20210111 Ver 1_Steeplechase Rd PJD_20210305

Preliminary ORM Data Entry Fields for New Actions
ACTION ID#: SAW- Begin Date(Date Received):
Prepare file folder n Assign Action ID Number in ORM n
1. Project Name [PCN Form A2a]: 17BP.7.R.128 (B-4956) Bridge No. 25
2. Work Type: ❑Private Institutional nGovernment ❑Commercial
3. Project Description/Purpose[PCN Form B3d and B3e]:
REPLACE BRIDGE NO.25 OVER POLECAT CREEK
ON SR 1105(EAST STEEPLE CHASE ROAD)
GUILFORD COUNTY
B-4956
4. Property Owner/Applicant [PCN Form A3 or A4]: Mike Mills, NCDOT Div 7 Engineer- mmills@ncdot.a
5. Agent/Consultant[PNC Form A5—or ORM Consultant ID Number]:
Axiom Environmental
6. Related Action ID Number(s) [PCN Form B5b]: N/A
7. Project Location—Coordinates, Street Address, and/or Location Description[PCN Form B lb]:
35.953615, -79.811838 SR 1105 (East Steeple Chase Road)
8. Project Location—Tax Parcel ID [PCN Form Bla]: Multiple, NCDOT project
9. Project Location—County[PCN Form A2b]: Guilford
10. Project Location—Nearest Municipality or Town[PCN Form A2c]: Greensboro
11. Project Information—Nearest Waterbody[PCN Form B2a]: Polecat Creek
12. Watershed/8-Digit Hydrologic Unit Code[PCN Form B2c]:03030003
Authorization: Section 10 ❑ Section 404 n Section 10 and 404 ❑
Regulatory Action Type:
_ Standard Permit Pre-Application Request
Nationwide Permit# Unauthorized Activity
Regional General Permit# IR Compliance
✓Jurisdictional Determination Request No Permit Required
Revised 20150602

Jurisdictional Determination Request
F F
F1RFF
US Army Corps
of Engineers
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination(JD)from the
U.S. Army Corps of Engineers, Wilmington District(Corps). Please include all supporting
information, as described within each category,with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www.saw.usace.armv.mil/Missions/RegulatorvPermitPro>cram/Contact/CountvLocator.asvx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE&CHARLOTTE REGULATORY WASHINGTON REGULATORY FIELD OFFICE
FIELD OFFICES US Army Corps of Engineers
US Army Corps of Engineers 2407 West Fifth Street
151 Patton Avenue,Room 208 Washington,North Carolina 27889
Asheville,North Carolina 28801-5006 General Number:[phone]
General Number:[phone] Fax Number:[phone]
Fax Number:[phone]
WILMINGTON REGULATORY FIELD OFFICE
RALEIGH REGULATORY FIELD OFFICE US Army Corps of Engineers
US Army Corps of Engineers 69 Darlington Avenue
3331 Heritage Trade Drive,Suite 105 Wilmington,North Carolina 28403
Wake Forest,North Carolina 27587 General Number:910-251-4633
General Number:[phone] Fax Number:[phone]
Fax Number:[phone]
INSTRUCTIONS:
All requestors must complete Parts A,B,C,D,E,F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency,please note the specific submittal requirements in Part H.
NOTE ON PART D—PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s)or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D-NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation(NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service,prior to starting work.
Version:May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: SR 1105 (East Steeple Chase Rd) Bridge 25
City, State: Greensboro, NC
County: Guilford
Parcel Index Number(s)(PIN): N/A
B. REQUESTOR INFORMATION
Name: Jerry Parker, NCDOT, Division 7 DEO
Mailing Address: 1584 Yanceyville Street
Greensboro, 27415-4996
Telephone Number: [phone]
Electronic Mail Address: [e-mail]
Select one:
❑ I am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant)
❑ Interested Buyer or Under Contract to Purchase
❑✓ Other,please explain. JD request for bridge replacement; lanc
C. PROPERTY OWNER INFORMATION2
Name: Mike Mills, NCDOT Div 7 Engineer
Mailing Address: 1584 Yanceyville Street
Greensboro, 27415-4996
Telephone Number: [phone]
Electronic Mail Address: [e-mail]
' Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request(copy of Deed,County GIS/Parcel/Tax Record).
Version:May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,a
By signing below,I authorize representatives of the Wilmington District,U.S. Army Corps of
Engineers(Corps)to enter upon the property herein described for the purpose of conducting on-
site investigations,if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I,the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Print Name
Capacity: ❑ Owner ❑Authorized Agents
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑✓ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
8 A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:_
3 For NCDOT requests following the current NCDOT/USACE protocols,skip to Part E.
4 If there are multiple parcels owned by different parties,please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version:May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION(JD)TYPE (Select One)
❑✓ I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination(PJD)provides an indication that there may
be"waters of the United States"or"navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional"waters of
the United States". PJDs cannot be appealed(33 C.F.R. 331.2);however, a PJD is
"preliminary"in the sense that an approved JD can be requested at any time. PJDs do
not expire.
❑ I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination(AJD)is a determination that
jurisdictional"waters of the United States"or"navigable waters of the United
States"are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable(33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner,permit applicant, or other"affected
party"(33 C.F.R. 331.2)who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
I I Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 4.16 acres.
❑ The property boundary(or review area boundary) is clearly physically marked on the site.
Version:May 2017 Page 4

Jurisdictional Determination Request
H REQUESTS FROM CONSULTANTS
❑✓ Project Coordinates(Decimal Degrees): Latitude: 35.953615
Longitude: -79.811838
nA legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
■ Graphical Scale
• Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US,404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non-wetland features(i.e.tidal/navigable waters,tributaries,
impoundments) should be labeled as Non-Wetland Waters of the US, stream,tributary,
open water, relatively permanent water,pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters, waters that lack a significant nexus to navigable waters, or non-
jurisdictional upland features should be identified as Non-Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional(i.e.
"Isolated", "No Significant Nexus", or"Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
■ Wetland and non-wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non-wetland Waters of
the United States,wetland, stream,open water, etc. Please include the acreage and
linear length of these features as appropriate.
✓� Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled"Survey Standards for Jurisdictional Determinations"to ensure that the
supplied map meets the necessary mapping standards.http://www.saw.usace.armv.mil/Missions/Reeulaton-Permit-
Program/Jurisdiction/
Version:May 2017 Page 5

Jurisdictional Determination Request
▪ Completed appropriate Jurisdictional Determination form
• PJDs1 please complete a Preliminary Jurisdictional Determination Form7 and include the
Aquatic Resource Table
• AJDs,please complete an Approved Jurisdictional Determination Form8
✓❑ Vicinity Map
❑✓ Aerial Photograph
• USGS Topographic Map
n Soil Survey Map
▪ Other Maps, as appropriate(e.g.National Wetland Inventory Map, Proposed Site
Plan,previous delineation maps, LIDAR maps,FEMA floodplain maps)
▪ Landscape Photos (if taken)
▪ NCSAM and/or NCWAM Assessment Forms and Rating Sheets
aNC Division of Water Resources Stream Identification Forms
▪ Other Assessment Forms
' www.saw.usace.armv.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 AB) A Prelim JD Form fillable.pdf
8 Please see http://www.saw.usace.armv.mil/Missions/Regulatorv-Permit-Pro ,ram/Jurisdiction/
Principal Purpose:The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses:This information may be shared with the Department of Justice and other federal,state,and local
government agencies,and the public,and may be made available as part of a public notice as required by federal
law.Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination(AJD),which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure:Submission of requested information is voluntary;however,if information is not provided,the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version:May 2017 Page 6

ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
North Carolina Department of Transportation, Highway Division 7
1584 Yanceyville Street, Greensboro NC, 27415-4996
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Replace 17BP.7.R.128 (B-4956) Bridge No. 25 over Polecat Creek on
SR 1105 (East Steeple Chase Road)
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES
AT DIFFERENT SITES)
State: North Carolina County/parish/borough: Guilford County City:
Greensboro
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.953615°, Long. -79.811838°
Name of nearest waterbody: Polecat Creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters: 284 linear feet: 4-10 width (ft)
Cowardin Class: R3UB2
Stream Flow: Perennial
Wetlands: <0.01 acres
Cowardin Class: PFO1
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: 0
Non-Tidal: 0
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
1

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre-construction notification" (PCN), or requests verification for a non-reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there "may be"waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
2

SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply
- checked items should be included in case file and, where checked and
requested, appropriately reference sources below):
X Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
X Data sheets prepared/submitted by or on behalf of the
applicant/consultant.
Office concurs with data sheets/delineation report.
Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
USGS NHD data.
USGS 8 and 12 digit HUC maps.
X U.S. Geological Survey map(s). Cite scale & quad name: Pleasant
Garden, NC (1970) 7.5-minute topographic quadrangle.
X USDA Natural Resources Conservation Service Soil Survey. Citation:
Web Soil Survey (online at http://websoilsurvey.nrcs.usda.gov), and Soil
Survey of Guilford County (1977)
National wetlands inventory map(s). Cite name:
State/Local wetland inventory map(s):
FEMA/FIRM maps:
100-year Floodplain Elevation is: (National Geodetic Vertical Datum
of 1929)
X Photographs: IX Aerial (Name & Date): NC OneMap 2014 Orthoimagery.
or Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not
necessarily been verified by the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of Signature and date of
Regulatory Project Manager person requesting preliminary JD
(REQUIRED) (REQUIRED, unless obtaining
the signature is impracticable)
3

Estimated amount
Cowardin of aquatic Class of
Class resource in review aquatic
Site number Latitude Longitude area resource
1. Polecat Creek 35.953731 -79.811825 R3UB2 284 feet length, non-section 10
4-10 feet avg width —non-wetland
2. Wetland WA 35.953824 -79.811697 PFO1 <0.01 acre non-section 10
wetland
4

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� NORTH CAROLINA DEPARTMENT
4 OF TRANSPORTATION
_ I DIVISION OF HIGHWAYS
35
PROJECT DEVELOPMENT AND
—' I 40 "-" a ENVIRONMENTAL ANALYSIS BRANCH
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-I VICINITY MAP
Guilford c
. I' CuBridge No. 25 on East Steeple Chase Road
1-r..
4 _ F a (SR 1105) over Polecat Creek
i42 ---- B-4956
' ( 73 I--- GUILFORD COUNTY WBS 17BP.7.R.128
\o Randolph DECEMBER 2018 FIGURE 1
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Prepared for: Project: Title: Drawn by: AEK
WBS 17BP.7.R.128
I.,, Date: Oct 2018
A �tiReplace Bridge No. 25 onProject StudyScale: 1:1200
fEast Steeple Chase Road Area Project No.:18 007.06
` I over Polecat Creek
' Guilford County, NC FIGURE
Axiom Environmental,Inc_
BackgroundImagery: Pleasant Garden, NC(1970)
7.5-minute topographic quadrangle provided by the U.S.Geological Survey.

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of, Jr • Stream data form location
NCDOT roads
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Prepared for: Project: Title: Drawn by: AEK
WBS 17BP.7.R.128,wi.rH Date: Oct 2018
�.. Replace Bridge No. 25 on Potential Scale: 1:300
East Steeple Chase Road Jurisdictional Project No.:18-007.06
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over Polecat Creek Areas
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� Guilford County, NC FIGURE
Axiom Envlronmantal,Inc.
Background Imagery:2014 aerial photography provided by the NC OneMap Program Jl
(online,supported by the N.C.Geographic Information Coordination Council).

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Prepared for: Project: Title: Drawn by: AEK
WBS 17BP.7.R.128
�Koerrr Date: Oct 2018
Replace Bridge No. 25 on NRCS
East Steeple Chase Road Soil Survey Scale: 1:3600
, /A over Polecat Creek Map Project No.:18-007.06
aFTRa � Guilford County, NC _ FIGURE
Axiom Envlronmanlal,Inc_
BackgroundImagery: Soil Survey of Guilford County(1977),map 39 and
map 45, provided by the Natural Resources Conservation Service(NRCS).

WA_ W(, 7
WETLAND DETERMINATION DATA FORM- Eastern Mountains rand Piedmont Region fj�
Project/Site G- r"Ji Q— t...a CrfE.�K_ City/County: 5 I-+t,Io�+�'I'I.'1 t orr'd Sampling Date: 1 U�O3o
ApplicandOwner: l L DOT State: P c— Sampling Point: W A 03 (•4'E
Investigator(s): 1.'.0."' er'''V.R t 7 o L. Section,Township.Range: J u.k A(�
Landform(hrllslope.terrace,etc.): IL 00 A 1-a t w Local reiel(concave,convex,none): ICd`"ilif{� Slope(%).
P
Subregion(LRR or MLRA)_ (
- l 3 0 LBt: 9]` ' al 3 ).�L 1 Long- 7 ct , �� 1 6 S g Datum: 4�'(y5-5`{
Soil Map Unit Name: (. A - Ll.r,fr EA C l•M 1❑G WI - G-J% 4 s re tit- I i ( fed ,,NWI classification: r fP
Are climatic I hydrologic conditions on the site typical for this time of year? Yes No X" (If no,explain in Remarks.)
Are Vegetation .Soil .or Hydrology significantly disturbed? Are'Normal Circumstances"present? Yes_ram Na
Are Vegetation .Soil ,or Hydrology naturally problem ttic? (If needed.explain any answers in Remarks)
SUMMARY OF FINDINGS -Attach site map showing sampling point locations, transects, important Features, etc.
Hydrophytic Vegetation Present? Yes No
H dric Soil Present? Yes T� Na Is the Sampled Area
y within a Wetland? Yes • No
Wetland Hydrology Present? Yes No
Remarks:
1'+ (t; �kLI t/.7014 It"' & e 41 fe, t.+�•! I.,rt,- ,c u' .
HYDROLOGY
Wetland Hydrology Indicators. Secondary indicators(minimum ol two required)
Primal yIndicators(minimum of one is required:chuck all that apply) _ Surface Soil Cracks(B6)
Surface Water (Al) _ True Aquatic Plants t1314) Sparsely Vegetated Concave Surface(B81
High Water Table(A2) Hydrogen Sulfide Odor(C1) y" Drainage Patterns(B1O)
' Saturation(A3) / Oxidized Rbizospheres on Living Roots(C3) _ Moss Trim Lines(B16)
Water Marks(81) _ Presence of Reduced Iron(C4) _ Dry-Season Water Table(C2)
Sediment Deposits(82) _ Recent iron Reduction in Tilled Soils(C6) _ Crayfish Burrows(C8)
i` Drift Deposits(B3) _ Thin Muck Surface(C7) _ Saturation Visible on Aerial Imagery(C9)
Algal Mat or Crust(B4) — Other(Explain in Remarks) — Stunted or Stressed Plants(Di)
_ iron Deposits(B5) ill Geomorphic Position(D2)
_ Inundation Visible un Aerial Imagery(87) _ Shallow Aquitard(D3)
Y Water-Stained Leaves(B9) i: Microtopographic Relief(04)
Aquatic Fauna(B13) FAC-Neutral Test(D5)
Field Observations: �/
Surface Water Present? Yes No Depth(inches):
Water Table Present? Yes No L(rr Depth(inches):
Saturation Present? Yes No Depth(inches): Wetland Hydrology Present? Yes > No
Oncludes capillary fringe)
Describe Recorded Data(stream gauge.monitoring well.aerial photos,previous inspections). if available.
Remarks:
r)/p pt Pi l t 0..- As S r"f t,,,4.1+-- t t.� )0.or fl ri I R 0 l f pi a 044 - 'C k
US Army Corps of Engineers Eastern Mountains and Piedmont-Version it)

VEGETATION (Four Strata)-Use scientific names of plants. Sanipitng Point: WA 0
Absolute Doninant Indicator Dominance Test worksheet
Iree Stratum (Plot size: -l] D ) %Cover cie ? Number of Dominant Species
1- {Lu14.`) it 7,14 r'4[ is Gam.t. That Are OBL, FACW,or FAC: (A)2. Yf�-*~ tkior:tti-add �j'
Total Number of Dominant
3• Species Across All Strata {B1
4.
Percent of Dominant Species j C]
5. That Are OBL.FACW.Or FAC: (NB)
6.
Prevalence Index worksheet
7.
= Iolal Cover _- Tptral%Cover Of: Multiply by:
50%of total cover: 1 20%of total cover: OBL species x 1
i -
Sapling/Shrub Stratum (Plot size: '1 y FACW species _- x 2
1 FAC species x 3=
2 FACU species x 4.
3. v UPL species x 5
4 Column Totals: (A) let
5
Prevalence Index = BIA=
6
Hydrophytic Vegetation Indicators:
7
1 •Rapid Test for Hydrophytic Vegetation
a.
_ ?•Clnminanrp Iasi is>509r,
9 _ 3-Prevalence Index is s3.0'
total Cover
4 •Morphological Adaptations'(Provide supporting
50%of total cover• -- 20%of total cover: "—
Herb Stratum (Pint size:
1 data in Remarks or on a separate Sheet)
t Prubrernaiic Hydrophytic Vegetation'(Explain)
2 _
Indicators of hydric soil and wetland hydrology muss
3-
be present,unless disturbed or problematic.
4- Definitions of Four Vegetation Strata:
5 -
Tree-Woody plants.excluding vines.3 in.(7-6 cm)or
6 - more in diameter al breast height(DBH),regardless of
7• height
$. �s
Sapling/Shrub-Woody plants.excluding vines.less
9 than 3 in.DBH and greater than or equal to 3.28 ft(1
10. m)tall.
Herb-All herbaceous(non-woody)plants.regardless
= Total Cover of size,and woody plants fess than 3.28 ft tall.
5096 of l cover. 20%of total cover:
Woody vine-All woody vines greater Than 3.28 ft in
(Plot size: riThU height.
•
1. \O3;-1 r Q-Urd+v �u. t���4 ]'.
2.
3.
4.
Hydrophytic
5 _ Vegetation
= Total Cover Present? Yes es Na
50%of total cover: ) 20%of total cover:
Remarks: (Include photo numbers here or on a separate sheet.)
115 Army Corps of Engineers Eastern Mountains and Piedmont-Version 2 0

SOIL Sampling paint: \MI-03A14
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(Inches] Color(moist] 96 Cntar(moist] % Type' Loc7 Texture Remarks
0-3 Ld r-S- tee •
!d 1.5-f_cfa qc (.I'-1 c~ C W1 - Cfk
'Type: C-Concentration. D=Depletion, PM=Reduced Matrix,M5=Masked Sand Grains. 2localion: PL-fore Lining,M-Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
Histosol(Al) _ Dark Surface(57) _ 2 cm Muck(A10)(MLRA 147)
Histic Epipedon(A2) Polyvalue Below Surface(S8)(MLRA 147.14B) „ Coast Prairie Redox(A16)
Black Histic(A3) _ Thin Dark Surface(59)(M1RA 147, 148) (MIRA 147,148)
Hydrogen Sulfide(A4) Loamy Gleyed Matrix(F 2) — Piedmont f Ioodplain Soils(119)
_ Stratified Layers(AS) , Depleted Matrix(I"3) (MLRA 136, 147)
_ 2 cm Muck(A10)(LRR N) _ Redox Dark Surface(F6) _ Very Shallow Dark Surface(TF12)
Depleted Below Dark Surface(A11) r Depleted Dark Surface(F7) _ Other(Explain in Remarks)
Thick Dark Surface(Al2) _ Redox Depressions(FE)
Sandy Mucky Mineral(51)(LRR N. _ Iron-Manganese Masses(F 12)(LRR N,
MLRA 147,148) MLRA 136)
_ Sandy Gleyed Matrix(S4) — Umbric Surface(F13)(MLRA 136,122) '{ndicalors of hydrophytic vegetation and
_ Sandy Redox(55) _ Piedmont Floodpiair►Soils(F 19)(MLRA 148) wetland hydrology must be present,
Stripped Matrix(56) _ Red Parent Material(F21)(MLRA 127, 147) unless disturbed or problematic.
Restrictive Layer(if observed):
Type.
Depth(inches): Hydric Soil Present? Yes No
Remarks: ``
t‘i
US Army Corps of Engineers Eastern Mountains and Piedmont -Version 2 0

vt,iA - uP
+WETLAND DETERMINATION DATA FORM- Eastern Mountains and Pied
rm ont Region _
Project/Site: I IV-;i .,PO le WA- (�Qe City/County; �c.Q11rf/P�j{?[., . i'G'w Sampling Date: 1 (� LI
Applicant/Owner: Iv C-GQ I// Slate: W� Sampling Point: (YR'0)(f/-2
Investigator(s): 4 )!'I to r'r per k!,>!$s'.._ Section,Township,Range: u A---y—
Landform -r(hillslope.terrace,etc.): T`ifpudAl ict i w, Local reiel(concave,convex,none). GUP/C 4.G-� Slope(%):
Subregion(LRR or MLRA) Lai: C L. Long: - 7t 16 Dacum [,taros iry
Soil Map Unit Name: (-IA':r.-4c oz, 2 •--r .[r'r Ir 14r I classification: /14-
Are climatic/hydrologic conditions on the site typical for this time of year? ':'es No_ x (if no,explain in Remarks.)
Are Vegetation •Sod .or Hydrology significantly disturbed? Are'Normal Circumstances'present? Yes i`r_ No
Are Vegetation ,Soil ,or Hydrology naturally problenittic? (If needed,explain any answers in Remarks.)
SUMMARY OF FINDINGS— Attach site map showing sampling point locations,transects, important features, etc.
Ftydrophytic Vegetation Present'? Yes K No
Is the Sampled Area
Hydne Soil Present? Yes No z••• within a Wetland? Yes No
. k/
Wetland Hydrology Present'? Yes ' No
Remarks:
10Cu� Pad' c-(..00U ii(Clit � v" -,7, - "-`trl.-w, e'Ir', ; '. AT•. C i 1101oCi -ram r
HYDROLOGY
Wetland Hydrology Indicators: Secondary IndiCalors(minimum of two required).
Primary Indicators(minimum of one Is required:check all that aeply) _ Surface Soil Cracks(BG)
Surface Water(Al) — True Aquatic Plants 0314) _ Sparsely Vegetated Concave Surface(68)
High Water Table(A2) _ Hydrogen Sulfide Odor(C1) _ Drainage Patterns(610)
_ Saturation(A3) r Oxidized Rhiiospheres on Living Roots(C3) _ Moss Trim Lines(816)
Water Marks(131) Presence of Reduced Iron(C4) Dry-Season Water Table(C2)
Sediment Deposits(132) Recent Iron Reduction In Tilled Soils ICS) Crayfish Burrows(C8)
Drift Deposits(B3) w Thin Muck Surface(C7) _ Saturation Visible on Aerial Imagery(C9)
• Algal Mat or Crust(134) „, Other(Explain in Remarks) _ Stunted or Stressed Plants(Di)
_ iron Deposits(135) /. Geomorphic Position(D2)
Inundation Visible on Aerial Imagery(67) _ Shallow Agwtard(D3)
Water-Stained Leaves(89) Microtopograpluc Relief(04)
Aquatic Fauna(1313) _ FAC-Neutral Test(D5)
Field Observations: •
,
Surface Water Present? Yes No X Depth(inches): r/0.
Water Table Present? Yes No X( Depth(inches): 7 rd
Saturation Present? Yes No • Depth(inches): ''fr.,. Wetland Hydrology Present? Yes I No
(includes capillary fringe)
❑escribe Recorded Data(stream gauge,monitoring well,aerial photos.previous inspections),if available
Remarks:
\API..--Af- 1)
US Army Corps of Engineers Eastern Mountains and Piedmont-Version 2.0

VEGETATION (Four Strata)— Use scientific names of plants. Sampling Point- I"'If i,t .
"� Absolute porainant Indicator Dominance Test worksheet:
tree Stratum (Pint size: !0 1 4f Cover SdECjeS? Number of Dominant Species
1• g l j ,�tt/][4 1I[ I�t• 1� � • t��lC�Q( ' That Are OBL.FACW,or FAC: (A)
2. WA C'r �rI; Ct
Total Number of Dominant
3. Species Across All Strata (8)
4.
Percent of Dominant Species 7 C
5. That Are OBL. FACW.or F AC: !' to (AIR)
6.
Prevalence index worksheet:
7
f 0 Total Cover Total%Cover of: Multiply Ca
50%of total cover. .5— _ 20%of total cover;_ -a 0B1 species x 1 - _
Sapling/Shrub Stratum (Plot size: l ) FACW species x 2=
1. 'CLx•`f}i+..0) t u•'0 C1$L FAC species x 3=
2 FACU species x 4
3 UPL species x 5
d. Column Totals: IAI 081
5.
Prevalence index =81A =
6
Hydrophytic Vegetation Indicators:
7.
1 -Rapid Test for Hydrophytic Vegetation
8.
- _ 7-[)nminanra Tact is,•Sf1%
9
_ 3-Prevalence Index is 53.0'
-;: = Total Cover 4-Morphological Adaptations'(Provide supporting
50%of total cover. (0 20%of total cover:
Herb Stratum (Plot sire: data in Remarks or on a separate sheet)
Piutrlernatic Hydtuphyhc Vegetation' (Explairi)
2.
-- 'Indicators of hydric soil and wetland hydrology must
3. - be present.unless disturbed or problematic.
4' Definitions of Four Vegetation Strata:
5
S Tree-Woody plants.excluding vines.3 in.(7.6 cm)or
- - more in diameter at breast height(D8F1).regardless of
7- height.
8.
SaplinglShrub-Woody plants,excluding vines,less
9. !Flan 3 in.DBH and greater than or equal to 3.28 ft(1
10. m)tall
11. - Herb-All herbaceous(non woody)plants.regardless
= Total Cover of size,and woody plants less than 3.28 ft tail.
50%of total cover: 20%of total cover:
Woody Vine stratum (Plot s (J ) Woody vine-All woody vines greater than 3.28 ft in
1. _ ! alt��h ) tLYeize:II((k '1 6 t-" •.dtil
2-
3
4.
- _ Hydrophytrc
5 Vegetation
0 = Total Cover Present? Yes No
•
50%of total cover: I 20%of total cover xi
Remarks: (Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont-Version 2.0

SOIL Sampling Point; ��_ u.
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
1inches� Color(mast} % Color(moist) % TyoeT Loci Texture Remarks
�v(: 3 toil
0.) 1- ([fir 57L1 1 f Q IVI r- r
'Type: C=Concentration.D=❑epleuon,RM=Reduced Matrix,MS=Masked Sand Grains. 'Location: PL=fare tinrnq,M-Matrix
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
Histosoi(Al) _ Dark Surface(57) _ 2 cm Muck(AID)(MLRA 147)
Histic Epipedon(A2) _ Poiyvalue Below Surface(S8)(MLRA 147, 148) _ Coast Prairie Redox(Ale)
Black Histic(A3) _ Thin Dark Surface(59)(MLRA 147, 148) (MLRA 147,148)
_ Hydrogen Sulfide(A4) _ Loamy Gleyed Matrix(f 2) Piedmont Floodplain Soils(F 19)
Stratified Layers(AS) — Depleted Mat,ix(13) {MLRA 136,147)
2 cm Muck(A10)(LRR N) _ Redox Dark Surface(F6) _ Very Shallow Dark Surface(TF12)
Depleted Below Dark Surface(Al 1) — Depleted Dark Surface(F 7) .__. Other(Explain in Remarks)
_ thick Dark Surface(Al2) _ Redox Depressions(Fe)
Sandy Mucky Mineral(51)(LRR N. Iron-Manganese Masses(F12)(LRR N,
MLRA 147,148) MLRA 136)
Sandy Gleyed Matrix(54) , Umbrir:Surface(F13)(MLRA 136. 122) 'Indicators of hydrophytic vegetation and
Sandy Redox(55) Piedmont Floodplain Soils(F 19)(MLRA 148) wetland hydrology must be present,
_ Stripped Matrix(56) _ Red Parent Material(F21) (MLRA 127,147) unless disturbed or problematic.
Restrictive Layer(if observed):
Type
Depth(inches): Hydric Soil Present? Yes No ,
Remarks:
1 1
US Army Corps of Engineers Eastern Mountains and Piedmont-Version 2.0

NC WAM FIELD ASSESSMENT RESULTS
Accompanies User Manual Version 5.0
USACE AID# NCDWR#
Project Name Bridge 25 Date of Evaluation 181030
Applicant/Owner Name NCDOT Wetland Site Name WA
Wetland Type Bottomland Hardwood Forest Assessor Name/Organization Perkinson/Axiom
Level III Ecoregion Piedmont Nearest Named Water Body Polecat Creek
River Basin Cape Fear USGS 8-Digit Catalogue Unit 03030003
County Guilford NCDWR Region Winston-Salem
❑ Yes ® No Precipitation within 48 hrs? Latitude/Longitude(deci-degrees) 35.953294, -79.811658
Evidence of stressors affecting the assessment area(may not be within the assessment area)
Please circle and/or make note on the last page if evidence of stressors is apparent. Consider departure from reference, if appropriate, in
recent past(for instance,within 10 years). Noteworthy stressors include, but are not limited to the following.
• Hydrological modifications(examples: ditches,dams, beaver dams,dikes, berms, ponds, etc.)
• Surface and sub-surface discharges into the wetland(examples:discharges containing obvious pollutants,presence of nearby septic
tanks, underground storage tanks(USTs), hog lagoons,etc.)
• Signs of vegetation stress(examples: vegetation mortality, insect damage, disease, storm damage, salt intrusion,etc.)
• Habitat/plant community alteration (examples: mowing,clear-cutting,exotics,etc.)
Is the assessment area intensively managed? ❑ Yes ® No
Regulatory Considerations-Were regulatory considerations evaluated? EYes ❑No If Yes, check all that apply to the assessment area.
❑ Anadromous fish
❑ Federally protected species or State endangered or threatened species
• NCDWR riparian buffer rule in effect
❑ Abuts a Primary Nursery Area(PNA)
❑ Publicly owned property
❑ N.C. Division of Coastal Management Area of Environmental Concern(AEC)(including buffer)
❑ Abuts a stream with a NCDWQ classification of SA or supplemental classifications of HQW, ORW,or Trout
❑ Designated NCNHP reference community
❑ Abuts a 303(d)-listed stream or a tributary to a 303(d)-listed stream
What type of natural stream is associated with the wetland, if any?(check all that apply)
❑ Blackwater
• Brownwater
❑ Tidal (if tidal,check one of the following boxes) ❑ Lunar ❑ Wind ❑ Both
Is the assessment area on a coastal island? ❑ Yes ® No
Is the assessment area's surface water storage capacity or duration substantially altered by beaver? ❑ Yes ® No
Does the assessment area experience overbank flooding during normal rainfall conditions? ❑ Yes ® No
1. Ground Surface Condition/Vegetation Condition—assessment area condition metric
Check a box in each column. Consider alteration to the ground surface(GS)in the assessment area and vegetation structure(VS)in the
assessment area. Compare to reference wetland if applicable(see User Manual). If a reference is not applicable,then rate the assessment
area based on evidence an effect.
GS VS
• ®A Not severely altered
❑B ❑B Severely altered over a majority of the assessment area(ground surface alteration examples: vehicle tracks, excessive
sedimentation, fire-plow lanes, skidder tracks, bedding, fill, soil compaction, obvious pollutants) (vegetation structure
alteration examples: mechanical disturbance, herbicides,salt intrusion[where appropriate],exotic species,grazing, less
diversity[if appropriate], hydrologic alteration)
2. Surface and Sub-Surface Storage Capacity and Duration—assessment area condition metric
Check a box in each column. Consider surface storage capacity and duration(Surf)and sub-surface storage capacity and duration(Sub).
Consider both increase and decrease in hydrology. A ditch <_ 1 foot deep is considered to affect surface water only, while a ditch > 1 foot
deep is expected to affect both surface and sub-surface water. Consider tidal flooding regime, if applicable.
Surf Sub
®A ®A Water storage capacity and duration are not altered.
❑B ❑B Water storage capacity or duration are altered, but not substantially(typically, not sufficient to change vegetation).
❑C ❑C Water storage capacity or duration are substantially altered(typically,alteration sufficient to result in vegetation change)
(examples: draining,flooding, soil compaction,filling, excessive sedimentation, underground utility lines).
3. Water Storage/Surface Relief—assessment area/wetland type condition metric(skip for all marshes)
Check a box in each column. Select the appropriate storage for the assessment area(AA)and the wetland type(WT).
AA WT
3a. ❑A ❑A Majority of wetland with depressions able to pond water> 1 deep
❑B ❑B Majority of wetland with depressions able to pond water 6 inches to 1 foot deep
❑C ❑C Majority of wetland with depressions able to pond water 3 to 6 inches deep
®D ®D Depressions able to pond water<3 inches deep
3b. ❑A Evidence that maximum depth of inundation is greater than 2 feet
❑B Evidence that maximum depth of inundation is between 1 and 2 feet
®C Evidence that maximum depth of inundation is less than 1 foot

4. Soil Texture/Structure—assessment area condition metric(skip for all marshes)
Check a box from each of the three soil property groups below. Dig soil profile in the dominant assessment area landscape feature.
Make soil observations within the top 12 inches. Use most recent National Technical Committee for Hydric Soils guidance for regional
indicators.
4a. DA Sandy soil
®B Loamy or clayey soils exhibiting redoximorphic features(concentrations, depletions, or rhizospheres)
DC Loamy or clayey soils not exhibiting redoximorphic features
❑D Loamy or clayey gleyed soil
❑E Histosol or histic epipedon
4b. ®A Soil ribbon < 1 inch
❑B Soil ribbon>_ 1 inch
4c. ®A No peat or muck presence
❑B A peat or muck presence
5. Discharge into Wetland—opportunity metric
Check a box in each column. Consider surface pollutants or discharges(Surf)and sub-surface pollutants or discharges(Sub). Examples
of sub-surface discharges include presence of nearby septic tank, underground storage tank(UST), etc.
Surf Sub
®A ®A Little or no evidence of pollutants or discharges entering the assessment area
❑B ❑B Noticeable evidence of pollutants or discharges entering the wetland and stressing, but not overwhelming the
treatment capacity of the assessment area
DC DC Noticeable evidence of pollutants or discharges(pathogen, particulate, or soluble)entering the assessment area and
potentially overwhelming the treatment capacity of the wetland (water discoloration, dead vegetation, excessive
sedimentation, odor)
6. Land Use—opportunity metric(skip for non-riparian wetlands)
Check all that apply(at least one box in each column). Evaluation involves a GIS effort with field adjustment. Consider sources draining
to assessment area within entire upstream watershed (WS),within 5 miles and within the watershed draining to the assessment area (5M),
and within 2 miles and within the watershed draining to the assessment area(2M).
WS 5M 2M
DA DA DA > 10%impervious surfaces
DB ❑B ❑B Confined animal operations(or other local, concentrated source of pollutants
DC DC DC >_20%coverage of pasture
❑D ❑D ❑D >_20%coverage of agricultural land (regularly plowed land)
®E EE EE >_20%coverage of maintained grass/herb
❑F OF OF >_20%coverage of clear-cut land
❑G ❑G ❑G Little or no opportunity to improve water quality. Lack of opportunity may result from little or no disturbance in
the watershed or hydrologic alterations that prevent drainage and/or overbank flow from affecting the
assessment area.
7. Wetland Acting as Vegetated Buffer—assessment area/wetland complex condition metric(skip for non-riparian wetlands)
7a. Is assessment area within 50 feet of a tributary or other open water?
EYes ❑No If Yes,continue to 7b. If No,skip to Metric 8.
Wetland buffer need only be present on one side of the water body. Make buffer judgment based on the average width of wetland.
Record a note if a portion of the buffer has been removed or disturbed.
7b. How much of the first 50 feet from the bank is wetland? (Wetland buffer need only be present on one side of the .water body. Make
buffer judgment based on the average width of wetland. Record a note if a portion of the buffer has been removed or disturbed.)
DA >_50 feet
DB From 30 to<50 feet
DC From 15 to<30 feet
®D From 5 to< 15 feet
❑E <5 feet or buffer bypassed by ditches
7c. Tributary width. If the tributary is anastomosed, combine widths of channels/braids for a total width.
®<_ 15-feet wide ❑> 15-feet wide ❑ Other open water(no tributary present)
7d. Do roots of assessment area vegetation extend into the bank of the tributary/open water?
DYes No
7e. Is stream or other open water sheltered or exposed?
®Sheltered—adjacent open water with width <2500 feet and no regular boat traffic.
❑Exposed—adjacent open water with width>_2500 feet or regular boat traffic.
8. Wetland Width at the Assessment Area—wetland type/wetland complex condition metric(evaluate WT for all marshes and
Estuarine Woody Wetland only; evaluate WC for Bottomland Hardwood Forest, Headwater Forest, and Riverine Swamp Forest
only)
Check a box in each column for riverine wetlands only. Select the average width for the wetland type at the assessment area(WT)and
the wetland complex at the assessment area(WC). See User Manual for WT and WC boundaries.
WT WC
❑A DA >_ 100 feet
DB ❑B From 80 to< 100 feet
DC DC From 50 to<80 feet
❑D ❑D From 40 to<50 feet
❑E ❑E From 30 to<40 feet
O F OF From 15 to<30 feet
❑G ®G From 5 to< 15 feet
❑H ❑H <5 feet

9. Inundation Duration—assessment area condition metric(skip for non-riparian wetlands)
Answer for assessment area dominant landform.
ZA Evidence of short-duration inundation(<7 consecutive days)
❑B Evidence of saturation,without evidence of inundation
❑C Evidence of long-duration inundation or very long-duration inundation(7 to 30 consecutive days or more)
10. Indicators of Deposition—assessment area condition metric(skip for non-riparian wetlands and all marshes)
Consider recent deposition only(no plant growth since deposition).
ZA Sediment deposition is not excessive, but at approximately natural levels.
❑B Sediment deposition is excessive, but not overwhelming the wetland.
❑C Sediment deposition is excessive and is overwhelming the wetland.
11. Wetland Size—wetland type/wetland complex condition metric
Check a box in each column. Involves a GIS effort with field adjustment. This metric evaluates three aspects of the wetland area: the
size of the wetland type (WT), the size of the wetland complex (WC), and the size of the forested wetland (FW) (if applicable, see User
Manual). See the User Manual for boundaries of these evaluation areas. If assessment area is clear-cut,select"K"for the FW column.
WT WC FW(if applicable)
❑A ❑A ❑A >_500 acres
❑B ❑B ❑B From 100 to<500 acres
❑C ❑C ❑C From 50 to< 100 acres
❑D ❑D El From 25 to<50 acres
❑E ❑E El From 10 to<25 acres
❑F OF OF From 5 to< 10 acres
❑G ❑G ❑G From 1 to<5 acres
❑H ❑H ❑H From 0.5 to< 1 acre
❑1 01 01 From 0.1 to<0.5 acre
❑J ❑J ❑J From 0.01 to<0.1 acre
®K ®K ®K <0.01 acre or assessment area is clear-cut
12. Wetland Intactness—wetland type condition metric(evaluate for Pocosins only)
❑A Pocosin is the full extent(>_90%)of its natural landscape size.
❑B Pocosin type is<90%of the full extent of its natural landscape size.
13. Connectivity to Other Natural Areas—landscape condition metric
13a. Check appropriate box(es) (a box may be checked in each column). Involves a GIS effort with field adjustment. This metric
evaluates whether the wetland is well connected (Well) and/or loosely connected (Loosely)to the landscape patch, the contiguous
naturally vegetated area and open water(if appropriate). Boundaries are formed by four-lane roads, regularly maintained utility line
corridors the width of a four-lane road or wider, urban landscapes, maintained fields (pasture and agriculture), or open water> 300
feet wide.
Well Loosely
❑A ❑A >_500 acres
❑B ®B From 100 to<500 acres
®C ❑C From 50 to< 100 acres
❑D ❑D From 10 to<50 acres
❑E ❑E < 10 acres
OF OF Wetland type has a poor or no connection to other natural habitats
13b. Evaluate for marshes only.
❑Yes ❑No Wetland type has a surface hydrology connection to open waters/stream or tidal wetlands.
14. Edge Effect—wetland type condition metric(skip for all marshes and Estuarine Woody Wetland)
May involve a GIS effort with field adjustment. Estimate distance from wetland type boundary to artificial edges. Artificial edges include
non-forested areas >_40 feet wide such as fields, development, roads, regularly maintained utility line corridors, and clear-cuts. Consider
the eight main points of the compass. Artificial edge occurs within 150 feet in how many directions? If the assessment area is clear cut,
select option"C."
❑A 0
®B 1 to
❑C 5to8
15. Vegetative Composition—assessment area condition metric(skip for all marshes and Pine Flat)
❑A Vegetation is close to reference condition in species present and their proportions. Lower strata composed of appropriate
species,with exotic plants absent or sparse within the assessment area.
®B Vegetation is different from reference condition in species diversity or proportions, but still largely composed of native species
characteristic of the wetland type. This may include communities of weedy native species that develop after clearcutting or clearing.
It also includes communities with exotics present, but not dominant, over a large portion of the expected strata.
❑C Vegetation severely altered from reference in composition, or expected species are unnaturally absent (planted stands of non-
characteristic species or at least one stratum inappropriately composed of a single species), or exotic species are dominant in at
least one stratum.
16. Vegetative Diversity—assessment area condition metric(evaluate for Non-tidal Freshwater Marsh only)
❑A Vegetation diversity is high and is composed primarily of native species(< 10%cover of exotics).
®B Vegetation diversity is low or has > 10%to 50%cover of exotics.
❑C Vegetation is dominated by exotic species(>50% cover of exotics).

17. Vegetative Structure—assessment area/wetland type condition metric
17a. Is vegetation present?
®Yes ❑No If Yes,continue to 17b. If No,skip to Metric 18.
17b. Evaluate percent coverage of assessment area vegetation for all marshes only. Skip to 17c for non-marsh wetlands.
❑A >_25%coverage of vegetation
❑B <25%coverage of vegetation
17c. Check a box in each column for each stratum. Evaluate this portion of the metric for non-marsh wetlands. Consider
structure in airspace above the assessment area (AA)and the wetland type(WT)separately.
AA WT
®A ®A Canopy closed, or nearly closed,with natural gaps associated with natural processes
= ❑B ❑B Canopy present, but opened more than natural gaps
0 ❑C ❑C Canopy sparse or absent
g❑A ❑A Dense mid-story/sapling layer
c ❑B ❑B Moderate density mid-story/sapling layer
®C ®C Mid-story/sapling layer sparse or absent
❑A ❑A Dense shrub layer
❑B ❑B Moderate density shrub layer
®C ®C Shrub layer sparse or absent
. ❑A ❑A Dense herb layer
_ ❑B ❑B Moderate density herb layer
®C ®C Herb layer sparse or absent
18. Snags—wetland type condition metric(skip for all marshes)
❑A Large snags(more than one)are visible(> 12 inches DBH,or large relative to species present and landscape stability).
• Not A
19. Diameter Class Distribution—wetland type condition metric(skip for all marshes)
®A Majority of canopy trees have stems>6 inches in diameter at breast height(DBH); many large trees(> 12 inches DBH)are
present.
❑B Majority of canopy trees have stems between 6 and 12 inches DBH,few are> 12 inch DBH.
❑C Majority of canopy trees are<6 inches DBH or no trees.
20. Large Woody Debris—wetland type condition metric(skip for all marshes)
Include both natural debris and man-placed natural debris.
❑A Large logs(more than one)are visible(> 12 inches in diameter,or large relative to species present and landscape stability).
• Not A
21. Vegetation/Open Water Dispersion—wetland type/open water condition metric(evaluate for Non-Tidal Freshwater Marsh only)
Select the figure that best describes the amount of interspersion between vegetation and open water in the growing season. Patterned
areas indicate vegetated areas,while solid white areas indicate open water.
❑A ❑B ❑C ❑D
•
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22. Hydrologic Connectivity—assessment area condition metric(evaluate for riparian wetlands and Salt/Brackish Marsh only)
Examples of activities that may severely alter hydrologic connectivity include intensive ditching,fill,sedimentation,channelization,diversion,
man-made berms, beaver dams, and stream incision. Documentation required if evaluated as B, C, or D.
❑A Overbank and overland flow are not severely altered in the assessment area.
®B Overbank flow is severely altered in the assessment area.
❑C Overland flow is severely altered in the assessment area.
❑D Both overbank and overland flow are severely altered in the assessment area.
Notes
Wetland is located in a depression in the floodplain of Polecat Creek and recieves accelerated runnoff from residential yard.

NC WAM Wetland Rating Sheet
Accompanies User Manual Version 5.0
Wetland Site Name WA Date of Assessment 181030
Wetland Type Bottomland Hardwood Forest Assessor Name/Organization Perkinson/Axiom
Notes on Field Assessment Form (Y/N) YES
Presence of regulatory considerations (Y/N) YES
Wetland is intensively managed (Y/N) NO
Assessment area is located within 50 feet of a natural tributary or other open water (Y/N) YES
Assessment area is substantially altered by beaver (Y/N) NO
Assessment area experiences overbank flooding during normal rainfall conditions (Y/N) NO
Assessment area is on a coastal island (Y/N) NO
Sub-function Rating Summary
Function Sub-function Metrics Rating
Hydrology Surface Storage and Retention Condition MEDIUM
Sub-surface Storage and
Retention Condition MEDIUM
Water Quality Pathogen Change Condition MEDIUM
Condition/Opportunity MEDIUM
Opportunity Presence (Y/N) NO
Particulate Change Condition MEDIUM
Condition/Opportunity MEDIUM
Opportunity Presence (Y/N) NO
Soluble Change Condition MEDIUM
Condition/Opportunity MEDIUM
Opportunity Presence (Y/N) NO
Physical Change Condition LOW
Condition/Opportunity LOW
Opportunity Presence (Y/N) NO
Pollution Change Condition NA
Condition/Opportunity NA
Opportunity Presence (Y/N) NA
Habitat Physical Structure Condition HIGH
Landscape Patch Structure Condition LOW
Vegetation Composition Condition MEDIUM
Function Rating Summary
Function Metrics Rating
Hydrology Condition MEDIUM
Water Quality Condition MEDIUM
Condition/Opportunity MEDIUM
Opportunity Presence (Y/N) NO
Habitat Condition MEDIUM
Overall Wetland Rating MEDIUM

Polecat Creek NORTH CAROLINA R3UB RIVERINE Linear 284 FOOT RFW 35.95373100 -79.81152500
Wetland WA NORTH CAROLINA PFO RIVERINE Area 0.0003 ACRE DELINEATE 35.95382400 -79.81169700