20130092 Ver 1_401 Application_20130113

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Carolina Wetland Services, Inc.
550 East Westinghouse Boulevard
Charlotte, NC 28273
704 -527 -1177 - Phone
704 -527 -1133 - Fax
TO: Ms. Karen Higgins
NCDWQ — Wetlands and Stormwater Branch
512 N Salisbury St
9th Floor Archdale Building
Raleigh NC 27603
20130092
Date: 01 -28 -13
CWS Project #: 2012 -2888
LETTER OF TRANSMITTAL,, (at* Z&HM
WE ARE SENDING YOU: ®Attached ❑Under separate cover via " the following items:
❑ Prints N Plans ❑ JD Package ❑ Specifications
❑ Copy of letter ❑ Change order ❑ Wetland Survey N Other
IF ENCLOSURES ARE NOT AS NOTED. KINDLY NOTIFY US AT ONCE
M
MM
cam
1
1/28/13
5
Application for Individual Water Quality Certification
2
1/28/13
1
Application Fee Check ($240)
THESE ARE TRANSMITTED as checked below:
®For approval ❑Approved as submitted
NFor your use ❑Approved as noted
❑As requested ❑Returned for corrections
❑For review and comment
❑Resubmit copies for approval
❑Submit copies for distribution
❑Return corrected prints
❑For your verification and signature
REMARKS: Karen. Please find attached five copies of the Preconstruction Notification and application for Water
Quality Certification for the Caldwell Road Culvert Replacement Project A check for the application fee is also attached
Copy to: File
Thank you,
omas Blackwell, PWS
Senior Scientist
NORTH CAROLINA - SOUTH CAROLINA
JAN 3 0 2013 '

v
Corps Submittal Cover Sheet 2 ® 1 '300
2
Please provide the following info:
1. Project Name Buckingham Lane and Caldwell Road Culvert Replacement Project
2. Name of Property Owner /Applicant: Town of Harrisburg
3. Name of Consultant/Agent: Carolina Wetlands Services, Inc., Mr. Thomas Blackwell, PWS
*Agent authorization needs to be attached.
4. Related/Previous Action ID number(s): N/A
5. Site Address: of Buckingham Lane and Caldwell Road and intersection of Caldwell Road
and Tom Query Road, Harrisburg, NC
6. Subdivision Name: N/A
7. City: Harrisburg
8. County: Cabarrus
9. Lat: N35.304864° Long: W80.6734400 (Decimal Degrees Please
10. Quadrangle Name: Harrisburg, NC, dated 1996
11. Waterway: UT to Back Creek
12. Watershed: Yadkin (HU# 03040105)
13. Requested Action:
X Nationwide Permit # 3
General Permit #
X Jurisdictional Determination Request!
Pre- Application Request :w
The following information will be completed by Corps office:
FI I03
^t013
R ate
1Vn9nnds & SU
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose:
Site/Waters Name:
Keywords:

1 CWS
January 14, 2013
Mr. Steve Kichefski
U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801
550 E WESTINGHOUSE BLVD.
CHARLOTTE, NC 28273
866- 527 -1177 (office)
704527 -1133 (fax)
Ms. Karen Higgins
NCDWQ — Wetlands and Stormwater Branch
1650 Mail Service Center
Raleigh, NC 27699
Subject: Pre- Construction Notification Pursuant to Nationwide Permit No. 3 and Water
Quality Certification No. 3883
Caldwell Street and Buckingham Lane Maintenance Project
Harrisburg, North Carolina
Carolina Wetland Services Project No. 2012 -2888
The Buckingham Lane and Caldwell Road Culvert Replacement Project is located at the intersection
of Buckingham Road at Caldwell Road and Caldwell Road at Tom Query Road (State Road 1166) in
Harrisburg, North Carolina (Figure 1. USGS Site Location Map, attached). The purpose of this project
is to upsize the existing road culverts to convey the 25 -year storm event per Town of Harrisburg
design standards. At Caldwell Road and Tom Query Road, the existing 54" corrugated metal pipe
(CMP) will be replaced with a 10'x 6' precast box culvert (PBC). At Buckingham Lane and Caldwell
Road the existing 54" CUP will be replaced with a 9' x 10' PBC. On behalf of the Town of
Harrisburg, US Infrastructure of the Carolinas, Inc. (USI) has sub - contracted Carolina Wetland
Services, Inc. (CWS) to provide Section 404/401 permitting services for this project.
Applicant Name: Town of Harrisburg, POC: Mr. Derek Slocum
Mailing Address: 4100 Main Street, Suite 100, Harrisburg, NC 28075
Phone Number of Owner /Applicant: 704 - 4550728
Street Address of Project: Buckingham Lane at Caldwell Road and Caldwell Road at Tom Query
Road, Harrisburg, North Carolina
Tax Parcel ID: 55060989040000, 55071011090000
Waterway: UT to Back Creek
Basin: Yadkin (HU# 03040105)
City: Harrisburg
County: Cabarrus
Decimal Degree Coordinate Location of Project Site: N35.3048640, W80.6734400
USGS Quadrangle Name: Harrisburg, NC, dated 1996
Current Land Use
The project area is approximately 2.22 acres in extent and is comprised of single family residential
properties with a mix of maintained grass and wooded lots, and public road right -of -way. Dominant
vegetation within the project area consists of red maple (Acer rubrum), boxelder (Acer negundo),
green ash (Fraxinus pennsylvanica), tulip poplar (Liriodendron tulipifera), winged elm (Ulmus alata),
NORTH CAROLINA* SOUTH CAROLINA
WWW.CWS- INC.NET

Caldwell Street and Buckingham Lane Maintenance Project January 14, 2013
Nationwide Permit No. 3 Project No. 2012 -2888
musclewood (Carpinus caroliniana) Japanese honeysuckle (Lonicera japonica), and fescue (Festuca
Sp.).
According to the Soil Survey of Cabamis County' (Figure 2. NRCS Soil Survey Map, attached), on-
site soils consist of Chewacla sandy loam, frequently flooded (Ch). Chewacla soils are somewhat
poorly drained and are listed on the North Carolina Hydric Soils List for Cabamis County2 and on the
National Hydric Soils Lis? as having hydric inclusion (Hydric Criteria 1).
Jurisdictional Determination
On January 9, 2013, CWS scientists Thomas Blackwell, PWS and Gregg Antemann, PWS delineated
jurisdictional waters of the U.S. within the project area. Jurisdictional areas were delineated using the
U.S. Army Corps of Engineers ( USACE) Routine On -Site Determination Method. This method is
defined in the 1987 Corps of Engineers Wetlands Delineation Manua14, with further technical guidance
from the Eastern Mountains & Piedmont Interim Regional Supplements, dated April 2012. A Wetland
Determination Data Form representative of non jurisdictional upland areas has been enclosed (DPI).
Jurisdictional stream channels were classified according to recent USACE and North Carolina
Division of Water Quality (NCDWQ) guidance. These classifications included sampling with a D-
shaped dip net, taking photographs, and defining approximate breakpoints (location at which a channel
changes classification) within each on -site stream channel. A NCDWQ Stream Classification Form
and USACE Stream Quality Assessment Worksheet representative of Stream A are enclosed (SCP1).
The results of the on -site field investigation indicate that there is one jurisdictional stream channel (Stream
A) located within the project area (Figure 3, attached). Stream A is an unnamed tributary to Back Creek.
Back Creek is within the Yadkin River basin (HU# 03040105)6 and is classified as "Class C" waters by the
NCDWQ. On -Site jurisdictional waters are summarized in Table 1, below.
Table 1. Summa ry of On -Site Jurisdictional Waters
Jurisdictional
Feature
Jurisdiction
SCP
No.
NCDWQ
Steam
Classification
Score
USACE
Stream
Assessment
Score
Approx.
Length
Linear Feet
(l�
Approx
Acreage
(ac.)
USACEIEPA
Rapanos
Classification
Intermittent/
Perennial
Stream A
RPW
Perennial
SCP1
35
50
517
0.047
On -Site Total:
517
0.047
Relatively Permanent Waters with Perennial Flow
I United States Department of Agriculture, 1988. Soil Survey of Cabarrus County, North Carolina.
2 United States Department of Agriculture — Natural Resources Conservation Service, 1999 North Carolina Hydric Soils List, USDA -
NRCS North Carolina State Office, Raleigh
3 United States Department of Agriculture —Natural Resources Conservation Service, 2010 2010 National Hydric Soils List by State
4 Environmental Laboratory 1987. "Corps of Engineers Wetlands Delineation Manual ", Technical Report Y -87 -1, US Army Engineer
Waterways Experiment Station, Vicksburg, Mississippi.
! US Army Corps of Engineers, April 2012. Regional Supplement to the Corps of Engineers Wetland Delineation Manual Eastern
Mountains and Piedmont Region US Army Engineer Research and Development Center, Vicksburg, Mississippi
6 "HU#" is the Hydrologic Unit Code U S Geological Survey, 1974 Hydrologic Unit Map, State of North Carolina
2

Caldwell Street and Buckingham Lane Maintenance Project January 14, 2013
Nationwide Permit No. 3 Proiect No. 2012 -2888
Stream A flows northeast across the project area for approximately 31 linear feet before entering a pipe
system beneath Buckingham Lane. Stream A emerges from the pipe north of Buckingham Lane and
flows northeast across the project area for approximately 372 linear feet before entering a pipe system
beneath Caldwell Road. Stream A emerges from the pipe north of Caldwell Road and flows for
approximately 15 linear before entering a pipe system beneath Tom Query Road. Stream A emerges
from the pipe north of Tom Query Road and flows for approximately 99 feet before it flows offsite to a
confluence with Back Creek. Stream A exhibited a strong bed and bank, moderate substrate sorting,
strong flow, moderate sinuosity, moderate depositional bars and benches, and an average ordinary high
water width of four feet. Biological sampling revealed a moderate presence of iron oxidizing bacteria
and a moderate presence of fish. Stream characteristics indicate that continuous flow is present year
round in a typical year. Stream A was classified as a Relatively Permanent Water with perennial flow
(RPW) according to USACE/BPA guidance. Perennial RPW Stream A scored 50 out of a possible 100
points on the USACE Stream Quality Assessment Worksheet and 35 out of a possible 63 points on the
NCDWQ Stream Classification Form, indicating perennial status (SCP1, enclosed). Photographs A,
B, and C (Figure 3, attached) are representative of Perennial RPW Stream A
Agency Correspondence
Cultural Resources
A letter was forwarded to the State Historic Preservation Office (SHPO) on January 14, 2013 to
determine the presence of any areas of architectural, historic, or archaeological significance that would
be affected by the project. As of the date of this submittal, a response from SHPO has not yet been
received. CWS consulted the National Register of Historic Places in Caban us County database and
found no listed properties within the project area.
Protected Species
A letter was forwarded to the North Carolina Natural Heritage Program ( NCNHP) on January 14, 2013
to determine the presence of any federally- listed, candidate endangered, threatened species or critical
habitat located within the project area. As of the date of this submittal, a response from the NCNHP
has not yet been received.
In addition, the NCNHP Geographic Information Systems (GIS) database Virtual Workroom and
Element Occurrence (EO) database was reviewed for a listing of EOs of endangered or threatened
species within or near the project area. The EO database identified no endangered or threatened species
within a two -mile radius of the project area.
Purpose and Need for the Project
As part of a comprehensive storm water program, the Town of Harrisburg retained Kimley -Horn and
Associates, Inc. to prepare a Storm Water Master Plan. As part of the master plan, residents were
contacted and asked to complete questionnaires about flooding, erosion, and other storm water issues.
Flooding and stream erosion were reported near the Caldwell Road culvert, and living space flooding
and stream erosion were reported near the Buckingham Lane culvert. In 2012, USI was retained by
the Town of Harrisburg to design replacements for the two culverts at Caldwell Road and Buckingham
Lane. The existing culvert at each street is a 54" CMP. Both roads are predicted to overtop in the ten -
year storm, and the Town plans to upgrade the culverts to address street and property flooding
concerns. The design storm for these roads is the 25 -year storm. Therefore, the existing culverts do
not meet the design standards.
The purpose of this project is to upsize these culverts to convey the 25 -year storm event per the Town
of Harrisburg's design standards. At the Buckingham Lane culvert, the existing 54" CUP will be
3

Caldwell Street and Buckingham Lane Maintenance Project January 14, 2013
Nationwide Permit No. 3 Project No. 2012 -2888
replaced with a 9'x 6' PBC of the same length. The culvert will be buried one foot as required by
WQC 3883 to ensure aquatic life passage. In addition, a 36 linear foot rip rap apron will be installed at
the outlet to dissipate flows exiting the culvert (Figures 4 and 5, attached). The rip rap apron has been
designed using the procedures referenced in the North Carolina Department of the Environment and
Natural Resources (NCDENR) Erosion and Sediment Control Planning and Design Manual
(NCDENR Manual)'. Rip rap energy dissipater design calculations are attached.
The Caldwell Road culvert is immediately upstream of Tom Query Road. The existing culvert at Tom
Query Road is a 60" CMP, and the road is predicted to overtop in the ten -year storm. For Caldwell
Road, a 10' x 6' PBC is proposed (Figures 4 and 6, attached). The culvert will be buried one foot as
required by WQC 3883 to ensure aquatic life passage. Because this culvert is approximately 15 feet
upstream of Tom Query Road, the optimum design would include a continuous 10' x 6' PBC from
upstream of Caldwell Road to downstream of Tom Query Road with a 20 degree bend. This approach
would enclose approximately 15 feet of open channel adjacent to the Caldwell Road/Tom Query Road
intersection and dramatically improve the hydraulic performance. The Town has had preliminary
discussions with North Carolina Department of Transportation ( NCDOT) about this approach, but
NCDOT does not plan to move forward with replacement of the Tom Query Road culvert at this time.
Therefore, the proposed design shows a connection to the existing 60" CMP at Tom Query Road.
Connecting the PBC to the 60" CMP is proposed for the following reasons:
1. The existing ditch at the corner of this busy intersection is a safety concern. Currently, there is
a hole over six feet deep at the edge of the road. This does not provide adequate clear zone for
the safety of the traveling public.
2. Connecting the box culvert to the 60" CMP with the tapered junction box as shown will
improve the hydraulic performance of the exiting 60" CMP.
In addition, the Caldwell Road culvert will be extended ten feet on the upstream side to provide
adequate clear zone for the safety of the traveling public.
Avoidance and Minimization
Impacts to on -site jurisdictional waters of the U.S. have been reduced to the maximum extent possible.
Proper sediment and erosion control measures will be used to minimize disturbances to downstream
waters. All work will be constructed in the dry in accordance with Water Quality Certification No. 3883.
There will be no additional piping associated with the Buckingham Lane culvert. The proposed rip rap
apron is necessary to dissipate the energy of storm flows exiting the culvert.
Proposed Impacts to Jurisdictional Waters
Unavoidable impacts to Jurisdictional Waters of the U.S. total 89 linear feet of impacts to Perennial RPW
Stream A. These impacts include 61 linear feet (0.005 acre) of permanent impacts and approximately 28
linear feet (0.002 acre) of temporary impacts. Permanent impacts to Perennial RPW Stream A are the
result of a 36 linear foot rip rap apron at the outlet of the Buckingham Lane culvert and 25 linear feet
of additional PBC at Caldwell Road. Temporary impacts are the result of the installation of temporary
coffer dams (8 linear feet each) upstream of both proposed work areas and temporary rock check dams (6
linear feet each) to be installed downstream of both work areas (Figure 4, attached). The temporary
cofferdam is necessary in order to allow work on the pipe replacement to be conducted in the dry. The
7 North Carolina Department of the Environment and Natural Resources March 2009 North Carolina Erosion and Sediment Control
Planning and Design Manual.

Caldwell Street and Buckingham Lane Maintenance Project January 14, 2013
Nationwide Permit No. 3 Proiect No. 2012 -2888
check dams are a temporary erosion and sediment control measure. Both the coffer dam and rock check
dams will be removed once work has been completed.
Table 2. Sum ary of Im acts to On -Site Jurisdictional Waters
Jurisdictional
Intermittent
NWP
Temporary / Permanent
Approx.
Feature
/ Perennial
pact Type
No.
Approximate
Acreage
Culvert
3
251f (Permanent)
0.002
Rip Rap
3
36 if (Permanent)
0.003
Apron
RPW Stream A
Perennial
Upstream
Coffer Dam
3
161f (Temporary)
0.001
Downstream
3
12 if (Temporary)
0.001
Check Dams
Stream Impacts (Total)
891f
0.008 acre
Stream Impacts (Temporary)
281f
0.002 acre
Stream Impacts (Permanent)
611f
0.005 acre
On behalf of CSWS, CWS is submitting a Pre- Construction Notification Application with attachments in
accordance with Nationwide Permit General Condition No. 31, (attached) and pursuant to Nationwide
Permit No. 3.
Compensatory Mitigation
Permanent impacts to jurisdictional waters of the U.S. have been limited to 61 linear feet of perennial
stream channel. Therefore, no mitigation is proposed for these impacts.
Please do not hesitate to contact Thomas Blackwell at 704 -527 -1177 or tom @cws- inc.net should you
have any questions or comments regarding these fmdings.
Thomas Blackwell, PWS Kelly Hines

Caldwell Street and Buckingham Lane Maintenance Project January 14, 2013
Nationwide Permit No. 3 Proiect No. 2012 -2888
Senior Scientist
Staff Scientist
Enclosures: Figure 1. USGS Site Location Map
Figure 2. USDA -NRCS Mecklenburg County Soil Survey
Figure 3. Approximate Jurisdictional Boundary Field Map
Figure 4. Proposed Impacts Overview
Figure 5. Proposed Impacts
Figure 6. Proposed Impacts
Request for Jurisdictional Determination Form
Pre- Construction Notification Pursuant to Nationwide Permit No. 3
NCDWQ Stream Classification Form (SCP1)
USACE Stream Quality Assessment Worksheet (SCP1)
USACE Wetland Determination Data Form (DPI)
Approved Jurisdictional Determination Form
Rip Rap Apron Design Calculations
CC: Derek Slocum, Town of Harrisburg
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REQUEST FOR JURISDICTIONAL DETERMINATION
DATE: January 14.2013
COUNTY Cabarrus County. North Carolina TOTAL ACREAGE OF TRACT 2.22 acres
PROJECT NAME (if applicable) Buckingham Lane and Caldwell Road Culvert Replacement Project
PROPERTY OWNER/APPLICANT (name, address and phone):
Town of Harrisburg
POC: Mr. Derek Slocum at (704) 455 -0728
4100 Main Street. Suite 100
Harrisburg, North Carolina 28075
NAME OF CONSULTANT. ENGINEER, DEVELOPER (if applicable):
Carolina Wetland Services, Inc.
POC: Mr. Thomas J. Blackwell. PWS at (704)'527 -1177
550 E. Westinghouse Blvd.
Charlotte, North Carolina 28273
STATUS OF PROJECT (check one):
( ) On -going site work for development purposes
( X) Project in planning stages
(Type of project: maintenance )
( ) No specific development planned at present
( ) Project already completed
(Type of project: )
ADDITIONAL INFORMATION REQUIRED:
Check items submitted - forward as much information as is available. At a minimum, the following first two items must be
forwarded.
(X) Figure 1. USGS 7.5- Minute Mint Hill, NC Topographic Quadrangles
(X ) Figure 2. USDA -NRCS Mecklenburg County Soil Survey
(X) Figure 3. Approximate Jurisdictional Boundary Field Map
(X) Pre- Construction Notification Pursuant to Nationwide Permit No. 3
(X) NCDWQ Stream Classification Forms (SCP1)
(X) USACE Stream Quality Assessment Worksheets (SCP1)
(X) USACE Wetland Determination Data Form (DPI)
(X) Approved Jurisdictional Determination Form
PWS
C �UAJI
ignature o perty er or
Authorized Agent
Mr. Thomas Blackwell,

AGENT AUTHORIZATION FORM
Name: Derek Slocum
Address: 4100 Main Street. Suite 100
Phone: 704 - 455 -0728
ProjectNamdDesraiption: Buel dnghamlane &CaldweHRoadCulvatReplac t►�ts
Date: December 21 2012
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: Steve Kichefski
Field Office: Asheville
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
The Town of Harrisburg hereby designates and authorizes Carolina Wetland Services, Inc. to act in their
behalf as their agent solely for the purpose of processing of Section 404 permits and Section 401 Water
Quality Certifications applications and to furnish upon request supplemental information in support of
applications, etc. for the Buckingham Lane and Caldwell Road Culvert Replacements from this day
forward until successful completion of the permitting process or revocation by the Town of Harrisburg.
Authorized this the 21 day of December , 2012 .
DereK 61 ocurr,
Town of Harrisburg
Authorized Representative
(Print Name)
Cc: Karen Higgins
NC DWQ, Wetlands, Buffers
Stormwater Compliance and Permitting Unit
1650 Mail Service Center
Raleigh, N.C. 27699 -1650
ow
Authorized Representative
(Signature)

91 o WAtF9 G
0
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
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: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d. 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
1e. 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:
Buckingham Lane and Caldwell Road Culvert Replacement Project
2b. County:
Cabarrus
2c. Nearest municipality / town:
Harrisburg
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:
Medford, James and Lana; Burkhalter, James.
3b. Deed Book and Page No.
015080244;042630270
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
8001 Buckingham Lane; 5733 Tom Query Rd.
3e. City, state, zip:
Harrisburg, NC 28075
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 13
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Town of Harrisburg
4b. Name:
Derek Slocum
4c. Business name
(if applicable):
Town of Harrisburg
4d. Street address:
4100 Main Street, Suite 100
4e. City, state, zip:
Harrisburg, NC 28075
4f. Telephone no.:
(704) 455 -0728
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
Thomas Blackwell, PWS
5b. Business name
(if applicable):
Carolina Wetland Services, Inc.
5c. Street address:
550 E. Westinghouse Blvd.
5d. City, state, zip:
Charlotte, NC 28273
5e. Telephone no.:
704- 527 -1177
5f. Fax no.:
704- 527 -1133
5g. Email address:
tom@cws- inc.net
Page 2 of 13
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):
55060989040000, 55071011090000
1 b. Site coordinates (in decimal degrees):
Latitude: 35.304864 Longitude: -
80.673440
(DD.DDDDDD) (- DD.DDDDDD)
1c. Property size:
2.22 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
Back Creek
2b. Water Quality Classification of nearest receiving water:
Class C
2c. River basin:
Yadkin (HU# 03040105)
Page 3 of 13
PCN Form — Version 1.3 December 10, 2008 Version

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 project area is approximately 2.22 acres in extent and is comprised of single family residential properties with a mix
of maintained grass and wooded lots, and public right -of -way. Dominant vegetation within the project area consists of red
maple (Acer rubrum), boxelder (Acer negundo), green ash (Fraxinus pennsylvanica), tulip poplar (Liriodendron tulipifera),
winged elm (Ulmus alata), musclewood (Carpinus caroliniana) Japanese honeysuckle (Lonicera japonica), and fescue
(Festuca sp.).
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
517 linear feet of perennial stream channel
3d. Explain the purpose of the proposed project:
The existing 54" corrugated metal pipes (CMP's) under Buckingham Lane and Caldwell Road are undersized and overtop
frequently, causing the road to flood.
As part of a comprehensive storm water program, the Town of Harrisburg retained Kimley -Horn and Associates, Inc. to
prepare a Storm Water Master Plan. As part of the master plan, residents were contacted and asked to complete
questionnaires about flooding, erosion, and other storm water issues. Flooding and stream erosion were reported near
the Caldwell Road culvert, and living space flooding and stream erosion were reported near the Buckingham Lane
culvert. In 2012, US Infrastructure of the Carolinas, Inc. (USI) was retained by the Town of Harrisburg to design
replacements for the two culverts at Caldwell Road and Buckingham Lane. The existing culvert at each street is a 54"
CMP. Both roads are predicted to overtop in the ten -year storm, and the Town plans to upgrade the culverts to address
street and property flooding concerns. The design storm for these roads is the 25 -year storm. Therefore, the existing
culverts do not meet the design standards.
3e. Describe the overall project in detail, including the type of equipment to be used:
The purpose of this project is to upsize these culverts to convey the 25 -year storm event per the Town of Harrisburg's
design standards. At the Buckingham Lane culvert, the existing 54" CMP will be replaced with a 9'x 6' PBC of the same
length. The culvert will be buried one foot as required by WQC 3883 to ensure aquatic life passage. In addition, a 36
linear foot rip rap apron will be installed at the outlet to dissipate flows exiting the culvert (Figures 4 and 5, attached). The
rip rap apron has been designed using the procedures referenced in the North Carolina Department of the Environment
and Natural Resources (NCDENR) Erosion and Sediment Control Planning and Design Manual (NCDENR Manual) . Rip
rap energy dissipater design calculations are attached.
The Caldwell Road culvert is immediately upstream of Tom Query Road. The existing culvert at Tom Query Road is a
60" CMP, and the road is predicted to overtop in the ten -year storm. For Caldwell Road, a 10' x 6' PBC is proposed
(Figures 4 and 6, attached). The culvert will be buried one foot as required by WQC 3883 to ensure aquatic life passage.
Because this culvert is approximately 15 feet upstream of Tom Query Road, the optimum design would include a
continuous 10'x 6' PBC from upstream of Caldwell Road to downstream of Tom Query Road with a 20 degree bend.
This approach would enclose approximately 15 feet of open channel adjacent to the Caldwell Road/Tom Query Road
intersection and dramatically improve the hydraulic performance. The Town has had preliminary discussions with North
Carolina Department of Transportation ( NCDOT) about this approach, but NCDOT does not plan to move forward with
replacement of the Tom Query Road culvert at this time. Therefore, the proposed design shows a connection to the
existing 60" CMP at Tom Query Road. Connecting the PBC to the 60" CMP is proposed for the following reasons:
1. The existing ditch at the corner of this busy intersection is a safety concern. Currently, there is a hole over six feet
deep at the edge of the road. This does not provide adequate clear zone for the safety of the traveling public.
2. Connecting the box culvert to the 60" CMP with the tapered junction box as shown will improve the hydraulic
performance of the exiting 60" CMP.
In addition, the Caldwell Road culvert will be extended ten feet on the upstream side to provide adequate clear zone for
the safety of the traveling public. A track hoe and other typical construction equipment will be used to construct this
project.
Page 4 of 13
PCN Form — Version 1.3 December 10, 2008 Version

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑ Yes ® No ❑ Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
Preliminary
❑ Prelimina ❑ 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.
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. is this a phased project? --FE]
—Yes No
6b. If yes, explain.
Page 5 of 13
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
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
I ❑ DWQ
W2 ❑ P ❑ 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:.
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
Swiidth
Permanent P or
()
intermittent
DWQ —non -404,
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Rip Rap Apron
Perennial RPW
® PER
® Corps
4
36
Stream A
❑ INT
❑ DWQ
S2 ®P ❑ T
Culvert
Perennial RPW
® PER
® Corps
4
25
Stream A
❑ INT
F-1 DWQ
S3 ❑ P ®T
Coffer Dam
Perennial RPW
® PER
® Corps
4
8
Stream A
F-1 INT
El DWQ
S4 []POT
Coffer Dam
Perennial RPW
® PER
® Corps
4
8
Stream A
El INT
El DWQ
S5 ❑ P ® T
Check Dam
Perennial RPW
® PER
® Corps
4
6
Stream A
❑ INT
❑ DWQ
S6 ❑ P ®T
Check Dam
Perennial RPW
❑ PER
® Corps
4
6
Stream A
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
89
3i. Comments: Permanent Impacts to Jurisdictional Streams total 61 If (0.005 acre) of perennial stream.
Page 6 of 13
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 ❑P ❑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:
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 any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar - Pamlico ❑ 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
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑ PEI T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 7 of 13
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.
Impacts to on -site jurisdictional waters of the U.S. have been reduced to the maximum extent possible. Proper sediment and
erosion control measures will be used to minimize disturbances to downstream waters. All work will be constructed in the dry
in accordance with Water Quality Certification No. 3883.
There will be no additional piping associated with the Buckingham Lane culvert. The proposed 36 linear feet of rip rap apron
will help dissipate flows exiting the pipe and minimize impacts to downstream waters. The additional 25 linear feet of precast
box culvert is proposed to connect the new PBC to the existing culvert under Tom Query Road. The use of additional pipe will
minimize flooding and overtopping in the channel between the two existing culverts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Impacts to on -site jurisdictional waters of the U.S. have been reduced to the maximum extent practicable. Proper sediment
and erosion control measures will be used to minimize disturbances to downstream waters. All work will be constructed in the
dry in accordance with Water Quality Certification No. 3883.
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 8 of 13
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 9 of 13
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No Z,
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes E] No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: There is no change in inpervious area
associated with this project.
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?
Town of Harrisburg
❑ 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 Pro ram 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
S. 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 10 of 13
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal /stateAocal) funds or the
® Yes ❑ No
use of public (federal /state) land?
1b. 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)?
1c. 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.
The project will not result in additional future development.
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 11 of 13
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?
A letter was forwarded to the North Carolina Natural Heritage Program ( NCNHP) on January 14, 2013 to determine the
presence of any federally - listed, candidate endangered, threatened species or critical habitat located within the project
area. As of the date of this submittal, a response from the NCNHP has not yet been received. In addition, the NCNHP
Geographic Information Systems (GIS) database Virtual Workroom and Element Occurrence (EO) database was
reviewed for a listing of EOs of endangered or threatened species within or near the project area. The EO database
identified no endangered or threatened species within a two -mile radius of the project area.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Fisheries: http: / /sharpfin.nmfs. noaa. gov /website /EFH– Mapper /map.aspx
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?
A letter was forwarded to the State Historic Preservation Office (SHPO) on January 14, 2013 to determine the presence
of any areas of architectural, historic, or archaeological significance that would be affected by the project. As of the date
of this submittal, a response from SHPO has not yet been received. CWS consulted the National Register of Historic
Places in Cabarrus County database and found no listed properties within the project area.
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? FEMA FIRM No. 3710550600J and 3710550700J
Mr. Thomas Blackwell, PWS
qr'_�kLl
1 -14 -2013
Applicant/Agent's Printed Name
—
Applican gent's Sig ature
Date
(Agent's signature Is valid only if an authorization letter from the applicant
Is provided.)
Page 12 of 13
PCN Form – Version 1.3 December 10, 2008 Version

Page 13 of 13
PCN Form — Version 1.3 December 10, 2008 Version

T:
NC DWQ Stream Identification Form Version 4.11
Date: I _ � _ -S
ProjectlSite: S �Uer
.Latitude: 35. 307 s(.,'7
Evaluator: 7' j 1, C CA
County: abC f f"A
Longitude: �„ , � 3t? y p a
Total Points:
Stream is at least intermittent
Stream Determination (circ
Other SI-reo.v►, A
if a 18 or perennial if t 30"
Ephemeral Intermittent :annla
e.g. Quad Name: C
A. Geomorphology (Subtotal= l S ) 's
Absent
Weak
Moderate
Strong
1g Continuity of channel bed and bank
0
1
2
3
2. Sinuosity of channel along thaiweg
0
1
d
3
3. In- channel structure: ex. ditie -pool, step -pool,
dpple-pool sequence
0
0.
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active /relict floodplain
0
1
1
3
6. Depositional bars or benches
0
1
1
3
7. Recent alluvial deposits
Q010
1
2
3
8. Headcuts
M2
1
2
3
9. Grade control
0
0.5
1
1.5
10. Natural valley
0
0.5
t 1
1 an
11. Second or greater order channel
No A0
Yes = 3
artificial ditches are not rated; see discussions in manual
B. Hydrology (Subtotal= L-t 6' )
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
CP
1
1
0
14. Leaf litter
1.5
1
0.5
0
15. Sediment on plants or debris
[61
0.
1
5
16. Organic debris lines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table?
No = 0
Ye6 = 3
C. Biology (Subtotal = 4 - 'S ) -
18. Fibrous roots in streambed
3
0
1
0
19. Rooted upland plants in streambed
CP
2
1
0
20. Macrobenthos (note diversity and abundance)
0
2
3
21. Aquatic Mollusks
[61
2
3
22. Fish
0.5
W
1.5
23. Crayfish
0
.5
1
1.5
24. Amphibians
0
037
1
1.5
25. Algae
01
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 cf manual.
Notes:
Sketch:
r'

OFFICE USE ONLY: USACE AID# DWQ #
SCP1— Perennial RPW Stream A
STREAM QUALITY ASSESSMENT WORKSHEET
1. Applicant's Name: Town of Harrisburg 2. Evaluator's Name: Thomas Blackwell and Gregg Antemann
3. Date of Evaluation: 01 -09 -13 4. Time of Evaluation: 11.00 AM
5. Name of Stream: Perennial Stream A 6. River Basin: Yadkin (HU# 03040105)
7. Approximate Drainage Area: 151 acres 8. Stream Order: first
9. Length of Reach Evaluated: 350 linear feet 10. County: Cabarrus
11. Location of reach under evaluation (include nearby roads and landmarks): Site is located at the intersection of Buckingham Lane
and Caldwell Road and Caldwell Road and Tom Query Road in Harrisburg, North Carolina.
12. Site Coordinates (if known): N35.3048640, W80.6734400
13. Proposed Channel Work (if any): culvert replacement
14. Recent Weather Conditions: mid 50s, no rain in past 48 hours
15. Site conditions at time of visit: cool, 600
16. Identify any special waterway classifications known: _Section 10 _Tidal Waters Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed _(I -IV)
17. Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area:
18. Does channel appear on USGS quad map ?Q NO 19. Does channel appear on USDA Soil Survey ?(D NO
20. Estimated Watershed Land Use: 90 % Residential _% Commercial _% Industrial _% Agricultural
10 % Forested _% Cleared / Logged _% Other ( )
21. Bankfull Width: 4' 22. Bank Height (from bed to top of bank): 4'
23. Channel slope down center of stream: Flat (0 to 2 %) X Gentle (2 to 4 %) _Moderate (4 to 10 %) _Steep ( >10 %)
24. Channel Sinuosity: Straight _.K _Occasional Bends _Frequent Meander _Very Sinuous Braided Channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each
characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the
worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or
weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character
of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more
continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score
of 100 representing a stream of the highest quality.
Total Score (from reverse): 50 Comments:
Evaluator's Signature , �M HKXWV'` Date 119/2013
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers in order to make a preliminary assessment of
stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 05/03. To Comment, please call 919- 876 -8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
SCP1— Perennial RPW Stream A
• These characteristics are not assessed in coastal streams.
#
ECOREGION POINT
RANGE
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow / persistent pools in stream
0-5
0 — 4
0-5
4
no flow or saturation = 0• strong flow = max points)
2
Evidence of past human alteration
0-6
0-5
0-5
1
extensive alteration = 0• no alteration = max poin ts
3
Riparian zone
0-6
0-4
0-5
2
no buffer = 0• contiguous, wide buffer = max points)
4
Evidence of nutrient or chemical discharges
0-5
0-4
0-4
3
extensive discharges = 0• no discharges = max points)
5
Groundwater discharge
0-3
0-4
0-4
1
no discharge = 0• springs, sees wetlands etc. = max points)
6
Presence of adjacent floodplain
0-4
0 - 4
0-2
3
no floodplain = 0• extensive floodplain = max points)
aEntrenchment
/ floodplain access
(deeply entrenched = 0• frequent flooding = max ints
0— 5
0— 4
0— 2
2
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
no wetlands = 0• laze adjacent wetlands = max points)
9
Channel sinuosity
0-5
0-4
0-3
2
extensive channelization = 0• natural meander = max points)
10
Sediment input
0-5
0-4
0-4
4
extensive deposition-- 0• little or no sediment = max points)
11
Size & diversity of channel bed substrate
NA*
0-4
0 - 5
2
fine homogenous = 0• laze diverse sizes = max points)
12
Evidence of channel incision or widening
0-5
0 - 4
0-5
2
>0
(deeply incised = 0• stable bed & banks = max points)
,F''.,
13
Presence of major bank failures
0-5
0 — 5
0-5
3
a
severe erosion = 0• no erosion stable banks = max oints
14
Root depth and density on banks
0-3
0 - 4
0-5
3
no visible roots = 0• dense roots throughout = max points)
15
Impact by agriculture or livestock production
substantial impact =0• no evidence = max points)
0-5
0 — 4
0-5
4
16
Presence of riffle- pool/ripple -pool complexes
0-3
0-5
0-6
2
no riffles/ripples or pools = 0• well-developed = max oints
17
Habitat complexity
Habitat
0-6
0 — 6
0-6
4
or no habitat = 0 uent varied habitats = max points)
18
Canopy coverage over streambed
0-5
0-5
0-5
2
no shading vegetation = 0• continuous canopy = max points)
19
Substrate embeddedness
NA*
0-4
0-4
2
(deeply embedded = 0• loose structure = max
20
Presence of stream invertebrates
0-4
0-5
0-5
2
>4
no evidence = 0• common numerous types = max ints
G7
21
Presence of amphibians
0-4
0-4
0-4
0
O
no evidence = 0• common numerous es = max oints
4
22
Presence of fish
0-4
0 — 4
0-4
0
no evidence = 0• common numerous es = max points)
23
Evidence of wildlife use
0-6
0-5
0-5
2
no evidence = 0• abundant evidence = max points)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page)
so
• These characteristics are not assessed in coastal streams.

WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Project/Site: Buckingham Ln & Caldwell Rd Culvert ReplCity /County: Harrisburg, Cabarn.Sampling Date: 1/g/2013
Applicant/Owner. Town of Harrisburg State: NC Sampling Point DPI- upland
Investigator(s): T.Blackwell, PWS & G.Antemann, PWS Section, Township, Range: Harrisburg, NC
Landform (hillslope, terrace, etc.): terrace Local relief (concave, convex, none): none Slope ( %): 0-2
Subregion (LRR or MLRA): MLRA Lat.: N35.304864° Long.: W80.6734400 Datum: NAD 83
Soil Map Unit Name Chewacla sandy loam, frequenty flooded (Ch) NWI Classification:
Are climatic/hydrologic conditions of the site typical for this time of the year? Yes X No (If no, explain in remarks)
Are vegetation soil or hydrology significantly disturbed? Are "normal Yes
Are vegetation soil or hydrology naturally problematic? circumstances" present?
SUMMARY OF FINDINGS
Hydrophytic vegetation present? No
Hydric soil present? No
Wetland hydrology present? No
Data point is representative of an upland area.
HYDROLOGY
(If needed, explain any answers in remarks)
Is the sampled area within a wetland? No
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required; check all that apply)
—Surface Soil Cracks (136)
Surface Water (Al)
_True Aquatic Plants (1314)
_Sparsely Vegetated Concave Surface (138)
High Water Table (A2)
_Hydrogen Sulfide Odor (C1)
_Drainage Patterns (1370)
Saturation (A3)
Oxidized Rhizospheres on Living
_Moss Trim Lines (616)
Water Marks (131)
—Roots (C3)
_ Dry- Season Water Table (C2)
Sediment Deposits (132)
_Presence of Reduced Iron (C4)
_Crayfish Burrows (C8)
Drift Deposits (133)
Recent Iron Reduction in Tilled
Visible on Aerial Imagery (C9)
Algal Mat or Crust (134)
_Soils (C6)
_Saturation
_Stunted or Stressed Plants (D1)
Iron Deposits (135)
_Thin Muck Surface (C7)
_Geomorphic Position (D2)
Inundation Visible on Aerial
_Other (Explain in Remarks)
—Shallow Aquitard (D3)
Imagery (137)
_ Microtopographic Relief (D4)
Water - Stained Leaves (139)
_ FAC- Neutral Test (D5)
Aquatic Fauna (1313)
Field Observations:
Surface water present? Yes
No X Depth (inches):
Wetland
Water table present? Yes
No X Depth (inches):
hydrology
Saturation present? Yes
No X Depth (inches):
present? N
(includes capillary fringe)
Describe recorded data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
No indicators of wetland hydrology present.
US Army Corps of Engineers Eastern Mountains and Piedmont Region

VtUr- IAI ION - use sclentitic names Ot
plants
Sampling Point: U121-upland
50/20 Thresholds
Tree Stratum Plot Size (
30 ft.
) Absolute %
Dominant
Indicator
20% 50%
Cover
Species
Status
Tree Stratum 4 10
1
Acernegundo
10
Y
FAC
Sapling/Shrub Stratum 4 10
2
Fraxinus pennsylvanice
5
Y
FACW
Herb Stratum 2 5
3
CeBis laevigata
5
Y
FACW
Woody Vine Stratum 0 0
4
5
Dominance Test Worksheet
6
Number of Dominant
7
Species that are OBL,
8
FACW, or FAC 4 (A)
9
Total Number of Dominant
10
Species Across all Strata 8 (B)
20
= Total Cover
Percent of Dominant
Species that are OBL,
Sapling/Shrub Plot Size (
15 ft
) Absolute %
Dominant
Indicator
FACW, or FAC. 50.00% (AB)
Stratum
Cover
Species
Status
Prevalence Index Worksheet
1 Ligustrum sinense 10 Y FACU
2
Acer saccharum
5
Y
FACU
Total % Cover of.
3
Juniperus viiginiana
5
Y
FACU
OBL species 0 x 1= 0
4
FACW species 10 x2= 20
5
FAC species 15 x3= 45
6
FACU species 25 x4= 100
7
UPL species 0 x5= 0
8
Column totals 50 (A) 165 (B)
9
Prevalence Index = B/A = 330
10
20
= Total Cover
Hydrophytic Vegetation Indicators:
Herb Stratum Plot Size (
5 ft
) Absolute %
Dominant
Indicator
_ Rapid test for hydrophytic vegetation
Cover
Species
Status
test is >50%
1
Lonioars japonica
5
Y
FAC
—Dominance
Prevalence index Is 53 0•
2
Qrsium homdulum
5
Y
FACU
_
Morphological adaptations' (provide
3
supporting data in Remarks or on a
4
_separate sheet)
5
Problematic hydrophytic vegetation'
6
(explain)
7
_
•Indicators of hydnc soil and wetland hydrology must be
8
present, unless disturbed or problematic
9
10
Definitions of Vegetation Strata:
11
12
Tree - Woody plants 3 in (7 6 cm) or more In diameter at
13
breast height (DBH), regardless of height
14
saplinglshrub- Woody plants less than 3 In DBH and
15
greater than 3 28 ft (1 m) tall
10
= Total Cover
Herb - All herbaceous (non-woody) plants, regardless of
Woody Vine
Absolute %
Dominant
Indicator
size, and woody plants less than 3.28 ft tail
Stratum Plot Size (
30 ft.
) Cover
Species
i�
Status
Woody hoes -All woody ulnae greater than 3 28 fl In
1
height.
2
3
4
Hydrophytic
5
vegetation
0
= Total Cover
present? N
Remarks: (Include photo numbers here or on a separate sheet)
US Army Corps of Engineers
50% of dominant species are FAC or wetter.
Eastern Mountains and Piedmont Region

SOIL
Semolina Point: DP1- upland
Profile Description: Describe to the depth needed to document the indicator or confirm the absence of indicators.
Depth
Inches
Matrix
Color moist %
Redox Features
Color moist % Type* Loc"
Texture
Remarks
0-12
10YR 3/3
100
sandy loam
"Type: C= Concentration, D= Depletion, RM= Reduced Matrix, CS= Covered or Coated Sand Grains
"Location: PL =Pore Lining, M =Matrix
Hydric Soil Indicators: Indicators for Problematic Hydric Soils:
_Dark Surface (S7)
Histisol (Al) Polyvalue Below Surface (S8) 2 cm Muck (A10) (MLRA 147)
Histic Epipedon (A2) (MLRA 147,148) _Coast Prairie Redox (A16) (MLRA 147,148)
Black Histic (A3) Thin Dark Surface (S9) Piedmont Floodplain Soils (F19)
Hydrogen Sulfide (A4) (MLRA 147,148) (MLRA 136,147)
Stratified Layers (A5) Loamy Gleyed Matrix (F2) Very Shallow Dark Surface (TF12)
2 cm Muck (A10) (LRR N) _Depleted Matrix (F3) _Other (Explain in Remarks)
Depleted Below Dark Surface (A11) Redox Dark Surface (F6)
Thick Dark Surface (Al2) _Depleted Dark Surface (F7)
Sandy Mucky Mineral (S1) Redox Depressions (F8)
(LRR N, MLRA 147,148) _ Iron- Manganese Masses (F12) (LRR N, MLRA 136)
Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136,122)
Sandy Redox (S5) _Piedmont Floodplain Soils (F19) (MLRA 148)
Stripped Matrix (S6) Red Parent Material (F21) (MLRA 127,147)
'Indicators of hydrophytic vegetation and wetland hydrology must be present, unless disturbed or problematic
Restrictive Layer (if observed):
Type:
Depth (inches):
Hydric soil present? N
Remarks:
No hydre soil indicators present.
US Army Corps of Engineers Eastern Mountains and Piedmont Region

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD): 1 -9 -2013
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:Asheville, NC
C. PROJECT LOCATION AND BACKGROUND INFORMATION: PERENNIAL RPW STREAM A
State:North Carolina County /parish/borough: Cabamu City: Harrisburg
Center coordinates of site (lat/long in degree decimal format): Lat. 35.3048640 0, Long. 80.673440° W.
Universal Transverse Mercator: NAD 83
Name of nearest waterbody: Back Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Rocky River
Name of watershed or Hydrologic Unit Code (HUC): Yadkin (HU# 03040105)
Check if map /diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s): 1 -9 -2013
SECTION H: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There _j na "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Xi� `waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply).. r
TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
Non -RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non - wetland waters: 517 linear feet: 4 width (ft) and/or 0.047 acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on: tablished b O
Elevation of established OHWM (if known):
2. Non - regulated waters/wetlands (check if applicable):]
[� Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
'Boxes checked below shall be supported by completing the appropriate sections in Section III below.
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year -round or has continuous flow at least "seasonally"
(e g, typically 3 months)
' Supporting documentation is presented in Section III F

SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section M.D.I. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.l.; otherwise, see Section HIM below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent ":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non- navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year -round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year -round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section HLC below.
1. Characteristics of non -TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: )Pick Lis
Drainage area: Pick L'
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
❑ Tributary flows through ick Lis tributaries before entering TNW.
Project waters are ick Lis river miles from TNW.
Project waters are ick Lis river miles from RPW.
Project waters are ick Lis aerial (straight) miles from TNW.
Project waters are ick Lis aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
Flow route can be described by identifying, a g, tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW

(b) General Tributary Characteristics (check all that apply):
Tributary is: ❑ Natural
❑ Artificial (man - made). Explain:
❑ Manipulated (man - altered). Explain: Natural channel ditched in areas.
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick Lis
Primary tributary substrate composition (check all that apply):
❑ Silts ❑ Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation. Type/' /o cover:
❑ Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Stable.
Presence of run/riflle /pool complexes. Explain:
Tributary geometry; Pick Lis
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: 'ck List
Estimate average number of flow events in review area/year: ick Lis
Describe flow regime:
Other information on duration and volume:
Surface flow is: 'ck Lis Characteristics:
Subsurface flow: ick List. Explain findings:
❑ Dye (or other) test performed:
Tributary has (check all that apply):
❑ Bed and banks
❑ OHWM' (check all indicators that apply):
❑ clear, natural line impressed on the bank
❑
❑ changes in the character of soil
❑
❑ shelving
❑
❑ vegetation matted down, bent, or absent
❑
❑ leaf litter disturbed or washed away
❑
❑ sediment deposition
❑
❑ water staining
❑
❑ other (list):
❑ Discontinuous OHWM.7 Explain:
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that apply):
High Tide Line indicated by: ® Mean High Water Mark indicated by:
❑ oil or scum line along shore objects ❑ survey to available datum;
❑ fine shell or debris deposits (foreshore) ❑ physical markings;
❑ physical markings/characteristics ❑ vegetation lines/changes in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
6A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e g, flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid

(iv) Biological Characteristics. Channel supports (check all that apply):
❑ Riparian corridor. Characteristics (type, average width):
❑ Wetland fringe. Characteristics:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non -TNW:
Flow is: Pick Lisp. Explain:
Surface flow is: ick Lis
Characteristics:
Subsurface flow: ick Lis . Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non -TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Nick Lisi river miles from TNW.
Project waters are ick List aerial (straight) miles from TNW.
Flow is from: fck List
Estimate approximate location of wetland as within the ick Lis floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average width):
❑ Vegetation type /percent cover. Explain:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if an
All wetland(s) being considered in the cumulative analysis: ric k Lis
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year -round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: Stream A flows northeast across the project area for approximately 31 linear feet before entering a pipe
system beneath Buckingham Lane. Stream A emerges from the pipe north of Buckingham Lane and flows northeast across
the project area for approximately 372 linear feet before entering a pipe system beneath Caldwell Road. Stream A emerges
from the pipe north of Caldwell Road and flows for approximately 15 linear before entering a pipe system beneath Tom Query
Road. Stream A emerges from the pipe north of Tom Query Road and flows for approximately 99 feet before it flows offsite
to a confluence with Back Creek. Stream A exhibited a strong bed and bank, moderate substrate sorting, strong flow,
moderate sinuosity, moderate depositional bars and benches, and an average ordinary high water width of four feet.

Biological sampling revealed a moderate presence of iron oxidizing bacteria and an absence of amphibians. Stream
characteristics indicate that continuous flow is present year round in a typical year. Stream A was classified as a Relatively
Permanent Water with perennial flow (RPW) according to USACE/EPA guidance. Perennial RPW Stream A scored 50 out of
a possible 100 points on the USACE Stream Quality Assessment Worksheet and 35 out of a possible 63 points on the
NCDWQ Stream Classification Form, indicating perennial status (SCPI, enclosed). Photographs A, B, and C (Figure 3,
attached) are representative of Perennial RPW Stream A.
❑ Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section M.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
® Tributary waters: 517 linear feet 4 width (ft).
❑ Other non - wetland waters: acres.
Identify type(s) of waters:
3. Non -RPWss that flow directly or indirectly into TNWs.
[� Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section M.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non - wetland waters: acres.
Identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
❑ Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year - round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
❑ Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
❑ Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs.
® Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters s
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1 -6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
BSee Footnote # 3
To complete the analysis refer to the key in Section III D 6 of the Instructional Guidebook

E. ISOLATED [INTERSTATE OR INTRA- STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) :io
which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
❑ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non - wetland waters: acres.
Identify type(s) of waters:
❑ Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
❑ Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
❑ Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
❑ Non - wetland waters (i.e., rivers, streams): linear feet width (ft).
❑ Lakes/ponds: acres.
Other non - wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Non - wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
❑ Other non - wetland waters: acres. List type of aquatic resource:
❑ Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
igMaps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
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.
U.S. Geological Survey map(s). Cite scale & quad name:7.5' Topographic Map Series, 1:24,000, Harrisburgl, NC Quadrangle.
USDA Natural Resources Conservation Service Soil Survey. Citation: Cabamis County Soil Survey.
National wetlands inventory map(s). Cite name:
State/Local wetland inventory map(s):
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurlsdkdon Fopowing Rapanos.

❑ FEMA/FIRM maps:
100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
® Photographs: ❑ Aerial (Name & Date):
or ® Other (Name & Date):Site Photographs, 1 -9 -2013.
Previous determination(s). File no. and date of response letter:
Applicable /supporting case law:
Applicable /supporting scientific literature:
Ej Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:

Harrisburg Culverts
Buckingham Road
USI Project # 120202
Structure 3
Span
9.00
Rise
5.00
Culvert Invert Out
622.95
Q (cfs)
255.00
Tailwater WSE
626.95
Brink Depth (Ye)
2.08
Best Fit or Envelope Design?
Envelope
Rip Rap Selected
Class II
Rip Rap 1350 in
14
Brink Velocity (fps)
13.64
Tailwater w
4.00
Pipe Area
18.69
Froude Number Fr
1.67
Tw/Ye
1.93
Tailwater Parameter Co
2.40
Check Mo/Ye
0.56
Calculated Depth of Pool (hs)
-0.89
Desired Depth of Pool (hs)
2.50
Check hs/D50
2.1
Bottom of Pool Elev
620.45
Rip Rap Thickness 3D50 or 2Dmax ft
3.83
Rip Rap Thickness 21350 or 1.5Dmax ft
2.88
Total Length of Basin Lb ft
36
Length of Scour Hole Ls ft
27
Length of Apron La ft
9
Ideal Width of Basin ft
33
Design Width of Basin ft
12
Basin Exit Depth c
2.13
Flow Area Ac
35
Exit Velocity (fps)
7.37
Rip Rap Plunge Pool Calculations
4/26/2012
10 Yr (Rational)
To use figure 3.3 in HEC -14, use the value above to determine yo /D and derive yo
Note: Use Envelope design for severe failure consequences; Use Best Fit where maintenance
access is readily available and structures /roadways are not at risk, per HEC -14
TW/Ye >0.75, Therefore rip rap is need on slopes of channel
>0.1, Therefore OK
>2.0, Therefore OK
At outfall of culvert
On bottom and sides
Note: Basin may be warped to match existing exit channel grades where appropriate, per HEC -14
J