20202009 Ver 1_ePCN Application_20210111

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
October 26, 2020 Ver 3.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
C Yes r No
Change only if needed.
BIMS # Assigned
20202009
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Sue Homewood:eads\slhoma=od
Information for Initial Review
la. Name of project:
COURTESY COPY - Line 333 Retrofit
1a. Who is the Primary Contact?*
Joey Lawler, PWS
1b. Primary Contact Email:*
[e-mail]
Date Submitted
1/11/2021
Nearest Body of Water
UWharrie River
Basin
Yadkin-PeeDee
Water Classification
WS-III
Site Coordinates
Latitude: Longitude:
35.896743'-79.9445150
Pre -Filing Meeting Information
ID#
Not required for courtesy submittal
Pre -fling Meeting or Request Date*
12/21/2020
Attach documentation of Pre -Filing Meeting Request here:*
Pre -File Meeting Request Form.pdf
Version#*
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone:*
[phone]
Version
IwA
224.5KB
A. Processing Information C^U
County (or Counties) where the project is located:
Randolph

Is this a NCDMS Project
r Yes r No
Is this project a public transportation project?*
r Yes r No
la. Type(s) of approval sought from the Corps:
* Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
r Yes
r No
1b. What type(s) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 12 - Utility Lines
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Piedmont Natural Gas
2b. Deed book and page no.:
N/A - Project located in easement
2c. Responsible party:
Piedmont Natural Gas
2d.Address
*
r Yes r No
r Yes r No

Street Address
4720 Piedmont Row Drive
Address tine 2
aty
Charlotte
Postal / Zip Code
28210
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Aaron Weldon
3b. Business Name:
Piedmont Natural Gas
3c.Address
Street Address
4720 Piedmont Row Drive
Address tine 2
aty
Charlotte
Postal / Zip Code
28210
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Joey Lawler, PWS
4b. Business Name:
S&ME, Inc.
4c.Address
Street Address
2016 Ayrsley Town Blvd., Suite 2-A
Address Line 2
City
Charlotte
Postal / Zip Cede
28273
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Agent Authorization Form.pdf
C. Project Information and Prior Project History
Project Information
1b. Subdivision name:
it apprcprate)
WA
1c. Nearest municipality/ town:
Archdale
2. Project Identification
State / Ravine / Rion
NC
Country
USA
2f. Fax Number:
Slate/Fr vine/tllegion
NC
Country
USA
3e. Fax Number:
State / Rmince / Region
NC
Country
USA
4e. Fax Number:
201.29KB

2a. Property Identification Number:
N/A
2c. Project Address
Street Address
Multiple Randolph County locations along Line 333
Address tine 2
CKY
Archdale
Postal / Zip Gxle
27263
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Uwharrie River
3b. Water Resources Classification of nearest receiving water:*
WS-III
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030300030106 and 030401030402
4. Project Description and History
2b. Property size:
N/A
State / Province / I?gion
NC
(buntry
USA
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
Line 333 natural gas transmission line was originally constructed in 1984-1985.The project area consists primarily of an existing, maintained utility easement. A temporary access road
will be required at one location. A portion of the temporary access road will pass through a small forested area. The project vicinity ranges from largely undeveloped agricultural and
forested land, and mixtures of residential and light industrial development.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
FIG2A-2D_USGS.pdf
1.91 MB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
FIG3A-3D_SOILS.pdf 2.79MB
4f. List the total estimated acreage of all existing wetlands on the property:
- 0.20
4g. List the total estimated linear feet of all existing streams on the property:
-100LF
4h. Explain the purpose of the proposed project:*
The purpose of the project is to retrofit the natural gas transmission line to accommodate an in -line inspection (ILI) device and is compatible with current safety and inspection
requirements.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The work will occur at approximately multiple locations along the existing pipeline, and with the exception of an access road, will be conducted within the existing 50-foot wide easement.
The proposed work will involve excavation and exposing the existing pipeline in areas wfiere replacement of existing fittings or similar upgrades are necessary to make the pipeline
compatible with the ILI device.
The work will first involve demarcation of disturbance limits, which in most instances will not exceed a 50' x 50' area within the existing easement. t'jurisdictional boundaries are present,
these areas will be demarcated as well. Appropriate erosion and sedimentation control (E&SC) measures will be installed in advance of excavation to prevent sedimentation of adjacent
jurisdictional features. Equipment crossing over herbaceous wetlands that may be located within the existing easement will do so on mats to avoid impacts. A track hoe will then excavate
a pit and expose the pipe. Spoil material will be temporarily stockpiled within the easement adjacent to the pit and contained within silt fence. In wetland areas, topsoil will be segregated
from the subsoil.
At one location (Site 4), temporary equipment access from Weant Road will be required. Construction of the temporary road will result in clearing a minor amount of forested wetlands.
Access from this location is required in order to avoid additional disturbance by utilizing the existing easement, where disturbance to agricultural fields, along with multiple crossings of
more significant wetlands and a stream would be required.
Following completion of the work to the pipeline, the spoil material will be replaced in the pit, and the topsoil will be replaced last. The affected areas will be restored to their pre -
construction grades and contours, and permanent seed and will be mulch applied. All work within wetland areas will be conducted in accordance with the applicable permit conditions.
4j. Please upload project drawings for the proposed project.
LINE 333 TYPICAL 81N RETROFIT DESIGN (1) (1).pdf 525.84KB
LINE 333 TYPICAL 81N RETROFIT NOTES (1) (1).pdf 479.09KB
Line 333 IFC Details.pdf 14.49MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*

r Yes r No f Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): J. Lawter, PWS
Agency/Consultant Company: SRME, Inc.
Other:
5d1. Jurisdictional determination upload
WETS Data 2020-12-29.pdf
WA data forms. pdf
Photo Log.pdf
6. Future Project Plans
92.92KB
235.68KB
1.29MB
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No additional permits should be required.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries P Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?)
2b. Impact type * M
2c. Type of W. *
2d. W. name*
2e. Forested*
2C Type of
Jurisdicition*(?)
2g. Impact
area*
4
Access Road
T
Headwater Forest
WA
Yes
Both
0.005
(acres)
Sb
Fitting Replacement
T
Seep
WB
Both
0.050
(acres)
7
Fitting Replacement
T
Headwater Forest
WC
�No
Both ]0.040
(acres)
8
Fitting Replacement
T
Headwater Forest
WD
�No
Both ]0.001
(acres)
9
Fitting Replacement
T
Bottomland Hardwood Forest
WF
No
Both
0.020
(acres)
2g. Total Temporary Wetland Impact
0.116
2g. Total Wetland Impact
0.116
2h. Comments:
All impacts are temporary
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Clh ck all that apply.
r Neuse
r- Catawba
r- Goose Creek
r- Other
2g. Total Permanent Wetland Impact
0.000
r Tar -Pamlico
R Randleman
r Jordan Lake

ib. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
lccess Road T S1 No 780 492
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 780.00 492.00
Zone 1
Zone 2
Total Permanent impacts: 0.00
0.00
Zone 1
Zone 2
Total combined buffer impacts: 780.00
492.00
6i. Comments:
Buffer impact is "deemed allowable" by the buffer rules because less than 2,500 sf of buffer Will be impacted, and the area will be restored to pre -
construction topographic and hydrologic conditions and replanted with comparable vegetation within two months of Wien construction is complete.
Supporting Documentation
FIG4A-4D_IMPACTS.pdf 3.09MB
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
See cover letter
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
See cover letter
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Project does not result in permanent wetland impacts.
F. Stormwater Manaqement and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
W Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
G Yes r No
Comments:
NA
G. Supplementary Information
u

1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 21-1.1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Project is deigned to retrofit an wasting utility line to meet current safety and inspection requirements. It is not designed in induce growth.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
See cover letter
Consultation Documentation Upload
Site 4.pdf
Site 5B.pdf
Site 7.pdf
Site 8.pdf
Site 9.pdf
Site4.pdf
Site5B.pdf
Site7.pdf
Site8.pdf
Site9.pdf
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
179.64KB
179.13KB
186.29KB
185.99KB
187.9KB
996.77KB
1.02MB
917.8KB
910.45KB
910.91 KB

6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
https://www. fisheries. noaa. gov/resou rce/ma p/esse ntia I -fish -habitat -ma ppe r
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 status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
See cover letter
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
lic. What source(s) did you use to make the floodplain determination?*
hftps://flood.nc.gov/ncflood/
Miscellaneous
Comments
Please see attached cover letter for additional information
Miscellaneous attachments not previously requested.
FIG1_VICINrfY.pdf 697.21 KB
Cover Letter.pdf 199.03KB
Signature u
*
W By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
,bey Lawler
Signature
J-#EY L_4WLI�—
Date
1 /11 /2021