20091345 Ver 2_401 Application_20100610

SeSEPI
ENGINEERING GROUP
To: NCDENR-DWQ
Attention: Amy Chapman
2321 Crabtree Blvd.
Raleigh, NC 27604
Phone:
919-733-1786
From:
David Whittington
Subject:
Granville Medical Center
We are sending you:
? Shop Drawings ? Prints
? Specifications ? Copy of Letter
? Checks
Date:
June 17, 2010
VIA:
Drop-off
SEPI Project and Task No.:
SC09.006.00
® Plans
? Change Order
SEPI Engineering Group, Inc.
1025 Wade Ave
Raleigh, NC 27605
Tel [phone]
Fax [phone]
Site/Civil Group
f'MQ
R@
OVA
JUN 2010
DENR - WATER QUALITY
WETLANDS AND STOWNIW RTER BRANCH
? Samples
? Reports
Copies Date Description
5 06-17-2010 SIA, Exhibits 1-5, BMP supplements & checklist, & Geotechnical Report
1 06-09-2010 Signed and notarized Sand Filter O & M Agreement
1 06-10-2010 $240.00 Check (#1623) for review fees
1 06-17-2010 CD Containing PDFs of SIA, Exhibits, Plans, and Cover Letter
5 06-16-2010 Cover Letter explaining system
5 06-17-2010 PCN Application
5 02-09-2010 EEP Willingness to Accept Payment
5 No Date Approved Jurisdiction Determination Form
1 1-22-2010 Complete Set of Civil Plans
These are transmitted as indicated below!
® For Approval
® For Your Use
? For Review and
Comment
Other
Comments:
? As Requested
? Approved as
Submitted
? For Your File
? Approved as Noted
? Returned for
Corrections
? Returned after Loan
? Resubmit Copies for
Approval
Please find the attached plans for the Granville Medical Center ED Expansion for
your review. Let me know if you have any comments or questions.
Thanks,
I
Signed: a- - Page:
1/1
LETTER OF TRANSMITTAL
C) g- 134sva
PAM
r,
(to be provided by DWQ)
Drainage Area Number:
Sand Filter Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a log in a
known set location. Any deficient BMP elements noted in the inspection will be corrected, repaired or
replaced immediately. These deficiencies can affect the integrity of structures, safety of the public, and
the removal efficiency of the BMP.
Important maintenance procedures:
- The drainage area will be carefully managed to reduce the sediment load to the sand filter.
- The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
- Once a year, sand media will be skimmed.
- The sand filter media will be replaced whenever it fails to function properly after maintenance.
The sand filter will be inspected quarterly and within 24 hours after every storm event greater than
1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance will be kept in
a known set location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired
immediately.
BMP element: Potential problem: How I will remediate the problem:
Entire BMP Trash/debris is resent. Remove the trash/debris.
rAdjacent pavement (if Sediment is present on the Sweep or vacuum the sediment as soon as
applicable) pavement surface. possible.
Perimeter of sand filter Areas of bare soil and/or erosive Regrade the soil if necessary to remove the
gullies have formed. gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer application.
Vegetation is too short or too long. Maintain vegetation at an appropriate
height.
Flow diversion structure The structure is clogged. Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged. Make any necessary repairs or replace if
damage is too large for repair.
_
Forebay or pretreatment area Sediment has accumulated to a Search for the source of the sediment and
depth of greater than six inches. remedy the problem if possible. Remove
the sediment and stabilize or dispose of it
in a location where it will not cause
impacts to streams or the BMP.
Erosion has occurred. Provide additional erosion protection such
as reinforced turf matting or riprap if
needed to prevent future erosion
problems.
Weeds are present. Remove the weeds, preferably by hand. If
a pesticide is used, wipe it on the plants
rather than spraying.
Permit Number:
Form SW401-Sand Filter O&M-Rev.4 2009Septl7 Page 1 of 3
BMP element: Potential problem: How I will remediate the problem:
Filter bed and underdrain Water is ponding on the surface for Check to see if the collector system is
collection system more than 24 hours after a storm. clogged and flush if necessary. If water
still ponds, remove the top few inches of
filter bed media and replace. If water still
ponds, then consult an expert.
Outlet device Clogging has occurred. Clean out the outlet device. Dispose of the
sediment offsite.
The outlet device is damaged Re air or re lace the outlet device.
Receiving water Erosion or other signs of damage Contact the NC Division of Water Quality
have occurred at the outlet. 401 Oversi ht Unit at 919-733-1786.
Form SW401-Sand Filter O&M-Rev.4 2009Septl7 Page 2 of 3
Permit Number:
(!o be provided bT DWQ)
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior
to any changes to the system or responsible party.
Project nalne:Granville Medical Center
BMP drainage area number
Print name:Gerry Leighton
TitleTacilities Director
Address: 1010 Colle,ize Street, Oxford, NC 27565
Phone:
Signature:
Date: ? / .
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been
sold and a resident of the subdivision has been named the president.
11
I,
a Notary Public for the State of
/1 C'' , County of cAA4 , do hereby certify that
2. ( personally appeared before me this Wday of
.zdAa 9-ojy , and acknowledge the due execution of the forgoing sand filter
maintenance requirements. Witness my hand and official seal,
EMa."S' -F I IAL SEAL
Noary Public, North Carolina
County of Vance
Jane H. Richard
y Comrr;;sshan Expires
s
see
SEAL
My commission expires 6011,4110
Form SW401-Sand Filter O&M-Rev.4 2009Sept17 Page 3 of 3
SeSEPI
ENGINEERING GROUP
1025 Wade Avenue
Raleigh, NC 27605
Tel [phone]
Fax [phone]
sepiengineering.com

June 16, 2010
NC Division of Water Quality rL, =?; @ .1, -? 0 " `RJ
401 Oversight/Express Review Permitting Unit ,;UN 1 l 2010
C/O Amy Chapman
2321 Crabtree Boulevard DENR-w.ATER{KJAUTY
Raleigh, North Carolina 27604 WEWDSANDSrORMAS% s"GH
Re: Granville Medical Center, Section 404/401 NWP 39 and Tar-Pamlico River Buffer
Authorization; NCDWQ Project 09-1345
Dear Ms. Chapman:
SEPI Engineering & Construction, Inc (SEPI), on behalf of the Granville Health System,
submitting this Section 401 Nationwide Permit 39 application. Concurrent with this
submission for the Section 401 Water Quality Certification (WQC), SEPI also requests a Tar-
Pamlico River buffer authorization for the proposed project. The project is located off of US
15 in Oxford, North Carolina. To accommodate expansion of an existing hospital to meet
the needs of the surrounding community served by the facility, Granville Health System is
requesting this Section 401 Nationwide Permit 39 and Tar-Pamlico buffer authorization.
Project Description
The proposed project involves the expansion of the existing hospital, including an
Emergency Department and Surgery Department addition and a new Boiler/Generator
Plant. The original hospital was constructed in 1939 with additions in 1962, 1974, 1985
and 1998. This proposed project involves the hospital expanding its emergency
department. Expansion of these hospital functions is needed to provide more effective care
for the surrounding community currently served by the facility.
The growth of the hospital footprint requires the relocation of existing access roads and
parking areas further east to the back portion of the property. The existing main hospital
access road currently terminates at the Emergency Department. With the expansion of the
Emergency Department, the access road needs to be moved to allow access to the new
public entrance at the rear of the facility. There is no alternative location to build the
access road. It served before as the main entrance to the emergency room and is planned to
also serve as the main entrance for both ambulance and patient drop off. The other service
entry poses a safety issue as incoming traffic will cross rail road tracks and would be forced
to stop if a train was on the tracks.
The site of the Granville Medical Center encompasses +/- 15.03 acres. The existing
impervious area is approximately 58% of the total parcel. With the addition of the new
S ESEPI
Page 2
parking areas and the building expansion, and the demolition of some parking the final
impervious percentage, the new total impervious is approximately 65% of the total parcel.
The drainage area of the site is approximately 9.75 acres. Based this drainage area, the
percentages for the existing and final impervious areas are approximately 56% and 67%
respectively. The sand filter is sized to treat only the new parking areas that account for
the increase in the impervious area.
Runoff from the new proposed northern parking lot will be directed to the sand filter. Due
to the steep slopes, the discharge from the sand filter will discharge into a preformed
riprap scour hole instead of a level spreader. A flow splitter is designed to control the
amount of flow going into sedimentation basin before entering the sand filter.
Project Site Investigation
The site for the proposed expansion has been reviewed for wetlands, streams and buffers.
For the proposed expansion site, the Granville County soil map depicts one drainage type
on the site, and the US Geologic Survey map also notes a drainage type. SEPI reviewed the
area associated with the proposed expansion, and we determined that the drainage is a
jurisdictional stream and is subject to the Tar-Pamlico buffer requirements. There are no
wetlands present in this area for the proposed expansion.
Mr. Martin Richmond of the NCDWQ conducted a site on October 8, 2009. Mr. Richmond
has provided a concurrence letter, and it has been attached to this buffer application.
Project Impacts to Waters of the United States
The layout of the proposed expansion cannot avoid impacts to the jurisdictional stream and
its associated riparian buffer. To access the back portion of the hospital tract, the road
improvements must be made. The existing pipe will be extended to accommodate the
hospital expansion and the access road.
Stream impacts total 60 feet, less than 0.01 acre of surface water. Impacts to the stream
were minimized by implementing a design slope of 2:1.
At this time, no compensatory mitigation for the stream impact is proposed.
Project Impacts to Tar-Pamlico Buffers
The layout of the proposed expansion cannot avoid impacts to the riparian buffer. To
access the back portion of the hospital tract, the road improvements must be made. This
side slope also minimized impacts to the Tar-Pamlico buffer. Table 1 summarizes impacts
to the Tar-Pamlico buffer.
Table 1. Project Buffer Impacts from the Pronnsed Hospital RYnancinn
Buffer Zone 1 6,871 square feet Y
Buffer Zone 2 4,428 square feet
?ENCTNSEPI
Page 3
Based on a review of the "Table of Uses" for the Tar-Pamlico buffer rules, we believe that
the proposed action fits into the category of "Road Impacts other than crossing of streams
and other surface waters subject to this rule".
All impacts are included in the PCN. However, there were not sufficient rows to convey the
impacts in the PCN so we have included the following table.

Impact number action Permanent or
Temporary
Zone 1
Zone 2
Road impacts Permanent 6,411 4,263
Temporary 717 350
Sewer line Permanent 460 165
Temporary 1,892 1,681
Total Buffer Impacts 9,480 6,459
Granville Health System proposes to pay into the Riparian Buffer Fund to compensate for
impact to the Neuse buffers. Table 2 summarizes the impacts to the buffers and the
required payment.
Table 2. Impacts to buffers and mitiLyation navmPnt
Buffer
Zone Impact Area
(square
feet Mitigation
Ratio Total
Mitigation Area
(s q. ft.
1 6,871 3 20,613
2 4,428 1.5 6,642
Total 27,255
On behalf of the Granville Health Systems, SEPI has coordinated the payment into the
Riparian Buffer Fund with the Ecosystem Enhancement Program. The EEP has agreed to
provide the required buffer compensation, and a copy of the acceptance letter is attached
to this application for a buffer authorization.
?ESNGINEEERINGPI
Page 4
Closing
SEPI asks that the USACE issue a Section 404 NWP 39 for the proposed project to impact 60
feet of stream (<0.01 acre of surface water impact). Additionally, SEPI asks that the NC
Division of Water Quality issue its corresponding 401 WQC and a Tar-Pamlico buffer
authorization for the proposed action. Granville Health System proposes to pay into the
EEP in-lieu fee program for the buffer impacts; no compensatory mitigation for stream
impacts is proposed at this time.
If you have any questions regarding this request, please contact me at [phone].
Thank you for your prompt attention to this matter.
AA:)__
Bill Piver, PE
SEPI Engineering VP Site/Civil
cc: Phillip Todd, SEPI Environmental
a[ VJ.?"{
G] p err`
C3 ti
Office Use Only:
Corps ;art;on ID no.
D4'JQ project no.
Furm Viushin 1,3 Doc 10 2CO9
Pre-Construction Notification (PC Form
A, Ap lis~rt.att lfriftr neat on
1. Processing
1aa. Type(s) of approval soua?it from tlae
! eclisrrE 401 Permit I euTln 1 p`er9a3it
Corps'
1 b. Specify Nationwide Perrnll (hlWP) [lUrT1Ijef: 39 or eneraal Permit (GP) rIUMbur:
1c. ITS the NWP or GP numbeF been verified by the Corps? ? Yes ® No
1 d. Type(a) of uppTovaal sought from the D'NQ (check atfl thal apply);
[ 1 401 Water Quality C ertificakon - Regular F-1 Non-404 Jurisdictional General Permit
? 401 Water Quality CEvllficaaron _. Exprdsz ? Riparian Buffer ALF;horizaatior
le. Is this notification solely for the record - For the record only for DWQ 401 For 1he reran: only fnr Corps Permll'.
because written approval is riot required'? Certilicaation,
? Yes H No ? Yes 0 No
If. Is p ayrr i?-nt into a m-Iligastton bank ur ir-ilUrr fCe program pfupiasud for miUgallsara ? No
sal im'pacts? If so, attach tho accsipLan letter from mitigation bank or in-lieu
fee program.
99_ Is the project Jacated in ;any or NC's Wenty co,9301 CMfll eS. If yes, a rlsti?:er 1Ia ? Yes H No
below.
l h- Is the project located will1in as NC DCM Area of Environmental C, ncern (AEC)? El Yes ? No
2. Project Informatlon
2a Narne of project- GranvMe MadC cai Center
2b_ County- Granville
2s:. Ncarest €rruddpaality I Is wfl: 7xforsi
2d_ SubdivisiOra POMP:
2e_ NCDOT only, TA.P_ or state
project nC:
3. OwnOr Information
3a dame(s) on Recorded Deed,
3h. Deed Book and Page No.
C, R.f sporisible Party (for LLC if
a pplis;c'Fblu):
3d_ Slreat address: 1010 College Drive
3e. City, slate, zip: C]xfoTd, C 27565 -
3r. Telephone rii)_; 919.690,3000
3sg_ Fax no.,
i
h. Email address:
Page I of I1
PCN Fore -1lersln,i 1.3 De, eenjt)er Iii, 2008 Vers`an
4. Aptplicant Informatlon (if different from owner)
...
_ ................ ............ .................... ........... .
........
.
.
..
.
-
4a. Applicant is- Q Agent © 01her, specify,
.
.
.
.....
.................
41b. Dame: Gerry L€ lghton
4c- Business name Grenville FleEdth System
{if epplicable};
-.--._....... ............ .... .............. ...............
_
old. Street address; 1510 College Drive
4e. City, state, Ap. Oxford, NO 27565
41- Telephone no.,

_..__ ........................
9 J,690.30 0
...............................................
4g. Fax no.,
4€?, Email ad&ess:
......... ..... ........... ....

--
5. Agent/ onsriitant Information (if appiicabie)
5$. Name- Phillip Todd
5I3. Business name SEP} Eng!noaring Group
(if applicable)-
5c. Street address: 1025 Wade Avenue
5d, clty, state, ZIP; Raleigh. NO 7605
5e- Telephone m-, 919-759.9977
5f. l=ax no.; 919.789,9591
59, Email address: ptodd@sepiongirl?iDCing.com
Rage 2 of 11
PCB! Form - Version 1.3 December 10, 2008 Version
B. Project Informatlon and Prior Project History
7. Property Identification
Ia- Property Ident€flcation no. (lax PIN or }parcel ID):
....................
1 b. Sita coordinates (in decimal degrees)-
.. ... .......... . . . . . . .
_
........ ....
ic. Property size,
2. Surfaoo Waters
2a. Mama of nearest body of wager (stream, river, etc-) to
proposed }project:
......................
-.
2b. Water {duality CflassifEcafion of nearest receiving wager=
2c- River brasin:
15 acres
3. Project Description
3a. Describe the existing conditlons on the site and the general land use in the vicinity of the project at the time of tilts
application:
Hospital developrrmnt and associated parking. Forested area atong stream corridor on the south side o[ the tract
.. ............
5b, UM the total estimated acreage of all existing wetlands on the property,
0
.....................
--
c, L.IM the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
480 feet
3d. e=xplain the purpose of the proposed project,
The hospital proposed to expand i#s facl€lties. Thls work requires improving road access to the back part of the hospital
property,
3e, Descrlbe the overall }project its detait, including the type of equipment to be used,
the proposed projeoE involves hospital expansion in the bade portion of the tract. Expansion of those hospital functions is
needed to provide care for the surrourrtiing community served by the facility. As part of the proposed project, access to
the back portion of the site is enhanced to allow for future davolopment of the hospital campus. Earth moving equtprnen#
used will include bull dozers, pays, tracked hoes, dump Vuoks, and front end loaders
4. Jwisdlctional Dater inations
...... ..........
-
4a. Have jurisdicUornal wetland or stream datermina#tons by the
Corps or State been requested or obtalned for this property f
project (inrWding all prior phases) In the past? ® Yes
Coop merts; Site 031t with Martin Richmond of NCDWQ
Raleigh General office on Oct 8, 2009.
.................. .
4b. If the Corps made the jurisdictional determination, what type
of determination was made? Preliminary Final
4c- if yes, who delineated tl)e Jurisr€ictlonal areas? AgencylCfonsu€tant Company, Si=Pi i=ngirkeerlrtg rout
Marne (if known), PiAlip Todd Other;
4d. IF yes, list the dates of the Corps jurisdictional determinations or State de#erminellons and attach dmumentation,
Site ylsit with Martin Richmond of NCaDWQ Raleigh Central office on Oct 3, 2009-
5. Project History
...................................
5a. Have permits or certiricatlons been r4'questod or obtained for
thls project (Inolori€ng alt prior phases) in the past?
- ................................
5b. If yes, explain in detail according to "help fileR kns#ra?oklor? },
Latitude, 36-325532
78-592491
(DD.DDD)
Longitude. -

O; NSW
.. ..................
-
Tar-Pamllco
El yes El No Unknown
Jordan Creek
El No 0 Unknown
Page 3 of 11
PCN Farm - Version 1, December 10, 2008 Version
6. Future Project Plans
------------
6a. Is lh s a phased project? - - ? Yes ? No
6b. If fires, explain -
Page 4of11
PCN Form - Versbn 1,3 December 10. M8 Ver on
------ ...........................................................................
PfOposed Impacts Inventory
1- Impacts Summary
.......................................................... ..... ......................................................... ....................................... _......................................... -.......... ----._.._..----- -
1 a. Which secllonE; were completed below for your project (check all tilal ; {Pply)'
? Wetlands ? Streams - tributaries ? Buffers
? Open Waters ? Fond Construction
....................................
. Wetlarid lmpacts
If there are wetland impacts proposed on the site, glen complete this questlon far each welland area irapacted-
a- 2b- 2c. 2d- e. f.
Wetland impact Type of trlrisdiclion
nornber - Typo of impact Type of wetland Forested (Corps - 404, 10 Area of Impact
Permanent (P) or (ir known) DWQ - ream-404, other) (acres)
Tam oraf T
Wi ? PEI T _ Yea Ej Corps
? No ? DQ
W2 ? P ? T [I Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes El Corps
160 Q LIWQ
-....... -..................................... -
4 ? P ? T - --.......... -.......................... .
? Yes
? Corps
? No ? DO
W5 ? PEI T ? Yes ? Corps
? No ? DWO
6 D P O T El Yes El corps
?No ?DWQ
I g. Total wct1Rnd inip acts
h. Comments,
.......................................................................................................................................
3. Stream Impnts
If there aro perarlnial or intermittent stroarn impacts (indudi lg tomporary impacts) proposer] on tho site, lhfOrt oormp€ete (his
I gLIOStlon fer all stream sites impacted.
a. 3b. 3C. 3d. 3e. 8f. 3g.
Stream lmpacl Type of ]impact Stream nallte perellrOal Type or jurisdictlon Average ImPaol
! riumbef - (PER) or
(Corps - 444, 10 slfear length
Permanent (P) or intermittent DWQ - riorl-404, v4d[h (Mlear
Temporary (T) (INT)? othcr) (feet) (eet)
S1 ® PEI T Ripe rxterlsionf
access road UT Jordan Creels ? PER
,- INT ? Corps
DWQ 4 85
S2 ? PEI T PER ? Gems
? INT ? DWQ
S3 [-] P [
] T D PER El Corps
- ? INT ? DWQ
4 ? P ? T PER ? Corps
? INT ? DWQ
S ? P ? T ? PEP, ? Corps
? IEVT ?DWQ
50 ? P ? T ? PER ? Corps
? INT ? DWQ
....................
.............
........
311- 'rota! slrr:L111 and iribtilary iinpaels
..............
- ----- 80
3!. Comments' The pipe extension is 60 feet in length, and 25 feet of rip rap will be laid at the pipe outlet for stability purposes.
Page of 11
PCN Form - Version 1. December 10, 008 Version
4. Open Water Impacts
1€ there are ipreposed ifnpac#s to lakes, ponds, estuaries, fributaries, sounds, t he Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 41b. 4c- 4d, 4e.
Open wafer Name of walerWdy
impact number- (If applicable) Type of impact aterbody type Area of impact (acres)
Permanent (P)
or Te pora?y

01 El P [_j T
02 EIPEIT
. ........................ ..._
03 QI'[IT
04 EIPEIT
-

0, Total open water irup acts
............ . ..................... .....
-.
49. Comments-
S. Pond or Lake Construction
If pond or lake construcUan ro used, then complete the u'hark below,
- -
5a. 5b. 5c. 5d. 5e-
Wetland Impacts (acres) kream lmpacts (Feet) Upland
Pond ID Proposed use or purpose of (aores)
pond
Flooded Filler! Excavated Flooded Filled Excavated Flooded
P1
_ .........
.......... . .

P2 ... .. .....................
- -
5f. Totnll
. ....... ......... -
5g. Comments,
- ................... ......
.
.
........... ............ .
5h. Is a darn high hazard permit required?
El Yes 0 No
....... .............................. --

If yes, permit III rya:
5L E=xpected pond surface area (acres)
5j. izo of pond watershed (acres):
.

5k. Meulod of oonstruckior?: ........................
---
Page 6ofII
PCN Forrn - Version 1.3 December I0, 2008 Version
6. Buffer Impacts (for DWQ)
If prof ect wi11 Impact a protac€ed r€parian buffer. than mmp€otc the chart below. If yes, then ifndividually list all buffer impacts
--...... be ow,_ I[ r Ian act regu?re ? iga?ioe?, t}ic yrou MYST fill out Section D of this form.
Oa.
? Meuse ®Ta#-Paml3co ©O#lier_
Project is in w1iich protected basin? El a#awba © Randlemaii
6b. 6c- Gd- Oe. 6t. 69,
Buffer impact
0Ufter ^ Reason Buffer Zono 1 impact Zone 2 impact
Permanent (P) for Impact Stream name mitigation (square feet) (square feet)
or Tomporary required?

Pipe
131 N P © T Extensions UTJordan ® Yes 6,411 4,263
access El No
road
Pipe
B D P ® T Extension/ UT Jordan El yes 717 350
access Q No

....- ...........................-...._.. road
...... ... ...... ... .
...

..
.. -.-.----..
R3 EQ P E:1 7

. . . c+war lire
relocation
.... ........

............................................ ®
Yes
No
4(30
1[35
6h- 'fetal buffer inrtiactk
.
- - -..... .._.... -_ .............................................. ........ .. 9.480 6659
..
..
.............
6i. Comments. There was not sufficient space in the table to note temporary bu ....................................
......-..---
ffer impact from the se

wer line relocation_
't'here are 1,892 square feet in Zone I and 1,681 square feel in Zone 2. Total butter impacts Incorpo rate these Impact;,
D. Impact Justification and Mitignt`ton
I. Avoidance and Minimization
1 a. Specifically dosuribo rnoasuros taken to avoid ar min€mize the proposed impacts in designing project.
Stream Impact#S caiinat be avolded- Slopes are 2`.1.
1L Specifically describe measures taken to avoid or minimize the proposed impacts through corxstructloII techniques.
Sediment fencing will be Imp€z-mented to note the limits of construction.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
a. Doos the project requ€ro Componsatory Mitigation for Ej Yes N No
impacts to Waters of the U.S. or Waters of the State"
2b- t#'yc;;, miti tinsi is required by (check all that apply): Q D Q El Corps
E] Mitigation bank
20- Ir yes. which mitigation option will be uses! for this pro)ect? El Payment to In4lou foe program
El Perm€tbee Responsible Mitigation
3. Compfete if Using a Mitigation Bank
a, Dame of Mitigation Bank.
3b. Cfedits PorOased (a€tach receipt and letter) Type Quantity
Page 7 of 11
P CB Form - Version 1 .8 Deco her 10, 2008 ersloo
Sc_ Comments,
4. Complete if Malting a Payment to In-lieu Fee Program
4 - Approv81 letter from in-laeu fee prograrn is attached,
- .................
4b. Stream mitigation requested:
...................
4c. If using stream mitigation, stream tempera twf?-.
4d- Buffer miUgatiun requested (DWQ only)- 27,255 square feet
......................
pie, Riparian wetland rn€t1gation requested:
4f. Non-riparian wetland mitigation requested,
4g. Coastal (tidal) wettarld mitigation requested-
4h. Comments-
acres
acres
af?ros
_
....... ..........
5. Complete if Using a Perrnfttee Responsible Mitigation Plan
5a- If using a perwIttee reuponsible mitigation plan, provide a description of tho pfcposed mitigation plan-
6. Buffer Mitigation (State Regulated Riparian Buffer Rues) -required by DWQ
8a. Will the project result in ail impact withiri a prolected riparian buffer that requires N Yes ? No
buffer mit gatlon?
6b. If yes, then identity the square feet of impact to each zone of the riparian buffer that requires mitigation- Calculate pile
amount of Mitigation required.
60. 60. 6e
ale I Reason for impact
Zone I Pipe Extunsionfacoess
_ roadfsewer line
zone 2 Pipe Exterasianl access
toad
Total impact
(square feet)
6,871
4.428
Multiplier
3 (for Catawba)
1,5
Required mi#i atson
(square feet)
20,613
6.642
- .....? q .........
6L Total buff er in iti ation re ul sd: 27,255
69, If buffer mitigation is required, discuss wW type of mitigation is proposed {e-g., payment to private mitigation back,
permittee respansibie riparian buffer restoration, payment into an approved ire-Iteu fee furid),
The applicant proposes payment to Fr.1' for the other inipa act t0 buffer zones. The E E P has agreed to accept
responsibility of imptemenling [he buffer mitlgailan on behaIf of the applicant.
6h. Comments,
Page 8 of 11
PC IN Form - Version 1.3 December 10, 2008 Version
® Yes
€Inear feet
0 warm ? cool
?cold
E. St*rmwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Ilan
la- Doe; the project Irto€ude or is It adjacent to protected riparian buffers identified
wlthln one of the NC Riparian Buffer Protaction Rules"
1b. If yes, then is a diffuse flow plan included? If no, explain why-
coniments,
2. Stoarmwater ManaW!pgpt i tan
2a. What is the overall percent imperviousness of this project?
2b- Does this project require a tormwalpr Managernerlt Plana?
2c. If this project DOES NOT require a Storrnwater Management Plan, explain why,
2d- It 1h1I ; project DOE require 8 tormwa( r Manar3amaxnt Plan, then provide a brief, narrative description of the plan-
2e, loo will be responsZle for the roviow of than Stormwater Management Plan?
3. Certified Local Government Stormwa3ter Review
3a- In which local government's jurlsdletlort Is this project?
8b. Which of the followialg (orally-Implemented storrnwater management programs
apply (check ail that apply):
3c- Has the approved Iorenwater miges+rment Plan wl9l proof of approval been
gUaohed?
4. DQ Stonnwater Program Review
N Yes ? No
(Q Yes ? Na
6.58
0 Yes ? No
? Certified Local Government
? DWQ Storrnwater Program
? DWQ 401 Unit
Oxford
? Phaso II
] SW
? USMP
? Water suppler alershed
? otlxer,
Yes No
?_ Coastal counties
HQ
4a. Which of the following state-implemented stormwater management programs apply ? ORVV
(check all that apply):
? Session L$U11 2006-246
? other:
4b- H is the approved StormAter Man8gera'ment Plan with proof of approval been
attached?
5- L}WQ 409 U.ni# tormwater Review
5a. Does Vie Stormwater Management Plan meet the appropriate requlrera'ments?
5b. Have a.II of the 401 Unit submittal rcquirernonts been met?
? Yes El No
M? Yes ? No
? Yes ? No
Page of 11
P Form - Version 1.3 13000M bar 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWIE Requirement)
1a_ toes €tre project involvo an expenditure of public (federallstatellocal) funds or the ? Yes ? No
use of public (federallstate) land?
lb It you answered 'yes" to the move, does the project require {reparation of an
env€ronmentaI document pursuard to the requ€mments of the Nat ona€ or State ? Yes ? No
(North Carolina) Envlroomental Policy Act (NE PNSE PA)?
1 C. If YOU arlswarod ° 3S" to the above, has the document review been finslized by the
State Clearing House? (If so, attach a copy of the EPA or SEPA final approval
letter.) El Yes ? No
comments;
2, Violations (DWQ Requirement)
2a. Is the site Ire violatlon of DWO Weiland Rules (15A VAC 2H .0500), Isolated
e€Iarid Rules (15A N CAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® Na
or Riparian Buffer Rules (15A ILIA 28 k200)?
b_ Is this an after-the-fact permit application? ? ? Yes ® No
o, If you answered "yos" to one or both o the above questions, provide an explanation of the violatlok(j-
8. Cumulative Impacts (DWO Requirement)
8a. Mil this project (based on past and reasonably anticipated future impacts) result in
additional development, which eou€d ImpaO nearby downstream water quality? ? ? Yes ® No
8b, €f you answered "yes" to the above, submit a qua Rative or quantitative cumulative impart analysis in oocorclance with the
most reGont DWO policy, If you answered "no," provide a short narrative descriplion,
4. Sewage Disposal (D Q Requirement)
4a_ Clearly detail the ultimate treatment methods and dlsposiUon (non-discharge or discharge) of wastewater generated from
the proposed projeck, or availablo capacity of the subject facility.
The additional sewage resulting from hospital expansion wlII be collected and tram ;portatad by the Oxford public sewer
system and wiII he treated at Me WVVTP.
Page 10 of I I
P i Form .,. Version 1.3 € ocember 10, 2008 Version
S.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will fhis project occur in or near an area wilh federa€ly protected species or
habitat?
5b_ Have you chewed with the U FWS concerning Endangered Species Act
impaots?
.......... ....
5c, If yos, indicate the USFWS Field Office you have contacted-
El Yes N No
? Yes No
? Raleigh
? Asheville
5d. What data sources did you use to determine whelher your site would impact Endangered Species or Designated Critical
Habitat?
GIS mop data was roviowed on December 21, 2009. The source of the data included INIC Natural Heritage Prouram GI
shape ile data fforn May 28, 2000,
8. Essentaa] Fish Habitat (Corps Requirement)
Ga. Wi€I this project occ4ir in or near an area designated as essential fish habitat? ? Yes ? No
6b. What data sources did yoti use to determine hether your site would impact E=ssential Fish HabilaV
NGDWQ Environmental Sensitivity Maps from Granville County, 2007 were assessed.
7. Historic or Prehistoric CulturaI Resources (Corps RegUirement)
7a. Will this pfvjeot occur in or near an area that the stake, federal or tribal
govemments have designated as having historic or cu€turaI preservation Yes ® No
status (e-g.. National Historic Trust designatlon or properties significant ii1
Norl!h Carol Ina history and archaeology)?
7b. What data sources did you use to determine whether your slle would lwpact historic of archeological resources?
NC HPO Goog€e Earth .krna polnts locatod on (or near) the key feature In individually listed }properties, and at or near the
cen Vold of the areas covorad by h€storic dist€icts were exa€nined. Date of the data was from May 12. 2009
....
8. Flood Zane Designation (Corps Requirement)
8a. Will this project occur in a iFEMA-designated 109-yearfloodplain?
? Yes No
8b- If yes, explain how project r?3eels FEMA requiremen s:
Sc. hiak sourcc{s) did you use to make the floodplain determination? FIRM Parcel 1913) and 1923J; Map ## 3720192800)
and #3720191300J
Bill Pi ver, PE
ApplicanUAgent's Printed Name
L
Applicant/Agent's "r nature' Date
(A?jerlVs sigaiitfure is valid onEy rf an authorizatiort letter from the appli irtt
is provided.1
Page I 1 of I I
PCN Fora T VersiDn 1.3 Deceinber 10, 2008 Vemlon
?-
.Ale
rnnoxnM
cl}rttar} 9, 010
Corry Loiglaoa
Graltvi [ie Zlt?A€ttr Systatii
1010 'Col logo 1 trCCE
Oxfbrdt INC 27565 gxpltution ofAcceptatkee. Novembor 9, 2010
Project' {;rarrv'sllc E c[licatl C.`citEtt. C:umity: GraEarille
Tltis louor revises omxe issiwA Alovenibex 3. -2009, '1. a pwposa of d tis leuer is to notify you tbal Zhu Now th Cat-01 i11:m 1".cr y';w1Yk
E ntianccinwa pmgrahn (N02-PP) is Wiling to ticcapt paymoni for 1Mpaots ossnciated Willi Ltta above rofort'110C E project. plcasc rkute
thELt ddb dl rlfiot3 c113as not assure lltattile, Payinani %V€I€ bu approved by fits-p"Init issuing rLgewifs as 3nitiption for project impimus s. h
is the t`cslxws-ssbi li ty of Mr- apl3j kw to eonlact €hQ,%e agelluias Lu doEerrillne if paynielrt En the NC'EMP wi l l be ap )rovul. You mosi a lsq
eOtT10 L., Wil11 till Other 31MG. fec€erel or 10CR1 govon M0111.13crmit.S, miulft0on& or;uLtlipr17-ali is as. Qoclattd with 1[w "VC]Ng ?tcdyjjy
__rl tr !? f .3;31; 1n Act to Proms tc Co3npeulr stitory liitio.iw,. l ri,?aEo M lri t3 ?ti #3ar?14 ,
'51) is necepu tco is valid for nine, months fro n) die date of tltis letter atl}d is EE€}t tntnsfmbEa Itive kwe nat r'ecei}ed a CovY of (ice
Issued 404 PerudtMl CeP111icatlo1dC:,?€I A Iseti'n}if;vEtltirr (11h limC frEtrExe, lli9 i1 C4I7t?4t3CC iwtll expiE c. it is the 11 1i?:-tut`s
t'espotisibili ty to send copies of ttmc pertmtits to N1'.I-?p. Ortm NC8HF ruz1vcs a copy of the poi nit(s) an i Li voice wi II be issued W-';ed
on Ow mquiEed mitigmion in that pcrniit attd patyinemf€ niust bo ntatlc Prior to conducting Ibeaulhariled work. 'E'lse norfouw OF tile In
t -ion} 12ec Lim lie Imid to NCREP by an appl icara is 011kitltttd based t1pi mt the Foe Scl3ed111e acid 1i0116es I isted at www, Limp,net,
Basc€l on tilt illfofniatiotl suppitcd by You theL inipacEs that may require cas?ii?icatsntnry wfUgallon are surftnllrized irs t13e F011OW131L
Lah€e.
River Cu Simani (feet) Wetlands (mtGras) ---- Buffer I Buf cr 11
Basimi Louallon (Sq, Ft,)
Cold Cool tirni Ri own Flan-kilxaria3r Coastal tk arsh
Imiipaet _
"Mr- 03020101 0 u 0 0 0 Fl 9, 54 9.13t}

Crccli#s May. 03D20101 U Q 0 0 0 Ci

21.'E?0
F

l3,6s?5
Pamlico
Upon receipt of liayntent. P-P-P will take resporkslbilily for providing 6?0ELtpansitory wit'tgation' if time f'egulaktury aguncics iequur('
mitigation credits greatef t€maEi indicitted above, and t1w appiimnt wants NCEEP to be responstlble for tltc Etdditional mitlgmiorr. I1w,
?%Ppl it?Eint vri11 need to RL111111a t a in! tgation irtluest to NCI 11 3P fol' approval prs or to periuh isstloiwe, '11 o Lnitigatioo witl be, performed
in accords meo with lht Metimoruadtnn of [.indtrstanding bctwcen the N.C. D)partmoni ofHnAronniew and N-ALEral csoui os fmd the
U.5, Army Corps of l ngi neem elated Novoinbor 41 1998.
If you l1ava any gtwstions or nee ndditiat3al infonwaiun, plensecoutact KellyWill €iarns at (919) 7101921.
inCarCly,
Willi E). Gilmore, PF5
Di rcGlor
ec: Cyndi Knroly, NCDW WMland$1401 1311t
Phillip Todd. agc3it
E't 10
Prow ", ow ftn&
i'+tL 1tr?LL
North ialiEla Ecosys€Gni Erth€ ftel letlt Program. 1 fi52 Mail SBrvioa CEiiiler. Raleigh G 27699-165P / 919.715-0476 / W WWL11ccE3Fr.ne1
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&1 0')141 w '
APPROVED JURISDICTIONAL DETERMINATIONFORM
77 t$ rcwkFk M10111d b@ Coe plated by i'ollotiwilig tht 1115Irilo lons pfovided in oGt' n J v of dbe? A) Fpl In I mijilC[iplll[1 nikidebo&-
Sk'CT1 TAE 1, R .1C{`R MUD; T(R&jXfIf Y
A. REPORT C'OAIPLETION DATE FOR r1ppn O)'F:D , uRTSUI(:TIOi4AL AETF,RM ]NATION (JD): UNk FWWR
B. i ESTRI T 01-PI E, FILE t+2A&M, AND NUMBER.- Wake Fora%t NC ItegnWaty oRice
C. PROIEC T LOL:A"I'1O111 AND BACKGROEND INFOILNIA<IION:1'he propumA proicut iulrolvcx 1}x cxpaLn?iorl of iIFS
"]Alltg hospilal, i2ichiting an Emm-genssy Mp2d=llt arrd Sttrgery P01001110 M tidditton And a 1101v IxwkEerlgettenu?r plaitE. 'E'lse
original I mipiiai 3vKx wwilrstCle'si in 1939 wilt Mditinp% in 1 %22 1974" 1955 mid I9W. The baspiml exists on p relatively fame
Imel of l;ettd (I 1 Dues), alld the proposed project invol yes Iiosphl expaltsion in tho back pxrrtion of (lla tract. Expansion orthma
hospital Ametions is sleetled to p ovid0 0M I.4r #ha 5LPrWL111diE1P, CU1111MMIly WFNICd 1?y 1110 I'acltily. AS jMd Of 11te I)r0114Sef1 113'9)jNl,
Lt us "; tp tale fluk 1for41011 of flit 6110 is to W el1€E@33Ce{1 14 EL 1MY for rwilfe deMEnlInleilt of the E10sllih1 cak19I3k1S,'1 Ei6 stUdy C6r ADI iS
10C,41Cd ikk &e 'l,,,,_ p,41i,liW River 13asill In {if Iville Cohinly, Noah C.arotiita, SI?I}= 13lgineerh2g Group (Shill) vas C0111M.Cled In
October 2M to perforin a stream and wel Land delinca#ion for #hiS f1r0jCC#.Tf1181)111€ ffil# For thIS JD is GTOWAItO HCANt ysti'm
laclklctl to OxfGT(T NC. T130 I1r4jecl 1S ]OCR" ofi``ol' US I $ 13i l7x rsl, dot#CS nkr[Al .
Stale. W, {'nsilk#'/1}af'!s#1l31nr aglY: (imilrille City- Oxford
Centel` Caivl'dilkil#es Of Site (Intifonf! ill {]egret (iectillsi fol'nlA) lgCowinig of Curfidor-L,ai. 36.325532°N
Lotlg*.-78.59201o W
Universal'D-miSverso Mekvntol'. 171 (NAID 93)
14n me of lu arest wRick-h-ad :.iordnsi C.1refc
Name of imafeM Tfadil1wial Navigable Wafor (Tf' Ml Mlo syli eik I1kc ag4j iic YtsowACC Rows, Tar Rlve'r
(i]UQ. W02Ujfj1-022d110
i'2irulc P rvA14rSCtC(1 0.a` 1lytli p]ogl (fosi# f otl(.
C'.k[ack i C' 1txPo {lSPlgrli3lk of i evka? ' 1lre;L 15ltillp3' pnteklliaf }1SClstfi iioYSaZ areas i*re eLvailable upon requesi.
Check if other siias (?irf offsi[e mitigation Sites, d1Sf}owl sites, cte...) ara associated mit11 Ilds notion wind arc rcoordcd 411
a di fl'cmn )0 forill.
D. REVIEW FE1< FORMED FOR SITE EVALUATION (CIMCK AM, THAT APPLY).
[? (}fliae(I?e?kl]e[eryuina[inn_ t}ate;
G C'ield 1ktU 111afl01l. Wtc(s):
$ECTION I I b SUM ril RY OF FMWNGS
A. HHAS3t;C"i'€ONI0D1.'1'FUNICtNYVfION OF JUR#ST)1CTLTON.
Th. Ap,NIV tp I}e sao "rmLlfgabjC 1e47fe1'S Of fhC- US "WitlAn )EVUS alld Alrbors Act (iWA) jltfiridictiost (MSiIL%F} wd by 33 CFR
garl 329) in 1130. rclvickvarea. jReQ2&nfl
?[?--??77? 1'?atties ?abj+;G1 #a lllc ebb a22s1 flow of tlso tirlc,
LJ W01M awo preseliily nevi" or 12@W k nom 11SO 41 the 114MI. Or M@y 11$ SWW-pl ble for use to tfin15ptl 1ntunwe ar foreign
cowtnamte. Explaitt.
B. (AYASECTION 404 DV?TERek1C NATION O df.11USI)WI710N.
Thvo'ARF''?L1ilv'sof ilm U,& %Vltliill C:leilii Wilier A(A (MA) jlldl9didi011 (Ar dditted by 1-1 {'.EAR past 3238) ilk [11C re\'ie V aTCa_ ?l egvived)
1, "8fC1'S of Aic U.5.
o. I kkdI1eW p resenet of NSnters at U.S. Ill irevi B%v Ell'ea (CIkeck fill flirt apply): l
0 TN%%'s, iiw4rA1ikag 1crr!W61d -"s
? Wcilamis Wa eltt Io TAR kYs
} Cl7iS14'C3 " pCfJllane3lf lti',LtCIS2 (1(I"%e{3) that flow dircctly or illd ircctty irilo TNWS
Klan-€tl' Ills 1112f {1s}iv dirczu ty or indir dly hill TN%Vs
Ll Wvthmis dircol ty abiW ing Rl'1'!S tlsat 110W jif"[iy of klttl'sreetiY illto rFN %V4;
Wcllo nt% WjRcellt to lxtt no[ di rceFly ltbUEtillp, lI l'1Vs [llat ftmv directly or h1direot€y ia1tO TXWS
[] Welland-. fujecen[ to k1o11-LUSYs Mat fimir diwvlyor hidimRy iato'I'MYs
a hopowidnlenisu£jimsdiclioitalwMers
n yy
LJ isolated (Ill#erst[ale or io mstt e) watcrs$ i nluditig dated %yetlaiiiLS
Idtillif}' (eslijtlatc) Si-90 Of 11-91Ci'S Of tllC 11.8. Ill 11LC YCVIe 1' nMil.
NOR-weltitlld?wafeys, Q,ltr? ,?{- {7G : •Wl l?k (ft) 891d10T WK.S.
Wellands: y{ Auts.
?, 7.IuttiK {lt?tYa3tl;krles) t?f3t?risdlctiukY t}ase[C r?t3: 39SZ C'aifss nlaafl3al afsd (3C?lVh1
M0V1k;F0rk fcF eststhlEslktcl Ofi?VM (if knalvn): Not cslablishcd.
' Bolos 1-,1Lcckcd belolr shall ba sii polio by conspletinit the 0fxnxipte Kvliwo in SCciifie it [ below.
Por pua]soses Of thIS roe3ls, Rtl RPIV is det'hwa as a [t ibn[aty tELal is not a TN%V aad VEM *pfcally Ilws yeas--romkd or leas contimmis Row at least
'Lsv%mnkfiy" (t--y,, [ Ecnliy 3 tssunilLU).
2. null-rcgLillkte{fi w aleo'slr3 #1;I??tls (elaeelt If jtj)131IUA11141) ?
? l'otentia€ly jurisdictlanal Lvatcrs anWar wdLaodi; 1vi:ro asks iscd wi€ltitl t€Ie review Am AM delemlined to be not
J4111 €l€cilorml, ExpliAll:
.5E '.'I'1ON Ill: c IVA AEIIAL"L 13
A. '1'N1.1's AND W9l.'1.11NDS 2LWACEN•1 T0'1'N%Vs
The 13t;$n l" {v131 assel'I ]all'Isdiedan ever TNIVs and iveflumds ndjrLcc)kt to'1'1VM. lff Me aquatle nesoureo is a TMV,
complete See#tau 11I.A.1 raid Section 11 .VdI. only, if tile nqua11C vvyo me Is :1 1YC0ami otljftmI In a TN W, complete
fieelEam:1f11.A.1 fikId 2 101d ged10ki 3I I.D.I.; CALMVISe, See SeellOki I I LB MOM
1. TN W
lalerilLfy W.
Smiuum izc rall4nalc supper big detcrlill•aa1 ion,
AVellle d ndimytt ta'1'l1 W
5k1111ITMAn altioasle "llpm tin Coneluslvn dw wedrLuld is •`adjaura":
D. CHARACTERISTICS OF TRI BUFAIIY (THAT IS NOT A T MJ AND ITS A.D,# AOi:NT WWI I'LANDS (Ut ANY)
This SOCII(m Nil 141ma rly-RS fkk€pl.rkwilokk ITgardfngc3l+tradlCrlstirsofthe til hill nry And M5 a{ljncoili %VolIfuldsi H6 ally, and If
helps deferklibeewhefhey or nat tike Slr{lidardsfDrjurisdielion eslablialecd inktievRip airooshave bcom Inc 1,
the ngenvics will assevI jtlrisallellolk owr w)Et-mmigabW IrlbiiI lr1cs 01' • KII's whava IEke tribidaries arc I'li'elatively
I}03`I11A 1a(.,i41 11'ilterVI (I1P1V4), J.C. trl bill Orks Via[ iypleaIIy 11aw Y1i11L1'aulld ai• I'ia Te eonti Ituous amy at least st-asonall •
(e.g., typlolly 3 mcnl#E+s). A ivetimid that 4I1rcel Cy abuts an RM Is Chao j t1 riadictiollal. If the a1i with: iol} irco is; Ilol at
'PN%V but liar ramro]lli-0i (pere111tial) flo1YM Skip to Seetiall I1i'.D.2. If Ilm agualEC 114's0lim Is 11 welIrtlltl WIWIly obllt#Ing
n #ributary with perenMal flow, skip to Sudwri llLD A.
A we 11 fw(11€lslt Is 001 t"M #n 11 W 00 tlatrs Ilk 1llrMly A5141 all 1.1P w rquires a sigiltflcan# IMUS ev:llalation. C01'IM
distActs mid EPA ir%lfiilRx'111 IiaelLid e Ili IIiC k'eCard -My avotlable 111forn1aI101i Ilka# {lacllillellls 11110 existonceof a
Significant ne_ tis between n relathrely perinalleni Iribil1Lary (IlaI Is not I}Ba`CLIY HI (dfi l US f111jACQFk1 XVOWktft II'(Ikt31 03113 #l
t rad I#lonal xlav€gable water, even ll ougll a SigitifIca tt nexim i`iitlling is ilot Yi qui felt xs *I ptul I Ie1` of iQk{i•,
If the %ya lerbijtli l is Iiof M II IR11 Wp ill` f, %yetljInd (11rcel ly fkblil [lug 11n tt 111Y, rL J 1) wl Ii rrquive ndelitla+tnl don to
{1t Sp1`I111110 1111W 55'#ilN'I)Otly 1L11, a slgkll Renal nexus wil h a 'IN W. If tlse trfll111 ELI'}' 119f8 n{lJii{`Cn I %V I1AWISa tli C 4glIMC(1 tlf
Ymmus. evalmidtnn Mimi Consider the I ril+niwry €11 combi IkMioll wil11 ill l of Its -Ad jams. mvilaft0s,'l`lils Agnifle and Imu.;
Ci•7LESE:ldoll that Cumbl3lCS, for alialylie(t1 InTVI}I WS , the iObtlIW-5- 111441 fill nr EIs LLIIJfi 1A W-CilflUdS Is UWd WIL(!#Ilea• llle
revi.e1y area itleildfied In IIwM] 1'0(1 11C81 is (14C #i'lblklfgvy al' Its mijmmli xwctlamig, f3vha#31. iftile 3DCovers PL iribulary
IVA11 mijit Fmllt we[lands, Complcae Scolou 11 1,11,1 r41` the ftjlllltniry, Section Ifl.112 fai- any o Site wel hands, mid Sec Run
l11,13,3 fny MI walands ndJamilt to tllilt Mbilifiry, both onsite all{l ofTsite. The detei•ltiination N'1ietlier a nigtlil'litaoI
l1i us cklsts IS (Iderinlned in Seclion IT].C helom
1. cliavaclertsks of non-'i'N Ws tlanl Flow divedly or Indirectly Erin TNW
(i) Gcomral AI•ea C:alidi€Swls:
Wntezsbed sin (I I M 0.020101 _0220111)_ 47.5 sq nu les
t gkhi,V?e Area (IEIIC 030M101). 1304 sq miles
Average akinual rainfal l: 42.+16 bichus
Avaalgo anual snovefal1: 7.5 iuc,>he%
(ii} ail}'siePal Clt(Ir?¢leriy#ItS;
{a) keI3tE0ilSllip v?r€C11'I?l1?x;
UbWary flows directly Into TN1V.
TribWary flaws 1€kroug11 (2 or mere) 0bulades 1leforC CaM ing •f'N W.
S13ppol1135P C cX at75e,kl&iion Is pros WC41 ill SCCIlalt 111. F.
I to I hat tliq IE*ftniclim al t j?ui{EGEk ilk txnalaias 11c 11wkal Itifollita(0tL regaldliNg S1S&S3 ditChMp lMheS, Md Cr0SjG3Mt 15WTUfcs grMIMy ITld 134
11maTidWca.
PFOJce1 WAICrs AM 10-20 river Erlrlet f 1ka'1'NW (YaE11:i31-.. Rce Dee River}
Pmjoei 5val om I (or Ee_ss) river mules front RPNV.
10i0jeeP tie'aters ore 10 (or less) uenal (srraigltt) MUCH ftmn TN W.
t'rojeel vWers are <10aedal (straight) mti les f -om RPWV
Proj"I 1'Emtys cross or wvo as 9lmle bourWg im JUpTaim Noim,
JdCiltify flOXV r41EtC ta'I'i AYS:
Juld n Creek. Drains 1o Tabbs Creek > Dmilts Io'far Riker
(b) (;0m0r;t!'E"rktrntary 11arclaristi (c1 C'1 11 Illi1E a? rlw}}:
Trlbiiiary is' l`a1uml
AldficiQ1(man-maade)- Explain,
manipulated (111all-ItR cd). BXPL1111
Tvib W wry 11ro130FNes Willi tt'pWt 10 E011 l)P E121E11: (c"ctktnute)-
AveFage depth: -;
J?.vCFa},e Blue xlol?c.??:1?
Ili hum ifllii1tmy sllbs{rale com posidon (chcck all that apply):
silts Saiws ? COilereie
D Cubblos ER 05atvel M=k
El Rcgkoa Q VegeEcaiom, TyveN cover-
E] Wier, E'sxittniln
T,ibaaia ry oond hioniFlability [ce, h3041y etodiv xEoE1 1i ImA-j- Exp1a1 n: luloderpteEy eradiq,.
PF0101WC Of rl[fVFiFfldj1O01 COfllllleXW, EX11 liar, „. it1f1 fkl*nu 5?[1
+irINItuy geptmeEry. ?l i'djAji l
1ibma;lty pradiemt (aplimbnafe averagc stupu): 0-2 %

"fefWttmy, Prnyidv? N Jreremlial flo4w.
T•.stilmafe overage mil nber of flour crcilts in riaviow nuedyear. Unknown
Dc?ew eflowmg!mc pucimial
Ottwr infOi3notiom ou diiraR n and voEmm:
surfxvw iluu is: 1 k #k CEfSGE vierisEics; , 19r
Sul}sisrfaco floti : No, Explain fuldi%sL
? € "(oz other) Eest perforkmed:
TrIbil [Ary Im (dkeck fll 111,51[ Apply):
1W tmd b4mi F.
01 [WM6 (clkecl; all indicatom that apply):
clear, natnial line ilnpmsml tam Elio Nknk
cltaaagcs in [lie cbarae[ff of k,'Oil
© ?1iclwiNg ?
E] mgmalion m aired dour 3, ? em, or absemE
] leaf littor distuarbed or washed may
SOdim nt &Prosi[icia
water sla€ ling
? of€ "(€iSi}:
Diwonlill Km, 011W61.2 Explain:
[ISO presciluo or2EI[er 211d debris
tlostfinalool ofIerresida., vegetiuian
Else prewlice of kvrack [file
sedinleur sorting
much
multiple ob.; lol rrr pvetliC E 11131u eVealic
abFg1t elsaDge in plant COaurntmity
If Fale[ors Collor thaa11110, 01 IWM 5uere wwd to detai mine lateral exlent of C:1VAj Lidsdfct [olt (clicek ali that
??--J yy fl?)[y):
L Higlk Tide UnG hidlea#£d by. l+'1C. R High WO f MfUR II1010MV1 bYL
El 0ll or-woml Iim Wmg sitorc objkmis ? slimey to -IVailobte datum;
51'€osv rcniEertaiw be deseliEop€o by idetatifyil , e,&„ trio mry a, wNclt flours lhrv,tglt Elm rtnimowei, to flow into Ir,b;daryb, which theft fbbv,'. into
1'NW,
°A of iuml {,r mtala-mafle discalttiuu;ay in t€te oEli1WA i1WS not [tmrsstttll} seven jakE55d16011 %Wk-le Ilt@ SlreMR IenlpOrarily ROM UYL&F?r0u ml,
Of wlkorc tlli? ()f 11?r'A! 11M boon FCiakMT( by {1 w5 'DpFkleaa 6r amatilluffli praetEccs). %Vht:M tiWM iS u break f,a the (A MM 6tlt 39 nfifelUkd Io 9110
vealubudy's rto%v r4`eme (0.g„ 3lotir 13-r%.r a EO4k OUIMP W ilnrrnll li a C11I%TetN the m?vndo %Q1 Ion& far kndicamrs of 11ow Wmyc and 10mv the
kFrCA,
rfbid,
© Fiocshe] ior dcbrisrlc wilts(€'oreshoro) physiolmnrkiw ;
E] PiLy3 i{ Hl rnalkll?gsJc]rArnclarisiics 0 ITRE4LtiM lilie-4Mta11 CS 311 I'C$CtREiUII Ey13M.
© iWal gauges
© 011w (1161}
(ill) Chemical i:hal-nierlsiles:
clthrmc ;rIZ4e trftwry (e.[; viler rtalor it clew, discolored, oily Min; wale' quai lyp gum ml wilorshod
011un wrislics, et-), lixlllain; Water is Seilli-lurlritl twilh a 11 odc'raty flow.
ldeealify specific poJltttailts, if1110%vw More than Iikvly (wdimell),
(iv) 13iologicxl ilarae[erist€es, Chnxiwl supports (cheek all C1a# Rpply):
® Riparhucarridon Characteristics i {au£r%-,M-?1t1e); Foreslgxlvt'clina00-5b R,
1W#hmd frin?c, Chamcicrixtle:'. Il l 4 1 sk 3,
® aibilai fuTL
[I redernily Listed spccics, Explain findliVfr:
LI Pislyspawil areas. axplahl fin i v.
01licr cnriratttsiCttit ]lyisctlslli 'e species, Expla ill fttldinGs:
XtomflOwildlife divClxily, Explain findings; Halrital for alnpllil}Mas, .
C ISSit'ftCIEdS#ICSOfISet RMIS11{1j19CBi11 141i0ri2I'N1V #hAt f101' Itli'Ceily pYiit{lit'C(q[y Jnl{}'L'N W
CI) Physical
(a) C3elieral WCH. nd ChaMcCCTJ;i cs;
Propertiesy.
WdIBEIII xiYA:' Ot:EtS
Westand type. ExjAahi:
Wa lund quality. Explain:
Project Iti'C#lands crass vF Sum, 811 Sim bogs idkirles, 1'x11€art5:
(l?} C'?rterEft )rlntiv Rel+lliotls}lilt IkiEi? t?fon-'i'l?Clw:
Surfue flow is: ?'J.e ???..;p?
C:itasrwterlsiiss:
S1 bsarFrLC#f flow. Exphi11 Findings:
? Dye (or oEiaer) test perfoniwA:
{?) :?( 1X1 iS? atcv ILEtrotaiairlitotl with NOLL-'PNW!
Dircctiy ablla-mg
Nil diftCEly f bUllik2a
? Biscrew wetland hydrologic =uiediorl. Explain.
[3 E0010gleal e(E11t1CCt1U13. Explain:
© Sc mlcd by lx;roilLmAor, UnEftin;
(tl) ?L27411'fRetaliotesllil?}#o'liW?l!
Project uretlattds are river suites fr41m TN IW,
Project waters are 'tc s marl (81 Might) flliief: Fraitt'!'H W-
How ig from PI' UN.
TsSlii,rAle tslsilroxias?wEe kreatiort ofucila3a€l as withiit the N*J$
(ii) iclWiltieAl l+E rAerct'iRllcs;
C:Itamderize IYC#€aaid Syslcm 11Fi91Cr ooh1r is cie r, brows, oil filin on swfacc; haler qualiky, gutlentl NvAItY$W
clwsrxtlcristic : Ctv.j. ]~:Ci11O11I;
IdeWiFy XpMi€k 1101htfatlES, if known:
(M) 111010gleftl [.llfraMeterlsUCK EVEthud slippui'ts {£lm'k Al 11111 ( apply).
LI R3puriml buffor, ('Wnolerfstiws (typa, average Ividth):
C1 Vegelnliolt lypoperceni Cover. Explain:
El I €abilk for-,
? Federally Listed species. 1?xplolri Andingn
Fislyspmml AMS. !?xplaIn fiildings: -
© 011Ier elluirptttsren[ptE}' seos`sfive giecio, Ltxplain findings;
Art€tEntkAvildt!re[Ciwsity, lixplainfndii%
3. Chanic'#erisl ics of PER WC 11PLIld 5 ad] neekit to Me t rliminq (If any)
Al i ?fetImid(a)1kelila Corsi{ emd ill t13C elltim Aiiw amlysis: k dial
Apptloxiillataly ( ) ACtx:S in total ark beitkg COLisldortd in Elio C41q u lativa 11 mlygN.
I-or CAC 1 we11alid. spwify 1110 110110wittg;
I)iTmE] AblkfS MN) X180 (J1t.R0r0, j Dircc#ly 11huf-4,7 (YIN) Sire (iii acres)
Sumimri20 #Verpil !biological, cheauical and physical fund ims Mng pCafURn(AIL
C. SIGN] FICA NT NEXUS DETERARNATION
A 4ppleanI 14CXvs Flai{]kpls will 11F.WR8 the #RLRS' cbtlracPe{']silrs nlid fuliclions of Me 1fi1}tltai-y itself #llLd 1lle Aln0li tk$
perfoi'im-d by film' is&JasLds PLAIneent to flie tributary to Tlelvwnoilla it Ilwy K1g14ifiex0 ly ari'Cel I41C C wilklc11l, }131Y'31ral,
.in(] bjeIGgleak] ili#egri#y of LI TN %V, Fol' C'AC11 pf t1LC V4)4lgtiN-itkg 2;11110[1Mjg Ft xlgl4l11Ctl ILI ilCYtl$ evIsis If the #r'ibutRry, Ili
£11itllAT)RIifo1l Willi Ml 01' its adjaCCkkt 55'Makt04, lkfks Ilkare thak1 a 33peculAtive Or fikstab3111I !nl effect Oil file C11e1441val,
plkvsleal i w1var hlolagfcal Iltiogrity Of rtTN %V. Consi{1e3:1110i13 when evallinfing slgillfieaTl# 11Cxv[ Iktel10C, Ilkkt fly8 Hal
llllilled 1o the 1'0!51mej 1111raliMI, mul freglicitcy 9f the 111mv of %ralek' in Illib f6billAFY am'! its pro iliilly to n TN W, nild
Ilse ftluctiolks p(LI-forlyked by the tAblitill'y 111113 All iIN ildjFi."0( 11'@tlilltil$. 11 I, Pol approprNfe to date!- 11ll1C signiticalit
plms based 6(kly 1) tk ony nlicelfiv. ill L-001011 of JIN FLkkCe [e.g, hel.% Bell a Ir1buta['y mid Its ndjareil# %ye#Iaull ON- be1Nve5'i4 ;I
11-111111kiry filld the' NVV). Mild imiy, lim foci 1111 adjace i ISCEIR,,(i ]ie5 ivi#m 11 41' 4Timie or :1 fiuoclitl;klll ]s not xolely
detey inaLliVe of Slgid 111caut kiemix.
Draw con LkCohmsIkCf11'£C'1LIIM fkiil11ITS 130C14Po lICI!flndtlieetfeclsoiltile TN liv,fig Ideli#iRed ill the AfopfrlfW"G111flaIlrc
and dlseussed In 11w Iikslrucllanal Guldebool€. Faeloys to ccuisider hiclude, f01` ElalNlklC:
• Does Ow, Irlbulmy. in wro binatinn shill 11R Adjaugil %mla s (iI`n11y}, hive thB CApwity to i=Fy pollulanls or fioud 5L7L1CYX
to TN 1Y$, or [o 3-"ioe Me 3Lmmnl of poliulanis or I loot! %valus marlAug a TN W?
F Dom f114 Iritnitiry, hi c4mubination wilh AS :I[1j vml I;-t1Iaw6 (ff any), provido habilal olld lifacycle mi:1111on I•uni riolls for
fish and OIbCT species, siwh as furling, nGStilig, :ipawlli3)g, or ! 1trilig yoklog i t spec Fes thRI are pFe-;8 # itk 1114' `t'W
• D60% tlka lrtbll[atyy 131 CRtikk elation with ils scent tvedands (ifany), have tbP- CS15RCity 10 k;121sfC.1 R[Lfrl',MlS alld Orgall{{'
Carbon t I m L sullpntt dLiv %(TvaIii foottkuhs?
• Does fhG Eriibalary, in Ofti bination k1'ilh AS titljt3CC[Ll wediwlis (kfmy), lkew otiker reiel l mmlips tba 11hy'sical, Chemical,
or biological Wegidly of 11,G 1'14' %V?
N010: flit nbove list of £Ur} Wel':k#ie ns 1S Iml iII145ISWC 1111[1 0Imy Illki:01a s nlmerivd or known la occur Slit}111{1 be
434)CIrn,einlfEi lkekn+,
illl]3 A1511 f1055'S 51li'eCII}' 131' iii{likECtly ]iilo']'i?NYs.
k1111cmit nextk$ 11mllilp 1by tkon-R11W #tint IaeS no fldjacent 5Ye#I-
F3xpla111131idhigs of I'r@SC11Cc or aimmu, trf xi?eOlicant nexkfs below. IiLsed mi (lie [ri3Rltary itself, theia so to Section I LD;
1. SlgniReftlit lwCxlps Midiklgs rok' klon-RI)w Rud 1#R i djoeCilt Ivellanjis, %vlwl'C fill 11013-IUIW flour [ ir"l]y 03' ilid! Y@Cll?'
flk#0 T INVS. 1 xph it 1111dings ofly-ownce or abscaCC OfSlgllifECan1 11"im bttlov?3 bmvt pit thr, Iribtavy+ in a ntilhimi [oo
w1tl all of its a¢djnocd ?rc#land3, llmn gu to Slw Eton I I LDL
3. Signl Rr5k711 F10h#l.% l ukli l4g$ FOIL 11' CtI}j kttlg a l jamil to mk RMY but that do ndif dlveC#4' a but I lie RtPW. 1334pNi1[
ti n{likgt or prewrLoC ?r abm= of signi fti-@Alt ROWS beIGIV, based cut lh 3 #ribLllaT]' ill COir3l3i112601k With all ONIS mtljimmlf
wetlands, Ihm go to SccEiu i 1-11. 1),
D. DEI')uMNIINATIOlk1S Oi` JURISDYC"1'101 AI, ]-'W'INGS. TiiF. Si1RJTC:T t?'ATERSfWV&TLANDS AIIF, (CIl1: UfL
A] J/PH AT APPLY).
1. '1'1 11'3 mid Adjacent 1Ve#lallds. C11"k fill 11MI ILpply ItELd 1.7fOVO,' $17.0 MlLktlateS 11k MOM Ke2L;
©` NWs; limar feel widdk (fi), Oil acres_
D We11rklxls Miami to TNWR, acres-
2. RPIVs(fiat I'lowdEreellyorindlreefly]lali)TNM.
® TriWari ofTNWS whore Ifibutaria 1}'llieetly #lptu year-lC}1511€l are 5llisiEictianal, ]'rolriele f1 lla and ra#iollalc
ialsli(,7lFtig tEkei 161 114l:it}' is pcreiwl al: SEratlg bed and bank, material so€C111g, strops evidcHoo of A fflc I Fun I p[bals f
Maderate o,ridelice of flour, delmsition.
'frita5a#arics of'i RW whCrG #ributwi havo 0011 lilt ms ilow flser150llnliyr' Eylliemly three 3t oralls enh yeas'} are
judWidia11a11. DA4 wppml Ing Ildr, Qonclp ton is prove led at ec(inn I f 1.13_ l}fo;.FW b rad male indicating Mal
Idbutary flaws z;c Iwmlly:
pro%,W elciinwes fu' jtkrisdielicuml walers in #1io rovieor area (check all lhsl apply);
E) rlAbut,Rty M'Ate[s: P.0 lillear feet f - H (ft) Nvid1b.
El Other 15011-weElandvv m tacre_e.
Identify type(s) of waters:
3 r Non-1x F1Ys? ill?l l I1(ti1' ?I#1'CCI1y (r 11tdla'cell? hate T111?Ys.
Waterbody Mat is mot a •l'NW or an MY, but flows directly or €ndircctly into a'f2V?Y, and it has a slgnificalll nexars
wilh n TNW is jild-idid iarml. Aalst MEPP srlillg I$€s 005€0IF51011 is groVided at S llon III.C.
1'rovido estimates for jarisdictiorml welters Witllill tlta 1"O iffiY area (Check 211 #Isat :Epply):
H Tributary watsxs: Iir1ERr feral (fl) width.
Otlker 140€t wo ltwd WAEers: aeres,
rdeaa#ify #ype(s) of Iffaters,
4. Welhulds(11redly abulIillgan ilM ibatflora'dWed lyor h1direttly irltor1'N WS,
VetEaslds rii reel ty llEsist R I'?Y itnrE t11tIS ?lre jsis is[iictidyalal a acl$?oetkt Xvetlrtnls,
Wedands directly abu itlg an f INV IO)Cro tribIltarics typically flow }ear-rotln& Prouido dMa and rationale
hidleRti krg 11;at Irlbutary is pumnilhd nt Sct;6viti III.D.2, above, Ffoviclc ratiuimle itadicrtiNg t1tsl wot€md is
direo€ly ahtl€I trig all RP%V_
Wc0ands directly abul#ing im i{PW vtrllcm tributaaras typically M%v "seasmally." FrovIde data indicating that
trlbubiryr iS 2c HS0281 ill Scctioll Ill,B Itnti rklliolieale hi Section III.D,2, hbov(. PIMifto rsktiari 414 CF4t1l52 11W
Provido acivago cstilllales for jnrisilictroltal wictlasrds in the r-eYiomr Area:
5. Weflakingmijacent {0 bal llui {11redly aurilIIng ark MJW that floss dieterly or indirtetly 124e TivTW-5,
Wt? I€Rnds lbal 41) not directly lib;at an Rilkv, Nit when cow3dered in combilsii#im With Elie tr butaky to which
they are adjacent and %yidt Mmilsrly situated adjacent wetlands, have a %ignificaiit nexus m4t€r a TN W 3r o
juzisidleltonnl. Date sapporthig tlis comiusion is provided at Sceliult 11f,C.
Pfovklet Wrepge esiimalva for juriF4000rial 51C1}R 0s ill the mview fire i,
fi, Wc11 wl.1; id]awlit to nola-t MVO t IElat rlnw ilhreell or hidlivetly Inia Tl IVs.
0 iYctl2aaids atijactxtt io sdi ?a#crs, Rllti I1L7vC w]xCli ccnlsft€CFCd fn rrork4biuallan w1t1t Ilse tr€b44trtr}' tivltloll they ttr
atijaccB# acrd Will silni}arip xilllatcai atljacenl wollattds, havo a s€gn€14n% l i1cxus 1,A111 rt TN W Ara jor€sdictiolml. lDDIA
;stkp rdljg Iitfs cotwhksioll is provk1ed at Seallon I I I.C.
Provide es{imater for jasiisdicliotral wetlands in Elie review ama: ages,
7. Impokkudknen#s of jkirisdleflonal waiei-0
As ik gerteml raltt Cite 111konrkt€a2gt: rtl o f t; JW Wietionrt3 tribtklwy rcrlkKiCIX ja?ristlictiaMlal.
? Delm)1vatater €1lar imp ondlslent war, created from "waters a# 9w U.S-," or
1}elii0i55h'$[fi t1Y1Et 54,?tar lileetS 11se criteria X01' 0170 {lf fES? C83e?i}riE_S1S3'eSelltCd ?lOkre ?I-t"i?, Q]'
n DeMolssliate ItMt rater is isolated wide a BONUS to t:nt>rt CKC (sec 12 below).
k?. ISOLr1. -E0 Jlt1l'3'ElMrA<i E OR lr~1'1'RA-S 1'A'1'Yj '%#ATK-RS, INCLUDING ISOLATED WETLANDS, THE USE,
ONGRADATfONOR1?FSTi LI?;TIO1`iOF-WHIGHCOULD A EC'TI1NTERSTATECOi1'1tVIERCF,IN0,11DING
ANY SUCH WATERS (C]l R K AT 1.'1•riA`r APPi. t'0
[J vellich arc or could be usod by €aitcrstate or I`omipa Imveltrs for romatiamal or otter purposes,
from w1kich fish or sbollfisla am'; os coukl 6c lakeik mid SOW Ill I1LEM O Or Ibrcigll 00111€IaCM0.
Q which aroorCotlld bC mod for iiidesllim 1M1allo."s by i11dwildie% In illler%tate C(i111nokl?e,
Q ?44iek?tEfte i1Elletl +wt[ers. Exp?ein:
J] Other SMIQ s• Explahl'
1dei4IIfLy %V jjCj` 11(01}r WK) SNMInlartm-L 1'211Ii71t$ile &ttClliO] i n [1 1?2`r11I11$ttOli;
tlrovide esEhimtes fos jurisdictional mraters lit tike rCvim aria (check all that apply),
R Tribuhly kvalcum If ROT feat widfh (11).
R Oll7er moli-walimcl wmt4 rm ttCr .
r4fewi fj- type{s} orwate:r;;
Wertands: acres.
?`ueE l?oolrio€aU3_
co111p11;vftt ,gwglysis raer t4 tt10 koy in Swtiao of thr- ImAmcEiasnmt Gui[tc6unk_
filar lu HS510-li42g OILdCeEEuiOg MA jai'isdiclimi bymA sdel • on Iht# ealegor}•, C-a1'Iis Mswkts W1114!1eV41 fi I1W Rdij! L (0 C101-1P S affil EPA
HQ for revietr consistroi with the process dcserlbcd in ttw C.urpsfl-IVA Me grandam heAw4bW CO 4 d d JrdrlsNdlnu Fnhlao ng RapaAert
Pw1OWURIS11]CTIONAL Wd'MRS, INCLUDING 11'FTLANDS (C:] [EC K ALL T€ AT AP.PF Y) t
If }latential wetlalwN were am&4; l Wi Il3ill 11kt± review strt;a, lhesc aMHS diet trot 11100t 1110 CF]WHA ikl Ilan 1987 Corps of
Lngince s Wettatlrl Delineation Mantka3 mullnr tLl propr]4le Rogiotkal Supple cn
s.
Rew€mv Mmt imladcd 1s>lalod wMors with tto substutklial naxus tp intemlote (or fomigaa) mmean
r] Prior 101210 )NJ MI upm1m; Court &zisim in "SIYAA1 C,` 1ho remiakv a m would have b mi re-gululed NISQll
InNly on the "Migratory Vigil M(1 ' {hl RR}
I-1 ml.ltm {10 liGt meet 111C "Significant Nexus" slnnJorr13 u-1i a sheik sl dueling is rcgoirc? l fifir jud-Aktion. Explain:
01C1er: (explain, irrmt UOWM ti above):
Pwvido xcrcHgo csl imatcs for tton jurisdictional tvalers 1 a the review" mo, v ere the r putosil €aT baah] of jurimlle ion Is lho
r+ BR Nclom (i.c, pro%mc4 of migraloiy birds, 3xesence of cidarlgered species, tige ofivoz fbr irrigt1tod $gdoxrllt mi ush g
be-A ]rrol sipltol jltdgmeksl (eheck M] 1Ttat gpply]:
Non-wodand svgkters (i,%, riae3x, RtretLins}: 1i rwir f4t width (A).
I tko0pollds' ages.
0111er 11011-tivcttfllld waters: arms. List lype oragkral is ivsouree:
1Yettands: ItCUM,
PrOwt& aOrC4rgc Oti rrxalea ror YLM1-jtLdSd:C1al m tcas ill tho Peale Y afO 113at & kkpE 111 *Qt the "S i f;nif€UME Kextue' >`tsa25EaFa],
w hue miO 0 IS k2dilig is a ttlircd for jurMid ion (chcck all 11kat apply):
tl m1-;W11.-Md a wterg riwan, Slw-ml R-), 11laear rccl, kvidth (ft).
s? 1.a1€cs7lao?sds: rtcres,
Q t l]ieF utnl uvl lasstl ?valcrs: acres. list lylle or;tguat is resource.
V?118rc1s atcrm

A. SUPPORTl ECG DNrA, Dalx revlem d fur JD (cheek rtlt that apply - checked items AM be 1mr[ <€ d iii case file aml, where
checked ftnrl regversle(l, giprollrialvly Forertrsoo fwu=s bdow):
Maps, plans. plots Or plat submitted bit m- [mi tx bbl f ur 111{7 a1a1f]u a331lcosisrtllaikl: SWv N e.
® Dala slieefs preparztfl,Sklbmitted by nr ns3 behidCel'tlla opp]kaoYcoeistilltir32,
? Offmc cmimirs with &ta xll3selS?delis?eaCiarl cepm I-
[] Ofliou duo mA oat»cur wi111 data shcctstdc]irscatim FCPOrt.
rl Data sl3eets: prepare[] by the CIJ ? ;
Cons nauigalslet?:tiCea * Study,
I:j U.S. Gcologieat Survey Vydt-o1o& Our.
USGS NH D data,
7[c? 1 FSCxS 8 and l2 digit HUC nears.
JR OrS. Cek3l(%TcaT I&IFVOY lltktp(5). Cila S) iRle & quad nar3 !.6! i?zt
USDA Nattiml R"oofces Coitserwrktion Service Soil Survey, CilUtiool:' I'M ]GrL F lily. 11
National IWIllkkldS 41VOI(Ory #llals(g), 4740 ktFll}1$:
StatdLocal %wtia2ud invetawy map(R);
? 100-}ektr F]00dj)Ta31r EIev24011 i5: atia3lal Ckodcctic Vertical ]lulu of 1920)
OF 01l1er (t 4kma & l Ialtt),
El I'Favio 18 determinati6N(5)_ Vile 310. and data of respmm4 ]e gen
® Appliviblelsupportingcase faw;Rapmos and Celmbd€ cases,
? ApfkEietrlk€p? aal,j,gr#prrgs 3elltiFie Iitceaturc;
Othel. infollmlioil (lrlessc bilwirp}: EPTt # v'?ci k +C6OiWiCti(p&&ii li?A Q IQ?er; 9
Js. A1.1111'1']ONALt:CIj'?']PXEENTST{}$f1PF{lR'FJI).
Stoyrn t r hup ct Anal-gsis
foe
Gr in ille Medi ial Center
me r en: Department p r?si n
1010 lle Street
Off r k Norte Carolina
Prepared B-tj:
EPT
1025 Wade Ave nac
Ral h, 27605
Jane 17, OtO
s I?P I
L c. r,um,r4 F, -Cos Tkumos
Contents
Executive Su Mill aarxj
Sand F! IteySpe611C.?ltion
SaIld filteY Shi-11 ('1a1CU1aiiO11S
Sand Filter Area anolf & fl(:) })Iii ic-r alei-ilai.ious
Saud Filte. x 1 '1T' , l ?i?i ??zt Checklist.
j) )cndiccs
D tch G,-;,lc. ttlat ions
itro,e, Rimoff Calculations
istinS Buffer Conclation;s Pliotc)81,a bs
Soil Booing for Pot ntial 145h Water Tablc- ( tI Geeteclinofo8ies)
FIRM Pauels 1923 & 1913
USA Topo8raplaicai Map froiia M SR Maps, fonnci1.i) Terraserver)
Raij.if all Data for l raukfi ntoii7 C Gleares# Collection poinf )
Sails Report lei] Stewart hri6ii°aeerin65 laic.
EA!bits 01-05
eSEPI
CC
F-Xc cll tiv(?? Slit III111anj
Tbe. C-tanville Medical Center is scck ng to expand its emergency department and to add
purki.ng to the rounds to offset parking last duo co the exl3311Sira11. In carder to treat sautrient
rkinufffrcum the cacPansion, a sand filte- BIMP device has !ream propo.d, Bna: ed (Iii the
attutc.ht!d Nitr€ gen and Phos?hoa-as calculations their export has acLU31ly been reduced ira the
east-developcd condition. The area where IVC are expanding the existing p r k 1 n g lut hats
b b con dcfined at 5.43 Acres. We are add:ng I.09 Acres cal' iinperviou;: parkiF1g ?,vi.thi11 this aareak.
Sincc the existing inipcivious is gran d fath e red we are b4i gic;oIIy treutingr the additiun{al
impervious with our proposed :sang f Iter. By VirLUe 0f 1 he'ite layout we afire.. actuaaIIy treating
Sol-no of the existing impervious as Well LhPrPhy MCI Uc:ill I Ile c-ai1e4llaa(ecl e) ppurt below curl-crit
levels.
The site has a f]i=,~Praaaial Uiaiiaarae,l tr6fa4ltaary of urdan Creek Punning through the southern
portion, just bplc:r,v oiae of the .uew p adking areas. Duc to the close proximity{ of the park ng
,area and 1 he. acrid Ii1ter to the stream, raaeing has been des igncd to Ininianize the iinpact LO
Zones I ;jnd 2 ul'the. Tear-Pamlico River basin protccted riparian buffers.

Pcr the AUDEM is Serar raa? cr b'_lfir' ?'ari?r 1, the int,.(P;a in the Usancl Filter .shall be cleanecl,
washed coarse mmom sand such as A`i-i'M ("i;-') wi; lk la ir'Jde.s less thim 2mm average
diameter-
S,ar3C1 1T1Ul t be UiIEC.aa b-?rwed-rata iimestone poducts may be uEed (if mate ria] is white or gray in
c°(dor it is probably not acceprable.
Sand must be clean. Natural, unwashed scud deposlts may imi be med. Likewise, sond that
has become contaminated by impropcr storage car histallat io tar:ac:t.it es :whul I neat lie used.
Manufactured sand or stone dusL Thal I nn[ lad tv ed.
f}/. SEPI
Qe
+ ESk4J:i'4.ISikii&CJN5 I&L4: LL15k'
€ nd Filter Siziu8 Calculations
?C-'
r, S I-I
ERt1aU.fGKG& U%'AK M W
)SEPI
ENGFa EI-',RJNG GROUP
l
I--?'1n1V?1?.-r; ?!IFbt,rd4s-- 4.-
Project 7 4?
Srubject An1:1 ? c.: _ ?irtt u?
Desigrcr
Date- -i
- I i f+ dR141.4 d i :d[ L 1T O'4Ae-: ..
iA?M 2-1SGt
J t19
r I_ I ? I ? 'r f w I I k
•
`! e1
j I_-l? iA:tlE1 US.IC'`i_!_I+?J r -_? I -! i i- k-- - ?
LTD f'L
,
A-q
f
I7
I
rr

i
j I
I
5 I I
i i
_ i I
• S 1 -a
I 6._ t -?
I _? _?. I L s
I j 1 ; ? I o
I ? I I I j
I '--- ,--- - ;I j Jy? it ?' --- -- - --I
1€ 25 Wade Avenue, Raleigh, NC 27605 ¦ Tel 919,789.9977 • Fcax 919.789.9591 • ?epial3?alxe?r'ta??.cor?
Sand FdI-ey Area umciff & Flow Split ter Calculations
eSEPT
SSEPI SLbjecl
_-q5 4
I'?°EJJ'' 6J. `,r4g, E{`L T,ofr fJ I II i _ e I
J.
• i I i
J.
i
rte-
a
I I i ? ta?tsn 4[4'?D '?i ?? J ?-•
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`_! C ? i ? r, ' ?_ - I ?, ?. i. ??x _ I ?!fl?.t ? _`'? ? tL?•? I??!?_y,+b ' I ? ; ? 2? ?C,I??r,F - ? 9 I I ? O?w b r?? P O)m b .l_ 1 f lf` tz 64 !......
I""
I --=fir i - Cr:3_r! t,a- f, r» r rub '?'Y_$ _k + ?R I
I ? ? I I k ? ? ? EI I I ? ? I I
WEI'
LW I
t,T,`- ?U!-k AAA ±[IQ S-C _ i t
.' . -Y r-
+ I ? I I ?`l
i
1025 VI ado Avenue, Ruleigl4, NC 27605 - Tel 919,789.9977 0 Fox 919.789-9591 0 sopienuineering_corn
Hydroraph Plot
HOrat3ow Hydrogrsphxs by latelisolve
Hyd. No. I
Sand Filter Runoff
Hydro graph type = Rational
Storm frequency = I yrs
Drainage area = 1.830 a
Intensity - 4.914 in/hr
IDI= uiw = Franklinton, N .IDF
Thursday, .Erin 3 2010, 9:12 AM
Peak discharge = 5.58 cf
Time interval = 1 min
Runoff coeff. = 0.62
Tc by User = 5.00 min
Asc/Rec limb fact = 1/1
Hydrograph Valumo = 1,673 curt
Q ()
6.00
5.00
4.00
3.00
2.00
1.00
0.00
0
Hd No_ 1
Sand Fitter Runoff
Fyd.No.I -- IYr
5
Q (cfs)
6.00
5.00
4.00
3.00
2.00
1.00
0.00
10
Hy rograp h Plat
Hytfraflaw F } ragraj)$xs by intLCJE.sajve
Hyd. No. 1
Sand Filter Runaff
Hydrograph type = Rational
Storm frequency = 2 yrs
Drainage area = 1.830 ac
Intensity = 5.887 in/hr
IDF Curve - Franklinton, N .IDF
'FhLirsd,ay, Jun 1U AM, 92=7 PM
Peak discharge 6.40 cfs
Time interval I min
Runoff coeff. = 0.02
Tc by User = 5.00 mill
Asc/Rec Jimb fact = 1/ 1
Hydrogropli VO1lir,ie = 1.919 c.I[t
(CIS)
7.00
6,00
,00
4.00
3.00
2,00 -
1,00 -

Hyd No. I
Sand FiFter Runoff
Hyd. Moc 1 2 Yr
5
Q (cfs)
7.40
6-00
5.00
4.00
3.00
- 2.00
- I JOO
0.00
10
Time (w r,)
H °drogr h Plot
r`,Yurarlow NyarOgMPirS DY 1S1Ik?IFS£;'9e
Hyd. No. 1
Sand Filter Runoff
Hydrnegraph type = Rational
Storm frequency = 10 yrs
Drainage area = 1.830 ac
Intensity = 6,839 in/hr
OF Curare = Franklintan, N .iDF
Thurs(Liy, Jun 10 2010, 12-7 PM
Peak discharge = 7.76 fs
Time interval = I min
Runoff caeff. = 4.62
To by laser = 5.40 rn[n
As,:Mec limb fact 1/1
sHyiroQraph Volumo _ 2,32 3 c?u';
Sand Filter Runoff
(cfs} Hyd. No. i -- 1 Yr
6,00
4.00
2.10
0.44
0
- HsiNo.i

Q (Fs)
8.04
6.oo
- 4.00
2,00
0.00
10
Time (miny
Sane Filter B_= uppJemoiit &? 1i,??c Est
eSEPI
.FCr ?
Pczm't Num ar,
A aier 6 A L Y
axL ? -I
La _
DEN 3
STORMWATER MANAGEMENT PERUTAPPLfCATION FORM
40, CERTFCATION APPLICATION FORM
SAND FILTER SUPPLEMENT
Tiers I'Dav must Sao filled-oot e? 1i,no, Frr()i'ed rW1d strbrrfih`ed;!wrtit aft of the requi(od r`r ormat€ert,
Make sure t0 orso d'lItV w;dsrrbR7i1 dlre R6,4vired hfems Chockdrsl (SecVof7111) acrd Me 16 l'vl,Agreerrferrt (Secllo;l M
1. PROJECT INFOR141ATION
Prolecl r? I-nc G aslvFIo f, ed::cal Ceiler
Contact r nC Bi.'I P.'-der, FF
Phone riullibm rf1t3-787-9977
Bale ?.une 1, H10
Ekainage afe-3 rum b--.,
1 (Parking Arova & Addiliumd f lsn 7ffj
H, CEBJG'J INFORMATION
&W Chara"terist;cs
i1)r3irlage Nfea (A nl 7UV15.CQ fly OIL
I'mporvio .rs area 51,07M f;`
% ImpervlOW; (I,1
6ta?0% %
Deign r.ainfol clep.Lri (R 1.00 isw
Peals Flow Call:ijlalisans
1-yr, 24hr rl r.0 neptll 2.82 in
1-yr, 24 h{ snlmsidy 0.12 9n"rrd
Pre-davolopmml "-y:, 24-ftr runoff
PcIsl.-&velppm;, W 1-Vr, 24-11r r(JrzoU ?tjf ryf
PraQFwsI 1-yf, 24-1hr peak: control ft ?sei
StDragO VolUMe
Dcsign wclum a (WQV) 4,25 pfd
Adllrst&J i;iV..or quakly veL umqu (yyQy SJ) 3,189.w ft3
Volbllf, con}ained in the sc?i,rnenlal rsJ7 faes,~rr and on lop (ill ihn sand INer s,19rOK
Top of sand fillerlfrgrate eledal*.) 45? fl arrr I
Woir 91eva ion (f:--men Izrrumber.s) 453.70 fl am-J.
%,ixlmum head an filo sediare tallar [rosin and sand filter (h 3,0011 OK
A: r..rap bead c n ft sedimeniatic n io-5in and s and 1i;trr (h l. r" J. OK
Rrfnof' C:oeffclersl (R,v) O.bA (ursitless)
Typa of Sand Fllter
]d on snr; d ialtr'.I r 11 Y or ;N
SH'Arl ulovavcm 445-00 it amsl
BOttrun Of tfle S a U. fi ltas ule'Jatien 417 50 Ir s;xlsl
G, mfaf-ice (d "Mi t )
. yf}
ClrasMlpre-east samf fi!tert Y W N
SHWT elev{atdon ft ams`i
Blatti n of the sand fslter Row Mon fi antBl
Clen;S nCe (d-,la,"rs)
If Isis; ',S a closed, Lm derggmm _d cfL?sed ws nd filler: The rkarance b&l.%veers
the slurface 0 the sand Il4cr and ME! lJ{lttlbm of the roof of Iho urida.r rm mf ft
Stfuc!uIc, yOsp..'}
I orrri SWIGf-Sand Filtor-Rav. r %j?Supt17 Farts I pnri I, VrDjact G,=alg., Stlrnrrldsy, Fagg I i
rw111lt N.mber.
(CobepvuVd-d 1)y )trr'J?
Sedimentatien Baslrt
Su 4,1,-e area (if M, mental cm barn (A s)
Sediulu,at,on b irdcNimberdepla7
Sand Filter
Surfi?m area o4 sang fiftcr (A F}
Top c. sand rrtcdia filler bad elf vation
m"om Uf nr d medaa lifter bf-d1 r- !n ele-aalion
DeW..b €Ir th a sand media filicr bed (d p)
C.c?e:fic?enl id, pmmeat2lity reg Ox, ?u.1d filter fk?
Millet dialreaer
011tfe1. disclurgolf,mrate
Timo, io drain ;lay saifd fflLer (t)
Tirrita to drain ;fie 9,ir4 jiater (I)
Addif octal Jnfvrnrailan
Doas i u I nc. ;r fircess c? Phe dosign volrurne byrms the sand fil;er??
Is aIa -all iif s"'--a-sphIiynq de;io used?
If rsrt reinq io SA 5w ;f(r5 Dues vokirr-t- is mass of lama dosign vduffle fviwr
ewcrtp ,Iis:ribu!c-J throtlgfi a vegetaied litter?
bk";:r 1 is the Ien j?fL €r¢ thrr aege1a3ed fiifler?
LDws thi: design utif. , [ovel spreader [ft oveMy dis r1uic. flcov'Is ,fie BMP !ccaied ai hic-nt 3Gft from surfr?pu a'r'$lteas (5511 if SA, walers)?
if n!;3 :s closed be Horn, is BMP I rated 3! 1nast IVjlJ from v aWra.tlpply vip'I"as$
Are 11m wc9?a atad side: Ic es cqua. to or Im5s tti n 3:1
Is Isle B MP I0[?,Itcij io S devorL'f 1 r.min aqe e u?rcnt wi h a recordoLd HESS
caseme ll to a public Righ, of My (RO1N)?
4i&- 31 is 1,110 W -ft Ok" 1118 s6'JimcnIZIIJ10 chaob riforebay (W ?
Wha1 i ? me depth of sati d oyef I he i,vtlet pipe (dphm)?
. H V ft ?It" aY4CLS MK Irt111-011, V46L711dy I=U W U h1I", :r[7 U 4.U
?75 ft
Ur%- 140tc0 I I III III I KJ'.11, 1JUI. IIIpy IIi:t!U LU L't 11 LL.I t,3;,ULL Lid
???1.?w E!; 1ITiSI
147.50 ft wn
l
i.O fl
3.50 (f[•+da y)
6.00 ni
1.68 Oi?^c
0.00 Nwrs 0K. Subrrratdra;4ia;.euelctlalirn .
1-67 days
y Y or N SDK;
Y Y v N OK
WA Y cr 14 Friter Dala
NA fl
NIA Y or N Enter Dafa
y YorN QK
Y Y & M' GK
Y Yor N CK
v Y or N OK
15,Ci4 UK
1,54 ft 0K
Form 9VJ401 • IL1i Falter-R?a,.a :2UCr-j3 =pt17 ? i rie I w1d Id. Prof L Dazign Sumrw?jy, Pago 2 of 2
Permit r?fo_
(to be provided by DM)
IIL:::RE[UIRED3T
Please indicate the page or plan sheet numbers Wiere the suppoAlnD documentaJon can bo found. An Incomplete submittal
package wall result in a requesi for additional informatton. This will delay final review and approval of the project. Irritfal
in the spaoo provided to indica€e the lollowlrag design requirements have beers rnel, If the applicant has designated an agent, the
agent may initial below. If a requirement has not been met, aiiach Justlficaiion,
Initials Page( Plan
Sheet No.
X 1. Plans (t° - W or larger} of the entire site with labeled drainage area bou€rda€les
- System dimensions (length. width, and depth) for both flee sedimentation chamber and the filter
chamber,
Maintenance access,
Flew splitting dovlce,
P€opesed d€ainago easement and pub€ic right of way (ROW),
- Design at ultimata build-oal,
- Off-site drainage (11 appl€caWe), and
f
1 - Boundaries of drainago easement.
X- l 0.22 Plan details (i. = 33` or larger) for the sand filter showing:
r - System dirnensior€s (Iongth, width, and depth) foT both the sod€montation chamber and the filteF
chamber,
Malnlena€rce access,
Row splitting device,
- Vegetalive filter strip dirrrons€ons and slope (If SA waters),
Proposed drainage easement and public right of way (ROW),
sign's a# u€lirr€ate build-out,
- Off-site drainage (if applicable), and
' - Bounwaries of drainage oasemerfI.
{.) ? { 3. SeOion view of the sand filter (V = 2C' or larger) showing,
- Depth(8) of the sedimerrta#ion chamber and said Mtar chamber,
- Depth of sand litter media,
- Connection between the sedimentatimi clamber and the sand filter camber and weir elevation,
- HVVT elevation,
- Outlet }pipe, and
- Clearance Iron the surface of the sand fitlo€ to the bottom of the roof of the underground structure p
,, , + _..... applicable}.
" 4. A soils report that is based upon an actual field investigat€on, soil borings, and infiltration tests. The
results of the so€Is report musl ?e verified in lire field by € WQ, by completing & sobmllting the soils
investigatian request form, Counly suit wraps are not an acceptable source of snits intofmation.
5_ Suppailing calculations (including dmInage caloulatfons)
6. fgried and nolarized operation and rnainlenasice (OW) agreement
T __.... 7. A copy of the €!ee€E restrictions (if required}.
Farm SVV4f)l-Sand ?:Mer-Rev.5 20(Y9Se017 tart €31, Page 3 of 4
)))e.ndkcc-s
itch Calculations
Niti,o c-3, Runoff CaIc-TLIati<>ns
istiu8 Buf fey aliditiol1s photo6raphs
Soil Boyhi6 foy Patenf ial Hi 6h Water Table (bij Gootechn)1o,5ies)
FIRM Para-Is 19E5 J 1913
SGS ` opc),5niphicat Maps (1yo m !1 Maps, Immerbg Tertaserver)
Rainfall l at . for Franlchntoi), NC (nearc?A collection point)
Sails RepoYt bij SfewiYt Eu8i ecrin& Inc.
F-xhibit.s 01-05
E P I
1'1tiCL'tiLLMNV & Cusco anRlO 4
Lot B South & East Ditch
Worksheet for Trapezoidal Chann, el
Project Description
Proieca File unlitled.frn2
Worksheet Granville Medical Lot B Ditch
Flow Element Trapezoidal Channel
Melhed Manning's FoTrr,.ula
Solve rar Chanrrel Death
Input Data
Mann'ngs ceffrGlent 0.030
Channel Slope 0.025000 ftlft
Left Side Slone .000 00 H ; V
Bight Side Slope 3.000000 H ; V
Bo!tom V:rrdth 1.00 rt

Results
Depth 0.33 ft
Flow area 0.65 W
Wetted PeHweter 3.07 ft
To Width 2.97 ft
Critical Depth 0.04 ft
Critical Slope 0.022 50 ftlft
Volo^ity 2-78 ft's
Velowity Head 0-12 f#
peoifi,, Energy 0-45 ft
FrOUde Number 1-05
Flow is supiercrit cal..

xJ->

io nlfO9 Fiow,Oas,er vi.11
7C?; }2;?t$!??41 "Hewed ME31 iWs, 1mi. 37 BratskSIde Road WaiGrlaLcry, UT 06TOF3 (M) 755.1666 Pare 1 p: ]
Tar-Panifi o Sl rtx water Rule 115A N AC B .0258
Piedmont of the Ter-Panilico River Basin.
11:0kides Ox,unf, H,.ulcm-on, 1toCKY :00HIIt mid Tarborit as u-d I :as Frankiila, Midi and E
Tiptal Nitrogen nndTatal Phosphorus Imading, Calculation NVorkshelet
I'mieel Nmna; Gr°anvilk lleefia
Ntc; & x,'70111++
By: Av
I#y;
I1a4'r{`flon-v (STtIYrEfor at re-d!'l'C'1f1pmew and posf-tlei!dEatoprf ew fable),'
? 1. tlo. OIL. res ofeaclh 1yl,v co-°'!mld co"'cs ill Lt.e [?Feejl bwN,.. The sllreatfs.llet€ will ,ralcutatc all of the :jtILEeL. in light blue.
* Conlpal'a lit;ol nseas of dcwtoplelvEE1 in I,rc.- and host- talates fifir mull"ismicy (L)mGM ft." LQ11111M (2)), dzndt also I01' L1+s ;k,[(ncY v,T
01V t; k+: Plans. 1f'u;l rtl, Ilwcl v valkics tars; t.EtrL 111Z:ss:lEwflinc is all error thilL ,Mass; bo uunTected
t,:lle slruillaj?L: sJ'11Eo kllc d evelolalIIL111, [Toni offsitc Es divencd <scr ind or tls•nu-11 Lilt! :-i€v, otl?itc catc.lal uL :trr.3 dmiiiiiig it mus
bc° t>cILtdcd ill EILe 1iCr[.`{It!V_ t'alu s 9 11d 2I?ALetl.
l _?? k+Y 1;? 141 E ?d
?417k 41? ?lAili< 1T5CE n?rc?tY ? ?? ?? t I ELFLk?bl. ?YLl"G`s? I °Stl?'111h ::r'?.Xt7 f?i ?'?{#.,. .: ?r,?t3Ltil1.:+',
f:,LAks? . I.I,I}:, , Il.> ..af . Sir? ' [27 . f;?l . f.?,: s t TI':I_it i:1: ": .T49
1 s;ttE511StRdtE?alt Cll ?)U t,dll' h t i 5.10 .ts 71.#33 fi,1 E1 5,25
I asil ltkp€] 1?.tD[ 4 0111.1 .{} 1,95 iT.€1lg 1,)L II,fI'lM
': i$?f1ts?¥i#lE)cL3'J{kll?

ts al
LI€`I?1tdI{.s.;??lt{It a7

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0,28
6.15

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71tll.al,l €l, 111) 5.09 4.23 0.00 1.23 0.011
'?#nt•:??SaT llkf???ilk a
% €a.t?ftil:R}; II.U(, 50) 2.04
O.QO
ll.la2
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t dru.;Recl laCt> lc+u, le_=1l1 5.09 (04 0.00 0.14 13.0?a
lit Li 147 F1 #fr111?111,}Il (i .,
46'. tf, oil1fEa
i tAE to l:
t{t? ?? ' llTalfl1lta:
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nS 06 1 kttkl
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. c,E.k};E` T ir.:E?llltatlR ? A,'Lk1C R7 G?[311
.
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Geciilechnologiesjnc.
Geotechnkal and constfLKflon Materials Testing Servkes
June 11, 20 L{1
Mr. Brian J. Kraynak, PF, LFFD AP
Sepi Engineering
1025 Wade Avenue
Kakigh, C. 27605
Re- Hand Auger Soil Boring
Granville Medical Center tomw3tcr BMP Pond
Oxford, North Carolina
GeoTechualcgies Project No. i,10-0339-TEA
Mr. KraynA,
€`urstt$at to your request, GmT'cclmologics, inc- has completed the autkrrizcd services for tiro ahovo
referenced project. Our services were performed on June 9, 2010 and included advancing a hand auger boring
to a depth of five feet below grade at the location of the proposed star water BM-P pond. As loosed upon
drawings provided by you, the proposed pond will be located approximately 200 feet east of the southeast corner
of (lie lower parku3g lot located south of the Family Medicine building (Suite 1012).
Teased upon 11w drakwhigs, [tic Cxiaing grouad surface is near an cluvt4tion of akni1450 feet. ]'lie ground
surfaco consi9ed of talc grass. The boring eMimmleted a thin layer of topsoil foIlowed by orange, brown silty
clay and clayey sitt ty} soils. Thcsv soil- w Cawtitatered to boring timnimilcn at a depth of about 5 feet
belmv existing grade. The soils'kvcrc generally dry to slightly malt. No groundwatcr %vas cncouawrcd in the
boring upon boring completion.
Ge61'echilologies,Inc. appreciates the opportunity to have provided you with our services on this phase
of laze project. 'lease contact us if you should have. (tu tioris regarding this letter or if we may be of any faither
assklancv.
S i m>mly,
P4 -& it
Mark R. Potritz, P.E.
C: Registration No, 25955
P. P
?r+r?li?ltisyt
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0 5955 -
3200 Walilnlgon Court, Suite 108 • Ralelj)h, WWI Caroiioa 27015 • PhOnO 914-164-1614 - Fax [phone] " wwW.g001erfiPa.carn
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Image courtesy of the, U.S. +Geotogical Survey
2004 Microsoft Corporation, Terns of Use Privacy Statement
l or l 1011512 00 9.56 GSM
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PrecipilationrregllellcyData Server f,rtp;ll?ii????er,n?vs.?roaa.gavlcgE b?t?Etc3srJ?lli3dv??t,pe?1"? ?e?f&??lits-.,
POINT PRECIPITATION F
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FREQUENCY ESTIMATES ?
FROM NOAA ATLAS 14
OXFD DAG, NORTH CAZl LINA (31-65f0) 363047 N 78,6092 `4V 459 feet
from'Prcciprta ion-FrL,que cy Atlas of flTe Ulriied Siaks' AfOAA ArEas 14, Volunm 2, VQ*;C?l 3
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HOAA, NR1ioi%,a }4reallw Sea rice, Sr %w Sprinp, Maryknd, 20U1
Fkirsfiscd: Thu Ocl f 52009
Confidence Limits I Seasonality I Locaton Maps I Miter info. I G13 data Maps Does Return to State Mal
---------
Fregitcrtey Fn imates {itrcites }
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I'S2 0.84 1.06 I "SQ 1,93 r.8 2.43 2.93 3.49 425 4.91 ?1 6.1 i 6.57 S.9S I0.8R 13.57 F6.01
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GEOTECHNIGAiL ENGINEERING REPORT
PROPOSED EMERGENCY.DEPARTMENT EXPANSION
Granville Medical Center
1010 College Street
Oxford, North Carolina
Stewart Geotechnical Project No.,. F9010.00
Prepared For:
GiRANVILLE MEDICAL CENTER
1010 College Street
Oxford, North Carolina 27565
Junc 2, NV9
I?kk ?'
:.5
STEW ART
CAR
4
%
i
0612-09
Donald W. Brai+ h'lr., PE, LEER AP
Gcot-echnical Fng€rieedriq Manager
This reFnrt wos peer revieGres! by ar+ rridcpcvidurt fwisallarrt, Nara d 0. PYvA4 PE (NC Lkflirsl No. 9551).
EXECUTIVE SUMMARY ................................................................................ ...,,.,..,.,,.,,-,..,.-..-..-.1
PROJECT INFORMATION..... ......................................................................................................................... 1
2.1 Work Authorization---------------------------------- --------------------------------------------------------------------------------------2
2.2 Site Location and Description ........... .... ....................... .......
..,..,..,.,..,..,.,.
2.3 Prajoct Undcrstanding ............................. ......................................................................................2
2.4 Geologic Area Overvlew-------------------------- -------------------------------------------------------------------------------------- 2
SUBSURFACE EXPLORATION........ ....... -- ....... -- ............. ............. ..... -- ............................................ 3
3,1 Field TesUng------------------------------------------------------------------------------------------------------------------------------------ 3
3.2 Exploration Results ........................................................................................................................ 3
3.2A Surface ................................................................................................ 3
3.2.2 Sail ..................................................................................................... 3
3.2.3 Groundwater...... .... .............. ............ ........... .............. -.' . I
r:N INEr:R1NG ASSESSMENT AND RECOMMENDAT€ONS ....................................................................... 6
4,1 General Discussiao7 ........................................................................................................................ 6
4.2 Foundation Recarnmcndatioss ---------------------------------------------------------------------------------------------------- 6
4.2.1 Grouted Hellcal Piers ............................................................................. G
4.2.2 Spread footings .................................................................................... 6
4.3 Slab-On-Grade Recornmendat€onr---------------------------------------------------------------------------------- ------------ 7
4.4 Seismic Design Considerations; -..- . .......................................................................................... 8
4.5 Retaining Walls-------------------------------------------------------------------------------------------------------------------------------- 8
4.S.1 Basement Walls .................................................................................... 6
4.5.2 Landscapc/Sitc Walls ............................................................................. 9
4.G Shoring CarssideratiorES , ............................................................. .9
CONSTR€1CT110N CONSIDERATIONS .........................................................................................................9Q
5.t Site Preparatlon -.---.--.-- .............1U
5.2 Grog fldwater ..................................................................................................... ......... .-- .--.10
5.3 Structural Fill Selection, Placement and Oompacl-iGn ----------------------------------------------------------- 10
5.4 Foundatlafl Bva€?atioa?s ...............................................................................................................11
5.4.1 Groutc€€ Helical Fiers ......................................................... . „ .....ii
5.4.2 Spread Footings...................................................................................i1
Appendix
F€gure I - Boring Locat€un Diagram
FIgurc 2 - Civil Survey
Boring Logs
Figures 3 & 4 - Subsurface Profiles
Site Photographs
Seismic Design Values
i EXECUTIVE SUMMARY
Stewart Engineering, Inc. (Stewart) has completed a geoLecnn€cal expioraUon at the slLe of Lhe proposed
Emergency Department (ED) Expansions on the campus of Granville Medical Canter iu Oxnard, North
Carol Ina. A summary of our Find Irigs, opinions and recommendations Is provided below.

7um Borings 9
liurmq Depths (ft) 16-24
Soil Types Encountered (USCS) €+'IL, MH, CL, CH, SM
Old Fill (It) 3-11Y1 (all 9 bor{ngs)
Groundwater Elevation (It) 453-458
Weathered Ruck Elevation (ft) 443'h-451 (2 horings)
Iiard Rack Elevation (ft) 443-451112 (6 borings)
Seismic Site Characterization D
Recomrnenda6 Foundatlon SysLerrE Deep Foundation - Grorrt Hel€cal Piers
1. The old fill encounter cd appears to be
uncontrolled and poses a significant seLtlernent
risk for conventional spread footings.
2. Numerous burled ut€lis_les In the area that may
Other items of Nate require mlocation. Pool-ly compacted backf-ill In
the assoc€ated trenches is also expected.
3. Depending ofl f€n-al siting of the mechanical
room, Its excavation may require underpinning
and/or shoring.
The owncr/dcsiguerlconb-actor should riot mly solely upoil the summary table above. This repast should
be read in Its entireLy prior to implementing the recarnmendabons in the preparation of design and
carrstrucdori doctime its. Stewart Eugirxeering should be retained to perform sufCient services Lo
determine plan/spedfcation compliance with the recommendations in this report.
2
Page 2
2.1 Work Authorization
The services discussed hcrein were proposed in a Stewart Fnginecizng, inc. proposal dated (revised) April
30, 2069 and authorized by Mr. Bruce Brooks of Granville Medical Center on M@y 20, 2499.
This report has been prepared for the exclusive use of Granville Medical Center and was completed in
general accordanoa ! with the industry standard of care using accepted geotedinical englneering practices.
2.2 Site Location and Description
The subject site is located on the Granville Medical Center campus at 1610 College Street in Dxrord,
Granville County, Noa#ht Carolina. More spccifical€y the FR expansion site is located an the southeast (Teat)
comber of ilhe existing haspflai buffding.
The southern portion of the expansion area is currently a crass-covered yard. Tile northern potion is
occupied by the FQ entrance, access drive and patient drop-aft' area. The ground sur-Face slopes gradually
downward from north to south through most of the proposed building footprint, but the slope increases at
the south erect of the footprint, Relief within the prupmed building footprint fs about approximately 4-6 feel
aooordIng to the site survey provided by Granville Medical Center. A copy of this drawing is included in the
Appendix this report as Figure 2 €pr general reference,
Also Oown on the provided drawing are numerous buried uHllties and associated structures (manholes,
vaults, etc.) within the proposed expansion footprint. Tlhcse iricludc one water line with 1!ccds to a (hydrant
and into the hosp1ta€, seven sanitary sewer lines and flue storm sewer lines. Also, during private Utility
locatioih, electrical service for the hospital ex€urior lighting was discavcred near the Eft entrance.
The existing bulldi€hg has a masonry vcneee that is cracking and some of the windows were observe-d to be
racked, both of which are likely clue to structural setifement. The porllon of the ex1sUng facility that Is
labeled "Future Lab" on the Boring Location Diagram (Fig4ih>v 1 in the A,ppcndix) includes a basement. The
provided as-built drawings by Wilkerson Associates indlcaLe a basement finIsf>ed floor Elevation of 461.13
feet (Sheet S-1, elated May 16, 1992) and a first floor FFE of 471.60 feet (Sheet 5-2, dated May 16, 1992)
for most repent hospital additions.
2.3 Project Understanding
It is our undersLandIng that the proposed addition will consist of an L-shaped, single-story building with an
approximately 17,509 s€ uarc foot footpiiint. The structure will consist of steel framing, concrete slab-an-
grade and brick veneer. The southern portion of the new addition, below the "Surgery Storage Expansion",
will include a small basement for additional mcchtanical space. The southern portion of the proposed
structure Is also being designed to accommodate the addition or two additional floors. According to input
from Stewart's structural group, the maArnum columTi hid is estimated at 150 k1p5i however, the future
vent€cal expansion area will require foundations to support a maximum column load of 356 kips. Floor
loads will riot exceed 106 pounds pct- square foot, The }proposed expansion FFEs will match those of the
existincq building, as mentioned in the preceding section of tills report, resulting in up to about 3Ya feet of
fill in the southcm }portion of the expansion.
The informatim presented in this section tiaas utlllzed In the geolechnical analysis. Therefore, If any of the
mated information is incorrect or has dunned, please inform us so that we may amend the
recommendations presented In this report, if appropriate or necessary.
2.4 Geologic Area Overview
The project site is located within central Granville County, North C,arollna, which lies withifl the Raleigh
Belt of the Piedmont Phtysiographic Province of the eastern Elnftcd States, Review of the Gcafogic A?ap of
the Oxford Quarlrartgfe, Granville wul Nance Lour}fles, NarU} Carolina (compiled by Jarvis B. Hadley,
1974) iridicates that the bedrock below the laa area is chtaractcOzed by mcdium-coarse- to fine-grained
horrmblende gabbro-diorite and quartz diorite.
0, Gran viikc Medical CcMcr €D LxpuoFSituF
()XkW(f, Alxth Carooina
P<[e 3
3 SUBSURFACE.EXPlIO.MIION
3.1 Field Testing
-Me subsurface conditions at the site were evaluated with a total of nine soil test borings, The borings
were advanced to depths ranging from approximately 16 Feet to 24 fee! below the existing grade. All test
locat"rons were rnarkcd in the field by Stewart Frigineer[ng using the provided site asap and measuring
from Lhe onslLe features. A Boring Locatlon Diagrain (Figure 1), which indicates the approximate lost
locations, fs presented in the Appendix of this report.
Prior to drilling, Stewart mritarWd the North Carollna One-Call Center for the loeatlon and rnarkIng of
burled publlc utfl€ties. A5 art added protection, a pivate utility locating firm was s[ib-conh-acttW to d}eck
for private utilities in the general vidnity of each boring. This was accomplished LISilIg geophysical
methods, with only utilities in the Immediate arcs (possible conflicts) ,,lanced.
Soil test borings wets advanced at this site utilizing a tra'sler-mounted CME 45 drilling rig. Drilling was
performed with 2TA-inch (.D.), hollow-stemmed, continuous flight augers. All boring and sampling
operations were canductcd in gencral compliance with ATM Da586. At predetermined Intervals, so€l
samples were obtained with a split-barrel sampler (standard 2-indh O.D.). -Hie sampler was restcd on the
bottom of the borehole and driven to a penetration of 18 irr-hes (or frauion Lhereoo wlLh blows of a
manual 140-pound drop hanimer falling 36 Inches. or the IS inches, tlhc ih4trrhbcr of hammer blows
required to achicvc 6 inches of pene-tratiQri is mcorded for three consecutive segments. The sum or the
blow counts for the second and third 6-inch segment is termed the standard Pcrietration Tcst (SF
resistance, or hi-value.
The soil samples obtained daring the drilling operation were placed in labeled contalners and transported
to our lab where they were visually-manually classified and logged by a Profcsslorial Frigineee, The Boring
Logs are included in the Appendix of this repart. Uniess oLherw€se requested, all samples will be disposed
of after 2 months.
3.2 Exploration Results
3.2.1 Surface
Borings B-4 and B-5 were pcrrormcd in an cxistirig sitfowalk and therefore encountered concrete (4
€nches) at the ground surface. The remainder of the borings encountered about 5 inches of topsail
and root mat at the grxound surraoo. Although not encountered En the borings, the general area also
€ncludes rnt,lch and landscap€ng vegetaLion in pianLer beds as well as asphalt pavement and tile
associated stone base in the d0vcway.
3.2.2 SoII
The following is a subsurface description of a generalized nature, provided to highlight tic major soil
strata cricountemd. The stratification of the subgrade rnateria€!5 i ustrated on Lhe taring logs
represents the condlLlons In the actual test locations; therefore, variations should be expected
between borings. Stratigraphy boundaries only represent the approximate depth/elevation of a noticed
materfal change, and the transition between material types is typically gradual. Furthermore, it is
often difficult to d€scf?rn between clear, f€II soil and native maLerlal. The ground surface elevations
presented on the Boring Logs and/or referenced in this report were interpolated from provided
topographic information and should be considered approximate. Solis encountered included:
Fill - rill soils were encountered In all nine barings to approximately 3 to 11112 feet below the
existing grade. The fill generally consists of Olayriy SILT (MM) and Clayey Sandy SILT (ML) wlLh
lesser amounts of Silty Fat CLAY (CH). The rill also contains varyirhg anio4111ts or gravel and oManic
material. The Wvalucs within the fill are sporadic, ranging from 4 to 22 blows per foot with an
average of 11 blows per foot. Given the varlation in subsurface conditions (soil type and
consistency), the fill appcai-s to be uncontrolled,
Reslduumi - ftesldual (native) soils are the product of in-place physfcal and/Or chcmical
weathering of the parent bedrock. The residual sails, which linderlle the fii€ soils, cons€sL of stiff
GrarrviUe MLrlirWl CceitLr LO Cxp?rnsfool
Oxford, North C?relrrra
Pagq 4
to very stiff Clayey SILT (MH), stiff to hard Sandy SILT (ML) aril lasser arrrounts of very stiff
$ilty Lean CLAY (CL) and SilLy SAND (SM).
Partially Weathered Rocks - Often times a transitional goo-waterial, refen-ed to as Paltia€ly
Weathered Dock (PWR), is cncoufitered betweerl the overlying still and bedrock or as suspended
layers/lenses within a sail mass. Partially Weathered rock is subdiv€ded into two classes by the
N,C, State Building Code as follows:
¦ Soft Weathered Rock ($VVR) - Defined as "broken or partlally weathered rock with
standard penetration resistance (ASTM D1586) butwecri 50 blows per six inches and
50 blows per inch". SWR was encountered In boring B-7 at an approximate elevation
of 451 feet.
bard Weathered Rack - Dermcd as "bmken or partially wea€trered rock normally
Craving Standard Penetrat€on resistances (ASTM D1586) €n excess of 50 blows M-
inch". NWR was cncountered €ri bnrIng B-3 just above the bedrock, at an approximate
e€evatlen of 443$12. feet.
Hard Rock - Hard rock is commonly dermed by residual or native material of sufficient hardness to
rcfmc mechanical auger penetration. Hard rock was encountered In six of the nine borings. It
wears that the bedrock ranges from about elevation 443-4511/z feet,
3.23 Groundwater
Groundwater measurements were attcrnpted at the time of completion of drilling at each of the
borings performed at tLre site. F€ve of the nine hoies were left open for 24 hours to obtain stabilized
groundwater readings. Following 24-hour me-a5urcments, the boreholes were backfll€ed wlth auger
Couinos (soil).
Groundwater was encounLered In each of the five borehoies that remained open overflight, as 5hawrk
in the table below. Aiso shown irl this table are the estimated groundwater depths for remaining four
hosings that were har-tilled prior to departure from the site. T3iese depths are based an the depth of
tilt first wet soil sample in con-datiorl to the swToundirrg gr Lundwater- table depths,
[,rarrwUe Me (cal Cents- Hj Faej3an5run
adwd, North cafnlorra
ki dw sarrraair&ny botkr?m ffF=DackAfked
paw
The grauodwater pond€tlons represent the conditions at the time of the exploration. Fluctuations in
groundwater Ievcls are common and should be expected. Common factors that lntluence groundwater
levels Include, but are not 1€mited to, soil stratification, dirnatc/weather, nearby bodies of water (lakes,
ponds, etc,), underground spe nq5, streams, rivers and surface water dlscharcge. At the onset, as well as
continually throughout tie construct€on proccss, the contractor Should monitor groundwater levels If
determined to be detrimental to the project. Management of groundwater can significantly impact
constr4icti011 pracedures/prackes, schedules and peojact budgets.
CS Ounvitle Mcdkal Center ED Expanston
Oxford, hurlh CaroAm
Page 6
4 lENGINEER;NG ASSIESSMENT AND RECOMMENDATIONS
4.1 General Discussion
[used on tiie subsurface conditions encountered during the f€eld exploration program, the construction
considerations discussed in Section 5 of this report and the estimated loads of the proposed structure,
it appears that the t,se of conventional spread foot€ngs over the old fill will result in excessive
settlement. This is due to the highly variable r-onsistency/compacIJIGn and low strength of the old fill.
As such, the expansion w€Il require the complete removal of the old fill or the m;e of a deep foundatlon
(Helical pier) systern. Given the quantity of the old fill Lhal would require removal, we anticipate that a
helical pier sysLern will be more economical, less disruptive to hospital daily operatlons and will require
loss time,
4.2 Foundation Recommendations
4.7,1 Groutad Helical biers
eased orl the old fill across the eaUre site, we recomround using grouted helical piers €nsLalled into the
underlying residuum to support the strkictural loads imposed by the bu€Iding. Tills will enable the loads
to be transfer to a deeper, more competent so€l stratum. Mcl"I: piers are foundation elements
cons€stirig of a steel shaft with one or more c€rcular steel bearing plates (helixes), followed by steel
shaft extenslons, Lhat are advanced as a unit into tiie subgradc by mcchanica€ twisLing. Between each
extension, a lead displacement plate is also installed to yearn the hole around the shaft and W pall
grout down into Lite hole. The installation equfpmerit typically c4nsi5tS of a backhoe, skid-steer or
mini excavator.
We recommend using helical pliers with a rrsin'smum shaft diameter of 13A-inclies with an allowable
compresslon capadLy of 45 k€ps using a F.O.S. of 2,0. The piers should be advanced through the fill
and into the residuum until the necessary torque Is ach€eved to }provide the 45 kip capacity- If
adequate torque is not achieved in the residual sails, thcri the piers will need to be extended to tiie
underlying weathered rock/rock, which is about 20-30 feet below the FFE of 471.60 ft. Typically when
he4cal piers are extended Lo rock, the piers are not able to achieve the pmdetennIhled torque and tiie
{liars spin on tap of tiie rock. Therefore, since this condition could be ericountered, we advise that the
rontractvr €r,c€ude aL least one static load test in the bid for capacity ver[R:at€on purposes. If the piers
do not reach the rack, the load test will not be needed and thus the owner should receive a credit, For
bidd€ng purposes, we suggest that pricing be based on 25-foot p€ers with an acid-deduct price for
vadat€ans in installation depths (typically per a Lenslon).
Total settlement of a foundation system supported by helical piers bearing on the weathered rock or
rock Is expected Lo be less than f inch. Please note that helical piers provIde negligible lateral load
res€stancc; therefore, lateral' foundation loads should be res€sted using battered piers or passive soil
pressure around the pile caps,
4.2,2 Spread Footing
After revlewiflg the prov€ded project information prt-witted earl€er in this report and the subsufface
canditluns encountered, It has been deLermined that the use of conventional spread footings will result In
excessive total and differential setdcmcr1ts. A5 such, the use of a spread foundation system will require
the camplete removal of the a €sLing 011, Since this fill extends below the adjacent (existing) foundaLions,
removal of the fill will be very difficult and require extens€ve shoring and urEdeopinnirig of the existing
construction. These factors will likely make this option less economically attractive when compared to the
Helical pier system discussed above; however, we are prov€ding it as a potential option for pricing and Lost
comparison it so desired.
Provided that the ofd Ml is completely removed from witb€n the expans€an footprint and replaced with
compacted Structural fill a% disr-ussed IaLer In this report, we recornmended that arl allowable net so€I
bearing pressure of 2,500 pounds per sqU€ l-c foot (psf) tw used Far the daslcgn of building foundations, Tai€s
bearing capacity should be kjsQd to determl tie the foundation sizes for the f€nal loading condWon (L e. aFter
Gran wtl JTedlcaf Cerp[er Flt Exp,m<an
Oxford, Nwdit Carolfna
PsU9 7
the future two-story vertical expansion). The allowable bearing pressure should include dead load plus
sustained live load. Basument foundations that are to be covered with backfill should also be designed to
aaoount for the sail loading. For tearing and frost depth considerations, we recommend that all
foundations boar at least 18 inches below the surroandin[g finished grade.
Based on the recomme-nded bearing capacity and a maximum column load of 150 kips, post-
construction settlement for the proposcd single-story expansion is expected to be on the order of 1/2-
inch. 0ifferentfal seUlernents within the proposed single-story expansion are expected to range up to
Vlro-inch over a typical 40-foot span. However, upon addition of the two future floors, additional
settiernenls will be reallted by the structure. We estimate that the reported rnaximurn column Load of
350 kips (total after vertical expansion) will result in an addltlanal 112-Inch of total settlement and
abouE another 1/4-inch of additfona€ differential scUlcment.
Please none that since the existing building has been in place for about 12 yeers, we expect. that its
foundation solls have likely undergone primary consoildatiori/settlement and thus any sctdomont of
the new building will be differential to the alder construction. As such, building connection details
should aocurnmodate for the anticipated movement. In addition, several of the proposed footings M11
be located near (behind) the existing basement wall and thus this new loading should be properly
analyzed during the design phase.
Sail forces may be used to resist butte uplift and 311ding of the fooi_frrgs. Soft adjacent to the footing wil€
provide passive resistance to lateral movement, while the sail at the footing base will afro provide
resistance to lateral movement via friction. We recommend a passive earth pressure coefficient (Kp) of
2,77 and an ultimate frict[Gn coeffident (d) of 0.30 for foundation design. We ra_cor mend thaE a safety
factor of at least !.5 be used to deLermine the soil's allowable passive resfstancc and the soil's allowable
friction. We also recommend using a moist unit weight of 126 pr-f to cornptiL.e the sell mass weight. The
volume of the soil mass for upllft may be calculated by assuming that it extends 36 dcgr ces (from vertical)
from the top perimeter- edge of the footing to the grot,rld surface.
4.3 Slab-On-Grade Recommendations
Based oil the conditions encountered at this site, we expect that t}re existing fl11 will provide adequate
support for the proposed slab-art-grade. In the slab design, we recommend placing a stone layer
below t1ie slab to provide 4iniform support and to provide a capillary break horn the subgrade soils.
We recommend using Aggregate Base Course (ABC) stone or are open-graded crushed stone (e.g_ No.
57 stone); € owever, it is our experience that open-graded cro5hed stone can collect water during
pefiods of rain and cause sakuraLion and soften ng of tiie sub€grade sails prior to p€acomcnt of the floor
stab. Therefore, construction sequcncfng/tinning, and the 5easan in which the stone is placed, should
be takers into consideration. prlor to stone placement, the slab S4rpport soils should be evaluated to
check stability and sail conditions.
Tile design of the concrete slab-are-glade should he based on estergaard's modulus of subgrade
reaction (k). We estimate Lhe soli k-value to be about: 100 pci for t1ie near surface sokls encountered
at thfs site; however, the placement of the above-mentioned stone base waif Increase the modulus
depending on luS LhIckness. We recommend placing 4 to 6 inches of stone beneath the slab-an-grade
and using the fallowing con-espanding k-values during design, often referred Le as Ices. If the floor slab
design is sensitive to , we recommend perrarrning plate load testing in accordance with AST M DI196
to allow ref Enernent of the pfovide-d k-values.
We also recommend tiie Instailation of a vapor retarded/baFiler below the addition slabs as a measure
of protectian agair«st water vapor intrusion. Even in the absence of groundwater, water vapors in the
soil can rise and collect just below the slab. Th€s buildup of rTmolstum typically leads to moisture
transmission through the sla# and could damage floorfnq and/or cause elevated moisture levc€s withifr
Csrwiviku Medical CoMer ED Expansfon
Oxford, North Carufiria
C?' .
Page #
the structure. To reduce such, we recommend considering the use of a vapor retarder mcetIng AST
E-1745. The vapor harrier should be installer! per the ACI guldelIties (ACE 302.28) and ASTIM E-1643,
It is important Lo paint rut that cracking of concrete Is normal and should be expected. Proper jointing of
slabs is par-a€nount in the control of cracking. The American Concrete lnstikA,te (AC!) recQrnmend5 a
maximinn panel size (in Feet) equal Lo approximately three Urnes t€ie thickness of the slab (in inches) in
both direrNons. Controlling the water-cement ratio of the wocrete, particularly after batchIng, and
Including Fiber reinforcement fm the mix can also help redtrac shrinkage cracking.
4.4 Seismic Design Considerations
Per the 2089 N.C. Statc Building Cock, a locally amendk-,d adoption of the. 2005 International Building
Cade (IBC), the design or a structure must consider dynarnic forces resulting frorn seismic events,
regardicss of their likelihood of occurrence. As park of a ge!nera€Jxed procedure to esHmaLe selsmic
forces, Lhe code assigns a Seismic Site Classification (letter designation of Class A through 1=) based
on the subgrade soil/rock conditions within Lhe upper 100 feet of the ground surrace at the subject
site.
Based on the SPT N-values rccar-ded frorrr the sail test barings, the subject site is consistent with a
Seismic Site Class "L?". The corresponding Mapped Acceleration Values (Ss & 51), Site Coefridemts (Fa
& Fv), Adjusted Spectral Accelerations (SMs &. SMI) and €]csign Spcctral Acceleration-, (SDs ?k SDI)
are included in the Appendix of this report. These values are rased on the NEIIRP (2803) values and
obtained via tiie on-line U.S. Geologic Survey (USG5) Ground Motion Parameter Calculator ducated at
h I-tp: //L-a rLh rru ake. users. g ov{resea rch/hazina ns/des IQ rt.
The following paragraphs briefly discuss our qualitative assessments of file other scisrmic-relatcd issues.
Detailed quantitative analyses for these items were not included In our Scope of Work and are not
considered necessary at this time given the development plans and the subsurface conditions
encocintere-d.
Uquefactioe Hazard - RNk level is low - The soils encountered were or st. Mc€ent flues
content and density to reader therm 110t hWdily liquefiable.
Sior}e Stability - RISK level is law - Based on the presumed grading, significant cut and fill
slopes are not planned for corfstruction.
Surrace Rupture - risk is low - No known active faults undedle the site.
4.5 Retaining Walls
4.51 Bastment Walls
The onsite lean SILTS (ML) and Silty SANDS (SM) are typically suitable for use as basernent wall backflll.
We do not recommend the use of soils that have high clay contents, wadi as the l1-, CL-, or CH-soil. Soil
should he compacted to the degree spedfied later in this report, yet extreme care should be given to
compaction efforts behind retaining walls as to not to exert excessive lateral stress an the wall. Fill placed;
within 5 feet Qf the wall shotild be placed in 6-Inch loose lifts and compacted wlth €ighLwe€ght tarpapers
such crs a sled tamp, jur aping-jack or a small walk-behind roller-.
Basement walls should have sufficient drainage to a',leviate hydrostatic pressure. This may consist of No.
57 stone encased In filter fabric (nonwoven) or a composite drain board, either of which should be
connected to the flec ssary pijAng to transport any collected water away frorn the rear of the reta€mirig
wall. This may require Lhe discharging into the existing storm sewer system. Also, where waterproofing of
bascment walls is specified, adequate protection of the waterpmo€ing material should be provided Le
prevent darrrage during backfill€rrg operations.
Since basement walls are rigid and stationary (restrained frorn de€lecUon and/or translation), we
recommerrd the cs& of the at-rm;t earth pressure coefficient (ko). In Lhe absence of Lhe laboratory test
data necessary to determine the typical retaining wall design parameter's, which was not Included in our
saoW, we are. }providing the fallowing estimates for the sol€s encountered aL the slte.
GJarovfYe Medical Center tO Ex?mmfwr
Oxford, Mardi Carotin a
Pala 4
4.E.2 gjpcJSitq..4yalis
The National Concrete Masonry Association (NCMA) recummcfBds that rncdianically-stabillzed earthen
(MSE) wall bac€cfil€ wlthin the reinforced (gcogdd) zone have a maxinitan on 35 perr_tpt Fines (material
passIng the #200 Mcvc). This criterion lirn€ts wall bac€ciil€ to sand or other granular ineteria€. ThereFore,
readily available soils ah_ this site are- not likely to be suitable for EASE wall construction using the NCMA
recommendations. I-Iowevci, -f it has been our past experhertce that low elastidity SILTS (Nit-) similar to hose
encountered onslke are offers used during wall COnstrUction, but such a decision roust be made by wall
designer and the appropriate soil strength pararnekets should be incorporated into die wall design.
For cantilevered or #i-ce-standhig walls that are allowed to move without top restraint, we recommend the
LISC of the active earths pressure coef ident (ka) and the other pertinent parameters in the above table.
However, €f the wall is movement-critical and mhnimal wall deFheckkon is rccluired, the at-rest (ko) earLh
la cssure coeMcient should be used in the design.
In the design of MSE retaining wall's, we suggest flic incorporation or a chimney [Irwin at the rear end of
the geogrid (at the face of the retained soil), as well as a blanket drain at the bottom of the wall, Lo reduce
hydrostatic pressures on the wall. This may consist of No. 57 stone encased In Filter Fabric (nonwoven) or
a composite drain board, either of whhch should be daylhglhted, h=urthcrmore, the designer should verhfy
acceptable global staUllty and settlement in addition to the standard [ntemal stabillty arialysis,
4.6 Shoring Considerations
The proposed nieclianical roGm will be excavated near, and possibly adjacent to, lhte existing Imaging
Unit Bnd Surgery Unit foundations. This excavation Is expecte4 to extend about 9 feet below the
adjacent foundation. If so, ternporary shoring andlar undcrpiniliiig wiil be necessary. Assuming that
the owner selects the helical pier foundation system, hellcat {Viers can also be used to provide shoring
and undcrpinnfng support if needed. If not, other such systems lice sheet piling, pile-and-lagging, jet-
grouting, and/Gr rr inl-piles can be tpscd for these functions. Ternpurafy underpinning and shoring
designs are typically design-build FuncLions performed for the contractor based on the anticipotE?d
construction approach (Le. means anc€ r udiods).
6" Granvifkc Nudicaf Center ED Expansfon
Oxford, ,VOMP cawO "i
*tfd` IYVL COfkbUark No cvhcir r roLwFumanded byWMA orAAgHfO A15k w3ff!??+kle?frhCS -PLi irrcd
2Urpc curly [i.e. root tv be used for harkfrlf in the re*?fo red zme).
V-7fues assurrreleVeiJ?'Cm? arkd no aCCM)f forS'CiWfhiu (curtfiquake) forces-
Pago 14
5 CONSTRUCTION rQNSIDEELATIONS
5.1 Site Preparation
Initially, all topsoil, vt!getdUOF1, pavement, demoiltion dehO5 ar,d any other unsatisfactory/deleterious
rnaEertals should be removed rrom the proposed areas Scheduled for site development for a lateral
distance of at least 5 feet beyond the €i€nits or new construction. If poorly compacted utility trench
backfili is encjuntcmd, It slloU€d he removed and r-elAaced to sufficient depth as deterzfiincd at the time of
testing.
After stripping in the areas to recelve fill, we recommend that the near-surface sails be assessed by means
of proofrolling. This should be peormed prior to fill plan-e meat or other construction and in the pE cscrice
or llte owner's testing agency, We rewrnmerid proofralling with a loaded, tandem-ax€c CLUMP truck with
repeated passes over the suhject area. The area should also be assessed with a prole rod to Identify
isolated soft areas that need repair prior to fr€€arlg operations. DenclenL areas should be repaired as
recornmended by the owner's testing agency.
The on5ite silts will be moisture sensitive and will likely becorne unstable due to the presence of exct-ss
moisture (water) ar[d construction traffic loading. Therefore proper site drainage should Ijc maintained
during casthwork operations. If not, the accumulation or water will result in construction delays. Common
approaches to reduce- wct weather delays Include grading the aim so that surface water flaws away from
the site, scaling the surface with a smooth-drum roller at the end of each day or prior to predpltation
events, 11me/oement treating critical areas to resist water penetration and/or forming temporary ditches,
swales, berms or other surface water diversion foahir es.
5.2 Groundwater
Given that gmundwater was encountered at a depth of about 5 feet belim the assumed mechanical roars
FFE, we do slot anticipate that gmurldwater will s€gnlfirantly Impact the proposed construction. however,
pockets of perched water may be er,ccx,ntered during site excava fans that will require pumpfnq from a
sump int. A perdied water condition is Enost likely to be encountered in the rill mass.
5.3 Structural Fill Solectlon, Placement and Compaction
Any material tAllised as sb-uctural fill should not contain racks greater than 3 Inches ill diameter or
greater than 25% retained on the -inch sieve. Structural fill material should not contain more than
4% (by ?welght) of organic matter or other deleterious material. Structural fill shaWd possess a
Maximum Dry Density (MDD) of 95 pounds per curie root (pnf) i)r greater as deternilned by Uie
Standard proctor Cumpaction Test (ASTM DG93), It is preferable for the Plasticity Irldc (PI) of
struchiral fill sail to not exceed 25 and the Liquid E_imit (L1_) not exceed 50, as determined by
Atte:'tkerg hlinlt testing (ASTM 04313). This correspurids to Unified Soil Ciasslfication System (USCS)
soil designations of SMo ML, and some L and SC in this reglon.
In order to ratilim the onsite elastir- silts (MN), which do not meet Erie above criteria, such material can
be 4i5ed at dept} of 4f feet below the finished grade inside the proposed building foutproint plus an
addRional 10 feet beyond the building perimeter. In proposed pavernent areas, these materials can be
used to 18 inches below finished 5ubgrade elevation.
Fill material E> quired to estabilsh subgrade elevations should be placed in O-inch thick (or less) loose lifts.
Fi1i soils should be compacted to the values shown in the following table, as determined by the Standard
Pro?:kor Compaction Test (ASTM D598). The moistUre content of the controlled fill should be maintained
within 13% or the material's optirnurn Enaistum content as determined by the Standard Proctor
Compaction Test; however, slight. &Mataon ft m this can sG}metlme5 be tolerated depending on the
grading plan, Such deviation should be considered by the eng[neer representing tile
owner's contractor's inaterlal testing first. Some moisture conditioning of fill soils may be necessary
prior to placernent, or whir-h drying during t€le "wet season" always proves to be Ehe most r-hallcnging.
GrafoOle Medical Center M. expansion
oxford, ldorth Carolina
Page ii
Building Pat, 1 06
II Sidewalks, UU11ty Pads, 45
Nori-Structural Areas 1 90
dote: Comp, 0f0e; effM cal uMiy fockM should be &n.-ca vn
rfar'emerrr loratkurr.
It is recommended that the placement arid compaction or structural fill be monitored by arr indcpandent
tesUng agency working for the owner, We recornmend that compactor testing be pmf'ormed at the
followfng rates:
Build Ing Pad - f test per lift pef 2,000 square feet fif fill placed (Minimum)
Parking Lot - 1 test per lift per 5,000 square feet of fill {placed (minimurn)
Trench backlit[ . i test per lift pcr 100 feet of trench backfill (minknum)
5.4 Foundation Evaluations
5.4.3 Grouted Helical Pica
helical pier instalfaUnfr should be Performed by an experienced contractor with properly sulted equipment
and tooling. The contractor slia€l provide the most suitable pier, taking into account the suLGurface
conditfuns discussed in this report, acid establ€sh the rcgUimd torque valise to achieve the design capacity.
This information should be sub [Red to the GeotechnIcal Engineer for review at least 2 weeks berore
mobilizing to the site.
The contractor's Jnsl_allation equ pment should be irl good working ordt!r and have a pressure pr torque
gauge to monitor resistance as the pier is advafl ed into the !?ubgradc. If a pressure gauge is used, it shall
be calibrated to the applied torque with proper documentation of Lhe calibration proved to the inspector for
review; however, to confirm the field rquc correlations, we mcommend using a s#,car pin torque lirttller
far the first 10 piers (mirlirrrtrrrr). The torque shotrfd lac monitored and recorded for each pier on a Arll-tfine
basis by the owner's testing agency. At minimrrrrr, Lh1s munitodrig should docurnerlt pier- Placerrrent, pier
type, installation equfpmcnt/method, torque applied at terenInal_lan, tz:rm[nation/tip elevation, cut-off
efevatlon, growing operations and any obstruction or subsurracc anomalles encountered. Connection
details relating to the pile cap conriection should also he checked during pile cap steel inspecl-Ion, The
grout used in the piers should be sampled and tasted to verify compressive strength.
5.4.2 Spread Footings
Following the remeval of the old rill and establishing the finished srrbgrade, should dais approach be
Impler k!ntcd, footing excavations should be perfarmcd using bucket with a fiat cuttitx} edge (rio
teeth) to reduce dfstrrrbarace of the exposed bearing soil. Once: excavated, the footings should be
cleaned of loose material and protected from disturbance. This includes protectfara surrace water run-
off and freezing. If water is allowed to accumulate within a footing excavation and saf e the bearing
sells, or if the bearing sells are allowed to freeze, the d-oficient sobs should be removed rrorn the
excavation and rechecked by the testing firm prior to concrete p€a+-ernent. When concrete cannot be
placed immediately, we recommend placing a rrrud-Treat to protect the bearing soil, but only follOWIFIQ
the footing evaluatfon.
Foundation bearing materials, and sometimes slab suppart sails, should be checked during construr-Oan to
verify satisractory bcaning conditlorls, materials and strength, We recommend using a 1l2-inch diarneter, T-
handled probe rod for an ovcralf qualitative assessrrtent throughout the roundatiorl excavations, followed
by strateglcafly-placed hand anger borings and Dynam c Cone Penetrometer (DCP) testing for quantitative
evaluation. Such testing should be completed prior to stone, steel or concrete placement. Unsolvable soil
detected during this evaluation should be repafrcd as directed by the owner's testing agency,
GrJfWF a Med+cal C.entcr ED Fxpanman
OxFord, NarM r?ro&na
k?:
Page 12
Based on the fill canditfo€rs encountered, (indercuttfnq arrd replacement should bk! expected In the areas pf
boOngs B°5, $-9 and adjacent to the E?xfstialg basement walls. Replacement is r ecornrnend to consist of
compacted 6119011 or compacted aggregate base course (AFC) stone, The use of No, 57 stone should only
be considered for shallow interior applfcatkmis due to file stone's ability to oollect wateo- and softer} the
subgrade. Use of No. 57 stone as a backffll material should not be permftted wlthout the approval of the
owflfWs testing agency.
` GranYUfe Midical Center ED fxyarrs/on
,7 Oxford, Noah Carojiy?a
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