEST MARKET STREET, SUITE 100
\� � •� 'ON•• /i1. �
\���••� ESS/ •� •••� �i� ENVIRONMENTAL RVICES ON 04/12/2017. SURVEYING8= CONSUI_Tirlc
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SEAL
PERMANENT
IMPACT
\ TEMPORARY
IMPACT
� y
WETLAND
AREA
�,IPiedmont
Natural Gas
_ GREENSBORO, NORTH CAROLINA 27409 JURISDICTIONAL BOUNDARIES OF
L- 446 4 JE ERY S. TH L-4464 � NC FIRM LICENSE NO. C-1362
% '� DRAWN BY: JSS REVISIONS LINE 204
��'•cgtio �cR:•� \� DATE:10/11/17 12/14/17 GUM BRANCH RD L/R
0 •••,SUR;I•.•••� ♦ JOB NO, 1613.06
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RY ISIO\\\\\ 30 15 0 30 IR# 2651465 SHEET 01 OF 01

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38
r NorthStar Energy Services, Inc. NC Engineering License F-0626
11712 Statesville Rd, Huntersville, NC 28078
51
PROFESSIONAL ENG/ARCH STAMP
J
PROPRIETARY & CONFIDENTIAL ALL RIGHTS RESERVED * DO NOT SCALE THIS DRAWING * USE DIMENSIONS ONLY
PIEDMONT'S NATURAL GAS FACILITY DRAWINGS ARE CONSIDERED CONFIDENTIAL (OM-1095) * DRAWING IS CURRENT ONLY THROUGH THE LATEST REVISED DATE * TO INSURE THERE IS NO RISK OF INAPPROPRIATE DISCLOSER ALL PREVIOUS PAPER COPIES OF THIS DRAWING MUST BE DESTROYED IN ACCORDANCE WITH RECORDS & INFO. MANAGEMENT (RIM) POLICY 1001
NO.
DATE
REVISION(S) DESCRIPTION
BY
I CHK
APPD
I DESCRIPTION
APPROVALS
Piedmont
Natural Ga.-.
COPYRIGHT 2015 PIEDMONT NATURAL GAS CORP.
CORP. OFFICE 4720 PIEDMONT ROW DRIVE
CHARLOTTE, NC 28210
LINE 204 M LV 19
PROPOSED OVERVIEW
NEW B E R N , NORTH CA RO L I N A
Resource Center New Bern, North Carolina
A
8/22/2017
ISSUE FOR REVIEW
MH
JM
RP
AREA CODE
1853
DATE
NIA
SIGNATURE INITIALS
N/A
REGIONAL
ENGINEER
B
11/20/2017
ISSUE FOR 90% REVIEW
MH
JM
RP
ACCOUNT NUMBER
-
PROJECT NUMBER
2651465
DATE
N/A
SIGNATURE INITIALS
N/A
MGR TECH
REC & STD
DRAWING BY
MH
STATION IDT
DATE
XX/XX/20XX
SIGNATURE / INITIALS
XXX
PRINCIPAL
ENGINEER
CHECKER INITIALS
XXX
LEGEND
PROPOSED PIPE ABOVE GROUND
PROPOSED PIPE BELOW GROUND
PROPOSED EQUIPMENT
PROPOSED TEMPORARY PIPE
EXISTING PIPE
PROPOSED PIPE TO BE ABANDONED
0' 10, 20'
SCALE: 1" = 10'
NOTES:
1. ANY CHANGES REQUIRED DUE TO FIELD
CONDITIONS MUST BE APPROVED BY THE
ENGINEERING DEPARTMENT.
2. ALL TIE-IN RELEVANT DIMENSIONS ARE TO BE FIELD
VERIFIED.
3. MATERIAL QUANTITIES ARE FINISHED QUANTITIES,
MATERIAL FOR TESTING NOT INCLUDED.
4. TRANSITION FITTING SHALL BE MACHINED TO
MATCH EXISTING PIPE PER PING SPECIFICATION
DM-ST-2340.
5. NIGHT CAPS TO BE USED ON ALL SECTIONS THAT
ARE NOT TIED IN.
6. IN AREAS OF SOLID ROCK, PAD DIRT SHALL BE USED
FOR BACK FILL TO 18" ABOVE PIPE.
7. PIPE TO BE WRAPPED WITH FRP WHERE IN
CONTACT WITH CONCRETE.
8. PIPE AND ASSEMBLY NOT TO BE COME IN DIRECT
CONTACT WITH CONCRETE.
9. ALL UNDERGROUND PIPING SHALL BE COATED
* INDICATES ELECTRICAL INSULATOR.
REF. DWG(S)
SHEET(S) 6 OF 10 I DWG SCALE 1 "=10'
DWG DATE 6/12/2017 ISUPERSEDED
DRAWING NUMBER REVISION
PNG-M-204-0001045 B
DISCIPLINE / RESOURCE CENTER / LINE NUMBER

Appendix V
Agency Scoping Information
NCNHDE-4493
October 17, 2017
Ashley Bentz
S&ME, Inc.
3201 Spring Forest Road
Raleigh, NC 27616
RE: Gum Branch
Dear Ashley Bentz:
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide information
about natural heritage resources for the project referenced above.
A query of the NCNHP database, based on the project area mapped with your request, indicates that there are
no records for rare species, important natural communities, natural areas, or conservation/managed areas
within the proposed project boundary. Please note that although there may be no documentation of natural
heritage elements within the project boundary, it does not imply or confirm their absence; the area may not have
been surveyed. The results of this query should not be substituted for field surveys where suitable habitat exists.
In the event that rare species are found within the project area, please contact the NCNHP so that we may
update our records.
The attached ‘Potential Occurrences’ table summarizes rare species and natural communities that have been
documented within a one-mile radius of the property boundary. The proximity of these records suggests that
these natural heritage elements may potentially be present in the project area if suitable habitat exists and is
included for reference. Tables of natural areas and conservation/managed area within a one-mile radius of the
project area, if any, are also included in this report.
Please note that natural heritage element data are maintained for the purposes of conservation planning, project
review, and scientific research, and are not intended for use as the primary criteria for regulatory decisions.
Information provided by the NCNHP database may not be published without prior written notification to the
NCNHP, and the NCNHP must be credited as an information source in these publications. Maps of NCNHP
data may not be redistributed without permission.
The NC Natural Heritage Program may follow this letter with additional correspondence if a Dedicated Nature
Preserve (DNP), Registered Heritage Area (RHA), Clean Water Management Trust Fund (CWMTF) easement,
or Federally-listed species are documented near the project area.
If you have questions regarding the information provided in this letter or need additional assistance, please
contact Rodney A. Butler at [e-mail] or 919.707.8603.
Sincerely,
NC Natural Heritage Program
Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One-mile Radius of the Project Area
Gum Branch
October 17, 2017
NCNHDE-4493
No Element Occurrences are Documented Within a One-mile Radius of the Project Area
Natural Areas Documented Within a One-mile Radius of the Project Area
Site Name Representational Rating Collective Rating
New River Swamps and Marshes R2 (Very High)C5 (General)
No Managed Areas are Documented Within a One-mile Radius of the Project Area
Definitions and an explanation of status designations and codes can be found at https://ncnhde.natureserve.org/content/help. Data query generated on October 17, 2017; source: NCNHP, Q3 July 2017. Please resubmit your
information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database.
Page 2 of 3
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Page 3 of 3
United States Department of the Interior
FISH AND WILDLIFE SERVICE
Raleigh ES Field Office
Post Office Box 33726
Raleigh, North Carolina 27636-3726
November 30, 2017
Joey Lawler
S&ME, Inc.
9751 Southern Pine Blvd
Charlotte, NC 28273
Re: PNG Gum Branch Road Launcher -Receiver Site — Onslow County, NC
Dear Mr. Lawler:
This letter is to inform you that the Service has established an on-line project planning and
consultation process which assists developers and consultants in determining whether a
federally -listed species or designated critical habitat may be affected by a proposed project. For
future projects, please visit the Raleigh Field Office's project planning website at
httys://www.fws.gov/raleigh/pi).htrnl. If you are only searching for a list of species that may be
present in the project's Action Area, then you may use the Service's Information, Planning, and
Consultation System (IPaC) website to determine if any listed, proposed, or candidate species
may be present in the Action Area and generate a species list. The IPaC website may be viewed
at 12qps://ecos.fws.gov/ipac/. The IPaC web site contains a complete and frequently updated list
of all endangered and threatened species protected by the provisions of the Endangered Species
Act of 1973, as amended (16 U.S.C. 1531 et seq.)(Act), a list of federal species of concern' that
are known to occur in each county in North Carolina, and other resources.
Section 7 of the Act requires that all federal agencies (or their designated non-federal
representative), in consultation with the Service, insure that any action federally authorized,
funded, or carried out by such agencies is not likely to jeopardize the continued existence of any
federally -listed endangered or threatened species. A biological assessment or evaluation may be
prepared to fulfill that requirement and in determining whether additional consultation with the
Service is necessary. In addition to the federally -protected species list, information on the
species' life histories and habitats and information on completing a biological assessment or
evaluation and can be found on our web page at http://www.fws.gov/raleigh. Please check the
web site often for updated information or changes.
' The term "federal species of concern" refers to those species which the Service believes might be in need of
concentrated conservation actions. Federal species of concern receive no legal protection and their designation does
not necessarily imply that the species will eventually be proposed for listing as a federally endangered or threatened
species. However, we recommend that all practicable measures be taken to avoid or minimize adverse impacts to
federal species of concern.

If your project contains suitable habitat for any of the federally -listed species known to be
present within the county where your project occurs, the proposed action has the potential to
adversely affect those species. As such, we recommend that surveys be conducted to determine
the species' presence or absence within the project area. The use of North Carolina Natural
Heritage program data should not be substituted for actual field surveys.
If you determine that the proposed action may affect (i.e., likely to adversely affect or not likely
to adversely affect) a federally -protected species, you should notify this office with your
determination, the results of your surveys, survey methodologies, and an analysis of the effects
of the action on listed species, including consideration of direct, indirect, and cumulative effects,
before conducting any activities that might affect the species. If you determine that the proposed
action will have no effect (i.e., no beneficial or adverse, direct or indirect effect) on federally
listed species, then you are not required to contact our office for concurrence (unless an
Environmental Impact Statement is prepared). However, you should maintain a complete record
of the assessment, including steps leading to your determination of effect, the qualified personnel
conducting the assessment, habitat conditions, site photographs, and any other related articles.
With regard to the above -referenced project, we offer the following remarks. Our comments are
submitted pursuant to, and in accordance with, provisions of the Endangered Species Act.
Based on the information provided and other information available, it appears that the proposed
action is not likely to adversely affect any federally -listed endangered or threatened species, their
formally designated critical habitat, or species currently proposed for listing under the Act at
these sites. We believe that the requirements of section 7(a)(2) of the Act have been satisfied for
your project. Please remember that obligations under section 7 consultation must be
reconsidered if: (1) new information reveals impacts of this identified action that may affect
listed species or critical habitat in a manner not previously considered; (2) this action is
subsequently modified in a manner that was not considered in this review; or, (3) a new species
is listed or critical habitat determined that may be affected by the identified action.
However, the Service is concerned about the potential impacts.the proposed action might have
on aquatic species. Aquatic resources are highly susceptible to sedimentation. Therefore, we
recommend that all practicable measures be taken to avoid adverse impacts to aquatic species,
including implementing directional boring methods and stringent sediment and erosion control
measures. An erosion and sedimentation control plan should be submitted to and approved by
the North Carolina Division of Land Resources, Land Quality Section prior to construction.
Erosion and sedimentation controls should be installed and maintained between the construction
site and any nearby down -gradient surface waters. In addition, we recommend maintaining
natural, vegetated buffers on all streams and creeks adjacent to the project site.
The North Carolina Wildlife Resources Commission has developed a Guidance Memorandum (a
copy can be found on our website at (http://www.fws.gov/raleigh) to address and mitigate
secondary and cumulative impacts to aquatic and terrestrial wildlife resources and water quality.
We recommend that you consider this document in the development of your projects and in
completing an initiation package for consultation (if necessary).
2

We hope you find our web page useful and informative and that following the process described
above will reduce the time required, and eliminate the need, for general correspondence for
species' lists. If you have any questions or comments, please contact John Ellis of this office at
[phone] ext. 26.
Sincerely,
Pete enjamin
Field Supervisor

AppendixVI
Restoartion Plan
RESTORATION PLAN
PNG Line 204 Gum Branch Road Site
Jacksonville, North Carolina
The proposed project has been planned to avoid and minimize jurisdictional impacts where practicable.
As part of mitigation for unavoidable impacts, the following plan is proposed for implementation to
restore temporarily-affected wetland areas. This plan entails restoration of temporarily-disturbed wetland
areas to their original contours and conditions to the degree practicable upon project completion.
Further, it specifies that these areas will be permanently stabilized with a native vegetated cover. The
measures outlined below will be reviewed with the project contractor prior to the plan’s implementation.
Proposed restoration activities include removal of any temporarily-placed fill material/equipment mats
and restoration of wetland areas to their original, pre-disturbance contours. The native seed mix below
will be used in combination with a relatively rapid-germinating cover species.
Table 1: Wetland Seed Mix Species
Species Common Name Percent
Bidens aristosa Showy tickseed sunflower 7
Carex vulpinoidea Fox sedge 12
Dichanthelium clandestinum Deer tongue 8
Elymus riparius Riverbank wildrye 20
Juncus effusus, NC Ecotype Soft rush 4
Panicum dichotomiflorum Smooth panicgrass 14
Panicum rigidulum Redtop panicgrass 8
Panicum virgatum Switchgrass 23
Polygonum pensylvanicum Pennsylvania smartweed 2
Sparganium americanum Eastern bur reed 2
•Combination seed mix to be applied to all disturbed streambanks, extending five feet landward following construction.
•Recommended application rate: 10-12 lbs. riparian seed mix plus 10-12 pounds of companion species/acre.
To provide relatively rapid establishment of cover, 50 percent of the total seed mix shall consist of
perennial rye (Lolium perenne) and/or German (foxtail) millet (Setaria italica) as companion species. Either
of these species will germinate and grow quickly, but will not interfere with development of the riparian
seed mix species.
Seed and planting materials must be from local region suppliers. Listed below are local supplier of native
seed and plant material. S&ME does not endorse this specific supplier; they are listed only for
informational purposes. Other local suppliers may be available and suitable.
Mellow Wetlands Farm
1312 Woody Store Road
Siler City, N.C. 27344
919.742.1200
919.742.1280 fax
www.mellowwetlandsfarm.com