20011099 Ver 1_Complete File_20010716

O?O? wAT ?9QG
r
O `C
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
December 6, 2001
Guilford County
DWQ Project No. 011099
SR 1853 (Sandy Camp Road)
APPROVAL of 401 Water Quality Certification and Randleman Watershed Buffer Rules with
Additional Conditions
Mr. J. M. Mills, P.E., Division Engineer
NCDOT Division 7
1584 Yanceyville Street
Greensboro, NC 27415
Dear Mr. Mills:
You have our approval, in accordance uitb she attached conditions and those listed below, to
permanently impact 5,350 square feet of ufler and 41 linear feet of streams, and to temporarily
impact 30 linear feet of unnamed tns to Deep River for the purpose of upgrading SR 1853
(Sandy Camp Road) in Guilford County The profit must be constructed in accordance with your
application dated 1 June 2001 and sub5--guent inibrmadon received by the DWQ Winston-Salem
Regional Office on November 21, 200L Aflar reviewing your application, we have decided that this
project is covered by General Water Quality Certification Number 3289. This certification
corresponds to Nationwide Permit 14 issued by the Corps of Engineers. In addition, you must acquire
any other federal, state or local perms befiffe you proms with your project including (but not
limited to) Sediment and Erosion C vbi4Nm-Disci and Water Supply Watershed regulations.
This approval will expire with the acccm4alnying permit, unless otherwise specified in the
Water Quality Certification. For this appmvA to be value you must follow the conditions listed in the
attached certification.
This approval is valid solely for the pwqK= ad design described in your application (unless
modified below). Should yoaxpro}esx yon most notify the DWQ and submit a new
application. If the property is sold, d w mew over ?n1t be given a copy of this Certification and
approval letter, and is thereby nespol'nrcomplying with all the conditions. If the proposed fill
is in excess of 150 linear feet of streamh Iffi otr 1 a of wetlands, compensatory mitigation will
":Z u ed as described in 15A XCAC 2HAM (6) (6) atad (7).• For this approval to be valid, you must
- - - the cdnditions listed in the ? " mu1 addmvndl conditions fisted below. _ ` -
L The use of NCDOT's Best Management Praczi=for the Protection of Surface _Waters (March
1997). 4
2 Sedi ation and Eroswn Cow Onfiddimes for Sensitive Watersheds (15A NCAC 413 .0024)
must be implemented prioyr so any l activities to minimize impacts to .
downstream aquatic resotr?txs, T 7"Pumnent herbaceous vegetation must be planted
on all bare soil within 10 days cf activities to provide long term erosion
control
3. The pipes required for this proff ;? be idled in such a manner that the original stream
profiles are not altered Cie, the eff do claerad must not be reduced by a widening of the
North Carolina Orj d cft r 4D1 Uorands Certification Unit,
1650 Mail Sw1AmCenfar t ,tlpCM*941W0 QAatTing Address)
2321 Crabtree OW, t ,lf>C 27W4-ZM goaa6on)
919-733-1788 (aSone), 919-73%P?3 f k4 .enrztate.nc.us/ncwetiands/
replacements. Any existing pipes which are perched shall be removed and new pipes installed to
ensure passage of aquatic life.
4. All work shall be performed during low flow conditions.
5. All mechanized equipment operated near surface waters must be regularly inspected and -
maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or
other toxic materials.
6. The presence of equipment in the channels must be minimized. Under no circumstances must
rock, sand or other materials be dredged from the wetted stream channel under authorization of
this permit, except in the immediate vicinity of the culverts.
7. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
8. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If necessary, rip-rap must be limited to the stream bank below the high water
mark, and vegetation must be used for stabilization above high water.
9. The existing ditches shall be vegetated according to the additional information provided by
NCDOT on 19 November 2001. -
Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certificate of Completion" form to notify NCDWQ when all work included in the §401
Certification has been completed. The responsible party shall complete the attached form
and return it to the 401/Wetlands Unit of the NC Division of Water Quality upon
completion of the project.
If you-do not accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 60 days of the date that you receive this letter. To ask for a hearing,
send a written petition that conforms to Chapter 150B of the North Carolina General Statutes to the
`Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This
certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean
Water Act.' If you have any questions; please telephone Ms. Cynthia Van Der Wiele at 919-733-5715
or Ms. Jennifer Frye of the Winston-Salem Regional Office at 336.771-4600.
?t « Sincerely,

Gregory J. Thorpe, P .D.
Acting Director
Attachment

Pc: Wilmington District Corps of Engineers _
e, MCorp of En 'veers Raleigh Field Office
'NCDWQ Winston-Salem Regional Office
Central Files

;k cr jA ??F._..
?r.r} File: Copy
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F WA7-F
?( A0 Michael F. Easley, Governor
`Q G William G. Ross Jr., Secretary
r North Carolina Department of Environment and Natural Resources
4 Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
November 26, 2001
MEMORANDUM
TO: John Dorney, 401/Wetlands Unit - Central Office
'4?
FROM: Larry Coble, WSRO WQ Supervisor
SUBJECT: NCDOT-SR 1853
011099
Guilford County
Central Office Received Application 7/16/01
WSRO Received Application 7/25/01
WSRO Requested Additional Information/
Project on HOLD 8/15/01
WSRO Received DOT Request for more time 9/05/01
WSRO Acknowledged Request/ Project
Still on HOLD 9/05/01
DOT/DWQ Randleman Rules Meeting 11/16/01
WSRO Received Additional Information 11/21/01
WSRO Forwarding Application/Additional
Information to Central Office 11/26/01
NCD NR
Customer Service
1 800 858-0368
Even though the WSRO has delegated authority to issue this 401 WQ Certification, this
Office does not feel that this project fully complies with the Randleman Lake Water
Supply Watershed Regulations and would require a variance. Specifically, the project
proposes to relocate existing ditches, which, according to 15A NCAC 02B .0250(2)(a)
are Subject to the Riparian Area Protection Requirements since they (the ditches) convey
runoff directly to classified waters. Therefore, the WSRO is forwarding the
application/additional information back to the Central Office for your consideration and
decision. 9 - 0 '??w
n"
Wfi
cc: Coleen Sullins, DWQ Section Chief \ ?P . p
Steve Zoufaly, DWQ Local Government Assistance Unit
Bob Zarzecki, 401/Wetlands Unit - Central Office ( \
WSRO ?J
Division of Water Quality / Water Quality Section
585 Waughtown Street Winston-Salem, NC 27107
Phone: [phone] Fax: [phone] Internet: http://wq.ehnr.state.nc.us
.7?; f=
y.
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
GOVERNOR SECRETARY
November 19, 2001
NC DENR Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
ATTN: Mrs. Jennifer Frye
Wetlands/401 Unit
SUBJECT: Guilford County, Replacement of two pipes on Sandy Camp Road (SR 1853)
DWQ 4 01 1099
Dear Mrs. Frye:
Per our discussion on November 16, 2001, I am submitting the revised erosion control plan for SR
1853. As we discussed during the field meeting, no new impervious surface will added because of
the secondary road upgrade. Existing ditches will be relocated with Zone 1 and Zone 2 and shoulder
widening will occur; however. infiltration will be improved by replacing the existing riprap lined
ditches with vegetated ditches. Proposed impacts due to the widening of vegetated shoulder are as
follows:
Zone
i Impact
(s care feet)
1 3,000
2 2,350
Total 5,350
As shown on the attached erosion control plan, no silt basins will be installed within the Riparian
Buffers; however, silt fences and temporary rock silt check dams will be installed as needed. Per our
discussion, these temporary devices are allowed within the Riparian Buffers, as installation of these
devices does not require vegetation removal.
If you have any questions or need any additional information, please contact me at [phone]
or Paul Ingram at [phone]. Your time and assistance are appreciated.
PHONE [phone] FAX [phone]
?df 4A7(o?
I
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
Sincerely,
0 ( 'e-
J?l ,
Lenwood E. Smith, II, PWS
Division Seven Environmental Officer
cc: Mr. John Dorney, NCDWQ
Ms. Cynthia Van der Wiele, NCDWQ
Mr. Mike Mills, NCDOT
Mr. Lane Hall, NCDOT
Mr. Paul Ingram, P.E., NCDOT
LYNDO TIPPETT
SECRETARY
PHONE [phone] FAX [phone]
PROJECT LEGEND
0 POWER POLE GUY WIRE
® TELEPHONE PEDESTAL - FENCELINE
® WELL/ WELL HOUSE EXISTING R/W
® EXISTING IRON PIPE PROPOSED R/W
O IRON NOT FOUND
NOTE' : ANY POINTS ON ASAP O'I'IIER TI IAN LEGEND POIN'T'S WILL BE LABE'LEll ON MAP.
2-26-9z
Ern_ier. Control _ Segue.^.ce of Oceratior.s
1. Review Erosion Control Plans and Standards. Identify all
=lease points (outlets of cressline pipes, tail ditches,
roadway ditches; ill -lopes, etc.)
2 "nstall all measures ? release points prior to clearing &
grubbing. See Erosion Control Standards for proper
installation.
3. Begin grading operations - install all other measures as
cradina progresses and monitor their effectiveness. 1f
any measures need to be changed, consult Highway
Maintenance Engineer. Show changes on _rosion Control
Plans.
4. Locate all borrow pits and waste areas with their erosion
control measures on Erosion Control Plans or attach a
separate sheet showing same.
5. Before moving to next job site, review all measures for
iveness; make any adjustments, clean-outs, or•
repair; tali Roadside Environmental Department for
installation of a ditch liner and seeding and mulching
of all disturbed areas.
6. Continue to check and maintain all measures after each
- significant rainfall until all disturbed areas become
stabilized
7. Fill in all silt basins and silt ditches; remove all silt
fences and slope drains; redistribute all stone from silt
checks, sediment dams, and silt screens. Seed and mulch
disturbed areas.
EROSION CONTROL LEGEND
TEMP. ROCK SED. DAM - TYPE A
® TEMP. ROCK SED. DAM - TYPE B
)IND.. TEMP. ROCK SILT CHECK DAM - TYPE B
JVt?-- F. G. ROVING OR E. C. MATTING
-EE 'L FL- STONE LINER
,,, TEMP. SILT FENCE
6 17 ?._d_L] f1 V L3??f?1'11171 i L
ROCK SILT SCREEN
0 PIPE OUTLET PROTECTION
--> -? EARTH BERM
TEMP. SLOPE DRAIN
-TSD- TEMP. SILT DITCH
I \0 SILT BASIN - TYPE B (MIN. 10'x2'x3')
Fill in all sift basins and silt ditches; remove all silt fences and slope drains;
redistrbuft all stone from silt checks, sediment dams, and silt screens.
Seed and mulch disturbed areas.
j o 0

LAWRENCE M. JONES X14°p6S
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60 Ft.
RIGHT OF WAY
Compacted A B C
TYPICAL CROSS - SECTION
- :?T'?:' [.t ,z ors -..?-, •. i.?. ? Qi"1"
VERT.,
o?ot wArFRO?
r
a ?
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
November 26, 2001
MEMORANDUM
TO: John Dorney, 401/Wetlands Unit - Central Office
FROM: Larry Coble, WSRO WQ Supervisor
SUBJECT: NCDOT-SR 1853
011099
Guilford County
Central Office Received Application 7/16/01
WSRO Received Application 7/25/01
WSRO Requested Additional Information/
Project on HOLD 8/15/01
WSRO Received DOT Request for more time 9/05/01
WSRO Acknowledged Request/ Project
Still on HOLD 9/05/01
DOT/DWQ Randleman Rules Meeting 11/16/01
WSRO Received Additional Information 11/21/01
DEV, 4
WSRO Forwarding Application/Additional
Information to Central Office 11/26/01
N NR
Customer Service
1 800 858-0368
Even though the WSRO has delegated authority to issue this 401 WQ Certification, this
Office does not feel that this project fully complies with the Randleman Lake Water
Supply Watershed Regulations and would require a variance. Specifically, the project
proposes to relocate existing ditches, which, according to 15A NCAC 02B .0250(2)(a)
are Subject to the Riparian Area Protection Requirements since they (the ditches) convey
runoff directly to classified waters. Therefore, the WSRO is forwarding the
application/additional information back to the Central Office for your consideration and
decision.
cc: Coleen Sullins, DWQ Section. Chief
Steve Zoufaly, DWQ Local Government Assistance Unit
B0Wwrw-6kf,"-4Gd'%,Wetlands s Unit '-=.CentWOffice
WSRO
Division of Water Quality / Water QuaLitySect(on
585 Waughtown Street Winston-Salem; NC 27167
Phone: [phone] Fax. [phone] Internet: httpJ/ rq.ehnr.state.nc.us
q?d'`SfNF°
yR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDo TIPPETT
GOVERNOR SECRETARY
November 19, 2001
NC DENR Division of Water Quality N011 2 1 2MI
585 Waughtown Street
Winston Salem, NC 27107
ATTN: Mrs. Jennifer Frye
Wetlands/401 Unit
SUBJECT: Guilford County, Replacement of two pipes on Sandy Camp Road (SR 1853)
DWQ # 01 1099
Dear Mrs. Frye:
Per our discussion on November 16, 2001, I am submitting the revised erosion control plan for SR
1853. As we discussed during the field meeting, no new impervious surface will added because of
the secondary road upgrade. Existing ditches will be relocated with Zone 1 and Zone 2 and shoulder
widening will occur; however, infiltration will be improved by replacing the existing riprap lined
ditches with vegetated ditches. Proposed impacts due to the widening of vegetated shoulder are as
follows:
Zone Impact
(square feet
1 3,000
2 2,350
Total 5,350
As shown on the attached erosion control plan, no silt basins will be installed within the Riparian
Buffers; however, silt fences and temporary rock silt check dams will be installed as needed. Per our
discussion, these temporary devices are allowed within the Riparian Buffers, as installation of these
devices does not require vegetation removal.
If you have any questions or need any additional information, please contact me at [phone]
or Paul Ingram at [phone]. Your time and assistance are appreciated.
PHONE [phone] FAX [phone]
y aaSWEa
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTAUON
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
SECRETARY
GOVERNOR
Sincerely,
Lenwood E. Smith, II, PWS
Division Seven Environmental Officer
cc: Mr. John Dorney, NCDWQ
Ms. Cynthia Van der Wiele, NCDWQ
Mr. Mike Mills, NCDOT
Mr. Lane Hall, NCDOT r ?.
Mr. Paul Ingram, P.E., NCDOT
PHONE [phone] FAX [phone]
PROJECT LEGEND
POWER POLE 0 GUY WIRE
® TELEPHONE PEDESTAL -"- FENCELINE
® W ELL I W ELL HOUSE -"-- EXISTING R/W
® EXISTING IRON PIPE PROPOSED R/W
O IRON NOT FOUND
NOTE : ANY 1101NTS ON iNIAP OTIll'sR THAN LEGEND POINTS WILL BE LABELED ON MAP.

EROSION CONTROL LEGEND
2-26-92
Erosion control _ Segue.^.ce of Oceratiors
1 Review Erosion Control Plans and Standards. identify all
release points (outlets Of crossline pipes, tail ditches,
roadway ditches; fill slopes, etc.)
2. Install all measures 2 release points prior tc clearing &
grubbing. See Erosion Contiol Standards for proper
installation.
3. Begin grading operations - install all other measures as
grading progresses and monitor their effectiveness.' If
any measures need to be changed, consult Highway
Maintenance Engineer. Show changes on Erosion Control
plans.
4. Locate all borrow pits and waste areas with their erosion
control measures on Erosion Control Plans 'or attach a
separate sheet showing same.
5. Before moving to next job site, review all measures. for
affectiveress; make any adjustments, clean-outs, or-
repair; call Roadside Environmental Department for
installation of a ditch liner and seeding and mulching
of all disturbed areas.
6. Continue to check and maintain all measures after each
- significant rainfall until all disturbed areas become
stabilized.
7. Fill in all silt basins and silt ditches; remove all silt
fences and slope drains; redistribute all stone from silt
checks, sediment dams, and silt screens. Seed and mulch
disturbed areas.
F?MFH
TEMP. ROCK SED. DAM - TYPE A
® TEMP. ROCK SED. DAM - TYPE B
>0- TEMP. ROCK SILT CHECK DAM - TYPE B
JUL-- F. G. ROVING OR E. C. MATTING
EEEE STONE LINER
-ill ill TEMP. SILT FENCE
/V-?? f? CS!'U1
ROCK SILT SCREEN
0 PIPE OUTLET PROTECTION
- --> EARTH BERM
TEMP. SLOPE DRAIN
TSD- TEMP. SILT DITCH
M SILT BASIN - TYPE B (MIN. IO'x2'x3')
- 1 '1 b d '!t d't h remove all silt fences and slope drains!
Fill in al si t asms an _ si i c es,
redistribtO all stone from silt checks, sediment dams, and silt screens.
Seed and mulch disturbed areas.
Nei 2. v 20 .
P1=18+43.2`•
LAWRENCE M. JONES y°06'35"
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.. ' A•NDREW$'.
' . ?. DB 3910-1793 ' I
PB.iO4-004
LOT 2
IDB 391-179.1
PB 4.07-115 •
60 Ft -
RIGHT OF WAY
1E 10' 10,
1/4` i FT 1/4'1 FT i
r. '7
Compacted A B C p ? ? ... • . •. •. .. •. ." . ' ' .. ". ? t-}ORIZ
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TYPICAL CROSS - SECTION 2 . 4
dea AAiE
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
GOVERNOR SECRETARY
November 19, 2001
NC DENR Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
ATTN: Mrs. Jennifer Frye
Wetlands/401 Unit
SUBJECT: Guilford County, Replacement of two pipes on Sandy Camp Road (SR 1853)
DWQ # 01 1099
Dear Mrs. Frye:
Per our discussion on November 16, 2001, I am submitting the revised erosion control plan for SR
1853. As we discussed during the field meeting, no new impervious surface will added because of
the secondary road upgrade. Existing ditches will be relocated with Zone 1 and Zone 2 and shoulder
widening will occur; however, infiltration will be improved by replacing the existing riprap lined
ditches with vegetated ditches. Proposed impacts due to the widening of vegetated shoulder are as
follows:
As shown on the attached erosion control plan, no silt basins be installed within the Riparian
Buffers; however, silt fences and temporary rock silt check dams will be installed as needed. Per our
discussion, these temporary devices are allowed within the Riparian Buffers, as installation of these
devices does not require vegetation removal.
If you have any questions or need any additional information, please contact me at [phone]
or Paul Ingram at [phone]. Your time and assistance are appreciated.
Zone Impact
(square feet
1 3,000
2 2,350
Total 5,350
i
PHONE [phone] FAX [phone]
Lry O??_ E4
Vrr'?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
Sincerely,
Lenwood E. Smith, II, PWS
Division Seven Environmental Officer
cc: Mr. John Dorney, NCDWQ
Ms. Cynthia Van der Wiele, NCDWQ
Mr. Mike Mills, NCDOT
Mr. Lane Hall, NCDOT
Mr. Paul Ingram, P.E., NCDOT

LYNDo TIPPETT
SECRETARY
PHONE [phone] FAX [phone]
PROJECT LEGEND
POWER POLE 0 GUY WIRE
® TELEPHONE PEDESTAL -'- FENCELINE
® W ELI., / W ELL HOUSE ---- EXISTING R/W
® EXISTING IRON PIPE PROPOSED R/W
O IRON NOT FOUND
NOTE' : ANY POINTS ON NIAP OTHEIR'I'IIAN LEGEND POINTS WILL BE,, LABEILEll ON MAP.
EROSION CONTROL LEGEND
2-26-92
Erosion Control _ Sequence of Oceratior.s
1 Review Erosion Control Plans and Standards. identify all
release points (outlets of crossline pipes, tail ditches,
roadway ditches; fill slopes, etc.)
2. Install all measures 2 release points prior to clearing &
grubbing. See Erosion Control Standards for proper
installation.
3. Begin grading operations - install all other measures as
grading progresses and monitor their effectiveness.' If
any measures need to be changed, consult Highway
Maintenance E?gineer. Show changes on Erosion Control
Plans.
4. Locate all borrow pits and waste areas with their erosion
control measures on Erosion Control Plans or attach a
separate sheet showing same.
5. Before moving to next job site, review all measures. for
effectiveness; make any adjustments, clean-outs, or,
repair; call Roadside Environmental Department for
installation of a ditch liner and seeding and mulching
of all disturbed areas.
6. Continue to check and maintain all measures after each
- significant rainfall until all disturbed areas become
staMized
7. Fill in all silt basins and silt ditches; remove all silt
fences and slope drains; redistribute all' stone from silt
checks, sediment dams, and silt screens. Seed and mulch
disturbed aeas.
13 TEMP. ROCK SED. DAM - TYPE A
® TEMP. ROCK SED. DAM - TYPE B
TEMP. ROCK SILT CHECK DAM - TYPE B
JUt?- F. G. ROVING OR E. C. MATTING
-E E E E- STONE LINER
-!}}---!I! TEMP. SILT FENCE
ROCK SILT SCREEN
0 PIPE OUTLET PROTECTION
-? -? EARTH BERM
TEMP. SLOPE DRAIN
TSD- TEMP. SILT DITCH
0 SILT BASIN - TYPE B (MIN. 10'x2'x3')
Fill in all silt basins and sift ditches; remove all silt fences and slope drains;
redistribWe all stbne from silt checks, sediment dams, and silt screens.
Seed and'mulch disturbed areas.
1.0 o .
• '• . • .' • ' . ' . ? ®• • • •• • ? P1=18+43.2`
LAWRENCE M. JONES : X11°06'35",
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60 Ft
RIGHT OF WAY
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Compacted A B C 0'?? ? :: - • • '`NOR{Z
VERT.-
=:r_
77
TYPICAL CROSS SECTION 2
Re: tracking notice, WSRO, August 15, 2001
Subject: Re: tracking notice, WSRO, August 15, 2001 FILE
Date: Wed, 15 Aug 2001 15:03:14 -0400 COPY
From: Jennifer Frye <[e-mail]>
Organization: NC DENR Water Quality
To: Beth Barnes <[e-mail]>
01 1099 On Hold - letter sent today - see attached.
01 1075 Have it - still reviewing it - this one will get issued from the
Region so the traditional staff report/recommendations won't be done.
Thanks,
Jen
Beth Barnes wrote:
> Hi, Jennifer:
> I do hope this finds you well and happy. Below is this week's
> Tracking Notices for the Winston-Salem Regional Office. The Central
> Office has not received your recommendations for this project(s) as
> August 15,
> 2001. if you have not received the specified application(s), please let
> me know; the application will be FAXED to you.
> TRACKING:
> DWQ NO. Project County Permit Type Received Expires
> 1. 011099 Guilford NW 14 and 7116101 9113101
> Randleman rules
> 2. 011075 Watauga NW 39 7/12/01 919101
> Please use the staff recommendation sheet in Filemaker Pro, and-then
> notify TODD that the report has been filed.
> Thanks for your prompt attention.
> Beth Barnes
Jennifer Serafin Frye
Division of Water Quality
NC Department of Environment and Natural Resources
Winston-Salem Regional Office
Winston-Salem, NC 27107
Voice: 336-771-4608 ext. 275 Fax: [phone]
Name: DOTSR1853.doc
EMS DOTSR1853.doc Type: Microsoft Word Document (application/msword)
Encoding: base64
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1 of 1 8/27/019:53 AN
FILE COPY
DIVISION OF WATER QUALITY
August 15, 2001
CERTIFIED MAIL 7099 3400 0006 9313 6345
Return Receipt Requested
Mr. J. M. Mills
NC Department of Transportation Division 7 Engineer
1584 Yanceyville Street
Greensboro, NC 27415
SUBJECT: Request for Additional Information
Sandy Camp Road (SR 1853)
DWQ # 01 1099
Guilford County
Dear Mr. Mills:
The Division of Water Quality has reviewed your plans to impact approximately 41,
linear feet of an Unnamed Tributary to Deep River, Class WS-IV waters, Cape Fear River
Basin, for the purpose of upgrading SR 1853. Insufficient evidence is present in our-files to
conclude that your project must be built as planned in waters and/or wetlands in accordance
with 15A NCAC 2H .0506. Therefore, unless modifications of the proposal are made as
described below, we will have to move toward denial of your 401 Certification as required by
15A NCAC 2H.0507(e) and will place this project on hold as incomplete until we receive this
additional information. We are requesting (by copy of this letter) that the U. S. Army Corps of
Engineers place your project on administrative hold.
Please submit the proposed method of conveying stormwater from the new impervious
area, both during construction and after. This project is located within the Randleman Lake
Water Supply Watershed and 15A NCAC 02B .250 (5) states that sheet flow must be
maintained in Zones 1 and 2 of the riparian area. Furthermore, temporary sediment and
erosion control measures cannot be placed within Zone 1. If it is the Department of
Transportation's position that sheet flow cannot be maintained, either during or after
construction, please submit the appropriate calculations and documentation for our review.
You may contact Mr. Todd St. John at 919-733-9584 if you have specific questions regarding
the necessary engineering information.
Please keep in mind that if sheet flow cannot be maintained to the maximum extent
practical through Zones 1 and 2, a variance from the Randleman Lake Water Supply
Watershed Regulations may be necessary. Please contact Mr. Steve Zoufaly, DWQ Local
Government Assistance Unit, at 919-733-5083, ext. 566 for more information.
01 1099
Page 2
Please respond, in writing, both to this Office and to John Dorney, 2321 Crabtree
Blvd., Raleigh, NC 27604-2260 within three weeks of receipt of this letter outlining your
intent to proceed with this project or withdraw your application. If you wish to
proceed, please address the items listed above.
If you have any questions regarding this matter, please contact Mrs. Jennifer Frye or
me at [phone].
Sincerely,
Larry D. Coble
WQ Regional Supervisor
cc: Lenwood Smith, NCDOT Division Seven Environmental Officer, 4261 Camp Burton Road, McLeansville, NC 27301
Jean Manuele, Raleigh Regulatory Field Office, USACE
Steve Zoufaly, DWQ Local Government Assistance Unit
Bob Zarzecki, Wetlands/401 Unit Central Office
Cynthia Van der Wiele, Wetlands/401 Unit Central Office
Central Files
WSRO
Re: [Fwd: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.]
Subject: Re: [Fwd: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford
Co.]
Date: Mon, 03 Dec 2001 14:53:25 -0500
From: Bob Zarzecki <bob.zarzecki @ncmail.net>
Organization: Division of Water Quality; 401 Certification Unit FILE COPY
To: John Dorney <[e-mail]>,
Cynthia Van Der Wiele <[e-mail]>
John & Cynthia,
The project involves paving of an existing gravel road. No additional impervious
surface is being
added to the project. However, existing ditch/swale systems are being relocated to
provide a safe
shoulder width.
I think that everyone agreed that the existing swales along the road are not
themselves subject to
riparian protection.
The WSRO is contending that if the swales are relocated then at some point during the
process a new
ditch or manmade conveyance will be constructed through the buffer where one did not
previously
exist. Therefore, they are contending that this is a new ditch or manmade
conveyance.
"Concentrated runoff from new ditches or manmade conveyances must be dispersed into
sheet flow
before the runoff enters Zone 2 of the riparian area."
I believe that John and Coleen are comfortable in calling the relocated swale an
"existing (not
new) ditch or manmade conveyance" exempt from the sheet flow requirement.
If everyone is ok with this interpretation, then I think Cynthia is fine in Issuing
this project.
Cynthia let me know if you need a
John Dorney wrote:
> bob -.please review. discuss with cynthia and decide how to proceed.
> thankx
> ------------------------------------------------------------------------
> Subject: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.
> Date: Mon, 26 Nov 2001 14:14:52 -0500
> From: Jennifer Frye <[e-mail]>
> Organization: NC DENR Water Quality
> To: John Dorney <John. Dorney@ncmail. net>
> John,
> Just giving you a heads up that we (Larry and I) are forwarding this one
> back to the CO. A memo went out to.you today with a copy of the most
> recent additional information (received on November 21). If you need
> anything else (letters, responses, etc.), please let me know. Your file
> should have all of the same information that mine has, but you never
> know. I have attached the memo in case the hard copy never makes it.
> Jennifer
> Jennifer Serafin Frye
1 of 2 12/5/013:16 Ph
Re: [Fwd: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.]
> Division of Water Quality
> NC Department of Environment and Natural Resources
> Winston-Salem Regional Office
> Winston-Salem, NC 27107
>? 6 1 ext. 275 Fax: [phone]
>
> Name:
> 011099DOTSR1853memotodorney.doc Type:
(application/msword)
> Encoding:
> Download Status:
Bob Zarzecki
NC DENR/DWQ 401 Wetlands Certification Unit
919-733-9726
-----------------------
011099DOTSR1853memotodorney.doc
Microsoft Word Document
base64
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2 of 2 12/5/01 3:16 PM
FILE COPY
November 26, 2001
MEMORANDUM
TO: John Dorney, 401/Wetlands Unit - Central Office
FROM: Larry Coble, WSRO WQ Supervisor
SUBJECT: NCDOT-SR 1853
01 1099
Guilford County
Central Office Received Application 7/16/01
WSRO Received Application 7/25/01
WSRO Requested Additional Information/
Project on HOLD 8/15/01
WSRO Received DOT Request for more time 9/05/01
WSRO Acknowledged Request/ Project
Still on HOLD 9/05/01
DOT/DWQ Randleman Rules Meeting 11/16/01
WSRO Received Additional Information 11/21/01
WSRO Forwarding Application/Additional
Information to Central Office 11/26/01
Even though the WSRO has delegated authority to issue this 401 WQ Certification, this
Office does not feel that this project fully complies with the Randleman Lake Water
Supply Watershed Regulations and would require a variance. Specifically, the project
proposes to relocate existing ditches, which, according to 15A NCAC 02B .0250(2)(a)
are Subject to the Riparian Area Protection Requirements since they (the ditches) convey
runoff directly to classified waters. Therefore, the WSRO is forwarding the
application/additional information back to the Central Office for your consideration and
decision.
cc: Coleen Sullins, DWQ Section Chief
Steve Zoufaly, DWQ Local Government Assistance Unit
Bob Zarzecki, 401/Wetlands Unit - Central Office
WSRO
[Fwd: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.]
Subject: [Fwd: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.]
Date: Sat, 01 Dec 2001 10:22:52 -0500
From: John Dorney <[e-mail]>
To: "bob.zarzecki" <bob.zarzecki @ ncmail.net>,
Cynthia Van Der Wiele <[e-mail]> FILE COPY
CC: Jennifer Frye <[e-mail]>
bob - please review. discuss with cynthia and decide how to proceed.
thankx
Subject: 01 1099 - DOT/Sandy Camp Road Road/Randleman project- Guilford Co.
Date: Mon, 26 Nov 2001 14:14:52 -0500
From: Jennifer Frye <jennifer.frye @ ncmail.net>
Organization: NC DENR Water Quality
To: John Dorney <[e-mail]>
John,
Just giving you a heads up that we (Larry and I) are forwarding this one
back to the CO. A memo went out to you today with a copy of the most
recent additional information (received on November 21). If you need
anything else (letters, responses, etc.), please let me know. Your file
should have all of the same information that mine has, but you never
know. I have attached the memo in case the hard copy never makes it.
Jennifer
Jennifer Serafin Frye
Division of Water Quality
NC Department of Environment and Natural Resources
Winston-Salem Regional office
Winston-Salem, NC 27107
Voice: 336-771-4608 ext. 275 Fax: [phone]
Name: 011099DOTSR 1853memotodomey.doc
Type: Microsoft Word Document
10011099DOTSR1853memotodorney.doc (application/msword)
Encoding: base64
Download Status: Not downloaded with message
1 of 1 12/5/013:15 P>
I IV
an oy
ISSUED n
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
June 11, 2001
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
ATTN: Ms. Cynthia Van der Wiele
Wetlands/401 Unit
Dear Ms. Van Der Wiele:
LYNDO TIPPETT
SECRETARY
VI'Li-
01 1099
SUBJECT: Guilford County, Replacement of two pipes on Sandy Camp Road (SR 1853)
Please find seven (7) copies a Pre-Construction Notification Application package attached for your
review. If you have any questions or need any additional information, please contact Len Smith
[phone] or Paul Ingram at [phone]. Thank you for your time and assistance.
Sincerely,
L .-4a,ic ?, .
S. L. Hall
District Engineer, District 2, Division 7
cc: Mrs. Jean Manuele
Mr. Lenwood Smith, II, PWS, NCDOT

PHONE [phone] FAX [phone]
.A ?nCq
Y? CunM `?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
LYNDO TIPPETT
SECRETARY
June 11, 2001
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 27615
ATTN: Mrs. Jean Manuele
NCDOT Coordinator
Dear Mrs. Manuele:
SUBJECT: Guilford County, Replacement of two pipes on_Sandy- Camp Road -(SR 1853)
The North Carolina Department of Transportation (NCDOT) proposes to replace pipes at Stations
12+70 (Site A) and 14+85 (Site B) under Sandy Camp Road (SR 1853) as part of a single project to
upgrade SR 1853 from an unpaved secondary road to a paved secondary road. The upgrade is being
conducted to reduce future maintenance needs, bring the road up to current construction standards,
and increase safety Travel-lane widths must also be increased_from _18' to 20' to accommodate
through traffic and bus traffic. Both pipes are being replaced to facilitate the upgrade and widening
of the travel lanes. The replacements will be as follows:
Site Existing Proposed Stream Type Impacts (ft)
A 37' of 36" CMP 60' of 42" CMP Intermittent 23 (m), 10 (tm )
B 52' of 48" RCP 70' of 81" X 59" CMPA Perennial 18 (m), 20 (tm )
RCP = reinforced concrete pipe; CMP = corrugated metal pipe; CMPA = corrugated metal pipe arch
pm = permanent; tmp = temporary
In addition to stream impacts, the project is located in within the Randleman Lake Water Supply
Watershed and within 0.5 miles from the critical area of a surface water intake. Impacts will be
minimized by strict enforcement of Best Management Practices (BMPs) for the protection of
wetlands and surface waters, and restrictions against the staging of equipment in or adjacent to
waters of the US. Riparian buffer impacts will be minimized through provision of diffuse flow on
the east side of the road by not cutting ditches and utilizing silt fence to prevent sediment loss
during construction. Diffuse flow cannot be maintained on the west side of the road due to
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
Page 2
Mrs. Manuele
June 11, 2001
topographic constraints (see the attached photographs). 15A NCAC 02B.0250 (2) (1) states that
road crossings are exempt from riparian area protection requirements in the Randleman Lake Water
supply watershed if no practical alternative exists. Because this is an upgrade of a substandard road
and no practical alternatives exists regarding travel lane improvements and ditching on the west
side, it is anticipated that these activities will be exempted from the riparian buffer protection
requirements. Article VII 7-1.8 of the Guilford County Ordinance also allows for road crossings in
stream buffers where no practical alternative exists. Article VII 7-1.10 of the Guilford County
Ordinance also designates the NCDOT as responsible for implementation of the Water Supply
Watershed Protection Rules as long as they comply with BMPs for the protection of surface waters.
As previously stated all BMPs will be followed. Following the proposed minimization and
avoidance practices, anticipated impacts within the Riparian Buffer (assuming Low Density
requirements are met) are as follows:
Zone* Impact
(square feet)
1 5280
2 3520
Total 8800
No wetlands are located in the project area. No threatened or endangered species or their habitats
were observed during surveys conducted by Lenwood Smith, II. Records from the NCDOT Historic
Architect indicate compliance with the National Historic Preservation Act.
The NCDOT anticipates that both pipe replacement activities will be authorized under Nationwide
Permit 14 and the dewatering operation at Site B will be authorized under NWP 33. This
application is intended as a request for formal written authorization from USACE to dewater the
stream at Site B under NWP 33. This application is also intended as request for written
authorization from the NC Division of Water Quality to replace both pipes under General Water
Quality Certificate #3289 (NWP 14). Enclosed please find the project site map and the pre-
construction notification form for the above referenced project. Construction is anticipated to begin
as soon as practicable following authorization and take 2 days to complete.
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
Page 3
Mrs. Manuele
June 11, 2001
If you have any questions or need any additional information, please contact Len Smith (336) 375-
5589 or Paul Ingram at [phone]. Thank you for your time and assistance.
Sincerely,
?,? L A aA,
S. L. Hall
District Engineer, District 2, Division 7
cc: Ms. Cynthia Van der Wiele, NCDWQ
Mr. Lenwood Smith, II, PWS, NCDOT
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
? ,F,YC C
1tf / 3`r
Cho`'
O
of
Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.army.mil/wetlands/Perm app.ht .
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.army.mil/wetlands/regiour.htm, or contact one of the field
offices listed at the end of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U. S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for some General Certifications is not required,
provided that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet
should contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is also required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on the last page of this application).
Page 1 of 11
CAMA Coordination - If the project occurs in any of North Carolina's twenty coastal counties (listed on
the last page of this application) the applicant should also contact the North Carolina Division of Coastal
Management (DCM) at [phone]. DCM will determine whether or not the project involves a
designated Area of Environmental Concern, in which case DCM will act as the lead permitting agency.
In such cases, DCM will require a Coastal Area Management Act (CAMA) Permit and will coordinate
the 404/401 Permits.
USACE Permits-- Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office (addresses are listed at the end of this
application). Upon receipt of an application, the USACE will determine if the application is complete as
soon as possible, not to exceed 30 days. This PCN form is designed for the convenience of the applicant
to address information needs for all USACE Nationwide, Regional or General permits, as well as
information required for State authorizations, certifications, and coordination. Fully providing the
information requested on this form will result in a complete application for any of the USACE
Nationwide, Regional or General permits. To review the minimum amount of information that must be
provided for a complete PCN for each USACE Nationwide permit, see Condition 13, 65 Fed.Reg. 12893
(March 9, 2000), available at http://www.saw.usace.army.mil/wetlands/nwpfinafFedReg.pdf.
Processing times vary by permit and begin once the application has been determined to be complete.
Please contact the appropriate regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required or specifically requested for a 401
Certification, then a non-refundable application- fee is- required- In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwetiands/fees.html. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 11
Office Use Only: 01 10 9 9 Form Version April 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: 14 & 33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
III. Applicant Information
1. Owner/Applicant Information
Name: Mr. J.M. Mills, PE.. Division Engineer - Division 7
Mailing Address: 1584 Yanceyville Street
Greensboro, NC 27415
Telephone Number: [phone] Fax Number:_ (336, 3) 34-3637
E-mail Address: [e-mail]
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Mr. S.L. Hall. District 2 Engineer
Company Affiliation: NCDOT - Division 7
Mailing Address: 1584 Yanceyyille Street
Greensboro NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address:, lhaMdot.state.nc.us
Page 3 of 11
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad. Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Sandy Camp Road (SR 1853)
2. T.I.P. Project Number (NCDOT Only): 6.492110T (Non•Ti
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Guilford Nearest Town: High Point
Subdivision name (include phase/lot.number):
Directions to site (include road numbers, landmarks, etc.): The project is accessed from
Interstate 40 by heading south Sandy Ridge Road (SR 1850) for approximately 3 miles and
turning left. An NCDOT maintenance camp and a prison camp are located on this road. Site
A is approximately feet north of the intersection of SR 1853 and K_ endale Road (SR
1834). Site B is approximately feet north of the intersection.
5. Site coordinates, if available (UTM or Lat/Long): See the attached sheet
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
Residential
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Deep River (Oak Hollow Lake)
9. River Basin: Cape Fear
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 4 of 11
10. Describe the purpose of the proposed work: Up W de of an unpaved secondary road to a
paved secondary road Paving and widening are being conducted to reduce future
maintenance costs. bring the road up to current construction standards and increase traffic
safety.
11. List the type of equipment to be used to construct the project: Road construction
gquipmen t
12. Describe the land use in the vicinity of this project: Maintained residential lawn and utility
line corridor.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
N/A
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application: N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 5 of I I
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
esJno Distance to
Nearest Stream
linear feet
Type of Wetland***
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodptains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FMM? or FBMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact proposed: N/A
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
indicate on map)
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
lease specify)
A Pipe replacement 10 ??P) UT to Deep River 67 Intermittent
B Pipe replacement 20 j UT to Deep River 10, Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usas.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapguest.coetc.).
Cumulative impacts (linear distance in feet) to all streams on site: 41 - permanent (rn , 30
-temporary (trrlp).
Page 6 of 11
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres
Name Wat)
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A

" List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands n stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Pipe replacement activities and widening activities are necessary to increase travel lane and
shoulder width to current construction standards. Travel lane widths must be increased from 18'
to 20' to accommodate through traffic and bus traffic. Impacts will be minimized by strict
enforcement of Best Management Practices (BMPs) for the protection of wetlands and surface
waters, and restrictions against the sta iging of equipment in or adjacent to waters of the US. The
project is located in within the Randleman Lake Water S=ly Watershed and within 0.5 miles
from the critical area of a surface. water intake. Impacts will be minimized by strict enforcement
ofBest Management Practices (BMPs) for the protection of wetlands and surface waters, and
restrictions against the staging of equipment in or adjacent to waters of the US. Riparian buffer
impacts will be minimized through provision of diffuse flow on the east side of the road by not
cutting ditches and utilizing silt fence to prevent sediment loss during construction. Diffuse flow
cannot be maintained on the west side of the road due to topggraphic constraints (see the
attached photographs). 15A NCAC 028.0250 (2) G) states that road crossings are exempt from
Page 7 of 11
riparian area protection requirements in the Randleman Lake Water supply watershed if no
practical alternative exists. Because this is an upgrade of substandard road and no practical
alternatives exists regarding travel lane improvements and ditching on the west site, it is
anticipated that these activities will be exem tp ed from the riparian buffer protection
requirements. Article VII 7-1.8 of the Guilford County Ordinance also allows for road crossings
in stream buffers where no practical alternative exists. Article VII 7-1.10 of the Guilford County
Ordinance also designates the NCDOT as responsible for implementation of the Water Supply
Watershed Protection Rules as long as the comply with BMPs for the protection of surface
waters.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
L Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
A finding of insignificant impact is anticipated. Cumulative impacts are less than 150
feet. The maximum amount of permanent impact of a single perennial stream is 18 linear
feet.
Page 8 of 11
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NOM, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/l*ndex.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National. or . North Carolina -Environmental- Policy _Act .(NEPA/SEPA)?._
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify Randleman - LD )?
Page 9 of 11
Yes ® No ? If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* (s uarpe feet) Multiplier Required
1 5280 3
2 3520 1.5
Total 8800
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
XL Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
In accordance with theFebruarv 25. 1991 deleization agreement one cot)v of the sediment and
erosion control plan will be submitted to DENR - Division of Land Resources and NCDOT
Roadside Environmental prior to construction.
XH. Sewage Disposal (DWQ Only)
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.
X 1H. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No ?
Is this an after-the-fact permit application?
Page 10 of 11
Yes ? No ?
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).

7////0/
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 11 of 11
SITE COORDINATES
Site Number Station Easternly Northernly
A 12+70 17 05 89 976 00 39 91 265
B 14+85 17 05 89 951 00 39 91 173
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... 11 ?i ' .J'• \i? ..? 1, t \.,) C
ff.
8°W
Name: KERNERSVILLE Location: 17 587839 E 3991220 N
Date: 7/6/2001 Caption: Location of proposed pipe replacements on Guilford -
Scale: 1 inch equals 2000 feet SR 1853
Copyright (C) 1997, Maptech, Inc.
PROJECT LEGEND
POWER POLE GUY WIRE
® TELEPHONE PEDESTAL -"- TENCELINE
® WELL/ WELL HOUSE -"- EXISTING R/W
41 EXISTING IRON PIPE PROPOSED R1W
O IRON NOT FOUND
NOTE: ANY POINTS ON 11 V 0THER T11AN LEGEND POINTS WILL I3E LABELED ON P&W.
EROSION CONTROL LEGEND
Erosion Control _ Sequence of operations 2-26-92
1. Review Erosion Control Plans and Standards. Identify all
release points (outlets of crossline pipes, tail ditches,
roadway ditches; fill slopes, etc.)
2. Install all measures @ release points prior to clearing &
grubbing. See Erosion Control Standards for proper
installation.
3. Begin grading operations - install all other measures as
grading progresses and monitor their effectiveness.' If
any measures need to be changed, consult Highway
Maintenance Engineer. Show changes on Erosion Control
Plans.
4. Locate all borrow pits and waste areas with their erosion
control measures on Erosion Control Plans•or attach a
separate sheet showing same.
5. Before moving to next job site, review all measures. for
effectiveness; make any adjustments, clean-outs, or-
repair; call Roadside Environmental Department for
installation of a ditch liner and seeding and mulching
of all disturbed areas. -"-
6. Continue to check and maintain all measures after each
- significant rainfall until all disturbed areas become
stabilized.
7. Fill in all silt basins and silt ditches; remove all silt
fences and slope drains; redistribute all stone from silt
checks, sediment dams, and silt screens. Seed and.mulch
disturbed areas.
TEMP. ROCK SED. DAM - TYPE A
® TEMP. ROCK SED. DAM - TYPE B
>0. TEMP. ROCK SILT CHECK DAM - TYPE B
1?-- F. G. ROVING OR E. C. MATTING
-EL[-? STONE LINER
?{#--i i! TEMP. SILT FENCE
0 PIPE OUTLET PROTECTION
----b, -? EARTH BERM
TEMP. SLOPE DRAIN
TSD- TEMP. SILT DITCH
` ®
°
° SILT BASIN - TYPE B (MIN. 10'x2'x3')

M
A T-
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4,7
-7
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.
1
1 S 1E1
ROCK SILT SCREEN
=TSD- TEMP. SILT DITCH
SILT BASIN - TYPE B (MIN. 10'x2'x3')
ROCK SILT SCREEN
c?iou wy?c all mvila llvlr.l Alft wICtA Z), 'w1ul
Seed.and mulch disturbed areas.

.25
p1=18+43
LAWRENCE M. JONES °06'36"
D81407-228 X11L7
R-1480-64'-
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DB 1407-228 LOT 1&2 , I
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& DANETTE 1 ' C
+ ANDREWS . . ' ?
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MAFZY SUE RAYLE SMITH
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HORIZ. SC
VERT. S(

ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 2
State Project # SR Number Road Name Coup
6.492110T 1853 Sand Cam Road Guilford
Guilford County
Bald Eagle (Haliaeetus leucocephalus). Lake Higgins Area.
Is the activity within the primary or secondary zone Yes ? No
James s in ussel Pleurobema collina) - Roanoke Basin
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Potential Species (Listed in Nearby Counties)
Schweinitz's sunflower Helianthus scInwinitzh Ma be surveyed for from late August to October
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
No 12/04/01 Len Smith 1.0
General Notes/Comments:
,]e, trT/ r 17
d I
Division Environmental Officer Date
NATURAL RESOURCE EVALUATION SHEET
State Project # SR Number Road Name Conn Investigator(s)
6.492110T 1853 Sandy Camp Road Guilford Len Smith
Date: River Basin: Water Quality Designation Buffer Rules (Y/1)
12/04/01 Cape Fear WS-IV Yes - Randleman
Primary Land Use Percent Residential Percent Agricultural: Percent Unmaintained:
Residential 40 40 20
Waters of the ITS
Streams
Station Stream Name Perennial or
Intermittent Ave. Wdth
OHWM Ave. Dpth
(OHWM) Ave. Wdth
OB Ave. Dpth
OB Notes
12+70 UT to Deep River Intermittent 6' 0.5' 8' 4'
14+85 UT to Deep River Perennial 10' <0.5' 12' 4'

M.M. = Mile Marker, OHWM = Measurements made from Ordinary High Water Marker, TOB =
Measurements made from the Top of the Bank
Wetlands

Station Within 100-year
Floodplain Distance to
Nearest Stream
linear feet)
Cowardin Classification
Dominant Plants
N/A

Open Water

Station Name of Waterbody
if applicable) Type of
Waterbod
M'M' Name of Waterbody
if applicable) Type of Waterbody
N/A

General Notes/Comments:
00
Division Environmental Officer Date
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: Seven County: Guilford Project ID: 6-4921101
River Basin: Cape Fear Bridge No: N/A
Route: 1853 Stream: UT to Oak Hollow Lake (Deep R.)
Water Quality Criteria:
Yes No
WS II,III OR IV, Crossing Within 0.5mi or r
Is a Hazardous sr r
WSI r I-1
WS II,III OR IV, Crossing Within 0.5mi of W.S. Critical Area ff r
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban C" F
Arterial Rural r I
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? r F,
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
STATION 12 + 70
EROSION CONTROL PLAN
GUILFORD COUNTY SR 1853 (SANDY CAMP RD.)
Project No. 6.492110T Pipe Replacement
Replacement of existing 37' of 36" CMP with 60' of 42" CMP.
Rip Rap sediment dam is required.
Stilling basin is not required.
Silt Fence will be installed as needed.
Seeding will be performed by Roadside Environmental as scheduled.
Comments:
During low flow, we will close the entire roadway- with a detour and replace
the existing pipe with 60' of 36" RCP. Once the pipe is installed, we will
install rip- rap outside the ditch to stabilize the ends of the pipe. The new
pipe will be buried 20% below the existing streambed. Once work is
complete, the temporary dams will be completely removed.
Prepared by: J. P. Ingram 07/05/01
+70
-E?'PL/-?,C. Eyc 1 STlrat? 7>40 " CMP U0 1?f NEW 4-Z" (,tlp

C?
C>
Ste, I sa•4 -

a ,
70
i I ? ??t85
?i
Z

tom
L
L/
STATION 14+55
EROSION CONTROL PLAN
GUILFORD COUNTY SR 1853 (SANDY CAMP ROAD)
Project No. 6.492100T Pipe Replacement
Replacement of Existing 52' of 48" RCP with 70' of 81" x 59" CAMP Arch
Rip Rap sediment dam is required
Stilling basin is not required
Silt fence will be installed as needed
Seeding will be performed by Roadside Environmental as scheduled
Comments:
We will close the entire roadway with a detour and replace existing pipe with 70' of 81"
x 59" CMP Arch. Once the pipe is installed we will install rip-rap outside the streambed
to stabilize the ends of the pipe. The new pipe will be buried 1' below the existing
streambed. Once work is complete the temporary dams will be removed.
Prepared by J.P. Ingram 07/05/01
r X` Fi , M 1
Z-f -=-T? LA.C C 4- 1 70

AT cj i F* i o r. 1 4 + Q?'w tt 1? l lase L°
5?t`+ CAE? A?w..c?-? M?fo
z i 85 3
fw. o
0 A-
XX4
y ?r
?:,- T - 7--,(, C- Z
ON C I i A Fps' I -, ,?, 4 -I ?L )
DAM <,
. ?.r

Upstream view of the channel at site A
d
"?X?`YE ? ,r .f ?" a y. f ?r j/ ?,M?. .,Y,R.t a. 'w"4 of ? t ?.`? '?-s'!.
? r
,..+'y? ? ar ?'+°y` ? ti`.- :-? ate _.y ••?.? {.?
K
a. , i •?1 F .k
s t Y ? •A
.x 1 . z `>
3
Inlet of the pipe being replaced at Site A
Outlet of the pipe being replaced at Site A
._ 4 y V ?llyd? a L Iw .6?
pl P•?f/
1Ta ? ? P
Upstream view of the channel at site B
11
i
Outlet of the pipe being replaced at Site B

' 51 ?'L.- .i Y? ? t is etif• ! ..?
4, .Y
Downstream view of the channel at site B
K
- - r'
View of the hill located south of the channel at Site A. Note the ditch on the west side that is currently
receiving drainage from the hill.

View of the hill located north of the channel at Site B. Note the ditch on the west side that is currently
receiving drainage from this location.
4`t

,ry.4 ...V;.

_ r -

p 4 Cy„
+
y .?? _

View of the terrain between Sites A and B. View facing north. Note the ditch on the west side.
r

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
August 31, 2001
NC DENR Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
ATTN: Mrs. Jennifer Frye
Wetlands/401 Unit
Dear Mrs. Frye:
?n
LYNDo TIPPETT
SECRETARY
SUBJECT: Guilford County, Replacement of two pipes on Sandy Camp Road (SR 1853)
DWQ # 01 1099
This letter is being written in response to your August 15, 2001 request for additional information
regarding the upgrade of SR 1853. In response to receipt of your letter, Division Seven has
contacted the Hydraulics Unit to provide assistance in the design of measures that would allow for
sheet flow in the Randleman Buffers.
If representatives of the Hydraulics Unit determine that maintenance of sheet flow requires the
addition of permanent drainage easements along the existing roadway additional efforts will have to
be made to acquire right-of-way access for these drainage easements. This is in accordance with GS
136 Article I Part 18 (26) which states that NCDOT may only use condemnation to acquire
additional right-of-way during secondary road improvements if the NDDOT is presented with
County Commissioners meeting minutes indicating approved for condemnation by a majority of the
Commissioners, and a petition requesting improvement is submitted by the abutting owners whose
frontage on the secondary road equals or exceeds seventy-five percent of the linear front footage
along the secondary road to be improved.
Due to the amount of time necessary to further study the possibility of maintaining sheet flow and
acquiring right-of-way the NCDOT wishes to request that no further action be taken by the NCDWQ
at this time and that the permit be put on administrative hold until fiuther notice. The NCDOT
would also like to request a formal meeting at the Division Office and site visit with all of the
NCDWQ representatives involved including Mr. John Domy, Ms. Cynthia Van der Wiele, and Mr.
Steve Zoufaly. Please contact me with dates of availability.
PHONE [phone] PAX 336-334-3637
ya ST/V?o
Lsy- d
ayR a??a
STATE OF NORTH CAROLINA
DEPARBNfiNT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEWLLE STREET, GREENSBORO, NC 27415 LYNDo TIPPETT
GOVERNOR SECRETARY
If you have any questions or need any additional information, please contact Len Smith at (336) 375-
5589 or Paul Ingram at [phone]. Your time and assistance are appreciated.
Sincerely,
?74
Lenwood E. Smith, II, PWS
Division Seven Environmental Officer
cc: Mr. John Dorney, NCDWQ
Ms. Cynthia. Van der Wiele, NCDWQ
Mr. Steve Zouflay, NCDWQ
Mr. Mice Mills, NCDOT
Mr. Lane Hall, NCDOT
Mr. Paul Ingram, P.E., NCDOT
Mr. Dave Henderson, P.E., NCDOT
PHONE [phone] FAX [phone]
?OF W ATFRQ
0
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department. of Environment and Natural Resources
'C Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
9
DWQ Project No.: I County: h'U 11 E:D,eh_
Applicant: CDEP A 2-r PAB N-r F -MA jsP6k -r 16 N A yyy?
Project Name: P.18!73 ?F GWL
Date of Issuance of 401 Water Quality Certification: / z o I
Certificate of Completion _y rvR?R U,LIIY SECTION.
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is. required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, J . F . Tr?l?-SAM , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans 7d
s, an d other supporting materialsSignature: Q Date: 62'_Zzt¢ O2L
Agent's Certification "
hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature: Date:
If this project was designed by a Certified Professional
I, . as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe
(periodically, weekly, full time) the construction of the project, for the Permitee hereby state. that, to the
best of my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No. Date
Eli,
Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650
Wetlands/401 Unit: [phone]

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