20120100 Ver 1_401 Application_20120212

� F
The
Catena
410 B Millstone Drive
Group Hillsborough NC 27278
[phone]
Mr John Thomas
US Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Hentage Trade Drive Suite 105
Wake Forest NC 27587
D January 31 2012
FEB - 2 2012
WETLANDaS
AN TORE WA E' BRANCH
Subject Winston Salem Employee Credit Union Stream Bank Stabilization and Soil
Remediahon Protect — PCN Submittal NWP #13 and #27
Forsyth County North Carolina
Dear Mr Thomas
The Catena Group Inc (Catena) has been retained by the City of Winston Salem through Griffith
Enterprises Inc to assist in acquiring the necessary environmental permits for their property in Forsyth
County NC
The site located adjacent to the current Winston Salem Credit Union (Forsyth County PIN Numbers
6835 52 0604 6835 42 8267 6835 42 7543 and 6835 41 1126) is approximately 5 74 acres It is
bordered to the south by the perennial Salem Creek and to the west by a perennial Unnamed Tributary
(UT) to Salem Creek The site was once used as a repository (circa 1940) for waste fly ash and is
currently covered by a layer approximately 6 8 feet thick (approximately 30 000 tons) that extends
throughout the banks of both streams The banks on both streams are both quite steep and eroding
resulting in fly ash entering the waterways and due to the thickness of the fly ash the banks will likely
remain unstable and continue to degrade for the foreseeable future
The City of Winston Salem currently holds a Phase I NPDES permit to manage stormwater runoff Salem
Creek identified as one of the most polluted streams in the area is on the 303d list due to stormwater
impacts The North Carolina Division of Water Quality has instituted a Total Maximum Daily Load
(TMDL) for Salem Creek for Biological Impairment with which the city must comply The City has
prepared a Water Quality Recovery Plan for this watershed and the proposed activities of this permit are
part of that plan
The City of Winston Salem proposes to remove the fly ash and dispose of it offsite In conjunction with
the removal the right descending bank of Salem Creek and the left descending bank of UT to Salem
Creek will be graded and stabilized following standard stream restoration procedures In addition a rock
bolder vein (7 feet long by 4 feet tall by 4 feet wide) will be installed in the river to help protect and
stabilize the newly graded bank
Please find enclosed the completed PCN form and attachments necessary for Nationwide Permits # 13 and
#27 We are very appreciative of your time and assistance with this matter If you have any questions
please contact me at 919 732 1300

Sincerely
)nlcR�Q 6 to'a
Michael Wood
The Catena Group, Inc
Enclosures PCN Form and Attachments
CC
NCDWQ US Fish & Wildlife Service
401/Wetlands Unit 160 Zillicoa Street
1650 Mail Service Center Asheville NC 28805
Raleigh NC 27699 1650
Alan Griffith
Griffith Enterprises
353 Jonestown Road #312
Winston Salem NC 27104

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIP'T'ION
PARCEL ID #
STREET ADDRESS
PROPERTY OWNER(S)
6835 -52 0604
Liberia Street
City of Winston Salem
6835 -42 8267
Alder Street
City of Winston Salem
6835 -42 -7543
Not Available
City of Winston Salem
6835 -41 -1126
Waughtown Street
City of Winston Salem
The undersigned registered property owner(s) of the above noted property do hereby authorize
Michael Wood of The Catena Group
(Contractor /Agent) (Name of Consulting Firm)
to act on the behalf of, and take all necessary actions for the processing issuance and acceptance
of an environmental pernut or certification and any and all standard conditions attached
Property Owner's Address (if different than above named property)
City of Winston Salem
Atan Keith Huff: Stormwater Division
P.O Box 2511
Winston- Salem. NC 27102
Telephone [phone]
Mobile [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge
-y4R,t- ��
(Alkhonzed Signature) Huff
Date /Z�2®�i
d
(Authorized Signature) Wood
Date 1214111

O�O c; \N AT 1
Office Use Only
Corps action ID no
DWQ project no
Form Version 13 Dec 10 2008
Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification PC Form
A Applicant Information
1
Processing
1 a
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 13 and 27 or General Permit (GP) number
1 c
Has the NWP or GP number been venfied by the Corps?
❑ Yes ® No
Id
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 1 h
below
❑ Yes ® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)
❑ Yes ® No
2
Project Information
2a
Name of project
Winston Salem Employee Credit Union Stormwater Pond
2b
County
Forsyth
2c
Nearest municipality / town
Winston Salem
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
City of Winston Salem Attn Keith Huff Stormwater Division
3b
Deed Book and Page No
3c
Responsible Party (for LLC if
applicable)
r� 6
3d
Street address
P O Box 2511 ,-
3e
City state zip
Winston Salem NC 27102
3f
Telephone no
336 727 6962
3g
Fax no
3h
Email address
Page 1 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
4c
Business name
(if applicable)
4d
Street address
4e
City state zip
4f
Telephone no
4g
Fax no
4h
Email address
5
Agent/Consultant Information (if applicable)
5a
Name
Michael Wood
5b
Business name
(if applicable)
The Catena Group Inc
5c
Street address
410 b Millstone Drive
5d
City state zip
Hdisboroigh NC 27278
5e
Telephone no
919 732 1300
5f
Fax no
919 732 1303
5g
Email address
mwood @thecatenagroup com
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)
6835 52 0604 6835 -42 8267 6835 -42 7543 6835 -41
1126 (Forsyth County PIN numbers)
1 b Site coordinates (in decimal degrees)
Latitude 36 086 Longitude 82 237
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
5 74 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc) to
Salem Creek (Middle Fork Muddy Creek)
proposed project
2b Water Quality Classification of nearest receiving water
C
2c River basin
Yadkin
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 majority of the proposed site is buned in 30 000 tons of fly ash (deposited in the 1940s) approximately 6-8 feet deep
which is evident in the eroding banks of Salem Creek The site is adjacent to the Winston Salem Employees Credit Union
on the north side of Salem Creek
3b List the total estimated acreage of all existing wetlands on the property
No wetlands were observed on site during field investigations
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
Salem Creek 500
Total 500 ft
3d Explain the purpose of the proposed project
As part of the City of Winston Salem s Water Quality Recovery Plan to reduce pollutant loading in Salem Creek
approximately 30 000 tons of fly ash some of which is eroding into Salem Creek will be removed and the affected banks
graded and stabilized
3e Describe the overall project in detail including the type of equipment to be used
Approximately 30 000 tons of will be removed from the site using traditional construction equipment Approximately 500
linear feet of the right descending stream bank of Salem Creek will be restored and stabilized through grading and using
with geotextile matting and native riparian vegetation as detailed on the attached plans In addition a rock boulder vane
(7ft long x 4ft tall x 4ft wide) will be installed near the downstream end of the restored bank
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments There are no wetlands and two streams as noted
on plans of which only Salem Creek will be impacted
4b If the Corps made the jurisdictional determination what type
0 preliminary ❑ Final
of determination was made?
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
[4—d 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
1a 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
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P [IT
❑ 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
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
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 SPOT
bank stabilization
Salem Creek
® PER
❑ INT
® Corps
® DWQ
25
500
S2 SPOT
rock boulder vane
Salem Creek
® PER
® Corps
25
7ft long x
4ft tall x
(fill)
❑ INT
® DWQ
Oft wide
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
500
31 Comments The right descending bank of Salem Creek will be impacted
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
01 ❑ PC] T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 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 any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse El Tar Pamlico El Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
im act
required?
131 [-]PST
❑ Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments Project is in Yadkin River Basin (Forsyth County) no protected buffers
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
The project has been deisgned to reduce and mimize the impacts of the current layer of fly ash which is eroding into Salem
Creek The removal of the fly ash will result in reduced impact to downstream ecosystems
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
1 Temporay construction entrance created off of Salem Avenue 2 Silt fence with stone outlets will be installed along Salem
Creek side of property 3 Temporary diversions and slope drains will be installed 4 When vegetation is removed roots will
be mechanically shaken to remove as much fly ash as possible 5 Contaminated soil and vegetation will be disposed of off
site 6 Erosion control measures inspected weekly and after each significant rain event 7 All disturbed areas will be
seeded 8 Ground cover will be established within 15 working or 21 calendar days (whichever is shorter) following completion
of any phase of grading 9 Permanent groundcover for all disturbed areas within 15 working days or 90 calendar dayy
(whichever is shorter) 10 Silt fence will remain in place until approval from engineer
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
❑ 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
la
Does the project include or is it adjacent to protected riparian buffers identified
El 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 The project only involves streambank
stabilization
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative 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?
City of Winston Salem
❑ 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
4a
Which of the following state implemented stormwater management programs apply
❑ HQW
❑ 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 9 of 11
PCN Form — Version 13 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
®Yes ❑ No
use of public (federal /state) land
lb
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 applications
❑ 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 quality9
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
N/A
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?
El Raleigh
5c If yes indicate the USFWS Field Office you have contacted
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCNHP GIS data
6 Essential Fish Habitat (Corps Requirement)
6a WIII this project occur in or near an area designated as essential fish habitats
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
USACE data
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a WIII 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?
SHPO GIS data Site ID FY2402 Happy Trails Truss Bridge There will be no Impacts to this resource
8 Flood Zone Designation (Corps Requirement)
8a WIII this project occur In a FEMA designated 100 year floodplain?
® Yes ❑ No
8b If yes explain how project meets FEMA requirements It will Increase floodplain capacity so positive Impact
8c What source(s) did you use to make the floodplain determination? www floodmaps nc gov
Michael G Wood
6
1/31/2012
Applicant/Agent s Printed Name
Applicant/Agent s Signature
Date
(Agents signature is valid only rf an authorization letter from the applicant
is provide d
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

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