20201225 Ver 1_Determination Request_20200915

Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Name:*
Is this a transportation project?*
What type of request is this?*
Owner Information
Name on the Recorded Deed:*
Responsible Party:
Telephone Number:
Elm Grove Farm Mitigation Site
f Yes r No
r% Buffer rJ IF Stream Determination
r Isolated Wetland r Stream
Check all that apply.
Farfields LLC
George Jenkins
(far LLC, Corporations, businness, agency, etc.)
5122300424
How would you like to received your determination?*
r USPS W Email
Email Address:* [e-mail]
Is there an agent or consultant responsible for the request?*
r Yes
r No
Attach agent authorization letter:* Jenkins landowner authorization 2020-08-
452.87KB
20 085559.pdf
PDF only
Agent/Consultant Information
How would you like to receive your f USPS
determination letter?* r Email
Name of Agent:* Barrett Jenkins
Company Name:* Restoration Systems
Email Address:* [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
r Yes
r No
r Other

Date of Visit:
Site Information
Nearest Highway/Street:* highway 258
Nearest Town:* Tarboro
Nearest Named Stream:* Tar River
River Basin:* Tar -Pamlico
County:*
Edgecombe
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Gick the upload button or drag and drop files here to attach document
Elm Grove Farm New Figure 3 USGS
2.76MB
1981 Speed.pdf
Rif file type only
TOPO map look up: https://viewer.nationalmap.gov/basic/
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.
Gick the upload button or drag and drop files here to attach document
Elm Grove Farm Figure 3 1970 Soil
745.12KB
Map.pdf
Rif file type only
Soil Survey Link: https://www.nres.usda.gov/wps/portal/nres/surveylist/soils/survey/state/?stateld=NC
Latitude and Longitude
Please provide the Latitude and Longitude for physical location for the determination that. If you have a
physical address you can look up the Latitude and Longitude by typing in an address or filling out the
information manually.
Choose below how you would like to r Address Lookup
provide this information. r Manually
Project Look Up Address: Street Address
4432 U.S. 258
Address Line 2
Gty
State / Province / Region
Tarboro
NC
Fbstal / Zip Code
Country
27886
US
Latitude: 35.93630770000001
Longitude:-77.4955808
M isc attachments: Elm Grove Farm - VIABILITY-
16.48MB
ASSESSMENT -REQUEST -FORM- pdf
pdf or kvre file types only

By digitally signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the "Determination Request' form."
Signature
Date Submitted: 9/15/2020
Initial Review RRO
ID#* 20201225
Version* 1
Do you want to send this for review? r Yes r No
Select Reviewer:* Rick Trone:eads\rvtrone
Select Regional Office:* Central Office - [phone]

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LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: Page:
Parcel ID Number:
County: c� y
`-1 7L-, a 7 g 2 2-0
Street Address: _ ' _ -3 2— f [ L0 `" t
_T r �peora ,
Property Owner (please print:
Property Owner (please print):
The undersigned, registered property owner(s) of the above property, do hereby authorize
r i.G of
(ContractorlAgentlProject Manager)' (Name of Contractor/Agent Firm/Agen y)2
to take all actions necessary for the evaluation of the property as a potential stream, wetland and/or
riparian buffer mitigation project, including conducting stream and/or wetland determinations and
delineations, as well as issuance and acceptance of any required permit(s) or certification(s). I
agree to allow regulatory agencies, including the NC Division of Water Resources, to visit the
property as part of these environmental reviews./
Property Owners(s) Address: eQ -7
(if different from above) fr' _ 1 _. I n
Property Owner Telephone Number:
Property Owner Telephone Number:
We hereby certify the above information to be true and accurate to the best of our knowledge.
Owner Autjr6r}Ze—d Signature)
(Property Owner Authorized Signature)
!V_ 12-,,0
(Date)
'Name of full delivery staff member (fulkdeliveries) or DM5 project manager (design -bid -build).
2Name of company (full -deliveries) or DMS (design -bid -build).

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BUFFER MITIGATI UTRIENT OFFSET
RCY COOPER
Governor SITE VIABILTV ENT REQUEST
MICHAEL S. REGAN `', •�'
Secretory
(Form must be complete and all ents included to process request)
LINDA CULPEPPER NORTH CAROUNA
Director Envlronmen taf Qualfry
❑ BUFFER MITIGATION ❑X NUTRIENT OFFSET ❑ BOTH
Name
Barrett Jenkins
Company
Restoration Systems, LLC
Address
1101 Haynes Street, Suite 211, Raleigh, NC 27604
Phone
(512)-230-0424
Email
[e-mail]
Do you have the right to access the property? Attachment 1
❑X YES ❑ NO
PARCEL/SITE DETAILS
Proposed Site Name
Elm Grove
Address
4432 US 258, Tarboro, NC 27886
City: Tarboro
Site Coordinates
35.935659-77.495615
County: Edgecombe
River Basin
Tar -Pam
8-Digit HUC: 03020103
Sub -watershed (if in
Jordan Lake or Falls)
Will this be part of a stream or wetland project/bank?
❑ YES ® NO
Has anyone from DWR or the USACE visited the site in the past 12 months? ❑ YES ❑X NO
Has a riparian buffer or stream call been performed by Division of Water Resources staff on the
subject site? ❑ YES ❑X NO
Is the project receiving any state or federal grant money? ❑ YES ❑X NO
Are there any State, Local or Federal Permits associated with the subject site? ❑ YES ❑X NO
PARCEL/SITE ATTACHMENTS (provide items 1-4 as a separate attachment, not to exceed 10 pages)
1. Detailed description of the site including existing site conditions and Aerial Site Map;
2. Include a timeline of land uses and land use changes from 1990-Present;
3. Most recent 1:24,000 scale USGS Topo Map showing the site; AND
4. Most recent published NRCS county soil survey showing site;
SEND COMPLETE REQUEST TO:
NCDWR - 401 & Buffer Permitting Branch
Attn: Katie Merritt
1617 Mail Service Center
Raleigh, NC 27699-1617
orbs email to [e-mail]

Restoration Systems' (RS) requests a viability assessment for two adjacent tracts with a single
landowner totaling approximately 260 acres, in Edgecombe County, NC, for the development of a
nutrient offset bank parcel. A landowner authorization letter is attached along with the following
detailed description of the parcel, including a historical land use analysis.
Site Description
The parcels, collectively +/- 260 acres utilized for row crop production are in the Deep Creek
Township, 3 miles from Tarboro, NC. NC DOT historic imagery from 1960 through today indicates
the current land use is substantively like historic land use. The site consists of two headwater
channels that drain off the property into the Tar River 1 mile downstream. The northern channel
is mapped intermittent and the southern channel is represented by topographic crenulations on
the most recent 1:24000 scale USGS topo quad for Speed, NC. The most recent published NRCS
USDA soil survey map for Edgecombe County (1979) depicts both channels as intermittent
features. The road crossing of the southern feature was replaced after flooding problems in 2016.
Water Quality
The site is located within the Tar -Pamlico River Basin 8 and 14-digit USGS Cataloguing Units
03020103-010010 and includes two unnamed tributaries to the Tar River, located approximately 1
mile downstream of the site. This section of the Tar River is listed as WS-IV, NSW The NCDEQ Tar -
Pamlico River Basin Restoration Priorities report amended August 2018 states this 14 digit
watershed contains 26 miles with 71 miles of streams and 71% of streams are unbuffered, which
represents the highest buffer impairment in the river basin. The site is located approximately 2
miles upstream of the Tarboro Water Supply Intake.
List of Attached Figures
Figure 1— Site Location Map
Figure 2 — 2019 USGS Quad (Speed)
Figure 3 —1981 USGS Quad (Speed)
Figure 4 - 1979 NRCS Soil Survey
Figure 5 — NCDOT 1960 Aerial
Figure 6 —1994 Google Earth Aerial
Figure 7 —1998 Google Earth Aerial
Figure 8 — 2005 Google Earth Aerial
Figure 9 — 2006 Google Earth Aerial
Figure 10 - 2016 Google Earth Aerial
Figure 11- 2018 Google Earth Aerial
References
NRCS. 1979 Soil Survey of Edgecombe County, North Carolina. United States Department of
Agriculture.
https://www.nrcs.usda.gov/lnternet/FSE_MANUSCRIPTS/north carolina/edgecombeNC1979/e
dgecombe.pdf
NC DEQ. Tar Pamlico River Basin Restoration Priorities. 2018. North Carolina Department of
Environment and
Natural Resources, Raleigh, North Carolina. Accessed online 06-2020,
https://files.nc.gov/ncdeg/Mitigation%20Services/Watershed_Planning/Tar-
Pamlico River Basin/RBRP-Tar-Pamlico-072018-.pdf
RS—Site Viability Request, Elm Grove Nutrient Offset Site Page 1

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RESTORATION SYSTEMS, LLC SCALE: 1 in=500ft N Elm Grove Farm Nutrient Offset Site
1101 HAYNES ST, SUITE 211 DATE: 06-2020 Figure 2 - USGS Topomap
RALEIGH, NC 27604
PHONE: [phone] SITE: PUNGO Edgecombe County, NC
FAX : [phone]
This map and a1I tlda-,tt.inetl within are supplied as is wen ne--,tty. Restnratien systems, ITC expressly
disd.ims r.sp.nsibilftyf., tlamages or liability from any claims that may arise out oft he use or misuse of this map. It is Aerial Imagery: (c ) ES RI
the sole responsibility of the user to ddermine if the tlda - this map is compatible with the user's needs. This map Feet Coordinate S stem:
and createtl as survey tld,, nor sh..Id A be us.d as such. It is the user's responsibility to obt ain proper survey y
�,,preparetl bya lieensetl snrveyer, where r,gnhetl by law. NAD 1983 SP NC FIPS 3200 Ft.
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CZ i
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: Page:
Parcel ID Number:
County: c� y
`-1 7L-, a 7 g 2 2-0
Street Address: _ ' _ -3 2— f [ L0 `" t
_T r �peora ,
Property Owner (please print:
Property Owner (please print):
The undersigned, registered property owner(s) of the above property, do hereby authorize
r i.G of
(ContractorlAgentlProject Manager)' (Name of Contractor/Agent Firm/Agen y)2
to take all actions necessary for the evaluation of the property as a potential stream, wetland and/or
riparian buffer mitigation project, including conducting stream and/or wetland determinations and
delineations, as well as issuance and acceptance of any required permit(s) or certification(s). I
agree to allow regulatory agencies, including the NC Division of Water Resources, to visit the
property as part of these environmental reviews./
Property Owners(s) Address: eQ -7
(if different from above) fr' _ 1 _. I n
Property Owner Telephone Number:
Property Owner Telephone Number:
We hereby certify the above information to be true and accurate to the best of our knowledge.
Owner Autjr6r}Ze—d Signature)
(Property Owner Authorized Signature)
!V_ 12-,,0
(Date)
'Name of full delivery staff member (fulkdeliveries) or DM5 project manager (design -bid -build).
2Name of company (full -deliveries) or DMS (design -bid -build).