20140204 Ver 1_Stream Call Request_20140307

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8FCling Department of Environment and Natural Resources
Division of Water Quality
Pat McC MAR — 1 2014 Thomas A. Reeder John E. Skvada, III
Governor Acting Director Secretary
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DWQ Use only: Project # Pf -132-6y'
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner information (corporationfindivdual who is legally responsible for the property and its compliance)
la. Name(s) on Recorded Deed
Weyerhaeuser Company
1b. Responsible Party (for LLC)
tc Mailing Address
1785 Weyerhaeuser Road Vanceboro, NC 285856
1d. Telephone Number
252 -22 9-8328
119. Email Address
I Clilf.tyson ®weyerhasuser.com
2. Location of Project Site - please include the county, nearest named town and highway number:
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3. Has anyone from DWD visited the s @e? N Staff Name Date of Visit?
Additional Requested Information
4. Agent/Consultant information (if applicable)
4a. Name, Company
4b. Mailing address
4c. Telephone no.
4d. Email address
5. Project and Site Information See attached maps
5a. Name of project
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5b. County
5c. Nearest Named Stream
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5d. River Basin
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5e. Provide a brief description of this project (attach site plan if available):
Final Harvest
Access at
call at
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey.
If you are unable to locate either of these maps, lease contact the Regional Office for assistance.
Please return form to: Anthony Scarbraugh
943 Washington Square Mall Note. Submittals on Friday after 12:00 pm
Washington, NC 27889 will be stamped as received on the
Fax: [phone] next business day.
Email . anthony scarbrauahliMncdenr oov
Please contact Anthony Scarbraugh at (252) 946 -6481 if you have any questions.

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