20140555 Ver 1_Application_20140603

Wainwright, David
From: Wainwright, David
Sent: Tuesday, June 17, 2014 7:25 AM
To: King, Art C
Subject: Moore Co. Bridge 73 & Richmond Co. Bridge 13
Art,
I have reviewed your application submittals for both Bridge No. 73 in Moore County (dated received June 3, 2014) and
Bridge No. 13 in Richmond County (dated received June 10, 2014). Both application were applied for as a USACE NW 3,
which corresponds to NCDWR General Certification Number 3883. Based on the impacts and information provided in
the application package, both projects are below impact thresholds requiring written authorization from the NCDWR.
Please review our General Certification 3883 to makesure that proposed impacts are below stated thresholds on page
one and that all other listed conditions can be met. If you find this is the case, no further action is required from us at
this time. If you find that they cannot be met, or thresholds do exceed those stated, either now or in the future, please
contact me so we can discuss further.
Thank you for notifying us of the project. Should you have any questions or need further assistance, please do not
hesitate to contact me.
David Wainwright
NCDENR, Division of Water Resources
Transportation Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699 -1617
Phone: [phone] Fax: [phone]
David.Wainwright @ncdenr.gov
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties unless the content is exempt by statute or other regulation.
APlease consider the environment before printing this email

I
i
20140555
", �yO0 G r , W Office Use Only:
/ / ';:
1 1 > T_ Corps action ID no.
D, 1 J4 DWQ project no.
p�D . Form Version 1.3 Dec 10 2008
Pre - Construction" oflcation PC Form
A. licant, Information
1. Processing
la. 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
1 d. Type(s) of approval sought from the DWQ (check all that apply):
❑ 401 Water Quality Certification — Regular El Non-404 Jurisdictional General Permit
El 401 Water Quality Certification — Express ❑ 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 ® No
For the record only for Corps Permit:
® Yes ❑ No
If 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.
EJ Yes ®No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
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:
NC 24/27 Bridge No. 620073
2b. County:
Moore
2c. Nearest municipality / town:
Cameron
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
17BP.8.R.57
3. Owner Information
3a. Name(s) on Recorded Deed:
NCDOT
3b. Deed Book and Page No.
N/A
3c. Responsible Party (for LLC if
applicable):
Robert W, Stone II, PE
.'3d. Street address:
902 N. Sandhills Blvd.
3e. City, state, zip:
Aberdeen, NC 28315
3f. Telephone no.:
910 - 944 -2344
3g. Fax no.:
910 - 944 -5623
3h. Email address:
robstone @ncdot.gov
r � it
JUN 3 2014
Page 1 of 10 DENR' WATER QUALITY
LANDS
PCN Form —Version 1.3 December 10, 200 8 t 8ATERBPw'JC'4

Z 0
4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ® Other, specify: Division Engineer
4b. Name: Robert W. Stone II, PE
4c. Business name
(if nnn1innk1 - %- NCDOT
4d. Street address:
902 N. Sandhills Blvd.
4e. City, state, zip:
Aberdeen, NC 28315
4f. Telephone no.:
910 -944 -2344
4g. Fax no.:
910 - 944 -5623
4h. Email address:
robstone @ncdot.gov
5. Agent/Consultant Information (if applicable)
5a. Name:
Art C. King
5b. Business name
(if annlirohinl.
NCDOT
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
902 North Sandhill Blvd
Aberdeen, NC 28315
910- 944 -2344
910 - 944 -5623
acking @ncdot.gov
Page 2 of 10
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):
N/A
1b. Site coordinates (in decimal degrees):
Latitude: 35.300898 Longitude: - 79.20912
(DD.DDDDDD) (- DD.DDDDDD)
1c. Property size:
acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
Beaver Creek
2b, Water Quality Classification of nearest receiving water:
WS -III
2c. River basin:
Cape Fear
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:
Rural wooded area
3b. List the total estimated acreage of all existing wetlands on the property:
0.02
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
120
3d. Explain the purpose of the proposed project:
Bridge Replacement
3e. Describe the overall project in detail, including the type of equipment to be used:
Remove existing bridge and bents with excavator. Replace with steel girders and driven pile end bents, utilizing crane.
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?
Comments:
❑ Yes ❑ No ® Unknown
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:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations'oe 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?
❑Yes ❑ 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 1.3 December 10, 2008 Version

J-- uivcinviy
mmary
ons were completed below for your project (check all that apply):
ffons
❑ Streams - tributaries ❑ Buffers
❑ 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 T
W1 ® P ❑ T Fill —9 —Yes ® Corps
❑ No ® DWQ 0.02
W2 ❑ P ❑ T
❑Yes
❑ Corps
❑ No
❑ DWQ
❑ Corps
W3 ❑ P ❑ T
❑ Yes
❑ No
❑ DWQ
❑ Corps
W4 ❑ P ❑ T
❑ Yes
❑ No
❑ DWQ
❑ Corps
W5 ❑ P ❑ T
❑ Yes
❑ No
❑ DWQ
❑ Corps
W6 ❑ P ❑ T
❑ Yes
❑ No
❑ DWQ
2g. Total wetland impacts
0.02
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
for
question 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 stream length
Permanent (P) or intermittent
DWQ – non -404, width (linear
(T) (INT)?
other) (feet) feet)
S1 ❑ P ❑ T NA ❑ PER ❑ Corps
❑ INT ❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P FIT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P [--IT
❑ PER
❑ Corps
❑ INT
❑ DWQ
❑ Corps
S5 ❑ P ❑ T
❑ PER
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑DWQ
3h. Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form – Version 1.3 December 10, 2008 Version

Page 5 of 10
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
NA
02 ❑P ❑T
03 ❑P ❑T
04 ❑P [IT
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction pro osed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID Wetland Impacts (acres) Stream Impacts (feet) Upland
Proposed use or purpose
number of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated Flooded
Pi NA
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.
Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Other:
❑ Catawba ❑ Randleman
6e. 6f. gg.
6b.
Buffer impact
6c.
6d.
number—
Permanent (P) or
Reason
for
Stream name
Buffer Zone 1 impact Zone 2 impact
mitigation (square feet)
Temporary T -
impact
(square feet)
required?
B1 ❑P ❑T
NA
❑Yes
❑ No
B2 ❑P ❑T
❑Yes
❑ No
B3 ❑P ❑T
❑Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Side slopes will be at maximum allowed 2:1 to minimize footprint in wetland area.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion control devices will be installed and current BMP's will be utilized.
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?
F-1 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 6 of 10
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 I El Yes ® No
buffer mitigation?
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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (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:
r
Page 7 of 10
PCN Form — Version 1.3 December 10, 2008 Version

Page 8 of 10
PCN Form — Version 1.3 December 10, 2008 Version
c. biormwater management and Diffuse Flow Plan (required by DWQ)
I. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?
❑ Yes ® No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments, ❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
35%
2b. Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
The majority of the proposed roadway improvements will drain to vegetated side slopes and roadside ditches, which will
convey the roadway runoff to existing drainage areas and eventually to Beaver Creek. Class B rip rap will line ditches
with high velocities to prevent erosion.
2e. Who will be responsible for the review of the Stormwater Management Plan?
9
El Certified Local Government
F1 DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
3b. Which of the following locally - implemented stormwater management programs
apply (check all that apply):
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ® No
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented stormwater management programs apply
(check all that apply):
❑ Coastal counties
El HQW
El ORW
❑ Session Law 2006 -246
El
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes No
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 1.3 December 10, 2008 Version

F. Supplementary Information
I. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the
use of public (federal /state) land?
® Yes ❑ No
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
E]' 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
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
additional development, which could impact nearby downstream water quality?
❑ Yes ® No
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.
Page 9 of 10
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
habitat? ❑ Yes
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts? ❑ Yes
5c. If yes, indicate the USFWS Field Office you have contacted. ❑ Raleigh
❑ Asheville
/KR •
/AA •
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? I ❑ Yes ® 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
status (e.g., National Historic Trust designation or properties significant in ❑Yes No
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
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: MOA (2a)
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM Panel #9536) Effective 10/17/2006
Applicant/Agent's Printed Name Applicant/Agent, Si Va ture Date
(Agent's signature is valid only if an authorization letter from the applicant
is orovided.)
Page 10 of 10
PCN Form — Version 1.3 December 10, 2008 Version

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:.i
WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site 7 rJ City /County: Sampling Date, j
Applicant/Owner. State:`, Sampling Point:
Investigator(s): _) I r 3 :a : =, j , h::h YY • . f/. t'�r + Gf Section, Township, Range:
Landform (hillslope, terrace,.etc.): 1�G'lI &VCA -T Local relief (concave, convex -tione j L bl i -C. Slope ( %):
Subregion (LRR or MLRA) Lat: ��% �/f Long�L Z. t_.1
Soil Map Unit Name: le"' �� t. Oro NWI classification-
Are climatic / hydrologic conditions on the site ty ical for this time of year? Yes No (If no, explain in Remarks.)
Are Vegetation , Soil / , or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No
Are Vegetation Soil F" , or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophybc Vegetation Present? Yes No
Is the Sampled Area
Hydric Soil Present? Yes No within a Wetland? Yes No
Wetland Hydrology Present? Yes No
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required• check all that apply)
— Surface Soil Crack 6)
_ Surface Water (Al)
_ True Aquatic Plants (B14)
_ Sparse tated Concave Surface (B8)
— High Water Table (A2)
— Hydrogen Sulfide Odor (C1) ainage Patterns (610)
— Saturation (A3)
— Oxidized Rhizospheres on Living
Roo (e3j_ Moss Trim Lines (B16)
_ Water Marks (B1)
_ Presence of Reduced Iron,,(
_ Dry- Season Water Table (C2)
Sediment Deposits (B2)
Recent Iron ReducttiQ,p,•rrf-Tilled Soils
(C6) — Crayfish Burrows (C8)
_
Drift Deposits (B3)
—
Thin Muck Strome (C7)
— Saturation Visible on Aerial Imagery (C9)
_
Algal Mat or Crust (B4)
—
— Othgj, L plain in Remarks)
— Stunted or Stressed Plants (D1)
—
Iron Deposits (85)
•r
5 a 7 /X,
— Geomorphic Position (D2)
—
inundation Visible on Aerial Imagery
­,�
C¢7,)° "" /KGl
— Shallow Aquitard (D3)
_
_ Water- Stained Leaves (B9) ,,.
— Microtopographic Relief (D4)
— Aquatic Fauna (B1 - "�
— FAC- Neutral Test (D5)
Field Observation
Surface Water Present? Yes
No Depth (inches):
Water Table Present? Yes
No Depth (inches): li
Saturation Present? Yes
No Depth (inches):_
Wetland Hydrology Present? Yes No
includes capillary fringe)
Describe Recorded Data (stream gauge,
monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont – Interim Version

VEGETATION (Four Strata) — Use scientific names of plants.
sampling Point: "v /tcvt
Absolute Dominant Indicator
Dominance Test worksheet:
Tree Stratum (Plot size y )
% Cover S e es? Status us
Number of Dominant Species
That Are OBL, FACW, or FAC: (A)
2. y
-
�'•
Total Number of Dominant
3. %;'' i' "� � er! it, ��,`�, •c �r'_t ' ` r3+ :C"i ;
l
Species Across All Strata: (B)
Percent
_
=~4r-
5
OBL, FACW, or FAC, lU (A/B)
Tha Areof
6
Prevalence Index worksheet:
Total % Cover of: Multiply by:
7 /� y
8
�
Total Cover
OBL species x 1 =
Sapling /Shrub Stratum (Plot size: V )
FACW species x 2 =
1. i .� ,,;' , ; t
o'
FAC species x 3 =
2• ;i ,
FACU species x 4 =
3 F W Q ��
UPL species x 5=
Column Totals' (A) (B)
q. %=
t�
5.
Prevalence Index = B/A =
M 4
Hydrophytic Vegetation Indicators:
7. r.
_ 1 - Rapid Test for Hydrophytic Vegetation
8
2 - Dominance Test is >50%
9
3 - Prevalence Index is 53.0'
�
10.
---- ����cccc
_
4 - Morphological Adaptations' (Provide supporting
Total Cover
_
data in Remarks or on a separate sheet)
Herb Stratum (Plot size : _ )
Problematic Hydrophytic Vegetation' (Explain)
1.
2.
'Indicators of hydric soil and wetland hydrology must
3
be present, unless disturbed or problematic.
4•
Definitions of Four Vegetation Strata:
5.
6
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
7.
height.
.nn
8 Nr.
Sapling /Shrub - Woody plants, excluding vines, less
9.
than 3 in. DBH and greater than 3.28 ft (1 m) tall.
10
Herb - All herbaceous (non- woody) plants, regardless
11
of size, and woody plants less than 3.28 ft tall.
12.
= Total Cover
Woody vine - All woody vines greater than 3.28 ft in
Woody Vine Stratum (Plot size: )L) )
g
2.
3.
4.
Hydrophytic
5.
Vegetation
Present? Yes No
g
= Total Cover
Remarks: (Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Interim Version
Pi

bUIL
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Tvpe Loc Texture Remarks
Hydric Soil Indicators:
_ Histosol (Al)
_ Histic Epipedon (A2)
_ Black Histic (A3)
_ Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
_ 2 cm Muck (A10) (LRR N)
_ Depleted Below Dark Surface (A11)
_ Thick Dark Surface (Al2)
_ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
_ Stripped Matrix (S6)
Restrictive Layer (if observed):
Type:
Depth (inches)
Reduced Matrix MS= Masked Sand Grains 'Location: PL =Pore Lining, M= Matrix.
Indicators for Problematic Hydric So
_ Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_ Coast Prairie Redox (A16)
_ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
_ Loamy Gleyed Matrix (F2)
_ Piedmont Floodplain Soils (F19)
— Depleted Matrix (F3)
(MLRA 136, 147)
Redox Dark Surface (F6)
_ Red Parent Material (T172)
_
_ Depleted Dark Surface (F7)
_ Very Shallow Dark Surface (TF12)
_ Redox Depressions (F8)
— Other (Explain in Remarks)
_ Iron- Manganese Masses (F12) (LRR N,
MLRA 136)
_ Umbric Surface (F13) (MLRA 136, 122)
31ndicators of hydrophytic vegetation and
_ Piedmont Floodplain Soils (F19) (MLRA 148)
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes No
US Army Corps of Engineers Eastern Mountains and Piedmont – Interim Version

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont
Project/Site: City /County: ^ + r` r Sampling Date:
Applicant/Owner ( / %r'i" State: Sampling Point: �f:
Investigator(s): ;li i� /r✓ Y� + -, f'S , (� , ro i.0 Section, Township, Range:
Landform (hillsiope, terrace, etc.): -'ct t�4, Lq I relief ('croncave,`convex, none): �� -, G -f.�nl Slope
-� -y/�
Subregion (LRR or MLRA)• Lat: <r /J� Long 7 ! , 2 �i �� ' Datu 0i
Soil Map Unit Name: '( ^eo NWI classification: Fv 41C
Are climatic / hydrologic conditions on the site typical for this time of year? Yes1,_ No (if no, explain in Remarks.)
Are Vegetation, Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes No
Are Vegetation, Soil or Hydrology naturally problematic? (if needed, explain any answers in Remarks.) '
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No
Is the Sampled Area
Hydric Soil Present? Yes No within a Wetland? Yes u'� No
Wetland Hydrology Present? Yes i— No
Remarks,
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required• check all that apply)
_ Surface Soil Cracks (B6)
_ Surface Water (Al)
_ True Aquatic Plants (B14)
_ Sparsely Vegetated Concave Surface (B8)
_ High Water Table (A2)
_ Hydrogen Sulfide Odor (Cl)
_ Drainage Patterns (B10)
��aturation (A3)
_ Oxidized Rh¢ospheres on Living Roots (C3)
_ Moss Trim Lines (B16)
_ Water Marks (B1)
_ Presence of Reduced Iron (C4)
_ Dry- Season Water Table (C2)
_ Sediment Deposits (132)
_ Recent Iron Reduction in Tilled Soils (C6)
_ Crayfish Burrows (C8)
_ Drift Deposits (133)
_ Thin Muck Surface (C7)
_ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (B4)
_ Other (Explain in Remarks)
_ Stunted or Stressed Plants (D1)
_ Iron Deposits (B5)
Geomorphic Position (132)
Inundation Visible on Aerial Imagery (137)
_ Shallow Agwtard (D3)
�- Water- Stained Leaves (69)
icrotopographic Relief (D4)
Aquatic Fauna (B13)
FAC- Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No
Depth (inches)-
Water Table Present? Yes No
F' ` Depth (inches): L�
Saturation Present? Yes _ No
Depth (inches)- f
Wetland
Hydrology Present? Yes tom'" No
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers - Eastern Mountains and Piedmont - Interim Version

VEGETATION (Four Strata) — Use scientific names of plants.
Herb Stratum (Plot size' `r 0 )
3.
4.
5
6.
8
9
10.
11
12.
t ? = Total Cover
7-0= —Total Cover
Woody Vine Stratum (Plot size:
3
4.
5.
6 7�
L_•) = Total Cover
(Include photo numbers here or on a separate
Sampling Point: VVI'•
Dominance Test worksheet:
Absolute
Dominant Indicator
Tree Stratum (Plot size,
% Cover
S e es? Status
4.
FAC species
Species Across All Strata:
(B)
Percent of Dominant Species
UPL species
3.
C) (AFB)
(A) (B)
4. �r. r. `.,r, q•
B/A =
5.
6.-
7.
8.
Total Cover
Sapling/Shrub Stratum (Plot size:
2.
3. ".
4.
5.
6.
7.
8.
9.
—
10
Herb Stratum (Plot size' `r 0 )
3.
4.
5
6.
8
9
10.
11
12.
t ? = Total Cover
7-0= —Total Cover
Woody Vine Stratum (Plot size:
3
4.
5.
6 7�
L_•) = Total Cover
(Include photo numbers here or on a separate
Sampling Point: VVI'•
Dominance Test worksheet:
Total % Cover of:
Number of Dominant Species
OBL species
That Are OBL, FACW, or FAC-
(A)
Total Number of Dominant '
FAC species
Species Across All Strata:
(B)
Percent of Dominant Species
UPL species
That Are OBL, FACW, or FAC:
C) (AFB)
Prevalence Index worksheet:
Total % Cover of:
Multiply by
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals:
(A) (B)
Prevalence Index =
B/A =
1 - Rapid Test for Hydrophytic Vegetation
2 - Dominance Test is >50%
_ 3 - Prevalence Index is <_3.0'
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic
npfinitinns of Four Vegetation Strata:
Tree – Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling /Shrub – Woody plants, excluding vines, less
than 3 in. DBH and greater than 3.28 ft (1 m) tall.
Herb – All herbaceous (non- woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine – All woody vines greater than 3.28 ft in
height.
Hydrophytic
Vegetation
Present? Yes No
US Army Corps of Engineers Eastern Mountains and Piedmont – Interim Version

n/
SOIL
Sampling Point
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type Loc Texture Remarks
tom,..! .t f:i '✓ r "/ % °� �/{d; ✓+P '� !/A --I
RM= Reduced Matrix, MS= Masked
Hydric Soil Indicators:
— Histosol (Al)
_ Histic Epipedon (A2)
_ Black Histic (A3)
_ Hydrogen Sulfide (A4)
_ Stratified Layers (A5)
2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
_ Thick Dark Surface (Al2)
_ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
_ Sandy Gleyed Matrix (S4)
_ Sandy Redox (S5)
_ Stripped Matrix (S6)
Restrictive Layer (if observed):
Tvoe:
Depth (inches):
Remarks:
2Location: PL =Pore Lining, M= Matrix.
Indicators for Problematic Hydric So
Dark Surface (S7)
_ 2 cm Muck (A10) (MLRA 147)
_ Polyvalue Below Surface (S8) (MLRA 147, 148)
_ Coast Prairie Redox (A16)
_ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
Loamy Gleyed Matrix (F2)
_ Piedmont Floodplain Soils (F19)
—"Depleted Matrix (F3)
(MLRA 136, 147)
_ Redox Dark Surface (F6)
_ Red Parent Material (TF2)
Depleted Dark Surface (F7)
_ Very Shallow Dark Surface (TF12)
Redox Depressions (F8)
_ Other (Explain in Remarks)
_ Iron- Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122) 'Indicators of hydrophytic vegetation and
_ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes �o
US Army Corps of Engineers Eastern Mountains and Piedmont – Interim Version

ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Art King
NCDOT Highway Div. 8
P.O. Box 1067
Aberdeen, NC 28315
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Bridge No. 620073 is located on NC 24/27 in Moore County, over Beaver Creek,
east of the town of Cameron.
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES
AT DIFFERENT SITES)
State:NC County /parish /borough: Moore City: Cameron
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.300898 °, Long. -79.209121'.
Universal Transverse Mercator:
Name of nearest waterbody: Beaver Creek
Identify (estimate) amount of waters in the review area:
Non - wetland waters:
Cowardin Class:
Stream Flow:
Wetlands: 0.02 acres.
Cowardin Class:
linear feet: width (ft) and /or acres.
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: N/A
Non - Tidal: N/A
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain 'an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre- construction notification" (PCN), or requests verification for a non - reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
This preliminary JD finds that there "may be" waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:

SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply
- checked items should be included in case file and, where checked and
requested, appropriately reference sources below):
❑ Maps, 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:
❑ USDA Natural Resources Conservation Service Soil Survey. Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State /Local wetland inventory map(s):
❑ FEMA/FIRM maps: FIRM #9536J.
❑ 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum
of 1929)
❑ Photographs: ❑ Aerial (Name & Date):
or ❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not
necessarily been verified by the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
3
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

SAMPLE
Estimated
amount of
Class of
Site
Latitude
Longitude
Cowardin
aquatic
aquatic
number
Class
resource in
resource
review area
1
Non - section 10
— non - wetland
2
Non- section10
— wetland
3
Non- section 10
— wetland
4
Non - section 10
— non - wetland

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