20081575 Ver 1_Stream Call Request_20130417

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CD F N_ .' E D
North Carolina Department of Environment and Natural Resources
Division of Water Quality APR 17 2013
Pat McCrory Charles Wakild, P.E. John E. Skvarla III
Governor Director �
Stream Origin /Buffer Applicability Determination
�pplicant/Owner's Name (corporation/individual who is legally responsible for the prope an its compliance:
Applicant/Owner Address: 316 8 `:��oN da9� �'- f �/U�Jo L'l��fl. �. -7'F' 18'
Applicant's phone number: J:`r' S Fax number: 25J.,
Applicant's email address: FV �7t?Z GJ �DL , Onsi
Consultant/Contact person Name (if applicable):
Consultant address (if applicable):
Consultant's phone number:
Consultant's email address:
Fax number:
Name of Project: TT �� a� (2 — a County: /01 V4
Nearest Named stream + River Basin (from USGS topographic map):
Please provide a brief description of this project (attach site plan if available):
Please attach a map of site location indicating project boundaries using USGS 1:24,000 topo map and NRCS county soil survey.
Location of project site - please include reference to the county, nearest named town and highway number:
P�'� ��� �4, /1�.►�hgas /f ls�><,m.v
f4wszv� �iG,r'LiJV�rS�fl a L4.6_xy1�s / N&— A*_0V 1712 /_ Y / lUccAV
Has any DWQ staff visited the site ?__Ae!!�, if yes, please provide DWQ staff name, C'�4a�s �u /��%%�R and date of
visit: 44z /e 2ddrg
This form may be submitted via email (amy.adams&cmail.net� 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 Intemet www.ncwaterquality.oM
943 Washington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolina
An Equal opportunity /Affirmative Action Employer — 50% Recycled/1 0% Post Consumer Paper Naturallff
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NC DWn Stream idenfificatian Farm VPrcinn d l l- ��i�1�•;.�_
Date:
Project/Site.
Lat4.td
Evaluator:
County: ;-,-
Longitude:
Total Points: / 1�
Stream is at least intermittent L
Stream Determination (circle one)
Other
if z 19 or perennial if z 30' 110�
Ephemeral Intermittent Perennial
e.g. Quad Name:
PKA
A. Geomorphology (Subtotal
Absent
Weak
Moderate
Strong
1a Continuity of channel bed and bank
0
19. Rooted upland plants in streambed
2
3
2. Sinuosity of channel along thalweg
1.
1
2
3
3. In- channel structure: ex. riffle -pool, step -pool,
ripple-pool sequence
0
1
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active /relict floodplain t,
No = 0
1
2
3
6. Depositional bars or benches -_._
0.5
1
2
3
7. Recent alluvial deposits
1
2
3
8. Headcuts
0
1
_
3
9. Grade control
1
0.5
1
1.5
10. Natural valley
0
1
1.5
11. Second or greater order channel
= 0
Yes = 3
arwiciar aricnes are not rarea, see aiscussions in manual
R Hvdrolonv (Suhtatal = 01 1
12. Presence of Baseflow
0
1
2 IN
33
13. Iron oxidizing bacteria
0
19. Rooted upland plants in streambed
2
3
14. Leaf litter
1.
0.5
0
15. Sediment on plants or debris
1
1
1.5
16. Organic debris lines or piles
0
5
1.5
17. Soil -based evidence of high water;able?
No = 0
es =
%-. rs(o(oav (JUDiOial = / , ' )
18. Fibrous roots in streambed
3
2
1 .
0
19. Rooted upland plants in streambed
0
20. Macrobenthos (note diversity and abundance)
1
2
3
21. Aquatic Mollusks
1
2
3
22. Fish -; -
0.5
1
1.5
23. Crayfish
0.5
1
1.5
24. Amphibians
0.5
1
1.5
25. Algae
1
1.5
26. Wetland plants in streambed
FA(W ='..0.75; OBL = 1.5 Other = 0
'perennial streams may also be identified using other metho s. See p. 35 o manual.
Notes:
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10° W
Name: GREENVILLE SW
Date: 4/17/2013
Scale: 1 inch equals 1000 feet
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08 -1575 A • / 13
N 35 34.708' • J
W 77 25.970'
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08 -1575 B 1N 35 34.6 4' R. • r
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W 77 25.854'
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9th Christian Jr ' *see
cademy ... **see
ed Oak : : • • .
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Location: 035° 34'42.85" N 077° 25'51.84" W
Caption: Stream Determination Midgette Investment, LLC, Corner of
Allen Road and Dickinson Ave. Greenville, NC
(C) 1998. Maotech. Inc.