20220345 Ver 2_ePCN Application_20220811

Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
OO Yes
O No
Is this project a public transportation project?*
OYes 0No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
6/16/2022
BIMS # Assigned* Version#*
20220345 2
Is a payment required for this project?*
0 No payment required
O Fee received
O Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
What amout is owed?*
® $240.00
0 $570.00
Select Project Reviewer*
Colleen Cohn:eads\cmcohn
la. Name of project:
DENC Person County Pipeline
la. Who is the Primary Contact?*
Joey Lawler, PWS
lb. Primary Contact Email:*
lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
8/11/2022
Nearest Body of Water
UTs to Cub Creek and Rock Fork
Basin
Tar -Pamlico; Neuse
Water Classification
Cub Creek = WS-IV;NSW / Rock Fork = WS-III;ORW,NSW
Site Coordinates
Latitude:
36.298370°
A. Processing Information
Longitude:
-78.843168°
County (or Counties) where the project is located:
Person
Is this a NCDMS Project
0Yes ONo
Is this project a public transportation project?*
0Yes ONo

la. Type(s) of approval sought from the Corps:
EI Section 404 Permit (wetlands, streams and waters, Clean Water Act)
❑ Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
O Yes
O No
Please provide the date of the previous submission.*
3/3/2022
1b. What type(s) of permit(s) do you wish to seek authorization?
O Nationwide Permit (NWP)
O Regional General Permit (RGP)
O Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
O Yes 0 No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
OO 401 Water Quality Certification - Regular
O Non-404 Jurisdictional General Permit
O Individual 401 Water Quality Certification
12 - Utility Lines
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
If. Is this an after -the -fact permit application?*
OYes C No
0 401 Water Quality Certification - Express
0 Riparian Buffer Authorization
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
0 Yes
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
0 Yes • No
1j. Is the project located in a designated trout watershed?
Yes • No
B. Applicant Information
OYes 0O No
OYes 0O No
ld. Who is applying for the permit?
0 Owner ✓ Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
OYes 0No
2. Owner Information
2a. Name(s) on recorded deed:
Dominion Energy North Carolina (easement only)
2b. Deed book and page no.:
N/A
2c. Contact Person:
Bob Lepsic, PWS

2d. Address
Street Address
2020 Energy Drive
Address Line 2
City
Apex
Postal / Zip Code
27502
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Bob Lepsic, PWS
3b. Business Name:
Dominion Energy North Carolina
3c. Address
Street Address
2020 Energy Way
Address Line 2
City
Apex
Postal / Zip Code
27502
3d. Telephone Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Joey Lawler, PWS
4b. Business Name:
[e-mail]
4c. Address
Street Address
2016 Ayrsley Town Boulevard, Suite 2A
Address Line 2
City
Charlotte
Postal / Zip Code
28273
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
1. Project Information
lb. Subdivision name:
(if appropriate)
N/A
lc. Nearest municipality / town:
Rougemont
2. Project Identification

2a. Property Identification Number:
See original submittal
2b. Property size:
See original submittal
2c. Project Address
Street Address
Origin: Upper Piedmont Landfill / Terminus: DENC transmission pipeline near Lady Shadow Trail
Address Line 2
Peed Road to Lady Shadow Trail
City State / Province / Region
Rougement NC
Postal / Zip Code Country
27572 USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
UTs to Cub Creek and Rock Fork
3b. Water Resources Classification of nearest receiving water: *
Cub Creek = WS-IV;NSW / Rock Fork = WS-III;ORW,NSW
3c. What river basin(s) is your project located in?*
Tar -Pamlico
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030201010101 and 030202010103
4. Project Description and History
4a. 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 new line originates at a proposed station site located within the southem portion of the landfill and will extend generally southwest for approximately 4.4 miles before tying into DENC's
existing T-12/T-12B pipeline easement.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
® Yes O No O Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
SAW-2022-00518 and DWR # 20220345
4f. List the total estimated acreage of all existing wetlands on the property:
0.385
4g. List the total estimated linear feet of all existing streams on the property:
282
4h. Explain the purpose of the proposed project:*
The purpose of the new pipeline is to transport methane gas recovered from the Upper Piedmont Environmental Landfill facility, which is operated by a private third -party company, to a
point of connection to an existing DENC transmission pipeline. The route consists primarily of a mixture of pine and hardwood forests in various stages of development, land disturbed for
silvicultural purposes, or other areas that have been developed in connection with residences, roadways, and other utility easements.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
See original submittal for overall project description. The proposed revision is required to avoid a conflict with an existing powerline easement, and will result in a portion of the permitted
alignment being shifted 30 feet north. An agreement with a landowner will also result in a second portion of the route shifted to avoid a currently -permitted wetland area entirely.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas? *
O Yes No
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
® Preliminary 0 Approved 0 Not Verified 0 Unknown 0 N/A
Corps AID Number:
SAW-2022-00518
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
J. Lawler, PWS and Rebeckah Sims, PWS
S&ME, Inc.
0 Unknown

5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
See original submittal.
6. Future Project Plans
6a. Is this a phased project?*
Yes O No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No additional phases are anticipated.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands O Streams -tributaries
_; Open Waters O Pond Construction
2. Wetland Impacts
O Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
1
Utility easement
P
Headwater Forest
WG
Yes
Both
0.023
(acres)
2
Utility easement
T
Headwater Forest
WG
No
Both
0.014
(acres)
2g. Total Temporary Wetland Impact
0.014
2g. Total Wetland Impact
0.037
21. Comments:
2g. Total Permanent Wetland Impact
0.023
Project -wide, the proposed re-route will result in additional temporary impacts of 0.009 acre. The project will not result in additional permanent
conversion impacts. Please see revised Impact Table for project -wide wetland impacts.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
See original submittal
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
See original submittal
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?
0 Yes ,6) No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Because impacts to WQ will now be avoided entirely, the project will not result in new permanent impacts that exceed those originally authorized (see attached table).
F. Stormwater Management and Diffuse Flow Plan (required by DWR) (J
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
O Yes ID No
What type of SCM are you providing?
O Level Spreader
0 Vegetated Conveyance (lower SHWT)
O Wetland Swale (higher SHWT)
O Other SCM that removes minimum 30% nitrogen
O✓ Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan

2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
L,Yes JNo
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
• Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
Yes • No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
Yes • No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes • No
3b. If you answered "no," provide a short narrative description.
Project is a utility line designed to transport reclaimed gas from a landfill to an existing pipeline.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
0Yes ®No0N/A
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 • No
5b. Have you checked with the USFWS conceming Endangered Species Act impacts?*
• Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
0 Yes • No
• No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
O Yes No
5g. Does this project involve bridge maintenance or removal?
0 Yes ® No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
0Yes ®No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
• Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
See original submittal.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes • No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper

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?*
Yes O No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
See original submittal.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes O No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Mapper
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
Additonal Information.pdf 1.96MB
File must be PDF or KMZ
Comments
Please see original submittal, attached revised figures and impact table. The proposed re-route will result in additional temporary impacts of 0.009 acre, and reduce permanent conversion
impacts by 0.004 acre.
Please note change in DENC (applicant) contact name and information.
Signature
*
• By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Joey Lawler
Signature
Date
8/11/2022

Dominion Energy Services, Inc.
220 Operations Way, MC C221 Cayce, South Carolina 29033
DominionEnergy.com
August 10, 2022
United States Army Corps of Engineers
Raleigh Regulatory Office
3331 Hermitage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Attention: April Norton
Person County Project Manager
[e-mail]
North Carolina Division of Water Resources
401 and Buffer Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attention: Mr. Paul Wojoski
RE:
Revision to Permit Authorization Under NWP No. 12
Dominion Energy North Carolina Person County Pipeline Project
Person County, North Carolina
SAW-2022-00518 and DWR # 20220345
S&ME Project No. 216697
Dear Ms. Norton and Mr. Wojoski,
IM Dominion
oilW Energy
Dominion Energy — North Carolina (DENC) is submitting the enclosed support materials pursuant to a
request for a revision of the aforementioned NWP authorization.
The proposed revision is required to avoid a conflict with an existing powerline easement and will result in
a portion of the permitted alignment being shifted 30 feet north. An agreement with a landowner will also
result in a second portion of the route shifted to avoid a currently -permitted wetland area entirely.
As detailed on the revised figures and associated Impact Table, the proposed re-route will result in
additional temporary impacts of 0.009 acre and reduce permanent conversion impacts by 0.004 acre on a
project -wide basis.
If you have questions, or require additional information, please contact Robert Lepsic, PWS by email at
[e-mail] at your convenience.
Jason Ericson
Director Environmental Services
CC: Robert Ley, P.E. (DENC)
Robert Lepsic, PWS (DENC)
Joey Lawler, PWS (S&ME)
1 of 1

REVSIED IMPACT EXHIBIT

0 50 100 - - 0 50 100
(FEET) � (FEET) M
U�J - &
1 inch = 50 feet 1 inch = 50 feet III -
Or
- f _ .. - • •
,., . fl 01 1
N -
fPO
3 ,t4, . ' - WETLAND o 4 H Q
-- - AvaDED x zwz
- _ ' W JO
E U w U
i " v +� w oC
/ a z
• ..,! WETLANDD e l 111 a (51_ >
Q �\ 0.023 � c CIF Q °u' z z
FORESTED WETLAND C•ONVER�SION Z ,z p 0O
U
Y
0.014 � c, o@ 0 z
+� \ z
PORARY WETLAND IMPACTS s • U O
,, QLc,_,' O CI-
aa
I • ---z ,•
liga. LAB.
o 4 ,
\ .,,
,
• lilt
oAlliMi 414 ,
vl
oIl me ,
=,I .1 ,. '
ysef.ASso.4SCALE:
'% `4Pi AS SHOWN
N .�, E * ,\ i___J 30-FT BUFFER DATE:
•
o► _ + t _ \S . PROPOSED LIMITS OF DISTURBANCE 8-9-22
Y- .4••v. cw ---- ACCESS ROADS AND EXTRA WORKSPACE PROJECT NUMBER
w "11N, PROPOSED ALIGNMENT 216997
a
REFERENCE: ��A DELINEATED POTENTIAL WETLANDS FIGURE NO.
GIS BASE LAYERS WERE OBTAINED FROM ESRI. THIS MAP IS FOR INFORMATIONAL - PERMANENT WETLAND CONVERSION IMPACTS 15
PURPOSES ONLY. ALL FEATURE LOCATIONS DISPLAYED ARE APPROXIMATED.THEY ARE
O NOT BASED ON CIVIL SURVEY INFORMATION,UNLESS STATED OTHERWISE. TEMPORARY WETLAND IMPACTS

REVISED IMAPCT TABLE
1 of 1

Table 1. Revised
Wetland ID
WA
Summa of Wetland Im .
NCWAM Wetland Type
Herbaceous headwater wetland
acts (Reflected b . ro
Currently Permitted
. osed ali : nment shift)
Impacts
Temporary
Disturbance
Impacts (Acre)
0.067
Proposed
Impacts
Temporary
Disturbance
Impacts (Acre)
0.067
Perm Conversion
Impacts
(Acres)
Perm Conversion
Impacts
(Acres)
0.000
0.000
WB
Forested basin wetland
0.034
0.016
0.034
0.016
WCC
Forested headwater wetland
0.018
0.014
0.018
0.014
WQ
Forested headwater wetland
0.005
0.000
0.000
0.000
WR
Herbaceous headwater wetland
0.000
0.116
0.000
0.116
WG
Forested headwater wetland
0.022
0.005
0.023
0.014
WI
Forested basin wetland
0.001
0.000
0.001
0.000
WK
Forested headwater wetland
0.005
0.003
0.005
0.003
WM
Forested headwater wetland
0.001
0.004
0.001
0.004
WN
Forested headwater wetland
0.008
0.009
0.008
0.009
WP
Forested headwater wetland.
0.031
0.021
0.031
0.021
TOTAL
0.125
0.255
0.121
0.264
Project -Wide Balance:
Additional Permanent Impacts = 0.000 acre
Additional Temporary Impacts = 0.009 acre
NOTE: WQ Now totally Avoided.