20091345 Ver 1_More Info Received_20100209

SeSEPI
ENGINEERING GAOU?
1025 Wade Avenue
Raleigh, NC 27605
Tel [phone]
Fax [phone]
sepiengineering.com
February 8, 2010
OR-%3 45
NC Division of Water Quality
401 Oversight/ Express Review Permitting Unit
2321 Crabtree Boulevard
Raleigh, North Carolina 27604
Attention: Ms. Cyndi Karoly
?S R. ? ?Ui V
dos Iiry 0
Re: Granville Medical Center, Section 404/401 NWP 39 and Tar-Pamlico River Buffer
Authorization; NCDWQ Project 09-1345
Granville Health System received a request from the NC Division of Water Quality for
additional information regarding the proposed expansion of Granville Medical Center in
Oxford, NC. The letter was dated January 11, 2010. SEPI Engineering & Construction, Inc
(SEPI), on behalf of the Granville Health System, provides responses to NCDWQ's request
for more information.
1. Diffuse flow requirements and compliance with Tar-Pamlico Riparian Buffer Rule.
Sheets are attached to this letter. Stormwater from the parking lot will be treated with a
sand filter and then discharged into a level spreader located on one side of the proposed
parking lot.
2. Provide an inventory of impervious surfaces, stormwater management plan and a
completed BMP supplemental form.
The site of the Granville Medical Center encompasses +/- 15.03 acres. The existing
impervious area is approximately 58% of the total parcel. With the addition of the new
parking areas and the building expansion, and the demolition of some parking the final
impervious percentage, the new total impervious is approximately 65% of the total parcel.
The drainage area of the site is approximately 9.75 acres. Based this drainage area, the
percentages for the existing and final impervious areas are approximately 56% and 67%
respectively. The sand filter is just treating the new parking areas to account for the
increase in the impervious area.
Runoff from the new proposed northern parking lot will be conveyed by swales, and this
will allow for stormwater to be partially treated and for slower flow entering the sand
filter. Water from the sand filter will be discharged into a level spreader. The level
spreader has been slightly oversized to allow for more diffuse flow along the slope below
the parking lots.
SceSE E PI
Page 2
3. List all temporary and permanent buffer impacts.
All impacts are included in the PCN. However, there were not sufficient rows to convey the
impacts in the PCN so we have included the following table.

Impact number action Permanent or
Temporary
Zone 1
Zone 2
Road impacts Permanent 6,411 4,263
Temporary 717 350
Sewer line Permanent 460 165
Temporary 1,892 1,681
Total Buffer Impacts I _T 9,480 6,459
4. Please note your fill slopes impacts to Zone 1 and 2 buffers cannot be evaluated at
this time and will require submission of a Major and/or Minor Variance
application(s).
The proposed grading has been re-evaluated. The project's impacts to buffers have been
divided into two proposed actions: 1) relocation of a road to accommodate expansion of
the hospital which necessitates stream and buffer impacts; and, 2) relocation of a sewer
line which necessitates buffer impacts.
For the relocation of the road, it is our understanding based on a review of the "Table of
Uses" for the Tar-Pamlico buffer rules that the proposed action fits into the category of
"Road Impacts other than crossing of streams and other surface waters subject to this rule".
The impacts to Tar-Pamlico buffer will be mitigated by payment into the EEP.
Impacts to the buffer from this proposed action are:
Buffer Impacts from the Road Relocation

Impact number action Permanent or
Temporary Impact
Zone 1
Zone 2
Road impacts Permanent 6,411 4,263
Temporary 717 350
Total Buffer Impacts 7,128 4,613
It is proposed that only the permanent impacts to Zone 1 and 2 be mitigated.
The sewer line relocation is necessary to accommodate the proposed expansion of the
hospital. The relocated line will started in the front of the hospital, will lie parallel to the
proposed road relocation and connect with the existing sewer line north of the stream.
Part of the relocated sewer line lies in the same buffer impact area as the relocated road.
S ESEPI
Page 3
Based on our understanding of the Table of Uses, the proposed action would fall into the
category of "Non-electric utility lines: impacts other than perpendicular crossings in Zone 2
(allowable) and Zone 1 (allowable with mitigation). The following table notes impacts to
the buffer from the sewer line relocation.
Buffer Impacts from the Sewer Line Relocation

Impact number action Permanent or
Temporary Impact
Zone 1
Zone 2
Sewer line Permanent 460 165
Tem orar 1,892 1,681
Total Buffer Impacts 2,352 1,846
It is proposed that mitigation be for the Zone 1 impacts only.
5. Please re-submit the site plans on full plan sheet along with one CD of full size
plans.
Full size plans and a CD of the full size plans are provided with this letter.
Other Information
Project Impacts to Waters of the United States
The layout of the proposed expansion cannot avoid impacts to the jurisdictional stream and
its associated riparian buffer. To access the back portion of the hospital tract, the road
improvements must be made. The existing pipe will be extended to accommodate the
hospital expansion and the access road.
Stream impacts now total 85 feet with 60 feet being from the pipe extension and another
25 feet from the placement of rip rap in the channel to prevent future erosion of the stream
bottom. The 42" pipe that is being extended captures off-site water from the property to
the south and along College Street as well as all the on-site water. No data exists for the
amount of runoff collected in this pipe; therefore, a full flow, worst-case scenario for the
design was assumed, and, based on engineering practice, 25 feet of rip rap in the channel is
needed to dissipate the energy out of this pipe.
Impacts to the stream were minimized by implementing a design slope of 2:1.
A revised permit drawing has been attached to this letter.
At this time, no compensatory mitigation for the stream impact is proposed.
?SEPI
Page 4
Buffer Mitigation into the EEP
Granville Health System proposes to pay into the Riparian Buffer Fund to compensate for
impact to the Neuse buffers. The following table summarizes the impacts to the buffers and
the required payment.
Impacts Requiring Buffer Mitigation
Impact number action Zone 1 Zone 2
Road impacts 6,411 4,263
Sewer line 460 165
Total Buffer Impacts 6,871 4,428
Impacts to Buffers and Required Mitigation
Buffer
Zone Impact Area
(square
feet Mitigation
Ratio Total
Mitigation Area
(s q. ft. Mitigation
Costs
1 6,871 3 20,613 $19,788.48
2 4,428 1.5 6,642 $6,376.32
Total 27,255 $26,164.80
On behalf of the Granville Health Systems, SEPI has coordinated the payment into the
Riparian Buffer Fund with the Ecosystem Enhancement Program. The EEP has agreed to
provide the required buffer compensation, and a copy of the acceptance letter is attached
to this application for a buffer authorization.
Rapanos form
A Rapanos form has been completed for the proposed project. This information has been
attached to the letter.
Closing
If you have any questions regarding this request or need additional information, please
contact me at [phone]. Thank you for your prompt attention to this matter.
Environmental Division Manager
cc: Mr. Eric Alsmeyer, USACE
WATF9QG
> 6

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification C Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ® Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ® Yes ? No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Granville Medical Center
2b. County: Granville
2c. Nearest municipality / town: Oxford
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address: 1010 College Drive
3e. City, state, zip: Oxford, NC 27565
3f. Telephone no.: 919.690.3000
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name: Gerry Leighton
4c. Business name
(if applicable): Granville Health System
4d. Street address: 1010 College Drive
4e. City, state, zip: Oxford, NC 27565
4f. Telephone no.: 919.690.3000
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Phillip Todd
5b. Business name
(if applicable): SEPI Engineering Group
5c. Street address: 1025 Wade Avenue
5d. City, state, zip: Raleigh, NC 27605
5e. Telephone no.: 919.789.9977
5f. Fax no.: 919.789.9591
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
1a. Property identification no. (tax PIN or parcel ID):
Latitude: 36.325532 Longitude: -
1 b. Site coordinates (in decimal degrees): 78.592491
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 15 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Jordan Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C; NSW
2c. River basin: Tar-Pamlico
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:
Hospital development and associated parking. Forested area along stream corridor on the south side of the tract
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
460 feet
3d. Explain the purpose of the proposed project:
The hospital proposed to expand its facilities. This work requires improving road access to the back part of the hospital
property.
3e. Describe the overall project in detail, including the type of equipment to be used:
the proposed project involves hospital expansion in the back portion of the tract. Expansion of these hospital functions is
needed to provide care for the surrounding community served by the facility. As part of the proposed project, access to
the back portion of the site is enhanced to allow for future development of the hospital campus. Earth moving equipment
used will include bull dozers, pans, tracked hoes, dump trucks, and front end loaders
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? ® Yes ? No ? Unknown
Comments: Site visit with Martin Richmond of NCDWQ
Raleigh Central office on Oct 8, 2009.
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: SEPI Engineering Group
Name (if known): Phillip Todd Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Site visit with Martin Richmond of NCDWQ Raleigh Central office on Oct 8, 2009.
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.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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
1a. Which sections were completed below for your project (check all that apply):
? Wetlands ? Streams - tributaries ® Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ®P ? T Pipe Extension/ UT Jordan Creek ® PER ® Corps 4 85
access road ? INT ® DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 80
3i. Comments: The pipe extension is 60 feet in length, and 25 feet of rip rap will be laid at the pipe outlet for stability purposes.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number -
Permanent (P)
or Temporary
T 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody type 4e.

Area of impact (acres)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a.

Pond ID 5b.

Proposed use or purpose of 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
number pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ® Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) for impact Stream name mitigation (square feet) (square feet)
or Temporary required?
T
Pipe
B1 ®P ? T Extension/
access UT Jordan Nos 6,411 4,263
road
Pipe
B2 ? P ®T Extension/
access UT Jordan ?? Nos 717 350
road

63 ®P ? T Sewer line ® Yes
460
165
relocation ® No
6h. Total buffer impacts 9,480 6,459
6i. Comments: There was not sufficient space in the table to note temporary buffer impact from the sewer line relocation.
There are 1,892 square feet in Zone 1 and 1,681 square feet in Zone 2. Total buffer impacts incorporate these impacts.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Stream impacts cannot be avoided. Slopes are 2:1.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sediment fencing will be implemented to note the limits of construction.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ? Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps
? Mitigation bank
2c. If yes, which mitigation option will be used for this project? ? 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
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ® Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): 27,255 square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ® Yes ? No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 Pipe Extension/access
road/sewer line 6,871 3 (2 for Catawba) 20,613
Zone 2 Pipe Extension/ access
road 4,428 1.5 6,642
6f. Total buffer mitigation required: 27,255
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).
The applicant proposes payment to EEP for the other impacts to buffer zones. The EEP has agreed to accept
responsibility of implementing the buffer mitigation on behalf of the applicant.
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
1a. Does the project include or is it adjacent to protected riparian buffers identified ® Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
® Yes ? No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 6.98%
2b. Does this project require a Stormwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
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? Oxford
? 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)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
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
? Yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
The additional sewage resulting from hospital expansion will be collected and transportated by the Oxford public sewer
system and will be treated at the WWTP.
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?
? 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?
GIS map data was reviewed on December 21, 2009. The source of the data included NC Natural Heritage Program GIS
shapefile data from May 28, 2009.
6. Essential Fish Habitat (Corps Requirement)

6a. Will this project occur in or near an area designated as essential fish habitat?
-T
? Yes ® No
-
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NCDWQ Environmental Sensitivity Maps from Granville County, 2007 were assessed.
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?
NC SHPO GoogleEarth kmz points located on (or near) the key feature in individually listed properties, and at or near the
centroid of the areas covered by historic districts were examined. Date of the data was from May 12, 2009
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? FIRM Panel 1913J and 1923J; Map # 3720192300J
and #3720191300J
2.0 LO - <02 -
Phillip Todd C6
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature 's 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--
Ecosystem
. PROGRAM
February 9, 2010
Gerry Leighton
Granville Health System
1010 College Street
Oxford, NC 27565
Project: Granville Medical Center
Expiration of Acceptance: November 9, 2010
County: Granville
This letter revises one issued November 3, 2009. The purpose of this letter is to notify you that the North Carolina Ecosystem
Enhancement Program (NCEEP) is willing to accept payment for impacts associated with the above referenced project. Please note
that this decision does not assure that the payment will be approved by the permit issuing agencies as mitigation for project impacts. I
is the responsibility of the applicant to contact these agencies to determine if payment to the NCEEP will be approved. You must also
comply with all other state, federal or local government permits, regulations or authorizations associated with the proposed activity
including SL 2009-337: An Act to Promote Compensatory Mitigation by Private Mitigation Banks
This acceptance is valid for nine months from the date of this letter and is not transferable. If we have not received a copy of the
issued 404 Permit/401 Certification/CAMA permit within this time frame, this acceptance will expire. It is the applicant's
responsibility to send copies of the permits to NCEEP. Once NCEEP receives a copy of the permit(s) an invoice will be issued based
on the required mitigation in that permit and payment must be made prior to conducting the authorized work. The amount of the In
Lieu Fee to be paid to NCEEP by an applicant is calculated based upon the Fee Schedule and policies listed at www.nceep.net.
Based on the information supplied by you the impacts that may require compensatory mitigation are summarized in the following
table.
River CU Stream (feet) Wetlands (acres) Buffer 1 Buffer 11
Basin Location (Sq. Ft.) (Sq. Ft.)
Cold Cool Warm Riparian Non-Riparian Coastal Marsh
Impact Tar- 03020101 0 0 0 0 0 0 9,250 9,130
Pamlico
Credits Tar- 03020101 0 0 0 0 0 0 27,750 13.695
Pamlico
Upon receipt of payment, EEP will take responsibility for providing the compensatory mitigation. If the regulatory agencies require
mitigation credits greater than indicated above, and the applicant wants NCEEP to be responsible for the additional mitigation, the
applicant will need to submit a mitigation request to NCEEP for approval prior to permit issuance. The mitigation will be performed
in accordance with the Memorandum of Understanding between the N.C. Department of Environment and Natural Resources and the
U.S. Army Corps of Engineers dated November 4, 1998.
If you have any questions or need additional information, please contact Kelly Williams at [phone].
cc: Cyndi Karoly, NCDWQ Wetlands/401 Unit
Phillip Todd, agent
File
Sincerely,
Willi D. Gilmore, PE VV
Director
Rutorwg... E ... Protectu-t? Ow ka t&
LVM;VA
NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 91 9-71 5-0476 / www.nceep.net
E w o
w ! j r "?;, p zI??oO 0 Wm O
??' I ° Q m orn o? ¢ m o
.Q
rn i
i aQ UUd s.C i Z OO
. 1, . N 0 o m o
a, cr o- r* c
z°°Z- 2
1 0) ' a °
O 3 w O
i < 0) r, N
N
i
i
?? l !\ m
?? ? I i. I I I ? ? I t , o
i? i I l !( I ' /Sg ?I M W
m o
w
s - ?? o Q
m
C3 Y
CL <
- 0
0
'" ?_ i i sy, a s X <w O
?'. N w
o i
r _
I I I' ? F O LLJ C)
! • '? i X i Q
Lu
Q
of
in
n U
v m o rn (n
Of
i ( k I Fr?Illi1ZLo O O?t
i I a I WO' ?x yLdLO F
0
\ o ?i W? , M ??z
< I C ?.L ! I? N fL' o
XWp»
e4 1 ? ?- t0 B
?Z wzz
--
in'
II
yy.
d?
AQ i
CJ << ?ry r
i
m i
d
` l
I 5? ? 7
s. f
a ?
_ -tl 1
idi?
6W&J141 uk-e
APPROVED JURISDICTIONAL DETERMINATION FORM ?tLA- -
U.S. Army Corps of Engineers C1'T?
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION 1: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD): Unknown
B. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wake Forest NC Regulatory Office
C. PROJECT LOCATION AND BACKGROUND INFORMATION: The proposed project involves the expansion of the
existing hospital, including an Emergency Department and Surgery Department addition and a new boiler/generator plant. The
original hospital was constructed in 1939 with additions in 1962, 1974, 1985 and 1998. The hospital exists on a relatively large
tract of land (11 acres), and the proposed project involves hospital expansion in the back portion of the tract. Expansion of these
hospital functions is needed to provide care for the surrounding community served by the facility. As part of the proposed project,
access to the back portion of the site is to be enhanced to allow for future development of the hospital campus. The study corridor is
located in the Tar - Pamlico River Basin in Granville County, North Carolina. SEPI Engineering Group (SEPI) was contracted in
October 2009 to perform a stream and wetland delineation for this project. The applicant for this JD is Granville Health System
located in Oxford NC. The project is located off of US 15 in Oxford, North Carolina.
State: NC County/parish/borough: Granville City: Oxford
Center coordinates of site (lat/long in degree decimal format): Beginning of Corridor - Lat. 36.325532°N
Long.-78.592491 ° W
Universal Transverse Mercator: 17 N (NAD 83)
Name of nearest waterbody: Jordan Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Tar River
Name of watershed or Hydrologic Unit Code (HUC): 03020101-022010
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
? Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on
a different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
? Office (Desk) Determination. Date:
? Field Determination. Date(s):
SECTION 11: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Appear to be no "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR
part 329) in the review area. [Required]
? Waters subject to the ebb and flow of the tide.
? Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign
commerce. Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There `ARE' "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
? TNWs, including territorial seas
? Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
? Non-RPWs that flow directly or indirectly into TNWs
? Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
? Impoundments of jurisdictional waters
? Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 60 linear feet: 4 width (ft) and/or acres.
Wetlands: 0.0 acres.
c. Limits (boundaries) of jurisdiction based on: 1987 Corps manual and OHWM
Elevation of established OHWM (if known): Not established.
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least
"seasonally" (e.g., typically 3 months).
2. Non-regulated waters/wetlands (check if applicable):3
? Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not
jurisdictional. Explain:
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW,
complete Section III.A.1 and Section IILD.I. only; if the aquatic resource is a wetland adjacent to a TNW, complete
Sections III.A.1 and 2 and Section III.D.I.; otherwise, see Section HI.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it
helps determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively
permanent waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally
(e.g., typically 3 months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a
TNW, but has year-round (perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting
a tributary with perennial flow, skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps
districts and EPA regions will include in the record any available information that documents the existence of a
significant nexus between a relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a
traditional navigable water, even though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to
determine if the waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant
nexus evaluation must consider the tributary in combination with all of its adjacent wetlands. This significant nexus
evaluation that combines, for analytical purposes, the tributary and all of its adjacent wetlands is used whether the
review area identified in the JD request is the tributary, or its adjacent wetlands, or both. If the JD covers a tributary
with adjacent wetlands, complete Section III.B.1 for the tributary, Section III.B.2 for any onsite wetlands, and Section
III.B.3 for all wetlands adjacent to that tributary, both onsite and offsite. The determination whether a significant
nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size (HUC 03020101-022010): 47.5 sq miles
Drainage Area (HUC 03020101): 1304 sq miles
Average annual rainfall: 42.46 inches
Average annual snowfall: 7.5 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through (2 or more) tributaries before entering TNW.
3 Supporting documentation is presented in Section III.F.
a Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in
the and West.
Project waters are 10-20 river miles from TNW (Yadkin - Pee Dee River).
Project waters are 1 (or less) river miles from RPW.
Project waters are 10 (or less) aerial (straight) miles from TNW.
Project waters are <10aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain: None.
Identify flow route to TNW':
Jordan Creek: Drains to Tabbs Creek > Drains to Tar River
(b) General Tributary Characteristics (check all that applv) -
Tributary is: ® Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 4 feet
Average depth: i? feet
Average side slopes: 3i,1.
Primary tributary substrate composition (check all that apply):
® Silts ® Sands ? Concrete
? Cobbles ® Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Moderately eroding.
Presence of run/riffle/pool complexes. Explain: Riffle 1; Pool in
Tributary geometry: Meandering.
Tributary gradient (approximate average slope): 0-2 %
(c) Flow
Tributary: Provides for perennial flow.
Estimate average number of flow events in review area/year: Unknown
Describe flow regime: perennial
Other information on duration and volume:
Surface flow is: Confined. Characteristics: Surface flow is moderate.
Subsurface flow: No. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
? OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
® changes in the character of soil
? shelving ?
? vegetation matted down, bent, or absent
? leaf litter disturbed or washed away ?
® sediment deposition ?
? water staining
? other (list):
El Discontinuous OHWM.' Explain:
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that
apply):
? High Tide Line indicated by: ? Mean High Water Mark indicated by:
? oil or scum line along shore objects ? survey to available datum;
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into
TNW.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground,
or where the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the
waterbody's flow regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the
break.
'Ibid.
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed
characteristics, etc.). Explain: Water is semi-turbid with a moderate flow.
Identify specific pollutants, if known: More than likely (sediment).
(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Forested wetland 0-50 ft.
® Wetland fringe. Characteristics: Emergent wetland.
® Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
® Aquatic/wildlife diversity. Explain findings: Habitat for amphibians. .
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions
performed by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical,
and biological integrity of a TNW. For each of the following situations, a significant nexus exists if the tributary, in
combination with all of its adjacent wetlands, has more than a speculative or insubstantial effect on the chemical,
physical and/or biological integrity of a TNW. Considerations when evaluating significant nexus include, but are not
limited to the volume, duration, and frequency of the flow of water in the tributary and its proximity to a TNW, and
the functions performed by the tributary and all its adjacent wetlands. It is not appropriate to determine significant
nexus based solely on any specific threshold of distance (e.g. between a tributary and its adjacent wetland or between a
tributary and the TNW). Similarly, the fact an adjacent wetland lies within or outside of a floodplain is not solely
determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance
and discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters
to TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for
fish and other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic
carbon that support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical,
or biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be
documented below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs.
Explain findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly
into TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination
with all of its adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain
findings of presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent
wetlands, then go to Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK
ALL THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
? TNWs: linear feet width (ft), Or, acres.
? Wetlands adjacent to TNWs: acres.
RPWs that flow directly or indirectly into TNWs.
® Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale
indicating that tributary is perennial: Strong bed and bank, material sorting, strong evidence of riffle / run / pools /
Moderate evidence of flow, deposition.
? Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that
tributary flows seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
® Tributary waters: 60 linear feet / - 4 (ft) width.
? Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
? Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus
with a TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
? Tributary waters: linear feet (ft) width.
? Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that
tributary is seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that
wetland is directly abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area:
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which
they are adjacent and with similarly situated adjacent wetlands, have a significant nexus with a TNW are
jurisidictional. Data supporting this conclusion is provided at Section IILC.
Provide acreage estimates for jurisdictional wetlands in the review area.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
? Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are
adjacent and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data
supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
? Demonstrate that impoundment was created from "waters of the U.S.," or
? Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING
ANY SUCH WATERS (CHECK ALL THAT APPLY):10
? which are or could be used by interstate or foreign travelers for recreational or other purposes.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
? which are or could be used for industrial purposes by industries in interstate commerce.
? Interstate isolated waters. Explain:
? Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
? Tributary waters: linear feet width (ft).
? Other non-wetland waters: acres.
Identify type(s) of waters:
? Wetlands: acres.
8See Footnote # 3.
9 To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA
HQ for review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
? If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of
Engineers Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based
solely on the "Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the
MBR factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using
best professional judgment (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard,
where such a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where
checked and requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant: State NC.
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: Oxford NC 1:24,000 Quad.
® USDA Natural Resources Conservation Service Soil Survey. Citation: Granville County 2007.
? 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: El Aerial (Name & Date):
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
[D Applicable/supporting case law:Rapanos and Carabell cases.
? Applicable/supporting scientific literature:
® Other information (please specify): SEP] field investigation performed October, 2009.
B. ADDITIONAL COMMENTS TO SUPPORT JD:
LEGEND Elev=470.13' (NAVD 88') SURVEY NOTES: NOTES:
M v
- - BOUNDARY LINE / r: VERTICAL CONTROL: HORIZONTAL CONTROL: 1. SITE IS LOCATED WITH IN THE TAR PAMLICO
RIGHT-OF-WAY NAVD 88 NAD 83~NSRSI 2007)ATE PLANE COORDINATES RIVER BAISIN.
RAILROAD RIGHT-OF-WAY / THIS MAP IS A RESULT OF A SURVEY OF AN EXISTING BUILDING OR OTHER STRUCTURE SUCH AS A NATURAL FEATURE OR WATERCOURSE. THIS IS NOT A BOUNDARY SURVEY.
1 THIS MAP IS EXEMPT FROM NCGS 47-30, AND IS NOT TO BE RECORDED m~ y,V h
- - - - - LOT LINE u v NOTES L ~ E
,;1 - EXIS77NG CONTOUR MAJOR U 1) HORIZONTAL AND VERTICAL CONTROL BASED ON GPS POINTS SET ON SITE UTILIZING VRS. 2) ALL DISTANCES ARE HORIZONTAL GROUND DISTANCES UNLESS OTHERWISE NOTED.
EXIS77NG CONTOUR MINOR 4 / + 3) NO BOUNDARY WORK PERFORMED DURING THIS SURVEY. 8845 Red Oak Blvd.
- - - - - - - - - - - EXISTING ROAD SIDEWALK EASEMENT 4) ALL LOCATIONS OF UNDERGROUND UTILITIES SHOWN HEREON ARE BASED ON ABOVE GROUND APPURTENANCES AS WELL AS CONSTRUCTION AND SURVEY DRAWINGS PROVIDED Charlotte, INC 28217-5593
BY OWNER, AS WELL AS DRAWINGS PROVIDED BY GRANVILLE HEALTH SERVICES. LOCATIONS OF UNDERGROUND NON-VISIBLE UTILITIES/STRUCTURES MAY VARY FROM 704.523.2230 phone
STORM SEWER PIPE I `a,~`°R v LOCATIONS SHOWN HEREON. ADDITIONAL BURIED UTILITIES/ STRUCTURES MAY BE 704.523.2235 fax ENCOUNTERED. NO EXCAVATIONS WERE MADE DURING THE PROCESS OF THIS SURVEY TO
E-1 CATCH BASIN l3~ , a 'a Asphalt LOCATE BURIED UTILITIES/STRUCTURES. NO SUE LOCATIONS DONE AT THIS TIME.
t -.Parking xN ~S SANITARY SEWER MANHOLE z ~ Lot nn PInc. l y ~A 5) THIS MAP IS SUBJECT TO ANY FACTS THAT MAY BE DISCLOSED BY A FULL AND ACCURATE TITLE SEARCH. SEPI
6) THIS PLAT IS SUBJECT TO ANY EASEMENTS, AGREEMENTS, OR RIGHTS-OF-WAY OF RECORD PRIOR TO DATE OF THIS PLAT, WHICH WAS NOT VISIBLE AT THE TIME OF INSPECTION.
SANITARY SEWER CLEAN OUT ~ ~BULANCE 7) THIS MAP NOT SUBMITTED TO OR APPROVED BY ANY PLANNING AGENCY.
e-e ONE BUILDING SANITARY SEWER LINE / STORY t \ 8) ALL BEARINGS ARE GRID BEARINGS UNLESS OTHERWISE NOTED. 9) WITH THE EXCEPTION OF EASEMENTS, ALL LINES NOT SURVEYED ARE CLEARLY MARKED BY
BRICK 1040 caar t -v, -w - WATER LINE DASHED LINES. E\GINJ.iT G&CONSTRUCTTON 10) PRECISION = 1 : 10,000+ „Wasa vies'
W WATER VALVE WSUUUCP 11) PROPERTY LOCATED IS NOT IN A FLOOD ZONE, AS SHOWN ON FIRM MAP 3720191300J, RALEIGH, NORTH CAROLINA 9 1 . 7 8 9 . 9 9 LI 7
' it n1 PARKING PANEL' 1913, EFFECTIVE APRIL 16, 2007, ALSO FIRM MAP 3720192300J, PANEL 1923, \ ib5 - x ? 15e, c TIVE APRIL 16, 2007. 7025 Wade Ave. Raleigh, NC 27605 EFFEC i- .
FIRE HYDRANT Mitt) ) 12) EASEMENT WIDTHS NOT KNOWN AT THIS DATE FOR UTILITY LINES, IF ANY. CHARLOTTE, NORTH CAROLINA 13) LOCATIONS OF ALL FINISH FLOOR ELEVATIONS TAKEN INSIDE ENTRANCE(S). 7 0 4 . 7 1 4 . 4 6 8 0
WATER METER 14) SCALE FACTOR: 0.99998354 PoNl~ypurv£, ~rv4CS'tbay v www.sepienginewing.com infoOseplanglneering.com
0 ELECTRIC BOXIVAULT 16B
P 4 1a Utilities:
' l Time Warner Cable -[phone] e
POWER POLE LANDSCAPE LIGHT 1 ~ v \ e 0 Granville k@~ , Progress Energy - [phone] 3 HEALTH 9VSTEM
GUY WIRE 01-, y~ J ,6 (877) $I ° ( a C+J'Y~ rW Quality Care Close 'Lo Hone Public Service Company of NC - 776-2427 v
- -TYV vw - UNDERGROUND POWER LINES x(I j=4 3e 'k + P Asphalt NCOL - [phone]
80' In om)=4777 Parking Granville Medical Center Embarq - [phone] . - ` ' Ors a a" " ner 1010 College St.
- ~wva- -owv~ OVERHEAD POWER LINES Lot ,
© COMMUNICATION MANHOLE .N(0-' Oxford Water Works - [phone] Oxford, NC 27565 > I 4 HI h, M II Ctl ~ ~ "Htclic N II ktl
CROSSWALK SIGNAL <p C11 Ex_ YI Asphalt Asphalt aP? rw.3
F o GAS SIGN j Inx(I)=4usr Parking Parking ; 1 HittnPvII~ e 1 .
Lot QI 0 _ : I ° m Inv(Out) r Lotnnppicenrer ''Rd
GAS VALVE IN) 9 a+ r EMERGENCY
? GAS METER
9 - S GAS LINE (GJ~ +°A, I .°a w_s w w-~ _w-- N - DEPARTMENT
TBIYL ToP 471.1 1'i -W- E~ JH 'e ADDITION
-uc UNDERGROUND CABLE LINE C~ p i.- mow- ~e Top FH E SSMH Inv(In) 46zsa' ,
t - t - UNDERGROUND 1£CfPHOA'E LINE P4^'n ~gsphal r'~, ` o x\ _ BR _Eq NURSING HOME Elev--475.92' InvTo°In4' 465'`43'.44' ""(0°`)-4674 l VICINITY MAP: NOT TO SCALE BOILER / r Inv(Ou )-46520
\ + Parking 4' w0 NUR - UNDERGROUND OXYGEN LINE _ ) NC o (NOT sHa)~- - GENERATOR a ~y
? ~ 7RfECINE z 1 + I i Asphalt v Parking, 1111 ti T PLANT AND
Lot RELATED
TREE ~ot r/ / w 4 n I ONE b;. T m . x yvi
SHRUB / m a PP TI STORY ! t +
ask BRICK Pnh'~ o Y 7 X FENCE +xera d e8 L 5, PROJECTS
0, mo s 4 s - 71 i,
STREET SIGN Ph i rva a a ,,p1 rnpEa75,05 ~O
Ex. Di /able = V~/ /xn~_ \ dan` c°,_ p `F 6/I\ / y ? 5U o15 lop=74.97' ~0ut)447468 p2b c 1 t ~,JI NC Oa` n~ m 'q.,1` 7 r a ' ` '1 ";4 v r
Ex. x7 x1G,eose 0e P4x o y Sh ( T., 474.87' Inv(C,Q 4P7 Oxford, NC rt'
-2.9 ra q0,• Can ni fz~
,~r .4 g - h9 v(Lx Imin) 47289' tl > x. ) „-ioP~ 474.87 + ` ' qa ~ ,C I ?~k°p ~11101Na `~nv(Outr472.50' hrvOu)-47373 i d / ~I~_ t tv z project number
/ + yN uv J / ' 9a n4 579 SUITES 1026, 1030, 1032 ~ -
Ex. DI D no t a<C3 ¦ 8500200
G rt aJ. ~ e `Tn 3.32 BRICK n - + Fan ~'r ig i. ~I~
Gas VC o Fs.. & P. -nn a P rop=L.74.05Inv Ip a47ss STORY - ,4 date
/TAM p 04 G T _ N ( 4. v7ooU 473.28 4" fl ' - / r r + Caa `<C _~QIP ~In w 11x - = 7 Top FH jV 9 ~w ¦ 22 JANUARY 2010
Elev=470.1 ' 3 o f F 1 s / /
P j ;op~wass xP it v~~ ~d 1 0 P'4 P4n. , rY-s r`x I (o4p=eases ry le.. - By V 0. , J ~ b
Poa i \ , , 4' po . O. h s p^ P~ ~ Oro ~ ~ m m tP"V _ { r: seal
i ,,L~~ ;r V CA `L1D1 p
x. ad ~i t 9 ~ ~ ~ x PeN ~01 0 77 4 a`6 - I' _ / iop=4F 45 557. Flammable +q _ 5 of
In"(In)-46508 4 b Q 4..,PPZ Tark 1 A~ f mo storage SEAL z:
m Out -4&C 94 4 ' + C„ Q Exssws a~,.` g 2 Y P 4p_ el.ls' Basement , '1a ur4 Asphalt t1
T.P~471 35' T ,:r 14 Parking v L 4 QUADRANGLE MAP: NOT TO SCALE s~ 7490
mv(In)N/A d0 Entrance + E Inv(Out)-460,91' 4 Qa II L Y ^ A LOt TaPSSMH 47 b31 t- ~ yGl NF-~ ~
1 _ TP ^.11 Inu In 1V4fi 11 qwS 'Y, _ _ ~b 4 Ivv(0,-E-465,38' av( ) mn(., tes.e0' co / + a a0o ,m I'd
/ Ex.YI ?1 t" C
f To -46632' o In Oust =N61.72' FF'd t1h~~ \o\ ' a b" a \ n° \ /
+ 4 FQB T d 3n o, b a n4 - - / ~ ~ V11liiqIIl I1/l/
i Concrete Gon Crete
l p C~ zSWH TO FE GRANVILLE FAMILY I / a- Helic6Pt r Arrow ~FIPOR,QT~, ~QG SEAL
q 7 Inu(In)N 465.64 MEDICINE P.A. I > GRANVILLE MEDICAL CENTER r V St x , ! A Iov(In)Nn 46497' SUITE 1012
I 1010 COLLEGE ST L / 4 + $ Inv Ou)t 464.07 v: . ' 80
„a y(InE x6421 /Y MULTI-LEVEL BRICK BUILDING i ~0 Pb t: PP, Pb 470"' ~ r Ex. Grave Rd)~ C-2197 (Width ries - -i % _
a4 ' TFpa~.A.. IJI ~F qp
~ 111 m '
F~ ~G i Y _F 2 x aV l Ex CB ti`. Q E,"F f `;•`R- nx 'Sd x ravel Rd. 1 5 b~ ~ +i-J, 1d~ ..h c?'' f 1111 201
In4(L)N w57a aev. ~ II q o. Inv,l,)E 453.61 _ ' e Cony ©0 JP ws
4 0l~ Im(0n0-463.47 12 ecv ~If r~~ 7" 4 SYom9 Storo9e ( ~ ~a+~'v«"`"*~~ agQl , rg ~ ~ ~ reeman hite, Inc -Wind a.,
A n 7 E ,/s MIT e A a ~~U \ Asphalt 'Asphalt e 4 Basement i Ex. CN p 2P F<? Gauge b drawn by 0. ~ n-
Top-486.54' d; 's ( 21J Entrance Parking n, s-46101' Parking III Top-46845(TC) Pee ,p' Lot P~
' T v' I~I Wolzr Meter o In'~(Out)-46476 )n TI. }=460. Lot w4 I A Ex SSMH Vauh / - 7
4nv(0 t-460.25] a rop 17068 ExiBIDIH 4 y ~'x~ `M Inm~Oo)~45E°~7 Ex.55MH 4s rn f 1~ Pe4>"T i 4 ~II checked
SOILS MAP: NOT TO SCALE by
J Top-461.61' L \ Top=464.m' 4571 nv In NE -405.12' In,(12) 4, 1 / Inv to Nw 45). 3
4lnv((In)-4677 ~u ~L xv n ~I Im(In)W 4.422d'
) aos n _ m )SIN -452 41 _ at e o oM8" v(oth452 20' i _ s' av in addenda / revisions
c VP I 0 P
I m>lh nr ss 6z m l 7 ~ I x E. sse11l / t ssun n 5 +P CD NO NAME DATE
i o mvQn}vE=a55.B2 Tnp- 7c.70' ~ .np-491,,4 xa, n(I )AE-455.82
Inv 1-NSA - Inr(Ir)N 45689 a 1 (SqN I y / Inv(Out =462.44' 1 n In) 45884 I ,h \x e' ~OON~ ~II IQ 6 - 0 Q) LYE
I AA / In v(OL)-45888.4 .x. CB +.be I A. 4 II,, aOC~ >>r ~yi ~~~VVVe l I J s rop 457,82'(TC) V /
nv n(1n) 454.74' Asphalt Undergrouna Ppy rk 4^ Iv(OW)-45457' Parking E(eotno +0.0.
E ca ya ` r, V ~ycJ r L eP y. d ,4` Lot Service Lot tole. rnp 461.00 (rc) /4~ Y~ ) to be Lo ated n lhls P I
nv(In)-455.,a Ex. slmn~ ~ isI~~' ~-'-4rec at lhls time + b /
/ o4t)=as4a7 np 45s.ao' / = um q 4 _ Inv(In) 45460'/ A{ ~C~ r~j/ Poi u r ~i l e 1 a sff-
3/ \ In(Out)_`54 44.0%' 1Pao \ L, ` ~P » 1(v" ~b pbz + / e4 - P ~I b0. 06.
a I ' 40}~.~ }dh +0.0.
b0 00
U i / NCSR 153 - - i ; PS1 0. THIS DRAWING REFLECTS Al_[_ CHANGES
,o so' p - PubIIC 44 n ENa DI O .0 PREVIOUSLY MADE ON THIS SHEET. VERIFY b THAT PREVIOUS CHANGES HAVE BEEN
e n pn tF36s' ADrivet T I I - + - INCORPORATED INTO THE CONTRACT BEFORE rr \ Pdz~ 'OJ PROCEEDING WITH ANY WORK NOT
O SPECIFICALLY REFERENCED BY THIS REVISION. 00
_ t
42 s n ~ - 36 a 3- _ Top -of Ditch- p~ o- WQ - REVIEW
i "oe 1 0 n - - D
+4°' kr P t a'~ k @h ht~ - xP _ 9 - E_ 0 aPe~-~'ap of-..Ditch a' - r0p of 0 itcf7
1 Top 460,3CB(TC a +k'a _ _G4avel Walx~ --Ex. a P 9 ` ) Ex. jP 0 77-77 ZONE BUFFER IMPACT
InvOuQ-95S7T A Too-58.40' - ( 4 I 1 ao 457,44' - Ex CB _
i :n)N 45240 n n V 450453 0 o Tap=45$ 02 (Tf.(' T Inv(l,)W 450.7o- ah1 nv(In) 45440 _ Granville County, N.C. Word ~fp EXHIBIT DRAWING
(I)w flies' L 1' o mv(In)s 453.45' PK Nail in n (Out)=450.7o Inv(Out) n5aF2' Granville Medical Center Oxford Orphanage SSMH
4 a I v Grand Lodge ojt> 401,72' Corner of Concrete Deed Book Page rand Lodge of N.C. T G4E:6 InvQn)N-417' ACq lnv(ln)W-435.85' sheet number
Elew-457.45' Inv(435.85' SCALE 0 25 50
458 1 Ex. FES q, Top =458 13' ~ MCP ® m
mv=459.`0[ 0~ Inv(In)=455.62' s"" EXH B-01
o. 0.03 Inv(Out)=455.5&' 1 op-447 62' SCALE: 1" 50' a ¦

I
W ® I 04 = L :31VOS
04 OZ 0 31VOS 9L'844 aw AN] 96.944 :NI ANI Wncl EWS -lVLLUdd- NVId 10'ddW18a=un8 wl aeline a3MVIN=
jagwnu ways o01 S:d01
131NI (INVA HIM 03OVId38 ONtl 03AOW32! 38 Ol 3d 'X3
`JNIMd~IO 1191HX3 =Z10
iovdW1 b3j3n9 3NOZ dOa °96 Al 09 0S 644 •ANI
- ---T - NOII03S ON3 038tlld
M31A3~J aMO - - - 2ADJO1
~a 'b N•3.O.O'N v~~o y0a! o s
1 s ~ 4 L dV8-dRl - oo°y° o'a - ~ 3'3l _ ,Zx sax ~r w -~-w w` w w t _
NOISU3aSIH1AS 030N3H333HA11VDIAI03ds r f ~Z 10N NHOM ANV HIIM ONI03300Hd fit
3H033910VH1N00 3H101NI 031VHOdH00Nl i v~ ~I
N338 3AVH S30NVHO SnOIA3Hd 1VH1 * ttt _ - - A3IH3A "133HSSIH1N030VA AISOOIA3Hd
MNVH0-nVS1031H38 6NIMtMO SIHI l(1ll1N00 N050N3- '-a_ -
/dlYIL 3L50dN00 f Al~l 09
I ~ q - -Y' 1•
d I - on
a YIN 9~ d''d EA' t ' / f>~e
S
i
I V,
e r
r 31H0 3WHN ON -
?x
SUOISIAaa epuappe - i
i j
Sgpa>payo 00
C I'/ l 0 0 f
I~I~ t o9 ov 0
e YofNo cstt Aso a J 101 ~I l~ 6uJod 7logdsV/.,
0u 'ap4Muemaw I c^ vauY 0'0 ONtNtlYd (cava ~ )p ~ Iui~ ur AAi A80LOZ 0
I / ril = y;. dII I''° , ~ I r~ „I° ~ i
z c ~N
a '
I f ~ ~ 11 _ IVIS NOIlO3NN00 1N3W18Vd30 3JId 'dOJd
anD3 X • ' i • ;pi " 'Fe,e 6 J 1 ONInne NOI88 i3A31-LLInW NIVJO J008 J,8VON003S 'dOJd lJS
~i~ ~~bllOd~~~ c ; APa 0 'x3 ~ ..r~,A~, a e 4 15 3931100 OLOL \ O
b' NI01S d p ~ ~a ao Plod A4 AIIWV3 311NANV aa~ .:,:8 d ~I;III Q J31N30 1VO103W 3llIANVJ9 NOIlVZIlVJ1n3N 010V 'dOJd Q 31VSN30NOO d4nd 'dOJd
r 1 OV To 'o eau WV31S 3JnSS38d HOIH 'dOJd
\ \ d \ N39,,xo 'doad _
"UII I II ItiltA e t W8V1V N30,1XO 'd08d E -
j i 0 ~Y I ~U g ` 3NIl land 'dOJd
z. 30NAJ ills 'dOJd
3lOHNVW 83M3S A8VIINVS 'dOJd
astir - It's lnO NV310 83M3S ,,8V11NVS 'dOJd 0'06
1 is
5l 6 ~OlSS3~~ ~ ~ ~ ~ ~ ~ ov bza 83M3S AJVIINVS `dOJd '
3A-IVA 31VO 3NIl J31VM 'dOJd r 6
A~ANnnnnno Seas 1NV8OAH 3JId 'dOJd
A - 8313N 831VM `dOJd
I - r lI 831N3A3Jcl MOIJNOV8 'dOHd dee
owz.k,ddnNVr lZ ¦ 3NI-1 831VM -c OJd -W -W t 6 S13lNl WJO1S 'dOJd O
aaep _ ' ..n'!. X65 S0 f
~ _ , I cu o S13lNl WJOlS 'dOJd ¦ i
OOZ0098 ¦ i a 01 ° aofidido OM3S 'N8O1S 'dOJd
~agwnu }oaroid ~hv zzd 1 Nolaa 'a JONIN vOINOO 'dOJd ti91~
JOPtlW JnOlNOO 'dOJd 594
V3JV 39VNIV80 NISV8 HO1VO
,06 = .l 81tlO5 ,04 = .,l 31VOS 8311n9 ONV 8Jn0 'dOJd _
ON pad 0 SBW' U.n - Mdld lOddWl 83d:Ine CIMHV IN9 GV08 - NVId. )H - Ned lOddWl ue44ne (3MU' nN=l 83JJne - - - - -
•es *is 'is 3ON3-4 X dWl 1V11dSOH 'JS llb'9 SS300V 3A1a0 'JS E9d'4 SS300V 3MUG
SJ-03rMJd • Zss'L NO n 0~ S3llnun HONA i3VdWi NLLL OW 13VdW1 Nol01on S oO i L 3N a3ddn8 1N3NVwa3d Z 3NOZ I NV210dw31 L 3NOZ- Al VOLLOn2LLSNOO f ltllldSOH W021J i' dWI ltllldSOH W021J lOVdWI 8n2IHS
V WOad 10dV4 IVa0dW31 L 3 NO(1 ISNOZ )dV131 L 3NOZ J3JJn8 1N3NVWJ3d L 3NOZ 83JJn8 1N3NVVIN3d Z 3NOZ 332/1
0 31413 a _ A _
aN`d1N'dld 3NI73381
;o l 401!0 l0 do1 rte 3NI7 N391X0 ONR02l92130Nn
2JOiV~13N3J 41!0 do ~ 4 01!O 1o dot >=%°e8geago 40110 10 407!0 do do _ - 3N17 3NOHd3731 ONn02192130Nn 4
l X131108 3N17 378V9 ON17089230Nn Dn- -
7
NOllla4d~ ~ 3NI7 SV9 e C' -
2/3131N SVO ?
- 3A7VA SV9
AON392J3W3 nearaz - _..r~ . ~ nc
ppOp N915 5V9
7VN91S N7VMS502/0 0
37OHNVPV NOLL V9INnl9W09
999LZ ON `PaaIXO 0 - o' 53N17 2/34IOd OV3H&3A0 - Aw,' -Nv,~
'is a6allo0 060b 'is 092
'is t9s't s3unun 'ds 1ajua0 JeaipaW ap1AUeJ0 W0HA 10VdWI NounUSNOO a3jens iN3NVwa3d Z 3N OZ SS3OOtl 3Na0 1V11SNOH WDili 303V I80 I a1.SN0O S3N17 aROd ONnO&,9N30Nn
AM10d431 Z 3NOZ 0 'H A8V80dW31 Z 3NOZ ro 3NIM An9
awug oy...10 o0;llH°^~ 370d N3MOd
W31SAS Hy1~1V3H 31VOS 1H917 3dV9SONV7
a~~L1uGv1~ 04 = °l :31VOS
V JNIaVJ - NV Id 1OVdV41 ag:~=in9 til a~~ne oe le?-INa 17nVAIX08 9/219373 CI
woo•suNaeul6ueldupop! Y713K 2131VM
e i,J I b L U O 9 a b l L I 4 t.. 0 1 INVHGAH 39Id
VNnoaae H1aoN '3110'AIVH0
soALZ ON ' 46!e1ea ecax snot 3A7VA 2/31VM x
L 6 ON s e L ' 6 L 6 JJS 0991 ONIOtl20 VNnoavo HLaoN'HOI31va a0d 1OVdwl NOLLonaSN0O 3N17 V31VM ---•H m
xorlaalrtaNOD >a ANV60dW31 Z 3NOZ 9[~mcHa[~B>g 1OtldWl 1N3NVM3d L 3NOZ 40~IOf0 doZ ~ - qoIIQyo daj---, = $ o",aa 3N17 V3M3S A,2WIINVS
o e a -Nql.• ~ ~ ~ - n ° o o ~ - - `•'J~"° ems, ~ - -
10VdWl LN3NVVM3d Z 3NOZ z~ 4011010_ - 4-0;i0 )o dot e ,~,oga;o _ w- w 100 NV370 N3M3S AMINVS d
IdrJS 37OHNVPV &3M39 AMINVE Os
OV LZ'9 ISn01Aa3d 03SOdOdd N/SV8 H91 VO n
0tl 8Z'9 Sn01A213d ONIISIX3 3dld N3M39 WNO1S <F-
xe} SEZZ'£Z5~ti0L
auogd 0£ZZ-£Z9-b0L 0tl 9L'6 snoln63dwl 03sodoad - 1N3PV3SV3 V7VM3G/5/OVO& 9NI1SIX3 - - - - - - cer~~ - g.4y - - =p 2/ON1W dnO1N09 ONI1S1X3
£699-L28Z ON 'alaoPeyO 3v 94'8 Sn01A83dw1 ONLLSIX3
'PA19 NeO PGkj 9b88 Vld4 31IS - ~s - - - xi m a~sa a0/'ViN unO1N09 9NIISIX3
(OV LO'O) JS O4Z = 3dld 3l 09
3NI7 107 - -
i oa , as AVM-j0 1H0IN OVOY71VH
1 wl V3aV loVdw wV3~ls o
OV b['0) AS £06'6 :e3-Ajne L 3Naz 5 ( AVM -j0-1H018
-7v 3N17 AdVON1708 - -
(OV 9L 0) AS L£OY 483ddne l 3NOZ V A g' a i ~ , - ~ ON393~
V3aV iOVdWl d3.AAnn