20120648 Ver 1_Complete File_20120727

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NCDENR RECEVED I
North Carolina Department of Environment and Natural Resources
Division of Water Quality J 0 L - 2 2012
Beverly Eaves Perdue
Governor
Charles Wakild, P.E.
Director
Stream Origin /Buffer Applicability Determination
Applicant/Owner's Name (corporation/individual who is legally responsible for the property and its compliance:
Applicant/Owner Address: "A DLL QCA
Applicant's phone number: "1 r ° `� - k? P Fax number:
Applicant's email address:
Consultant/Contact person Name (if applicable): Lg-1A
Consultant address (if applicable):
Consultant's phone number: Fax number:
Consultant's email address:
Name ofProject: ` T_� County: Lo Aucy_
Nearest Named stream + River Basin (from UScCase number 126 ( Is this stream call for the purpose of:
buffer mitigation
Please provide a brief description of this project (attach site plan if available): nutrient offset credit
�lV "1ST
c
Location of project site - please include reference to the county, nearest named town and highway number:
Please attach a map of site location indicating project boundaries using USGS 1:24,000 topo map and NRCS county soil
survey.
Has any DWQ staff visited the site? if yes, please provide DWQ staff name,
visit:
and date of
This form may be submitted via email (amy.adams ,ncdenr.gov), faxed (252- 946- 9215), mailed or hand - delivered to:
943 Washington Square Mall, Washington, NC 27889. (Note: Submittals of the review packages on Friday after 12:00 pm will
be stamped as received on the next business day).
Please contact Amy Adams at 252- 948 -3917 if you have any questions regarding this form.
North Carolina Division of Water Quality Internet: www.newaterquality.org
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolliina
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper ;Vatmallff

www
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Google earth miles 1
km 2

INN V W(2 atream Identification Form Version 4.11
Date: -2- Project/Site: ), ' Latitude: �3G , :5342, (
Evaluator: County: I Longitude:-76 T 1b
Total Points: Stream Determination circle one Other
Stream is at least intermittent � )
if a 19 or perennial if 2 30' 14,25 Ephemeral Intermittent Perennial e.g. Quad Name:
1! e-
r,. 1 wf 1 ivi nU,v touotot;at =
s )
Absent
0
Weak
1
Moderate
2
Strong
3
1 a. Continuity of channel bed and bank
2. Sinuosity of channel along thalweg
0
1
.2
3
3. in- channel structure: ex. riffle -pool, step -pool,
ripple-pool sequence
2
1
2
3
4. Particle size of stream substrate
p
1
2
3
5. Active /relict floodplain
0
1
2
3
6. Depositional bars or benches
0
1
2
3
7. Recent alluvial deposits
0
1
2
3
8- Headcuts
0
1
2
3
9. Grade control
0
1
1.5
10. Natural valley
0 J-ZM
1
1.5
11. Second or greater order channel
No = 0
Yeas = 3
B- Hvdroloav (Si,htr)tal =
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
1
2
3
14. Leaf litter
1.5
1
2
p
15. Sediment on plants or debris
0
D.5
2
3
16. Organic debris lines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table? 0
r, n:_,__.. ,- Case number 129
Yes - 3
18. Fibrous roots in streambed
3
2
1
p
19. Rooted upland plants in streambed
3
2
1 -
0
20. Macrobenthos (note diversity and abundance)
0
1
2
3
21. Aquatic Mollusks
C70
1
2
3
22, Fish
0
0.5
1
1.5
23. Crayfish
0
0.5
1
1.5
24. Amphibians
0.5
1
1 -5
25. Algae
0
0.5
1
1.5
26. Wetland plants in streambed
FACW 0.7 OBL - 1.5 Other -= 0
'perennial streams may also be identified using other methods- See p. 35 of manual.
Notes; WE
Sketch:

NC n VV O Stream Yd,- ntiflratinn Pnrm Vnro n A 1 7
Date:
Project/Site: �� I� L '
Latitude: , -3 Q* L
� it
Evaluator: [
County:
Longitude:
Total Points:
Stream is at least intermittent
2
Stream Determination c
Ephemeral Intermitt Pe!2n:io
Other
if z 1 g or erenniat if 2 30' z -
.0
e.g. Quad Name:
,w.r ueamor noto (Subtotal = j J
1 a. Continuity of channel bed and bank
Absent
Weak
Moderate
Strong
0
1
2
3
2. Sinuosity of channel along thalweg
.0
1
2
3
3. In- channel structure: ex. riffle -pool, step -pool,
rip le- ool se uence
)
1
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active /relict floodplain
0
1
2
3
6. Depositional bars or benches
0
0
2
3
7. Recent alluvial deposits
0
$1, ,
2
3
8. Headcutss
p
1
2
3
9. Grade control
0.5
1
1.5
10. Natural valley
0
0.5
1
1.5
1 1. Second or greater order channel
a
No = 0
Yes = 3
B_ Hvdroloov (Subtotal = t 1
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
1
2
3
14. Leaf litter
1.5
1 `
0.5
0
15. Sediment on plants or debris
p
1
1
1.
16. Organic debris lines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table? Case number 13 00
Yes= 3
V. VIV IVyy IJUVIVIa1 -
18. Fibrous roots in streambed 1
3
2
1
0
19. Rooted upland plants in streambed
2
1
0
20. Macrobenthos (note diversity and abundance)
1
2
3
21. Aquatic Mollusks
1
2
3
22. Fish
0
0.5
1
1.5
23. Crayfish
0
0.5
1
1.5
24. Amphibians
0
0.5
1
1.5
25. Algae
05
-
1.5
26. Wetland plants in streambed
FACW = 0.75;
BL = 1 ther = 0
`perennial streams may also be identified using other methods_ See p.-35 of manual.
Notes:
Sketch:

AC V WQ Ntream Identification Form Version 4.11
Date: Project/Site: Latitude:
Evaluator: County: Longitude:
Total Points:
Stream is at least intermittent Stream Determination (circle one) Other
if a 19 or perennial if 2 30• Ephemeral Intermittent Perennial e.g. Quad Name:
f-- �%;W111U1 nvry tauutoral = )
Atosent
Weak
Moderate
Strong
1 a. Continuity of channel bed and bank
0
1
2
3
2. Sinuosity of channel along thalweg
3. In- channel structure: ex. riffle -pool, step -pool,
ripple-pool sequence
0
0
1
1
2
2
3
3
4_ Particle size of stream substrate
0
1
2
3
5. Active /relict floodplain
0
1
2
3
6. Depositional bars or benches
0
1
2
3
7. Recent alluvial deposits
0
1
2
3
8: Headcuts
0
1
2
3
9. Grade control
0
0.5
1
1.5
10. Natural valley
0
0.5
1
1.5
11. Second or greater order channel
e artlfirinI rfitrh- n- nnf r to& moo fll- .. ,.,.....:..
No = 0
Yes = 3
B. Hvdroloav (Suhtntal =
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
1
2
3
14. Leaf litter
1.5
1
0.5
0
15. Sediment on plants or debris
0
0.5
1
1 5
16. Organic debris lines or piles
0
0.5
1
1 5
17. Soil -based evidence of high water table?
Case number 132-0
Yes = 3
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
1.5
23. Crayfish
0
0.5
1
1-5
24_ Amphibians
0
0.5
1
1.5
25. Algae
0
0.5
1
1.5
26. Wetland plants in streambed
FACW = 0.75;
OBL = 1.5 Other = 0
'perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch: