20091266 Ver 1_Stream Call Letter_20111007

NC DWQ Stream Identification Form Version 4.11
Date: Pro ect/Site: Latitude:
Evaluator: County: Longitude:
Total Points

Stream is at least intermittent Stream Determination circle one
- Other
if a 19 or perennial ifz 30' Ephemera Intermittent Perennial e.g. Quad Name: (, ;; SE
A.. Geomorphology (Subtotal= )
1 a. Continuity of channel bed and bank Absent
0 Weak Moderate
2 Strong
3
2. Sinuosity of channel along thalweg 1 2 3
3. In-channel structure: ex. riffle-pool, step-pool,
ripple-pool sequence ( 1 2
3
4. Particle size of stream substrate 0' 1 2 3
5. Active/relict floodplain 0 ?J 2 3
6. Depositional bars or benches 0? 1 2 3
7. Recent alluvial deposits (Qy 1 2 3
8. Headcuts (a 1 2 3
9. Grade control 0.5 1 1 5
10. Natural valley 0 O. 1 1.5
11. Second or greater order channel (No 0` Yes = 3
arnnciai ditches are not rated; see discussions in manual
B. Hydrology Subtotal = !.
12. Presence of Baseflow (0 1 2 3
13. Iron oxidizing bacteria (0 1 2 3
14. Leaf litter 1.5 1 _ 0
15. Sediment on plants or debris 0 10? 1 1.5
16. Organic debris lines or piles 0 6 3 1 1.5
17. Soil-based evidence of high water table? No=0 es = 3
%.o
18. Fibrous roots in streambed 3 ?- 1 0
19. Rooted upland plants in streambed 3 2 0
20. Macrobenthos (note diversity and abundance) Q 1 2 3
21. Aquatic Mollusks 0 : 1 2 3
22. Fish 0 0.5 1 1.5
23. Crayfish 0 G 0.5 1 1.5
24. Amphibians a 0 0.5 1 1.5
25. Algae 0.5 1 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other=b
'perennial streams may also be identified using other methods. See p. 35 of manual
Notes:

Sketch:
NC DWO Stream Identificatinn Farm Vprvil n d 11 1R?Z?6
Date: ,1 I ProjectlSite: Latitude:
Evaluator. (
ft'? l I ur; ; County: l Longitude:
Total Points:
Stream is at least intermittent
* Stream Determination (circle one)

E
heme
l I
r
n
l) Other
iiz 19 or perennial irz 30 p
ra
ntermittent pe
e
nia e.g. Quad Name: r,cOi ! S
A.. ueomor solo (Subtotal
8 Absent Weak Moderate Strong
1
. Continuity of channel bed and bank 0 1 '?-2,) 3
2. Sinuosity of channel along thalweg 0 2 3
3. In-channel structure: ex. riffle-pool, step-pool,

ripple-pool sequence 0 1 ( 3
4. Particle size of stream substrate 0 `
1 2 3
5. Active/relict floodplain 01
2 3
6. Depositional bars or benches 0 1 r2 3
7. Recent alluvial deposits 0 1' 2 3
-
B. Headcuts 0 1 2 3
9. Grade control 0-5 1 1.5
10_ Natural valley 0 0.5 1
11. Second or greater order channel IN , Yes = 3
?.?. •? ?? _ a.=u, -v uixussiuns in manual
B. Hvdroloov (Subtotal = n
12. Presence of Baseflow 0 1 2 47) .
13. Iron oxidizing bacteria '0) 1 2 3
14. Leaf litter 1 0.5 0
15. Sediment on plants or debris 0 0.5 1., 1.5
16. Organic debris lines or piles
17. Soil-based evidence of high water table? 0 0.5
No = 0 1 1-5
Yes =.
18. Fibrous roots in streambed /3 2
1 0
19. Rooted upland plants in streambed 3
2 1 0
20. Macrobenthos (note diversity
and abundance) 0 1'
, 2 3
21. Aquatic Mollusks ?;0"- 1 2 3
22. Fish 0 0.5 1 ?
23. Crayfish ATE 0.5 1 1.5
24. Amphibians 0 0.5
1.5
25. Algae i0 0.5 1 1.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 61?? y 0
'perennial streams may also be identified using other methods. See p. 35 of manual. -
Notes:

Sketch:
t;

.., .. P4/fn n;j I .. ( ,
d?OF W A rFgQG Michael F. Easley, Governor
9 ?aA k4 J? a S5 r Willinnr G. Ross Jr., Secretary
r t „ North Carolina Department of Environment and Natural Resources
J ?
p Colleen Sullins, Director
Division :ofWater Quality
Stream Origin Determination
Applicant/Owner's Name (corporation/individual who is legally responsible for the property and its compliance
C14? OT C7oloh ofo
Applicant/Owner Address: d 7r_W? ) _CL(-D5j 0r0 ?__ 743
------
Applicant's phone number: f S ?L? 43 33_ Fax number:
Applicant's email address:
Consultant/Contact person Name (if
6
Consultant address (if applicable): rO t)19? _ 1050(o C-70 /(YS L-10rO a.:? S3Z_
Consultant's phone number: Fax number:
Consultant's email address: d3 '77'lU? tw' 6111,?Cf ?01?+'??C' Y'?
ect: ln, (/ ®Yh F ,_ l . _ _ Y: j'?
Name of Pro' Count
j_-__-
Nearest Named stream -1• River Basin (from USGS topographic map):
U `T -h) Please provide a brief description of this project (attach site plan if available):
Location of project site - please include reference to the county, nearest named town and highway number:
Has any DWQ staff visited the site7_/V0, if yes, please provide DWQ staff name, and date of
visit:
This form may be submitted via email (chris.pullinger(l?ncmail.netfaxed (252-946-9215), mailed or hand-delivered to:
943 Washington Square Mall, Washington, NC 27889. (Note: Sub+rrittals of the review packages on hriday after 12:00 pm will
be stamped as received on the ne-v business da)).
Please contact Chris Pullinger at 252-948-3920 if you have any questions regarding this form.
North Carolina Division of Water Quality Internet: h2o.enr.state.ne.us
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolina
11 1 - 0 - . - It. .
Please attach a map of site location indicating project boundaries using USGS 1:24,000 topo map and NRCS county soil survey.
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