20140202 Ver 1_Stream Call Request_20140225

NCDENR
-North Carolina Department of Environment and Natural Resources
Division of Water Quality
{FNW(:rorVJ14 Thomas A. Reeder John E. Skvarla, III
Governor Acting Director Secretary
vi 4
DWQ Use Only Project # tf - saw-
Stream Origin /Buffer Applicability Determination
Required Information
1. Owner Information (corporation /individual who is legally responsible for the property and its compliance)
1a. Name(s) on Recorded Deed
WTKL, LLC
1b. Responsible Party (for LLC)
Tim Haithcock
1c. Mailing Address
126 Fairmax Road, Goldsboro, NC 27534
1d. Telephone Number
(929) 705 -4052
le. Email Address
5a. Name of project
2. Location of Project Site - please include the county, nearest named town and highway number:
4374, 4388 & 4392 US Highway 70 E, just southeast of the intersection of Hwy 70 and Hwy 111, in Goldsboro, Wayne County, NC.
The Property is presently bordered to the north by E US Highway 70 followed by vacant fields. The site is bordered to the
west by Handy Mart service station and Auto Zone followed by NC Highway 111 and a used car lot. It is bordered to the east
by a vacant agricultural field and to the south by a vacant field and a Food Lion shopping center,
3. Has anyone from DWQ visited the site?
I Y / N
I Staff Name
I N/A
Date of Visit?
N/A
Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
Walter Cole, LSS with S &ME
4b. Mailing address
3201 Spring Forest Road
4c. Telephone no.
(919) 872 -2660
4d. Email address
wcole @smeinc.com
5. Project and Site Information -
5a. Name of project
Walmart Store #86426
5b. County
Wayne
5c. Nearest Named Stream
Walnut Creek
5d. River Basin
Neuse
5e. Provide a brief description of this project (attach site plan if available): A Walmart Neighborhood Market (Store No '
86426 - Goldsboro SE) is planned for construction and development of the 4.95 acre site will include a Walmart building,
associated paved parking and access drive (primarily north of the proposed building), and a stormwater pond along the
southern property boundary.
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, please contact the Regional Office for assistance.
DWQ Use Only: Is this stream call for the purpose of: buffer mitigation nutrient offset credit
Please return form to: Anthony Scarbraugh
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12.00 pm
will be stamped as received on the
Fax: [phone] next business day.
Email: anthonv.scarbraughra)ncdenr.gov
Please contact Anthony Scarbraugh at (252) 946 -6481 if you have any questions.

AGENT AUTHORIZATION FORM
Date: 11 -22 -2013
Project Information
Type of Project: Commercial
Location: Southeast of the intersection of US 70 and NC Hwy
Goldsboro, Wayne County, North Carolina
Property Owner/Representative Information
Business Name:
Mailing Address: 49 f Q
City, State, Zip Code: /%mil G�Z S
Telephone No.
Contact: / /. .L Al
Agent Information
Business Name:
S &ME, Inc.
Street Address:
3201 Spring Forest Road
City, State, Zip Code:
Raleigh, NC 27616
Telephone No.
919- 872 -2660
Contact:
Mr. Walter Cole
115 11111111111":
/,o ` >•,d G-zi� _ hereby authorize
(Name of Landowner or Representative)
S &ME to act as agent with the USCAE in connection with the
above - mentioned project.

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MAP SOURCE: W TOPO TERRAIN NAVIGATOR; USGS TOPOGRAPHIC QUADRANGLE MAPS; MAP EDITION 4.0
SCALE: 1:8,000 BY: 1� GO FIGURE NO.
DATE. *S&ME USGS TOPOGRAPHIC MAP
FEB 2014
GRAM LDSBORO SE QUADRANGLE .�
VW VV.SMEINC.COM PROPOSED WALMART STORE #86426
PROJECTNO: NC ENGINEER LICENSE #F-0176
1054- 13 -378D 3201 SPRING FOREST RD, RALEIGH, NC 27818 GOLDSBORO, WAYNE COUNTY, NC

MAP SOURCE: USDA -SCS WAYNE COUNTY SOIL SURVEY MAP; ISSUED JUNE 1974
1�111 , :20.000 *S&ME FIGURE NO
DATE USDA -SCS SOIL SURVEY MAP
Y W2014 WAYNE COUNTY SHEET 26 2
DRAWN aw. WC
VMM.SMEINC.COM PROPOSED WALMART STORE # 86426
PROJECTNO NO ENGINEER LICENSE #F-0176 GOLDSBORO, WAYNE COUNTY, NC
054- 13 -378D 3201 SPRING FOREST RD, RALEIGH. NC 27616

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