20201851 Ver 1_Attachment B - Preliminary JD (SAW-2019-02288)_20210112

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Td. SAW-2019-02288 County: Mecklenburg U.S.G.S. Quad: NC- Weddington
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Requestor: Novant Health, Inc.
Keven Gorman
Address: 3600 Country Club Road, Suite 201
Winston Salem, NC 27104
Telephone Number: 704-521-9880
E-mail: kgorman60cnesch.com
Size (acres) 40 Nearest Town Charlotte
Nearest Waterway Clems Branch River Basin Santee
USGS HUC 03050103 Coordinates Latitude: 35.0393
Longitude:-80.8433
Location description: The review area is located on the southeast corner of the intersection of Providence Road and Johnston
Road. PINS: 22314152, 22314153, 22314154, 22314155, 22314156, 22314157, and 22314158.
Indicate Which of the Following Apply:
A. Preliminary Determination
® There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters, including wetlands have been delineated, and the delineation has been verified by the Corps to be sufficiently accurate
and reliable. The approximate boundaries of these waters are shown on the enclosed delineation map dated 1/24/2020. Therefore
this preliminary jurisdiction determination may be used in the permit evaluation process, including determining compensatory
mitigation. For purposes of computation of impacts, compensatory mitigation requirements, and other resource protection
measures, a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any
way by the permitted activity- on the site as if they are jurisdictional waters of the U.S. This preliminary determination is not an
appealable action under the Regulatory Program Administrative Appeal Process (Reference 33 CFR Part 331). However, you may
request an approved JD, which is an appealable action, by contacting the Corps district for further instruction.
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403).
However, since the waters, including wetlands have not been properly delineated, this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is
merely an effective presumption of CWA/RHA jurisdiction over all of the waters, including wetlands at the project area, which
is not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the waters,
including wetlands on your project area/property delineated. As the Corps may not be able to accomplish this wetland
delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in law or our published regulations, this determination may be relied upon for
a period not to exceed five years from the date of this notification.
❑ There are waters, including wetlandson the above described project area/property subject to the permit requirements of Section
404 of the Clean Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ We recommend you have the waters, including wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.
❑ The waters, including wetlands on your project area/property have been delineated and the delineation has been verified by
the Corps. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly

SAW-2019-02288
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once
verified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided
there is no change in the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The waters, including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below onDATE. Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact David L. Shaeffer at 704-510-1437 or
david.l.shaeffer(&usace.armv.mil.
C. Basis For Determination: Basis For Determination: See the preliminary jurisdictional determination
form dated 2/6/2020.
D. Remarks: None.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 4985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Phillip Shannin, Review Officer
60 Forsyth Street SW, Room I OM15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by Not applicable.
**It is not necessary to submit an RFRFJAform
tto the Division Office if you do not object to the determination in this correspondence.**
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SH AEFFER.DAVI D.LEIGH.1260750573
Corps Regulatory Official: Date:zozo.oz.oeo7:os:ze-osroo'
Date of JD: 2/6/2020 Expiration Date of JD: Not applicable

SAW-2019-02288
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete the Customer Satisfaction Survey located at
http://corpsmapu.usace.army.mil/cm_apex/V`p=136:4:0
Copy fwnished:
Agent: CWS, Inc.
Mean Shelton
Address: 550 E. Westinghouse Blvd
Charlotte, NC 28273
Telephone Number: 757-576-6433
E-mail: mei!an(a cws-inc.net

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Novant Health, Inc., Keven Gorman File Number: SAW-2019-02288 Date: 2/6/2020
Attached is:
See Section below
PROFFERED PERMIT (Standard Permit or Letter of permission)
A
RED PERMIT (Standard Permit or Letter of ermission)
B
DENIAL
LAPPROVED
C
JURISDICTIONAL DETERMINATION
D
INARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identities your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.arnly.mil/Missions/CiviIWorks/Re"latoryProg-ramandPermits.aspx
or the Corps regulations at 33 CFR Part 331. AL
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section IT of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section 11 of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section IT of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.

SECTION IT - REQUEST FOR VAL or OBJECTIONS TO AN INITIAL PROFFERED PERMTTA
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POTNT F CONTACT FOR QUESTIONS R INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Phillip Shannin, Administrative Appeal Review Officer
Attn: David L. Shaeffer
CESAD-PDO
Charlotte Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 1 OM15
8430 University Executive Park Drive, Suite 615
Atlanta, Georgia 30303-8801
Charlotte, North Carolina 28262
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunit to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: David L. Shaeffer, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and Approved Jurisdietional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Phillip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 2/6/2020
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Novant Health, Inc., Keven Gorman, 3600
Country Club Road, Suite 201, Winston Salem, NC 27104
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, Novant Health South Charlotte Med
Center, SAW-2049-02288
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The review area is located on the southeast
corner of the intersection of Providence Road and Johnston Road. PINS: 22314152, 22314153, 22314154, 22314155,
22314156, 22314157, and 22314158.
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County: Mecklenburg City: Charlotte
Center coordinates of site (lat/long in degree decimal format): Latitude: 35.0393 Longitude:-80.8433
Universal Transverse Mercator:
Name of nearest waterbody: Clems Branch
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
® Field Determination. Date(s): 1 /21 /2020 by the Corps
TABLE OF AQUATIC RESOURCES INREVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Estimated amount of
Geographic authority to
Type of aquatic
Latitude (decimal
Longitude (decimal
aquatic resources in
resources (i.e.,
which the aquatic resource
Site Number
review area (acreage
"may be" subject (i.e.,
degrees)
degrees)
wetland vs. non -
and linear feet, if
Section 404 or Section
wetland waters)
applicable
10/404)
Wetland AA
35.039885
-80.844043
0.03 ac.
Wetland Waters
Section 404
Wetland BB
35.040424
-80.844375
0.40 ac.
Wetland Waters
Section 404
Wetland CC
35.040441
-80.845471
0.18 ac.
Wetland Waters
Section 404
Intermittent
35.039997
-80.844220
36 If
Non -Wetland
Section 404
Stream A
Waters
Perennial
35.040496
-80.845322
160 If
Non -Wetland
Section 404
Stream A
Waters
Pond A
35.040278
-80.844888
1.00 ac.
Non -Wetland
Section 404
Waters

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in the review
area, and the requestor of this PJD is hereby advised of his or her option to request and obtain an
approved JD (AJD) for that review area based on an informed decision after having discussed the
various types of JDs and their characteristics and circumstances when they may be appropriate.
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 anon -reporting NWP or other general permit, and the permit applicant has
not requested an AJD for the activity, the permit applicant is hereby made aware that: (1) the permit
applicant has elected to seek a permit authorization based on a PJD, which does not make an official
determination of jurisdictional aquatic resources; (2) the applicant has the option to request an AJD
before accepting the terms and conditions of the permit authorization, and that basing a permit
authorization on an AJD could possibly result in less compensatory mitigation being required or
different special conditions; (3) 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) 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)
undertaking any activity in reliance upon the subject permit authorization without requesting an AJD
constitutes the applicant's acceptance of the use of the PJD; (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 PJD constitutes agreement that all aquatic resources in the review area
affected in any way by that activity will be treated as jurisdictional, and waives 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 AJD
or a PJD, the JD will be processed as soon as practicable. Further, an AJD, 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. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic jurisdiction exists over
aquatic resources in the review area, or to provide an official delineation of jurisdictional aquatic
resources in the review area, the Corps will provide an AJD to accomplish that result, as soon as is
practicable. This PJD finds that there " may be " waters of the U.S. and/or that there " may be "
navigable waters of the U.S. on the subject review area, and identifies all aquatic features in the
review area that could be affected by the proposed activity, based on the following information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject tile. Appropriately reference sources below where
indicated for all checked items:
® Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: Figure 7 dated 1/24/2020
® Data sheets prepared/submitted by or on behalf of the PJD requestor.
® Office concurs with data sheets/delineation report.
❑ Office does not concurwith data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
® U.S. Geological Survey Hydrologic Atlas: 'National map. og_v
® USGS NHD data.
® USGS 8 and 12 digit HUC maps.
❑ U.S. Geological Survey map(s). Cite scale & quad name:
® Natural Resources Conservation Service Soil Survey. Citation:ESRI NRCS SSURGO Soils Mapservice
National wetlands inventory map(s). Cite name: USFWS NWI Mapservice
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100-year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
® Photographs: ❑Aerial (Name & Date):
or ®Other (Name & Date):Site photos 1-6 dated 10/23/2019
❑ 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 jurisdictional determinations.
Digitally signed by
SHAEFFER.DAVID.LEIGH.121
0750573
Date: 2020.02.06 07:06:00
-05'00'
Signature and date of Regulatory
staff member completing PJD
2/6/2020
Signature and date of person requesting PJD
(REQUIRED, unless obtaining the signature is
impracticable) t
t Districts may establish timeframes for requester to return signed PJD forms. If the requester does not respond within the
established time frame, the district may presume concurrence and no additional follow up is necessary prior to finalizing an
action.

Perennial Stream A
160 If
\103MM
6 2 ,
Pond A
1.0 acre
Wetland CC
0.18 acre
Wetland BB
0.40 acre
n
1.4
Legend
Project Limits (40 ac.)
- - Intermittent Stream
Perennial Stream
® Wetland
`-A SCP1
- Pond
Culvert
Intermittent Stream A
36 If
1�
Gravel Path
Roads
CTax Parcels
ODP Data Point
1 inch = 65 feet
•SCP Stream Classification Point
< Indicates Flow
Wetland AA
REFERENCE: BACKGROUND GIS LAYER(S) PROVIDED BY MECKLENBURG
COUNTY GIS DEPARTMENT, DATED2019.
0.03 acre
Photo Location and Direction
NOTE: JURISDICTIONAL WATERS OF THE U.S. WERE DELINEATED (FLAGGED
IN THE FIELD), CLASSIFIED, AND MAPPED USING A SUB -FOOT CAPABLE GPS
4OO ZOO 0 400 Feet
UNIT BY CWS, INC., ON OCTOBER 17AND 18, 2018. JURISDICTIONAL FEATURES
HAVE NOT BEEN VERIFIED BY THE USAGE.
SCALE:
1 inch = 400 feet
DATE:
1/24/2020
Jurisdictional Boundaries
FIGURE NO.
CWS PROJECT NO:
DRAWN BY:
7
2019-0385
MLS
Novant Health South Charlotte Med Center
ofCOORDINATES:
CHECKED BY:
CAR ❑ L I N A
Mecklenburg County
35.039345,-80.843341
CAG
WETLAND SERVICES
Charlotte, North Carolina
7
G:\Shared drives\Consulting Team Drivek201 W019 Consulting Projectsk2019-0385 Novant Health South Charlotte Mad Center%JD\Updates per USACE site visiffigure7_JD (Updated).mxd