20110199 Ver 1_401 Application_20110311

9 0 1 1 0 1 9 9
ft I
P.O. Box 244 Bunnlevel, NC 28323 [phone]
MEMORANDUM
To: Ian McMillian
From: Adam Carter
Date: 11/17/2008
Re: 401 Permit Review
Ian McMillian:
?D
hY1A 7011
DENR - rVATER. QUAL
?- -
Enclosed are copies of Erwin Pump Station and Forcemain from Swift Textiles WWTP to North Harnett
Regional WWTP and The Happy Acre Water Extension in Anderson Creek. Steve Ward from Harnett County Dept Public
Utilities has sent a check $240.00 for the Erwin Project a week ahead of the project. The Happy Acres check is attached to
this memo!
Thank you!
Please contact me if there is any additional information you need regarding site conditions.
Thank you.
Adam Carter
Wetland Solutions
Feburary 8, 2011
Owner Information
Name
Mailing Address:
City, State, Zip:
Telephone #:
Propertv Description
Project Name: Happy Acres
Address: See Attachment
PIN #: See Attachement
County: Harnett
1, cS-1we' 6t1 , as owner/agent of the above referenced
property, authorize the US Army Corps of Engineers and the NC Division of Water Quality to
enter the subject property for the purpose of a jurisdictional determination.
I also authorize Mr. Adam Carter of Wetland Solutions, LLC to act in my behalf as my
agent in processing applications for wetland certification and/or permits.
Harnett County Public Utilities
P.O. Box 1119
Lillington NC, 27546
[phone]
D E-AR 'll
Try
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' -J -t(
Signature
Title
Date
ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Steve Ward
Harnett County Publis Utilitities
308 W Duncan St
Lillingotn, NC 27546
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The
project Happy Acres Gravity Flow Utility line is located in South Central Harnett
County in Anderson Creek Township immediately to the west of the intersection
of Ray Road (SR 1120) and Overhills Road (SR 1121).
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES
AT DIFFERENT SITES)
State:NC County/parish/borough: Harnett City: Anderson Township
Center coordinates of site (lat/long in degree decimal format): Lat. 35.2574°
N, Long. 78.9783° W.
Universal Transverse Mercator:
Name of nearest waterbody: Pistol BR Creek to Jumping Run Creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters: linear feet: width (ft) and/or
acres.
Cowardin Class:
Stream Flow:
Wetlands: 4.5acres
acres.
Cowardin Class: Emergent
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal:
Non-Tidal:
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
? Office (Desk) Determination. Date:
? Field Determination. Date(s):
1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre-construction notification" (PCN), or requests verification for a non-reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
2
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there "may be"waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply
- checked items should be included in case file and, where checked and
requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the
applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
? Data sheets prepared by the Corps:
? Corps navigable waters' study:
? U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000
Anderson Creek and Manchester quads.
® USDA Natural Resources Conservation Service Soil Survey.
Citation:USDA Soil Survey, Harnett County, sheets 10 and 14.
® National wetlands inventory map(s). Cite name:U.S. Fish & Wildlife
Service, National Wetlands Inventory, 19990518,
onemap_prod.SDEADMIN.nwi_poly: U.S. Fish & Wildlife Service, National
Wetlands Inventory, St.Petersburg, Florida..
? State/Local wetland inventory map(s):
? FEMA/FIRM maps:
? 100-year Floodplain Elevation is: (National Geodectic Vertical Datum
of 1929)
? Photographs: ® Aerial (Name & Date):Arc World Imagery: World
Imagery; Source: ESRI, i-cubed, USDA FSA, USGS, AEX, GeoEye,
Getmapping, Aerogrid, IGP; Accessed December 4, 2010.
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
? Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not
necessarily been verified by the Corps and should not be relied upon for
later iurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)
WETLAND DETERMINATION DATA FORM - Atlantic and Gulf Coastal Plain Region
f- Sampling Date:
Project/Site: Cdy/County: ?j?
a State: Sampling Pant
Applicant/Owner
Investigator(s): Section, Township, Range: a
G' a Slope (%):
Dn,? P Local relief (concave, convex, none): C]
Landform (hillslope, terrace, etc.): ?r Datum:
Lat ro2 5 7y Long" 7? 725 - rLi?•?
Subregion (LRR or MLRA): L1f ?r
OeL A NWI classification: rrls
Soil Map Unit Name:
Are c imatic ( hydrologic conditions on the site typical for this time of year? Yes No (if no, explain in Remarks.)
Are Vegetation Soil or Hydrology significantly disturbed? Are 'Normal Circumstances present? Yes No
Are Vegetation . Sal or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
transects, important features, etc.
SUMMARY OF FINDINGS - Attach, site map showing sampling point locations,
Hydrophytic Vegetation Present? Yes No Is the Sampled Area
Hydric Sal Present? Yes No within a Wetland? Yes No
Wetland Hydrology Present? Yes No
HYDROLOGY
Secorndarv indicators (minimum of two required)
Wetland Hydrolog)? Indicators' Surface Sod Cracks (66)
Primary indicators (minimum of one is required: chec k all that aooly)
Water-Stained Leaves (139) -
,_, Spam* Vegetated Concave Surface (68)
_ Surface Water (Al) -
High Water Table (A2) _ Aquatic Fauna (B13) _ Drainage Patterns (B10)
-
Saturation (A3) _ Marl Deposits (B15) (LRR U) _ Moss Trim Lines (B16)
_
Water Marks (B7) _ Hydrogen Sulfide Odor (C1) _ Dry-Season Water Table (C2)
_
Sediment Deposits (B2) _ Oxidized Rhizospheres on Living Roots (C3) _ Crayfish Burrows (C8)
_
Drift Deposits (B3) _ Presence of Reduced Iron (C4) - Saturation Visible on Aerial Imagery (C9)
Algal Mat or Crust (64) - Recent Iron Reduction in Tilled Soils (C6) - Geomorphic Position (D2)
r
Iron Deposits (B5) _ Thin Muck Surface (C7) S ow Aquitard (133)
Inundation Visible on Aerial Imagery (B7) _ Other (Explain in Remarks) AC-Neutral Test (135)
_
ield Observations:
F
Surface Water Present? Yes _V No
Water Table Present? Yes No Depth (inches):
Depth (inches): f r.
N th (inches): %h i n Wetland
De Hydrology Present? Yes No
o
Saturation Present? Yes p
induces e
Describe Recorded Data (stream gauge, monitoring
wed, aerial photos, previous inspections), if available:
Remarks:
Atlantic and Gulf Coastal Plain Region - Interim Version
US Army Corps of Engineers
VEGETATION - Use scientific names of plants.
Sampling Point: G' 1
Absolute Dominant Indicator Dominance Test worksheet
Tree Stratum (Plot size: % Cover Species? Status
1 Number of Dominanl Species L1
That Are OBL, FACW, or FAC: l1 (A)
2• - r r
all ?--
Total Number of Dominant
(B)
All St
t
3. ra
a:
Species Across
4 Percent of Dominant Species e
AiB
f©G l
5.
(
)
That Are OBL, FACW, or FAC:

6.
Prevalence Index worksheet:
7.
Total Cover
Total % Cover of Multiply by:
Saolino Stratum (Plot size: y 6
4
t? OBL species x 1 =
2=
i
,L110 .
1-irsaAe-r%
1 es x
FACW spec

2. c, I. (? L
1
FAC species x3=
3. t?`S Pl. {? n r I A. i U.r F/ (mil FACU species x4=
4 UPL species X5=
5. Column Totals: (A) (B)
6.
Prevalence Index = B/A =
7'
drophytic Vegetation Indicators:
Shrub Stra(Plot size: 3 6 Total Cover Test is >50%
713ominiince
1. L- t' t in& t&2 v f Al 'V _ Prevalence Index is 53.0'
/Q _ Problematic Hydrophytic Vegetation' (Explain)
2
3.-
4
'Indicators of hydric soil and wetland hydrology must
. be present, unless disturbed or problematic.
5.
6. Definitions of Vegetation Strata:
7•
=Total Cover Tree - Woody plants, excluding woody vines,
approximately 20 it (6 m) or more in height and 3 in.
SOA Herb Stratum (Plot size=d (7.6 cm) or larger in diameter at breast height (DBH).
1. Sapling - Woody plants, excluding woody vines,
2. approximately 20 ft (6 m) or more in height and less
3 than 3 in. (I.6 cm) DBH.

4- excluding woody vines
Shrub - Woody plants

5 ,
,
approximately 3 to 20 it (1 to 6 m) in height

6. including
) plants
Herb-All herbaceous (non-wood
7, ,
y
herbaceous vines, regardless of size. includes woody
8. plants, except woody vines, less than approximately
3 ft (1 m) in height
9
-
10.
Woody vine -All woody vines, regardless of height.

11.

12

iz
Pl
t
V
St
d
: 3
WW =Total Cover
ra (
o
s
e
a
ooo
?
1. V, 7
2.
3.
4
Hydrophytic /
5• Ve
etation

l g
J
d = Total Cover Present? Yes No
Remarks: (If observed, list morphological adaptations below).
1Acic 1 ?? 5?r? ? - ??e t? vv- x ? c. ?
l
A
e
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
SOIL
Sampling Point , Wd-
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix
(inches) Color (moist) % Redox Features
Color (moist) % Tye Loe Texture Remarks

0 S L S

r*2/
,•
-56 1 In
l
d Gtn9/
'Type: C=Concentration etion RM=Reduced Matrix, CS--Covered or Coated Sand Grains. 2Location: PL=Pore Lining, M--Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
_ Histosol (Al) _ Polyvalue Below Surface (S8) (LRR S, T, U) _ 1 cm Muck (A9) (LRR O)
Histic Epipedon (A2) _ Thin Dark Surface (S9) (LRR S, T, U) _ 2 cm Muck (A10) (LRR S)
_
Black Histic (A3) _ Loamy Mucky Mineral (F7) (LRR O) - Reduced Vertic (F18) (outside MLRA 150A,B)
_
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2) - Piedmont Roodpiain Soils (F19) (LRR P, S, T)
Stratified Layers (A5) _ Depleted Matrix (F3) _ Anomalous Bright Loamy Soils (F20)
Organic Bodies (A6) (LRR P, T. U) _ Redox Dark Surface (F6) (MLRA 1536)
5 cm Mucky Mineral (A7) (LRR P, T, U) _ Depleted Dark Surface (F7) _ Red Parent Material (TF2)
_
_ Muck Presence (A8) (LRR U) _ Redox Depressions (F8) _ Very Shallow Dark Surface (TF12) (LRR T, U)
_ 1 cm Muck (A9) (LRR P, T) - Mad (F10) (LRR U) _ Other (Explain in Remarks)
_ Depleted Below Dark Surface (Al 1) _ Depleted Ochric (F11) (MI.RA 151)
_ Thick Dark Surface (A12) _ Iron-Manganese Masses (F12) (LM O, P, T) 3Indicators of hydrophytic vegetation and
_ Coast Prairie Redox (A16) (MLRA 150A) _ Umtxic Surface (F13) (LRR P, T, U) wetland hydrology must be present,
_ Sandy Mucky Mineral (S1) (LRR O, S) _ Delta Octuic (F17) (MLRA 151) unless disturbed or problematic.
- Sandy Gleyed Matrix (S4) - Reduced Verfic (F18) (MLRA 150A,1508)
Sandy Redox (S5) _ Piedmont Floodpiain Soils (F19) (MLRA 149A)
Stripped Matrix (S6) - Anomalous Bright Loamy Soils (F20) PILRA 149A,153C,153D)
?Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type:
Depth (inches): Hydric Soil Present? Yes No
Remarks: ?a ?dIj 5
r i Q ?JnVG'!`?r c? ul?ja4C Ql??.
h? J
jt a "
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
VEGETATION - Use scientific names of plants.
Sampling Point 8
Absolute Dominant Indicator Dominance Test worksheet
aM
1 km (Plot size:
A-ae_otc % Cover Species? Status
15 °la Number of Dominant Species
That Are OBL, FACW, or FAC: (A)
.
2. L. 6c c _ lkA
-

3.
D 70 J? Total Number of Dominant

Species Across Ail Strata:
Strata: (B)
a
Percent of Dominant Species
5.
5. or FAC: (AB)
FACW
That Are OBL
,
,
6
.
Prevalence Index worksheet
.
7-
= Total Cover Total % Cover of Multiply by:
Saolina S tratum Plot size: y? X,9 OBL species X1=
1. td u 1 Lr? /? _Y FACW species x2=
2. tk*YJ*a h, Lay- 6?4 m A JILIL.ok SZ FAC species x3=
3. CIA _?4? FACU species x4=
4. UPL species x5=
5. Column Totals: (A) (B)

6.
Prevalence Index = B/A =
7
.

Shrub Stratum (Plot size: 7"?)
Total Cover
Hydfophytic Vegetation indicators:
_ Donrinnance Test is >50%
1. _ { _ Prevalence Index is s3.0'
2 Problematic Hydrophytic Vegetation' (Explain)
3.
'
4 Indicators of hydric soil and wetiand hydrology must
De presem unless disturbed or problematic.
.
5.
6. Definitions of Vegetation Strata:

7.
Tree - Woody plants, excluding woody vines,
= Total Cover approximately 20 ft (6 m) or more in height and 3 in.
Herb Stratum (Plot size: 3445d
? (7.6 cm) or larger in diameter at breast height (DBH).
Sapling - Woody plants, excluding woody vines,
2 approximately 20 ft (6 m) or more in height and less
3. than 3 in. (7.6 cm) DBH.
4 cl
di
d
vin
Sh
b - W
d
l
t
ng woo
y
ru
y p
an
s, ex
u
es,
oo
5. approximately 3 to 20 ft (1 to 6 m) in height

Herb-All herbaceous (non-woody) plants, including
7. herbaceous vines, regardless of size. Includes woody
8. Plants, except woody vines, less than approArnately
3 it (1 m) in height
.
9.
10. Woody vine -Ali woody vines, regardless of height
11.
12.
= T
tal C
over
o
Wood Vi ne Stratum (Plot size: ICJ )

3.
4.
5. Hydrophybc
V
t
i
-
=Total Cover ege
on
at
Present? Yes No
Remarks: (If obs
aptations below). 11
, morpholoaical
< 0.O r rLa,t#/f"t C 444 }
ri
/
pot4.
o,
a
-!cam t?J:
#L 31,51 !'tc La So'v?uN?{ TitC Lzvy p"d c--s04J W %C PrNU,S 1-4d'&AI-0
/?
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
WETLAND DETERMINATION DATA FORM - Atlantc and Gulf Coastal Plain Region
Project/Site: Ilao'o AefI City/County: 1v1 G /'/ Sampling Date: /l
Applicant/Owner. P /L 1 r State: _ Sampling Point ?j --3
Investigator(s): Section, Township,
Range:
Landform (hdlsiope, terrace, et(-): 111 Local relief (concave, convex, none): (0111 Ve- Slope (96):
Subregion (LRR or MLRA): P Lat 3 Long: ' 70 Q ??3 Datum:.NAR 83
Soil Map Unit Name: K11 R NWI classification:
ua'rid
Are climatic /hydrologic conditions on the site typical for this time of year? Yes No (if no, explain in Remarks.)
Are Vegetation . Soil or Hydrology significantly disturbed? Are 'Normal Circumstances' present? Yes No
Are Vegetation . Sod or Hydrology naturally problematic? (If needed, explain any, answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No is the Sampled Area
Hyddc Soil Present? Yes No within a Wetland? Yes No
Welland Hydrology Present? Yes No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators (minimum of two required)
Primary Indicators (mirumum of one is required: check all that aooiv) _ Surface Soil Cracks (B6)
_ Surface Water (Al) _ Water-Stained Leaves (69) _ Sparsely Vegetated Concave Surface (B8)
_ High Water Table (A2) _ Aquatic Fauna (B13) _ Drainage Patterns (B10)
_ Saturation (A3) _ Marl Deposits (B15) (LRR U) _ Moss Trim Lines (B16)
- Water Marks (B7) _ Hydrogen Sulfide Odor (C1) _ Dry-Season Water Table (C2)
_ Sediment Deposits (B2) - Oxidized Rhizospheres on Living Roots (C3) _ Crayfish Burrows (C8)
- Drift Deposits (B3) _ Presence of Reduced Iron (C4) _ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (134) - Recent Iron Reduction in Tided Soils (C6) _ Geomorphic Position (D2)
_ Iron Deposits (B5) - Thin Muck Surface (C7) _ Shallow Aquifard (D3)
Inundation Visible on Aerial Imagery (B7) Other (Explain in Remarks) _ FAC-Neutral Test (135)
Field Observations:
Surface Water Present? Yes No
1? (inches):
.
Water Table Present? Yes No Depth (inches):
J
Saturation Present? Yes No I
Depth (inches): Wetland Hydrology Present? Yes 1 No
includes capillary fringe)
Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
W o?r? c? ?tt/G t 1 rj iUt /? Gv mpl`16, /
&t tS Ec ,&yT i , t'y"..'

1/0 6bmo"OG??/&-d.
Sb I WW 1)
Q k#Clt 4610 acras,s t4k
10C4

US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
SOIL
Sampling Point !r&- ;
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
finches) Color (moist) Color (moist) Loci Texture Remarks

61
in.,
?
LS
_
10 LS
'Type: C=Concentration D= lion, RM=Reduced Matrix, CS=Covered or Coated Sand Grains. ZLocation: PL=Pore Lining, M--Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric SoIW:
_ Histosol (Al) _ Polyvakre Below Surface (S8) (LRR S, T, U) _ 1 cm Muck (A9) (LRR O)
_ Histic Epipedon (A2) _ Thin Dark Surface (S9) (LRR S, T, U) _ 2 kin Muck (A10) (LRR S)
_ Black Histic (A3) _ Loamy Mucky Mineral (F1) (LRR O) _ Reduced Vertic (F18) (outside MLRA 150A,B)
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2) - Piedmont Floodplain Soils (F19) (LRR P, S, T)
Stratified Layers (A5) _ Depleted Matrix (F3) _ Anomalous Bright Loamy Soils (F20)
7 Organic Bodies (A6) (LRR P, T, U) _ Redox Dads Surface (F6) (MLRA 1538)
_ 5 an Mucky Mineral (A7) (LRR P, T, U) _ Depleted Dark Surface (FT) _ Red Parent Material (TF2)
_ Muck Presence (A8) (LRR U) _ Redox Depressions (F8) _ Very Shallow Dark Surface (TF12) (LRR T, U)
- 1 cm Muck (A9) (LRR P, T) _ Mari (F10) (LRR U) - Other (Explain in Remarks)
_ Depleted Below Dark Surface (A11) _ Depleted Ochric (F11) (MLRA 151)
- Thick Dark Surface (A12) _ Iron-Manganese Masses (F12) (LRR O, P, T) 3Indicators of hydrophytic vegetation and
Coast Prairie Redox (A16) (MLRA 150A) _ Umbric Surface (1713) (LRR P, T, U) wetland hydrology must be present,
Z Sandy Mucky Mineral (81) (LRR O, S) _Deft Ocuic (F17) (MLRA 151) unless disturbed or problematic.
Sandy Gieyed Matrix (S4) _ Reduced Vertic (F18) (MLRA 15M 1508)
Sandy Redox (S5) _ Piedmont Roodplain Soils (F19) (WA-RA 149A)
_ Stripped Matrix (S6) - Anomalous Bright Loamy Soils (1720) (NILRA 149A,153C,1530)
_ Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type: i
Depth (inches): Ye
HydricSaPresent? No
Remarks:
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
WETLAND DETERMINATION DATA FORM - Atlantic and Gulf Coastal Plain Region
Project/Site: 7C? City/County: r'/1 Sampling Date: -g -'?-
Applicant/Owner. -, t? ? r T); State: 1_ Sampling Point:
Investigator(s): ^ ;"Al Section, Township, Range:
Landform (hillslope, terrace, etc.): ?B!`lAr?,? ? 16 Local relief ((cconcave, convex, none): 'Lair! ?uC Slope
Subregion (LRR or MLRA): ?A Lat: ? 1 Long: Datum:
/ ra.J !Soil Map Unit Name: tad DaI1oKC l NWI classification: j?p arAg'1'* L? 1a1- led'
r??"c
•' '=arrlc..wc
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no, explain in Remarks.) Are Vegetation Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No
Are Vegetation Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
1-JVIB1V1/'%F%I yr ruwilw%"J - ^LLdWI .SILO 111dy WMWI,Ig SUMP11HU 1301n1t IOGMWFIS, iransects, important ieawres, etc.
Hydrophytic Vegetation Present? Yes No Is the Sampled Area ??
Hydric Soil Present? Yes
J4 No within a Wetland? Yes ? No
Wetland Hydrology Present? Yes No
HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that apply) - Surface Soil Cracks (136)
- Surface Water (Al) - Water-Stained Leaves (139) - Sparsely Vegetated Concave Surface (B8)
- High Water Table (A2) _ Aquatic Fauna (613) _ Drainage Patterns (1310)
- Saturation (A3) - Marl Deposits (B15) (LRR U) _ Moss Trim Lines (616)
- Water Marks (131) - Hydrogen Sulfide Odor (C1) _ Dry-Season Water Table (C2)
- Sediment Deposits (132) - Oxidized Rhizospheres on Living Roots (C3) _ Crayfish Burrows (C8)
_ Drift Deposits (B3) _ Presence of Reduced Iron (C4) - Saturation Visible on Aerial Imagery (C9)
- Algal Mat or Crust (134) - Recent Iron Reduction in Tilled Soils (C6) - Geomorphic Position (D2)
Iron Deposits (135) _ Thin Muck Surface (C7) _ Shallow Aquitard (D3)
_ Inundation Visible on Aerial Imagery (137) _ Other (Explain in Remarks) AC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No Depth (inches):
Water Table Present? Yes No Depth (inches): 2 1 K)
Saturation Present? Yes No Depth (inches): r A Wetland H ydrology Present? Yes No
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
VEGETATION - Use scientific names of plants.
Sampling Point: d/i°
Absolute Dominant Indicator Dominance Test worksheet:
Tree Stratum (Plot size: 3 LA Y,
1. L(r't D Ck d J , % Cover Species? Status
)a-C Number of Dominant Species L
That Are OBL, FACW, or FAC: (A)
2. L I Q r r mil- z
Total Number of Dominant
3• Species Across All Strata: (B)

4.

5
Percent of Dominant Species
o
1?G
Y (A/B)
That Are OBL, FACW, or FAC:
6.
7 Prevalence Index worksheet:

Saplin
Str
tum (Plot siz
: l Total Cover Total % Cover of: Multiply by:
OBL species x 1 =
g
a
e
P
1.. 1- i r fQ lw? FACW species x2=
2. i 6 C r a 1
T FAC species x3=
3. c_AS P1„ n r in 4) r% i c
.p 2 Yb F ) FACU species x4=
4. UPL species X5=
5. Column Totals: (A) (B)
6.
7 Prevalence Index = B/A =

b
Shrub Stratum (Plot size:
=
Total Cover Hydrophytic Vegetation Indicators:

, 1
- Dominance Testis >50%
_ Prevalence Index is s3.0'
2. r c4 tn.3 r-u.r/x / n P n S C /Q -? _ Problematic Hydrophytic Vegetation' (Explain)
3.
4. 'Indicators of hydric soil and wetland hydrology must
5 be present, unless disturbed or problematic.

6. Definitions of Vegetation Strata:

7.

Total Cover
Tree - Woody plants, excluding woody vines,
i
l
t
20 ft
6
i
h
i
h
approx
ma
y
e
(
m) or more
n
e
g
t and 3 in.
Herb Stratum (Plot size: (7.6 cm) or larger in diameter at breast height (DBH).
1.

2.
47A 17 Sapling - Woody plants, excluding woody vines,
roximatel
a
20 It (6 m) or more in hei
ht and l
- pp
y
g
ess
3. than 3 in. (7.6 cm) DBH.
4. Sh
b
ru
- Woody plants, excluding woody vines,
5. approximately 3 to 20 ft (1 to 6 m) in height.
6. Herb - All herbaceous (non-woody) plants, including
7. herbaceous vines, regardless of size. Includes woody
g_ plants, except woody vines, less than approximately
9.
3 ft (1 m) in height.
10. Woody vine - All woody vines, regardless of height.
11.
12.
J = Total Cover
Woody TV• eStratuW (Plot size:
1. lV i 1 5 ?g ! lei r!
2.
3.
4.

5. Hydrophytic

l Vegetation
? = Total Cover Present? Yes No
Remarks: (if observed, list morphological adaptations below).
g
L
1
A
'
lK-C)
0A(
j ,
OePo kd 1 C
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
SOIL
Sampling Point: ALO_
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist)
% Color (moist) % Tvpe Loc Texture Remarks
/?
?-6 W - 0
[sue
? DTI
f i
/-?--? ?'r L Si

'Type: C=Concentration, D=De letion, RM=Reduced Matrix, CS=Covered or Coated Sand Grains. 2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
- Histosol (Al) _ Polyvalue Below Surface (S8) (LRR S, T, U) _ 1 cm Muck (A9) (LRR O)
- Histic Epipedon (A2) - Thin Dark Surface (S9) (LRR S, T, U) - 2 cm Muck (A10) (LRR S)
- Black Histic (A3) - Loamy Mucky Mineral (F1) (LRR O) - Reduced Vertic (F18) (outside MLRA 150A,B)
- Hydrogen Sulfide (A4) - Loamy Gleyed Matrix (F2) _ Piedmont Floodplain Soils (F19) (LRR P, S, T)
Stratified Layers (A5) _ Depleted Matrix (F3) - Anomalous Bright Loamy Soils (F20)
Organic Bodies (A6) (LRR P, T, U) _ Redox Dark Surface (F6) (MLRA 153B)
_ 5 cm Mucky Mineral (A7) (LRR P, T, U) _ Depleted Dark Surface (F7) _ Red Parent Material (TF2)
Muck Presence (A8) (LRR U) _ Redox Depressions (F8) _ Very Shallow Dark Surface (TF12) (LRR T, U)
_ 1 cm Muck (A9) (LRR P, T) - Mari (F10) (LRR U) _ Other (Explain in Remarks)
_ Depleted Below Dark Surface (A11) _ Depleted Ochric (F11) (MLRA 151)
Thick Dark Surface (A12) _ Iron-Manganese Masses (F12) (LRR O, P, T) 3Indicators of hydrophytic vegetation and
_ Coast Prairie Redox (A16) (MLRA 150A) _ Umbric Surface (F13) (LRR P, T, U) wetland hydrology must be present,
Sandy Mucky Mineral (S1) (LRR O, S) _ Delta Ochric (F17) (MLRA 151) unless disturbed or problematic.
_ Sandy Gleyed Matrix (S4) _ Reduced Vedic (F18) (MLRA 150A, 150B)
Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 149A)
Stripped Matrix (S6) _ Anomalous Bright Loamy Soils (F20) (MLRA 149A,153C,153D)
?Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type:
De
th (inches):
Z
p Hydric Soil Present? Yes
No
Remarks: !
,?a.? ?dii?t r S
i ??' 0. C'?Y?VG?'?,rµ? alru(1v?cJC or-C,?,

US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
WETLAND DETERMINATION DATA FORM - Atlantic and Gulf Coastal Plain Region
Project/Site: xerr. City/County: //' ,' -(/ Sampling Date:
Applicant/Owner. r A I/ //L / r r State: _ Sampling Point: 7 Jr71
Investigator(s): Section, Township, Range: Jail kib tal Ir
Landform (hillslope, terrace, etc.)::: i Local relief (concave, convex, nonee): CL 19 V e ? Slope ?(n?
Subregion (LRR or MLRA): L/t?r? P Lat: 3 , 9 ?++/-, Y Long: - 78, q /93 Datum: NA g3
Soil Map Unit Name: NWI classification: R 1 a r'1 M
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no, explain in Remarks.)
Are Vegetation , Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes _ No
Are Vegetation , Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No Is the Sampled Area
Hydric Soil Present? Yes No _Z7, within a Wetland? Yes No
Wetland Hydrology Present? Yes No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators: Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is reauired: check all that apply) - Surface Soil Cracks (136)
- Surface Water (Al) _ Water-Stained Leaves (139) - Sparsely Vegetated Concave Surface (138)
High Water Table (A2) _ Aquatic Fauna (B13) - Drainage Patterns (B10)
- Saturation (A3) - Marl Deposits (1315) (LRR U) - Moss Trim Lines (616)
Water Marks (B1) - Hydrogen Sulfide Odor (C1) _ Dry-Season Water Table (C2)
_ Sediment Deposits (132) - Oxidized Rhizospheres on Living Roots (C3) - Crayfish Burrows (C8)
- Drift Deposits (133) - Presence of Reduced Iron (C4) _ Saturation Visible on Aerial Imagery (C9)
- Algal Mat or Crust (134) - Recent Iron Reduction in Tilled Soils (C6) - Geomorphic Position (D2)
- Iron Deposits (B5) _ Thin Muck Surface (C7) _ Shallow Aquitard (D3)
_ Inundation Visible on Aerial Imagery (B7) _ Other (Explain in Remarks) _ FAC-Neutral Test (D5)
Field Observations: Surface Water Present? Yes No V/,
Depth (inches):_
Water Table Present? Yes
Saturation Present? Y No V Depth (inches):
N
l
Z
es
includes capillary fringe) o
Depth (inches): Wetland Hydro logy Present? Yes No
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
W e?=?? ??G
?rJ? IVI. ? 10 ?i?Gu? ?.?-rP
S?t°? 1 ln.lti,,?
w SD?vI?oWG ? ?Glr?. Sb T WC-Ki a be#ce /0C4 d? ac??6's LJc
o? rte ? rv? ? 17 -Z
1Aq
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
VEGETATION - Use scientific names of plants.
Sampling Point: 8-3t"o
,
Tree.Stratum (Plot size: s o Absolute Dominant Indicator
% Cover Species? Status Dominance Test worksheet:

1. C d?
5°l?
I
E& Number of Dominant Species
That Are OBL
FACW
or FAC: (A)
2. L i Gf ? -
1
to 0
1
1 ,
,

3. &joc
n^ ?y? 1
I
-L+a?14 - R Total Number of Dominant
Species Across All Strata: (B)
4.

5. Percent of Dominant Species
Th
t A
OBL
FACW
FA
6
?"?
re
a
,
, or
-
C:
(A/B)
6.
7.
Prevalence Index worksheet:
= Total Cover Total % Cover of: Multiply by:
-5A x Sapling Stratum t(Plot size: ) OBL species x 1 =
1. PIAL-4S 4-IMCOG, N; y FACW species x2=
2• , r v, to _
[tA _S FAC species x3=
3. FACU species x 4 --
4. UPL species x5=

5. Column Totals: (A) (B)

6.
7.
Prevalence Index = B/A =

h = Total Cover Hydrophytic Vegetation Indicators:
S
rub Stratum (Plot size: Dominance Test is >50%
1. % V _ Prevalence index is s3.0'
2. C E a vl Mc _ Problematic Hydrophytic Vegetation' (Explain)
3. Q k 4rv
f
4. 'Indicators of hydric soil and wetland hydrology must
5.
be present, unless disturbed or problematic.

6. Definitions of Vegetation Strata:

7.

Herb St
t
Pl
t
i
305d
= Total Cover Tree - Woody plants, excluding woody vines,
approximately 20 It (6 m) or more in height and 3 in.
ra
um (
)
o
ze:
s (7.6 cm) or larger in diameter at breast height (DBH).

2. Sapling - Woody plants, excluding woody vines,
i
l
approx
mate
y 20 ft (6 m) or more in height and less
3. than 3 in. (7.6 cm) DBH.

4.

5 Shrub - Woody plants, excluding woody vines,
. approximately 3 to 20 It (1 to 6 m) in height.
6.

7 Herb - All herbaceous (non-woody) plants, including
. herbaceous vines
re
ardless of
i
I
d
l
d
,
g
ze.
s
nc
u
es woo
y
8. plants, except woody vines, less than approximately
9.
3 It (1 m) in height.
10. Woody vine - All woody vines, regardless of height.

11.
12.
qV t = Total Cover
Wood Vine Stratum (Plot size: 3V )
1
Sm, - p '
. -
/
_
3.
4.
5. Hydrophytic

1 = T
t
l C Vegetation /
P
t?
a
o
over resen
Yes V No
Remarks: (If observe j, list morpholpgical adaptations bellow). j / .,r
C 10f
Pa / /P?o,r ?/-F """,5 bGA-)qz-v 111' 0, i Ca,44A Q old ? r-I*CQ1/ 1ve^c
`]c1p
{
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-
a L-3-0 t let
C PAN U-5 / OaO6 M op X
US Army Corps of Engineers
Atlantic and Gulf Coastal Plain Region - Interim Version
pz, /?
SOIL
Sampling Point: 15
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color moist % Color (moist) % Tvne Loc Texture Remarks
Q=2 / () 11 r `1 L5
2-? - ! 0 r / L11 45
16 LS
'Type: C=Concentration, D=De letion, RM=Reduced Matrix, CS=Covered or Coated Sand Grains. 2Location: PL=Pore Lining, M=Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
_ Histosol (Al) - Polyvalue Below Surface (S8) (LRR S, T, U) _ 1 cm Muck (A9) (LRR O)
- Histic Epipedon (A2) _ Thin Dark Surface (S9) (LRR S, T, U) - 2 cm Muck (A10) (LRR S)
- Black Histic (A3) - Loamy Mucky Mineral (F1) (LRR O) - Reduced Vertic (F18) (outside MLRA 150A,B)
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2) - Piedmont Floodplain Soils (F19) (LRR P, S, T)
Stratified Layers (A5)
Z Or
ani
B
di
A6
LRR P
T
U _ Depleted Matrix (F3) _ Anomalous Bright Loamy Soils (F20)
g
c
o
es (
) (
,
,
) _ Redox Dark Surface (F6) (MLRA 1538)
- 5 cm Mucky Mineral (A7) (LRR P, T, U) _ Depleted Dark Surface (F7) _ Red Parent Material (TF2)
- Muck Presence (A8) (LRR U) - Redox Depressions (F8) _ Very Shallow Dark Surface (TF12) (LRR T, U)
- 1 cm Muck (A9) (LRR P, T) _ Marl (F10) (LRR U) _ Other (Explain in Remarks)
- Depleted Below Dark Surface (A11) - Depleted Ochric (F11) (MLRA 151)
Thick Dark Surface (A12) _ Iron-Manganese Masses (F12) (LRR O, P, T) 3Indicators of hydrophytic vegetation and
Coast Prairie Redox (A16) (MLRA 150A)
d
M
Z S - Umbric Surface (F13) (LRR P, T, U) wetland hydrology must be present,
an
y
ucky Mineral (S1) (LRR O, S) _ Delta Ochric (F17) (MLRA 151) unless disturbed or problematic.
_ Sandy Gleyed Matrix (S4)
V Sand
R
d
S5 _ Reduced Vertic (F18) (MLRA 150A, 150B)
y
e
ox (
) _ Piedmont Floodplain Soils (F19) (MLRA 149 A)
- Stripped Matrix (S6) - Anomalous Bright Loamy Soils (F20) (MLRA 149A, 153C, 153D)
_ Dark Surface (S7) (LRR P, S, T, U)
Restrictive Layer (if observed):
Type:
Depth (inches): Hydric Soil Present? Yes ZNO
Remarks:
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region - Interim Version
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PC Form
Im IF WA
"
A. Applicant Information a Air
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NW-12 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? FN Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
? 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
® 401 Water Quality Certification - Express ? Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
® Yes ? No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. N Yes ? No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Wastewater Extension to Happy Acres __---------° °?
2b. County:
D L
Harnett
2c. Nearest municipality / town: Anderson Creek
JIM
2d. Subdivision name: N/A M R ' ?ull
2e. NCDOT only, T.I.P. or state
project no:
DENR - WATEt ?'°'?
? &anch
3. Owner Information
3a. Name(s) on Recorded Deed:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable): Harnett County Department of Public Utilities, attn: Steve Ward, Director
3d. Street address: P.O. Box 1119; 700 McKinney Pkwy.
3e. City, state, zip: Lillington, NC 27546
3f. Telephone no. [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 10
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Adam Carter
5b. Business name
(if applicable): Wetland Solutions, LLC
5c. Street address: PO Box 244
5d. City, state, zip: Bunnlevel, NC 28323
5e. Telephone no.: [phone]
5f. Fax no.:
5g. Email address: [e-mail]
Page 2 of 10
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):

1 b. Site coordinates (in decimal degrees): Latitude: 35.255555 Longitude: -
78.977777
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Pistol Branch, to Jumping Run Creek
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Upper Cape Fear, HUC #03030004
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Site is undeveloped. Land use in the area is residential, commercial and institutional
3b. List the total estimated acreage of all existing wetlands on the property:
4.5 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1000ft
3d. Explain the purpose of the proposed project:
To service community with sewer
3e. Describe the overall project in detail, including the type of equipment to be used:
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:

? Yes ®No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes ® No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ®No
6b. If yes, explain.
Page 3 of 10
PCN Form -Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ? Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
Riparian
W1 ? P ® T TEMP.Excavation Nonriverian ® Yes ® Corps 0.01350
& Backfill Bottomland ? No ® DWQ
Hardwood Forest
W2 ? P ®T TEMP.Excavation Bottomland ® Yes ® Corps 0.02433
& Backfill Hardwood Forest ? No ® DWQ
W3 ? P ®T TEMP.Excavation
& Backfill Bottomland
Hardwood Forest ® Yes
? No ® Corps
® DWQ 0.00427
W4 ? P ®T TEMP.Excavation Bottomland ® Yes ® Corps 0.03492
& Backfill Hardwood Forest ? No ® DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 0.07702
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ? P ? T ? PER ? Corps
? INT ? DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
B1 ?P?T ?Yes
? No
B2 ? P ? T ? Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The project was designed to avoid jurisdictional waters to the extent that is practicable. To remain financially viable, this
project requires the installaion of forcemain verses gravity flow lines. Existing property boundaries and the horizontal
alignment of the proposed directional bore under the Cape Fear River places restrictions on the overall design and requires
some unavoidable temporary impacts to jurisdictional waters. The cleared construction corridor has a width of 25 feet through
wetland impact areas, and the subsequent maintenance corridor widths have been reduced to the minimum width of 12 feet
through wetland impact areas.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Stormwater BMPs will be utilized and adhered to throughout the project, to include proper construction sequences. BMPs will
include silt fences, erosion control matting, seeding and mulching, check dams, rip rap lined channels, and other methods
approved by the NCDENR. Erosion control measures to be used are detailed on the enclosed site plans.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ? Yes ® No
2b: If yes,-mitigation is required by (check all that apply): ? DWQ ® Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

El Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete If Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: N/A linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: 0.07702 acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form -Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 7 of 10
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ®No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? <1.0 %
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Linear utility project with incidental built
upon area, no new impervious surfaces other than manhole lids.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ® Yes ? No
Page 8 of 10
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
? Yes
? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
all wastewater will be transferred to the existing NPDES discharge location for the South Harnett Regional WWTP
(N00088366) for treatment and disposal;
Page 9 of 10
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
? Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC DENR, Div. of Parks and Recreation, Natura, 20100101, Natural Heritage Element Occurrences: NC DENR, Div. of
Parks and Recreation, Natural Heritage Program, Raleigh, North Carolina
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
South Atlantic Habitat and Ecosystem IMS available at: http://ocean.floridamarine.org/efh-coral/ims/viewer.htm
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
N/A
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
hftp://www. ncdot.org/it/gis/DataDistribution/FEMAFloodData/default.html

' '
Applicant/Agent
s Printed Name Applicant/Agent
s Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 10 of 10
PCN Form - Version 1.3 December 10, 2008 Version
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