20110814 Ver 1_401 Application_20110811

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August 29, 2011
NC DWQ, 401 /Wetlands Unit
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
Re: Pre-Construction Notification
Written Approval - 401 Water Quality Certification
Transco - Bank Stabilization and Maintenance of Exposed 30-inch Pipeline
in Ponders Branch
Cleveland County, Grover, North Carolina
Submar Job #10433
On behalf of Transco, Submar, Inc. is submitting this request for Section 401 Water Quality
Certification Written Approval to conduct bank stabilization activities and restore cover to
natural gas pipelines within waters of the United States. Based on a review of the Corps of
Engineers Regulatory Program, it appears that the work proposed herein could meet the criteria
established for authorization under Nationwide Permits (NWP) No. 3 - Maintenance and
No. 18 - Minor Discharges, as found in the March 12, 2007, Federal Register, Reissuance of
Nationwide Permits (72 FR 11180). Please refer to the enclosed Pre-Construction Notification
for project specific details. We will comply with the general and regional conditions of the
permits during construction. D ti l? 2 ?i?n
CONTACT INFORMATION
2011
Applicant Agent DINR - WAi ER QUALi 1 Y
WETLANDS AND STORMWATER BRANCH
Transco Submar, Inc.
2800 Post Oak Boulevard 805 Dunn Street
Houston, Texas 77056 Houma, Louisiana 70360
Attn: Mr. Randall Flowers Attn: Brandon M. Clark
PROJECT LOCATION & DESCRIPTION
The Transco right-of-way (ROW) crosses Ponders Branch in Cleveland County, about 2 miles
southeast of Grover, North Carolina (Figure I - Vicinity Map). The GPS coordinates for the site
are N35.16760° and W81.41558° (Figure 2 - Topographic Map).
805 Dunn Street - Houma, LA 70360 - 985-868-0001 - Fax [phone] - www.submar.com
August 29, 2011
Page 2
The Transco Pipeline right-of-way crosses Ponders Branch in Cleveland County, about 2 miles
southeast of Grover, North Carolina. The creek flows in a southeasterly direction as it crosses
the right-of-way. The soil in the area is composed of clay and rock. The banks in the project
area are approximately 3 feet high and are vegetated with grass and forbs.
There are six natural gas pipelines in this section of the right-of-way. The 30-inch Line A is the
line farthest upstream, followed by the 16-inch Lateral, the 36-inch Line B, the 36-inch Line C,
the 42-inch Line D, and the 12-inch Lateral. Headcuts moving upstream through the right-of-
way have exposed Line A for approximately 10 feet across the streambed. Existing riprap that
was placed in the stream and used as a grade control structure has stopped the headcuts from
completely exposing the pipelines; however, all of the pipelines have shallow cover. The stream
flow has caused lateral bank migration, further exposing Line A (Figures 4 and 5 - Site
Photographs).
To provide cover over the pipelines and stop the erosion at the site, Submar proposes to cut back
both banks and place fill to create gentle, more stable slopes. Submar will also place fill around
the exposed pipeline. Submar will then armor the pipelines with a system of articulating
concrete revetment mats that will cover the pipelines in the streambed and extend up both banks.
The mat tail on the downstream end of the mat system will articulate with the streambed to
prevent future headcuts from migrating upstream. Submar's articulating concrete mat system
will provide and maintain cover over the pipelines in the matted area (Sheet 3 - Proposed
Design).
The Submar Revetment Mattress is an articulating concrete mat used primarily for erosion
control. The mat is 4.5-inches thick and has a low hydraulic profile when placed in a streambed.
Pipeline companies prefer our mat over their pipelines for several reasons. If the stream
undergoes significant changes, the mats can be repositioned to compensate for changing flow
patterns. The mat has open areas that allow revegetation through the mat. The design for matted
areas includes a rapid return to a natural appearance.
PURPOSE AND NEED
The pipeline is exposed, so a repair to restore cover is required. Headcuts migrating upstream
have exposed the top of Line A across the creek while the remaining five lines have a reduced
amount of cover. The exposed and shallow covered natural gas pipelines are considered out of
compliance with the U.S. Department of Transportation Pipeline and Hazardous Materials Safety
Administration (PHMSA) regulation 49 CFR Part 192, Subpart G (192.327) regarding minimum
pipeline coverage. The regulation states that "the transmission line or main may be installed
with less cover if it is provided with additional protection to withstand anticipated external
loads." Submar's concrete mattress system is considered an engineered alternative that provides
additional protection to withstand anticipated external loads that are present within dynamic
stream systems. At some point, this exposure may likely suffer structural damage if left
unprotected. This unfortunate event could cause environmental damage and endanger the public.
805 Dunn Street • Houma, LA 70360 • 985-868-0001 • Fax [phone] • www.submar.com
August 29, 2011 Page 3
DIRECT AND INDIRECT ENVIRONMENTAL IMPACTS
The proposed project involves the installation of 31 articulating concrete mats over the exposed
pipeline to restore cover. Of the 31 total mats proposed, 8 (approximately 12 cubic yards) will
be installed below the ordinary high water mark. About 9 cubic yards of clean uncontaminated
fill will also be placed below the ordinary high water mark. It appears that the project may
permanently impact about 0.03 acre of other waters of the United States. It is anticipated that no
wetlands will be impacted. We expect temporary impacts (approximately 0.17 acre) during
construction; however, anticipate no long-term adverse impacts to the project area.
THREATENED AND ENDANGERED SPECIES
Submar reviewed published information to determine federal and state listings of threatened and
endangered species within the vicinity of the site. Listed species that are known to have current
or historical ranges within Cleveland County include the Dwarf-flowered heartleaf (Hexastylis
naniora). Federal species of concern that are under consideration for listing include Gray's
saxifrage (Saxifraga caroliniana), Sweet pinesap (Monotropsis odorata), Torrey's Mountain-
mint (Pycnanthemum torrei ).
Based on available information on the location, scope, and timing of the proposed work, it
appears that the project will have no effect on listed species or their critical habitats. Project
activities may cause temporary disturbance to local habitat, but are expected to have no long-
term adverse effect to these species. If at any time threatened or endangered species are
encountered within the project area, activities will be stopped and U.S. Fish and Wildlife Service
will be contacted for guidance. A letter was sent to the U.S. Fish and Wildlife Service Asheville
Ecological Field Office for concurrence.
CULTURAL RESOURCES
A letter was sent to the State Historic Preservation Office for a determination of possible effects
to cultural resources protected under the National Historic Preservation Act.
In the event that a previously unknown historic property that may be eligible for inclusion in the
National Register of Historic Places or human remains, unregistered cemeteries, or burial
artifacts are discovered during the proposed activity, we will immediately cease all ground
disturbing activities in the immediate area of the discovery and take immediate steps to protect
the inadvertent discovery by flagging the area as an exclusion zone. In the case of human
remains, at no time will the remains be allowed to be viewed by the public or removed until the
appropriate steps are determined by the Corps Archaeologist. Concurrently, we will immediately
notify the Asheville Corps Regulatory Archaeologist at [phone] so that the Regulatory
Archaeologist can contact the State Historic Preservation Officer and concerned Federally
Recognized Tribes. Additionally, we will notify local law enforcement within 24 hours of the
human remains accidental discovery.
805 Dunn Street e Houma, LA 70360 . 985-868-0001 . Fax [phone] . www.submar.com
T V
August 29, 2011
ADDITIONAL PERMITS TO BE REQUESTED
Page 4
No other state or federal environmental permits are required for the subject work. NWP-3 and
NWP-18 are certified Nationwide Permits under the North Carolina Department of Environment
and Natural Resources Division of Water Quality (DWQ) Program. Therefore, an individual
WQC will not be required. However, written approval is being requested from DWQ.
Your prompt attention and approval of this permit request will be appreciated. If you have any
questions, or if I may be of further service, please call me at [phone]. Thank you in
advance for your assistance in this matter.
Sincerely,
SUBMAR
(y) - c(O'L
Brandon M. Clark
Regulatory and Compliance Manager
Enclosures
cc: Mr. Randall Flowers, Transco
2800 Post Oak Boulevard, Houston, Texas 77056
805 Dunn Street - Houma, LA 70360 • 985-868-0001 - Fax [phone] • www.submar.com
201108 14
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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
A. Applicant Information rmp?4 mm
1.
Ly 77T
Processing Lf&
1 a. Type(s) of approval sought from the
Corps: y
®Section 404 Permit El Section 1 Permit
1 b. Specify Nationwide Permit (NWP) number: 3 and 18 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ® 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
1 e. 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. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
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: Bank Stabilization and Maintenance of Exposed 30" Pipeline in Ponders Branch
2b. County: Cleveland
2c. Nearest municipality / town: Grover
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: Property Deed - Southern Power Company, and ROW Agreement J.B. Ellis & Inez B.
Ellis, R.L. Ellis, Eleanor J. Ellis, W.C. Ellis & MAbel T. Ellis
3b. Deed Book and Page No. Book 1575 and Page 876 and ROW Agreement April 3, 1947 Book 5-T and Page 219
3c. Responsible Party (for LLC if
applicable): Transco, Attn: Mr. Randall Flowers
3d. Street address: 2800 Post Oak Boulevard D
3e. City, state, zip: Houston, Texas 77056 LIL 1 _95 111 li
3f. Telephone no.: 713-215-3427 s
3g. Fax no.: 713-215-5442 ll
3h. Email address: I. Randall. [e-mail] TNGSqNp TEizQLHL;14
BRANCH
Page I of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ® Agent ? Other, specify:
4b. Name: Transcontinental Gas Pipe Line Company, LLC
4c. Business name
(if applicable): CT Corporation System (Registered Agent)
4d. Street address: 150 Fayetteville Road - Post Office Box 1011
4e. City, state, zip: Raleigh, North Carolina 27601
4f. Telephone no.: 919-821-7139
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Brandon M. Clark
5b. Business name
(if applicable): Submar, Inc.
5c. Street address: 805 Dunn Street
5d. City, state, zip: Houma, Louisiana 70360
5e. Telephone no.: 1-800-978-2627
5f. Fax no.: 985-851-0108
5g. Email address: [e-mail]
Page 2 of 11
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): Parcel ID 60765
1 b. Site coordinates (in decimal degrees): Latitude: 35.16760 Longitude: - 81.41558
(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 Ponders Branch
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Broad
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:
The site is currently being maintained as a right-of-way for existing natural gas pipelines. Current land cover is (311)
Managed Herbaceous Cover and (321) Managed Shrublands while land use is categorized as (1.06.02.02) Gas Storage
and Transmission.
3b. List the total estimated acreage of all existing wetlands on the property:
Unknown
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Stream is approximately 170 linear feet at limits of maintained right-of-way crossing.
3d. Explain the purpose of the proposed project:
Project purpose is to conduct erosion control activities within Ponders Branch to restore protective cover to Line A, an
exposed natural gas pipeline and to protect five other lines from future exposure.
3e. Describe the overall project in detail, including the type of equipment to be used:
Submar proposes to cut back the banks to create a gentler, more stable slope (2:1) and place fill around the exposed
Line A. We will then armor all six pipelines with a system of articulating concrete revetment mats. Proposed project
involves the installation of 31 articulating concrete mats over the exposed pipeline to restore cover. Of the 31 total mats
proposed, 8 (approximately 12 cubic yards) will be installed below the ordinary high water mark. About 9 cubic yards of
clean uncontaminated fill will also be placed below the ordinary high water mark. It appears that the project may
permanently impact about 0.03 acre of other waters of the United States. The mat system will cover the pipelines in the
creekbed and extend up both banks. The tail on the downstream end of the mat system will articulate with the creekbed
to prevent the upstream migration of future headcut erosion. Submar's articulating concrete mat system will provide and
maintain cover over the pipelines in the matted area. A track excavator and track loader will be used.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the 14
Corps or State been requested or obtained for this property /
? Yes ? No ®Unknown
project (including all prior phases) in the past?
Comments: Corps permit likely issued when pipeline installed
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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 4 of 11
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
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? PEI T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments: No known wetlands on site
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 - or
(PER)
(Corps - 404, 10
stream
length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ®P ? T Excavations and Ponders Branch ® PER ® Corps
25
135
Fill ? 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 135
3i. Comments: Impacts associated with excavation of the banks to create more gentle 2:1 slopes and fill associated with the
pre-formed concrete mattresses will be approximately 135 linear feet.
Page 5 of 11
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: N/A
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID
number
Proposed use or purpose
of pond
Wetland impacts (acres)
Stream Impacts (feet) Upland
Flooded I Filled I Excavated I Flooded I Filled I Excavated I Flooded
P1
P2
5f. Total
5g. Comments: N/A
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.
Project is in which protected basin?
6b. 6c. 6d.
Buffer impact
number - Reason
Permanent (P) or for
Temoorarv (T) impact
61 ?P?T
B2 ?P?T
B3 ?P?T
6i. Comments:
? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6e. 6f. 6g.
Buffer
Stream name mitigation
required?
? Yes
? No
? Yes
? No
? Yes
? No
6h. Total buffer impacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Project is designed to minimize the amount of material to be placed within the stream, but maximize the protection of the
currently exposed line and additional lines within the section of right-of-way. Once the concrete mats are placed within the
stream, we propose to utilize native bed material and boulders to place over the mats to simulate the natural setting. A grade
control will also be installed with native rock near Pipeline C to replicate the existing grade control.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Measures to control sediment and erosion will be implemented prior to any ground disturbance and will be maintained
throughout project construction. Permanent grass will be planted to help control erosion immediately following any final ground
disturbing activity. Native annual small grains and herbs appropriate for the season will be planted. Fescue based mixtures
will be avoided. Also, fertilizers and pesticides will not be used near streams. Additionally, construction best management
practices, using pre-formed concrete mats, working in the dry, using clean uncontaminated fills, and soil stabilization
measures.
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: 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: 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 7 of 11
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 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. 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? 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: Total project imapcts (temporary and
permanent) are less than 1 acre.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative 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? Cleveland County
? 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 9of11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. 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
letter.) ? Yes ? No
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.
No wastewater is anticipated to be generated from the propsed project. Any sewage generated will be contained within a
porta-potty and hauled off site by an authorized waste disposal company at the completion of the project.
Page 10 of 11
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?

5c. If yes, indicate the USFWS Field Office you have contacted. ?
Raleigh
® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS Threatened and Endangered Species list for Cleveland County and USFWS letter sent August 4, 2011.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? T[:] Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://ocean.floridamarine.org/efh-coral/ims/viewer.htm and EFH layer on Google Earth
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?
Electronic resources at http://www.hpo.dcr.state.nc.us and National Register of Historic Places layer on Google Earth and
concurrence letter sent to the State Historic Preservation Office on August 4, 2011.
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? The National Flood Hazard Layer (NFHL) for Google
Earth developed by the Federal Emergency Management Agency (FEMA), its mapping partners, and America's
communities. Viewed data from the National Flood Hazard Layer as an overlay in Google Earth.
&, r'le M C" 9-411
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 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. A/IA PLAN NO. N/A PARCEL ID: (001?6
STREETADDRESS: Trar1Scb IZ?ah?-0?-LJ , ??,r?. Ib-[b01-$i,?{ gyp}
:Fonders rar4A, , Gr_? NC zn Cie-jelonA & 41
Please print:
Property Owner: Trne%q D Pr4n, Mr. Randall Flowers
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
&CL"Jeyl M, Q.Prk of Su6rnar?,Tnc..
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, Issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
o1b00 Fbs+ Oak &LIe-varA . ?buS?rm , TX °17015(o
Telephone: `I13 - PICT - 34al
We hereby certify the above Information submitted In this application Is true and accurate to the
best of our knowledge.
(Yl• Clckk
Authorized Signature
Date: W' )q I I 1
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805 Dunn Street PROJECT TITLE:
Houma, LA 70360 Shallow Cover and Pipeline Exposure -?
Phone [phone]
Fax: [phone] Repairs in Ponders Branch W / /dims Gas Pipelines
Email: [e-mail] Cleveland County Transco
Website: www.submar.com
Grover, North Carolina
SOURCE: DeLorme Street Atlas USA 2009 DRAWING NO.: 10433 DATE: 08104/2011 SHEET TITLE: Vicinity Map SHEET., Figure 1
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805 Dunn StreetPROJECT TITLE:
9Houma, LA 70360 Shallow Cover and Pipeline Exposure
Phone: [phone] Williams
Fax [phone] `'�' Repairs in Ponders Branch � Gas Pipelines
Email submar@submarcom Cleveland County Transco
Website www.submarcom
>�k Grover, North Carolina
SOURCE: USGS 7.5 Minute Topo, "Grover, NC".Map dated 1996. DRAWING NO.: 10433 DATE: 08/04/2011 SHEET TITLE: Topo Map SHEET: Figure 2

805 Dunn Street PROJECT TITLE:
Houma, LA 70360 Shallow Cover and Pipeline Exposure -?
Phone: [phone] ??//lams
Fax: [phone] Repairs in Ponders Branch Gas Pipelines
Email: [e-mail] Cleveland County Transco
Website: www.submar.com
i' Grover, North Carolina
SOURCE: Google Earth, 2008 Imagery I DRAWING NO.: 10433 DATE: 0 810412 01 1 SHEET TITLE: Aerial Map SHEET: Figure 3 1
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805 Dunn Street
Houma, LA 70360
Phone: [phone]

Fax.' 985-851-0108- PROJECT TITLE:
Shallow Cover and Pipeline Exposure

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Email: submar@submaccom Cleveland County Transco
Website: www.submar.com
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Grover, North Carolina
SOURCE: Site Visit June 6, 2011 DRAWING NO.: 10433 DATE: 08/04/2011 SHEET TITLE: Site Photos SHEET: Figure 4
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