20200962 Ver 1_Signed_StreamlinedConsultationForm29Feb2016 (3)_20200727

Northern Long-Eared Bat 4(d) Rule Streamlined Consultation Form
Federal agencies should use this form for the optional streamlined consultation framework for the northern long-
eared bat (NLEB). This framework allows federal agencies to rely upon the U.S. Fish and Wildlife Service’s
(USFWS) January 5, 2016, intra-Service Programmatic Biological Opinion (BO) on the final 4(d) rule for the
NLEB for section 7(a)(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined
framework; (2) describing the project with sufficient detail to support the required determination; and (3) enabling
the USFWS to track effects and determine if reinitiation of consultation is required per 50 CFR 402.16.
This form is not necessary if an agency determines that a proposed action will have no effect to the NLEB or if
the USFWS has concurred in writing with an agency's determination that a proposed action may affect, but is not
likely to adversely affect the NLEB (i.e., the standard informal consultation process). Actions that may cause
prohibited incidental take require separate formal consultation. Providing this information does not address
section 7(a)(2) compliance for any other listed species.
Information to Determine 4(d) Rule Compliance: YES NO
1. Does the project occur wholly outside of the WNS Zone1? ☐ ☒
2. Have you contacted the appropriate agency2 to determine if your project is near
known hibernacula or maternity roost trees?
☒ ☐
3. Could the project disturb hibernating NLEBs in a known hibernaculum? ☐ ☒
4. Could the project alter the entrance or interior environment of a known
hibernaculum?
☐ ☒
5. Does the project remove any trees within 0.25 miles of a known hibernaculum at
any time of year?
☐ ☒
6. Would the project cut or destroy known occupied maternity roost trees, or any
other trees within a 150-foot radius from the maternity roost tree from June 1
through July 31.
☐ ☒

You are eligible to use this form if you have answered yes to question #1 or yes to question #2 and no to
questions 3, 4, 5 and 6. The remainder of the form will be used by the USFWS to track our assumptions in the
BO.

Agency and Applicant3 (Name, Email, Phone No.): NCDOT, Division 12, Jeff Wyatt,
[e-mail], 980-552-4219
Project Name: DF15712.2002803
Project Location (include coordinates if known): SR 1110 (Liledoun Road) Alexander County, NC
Basic Project Description (provide narrative below or attach additional information): replacement of
culvert at Ut to Lower Little River after flood event.

1 http://www.fws.gov/midwest/endangered/mammals/nleb/pdf/WNSZone.pdf
2 See http://www.fws.gov/midwest/endangered/mammals/nleb/nhisites.html
3 If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are party to the consultation.

General Project Information YES NO
Does the project occur within 0.25 miles of a known hibernaculum? ☐ ☒
Does the project occur within 150 feet of a known maternity roost tree? ☐ ☒
Does the project include forest conversion4? (if yes, report acreage below) ☐ ☒
Estimated total acres of forest conversion
If known, estimated acres5 of forest conversion from April 1 to October 31
If known, estimated acres of forest conversion from June 1 to July 316
Does the project include timber harvest? (if yes, report acreage below) ☐ ☒
Estimated total acres of timber harvest
If known, estimated acres of timber harvest from April 1 to October 31
If known, estimated acres of timber harvest from June 1 to July 31
Does the project include prescribed fire? (if yes, report acreage below) ☐ ☒
Estimated total acres of prescribed fire
If known, estimated acres of prescribed fire from April 1 to October 31
If known, estimated acres of prescribed fire from June 1 to July 31
Does the project install new wind turbines? (if yes, report capacity in MW below) ☐ ☒
Estimated wind capacity (MW)

Agency Determination:
By signing this form, the action agency determines that this project may affect the NLEB, but that any
resulting incidental take of the NLEB is not prohibited by the final 4(d) rule.
If the USFWS does not respond within 30 days from submittal of this form, the action agency may
presume that its determination is informed by the best available information and that its project
responsibilities under 7(a)(2) with respect to the NLEB are fulfilled through the USFWS January 5,
2016, Programmatic BO. The action agency will update this determination annually for multi-year
activities.
The action agency understands that the USFWS presumes that all activities are implemented as
described herein. The action agency will promptly report any departures from the described activities to
the appropriate USFWS Field Office. The action agency will provide the appropriate USFWS Field
Office with the results of any surveys conducted for the NLEB. Involved parties will promptly notify the
appropriate USFWS Field Office upon finding a dead, injured, or sick NLEB.

Signature: ________________________________________ Date Submitted: ________________

4 Any activity that temporarily or permanently removes suitable forested habitat, including, but not limited to, tree removal
from development, energy production and transmission, mining, agriculture, etc. (see page 48 of the BO).
5 If the project removes less than 10 trees and the acreage is unknown, report the acreage as less than 0.1 acre.
6 If the activity includes tree clearing in June and July, also include those acreage in April to October.
7/20/2020