20031455 Ver 1_Complete File_20031117

F WATF Michael F. Easley, Governor
\O?C RQG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
0 Alan W. Klimek, P.E. Director
Division of Water Quality
O ?
DWQ Project No.: E) S115 >
Applicant: tic-DDT - 'Tb? J l
Project Name: S R. A 1 ?(.0
Date of Issuance of 401 Water Quality

Certificate of Completion
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, &I •L- L-klely- - , 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: /I ? ?; A Date:
Agent's Certification
I, , 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
WETLANDS 1401 GROUP
FEB 0 4 2004
WATER QUALITY SECTION
lvmx?
MEM
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetiands/
V+IAMichael F. Easley, Governor
`0?0 ?QG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
r Alan W. Klimek, P.E. Director
> Coleen H. Sullins, Deputy Director
G1 = Division of Water Quality
December 11, 2003
Cleveland County
DWQ Project No. 031455
SR 2126 (China Avenue)
APPROVAL of 401 Water Quality Certification with Additional Conditions
WETLANDS 1401 GROUP
Mr. Michael L. Holder, P.E.
Division Engineer DEC 1 9 2003
N C Department of Transportation
Post Office Box 47
Shelby, North Carolina 28151 WATER (QUALITY SECTION
Dear Mr. Holder:
You have our approval, in accordance with the attached conditions and those listed below, to replace and extend the
existing 70 linear feet of culvert with new impacts totaling 35 linear feet (20 feet of new culvert, 10 feet of riprap and
5 feet of embedded energy dissipator) in an unnamed tributary to Buffalo Creek (Kings Mountain Reservoir) in order
to make repairs to a culvert oil NCSR 2126 in Cleveland County. NC Division of Water Quality staff reviewed the
repair work on December 1, 2003, and were satisfied that the project was constructed in accordance with the after-
the-fact application dated November 4, 2003 (received November 17, 2003).
After reviewing your application, we have decided that this fill is covered by General Water Quality Certification No.
3404, corresponding to the U.S. Army Corps of Engineers Nationwide Permit Numbers 14. In addition, you must
acquire any other federal, state or local permits before you proceed with your project including (but not limited to)
Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire
with the accompanying 404 Permit unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design described in your application (unless modified below).
Should your project change, you must notify the DWQ in writing and submit a new application. If the property is
sold, the new owner must be given a copy of this Certification and approval letter, and is thereby responsible for
complying with all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or of
total impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to be valid, you must follow the conditions
listed in the attached certification and any additional conditions listed below.
Erosion and sediment control practices must be in full compliance with all specifications governing the proper
design, installation and operation and maintenance of such Best Management Practices.in order to protect surface
waters standards:
a. The erosion and sediment control measures for the project must be designed, installed, operated, and
maintained in accordance with the most recent version of the North Carolina Sediment and Erosion
Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control measures must
be such that they equal, or exceed, the requirements specified in the most recent version of the North
Carolina Sediment and Erosion Control Manual. The devices shall be maintained on all construction
sites, borrow sites, and waste pile (spoil) projects, including contractor-owned or leased borrow pits
associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must be designed, installed, operated,
and maintained in accordance with the most recent version of the North Carolina Surface Mining
Manual.
199 North Main Street Mooresville, N.C. 28115 Telephone: [phone] Fax: [phone] Customer Service: 1-877/623-6748
Mr. Mike Holder
December 11, 2003
Page Two
d. The reclamation measures and implementation must comply with the reclamation in accordance with the
requirements of the Sedimentation Pollution Control Act.
2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the footprint
of the impacts depicted in the Preconstruction Notice Application. All construction activities, including the
design, installation, operation, and maintenance of sediment and erosion control Best Management Practices,
shall be performed so that no violations of state water quality standards, statutes, or rules occur.
3. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control, devices in wetlands and waters is unavoidable, they
shall be removed and the natural grade restored within six months of the date that the Division of Land
Resources has released the project.
4. Please note that the unnamed tributary to Buffalo Creek (Kings Mountain Reservoir) is classified as WS III CA
waters.
5. NCDOT must submit a plan for written DWQ approval to address any head cutting or associated stream bank or
riparian area that becomes unstable, should it occur, resulting from this project. Any repair designs must be
submitted to and receive written approval from the NCDWQ before the repair work is performed.
6. Any riprap used must not interfere with thalweg performance and aquatic life passage during low flow conditions.
Rock check dams at culvert outlets should be removed at project completion to avoid blocking aquatic life
movement.
7. Stormwater should be directed to vegetated buffer areas, grass lined ditches or other means appropriate to the site
for the purpose of pre-treating stormwater runoff, and must not be routed directly into streams. Mowing of
existing vegetated buffers is strongly discouraged, so that they may be utilized for stormwater sheet flow.
8. 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. NCDOT is strongly advised to send in photographs upstream and
downstream of each structure to document correct installation.
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, which
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 Mr. Mike Parker of the
Asheville Regional Office at 828.251.6208.
Sincerely,
Alan W. Klimek, P.E.
Attachment
cc: Wilmington District Corps of Engineers
Trish Simon, Division 12, DEO
Neil Trivette, Roadside Environmental
Steve Lund, USACE Asheville Field Office
Wetlands/401 Unit
Mooresville Regional Office
Mike Parker, NCDWQ Asheville Regional Office
Central Files
PJA-_?

WETLANDS 1401 GROUP
:- .R NO V 1 7 2003
STATE of NORTH CAROLINA WATER QUALITY SECTION
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
November 4, 2003
Mr. Steve Lund - NCDOT Projects
US Army Corp of Engineers 031455
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
Dear Mr. Lund:
The North Carolina. Department of Transportation, Division of Highways, submits the following project
for your issuance of a Section 404 Permit. This Office requests a Nationwide #14 Permit for the
following project. Please note that initially this project was to be constructed under Nationwide #3
Permit (Action Id # 200430011) which was issued from your Office on October 7, 2003. Enclosed is a
copy of the original authorization permit. During excavation of the deteriorated pipe it was found that
several feet of garbage buried both ends of the pipe and the upstream and downstream slopes of the
road were covered in several feet of decomposing garbage. It has been determined that it will be
necessary to extend the replacement pipe 20 feet so an adequate slope of 1.5 to 1 may be constructed.
All garbage and debris from this site is to be disposed of in the Cleveland County Sanitary Landfill.
COUNTY: Cleveland
LOCATION: Pipe replacement on SR 2126, China Avenue
STREAM: Unnamed Tributary to Buffalo Creek, (Kings Mountain Reservoir) WS-III
Watershed (from a point 0.3 mile upstream of Long Creek to dam at Kings
Mountain Reservoir, Buffalo Creek), Broad River Basin
PROJECT DESCRIPTION: The project now consists of the replacement of a deteriorating 70-foot
long 36" CMP with a 90-foot long 36" RCP or HDPE. Five feet of riprap will be placed on the
streambank at the pipe's inlet and outlet for structure stabilization. A stream profile was established by
measuring thalweg elevations at various points approximately 40 feet upstream and downstream of the
existing pipe. The proposed pipe will be buried 20% (-T') below streambed grade based upon the
established thalweg profile. The proposed pipe gradient has been calculated to be at a 71/o slope;
therefore, it is possible that stream destabilization may occur as a result of pipe installation. In an effort
to prevent stream channel headcutting or downcutting, it is proposed that a grade control structure
(cross vane weir) be constructed upstream of the pipe within DOT right of way and a five foot riprap
energy dissipater will be installed at the pipe outlet. The riprap will be embedded into the streambed so
as not to inhibit aquatic passage.
I
Mr. Steve Lund
Pipe Replacement, SR 2126
November 4, 2003 - Page 2
The tributary is a small stream with limited flow; therefore, no stream diversion is planned. Enclosed is
a PCN application, sketches of planned activities, and location maps relative to the proposed project.
This project is located within a WS-III watershed in the critical watershed area. Although the crossing
is within the critical watershed area, SR 2126, is not a rural or urban arterial and no hazardous spill
basins are required for this project. Enclosed is the NCDOT hazardous spill basin checklist.
A review of the Natural Heritage information for the threatened species listed for Cleveland County, the
dwarf-flowered heartleaf (Hexastylis nanflora), did not reveal any known sites in the close vicinity of
the proposed project. A survey for this species was conducted on September 22, 2003 in the vicinity of
the proposed project. It was determined that neither the species nor suitable habitat is located in the
project area; therefore, no impact on this species is anticipated. A review of the available information
from the National Register of Historic Places was also conducted. It is anticipated that no site listed on
the National Register will be affected by the proposed project.
Your earliest consideration for this request would be greatly appreciated. Should you have any
questions, please call me at 704-480-9020.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY: JxtL,
Trish Simon
Division 12 Environmental Supervisor
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Larry Carpenter, P.E., Cleveland County Maintenance Engineer
Mr. Ron Linville, Wildlife Resource Commission
Mr. Brian Cole, U.S. Fish & Wildlife Service
Mr. Neil Trivette, Roadside Environmental Field Engineer
Mr. John Dorney, DEW DWQ, 401/Wetlands Unit
Mr. Mike Parker, DWQ, Asheville Regional Office
File

Office Use Only: 081 14 5 version October 2001
USAGE 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.
L Processing
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: Nationwide Permit # 11
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 VII - Mitigation), check here: ?
11 Applicant Information
1. Owner/Applicant Information
Name: Mike Holder. NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
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: Trish Simon
Company Affiliation: NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: [e-mail],
Page 1 of 8
14
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.
Name of project: County Maintenance pipe replacement on SR 2126, China Av.. Cleveland
County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 12.202311
3. Property Identification Number (Tax PIN): NCDOT Ri htg_ of way
4. Location
County: Cleveland Nearest Town: Shelby
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): Hwy 180 north of Shelby, east
on SR 2052, right on SR 2033, left on SR 2125 and proceed to project site
5. Site coordinates, if available (UTM or Lat/Long): 35°17'26'N/81°28'23W
(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:
Pine on a paved secondary road
7. Property size (acres): <0.10 acres NCDOT right of way
8. Nearest body of water (stream/river/sound/ocean/lake): _ Unnamed tributary to Buffalo
Creek (Kings Mountain Reservoir) ffrom a point 0.3 mile upstream of Long, Creek to dam at
Kings Mt. Reservior, Buffalo Creek) WS-III CA Waters.
9. River Basin: Broad
(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/mWs/.)
Page 2 of 8
10. Describe the purpose of the proposed work: The project consists of replacing; a deteriorated
36" 70-foot CHIP with a 36".90-foot RCP or HDPE with associated dprap for structure
protection.
11. List the type of equipment to be used to construct the project: A trackhoe will be used
for excavation and placement of ripran.
12. Describe the land use in the vicinity of this project: The surrounding area is wooded in a
residential subdivision.
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.
The,. project was to be constructed under a Nationwide #3 (Action M#20043001 1) which was
issued on October 7, 2003 During the current excavation of the deteriorated Roe it was
discovered that several feet of garbage buried both the inlet and outlet of the pipe. Additionally,
length of pipe needed were erroneous It has been determined that it will be necessary to install a
90 foot Rpe to provide an adequate embankment slope of -1.5:1.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
No future permit requests anticipated.
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 3 of 8
1. Wetland Impacts: NONE
Wetland Impact
Site Number
indicate on map)
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
no Distance to
Nearest Stream

Oinear feet
Type of Wetland***

List each impact separately and identify temporary impacts. Impacts include, but are not Umtteu to: mecnamzea clearing, graamg, uu,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both shvcture and flooding.
** 100-Year floodplams are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplam maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at htt)J/www.femagov.
*** 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: 0
2. Stream Impacts, including all intermittent and perennial streams
stream
Impact Site
Number Type of Impact* of ct
Impa
Length Stream Name** Average Width
of Stream Perennial or
Intermittent?
(indicate on r feet)
(linear Before Impact (please specify)
map)
Pipe culvert ITT to Buffalo
1 (increase in pipe 20 feet Creek (Kings Mt 2 feett Perennial
length) Reservoir)

Riprap energy
I dissipator embedded 5 feet outlet
into strearnbed
Riprap on 5 feet inlet
1 streambank at
5 feet outlet
outlet
List each impact separately and identify temporary impacts. impacts include, but are not ttmttea to: cuma-w tma m bw,utw gat,-14y,
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/straightemrig, 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.eov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mMuest.corn, etc.).
} Stream has "backed up" due to pipe/slope failure and has overwidened the stream upstream of the pipe.
Cumulative impacts (linear distance in feet) to all streams on site: Fill in stream = 25 feet;
Riprap impacts on streambank =10 feet.
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S. NO OPEN WATER Tx"ACTS
Open Water Impact Area of Name of Waterbody Type of Waterbody
Site Number Type of Impact* Impact (lake, pond, estuary, sound,
(indicate on maul (acres) (if applicable) bay, ocean, etc.
List each impact separately and identify temporary impacts. Impacts
flooding, drainage, bulkheads, etc.
are not limited to: fill, excavation, dredging,
Page 4 of 8
4. Pond Creation NO 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 ap lication.
Pond to be created in (check all that apply): ? uplands [stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
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.
Due to the topography at the site it is necessary to replace the 70-foot deteriorated pipe with a
90-foot pi 2e to provide an adequate road embankment slope of -1.5: 1The pipe will be buried
20% based upon the thalweg elevations taken upstream and downstream of the existing pipe.
Due to the large amounts of trash deposited at the site over the years and the collapsed pipe. the
stream flow has been mostly blocked and has therefore caused stream aggradation and widening
of the stream channel W stream of the nine Based upon thalwgg elevation calculations, the pipe
will be on a 70/a grade Due to this steer slope it is anticipated that a 5-foot riprap energy
dissipator is necessary at the nine outlet to prevent stream destabilization. The riprap will be
embedded into the streambed and will not inhibit any aquatic passage Also in an effort to
prevent upstream headcuttina a grade control structure (cross vane weir) is to be constructed
Wstream of the pipe within DOT ROW.
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.
Page 5 of 8

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/stnngide.htn1.
1. 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.
IMPACTS < 150 FEET: MITIGATION NOT ANTICIPATED
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 NCWRP, check the NCWRP website at http://h2o.enr.state.nc.Wwrp/index.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):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
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 ?
Page 6 of 8
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 )?
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* Impact Multiplier ? RwMired
2 1.5
Total
* 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.
NA
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.
No additional impervious surface is proposed in this project.
XIi. 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.
NA
Page 7 of 8
XIIL 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?
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).
NA

3
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
STATE OF NORTH CAROLINA SUBJECT
-DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
PROJECT
HIGHWAY BUILDING PREPARED BY DATE STATION
COUNTY
P. 0. BOX 25201
RALEIGH. NORTH CAROLINA 27611 CHECKED BY DATE STR NO SHEET OF_
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SD-01
STATE OF NORTH CAROLINA SUBJECT
DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
HIGHWAY BUILDING
P. O. BOX 25201
RALEIGH. NORTH CAROLINA 27611
PROJECT
COUNTY
PREPARED BY DATE STATION
CHECKED BY DATE STIR NO SHEET OF_
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STATE OF NORTH CAROLINA SUBJECT
• DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
HIGHWAY BUILDING
P. O. BOX 25201
RALEIGH. NORTH CAROLINA 27611
PROJECT
PREPARED BY DATE STATION
COUNTY
CHECKED BY DATE STIR NO SHEET OF_
SD-O i
Downstream of existing pipe after partial
fill excavation (11/3/03)
Upstream of existing pipe after partial fill excavation
11/3/03
j
-40
•
a Pipe Replacement •`??, \?
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Name: WACO Location: 035° 17'27.49" N 081 ° 28' 16.14" W
Date: 91222003 Caption: Pipe Replacement, SR 2126, UT to Buffalo Creek (Kings Mountain
Scale: 1 inch equals 1000 feet Reservoir), WS-III CA Watershed, Broad River Basin
(C) 19%, Wptech, Inc
230
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133' 030 \.\ °BesJn
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' = CLEVELAND CO. NC 607L SURVEY fit
FIELD SHEET NO. 173-30A
SCALE = 1:24,000
.?• SCS 124 S. POST RD.
ts?, as • „thy., SHELBY, NC 28150.
Asa y? _?*?`' ?,"; r f' s? !?" wr c3'• .: `i ?
n r ?

8.10 SOIL MAPPING LEGEND OF APPROVE? AND PROVISIONAL MAP UNITS
CLEVELAND COUNTY, NORTH CAP,OLINA .
(MAP UNITS LISTED ALPHABETICALLY B'i m4ME)
September, 1999
Fi=1d Old Corr.
Symbol Symbols Status Mao Unit Name Notes
36B (309,570,5068, A Apoling sandy loam, 1 to 6 percent slopes 1,32,34,41
338,2363,34B)
36C (36D,30C,57C, A A.ppling sandy loam, 6 to 12 percent slopes 21,33,35,
57D, 34C, 236C) 51,52
70B (70) A Buncombe loamy sand, 1 to 5 percent slopes, occasionally flooded 9,36,72
31B2 (258,25C3,318, A Cecil sandy clay loam, 2 to 8 percent slopes, eroded 12,30,36,
2582,199,238, 38,62,70,71
31C,32B2,2322
938,SOB,50C,90B)
38 A Cecil-Urban land complex, 2 to 8 percent slopes 31,36
4A (4) A Chewacla loam, 0 to 2 percent slopes, occasionally flooded 10,36,53
90D A Cliffield-Pigeonroost complex, 15 to 30 percent slopes, very stony 40
90E A Cliffield-Pigeon roost complex, 30 to 50 percent slopes, very stony 40
90F A Cliffield-Rock outcrop complex, 50 to 95 percent slopes 40
250B (250,5448,544) A Dogue sandy loam, 2 to 8 percent slopes, rarely flooded 61,79,83
2500)
950 A Evard-Cowee complex, 15 to 30 percent slopes, stony 6,17,47,73
95E (92C,92D) A Evard-Cowee complex, 30 to 50 percent slopes, stony 6,17,48,74,
80,81,82
95F A Evard-Cowee complex, 50 to 85 percent slopes, rocky 6,47,75
38D (39D,318E,37E, A Grover gravelly sandy loam, 15 to 30 percent slopes, rocky 40,43,58
30D)
38E A Grover gravelly sandy loam, 30 to 60 percent slopes, very stony 54,76
59B (80A,80) A Helena-Worsham complex, 1 to 6 percent slopes 18,36
388 (39B) A Hulett gravelly sandy loam, 2 to 8 percent slopes 40
38C (39C,318C,318D) A Hulett gravelly sandy loam, 8 to 15 percent slopes, stony 40
138C (1388) A Hulett-Saw complex, 4 to 15 percent slopes, very rocky 47,52,55
238B A Hulett-Urban land complex, 2 to 8 percent slopes 40
37B2 (37B,3183,3892) A Madison gravelly sandy clay loam, 2 to 8 percent slopes, eroded 25,36
37C2 (37D,37D2) A Madison gravelly sandy clay loam, 8 to 15 percent slopes, eroded .25,52
137B2 (19882, 1978) A Madison-Bethlehem complex, 2 to 8 percent slopes, stony, eroded 40
137C2 (198C2, 197C, A Madison-Bethlehem complex, 8 to 15 percent slopes, very stony, eroded 40
17C)
17B A Madison-Bethlehem-Urban land complex, 2 to 8 percent slopes 52
49E (48F) A Montonia very channery silt loam, 25 to 60 percent slopes, very stony 1,2,37
32C2 (320,25C2,19D, A Pacolet sandy clay loam, 8 to 15 percent slopes, eroded 1,13,39,63,66
324D3,23C2,'
19D,236D,237C,
230,23D2,22C,
93C,28C3)
32D2 (36E,324E,32E, A Pacolet sandy clay loam, 15 to 25 percent slopes, eroded 24,52,56,64
344E,93D,35D)
9882 (97B,35S) A Paco let -Bethlehem complex, 2 to 8 percent slopes, eroded 1,42 '.
98C2 (26C2,244D,28D, A Pacolet -Bethlehem complex, 8 to 15 percent slopes, eroded 1,16,42,65
27C,35C,324D,97C)
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: I? County: Cleveland Project ID:
River Basin: Broad Bridge No: Pipep Replacement
Route: SR 2126, China Avenue
Reservoir), WS-III CA
Stream: Buffalo Creek (Kings Mountain
Water Ouali , Criteria:
Stream Crossing Blue Line On USGS
ORW
WSI
WS II,III OR IV, Crossing Within 0.5mi of W.S. Critical Area
Roadway Criteria:
Route Designation-
Additional Site Information:
Arterial Urban
Arterial Rural
Is a Hazardous Spffl Basin Required?
Yes No
rr r
r rV,
r P
P, r
Yes No
r W
r r
Yes No

r r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. 7(1043(101 1 County Cleveland Quad WAC O
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property owner: NC Department of Transportation
Attn: Michael Holder
Address: PO Box 47
Shelby, NC 28151
Telephone No: [phone]
Zone: 44 UTM or LAT/LONG: North: 3905327 East: 542890
Size and Location of project (water body, road name/number, town, etc.)existing deteriorated 70-foot long corrugated
metal pipe on SR2126 over an unnamed tributary to Buffalo Creek near Shelby, Cleveland County, North Carolina
Description of Activity: Replace the existing 70-foot long, 36-inch diameter corrugated metal pipe with a reinforced
concrete pipe of the same dimensions. Place 5 feet of riprap at bth the inlet and outlet ends of the new pipe for scour
protection. Permanent stream impacts are 10 linear feet of perennial channel. SPECIAL CONDITIONS: All
conditions of the attached NC Wildlife Resources Commission memorandum of October 1, 2003, are hereby
incorporated as special conditions of this permit.
Applicable Law: _X Section 404 (Clean Water Act, 33 U.S.C. 1344)
(check all that apply) Section 10 (River and Harbors Act of 1899)
Authorization: NW03 Nationwide Permit Number
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) provided it is accomplished in
strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section 404 (if
Section 404 block above is checked), before beginning work you must also receive a Section 401 water quality
certification from the N.C. Division of Environmental Management, telephone [phone]. For any activity within
the twenty coastal counties, before beginning work you must contact the N.C. Division of Coastal Management,
telephone [phone].
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions of
the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriate legal action.
This Department of the Army RGP or NWP verification does not relieve the permittee of the responsibility to obtain any
other required Federal, State, or local approvals/permits. The permittee may need to contact appropriate State and local
agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide
Permit, please contact the Corps Regulatory Official specified below.
Date: October 7, 1001
Corps Regulatory Official: Deborah M. Miller Telephone No.: [phone]
Expiration Date of Verification: October 7 9005
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORMS, PROJECT PLANS, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
CC: Trish Simon, Division 12 Environmental Officer, P.O. Box 47, Shelby, NC 28151
CESAW Form 591
Revised July 1995
6?6
11 STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GovERNOR SECRETARY
031455
WETLANDS 1401 GROUP
NOV Y 7 2003
MEMO TO: John Dorney, DENR/DWQ/401/Wetlands Unit
FROM: Trish Simon, Division 12 Environmental Supervisor 15
DATE: November 4, 2003
SUBJECT: Pre-Construction Notification/401 Automated Payment
WATER QUALITY SECTION
Enclosed are seven copies of a pre-construction notification for a NCDOT project in
Cleveland County for your review.
Project information for the 401 Automated Payment Procedure
• Work order number: 150455-55120005-12.202311-3855
• TIP #: NA
• Project Category: $200.00 Fee PAYmc,V
RECEIVED
is
Post Office Box 47 Shelby, North Carolina 28151-0047