20130614 Ver 1_NC ERFO FSR 2011-1-(1) (3)_20130822

0-
U.S. Department
of Transportation
Federal Highway
Administration
FEDERAL EXPRESS
Mr. Tom Steffens
Eastern Federal Lands
Highway Division
AUG 2'0 2013
U.S. Army Corps of Engineers
Washington Regulatory Field Office
2407 West Fifth Street
Washington, NC 27889
Mr. Garcy Ward
21400 Ridgeto
Sterling, VA 200514-0,",
9
In Reply Refer to: HFPP -15
North Carolina Division of Water Quality
Wetlands, Buffers, Stormwater Compliance and Permitting Unit
512 North Salisbury Street
Archdale Building, 9t" Floor
Raleigh, NC 27604
Subject:. Project NC ERFO FSR 2011 -1(1), Repair of Bridge and Six Culverts
Croatan National Forest
Submittal of Pre - Construction Notification
Dear Mr. Steffens and Mr. Ward:
/-3- OCR q
The Eastern Federal Lands Highway Division, of the Federal Highway Administration (FHWA),
in cooperation with the USDA Forest Service - Croatan National Forest is in-receipt of the
Division of Water Quality (DWQ) letter dated July 25, 2013 indicating that the permit
application was deficient. Further coordination was also,completed via phone on July 30, 2013
to discuss concerns and comments on the project. Below you will find responses to the
comments provided in your letter:
1. Site Numbers. The site numbers in the Categorical Exclusion differ from the site
numbers in the wetland delineation. The Pre - Construction Notification (PCN) Form has
been revised to match the Categorical Exclusion; however, please reference the road
name and milepost for each site.
2'. River Basins and Riparian Buffer Rules. It was determined by DWQ that the stream at
Middle Little Road milepost 3.953 is ephemeral, and therefore not subject to the buffer
rules. The PCN was revised to state that the three sites in Craven County are in the
Neuse River Basin. The proposed bridge at Middle Little Road milepost 3.517 and the
culvert at Brown Road milepost 0.100 would both impact less than 40 linear feet of
riparian buffer; however, there would also be impacts resulting from the temporary
sediment and erosion control diversion berm. The PCN was revised to include impacts to'
the riparian buffer.
1)

2
3. Stream, buffer, and open water impacts. The PCN has been revised to provide separate
impact areas for stream, buffer, and open water impacts.
4. Wetland impacts. Additional sheets have been developed that provide an enlarged view
of the wetland impacts, and also include cross hatching to differential the types of
impacts.
5. Riprap. The placement of riprap was removed from the project in order to reduce
impacts to the wetlands and streams.
Channel modification through the excavation of material at the inlet and outlet of the culverts
will be necessary at all of the sites except for the bridge at Middle Little Road milepost 3.517.
FHWA requests a waiver from Nationwide Permit 14 Regional Condition 4.5.6, "Excavation of
existing stream channels shall be limited to the minimum necessary to construct or install the
proposed culvert. The final width of the impacted streams at the culvert inlet and outlet should be
no greater than the original stream width. A waiver from this condition may be requested in
writing. The waiver will be issued if it can be demonstrated that it is not practicable to limit the
final width of the culvert to that of the impacted stream at the culvert inlet and outlet and the
proposed design would result in less impacts to the aquatic environment."
1. Millis Road milepost 7.300 and Petiford Creek Road milepost 0.394. The culverts at
Millis Road milepost 7.300 will be shortened from 48 to 27 feet in length. The culverts
at Petiford Creek Road milepost 0.394 will be reduced from 41 to 24.5 feet in length.
The reduction in culvert length requires excavation at the inlet and outlet of the new
culvert to ensure drainage and aquatic passage. The width of the stream channel will not
change.
2. Black Swamp Road milepost 0.630 and Black Swamp Road milepost 4.076. The culverts
at Black Swamp Road milepost 0.630 will be shortened from 34 to 32.67 feet in length.
The culverts at Black Swamp Road milepost 4.076 will be shortened from 37 to 29.67
feet in length. The reduction in culvert length requires excavation at the inlet and outlet of
the new culvert to ensure drainage and aquatic passage. The width of the stream channel
will not change.
3. Middle Little Road milepost 3.517, Middle Little Road milepost 3.953, and Brown Road
milepost 0.100. Middle Little Road milepost 3.953 would be shortened from 29.67 to 23
feet in length. No excavation will be done at Middle Little Road milepost 3.517. The
culverts at Brown road would be shortened from 38.5 feet to 25 feet in length. The
reduction in culvert length requires excavation at the inlet and outlet of the new culvert to
ensure drainage and aquatic passage. The width of the stream channel will not change.
Enclosed you will find the revised project plans and the revised PCN form. Please provide us
with,your response within thirty (30) days of the receipt of this letter. If you have any questions
concerning this matter, please contact Ms. Lisa Landers, Environmental Protection Specialist, at
Lisa. Landersgdot. gov or (571) 434 -1592.
Sincerely yours,
Kevin S. Rose
Environmental Compliance Specialist

J
Enclosures
cc:
Ms. Rachelle Powell, Croatan and Uwharrie National Forests, USDA Forest Service
Mr. Cliff Northrop, National Forests in North Carolina, USDA Forest Service
Mr. Lynn Hicks, National Forests in North Carolina, USDA Forest Service

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
ATE
Pre - Construction No ft6ation (PCN) Form
A.
Applicant Information J
1.
Processing
1a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
❑ Yes ❑X No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
Q 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express NX Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ Yes 0 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 ❑X No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
Nx Yes ❑ No
,
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑Yes ❑X No
2.
Project Information
2a.
Name of project:
NC ERFO FSR 2011 -1 (1)
2b.
County:
Carteret, Craven, Jones
2c.
Nearest municipality / town:
Croatan National Forest - Swansboro, Newport, New Bern
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:
USDA Forest Service
3b.
Deed Book and Page No.
n/a
3c.
Responsible Party (for LLC if
applicable):
Kevin Rose, Federal Highway Administration
3d.
Street address:
21400 Ridgetop Circle
3e.
City, state, zip:
Sterling, VA 20166
3f.
Telephone no.:
571 -434 -1541
3g.
Fax no.:
571 -434 -1577
3h.
Email address:
Kevin. Rose @dot.gov
Page 1 of 10
PCN Form — Version 1.4 January 2009

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ❑ Other, specify:
4b.
Name:
Kevin Rose
4c.
Business name
(if applicable):
Federal Highway Administration
4d.
Street address:
21400 Ridgetop Circle
4e.
City, state, zip:
Sterling, VA 20166
4f.
Telephone no.:
571 - 434 -1541
4g.
Fax no.:
571 - 434 -1577
4h.
Email address:
Kevin. Rose @dot.gov
5.
Agent/Consultant Information (if applicable)
5a.
Name:
n/a
5b.
Business name
(if applicable):
5c.
Street address:
5d.
City, state, zip:
5e.
Telephone no.:
5f.
Fax no.:
5g.
Email address:
Page 2 of 10

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
n/a
1 b.
Site coordinates (in decimal degrees):
Latitude: Longitude:
1c.
Property size:
2,250 acres
2.
Surface Waters
2a.
Name of nearest "body of water to proposed project:
White Oak River, Petiford Creek, Brice Creek
2b.
Water Quality Classification of nearest receiving water:
SA, NSW; SA, HQW; SC, SW, NSW
2c.
River basin:
j White Oak, Neuse
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 area surrounding project sites in within the Croatan National Forest and is undeveloped vegetated area
3b.
List the total estimated acreage of all existing wetlands on the property:
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
3d.
The
Explain the purpose of the proposed project:
project will replace damaged culverts.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project includes the replacements of multiple culverts, and the repair of a bridge abutment.
4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ❑x No ❑ Unknown
Comments: The draft wetland delineation is attached.
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency /Consultant Company: Aquaeter
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
this project (including all prior phases) in the past?
101 es 0 No ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑Yes No
6b.
If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

1
C. Proposed Impacts Inventory Petiford Creek Road Milepost 0.394
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑X Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 T
Diversion Berm
Pocosin
Yes
Corps
0.017
W2 P
Embankment
Pocosin
Yes
Corps
0.004
W3 P
Wingwall
Pocosin
Yes
Corps
0.007
W4
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
W6 -
Choose one'
Choose one
Yes /No
2g. Total Wetland Impacts:
0.028
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact '
length
(linear
feet)
S1 T
Diversion Berm
trib to Petiford Creek
PER
Corps
6
27.5
S2 P
Excavation
trib to Petiford Creek
PER
Corps
6
20
S3 P
Culvert
trib to Petiford Creek
PER
Corps
6
-0.5
S4 -
Choose one
-
S5 -
Choose one
-
S6
Choose one
-
3h. Total stream and tributary impacts
47
3i. Comments:
Page 4 of 10
RCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
O2
Choose one
Choose
03 -
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 vou MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1 -
Yes /No
B2 -
Yes /No
B3
Yes /No
B4
Yes /No
B5
Yes /No
B6
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

C. Proposed Impacts Inventory Brown Road Milepost 0.100
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
X Wetlands ❑X Streams —tributaries ❑X Buffers N 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 T
Diversion Berm
Pine Flat
Yes
Corps
0.014
W2 P
Embankment
Pine Flat
Yes
Corps
0.003
W3 P
Wingwall
Pine Flat
Yes
Corps
0.001
W4 P
Road Embankment
Pine Flat
Yes
Corps
0.002
W5
Choose one
Choose one
Yes /No
-
W6 -
Choose one
Choose one
Yes /No
-
2g. Total Wetland Impacts:
0.020
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. n
3a.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
'Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
trib to E Prong Brice Cr
PER
Corps
6.5
29.7
S2 P
Excavation
trib to E Prong Brice Cr
PER
Corps
6.5
11
S3 P
Culvert
trib to E Prong Brice Cr
PER
Corps
6.5
0.25
S4 -
Choose one
-
S5 -
Choose one
-
-
S6 -
Choose one
-
,3h. Total stream 'and tributary impacts
40.725
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a. .
Open water
impact number
Permanent (P) or
Temporary ( T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 T
n/a
Diversion Berm
Other
0.010
O2 -
Choose one
Choose
03 -
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
0.010
4g. Comments:
i
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 vou MUST fill out Section D'of this form.
6a. Project is in which protected basin?
❑X Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1 T
Diversion Berm
tributary to East Prong Brice Creek
No
1039
0
B2 P
Embankment
tributary to East Prong Brice Creek
No
181
0
B3 P
Wingwall
tributary to East Prong Brice Creek
No
95
0
B4
Yes /No
B5
Yes /No
B6 -
Yes /No
6h. Total Buffer Impacts:
1315
0
6i. Comments:
Page 5 of 10

C. Proposed Impacts Inventory Middle Little Road Milepost 3.517
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑X Streams — tributaries ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1
Choose one
Choose one
Yes /No
-
W2 -
Choose one
Choose one
Yes /No
-
W3 -
Choose one
Choose one
Yes /No
-
W4
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
trib to Brice Creek
PER
Corps
8
30.5
S2 P
Wingwall
trib to Brice Creek
PER
Corps
8
9
S3
Choose one
S4
Choose one
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
39.5
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
'Area of impact (acres)
01
Choose one
Choose
O2 -
Choose one
Choose
03
Choose one
Choose
04 -
Choose one
Choose
i 4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction .
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 vou MUST fill out Section D of this form.
6a. Project is in which protected basin?
J
0 Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
131 T
Diversion Berm
unnamed tributary to Brice Creek
No
103
0
B2 P
Wingwalls
unnamed tributary to Brice Creek
No
29
0
B3
Yes /No
B4
Yes /No
B5 _
Yes /No
B6
Yes /No
6h. Total Buffer Impacts:
132
0
6i. Comments: The road crossing impacts less than 40 linear feet of riparian buffer; therefore is exempt.
Page 5 of 10

C. Proposed Impacts Inventory Black Swannp Road Milepost 4.076
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
'❑X Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 T
Diversion Berm
Pocosin
No
Corps
0.005
W2 -
Choose one
Choose one
Yes /No
W3 -
Choose one
Choose one
Yes /No
W4 -
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
2g. Total Wetland Impacts:
0.005
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
, Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
trib to Holston Creek
PER
Corps
14
20.3
S2 P
Excavation
trib to Holston Creek
PER
Corps
14
14
S3 P
Culvert
trib to Holston Creek
PER
Corps
14
2.5
S4 -
Choose one
-
S5
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
36.8
3i. Comments:
�1
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e. `
Area of impact (acres)
01 -
Choose one
Choose
O2 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name •
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1
Yes /No
B2
Yes /No
B3
Yes /No
B4 _
Yes /No
B5 -
Yes /No
B6
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10 -

C. Proposed Impacts Inventory Black Swamp Road Milepost 0.630
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑X Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 P
Embankment
Pocosin
No
Corps
0.001
W2 P
Wingwall
Pocosin
No
Corps
0.001
W3 T
Diversion Berm
Pocosin
No
Corps
0.025
W4 _
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
-
W6 -
Choose one
Choose one
Yes /No
-
2g. Total Wetland Impacts:
0.027
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
Black Swamp Creek
PER
Corps
17.5
48.5
S2 P
Excavation
Black Swamp Creek
PER
Corps
17.5
7
S3 P
Culvert
Black Swamp Creek
PER
Corps
17.5
7
S4 -
Choose one
-
-
S5
Choose one
-
S6 -
Choose one
-
3h. Total stream and tributary impacts
62.5
3i. Comments:
Page 4 of 10
. PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
1
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
02 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below. -
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number --
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
131
Yes /No
B2
Yes /No
B3 _
Yes /No
B4 -
Yes /No
135 -
Yes /No
B6 -
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

C. Proposed Impacts Inventory Millis Road Milepost 7.300
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑X Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 T
Diversion Berm
Pocosin
Yes
Corps
0.030
W2 P
Embankment
Pocosin
Yes
Corps
0.004
W3 P
Wingwall
Pocosin
Yes
Corps
0.007
W4 _
Choose one
Choose one
Yes /No
-
W5
Choose one
Choose one
Yes /No
-
W6 -
Choose one
Choose one
Yes /No
2g. Total Wetland Impacts:
0.041
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.
Stream impact
number
'Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
trib to Petiford Creek
PER
Corps
11
19.6
S2 P
Excavation
trib to Petiford Creek
PER
Corps
11
22
S3 P
Culvert
trib to Petiford Creek
PER
Corps
11
-4.5
S4
Choose one
S5 -
Choose one
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
37.1
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
O2
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction '
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1
Yes /No
B2
Yes /No
B3
Yes /No
B4 -
Yes /No
B5 -
Yes /No
B6 -
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

C. Proposed Impacts Inventory Middle Little Road Milepost 3.953 (Ephemeral)
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑X Wetlands ❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 T
Diversion Berm
Pine Flat
Yes
Corps
0.005
W2 P
Wingwall
Pine Flat
Yes
Corps
0.001
W3 -
Choose one
Choose one
Yes /No
W4 -
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
-
W6 -
r
Choose one
Choose one
Yes /No
2g. Total Wetland Impacts:
0.006
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f."
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 T
Diversion Berm
trib to Brice Creek
PER
Corps
14
16.2
S2 P
Excavation
crib to Brice Creek
PER
Corps
14
14
S3 P
Culvert
trib to Brice Creek
PER
Corps
14
2.5
S4
Choose one
-
-
S5 -
Choose one
S6 -
Choose one
-
3h. Total stream and tributary impacts
32.7
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivi ually list all open water impacts below.
4a.
Open water
,impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
O2 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 miti ation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1 -
Yes /No
B2 -
Yes /No
B3 -
Yes /No
B4 -
Yes /No
B5 -
Yes /No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation.
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Culverts will be replaced in same location as the existing culvert, and were sized for,the same hydraulic capacity after accommodating sinking them a
foot below the substrate level per NCDWQ
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sedimentation of adjacent wetlands will be minimized through the use of silt fence. The area to be dewatered for construction was minimized.
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 X❑ 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
El 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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
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:
Choose one
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 6 of 10
PCN Form — Version 1.4 January 2009

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 QX 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 7of10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes' ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
%'
2b.
Does this project require a Stormwater Management Plan?
❑ Yes .❑X No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
The project will replace existing culverts and the total ground disturbance is approximately 0.26 acres. No
new impervious area will be created by this
project.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e.
Who will be responsible for the review of the Stormwater Management Plan?
DWQ
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
n/a
❑ Phase II
❑ NSW
3b.
Which of the following locally - implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
El Yes ❑X No
attached?
4.
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a.
Which of the following state - implemented stormwater management programs apply
❑ORW -
(check all that apply):
E] Session Law 2006 -246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑X No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal /state /local) funds or the
❑X Yes ❑ No
use of public (federal /state) land? -
1 b.
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
❑X Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the, NEPA or SEPA final approval
Q Yes ❑ No
letter.) Categorical Exclusion is attached
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,
El Yes ❑X No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b.
Is this an after - the -fact permit application?
El Yes ❑X 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
El Yes ❑X 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.
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 9 of 10
PCN Form — Version 1.4 January 2009

S. 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
❑X Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Coordination with the Wildlife Biologist at the Croatan National Forest and the USFWS. ,
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
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 ❑X 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?
Coordination with the State Historic Preservation Office.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
The project replaces existing infrastructure and improves the hydrologic connectivity.
8c. What source(s) did you use to make the floodplain determination?
Kevin S. Rose
08 -20 -2013
Applicant/Agent's Printed Name
Date
pplicant/ gent' ignature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

j
J -1
,
FEDERAL HIGHWAY ADMINISTRATION
EASTERN FEDERAL LANDS HIGHWAY DIVISION
SPECIAL CONTRACT REQUIREMENTS
Project WON
NOUN
The following Special Contract Requirements amend and supplement the Standard
Specifications for Construction of Roads and Bridges on Federal Highway Projects (FP -03)
U. S. Customary Units, U. S. Department of Transportation, Federal Highway Administration.
l

J -2.
Section 101. — TERMS, FORMAT, AND DEFINITIONS
101.01. Delete the last paragraph.
Section 102. —BID, AWARD, AND EXECUTION OF CONTRACT
102.04. Add the following:
Furnish documentary evidence as to the ownership and value of the assets pledged in support of
the bond and details of the security interest in the assets by the individual sureties for the
apparent low bidder within 14 calendar days after the opening of bids. Failure to submit
evidence within the time required will be grounds for declaring the surety unacceptable.
In addition, the CO may, after reviewing the Affidavit of Individual Surety and documentary
information on the security interest and the assets pledged, by certified mail to the surety's
business or residence address (as shown on the bond), request the-surety to provide further
information and /or documents with respect to any of the documents provided. The CO may
require such information to be furnished under oath. Failure of the surety to accept such mail, or
failure of the surety to respond with the_requested information or documents within 7 business
days of receipt of the request, will be cause for rejection of the surety.
These requirements are in addition to the requirements in FAR Subpart 28.203, except where in
conflict with the requirements in the FAR, in which case the FAR controls.
102.06. Add the following after the last paragraph:
Submit the documentary evidence for individual sureties at the same time as the Affidavit of
Individual Surety and security interest in assets pledged. A Contractor submitting an
unacceptable individual surety in satisfaction of a performance or payment bond before the
issuance of the Notice to Proceed will be permitted one opportunity to substitute an acceptable
surety or sureties within 7 business days of receipt of notification that the surety is unacceptable.
The Government's right to direct the substitution of sureties to ensure the continuing
acceptability of the bonds during the performance of the Contract according to FAR Clause
52.228 -2, Additional Bond Security, is not restricted.
These requirements are in addition to the requirements in FAR Subpart 28.203, except where in
conflict with the requirements in the FAR, in which case the FAR controls.
Section 104. — CONTROL OF WORK
104.03(a). Add the following to the third paragraph:
MraWings will be reviewed in the order they are received.

J -3
104.E t3. Add the followin
(e) As -built working drawings. Furnish 2 sets of as -built working drawings. The
Government will provide 2 sets of contract drawings to be used exclusively for recording the
as -built details of the project.
Keep the as -built working drawings current on a weekly basis and have at least 1 set
available on the jobsite at all times. Accurately and neatly record changes from the contract
plans, which are made in the work, or additional information, which might be uncovered in
the course of construction, as they occur by means of details and notes. Maintain a log of all
changes made to the as -built working drawings, and monthly, at the estimate cutoff date,
make the as -built working drawings and log available for review by the CO.
Note all additions or revisions to the location, character, and dimensions of the prescribed
work shown on the contract drawings. Line out all details shown that are not applicable to
the completed work. Use the red -line process (red pencil of red ink) to record on the as -built
working drawings and final as -built drawings, as a minimum, but not limited to, the
infonmation described below:
(1) Typical section(s)
(a) Revisions in dimensions; and
(b) Revisions in materials.
(2) Plan and profile
(a) Plan
(1) Revisions to the aligmment;
(2) Changes in the construction limits;
r
(3) Revisions in location, type, and grade of road approaches;
(4) Location and type of utilities;
(S) Location, size, and type of underdrains;
(6) Skew of culverts;
(7) Channel changes;
(8) Location of monuments and permanent references;
(9) Elevations for all aerial and underground crossings of utilities; and

J ,4
(10) Location, length, and type of fencing.
(b) Profile
(1) Revisions to grades, elevations, and stationing of intersection PIs;
(2) Equations;
(3) Culvert diameter; length, type, and stationing; .
(4) Length of culvert extension, and length of existing culvert;
(5) Location, length, stationing, and type of retaining walls; and
(6) Location, -length, stationing, and end treatment of guardrail.
(3) Bridge
(a) Stationing of bridge ends;
(b) Elevations including footing, bearing pads, deck, and top of walls;
(c) Pile driving record with pile length, size, type, and tip elevation;
(d) Post - tensioning records including stressing sequence, jacking force, and duct size
and layout;
(e) Construction and concrete placement sequences;
(fl Bearing details with orientation;
(g) Expansion joints including actual clearance with atmospheric temperature; and
(h) Any changes in plan or dimensions including any major changes in reinforcing.
_r
(4) Miscellaneous
(a) Revisions to parking areas or turnouts;
(b) Final location, type and length of curbs, sidewalks, etc.;
(c) Fencing type and limits; and
(d) Landscaping and planting.

J -5
(5) Special Contract Procedures
(a) Method of excavation, concrete placement, girder erection, stricture repairs, etc.
Prepare final as -built drawings after the completion of each definable feature of work as
listed in the Contractor Quality Control Plan (Foundations, Utilities, Structural Steel, etc., as
appropriate for the project). 'The as -built working drawings and final as -built drawings will
be jointly reviewed for accuracy and completeness by the CO and the Contractor prior to
submission of each monthly.pay estimate.
If the monthly review finds that the Contractor is not maintaining the as -built working
drawings, payment of the Contractor's invoice will be withheld until the as -built working
drawings are brought up to date.
Furnish the as -built working drawings to the CO before the final inspection. Correct all
details found during the final inspection that are not shown on the as -built working drawings
and return to the CO within 5 working days for approval.
Once final as -built working drawings have been approved by the CO, provide final as -built
drawings in the latest version of Adobe Acrobat (PDF) format (at the time of submission) on
two sets of CD -R or DVD -R. Include the latest version Adobe Acrobat reader on the CD -R
or DVD -R. Provide the final as -built drawings with a resolution quality such that the
redlined drawings and notations are clearly discernable. Final payment per Subsection
109.09 will not be made until the CD -R or DVD -R of the final as -built drawings have been
reviewed and approved by the CO.
No direct payment will be made for maintaining and furnishing as -built working drawings.
104.05. Add the following:
When hauling on r `:: =Fou Service roads, do not exceed the following load restrictions:
Single Units Gross Vehicle Weight _ pounds
2 axles 40,000
3 axles 48,000
4 or more axles 52,000
Combination Units
3 axles 57,000
4 axles 62,000
5 or more axles 66,000

}. J -6
Where the ground is saturated with
water or during °periods of freezing: and thawing, •the CO may impose' further. load *-- restrictions or
'suspend hauling.
Operate.loaded;",vehicles hauling material,, at, speeds• not exceeding' f ii'les'pef hour, 'or the • ,
posted' speed -limit *whichever is lower, and'spaced at 500 '-footmimmurn intervals.• � Do 'not,exceed
25 miles ' erlhour, "or the posted speed. limit w'hichever:is lower;_or,operate more than'=1:loaded.
hauling vehicle at a time on a bridge.
Section'405. =• CONTROL.OF MATERIAL
1®S.011s. D to the` hi' d paragr =h'acid ub�stai, ute fh of
110 Wx`i710,
105.02(b). 'Add the following:
If any material is,to be excavated fro'rn any.material..source,outside the construction limits;
other than- - commercially operated sites, provide'a certif cation from •the•State Historic!
Preservation Officer.or Indian Tribal Council, if applicable; before Work; begins -that states:
(1) A cultural resource survey (a survey,fonhistorical sites and archeological remains)
has been performed at the - proposed site; and
(2)' No significant cultural resources exist in the area that will be disturbed by the
Contractor. :+
Section 106. — ACCEPTANCE OF WORK
06x01: Ad'd'the" afo11

J -7
Uis'e';pr`euai�lingindustry standar~ds`ainh'e a bseric'e- of contr�actre. uirem ritsaorltolerances:
106.03. Delete the first sentence of the second paragraph and substitute the following:
Other than references in or to the FAR or Federal Law, when these Standard Specifications or
Supplemental Contract Requirements reference certifications; certificates; or certified
documents, equipment, or individuals, these references are not certifications under Section 4301
of Public Law 104 -106, National Defense Authorization Act for Fiscal Year 1996.
ithe;lfo'l�lowaing,
;eat ons befdre1 nc6 o atkii ,the material into ,the work to ensurte , that
of,the�contraet`laaYe'tb,een n7et. ih h Mark- the�_cerhificat"ons w
o- Project =�n�a_� p'3
o''?P,roect number
o.�Contract iaei, �riumbert;
clew,- 'pt-i' ®n;
ro'sCon�fracto'r;':�s sisgnat�ire�;'�a�iid
\
Section 107. —LEGAL RELATIONS AND RESPONSIBILITY TO THE PUBLIC
107.01. Delete the second sentence of the third paragraph and substitute the following:
Obtain all additional pen-nits or agreements and modifications to Government - obtained permits
or agreements that are required.
107.02. Add the following after the sixth paragraph:
Notify the CO in writing at least 48 hours in advance of any scheduled utility shutdown,
investigation, and /or related work.

r
J -8
107:05: Add.•the,following -after ,tlie. second paragraph':. : -
Submit all claims•f6the insurance�company. for. investigation;iregardless`of deductible- unless the
Contractor has chosen to pay`tlie 'c'la'im directly:. Provide �theresults ,of. any, investiga6ons'.and.
subsequent- actions to the CO within, week of receipt .from the insurance company or, of action.
Determination by the insurance company that the claim is not covered b'- :'the�pglicy isA of an.
adequate basis for the Contractor to fail to meet its obligations,under the,requirements of this
Section.
Sectiori•108: -' PROSECUTION. ',AND -PRO G'RESS,
108.01. Add the ,following:. '
,
-Construction operations are limited as follows:
,La) No work will be permitted on Sundays or National legal holidays.
b No k wi�l +l',b'erpe 'ittecl oin rig T 0� 4 ,ul�y'31 `= (x 4i at t all z vin sll,
Theo ,�,.
C�� '.ea�iE• a .�T1 %�_
1 .

J -9
Section 109.— MEASUREMENT AND PAYMENT
109.08(b). Add the following:
Submit invoices by the 7th day after the closing date. Invoices received after the 16th clay
following the closing date will not be accepted for payment processing that month. Include
late, unprocessed invoice submittals in the following month's invoice.
109.08(c). Add the following:
The government's designated billing office is:
Federal Highway Administration
Eastern Federal Lands Highway Division
Loudoun Tech Center
21400 Ridgetop Circle
Room 200
Sterling, Virginia 20166 -6511
ATTN: CONSTRUCTION DIVISION
Section 152. — CONSTRUCTION SURVEY AND STAKING
152.02. Delete the second sentence of the second paragraph and substitute the following:
Reestablish any missing initial reference lines, control points, and stakes set by the Government.
152.03. Delete the text of paragraphs
152.03(1)(9) and (10). Delete the Subsections and substitute the following:
(9) Pennanent and temporary traffic control signs, signals, markings, delineators, object
markers, etc.
(10) 'Excavation limits for various drainage, walls, strictures, and other pertinent items.
Section 154. — CONTRACTOR SAMPLING AND TESTING
154.03. Add the following:
Furnish test results to the CO immediately after completing the test. The requirements for
furnishing test results do not include sample aging or curing time; therefore, reporting times will
be extended accordingly.
Submit proposals for using alternate AASHTO or State approved test methods in writing for
approval. Alternate methods may be allowed based on documented equivalence to the method

J -10
specified.
Federal Highway rA'din.iristration
.. � .;� )L �- S'n'ag �"Y. €'•!'f.�fc:� 1
Eastern Federal'Lands Hi'glwa, F Dui'si n
�' M1 �S,'.: .aric'�'-�",��^'"�.a",`<"r�•�,` '�' a""'�'m aa, ,� "c,.� ^s'aa�.a ..rox.a.+::w..x�..yaw.�ara»t
�1�827�T1ack�Delozrer�Dn��e
Sevi.ervilll-q s & 7,876
' --.`'r a,.r.,,•,,,.,,,:, �..,
AT�TNt��MAT�ER�I�A�L'�S' =L�AB:ORA�T�ORY
Section 155.— SCHEDULES FOR CONSTRUCTION CONTRACTS
155.02. Add the following after the third paragraph:
155.02A Weather Delays.
(a) Weather Delay Definitions.
(1) Reasonably Predictable Weather. The number of workdays that can expected to be
lost in any month due'to rainfall based on 10 -year historical weather data.
(2) Rain Day. A potentially lost workday on which rainfall is equal to or greater than
0.10 inches.
(3) Drying Day. A work day(s) immediately following a rainfall equal to or greater than
1.00 inch which is potentially lost because of wet. ground conditions.
(4) Workday. A day not excluded from work by Section 108 of the Special Contract
Requirements.
(5) Unusually Severe Weather. When the number of Actual Workdays Lost is greater
than the calculated Total Lost Days for the month in question.
(b) Reasonably Predictable Weather. Determine Reasonably Predictable Weather for this
contract by completing Table 155 -1. Calculate data for Table 155 -1 as follows:
(1) Using the last 10 years of historical weather data from the nearest NOAA weather
data collection station, compute the average number of workdays lost (rain days plus
drying days) for each month and the standard deviation from the average. Add the
average number of workdays lost to, the standard deviation.
(2) The Total number of Lost Days (Average Workdays Lost plus 1 Standard Deviation,
rounded to whole days) will be considered nonnal for each month.
(3) Submit a completed Table 155 71 with the initial construction schedule. -

J -I 1
(c) Unusually Severe Weather! Under FAR Clause 52.249 -10, Default (Fixed -Price
Construction), the Contractor can request time for a delay due to Unusually Severe Weather.
The number of Actual Workdays Lost is calculated by first totaling the actual Rain' Days plus
the actual Drying Days occurring in the month in question. From this total, deduct any
workdays meeting the following conditions:
(1) The Rain Day or Drying Day occurred on 'a non -work weekday such as a holiday.
(2) Rainfall occurred at a time when no weather dependent work was in progress or
occurred during planned or unplanned shutdowns due to other circumstances such as
equipment failure, strikes, material supplies, delays; etc.
(3) The Contractor was still working or able to work on weather dependent activities to
the extent that less than 50 percent of the workday was lost due to weather.
If the net number of Actual Workdays Lost is greater than the Total Lost Days, then
Unusually Severe Weather occurred during the month in question.
(d) Time Adjustments for Rain Delays. If the net number of Actual Workdays Lost to rain
is less than the Total Lost Days for the month in question, no time adjustments will be made.
If the net number of Actual Workdays Lost is snore, then an excusable time extension may be
granted. The Contractor must submit a Weather Time Impact Analysis supporting any
alleged delays due to Unusually Severe Weather.
(e) Delays Due To Other Weather Conditions. Delays due to other unusually severe '
weather conditions (snow, extreme cold or heat, high winds, etc.) must be supported with a
Weather Time Impact Analysis using historical weather data.
155.02. Delete the last paragraph and substitute the following:
The Construction Contract Time shown on the construction schedule for contract completion or
for any interim completion dates shall be the calendar dates established in the contract.
155.04. Add the following to the first paragraph:
For a computer - generated CPM, use Primavera software or software that is file - compatible with
Primavera.

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Add the. - following at the end of the- Subsection: `
TABLE 155 -1
ProjectNuniber
Location of NOAA Data Collection Station
Data Years, (10 -year history): through 20
REASONABLY PREDICTABLE1WEATHER,,
MONTH
AVERAGE WORKDAYS
LOST t.
STANDARD
'DEVIATION
TOTAL LOST
DAYS,.,
JANUARY
FEBRUARY
;
MARCH
APRIL
.,.•
MAY'
4 'p
JUNE
JULY
s
AUGUST
R
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER.
..
,
Section 156. — PUBLIC TRAFFIC r
156.03. 'Add'the f6llowia g:
Hauling will only be permitted from the nearest point of public access to the work site.
Minimize hauling over completed pavement.
0

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156.04. Add the following:
(g) Ensure that all drains and inlets within the project limits are fully functional throughout
the duration of the project.
156.06(b). Delete the second sentence and substitute the following:
For shoulder drop -offs in excess of 3 inches, provide a IV: 3H fillet with "Low Shoulder"
warning signs.
t
o Do o 01 aoe- =o o n
.'.'ffi -k,.q
J 3 4.Y
0
156.07. Delete the Subsection and - substitute the following:
156.07,: Nighttime Operations. Nighttime operations are not permitted. Perform construction
operations during the hours of daylight (' /2 hour after sunrise to '/2 hour before sunset).
156.08. Delete the second sentence of the first paragraph and substitute the following:
The traffic safety supervisor may be the superintendent.;
Section 201. — CLEARING AND GRUBBING
M,l i0.6$ - A;cic1 tsheo;l 10 aiiav

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Section 203. — REMOVAL OF STRUCTURES AND OBSTRUCTIONS
Fad �� amn� e n'� 1 ®ta a�f > l _gyp. .. , F _ • '.
aim d
203.05(b). Delete the Subsection and- substitute the following:
(b) Burn. Burning is prohibited. Dispose of material according to Subsection 203.05(a).
203.05(c). Delete the Subsection and substitute the following: r .
Y {.
(c) Bury. Burying debris is prohibited - Dispose of material according to- Subsection
203.05(a).
Section 204. .EXCAVATION AND EMBANKMENT.
204.13(d). Add the following:
Flush the exposed faces of rock embankment with soil conserved*from the excavation.
i

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Section 301. UNTREATED AGGREGATE COURSES
301.03. Add the following after the second paragraph:
Submit the representative 300 -pound sample to the EFLHD Central Laboratory in Sevierville,
Tennessee.
Section 552.— STRUCTURAL CONCRETE
552.03(g). Add the following:
Use Type I or II portland cement in all concrete.
552.03(v). Add the following:
Provide Class '" A �) concrete with a minimum 28 -day compressive strength of
pounds per square inch.
552.09(b)(4). Add the following:
Provide for compressive strength testing of the concrete cylinders by an independent
laboratory, qualified to perform the testing, and as approved by the CO.
Section 554.— REINFORCING STEEL
554.08. Delete the first sentence of the first paragraph and substitute the following:
Place, fasten, and support the bars according to the CRSI Manual of Standard Practice. Use
precast concrete blocks or inetal supports.
Section 601. —MINOR CONCRETE STRUCTURES
601.03. Delete the first sentence and substitute the following:
Conform to Table 601 -1 or furnish a concrete mix used locally by either a Federal or State
agency for the construction of minor concrete structures, that also meets the minimum 28 -day
compressive strength requirement of Table 601 -1.

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Section 602.— CULVERTS'AND DRAINS
602.03. Add the following:
• r
Furnish. im =- cculvert pipe Classy.
Construct either cast= in- place,or precast concrete I " Construct cast -in -place s
according to Section
Section 605.' UNDERDRAINS', SHEET DRAINS, AND PAVEMENT EDGE DRAINS
I _JJl• + toi •
Section 625. —TURF ESTABLISHMENT
625.01. Add the following:
The work,does not include, areas previously.protected by soil erosion control, measures according
to Section 157, and upon which permanent suitable vegetation has started growth.
625.06. Add the following: ' ` <•
Apply limestone and- fertilizer'at the foflowing,rates:
Item Rate (pounds pe'r acre)
Agricultural Limestone (85 percent CaCO3) `4 ;
Fertilizer e,a
625.07. Add the following:
Apply�seed at the rates for each season as follows:
Seeding:Seasons and
I

625.08. Add the following:
Apply
ffl� d '�e+1i1'�vng0
mulch at the rate
1�2ti�rd. aia�_ a� a soli, �ilti e:le f ©i)q�n
Section 635. — TEMPORARY TRAFFIC CONTROL
635.02. Delete the Constriction sign panels Section reference and substitute'the following:
J -17
0
Construction sign panels
635.03. Add the following:
633.02
For all signs and other devices requiring orange color, use fluorescent orange, fluorescent red -
orange, or fluorescent yellow- orange color.
635.03(i). Add the following:
Submit a certification that the devices have been successfully crash tested to meet the
requirements of NCHRP Report 350 and /or have been accepted by the FHWA.
635.07. Delete the last sentence of the first paragraph and substitute the following:
Remove or completely cover all unnecessary signs, or signs that conflict with the construction
signing or Traffic Control Plan. Cover signs that are not removed' so that no part of the covered
sign is visible to traffic. Provide sign covers for temporary signs meeting the following
requirements:
(a) Large enough to completely cover the sign.
(b) Easy to attach to and remove from the sign without damaging the sign face. Do not use
adhesives, glues, tapes, or mechanical fasteners that mar the sign face.

J -18
(c) Black, non - reflective, and,opaque. A'
(d) Made of plywood.(minimum of 3 /8 --inchesthick); aluminum-, (minimum of -.0' :040 inches'
thick), or sheet, rrietal of a sufficient thickness that the covering will not be lifted, bent, or
damaged by wind. w
(e) Durable enough to resist deterioration due'to :weathering and atmospheric conditions for
.the duration of the project.
Section 637 . = `,FACILITIES: AND, SERVICES
63 7.02. Add the following: • . • x " ''..z
Locate t lie. Government' :fieId�',offrce,'W: ere= high =:sp6 d ntercet= access;:•ashdes'cribe`&in:Subs6 tion`.
637.03(x).(7), is available. -�P - �- °� '� 5� �e ' • - e ' ire , ° r s °
Mii rr a7l�_ 1 - _ _ ©fir ( m±W a �r :Locate;the`,ffeld o'ffice-within "15 miles.Uthe
project site. In remote 'locations where'higli- speed. Inteinet service is not available, the field
office distance`'raiige may:be.extended. or`waived-by.the''CO, 'All field offrce4bcations are
subject to approval bythe CO.
637.03. Delete the third•and fourth sentences of the first paragraph and substitute the following:
Provide local and long distance telephone services. The Government will be responsible for the
cost of long,distance-ca'lls'made by Government employees for, Government,busiriess and :
charged against this phone service. Bill the Government separatelyrfor these charges.
637.03(a). Add the following:
'Divide the field 6ffice into-3 areas by permanent walls with hinged ;doors. If window air -
conditioning is ,provided; provide a- separate unit for:each'room:
Clean the field office weekly to the approval of,the CO`.
Supply the following equipment in the .field office:.
(1) .Copy,machine. , One•sel- f- feeding•plain paper photo copying machine with the
following minimum. capabilities:
(6) Automatic document feeder capable: of-inaking at least 8 copies per minute;,
(b) -Reproducing copies at standard sizes up, to and including 11, x 17 inches; -and-
(c) Reducing 11 x 17 inches plan sheets to 8 '/z x 14 inches legal size and to 8 1/2 x

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11 inches letter size.
Furnish all necessary supplies, except paper. Paper will be supplied by the Government.
(2) Printer. ' One plain paper printing machine with printing capabilities of standard
sizes up to and including 11 x 17 inches. The printer must be capable of printing from
direct personal computer (PC) and local area network (LAN) hookups. ,,The printer may
be one machine in combination with the copy machine. Furnish all necessary supplies,
except paper. Paper, will be supplied by the Government.
(3) Facsimile (FAX) machine. One FAX machine with the following minimum
capabilities:
(a) Automatic document feeder with a minimum capacity of 20 pages;
(b) Sending standard size documents up to and including 11 x 17 inches;
(c) Printing on plain paper; and
(d) Automatic dial /redial.
The FAX machine may be one machine in bombination with the copy machine. Furnish
all necessary supplies, except paper. Paper will be supplied by the Government.
(4) Telephone. Two dual line telephones (touch tone, hold button, intercom, and
conference calling capabilities) with 2 separate lines, for the exclusive use of the CO.
(5) Answering machine. One digital answering device capable of answering,
recording, storing, and playing back messages at least 30 minutes in length.
(6) Cellular telephone. M durable, hand held digital /cellular wireless telephone(s)
for the use of the CO., Furnish cellular telephone(s) that are similar or.compatible with
the Contractor's key field personnel (Project Superintendent, Traffic Control Supervisor,
etc.) to enable the direct communication between the CO and the Contractor's key field
personnel. Furnish each cellular telephone(s) with the following minimum capabilities:
(a) Direct Connect feature, or equivalent, to communicate onsite with Contractor's
key field personnel;
(b) Voicemail capable of answering, recording, storing, and playing back messages
at least 30 minutes in length;
(c) Hands free device that can be used safely and effectively while driving, and is
acceptable by the local law enforcement agencies;
(d) Customized communication configuration, independent of the other units, so

that the CO'may limit any features if necessary;
J -20
(e)' Carrying case•that' can be�woni' on th&beli and is appropriate'•for'Dse on •
construction projects; and
s `(' Other. necessary�cellular• tel' epl�one ,,access'oriesriincluding -a cigarette lighter
power adapter /charger.` k
The cellular telephone plan'shall_provide,the.- necessary. amount. of mbnthly Virect_
Connect airtime and monthly Digital /Cellular airtime for use on'the project. Ensure that
each unit -has unlimited Direct Connect capabilities and�eaeh „unit is equipped with.
unlimited airtime, roaming, and local and long distance airtime necessary per month for,
official business only. Provide phones that work properly at the project site and at -the
Contractor's-and Government field office' to cations,., 7
(7) High -speed Iiiter et access: Provide; :install',- and. maintain high- speed'Internet
access service having at least 768.kilobit'per'seeond download ,and, 256 kilobit per second
upload speed. The high -speed Internet access `service can be +provided-'via.DSL, FIOS, a
dedicated T1 dine, or cable. Alternate Internet access service options may be submitted to
the CO for approval. The system must include a modem •and,a.router with a firewall or a
router and a firewall appliance. The system.must have the - capability to support,
simultaneous Internet access ofatfleast 3' workstations °connected =by Category 6 -RJ45
-LAN office drop "l 1+ ifirew all configuration must�be submitted'to the,CO. for
approval and cannot'be'changed after it is approved, unless a change request is submitted
and approved in,advance.,, Only U.S. -DOT equipm,'ent is to be connected to the system.
If any equipment supplied becomes defective, is stolen, or for any other reason does not
function -as intended; replace the equipment with an_,equat or better unit at no additional cost
to the Govenment. Replace:any defective-equip'ment within-eight -hours after being notified
by the CO. °
A >
The Contractor. will retain ownership-of all equipment supplied'by the Contractor. The CO
will notify,the Contractor when -the`equipment-is'no' longer, needed and request.its removal.,
Section 703. — AGGREGATE
703.02. Add the following:
Gravel-will not be permitted.
703.05(a). Delete items (3) and (4).

Section 718. — TRAFFIC SIGNING AND MARKING MATERIAL
718.01. Add the following:
For a list of acceptable manufacturers and products, refer to the Sheeting Guide at:
http : / /safety.fhwa.dot.gov'/roadwav dept /night visib /sign visib /sheetguide /.
I
It
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