20041367 Ver 1_Complete File_20040819

Mr. J.M. Mills, PE
September 2, 2004
DWQ# 04-1367
Page 4
DWQ Project No.: U'1 - 1 3 4 -?
County: 6 /f 5 ??/iLL
Applicant: ?V e- .y 0 7- 4 1 / 12 / 7 0 A--, 3-
Project Name: D 0 L'Z ,LO 6V 0 S z ?v
Date of Issuance of 401 Water Oualitv Certification: S ?' rl'2t?-rd 2n -b, L U J cr
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ by
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of
these.
Applicant?e ifcatio
I, \ % A kkd],-, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and
other supporting materials.
Signature: 411 ?tiX ?? Date:
Agent's Certifii-f n
I, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and
other supportin material
Signature: ? Date:
Engineer's Ce ification
Partial Final
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Registration No.
Date
I #°_
o?o? w A r?RQ?
r? ? ? r
1 L.^Ar` 1
O 15E?0010111W "C
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
September 3, 2004
Caswell County
DWQ Project No. 04-1367
Poole Rd (no SR#)
APPROVAL of 401 Water Quality Certification
Mr. J.M. Mills, P.E.
Division Engineer, Division 7
North Carolina Department of Transportation
1584 Yanceyville Street
Greensboro, North Carolina, 27415
Dear Mr. Mills:
WITIANDS/401 GROUP
SF p 0 s? 2004
WA T&? QUALITY SECTION
You have our approval, in accordance with the attached conditions and those listed below, to incur the following impacts
in order to pave and improve traffic safety on Poole Rd in Caswell County.
• 95 linear feet of new impacts to an unnamed tributary to Pumpkin Creek (35 feet of new pipe and 40 feet of rip-rap);
• Temporary dewatering impacts of approximately 50 square feet for sandbags and rock silt dam.
The project shall be constructed in accordance with your application dated August 13, 2004 (received August 19, 2004)
and with the modifications requested during a site visit conducted by NCDWQ and NCDOT on September 2, 2004. After
reviewing your application, we have decided that this fill is covered by General Water Quality Certification Nos. 3404
and 3366, corresponding to the U.S. Army Corps of Engineers Nationwide Permit Numbers 14 and 33. In addition, you
should acquire any other federal, state or local permits before you proceed with your project including (but not limited to)
Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire with
the accompanying 404 permit, unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design described in your application (unless modified below). Should
your project change, you must notify the Division of Water Quality (Division) and submit a new application. If the
property is sold, the new owner must be given a copy of this approval letter and certifications, and is thereby responsible
for complying with all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or if
total impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the conditions
listed in the attached certification and any additional conditions listed below.
1. NCDOT will conduct a pre-construction meeting and ensure that the project manager understands the issues with
stream and pipe alignment that were identified during the site visit conducted September 2, 2004.
2. NCDOT will align the new pipe as best as possible with the natural stream. This will require the pipe to be installed
slightly south of the existing pipe and on skew.
3. Erosion and sediment control practices must be in full compliance with all specifications governing the proper design,
installation and operation and maintenance of such Best Management Practices in order to protect surface waters
standards:
a. The erosion and sediment control measures for the project must be designed, installed, operated, and maintained
in accordance with the most recent version of the North Carolina Sediment and Erosion Control Planning and
Design Manual.
N r hCarolma
Vaturally
North Carolina Division of Water Quality 585 Waughtown Street Phone [phone] Customer Service
Internet: h2o.enr.state.nc.us Winston-Salem, NC 27107 FAX [phone]
An Equal OpportunitylAifirmative Action Employer - 50% Recycled/10% Post Consumer Paper
Mr. J.M. Mills, PE
September 2, 2004
DWQ# 04-1367
Page 2
~ ?Y
b. The design, installation, operation, and maintenance of the sediment and erosion control measures must be such
that they equal, or exceed, the requirements specified in the most recent version of the North Carolina Sediment
and Erosion Control Manual. The devices shall be maintained on all construction sites, borrow sites, and waste
pile (spoil) projects, including contractor-owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must be designed, installed, operated, and
maintained in accordance with the most recent version of the North Carolina Surface Mining Manual.
d. The reclamation measures and implementation must comply with the reclamation in accordance with the
requirements of the Sedimentation Pollution Control Act.
4. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the footprint of the
impacts depicted in the Preconstruction Notice Application. All construction activities, including the design,
installation, operation, and maintenance of sediment and erosion control Best Management Practices, shall be
performed so that no violations of state water quality standards, statutes, or rules occur.
5. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent practicable.
If placement of sediment and erosion control devices in wetlands and waters is unavoidable, they shall be removed
and the natural grade restored within six months of the completion of the project.
6. Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing
season following completion of construction.
7. Stormwater should be directed to vegetated buffer areas, grass lined ditches or other means appropriate to the site for
the purpose of pre-treating stormwater runoff, and must not be routed directly into streams. Mowing of existing
vegetated buffers is strongly discouraged, so that they may be utilized for stormwater sheet flow.
8. Where practicable, culverts that are less than 48-inch in diameter should be buried to a depth equal to or greater than
20% of their size to allow for aquatic life passage. Culverts that are 48-inch in diameter or larger should be buried at
least 12 inches below the stream bottom to allow natural stream bottom material to become established in the culvert
following installation and to provide aquatic life passage during periods of low flow. These measurements must be
based on natural thalweg depths. This may require increasing the size of the culvert to meet flow conveyance
requirements. If any of the existing pipes are perched, they shall be removed and replaced, and re-installed correctly,
unless demonstrated that this is topographically unfeasible. All waters must flow through without freefalling or
damming on either end of the culverts during low flow conditions, to maintain aquatic life and/or fish passage.
9. The dimension, pattern and profile of the stream above and below the crossing should not be modified by widening
the stream channel or reducing the depth of the stream.
10. Disturbed floodplains and streams should be restored to natural geomorphic conditions.
It. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted when practical. If
rip-rap is necessary, it must be limited to the stream bank below the high water mark, and vegetation must be used for
stabilization above high water. Any rip-rap used must not interfere with aquatic life passage during low flow
conditions.
12. If concrete is used, work must be accomplished so the wet concrete does not contact the stream water. This will
lessen the chance of altering the stream's water chemistry and causing a fish kill.
13. Heavy equipment must be operated from the banks rather than in the stream channel in order to minimize
sedimentation and reduce the likelihood of introducing other pollutants into the stream.
14. All mechanized equipment operated near surface waters must be regularly inspected and maintained to prevent
contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic materials.
15. The presence of equipment in the channels must be minimized. Under no circumstances must rock, sand or other
materials be dredged from the wetted stream channel under authorization of this permit, except in the immediate
vicinity of the culverts.
16. Temporary dewatering sites must be restored to preexisting conditions unless more natural geomorphic conditions can
be provided.
17. All work shall be performed during low flow conditions.
J Mr. J.M. Mills, PE
September 2, 2004
DWQ# 04-1367
Page 3
18. Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of Completion
Form" to notify DWQ when all work included in the 401 Certification has been completed. The responsible party
shall complete the attached form and return it to the 401/Wetlands Unit of the Division of Water Quality upon
completion of the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act
within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition, which conforms to
Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you have
any questions, please contact Sue Homewood at 336-771-4600 extension 287 or at [e-mail].
Sincerely,
Alan W. Klimek, P.E.
Attachment
cc: Wilmington District Corps of Engineers
John Thomas, USACE Raleigh Field Office
Jerry Parker, Division 7, Division Environmental Officer
Wetlands/401 Unit
Winston Salem Regional Office
Central Files
Mr. J.M. Mills, PE
September 2, 2004
DWQ# 04-1367
Page 4
DWQ Project No.:
County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ 1
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all c
these.
Applicant's Certification
I, , hereby state that, to the best of my abilities, due care and diligence w,
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
other supporting materials.
Signature:
Agent's Certification
Date:
I, , hereby state that, to the best of my abilities, due care and diligence w,
used in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent of the 401 Wa
Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Registration No.
Date
eY s? oI,
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GovERNoR
August 13, 2004
Ms. Beth Barnes
Wetlands/401 Unit
NC DENR Division of Water Quality
7
1650 Mail Service Center 4 J
Raleigh, NC 27699
(Seven Copies)
Mr. John Thomas
US Army Corps of Engineers
6508 Falls of the Neuse Suite 120
Raleigh, NC 27615-6814
(Two Copies)
Subject: Caswell County, Pipe Replacement on Poole Road
Project Number WBS Element # 37636
To Whom It May Concern:
WETLANDS/ 401 GROUP
AUG 1 9 2004
WATER QUALITY SECTION
LYNDO TIPPETT
SECRETARY
. The North Carolina Department of Transportation (NCDOT) proposes to replace an undersized
pipe on Poole Road in order to accommodate proposed road widening and paving which will reduce
future maintenance needs and increase traffic safety. In an effort to obtain the necessary permits
for the subject pipe replacement, we are providing a pre-construction notification application with
supporting documentation. We believe this project can be permitted under the Nationwide Permit
numbers 14 and 33.
It, is the department's opinion that the project has been designed to have minimal disturbance,
to provide maximum nutrient removal and erosion protection, to have least adverse effects on
aquatic life and habitat, and to protect water quality to the maximum extent practical through the
use of best management practices.
Mussel pre-screenings were conducted on August 11, 2004 by NCDOT biologists. It was
determined that the site had low probability of supporting mussel fauna and no furtherscreening
was deemed necessary. It was determined that there was no habitat for the James spinymussel
and therefore a biological conclusion of "NO EFFECT" was issued for the James spinymussel (see
attached letter)
The following information is being provided to satisfy condition I of General Water Quality
Certificate #3404 and #3366.
P. O. Sox 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
PROJECT INFORMATION
Road Name SR Number Project Length
miles Classification
Poole Road No SR # N/A Rural/Residential
River Basin: DWQ
ID Water Quality
Designation % Impervious
Surface
Roanoke 22 - 49 B N/A
Buffer Rulesa Buffer Rule Conditions where applicable)
No Request Exemption
Protected Species
Presentb Mapped Historic
Pro erti& CAMA
AEC Essential Fishery
Habitat
No No No No
a Separate documentation attached as needed: b See the attached Endangered
Species Review Sheet for further information: -When Applicable - See the attached
Historic Review Letter for further information
PIPE REPLACEMENT INFORMATION
Site Poole Road Stream Type Perennial
Station
Existing Pipe (1) 45'X 60" CMP Proposed (1) 80'X 83" X 59"
Pi CMPA
Construction Pump around with offsite detour Dewatering Sandbags & rock silt dam
Method Device*
Burial Depth Minimum of 20% of pipe diameter E/C Plan
Date
Construction As soon as practicable Duration Four weeks
Date
Impacts (ft.) 35 ft-enclosure; 20 linear ft-rip-rap dissipaters; 50 sf-temporary sandbags and
rock silt dam
Special
Conditions
Restoration Within 15 working days of the pipe replacement the natural stream contours
Plan will be restored and seeded. Temporary silt screens will be cleaned and
removed following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; EEC; = Erosion
control. *A less intrusive dewatering device may be used in lieu of the one proposed.
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
MINIMMTION RIFORLIATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters
of the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
TWIGATION WFORLIATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not
occur in a unique natural wetland.
APPLICATION INFORMATI011
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Jerry Parker at [phone]. Your time and effort are appreciated.
Sincerely,
Mr J. . Mills, P.E.
Di 'sio Engineer, Division 7
Enclosures
CC: Jerry Parker. NCDOT
Derek Dixon, NCDOT
Barry Harrington, NCDOT
Herbert McDowell, NCDOT
Sue Homewood, NCDWQ
P. 0. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
Office Use Only: >?• Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter 'Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
X Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP Wand 33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: Mr. J.M. Mills RE Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro, NC 27415
Telephone Number: [phone] Fax Number: (336),334-3673
E-mail Address: mmillsndot.state.nc.us
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Jerry A. Parker
Company Affiliation: NC DOT
Mailing Address: P.O. Box 14996
Greensboro, NC 27415
Telephone Number: (336)_256-2063 Fax Number: [phone]
E-mail Address: [e-mail]
Page I of 8
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Poole Road State Road Number Not Yet Assigned) Caswell County
2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS Element #37656
3. Property Identification Number (Tax PIN): Not Applicable
4. Location
County: Caswell Nearest Town: Danville, Va.
Subdivision name (include phase/lot number): Not Applicable
Directions to site (include road numbers, landmarks, etc.): Project site is south of Danville,
Virginia in Caswell County North Carolina. From 1-85/40, take Exit 131A (I-840) to
Burlington/Wendover Avenue: turn right and head west for approximately 4 miles to US 29.
Take US 29 North for 37 miles to the Elizabeth St. Exit. Turn right on Elizabeth: drive 0.2
mile to Holland Rd. Turn left, take Holland Rd for 0.5 mile and veer right onto Indian Valley
Rd (in Virgina). Turn right at first road (maybe unnamed): This road becomes Poole Rd at
State Line. Site is approximately 1,000 feet south of state border.
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS map.
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): Not Applicable
7. Nearest body of water (stream/river/sound/ocean/lake): UT to Pumpkin Creek
8. River Basin: Roanoke
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 2 of 8
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Rural community and farmland
10. Describe the overall project in detail, including the type of equipment to be used: The
project will involve paving an unpaved secondary troad and bringing the travel lanes ,
shoulders ditchlines and drainage structures up to current standards. It will involve replacing
a 45 ft long by 60" corrugated metal pipe with an 80 ft long by 83" x 59" corrugated metal
arch The increase in size of culvert has been recommended by the hydraulics section of
NCDOT in order to maintain stream stability and to eliminate flooding Proposed right-of-
way width is illustrated on the attached site plan. Equipment used will be standard road
construction equipment (trackhoe,grader, backhoe and bulldozer).
11. Explain the purpose of the proposed work: To upgrade an unpaved secondary road. Paving
and widening are being conducted to maintain traffic safety, eliminate flooding, reduce future
maintenance costs and bring the road up to current construction standards.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
Not Applicable
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Not Applicable
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 3 of 8
1. Provide a written description of the proposed impacts: Permanent stream impacts will
result from 35 additional feet of channel enclosure and placement of 20 linear feet of rip-rap
energy dissipaters Fifty square feet of temporary stream impacts will result from placement of
cofferdams and silt screens. Silt screens will be cleaned and removed following vegetation
establishment.
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, gradmg, tut,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://ww,,v.fcnii.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: N/A
Total area of wetland impact proposed: N/A
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)

Pipe replacement 35 ft(en)
50 sf(tmp)
20ftr
UT to Pumpkin Creek Two to four
feet
Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated np-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usgs.Qov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.ma x uest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 35 linear feet- enclosure
(en) 50 square feet- temporary (tmp), 20 linear ft- rip rap (rp)
Page 4 of 8
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding„ drainage, bulkheads, eta
5. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): Not Applicable
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): Not Applicable
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Pipe replacement activities are necessary to brim the project up to current construction standards
and to decrease the possibility of flooding due to the undersized pipes. Impacts will be
minimized by strict enforcement of Best Management Practices for the protection of wetland and
surface waters, restrictions against the staging of equipment in or adjacent to waters of the US,
and coordination (including a pre-construction meeting with the Division Environmental
Officer.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 5 of 8
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://l12o.enr.state.nc.us/newetlands/strmizide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
A finding of insignificant impact is anticipated• therefore a mitigation plan is not provided.
Cumulative impacts are less than 150 feet. The maximum amount of permanent impact to a
single stream is 35 linear feet No Outstanding Resource Waters, federally protected species
or their habitats or essential fishery habitats occur in the project area. The project is not
located in a High Quality Water.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet): Not Applicable
Amount of buffer mitigation requested (square feet): Not Applicable
Amount of Riparian wetland mitigation requested (acres): Not Applicable
Amount of Non-riparian wetland mitigation requested (acres): Not Applicable
Amount of Coastal wetland mitigation requested (acres): Not Applicable
Page 6 of 8
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet Multiplier Required
Mitigation
1 N/A 3
2 N/A 1.5
Total N/A
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 7 of 8
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
Not Applicable
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
Not Applicable
XH. Sewage Disposal (required by DWQ)
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.
Not Applicable
X1H. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes, No X
Is this an after-the-fact permit application?
Yes No X
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
?5- p-O4-
nt/Agent's Signature Date
ire is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
Jr ? y3
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
August 16, 2004
MEMORANDUM TO:
FROM:
Mike Mills, PE
Division Engineer
Jared Gray, Environmental Biologist
Office of Natural Environment
LYNDO TIPPETT
SECRETARY
SUBJECT: Protected species survey report for the James spinymussel
(Pleurobenta collina) for the proposed pipe replacement project
on UT's Pumpkin Branch on Poole Road; Caswell County,
Division 7 Project.
ATTENTION:
Jerry Parker
Division Environmental Officer
The following memorandum addresses the James spinymussel (Pleurobema collina),
federally protected species listed by the US Fish and Wildlife Service for Caswell County. The
habitat requirements for the James spinymussel include creeks or river areas with sediment of
cobble and sand in reaches with slow to moderate current. (Bogan, 2002). Habitat for the James
spinymussel does not exist in the UT's Pumpkin Branch. A habitat assessment for James
spinymusscl was conducted and there was not suitable habitat for mussels. This project was pre-
screened by Alderman Environmental Services, and was considered to have a low probability of
containing mussels.
Surveys, Habitat and Methods
A mussel habitat assessment was conducted on August 11, 2004 by NCDOT biologists,
Neil Medlin, Steve Mitchell and Jared Gray. The northern UT Pumpkin Branch below the rock
quarry at Poole Road had iron-oxidizing bacteria with unconsolidated substrate. This stream was
very shallow with a depth of approximately one-inch. The second UT Pumpkin Branch had no
water in the channel. The substrate was mostly sand. The southern UT Pumpkin Branch we
assessed was extremely shallow with a water depth of one-inch. The substrate consisted of sand,
silt and detritus. The land use was active rock quarry mining in a rural community. Habitat
assessment were conducted by visually looking at the streams and taking notes on stream substrate,
size and depth, along with a GPS reading of our location. The longitude and latitude of the three
streams in which we assessed are 36.53610, -79.468835, 36.53064, -7946999, and 36.52955, -
7947033. There was no evidence of freshwater mussels in 1.00 man-hours of habitat assessment
time.
MAILING ADDRESS: TELEPHONE [phone] LOCATION:
NC DEPARTMENTOFTRAN:,PORTATION FAX: [phone] IRAN ;PORTATION BUILDING
PROJECT DEVELOPMENT AND ENVIRGNMENTALANALYus 1 SOUTH WILMINGTON STREET
1548IMLSERVICECENTER Minim. wwwNCDOT.ORG RALEIGH NC
Qualifications of Investigators
Investigator: Jared Gray
Education: B.S. Environmental Science, Morehead State University
Experience: Environmental Biologist, Enviro-Pro, October 1994 - May 1997
Environmental Technician, Appian Consulting Engineers, P.A., October 1997 -
May 1998
Environmental Specialist, NCDOT, October 1998-present
Expertise: Endangered species (terrestrial/aquatic) surveys; benthic macroinvertebrate
collection, wetland delineation; soils, water quality analysis, and 404/401
permitting.
Investigator: Neil Medlin, Environmental Specialist
Education: M.A. Biology, Appalachian State University
B.S. Biology, Appalachian State University
Experience: Environmental Specialist, NCDOT, January 2002 - present
Environmental Biologist, NC Division of Water Quality
June 1990 - January 2002
Environmental Biologist, FL Department of Environmental Protection (formerly
Department of Environmental Regulation), August 1986 - June 1990
Expertise: Freshwater fish and benthic macroinvcrtebrate collection and identification;
aquatic habitat evaluations and function; biocriteria and biotic indices evaluations;
Endangered species (terrestrial/aquatic) surveys.
Investigator: Steve Mitchell, Environmental Supervisor
Education: B.S. Biology, East Carolina University
Experience: Environmental Specialist/Supervisor, NCDOT, August 2004 - present
Environmental Scientist, NC Division of Water Quality,
Department of Environment and Natural Resources
September 20, 1978 to August 2004
Expertise: Phytoplankton, submersed aquatic vegetation, freshwater fish, and benthic
macroinvertebrate collection and identification; aquatic habitat evaluations and
function; biocriteria and biotic indices evaluations; Surface water origination
determination; Endangered species (terrestrial/aquatic) surveys; Wetland
determination/delineation's; 404/401-permit approval.
BIOLOGICAL CONCLUSION: No Effect
Given that there was no James spinymussel habitat and that there was no evidence
of freshwater mussels, it is apparent that the James Spinymussel does not occur in the
project footprint. The North Carolina Natural Heritage Program (NCNHP) does not list a
known population up or downstream in any of the UT's Pumpkin Branch.
File: UT Pumpkin Branch
Bogan, Art, 2002. Workbook and Key to the Freshwater Bivalves of North Carolina.
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Starting from: 801 Summit Ave, Greensboro, NC 27405-7856
Arriving at: Poole Rd, Pelham, NC 27311-8567
Distance: 40.3 miles Approximate Travel Time: 1 hour 4 mins
Your Directions
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Your Full Route Your Destination
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Name: DANVILLE Location: 036° 32'37.3" N 079° 27'02.3" W
Date: 8/17/2004 Caption: Poole Road (No State Road #))
Scale: 1 inch equals 2000 feet Caswell County
PUr.1P
e-'
FL07.J >
RIP RAP
UVJI UNDERLYING
FILTER FABRIC
IMPERVIOUS
DIRE
SILT FENCE
AS NEEDED
45' EXISTING
60" CrA PIPE
k DAVID'S BROAD (PRIVATE)
- 77 SILT UaG
POND
OWN 33"A S0"
CC7 PIPE ARCH
- PIPE
REPLACEMENT
POOLE LOAD
PUMP AROUND FOR UT OF PUMPKIN CREED
POOLE ROAD (NO SR# )
CASWELL COUNTY
NCDOT - DIVISION 7
(NOT TO SCALE)

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