20221345 Ver 1_ONwasa Hubert-PineyG PJD-PCN-Binder1_20220928

www.MogMit.com
MMI - Charlotte [phone]
MMI - Raleigh [phone]
MOGENSEN MITIGATION INC. Ma
ENVIRONMENTAL CONSULTING
14 June 2022
Ryan Davenport
NC-DCM Morehead City Office
400 Commerce Ave
Morehead City, NC 28557
Tom Charles
US -ACE Wilmington District Office
69 Darlington Avenue
Wilmington, NC 28403
MOGENSEN MITIGATION, INC
Subject: PJD Request and PCN for ONWASA Wastewater and Water Lines along NC-24 from
Hubert to Piney Green, Onslow County NC.
Dear Ryan and Tom,
Onslow Water & Sewer Authority (ONWASA) is planning to install a new potable water line and
wastewater force main line along 6.7 miles of NC-24 from Piney Green Rd to the eastern end of
Hubert Blvd in eastern Onslow County. The wastewater project will allow the existing Swansboro
WWTP and Hubert WWTP to be retired, and will include a lift station on the existing Hubert WWTP
property. The wastewater facilities will be built first (possibly beginning in fall 2022) and the
potable water facilities will be built a year later using the same construction corridors, which are
marked in red on the attached series of Google Earth aerials. This PJD Request and PCN is
intended for permitting both projects.
The western half of the project (from Piney Green Rd to the west end of Hubert Blvd) is in the
Wallace Creek watershed (New River HUC # 03020302-0206). The water and wastewater lines
along this western portion will be installed along the south edge of the NC-24 right-of-way on
Camp Lejeune Marine Corps Base property. The wastewater force main will end at the existing
Piney Green lift station on Camp Lejeune, 500 feet south of NC-24. The lift station will transfer the
flow to the existing French Creek WWTP for discharge into the New River south of Jacksonville.
The potable water line will cross to the north side of NC-24 about 500 feet east of Piney Green Rd.
The eastern half of the project (from the west end of Hubert Blvd to the east end of Hubert Blvd) is
in the Queens Creek watershed (White Oak River HUC # 03020301-0301). The water and
wastewater lines will cross under NC-24 near the west end of Hubert Blvd, and will be installed
along the north edge of the NC-24 right-of-way, mostly on NC -DOT and Onslow County property,
Environmental Field Studies ■ Wetland & Stream Delineation ■ 404-401 Permits ■ Mitigation Plans & Banking

MOGENSEN MITIGATION INC.
from here to the eastern end of the project. The existing lines from Hubert eastward to
Swansboro are adequate; no upgrade or replacement of the these lines is currently proposed.
Jurisdictional waters along the proposed alignment were delineated by Gerald Pottern of
Mogensen Mitigation Inc (MMI) in 2021. The JD review area (study corridors) are marked in
yellow on the attached aerials. All of the streams and wetlands examined and mapped appear to
be non -tidal freshwater features, with trees, shrubs, and herbaceous plant communities typical of
inland wetlands. We did not encounter any of the NC Division of Coastal Management (DCM)
"coastal wetland" indicator plant species of Spartina, Salicornia, Distichlis, Limonium, or Cladium.
We did find Scirpus and Typha species in several wetlands, but these are the same species that
occur in freshwater inland habitats. The nearest "coastal wetland" as defined by the DCM plant
list appears to be along Queens Creek at least 800 feet downstream from the project corridor,
south of NC-24.
Wallace Creek and its tributaries in the western half of the project area are designated Class SB-
NSW waters. Queens Creek and its tributaries (including Bell Swamp and Pasture Branch) in the
eastern half of the project area are designated Class SA-HQW waters.
All of the stream crossings and most of the jurisdictional wetland crossings will be installed by
horizontal directional drilling (HDD) to avoid impacts to waters and adjacent riparian forests.
There are five areas where wetlands have been channelized and converted into roadside drainage
ditches, and temporary construction impacts may be unavoidable. Ryan Davenport of DCM
indicated to me last year that a CAMA General Permit application should be submitted.
Supporting documents submitted as part of this package include the following:
1) JD Request Form and Appendix 2 PJD Form
2) Agent authorization form signed by ONWASA
3) ORM data table listing all waters in the JD review area
4) USGS topographic map and HUC watershed map
5) USDA Soil Survey maps
6) National Wetland Inventory (NWI) maps
7) FEMA flood hazard maps
8) SHPO historic resources map
9) Preliminary jurisdictional waters JD maps on aerial image base maps.
10) Proposed impacts to jurisdictional waters on aerial image base maps.
11) Camp Lejeune NEPA review decision document
12) Biological Assessment report on federal E&T species
13) ACE wetland and upland delineation data forms
www.MogMit.com Page 1 2
MOGENSEN MITIGATION, INC

MOGENSEN MITIGATION INC.
Sincerely,
Gerald Pottern, Senior Biologist
Mogensen Mitigation Inc.
104 East Chestnut Ave
Wake Forest NC 27587
919-556-8845 office
919-649-6506 mobile
[e-mail]
cc: Carl Scharfe, The Wooten Company
MVK
MOGENSEN MITIGATION, INC
www.MogMit.com Page 1 3

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit
X Section 404 Permit
1 b. Specify Nationwide Permit (NWP) number: 58 or General Permit (GP) number:
lc. Has the NWP or GP number been verified by the Corps?
❑ Yes X No
1d. Type(s) of approval sought from
the DWQ (check all that apply):
— Regular ❑ Non-404 Jurisdictional General Permit
— Express ❑ Riparian Buffer Authorization
X 401 Water Quality Certification
❑ 401 Water Quality Certification
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
For the record only for Corps Permit:
❑ Yes X No
❑ Yes X 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
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
X Yes ❑ No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
X Yes ❑ No
2. Project Information
2a. Name of project:
ONWASA Water and Wastewater Lines, NC-24 from Hubert to Piney Green
2b. County:
Onslow
2c. Nearest municipality / town:
Jacksonville & Hubert
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Onslow County (wastewater plant) = PIN # 532504949834
3b. Deed Book and Page No.
1178 / 582
3c. Responsible Party (for LLC if
applicable):
David Mohr, ONWASA Chief Operations Officer
3d. Street address:
228 Georgetown Road
3e. City, state, zip:
Jacksonville, NC 28540
3f. Telephone no.:
910-937-7521
3g. Fax no.:
3h. Email address:
dmohr©onwasa.com
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:
same as owner
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
Gerald Pottern
5b. Business name
(if applicable):
Mogensen Mitigation Inc.
5c. Street address:
104 East Chestnut Ave
5d. City, state, zip:
Wake Forest, NC 27587
5e. Telephone no.:
919-556-8845
5f. Fax no.:
5g. Email address:
gerald©mogmit.com
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
la. Property identification no. (tax PIN or parcel ID):
PIN # 532504949, # 436000377695, + DOT R-O-W
lb. Site coordinates (in decimal degrees): Latitude: 34.7116 Longitude: -77.2379
lc. Property size:
65 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Wallace Creek + Queens Creek
2b. Water Quality Classification of nearest receiving water:
SB-NSW (Wallace) + SA-HQW (Queens)
2c. River basin:
New River + White Oak River
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:
See attached text "'
3b. List the total estimated acreage of all existing wetlands on the property: 4.1
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,020
3d. Explain the purpose of the proposed project:
See attached text "'
3e. Describe the overall project in detail, including the type of equipment to be used:
See attached text "'
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.
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): Gerald Pottern
Agency/Consultant Company: Mogensen Mitigation Inc
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Gerald Pottern delineated streams and wetlands throughout the project area in 2021 but they have not yet been field verified by ACE or DCM.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
Yes X No Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
X Yes ❑ No
6b. If yes, explain.
The wastewater lines and lift station will be built first, and the potable water lines will be installed a year later. This PCN applies to both projects.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
la. Which sections
were completed below for your project (check all that apply):
❑ Streams — tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
X Wetlands
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
Excavation
Pine Flat
No
Corps
0.024
W2 T
Excavation
Pine Flat
No
Corps
0.112
W3 T
Excavation
Pine Flat
Yes
Corps
0.065
W4 T
Excavation
Pine Flat
Yes
Corps
0.165
W5 T
Excavation
Pine Flat
No
Corps
0.027
30416
2g. Total Wetland Impacts:
0.397
2h. Comments:
All of the affected wetlands are currently maintained by NC -DOT as roadside drainage ditches, and are subject to occasional brush cutting. They area
contiguous with wetlands and/or streams beyond the right-of-way.
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 -
Choose one
-
-
S2 -
Choose one
-
-
S3 -
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
3i. Comments:
No Stream impacts
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 individually 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: No open water impacts
5. Pond or Lake Construction
If pond or lake construction proposed, then 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

D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Horizontal Directional Drilling (HDD) pipe installation will be used wherever practicable to avoid and minimize stream and wetland impacts. Proposed
impacts are limited to areas where wetlands are channelized into roadside ditches and avoidance is impossible. Using the existing mowed roadsides
for construction access will help minimize the need for clearing for clearing wetlands and riparian forests.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Same as above.
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?
No
❑ Yes X
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
❑ 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 X 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 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
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?
❑ Yes X No
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?
0
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 water and wastewater lines will be buried and will not create any new impervious surface except at the new lift station site, which is on the existing
Hubert WWTP property.
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?
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):
X Coastal counties
X HQW
❑ORW
❑Session Law 2006-246
❑Other:
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 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land?
X Yes ❑ No
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
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
❑Yes X No
lc. 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.) Camp Lejeune environmnetal staff conducted their own in-house NEPA review,
Comments: which is provided as an attachment.
❑ Yes X No
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,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
❑Yes X No
2b. Is this an after -the -fact permit application?
❑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
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.
All wastewater from Swansboro and Hubert will be transferred to Camp Lejeune's French Creek WWTP which has a permitted capacity of 15 MGD.
Some of the treated wastewater is used for irrigation and other non -potable uses, and the remainder is discharged into the New River in accodance
with the facility's NPDES permit.
Page 9 of 10
PCN Form — Version 1.4 January 2009

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?
❑ No
X Yes
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ No
X Yes
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?
FWS - IPAC tool, NCNHP dtatabase, NC-WRC consultation. See attached Endangered Species Biological Assessment report.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ No
X Yes
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The NOAA- NMFS Essential Fish Habitat Mapping Tool indicates essential habitat for Snapper -Grouper species, coastal migratory pelagic species,
and Penaied shrimp in the tidal -influenced reach of Queens Creek south of NC-24. The project limits are beyond the EFH mapped areas.
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
North Carolina history and archaeology)?
❑ No
X Yes
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
The NC State Historic Preservation Office (SHPO) database shows the Isaac Henderson House (ON-0192) as determined eligible for National
Register listing. It is 300 feet north of the project corridor. Two other houses near the project are identified as "surveyed only".
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ No
X Yes
8b. If yes, explain how project meets FEMA requirements:
The project will cross FEMA-mapped flood hazard areas along Bell Swamp, Queen Creek, and Pasture Branch. The pipeline crossings will be within
the highway right-of-way and buried below existing grade. No above grade fill in floodplains will occur.
8c. What source(s) did you use to make the floodplain determination?
Onslow County Flood Imformation Risk Map (FIRM) Panels # 5304 and 5324.
Gerald Pottern
Applicant/Agent's Printed Name
Ogiefle06/14/2022
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

PCN SECTION 3 -- SUPPLEMENTARY TEXT
3A. EXISTING CONDITIONS:
From the wastewater pump station along Piney Green Rd eastward to the west end of Hubert Blvd, the project corridor
runs just inside the southern edge of the NC-24 right -of way for 3.7 miles, mostly on Camp Lejeune property. The area
between the highway pavement and the edge of the right-of-way is 70 to 90 feet wide and mostly undeveloped, except
for a bank on the southeast corner of NC-24 and Piney Green Rd. It is roughly half cleared and mowed land, and half
forested with a mix of pines and hardwoods. There is a mowed path just south of the right-of-way, and several gravel
access roads onto Camp Lejeune cross this corridor. The project corridor crosses NC-24 at the west end of Hubert Blvd,
then follows just inside the northern edge of the highway right -of way for the remaining 3.0 miles to the east end of
Hubert Blvd. This segment runs alongside a fire station, a county park, the Hubert wastewater treatment plant, and
several commercial businesses. Much of it this portion is mowed roadside, but some areas are forested especially near
the stream crossings (Bell Swamp, Queen Creek, Pasture Branch, and tributaries).
3D. PROJECT PURPOSE:
Onslow Water & Sewer Authority (ONWASA) is planning to install new potable water and wastewater force main lines
along 6.7 miles of NC-24 from Piney Green Rd to the eastern end of Hubert Blvd in eastern Onslow County. The
wastewater project will allow the existing Swansboro WWTP and Hubert WWTP to be retired, and will include a new lift
station on the existing Hubert WWTP property. Camp Lejeune's existing wastewater lift station on Piney Green Rd will
convey the flow to the existing French Creek WWTP for discharge into the New River south of Jacksonville. The
wastewater facilities will be built first (possibly beginning in fall 2022) and the potable water facilities will be built a year
later using the same construction corridors. The existing lines from Hubert eastward to Swansboro are adequate; no
upgrade or replacement of these lines is currently proposed. This PJD Request and PCN is intended for permitting both
projects.
3E. CONSTRUCTION METHODS:
Ground disturbing activities will include tree clearing and grubbing as needed within the construction LOD, generally 35
to 45 feet wide to accommodate both water and wastewater lines. Using the existing mowed roadsides for equipment
access will help minimize the need for forest clearing. All stream crossings and most of the wetland crossings will be
installed by horizontal directional drilling (HDD) to avoid stream and wetland impacts. In some areas, streams and
wetlands have been channelized and converted to roadside ditches; temporary construction impacts are unavoidable in
these areas, which contain mainly saplings, shrubs, and herbaceous plants. For the open -trench segments in upland
areas, trench widths will range from four to six feet, and average depth will be approximately three feet below existing
ground elevation. Impacts to jurisdictional waters will be permitted through a USACE Nationwide Permit 58, and
construction will be in accordance with an Erosion and Sedimentation Control Plan approved by the NC Division of
Energy, Mineral, and Land Resources (NCDEMLR). There are five roadside ditch wetland areas that will be temporarily
affected, totaling 0.40 acre. All affected water features will be restored to pre -project grade and contours to maintain
proper drainage and roadside embankment stability for the highway. Natural durable materials, native seed mixes, and
native plants and shrubs will be utilized in the restoration.

Jurisdictional Determination Request
US Army Corps
of Engineers
-
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http: //www. saw.usace. army.mil/Missions/Re gulatoryPermitPro gram/Contact/CountyLocator. aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
INSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Depailment of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: NC-24 from Piney Green Rd to Hubert
City, State: Jacksonville to Hubert, NC
County: Onslow
Parcel Index Number(s) (PIN): 532504949834, 436000377695
B. REQUESTOR INFORMATION
Name: Gerald Pottern, Mogensen Mitigation lei
Mailing Address: 104 E Chestnut Ave
Telephone Number:
Electronic Mail Address:
Select one:
Wake Forest NC 27587
919-556-8845, 919-649-6506 cell
[e-mail]
I am the current property owner.
I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION2
Name: David Mohr, ONWASA Chief Operatior
Mailing Address: 228 Georgetown Road
Telephone Number:
Electronic Mail Address:
Jacksonville, NC 28540
910-937-7521
[e-mail]
' Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3'4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Gerald Pottern
Print Name
Capacity: ❑ Owner ❑✓ Authorized Agents
05/19/2022
Date
Gerald Pottern (agent authorization letter attached)
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
El
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑✓ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
L
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:
3 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization faun/letter signed by owner(s).
Version: May 2017
Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
❑✓
I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
n
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
Size of Property or Review Area — 65 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017
Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
❑✓
❑✓
Project Coordinates (Decimal Degrees): Latitude: 34.7143 (W end), 34.
Longitude: -77.3214 (W end), -7
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x 17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
• Graphical Scale
• Boundary of Review Area
• Date
• Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
• Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
• Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
n
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Pro gram/Jurisdiction/
Version: May 2017
Page 5

Jurisdictional Determination Request
z
❑
Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Form'
Vicinity Map
Aerial Photograph
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
Other Assessment Forms
' www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 App A Prelim JD Form fillable.pdf
' Please see http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD:
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Gerald Pottern, 104 E Chestnut Ave, Wake Forest NC 27587
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Onslow City: Jacksonville + Hubert
Center coordinates of site (lat/long in degree decimal format):
Lat.: 34.7092
Long.: -77.2645
Universal Transverse Mercator:
Name of nearest waterbody: Wallace Cr + Queens Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
see
attached
ORM table
of features

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
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 AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) 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) 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) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (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 PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives 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 AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, 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. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be"waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
• Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map: USGS National Map, Google Earth aerials
O Data sheets prepared/submitted by or on behalf of the PJD requestor.
n Office concurs with data sheets/delineation report.
n Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
■❑ U.S. Geological Survey Hydrologic Atlas: 03020301 (White Oak R) + 03030301 (New R)
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
• U.S. Geological Survey map(s). Cite scale & quad name: Camp Lejeune + Hubert, NC
■❑ Natural Resources Conservation Service Soil Survey. Citation: Onslow County
■❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps: Onslow Co FIRM Panels 5304 and 5324.
❑ 100-year Floodplain Elevation is: 12 ft @ Queen Cr .(National Geodetic Vertical Datum of 1929)
❑ Photographs: ❑■ Aerial (Name & Date): Google Earth - March 2019
or n Other (Name & Date):
n Previous determination(s). File no. and date of response letter:
n 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
determi nations.
Signature and date of
Regulatory staff member
completing PJD
Gerald Digitally signed by Gerald Pottem
r n o tt Le rr� Date: 2022.06.09 19:07:55-04'00'
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: omi-s1-o' coArE12 µ,JD SEWE)2 AVW2/TY
Mailing Address: 3Z 8 c z�E.1 v�,c� �� .
J A. cK..s d r..N\11 �.vE- , IC, _ Z 8 S� o
Phone Number: 0?4o) 937 -- 7S /
Email Address: girrppAi' gj Onwas0-, Corn
I certify that I have authorized G e-Y2,4L c) Pcn7-T Z jJ
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: //,' "7t JA Y 0.4
O77L/ TY Co 2rL.c)02 L P(zo./G- N1 7�
at my property located at ar1 wha 6A -- 0 u Ae•P 412 M a. I:36 0pE, T7ES
in Cf3 ' L.o 60 County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
t>4,0 c> ,t/1. ,d/la , PE'
Print or Type Name
( i 4 /eT OPer2 nc)►A9 4r /Gc--2.
Title
oSi/9 /ZOZZ
Date
This certification is valid through D6 / .3O / Z 0 Z y

DWR Pre -Filing Meeting Request Form
NORTH CAROLINA
Environmental Qualify
Contact Name*
Contact Email Address*
Project Owner*
Project Name*
Project County*
Gerald Pottern, Mogensen Mitigation Inc
[e-mail]
Onslow Water & Sewer Authority
ONWASA sewer & water lines, NC-24 Piney Green to Hubert
Onslow
Owner Address: * Street Address
228 Georgetown Rd
Address Line 2
City State / Province / Region
Jacksonville NC
Postal / Zip Code Country
28540 US
Is this a transportation project?* Yes No
Type(s) of approval sought from the DWR:
401 Water Quality Certification - 401 Water Quality Certification -
Regular Express
Individual Permit Modification
Shoreline Stabilization
Does this project have an existing project ID#?*
Yes No
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below and include location information.*
Onslow Water & Sewer Authority (ONWASA) is planning new
wastewater force main lines, potable water lines, and a pump station
along 6.7 miles of NC-24 between Piney Green Rd and the eastern
end of Hubert Blvd in eastern Onslow County. The wastewater
facilities will be built first (possibly in fall 2022) and the potable water
facilities will be built a year later using the same construction corridors
(in red on the attached figures). Streams, wetlands, and waters were
delineated by Gerald Pottern of Mogensen Mitigation Inc (MMI) in
2021. The JD study corridors are indicated in yellow. Most of the
stream and wetland crossings will be directionally bored to avoid and
minimize impacts to waters. Wallace Creek and tributaries in the
western half of the project area are designated Class SB-NSW, Queen
Creek and tributaries (Bell Swamp and Pasture Branch) in the eastern
half of the project area are designated Class SA-HQW. Ryan
Davenport of DCM has indicated that a CAMA General Permit
application should be submitted.

By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401
Certification Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting
location and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you
can submit an application.
Signature*
Submittal Date 2/17/2022

ONWASA Wastewater and Water Lines along NC-24 from Hubert to Piney Green, Onslow County NC
Support Figures for PJD Request and PCN Application --- Mogensen Mitigation Inc. --- June 2022
Figure 1. USGS Project Vicinity Map, from NC One Map GIS
Figure 2. USGS 12-digit HUC Watershed Boundary and NC-DEQ Stream Classifications
Figure 3A. USDA Soil Survey of Onslow County -- Western Half.
Figure 3B. USDA Soil Survey of Onslow County -- Eastern Half.
Figure 4A. National Wetland Inventory Map -- Western Half, from NC One Map.
Figure 4B. National Wetland Inventory Map -- Western Half, from NC One Map.
Figure 5A. NC Flood Risk Information System -- FEMA Flood Hazard Map -- Western Half.
Figure 5B. NC Flood Risk Information System -- FEMA Flood Hazard Map -- Eastern Half.
Figure 6. NC State Historic Preservation Office (SHPO) map of historic structures

Figure 1. USGS Project Vicinity Map, from NC One Map GIS -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert, Onslow County NC.

Figure 2. USGS 12-digit HUC Watershed Boundary and NC-DEQ Stream Classifications -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert, Onslow County NC.

Figure 3A. USDA Soil Survey of Onslow County -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert -- Western Half.

Figure 3B. USDA Soil Survey of Onslow County -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert -- Eastern Half.

Figure 4A. National Wetland Inventory Map -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert -- Western Half, from NC One Map.

Figure 4B. National Wetland Inventory Map -- ONWASA Water and Sewer Lines Project, NC-24 from Piney Green to Hubert -- Eastern Half, from NC One Map

Figure 5A. NC Flood Risk Information System -- FEMA Flood Hazard Map - ONWASA Water and Sewer, Piney Green to Hubert, Western half.

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UNITED STATES MARINE CORPS
MARINE CORPS INSTALLATIONS EAST -MARINE CORPS BASE
PSC BOX 20005
CAMP LEJEUNE NC 28542-0005
5090
16 Feb 2022
Subj: DECISION MEMORANDUM, CATEGORICAL EXCLUSION; INSTALL
ONWASA FORCEMAIN AND PUMP STATION FROM SWANSBORO TO
PINEY GREEN, ONWASA/Swansboro, (NEPA LE21068)
Ref (a) MCO 5090.2 - V12
(b) 32 C.F.R. 775.6(f)
Encl: (1) l&E/Utilities/Water-Wastewater REIR of 16 Mar 21
(2) Supporting Documents
(3) Applicable Conditions
1. In response to enclosure (1), this document satisfies the National Environmental
Policy Act (NEPA) review requirement under reference (a) and qualifies as a categorical
exclusion in compliance with reference (b).
2. As outlined in enclosure (1) and (2), the proposed scope of the project is:
ONWASA will install a new force main sewer piping and air release valves and a new water
main along HWY24 from HWY172 to Piney Green. The sewer force main and water main
proposed to be installed on Base property will be constructed in parallel with 10 feet
of horizontal separation. The force main will be located as close to the NCDOT
right-of-way line as is feasible and the water main will be installed 10 feet inside
(closer to the road) than that. The exception to this is near the Piney Green gate,
where the water main (blue) crosses Hwy 24 to re -connect to the ONWASA system and the
force main (green) connects to the Piney Green pumping station.
a) It is estimated that the clearing limits will be 15' on either side of both
utilities. In areas using trenchless methods, such as Horizontal Directional Drilling
(HDD), clearing will not be necessary.
b) HDD will be used to avoid wetlands.
c) Installation will include several methods (open cut, HDD, Bore & Jack)
3. Pursuant to paragraph (35) of reference (b), this project qualifies for the
following categorical exclusion: " (35) Acquisition, installation, modernization, repair
or operation of utility (including but not limited to water, sewer and electrical) and
communication systems (including but not limited to data processing cable and similar
electronic equipment) that use existing rights of way, easements, distribution systems,
and facilities" This project will not result in any extraordinary circumstances.
4. In accordance with NEPA, this decision memorandum documents the proper level of

environmental review for this project but may not constitute authority to proceed with
implementation of the project. Please carefully review and follow all applicable
conditions.
5. If the project changes, coordinate with the NEPA Program Manager at (910-451-4542)
to determine if this decision memorandum continues to cover your proposed action.
Accepted /s/ Lowder, Robert A. P.E.
Receipt Acknowledged Johnston CIV Brian K
16Feb 22

Enclosure 1: REIR
REQUEST FOR ENVIRONMENTAL IMPACT REVIEW
SECTION I - PROPONENT INFORMATION
Project Title: Install ONWASA Forcemain and Pump Station from Swansboro to Piney
Green
Short Plain English Description of Action: ONWASA will abandon their existing
wastewater treatment plant in Swansboro and will replace with a new pump station and
force main sewer line from Swansboro along HWY24 to the ONWASA's Piney Green pump
station. ONWASA also plans to install a water line along HWY 24. _ -
Project ID: ONWASA/Swansboro
Start By Date: 16-Mar-21
End By Date: 31-May-21
Activity Sponsor (Unit/Command): I&E/Utilities/Water-Wastewater
Activity Sponsor POC: Sonny Scozzari
Phone: [phone] x232
Activity Sponsor POC (Alternate): Brian Johnston
Phone: [phone] x222
Base Location: Mainside
Project will result in permanent site improvement?: Yes
New or Modified Real Estate License Will Be Issued By Base?:
Descriptive Information
Purpose and Need of Action: To enhance the movement of potable water from the water
treatment facility to ONWASA's customers within the distribution system, including service
to the Piney Green Gate, a planned emergency interconnection with the Camp Lejeune
water system in the Midway Park area will be installed. Per the Intergovernmental Service
Agreement (IGSA) ONWASA is requesting access to base property along HWY24 so they
can install a new force main sewer line from HWY172 to Piney Green. This line is requires
so they can demolish the wastewater treatment plant in Swansboro per the
Intergovernmental Service Agreement (IGSA). The water line is not covered by the IGSA
and will require a easement.
Enclosure (1)
3

Scope of Project (Project Narrative): ONWASA will install a new force main sewer
piping and air release valves and a new water main along HWY24 from HWY172 to Piney
Green. The sewer force main and water main proposed to be installed on Base property
will be constructed in parallel with 10, feet of horizontal separation. The force main will be
located as close to the NCDOT right-of-way line as is feasible and the water main will be
installed 10 feet inside (closer to the road) than that. The exception to this is near the
Piney Green gate, where the water main (blue) crosses Hwy 24 to re -connect to the
ONWASA system and the force main (green) connects to the Piney Green pumping station.
a) It is estimated that the clearing limits will be 15' on either side of both utilities. In areas
using trenchless methods, such as Horizontal Directional Drilling (HDD), clearing will
not be necessary. b) HDD will be used to avoid wetlands. c) Installation will include
several methods (open cut, HDD, Bore & Jack)
Identify Other Alternatives Considered: Remodel Swansboro wastewater treatment
plant - Not cost effective. Bore under HWY24 crossing at HWY172 and Piney Green - Not
cost Effective. Bring line through Bear Creek Gate and Lyman Rd. - Not cost effective .
Information concerning avoidance, specific best management practices,or mitigation
necessary to complete the project: ONWASA will follow all State and Federal
requirements during construction.
Preferred and Alternative Sites
Preferred Site Description: Please see attached map.
RDD or IDD Comments, Site Approval:
Clarify Pending status::
Towers working group coordination (if applicable):
Action Sponsor: Sonny Scozzari
Rank: WS-11
Title: Wastewater Foreman
End of Form
SECTION II - PRELIMINARY ENVIRONMENTAL SURVEY
a. AIR QUALITY
1. Will your project involve any of the following?:
(Indicate all that apply, indicate "new" or "modified" as appropriate):
Abrasive Blasting:
Landfill:
Lime Storage:
Open Burning:
Painting:
Paint Booth:
4
Enclosure (1)

Paint Gun Cleaners:
Paint Strippers:
Refrigerant Storage Recovery, and/or Recycling:
Tanks (ASTs, USTs):
Surface Coating:
Welding:
Woodworking:
Boilers:
Generators:
Engine Test Stands:
Fiberglass Repair:
Bulk Chemical Storage (liquid or solid):
Remediation:
Grinding:
Jet Engine Testing:
Fuel Dispensing:
Parts Oven:
Parts Cleaner:
Fire Training Pit:
Provide proposed construction dates, equipment size, specification, and estimated
types.: Construction start date is pending on this review. They will use the following
equipment to install the line. 1. excavator, 2. backhoe, 3. vacuum truck, 4. Multiple work
trucks, 5. dump trucks.
2. Will pollution control equipment be involved (e.g.filter or incinerators)?: Yes
3. Will the project involve the use of disposal of asbestos?: No
4. Will project cause dust problems either temporarily during construction or over
the long term?: Unknown
b. LAND QUALITY
1. Number of acres involved? Indicate total project area and total disturbed area.:
Approx 6 acres
2. Will the action require use of earthen fill material?: Yes
3. Will vegetation be cleared?: Yes
4. Will the project increase impervious area by 10,000ft squared or more?: No
5. Will wetlands be involved? How many acres? What work will be done in
wetlands?': Yes
c. GROUNDWATER QUALITY
1. Does the project involve use of herbicides, insecticides, or pesticides?: No
Enclosure (1)
5

2. Does the project involve installation/use of septic tanks, leach beds, or other on -site
disposal of sanitary waste?: No
3. Will there be any wells dug or any excavation deeper than 20 feet?: No
4. Will the project generate or use any toxic or hazardous/waste materials?: No
5. Are there any known Installation Restoration Program (Comprehensive
Environmental Response, Compensation, and Liability Act - CERCLA or Resource
Conservation Recovery Act - RCRA) sites or hazardous waste treatment, storage,
and disposal (RCRA) facilities within the proposed project area?: No
6. Will there be an increase of solid waste (temporarily or permanently) caused by
implementing the project/action?: No
7. Will the project or action be carried out within 100 to 500 feet of a drinking water
supply well? If yes, provide distance to nearest drinking water well.: Yes
8. Does the project require the installation or removal of any petroleum or non -
petroleum underground storage tank (UST)?: No
d. SURFACE WATER QUALITY
1. Is the project located on or in a water body or adjacent to or in the 100-year flood
plain?: Unknown
2. Will the project involve construction of drainage ditches/underground drains for
purposes of lowering water table?: No
3. After construction is complete, will petroleum products including fuel, oil and
lubricants be routinely stored or used (temporarily or permanently) at the site? : No
4. Does the project require the installation of any petroleum or non -petroleum above
ground storage tank (AST)?: No
e. NATURAL RESOURCES
1. Will trees be removed?: Unknown
Amount to be removed::
2. Will shrubs, or other low -growing vegetation be cut?: Unknown
3. Will completion of the project result in a change in land use from what is presently
shown in the Base Master Plan? : Yes
4. Will public access for hunting, boating, fishing, ect., be restricted?: No
5. Are there potential effects on any threatened or endangered species?: Unknown
6. Does the project involve the transfer (purchase, sale, lease, easement or otherwise)
of any real estate interest?: Unknown
f. CULTURAL RESOURCES
1. Are there any known archaeological sites in the area of your project/action?: No
2. Are there any known historic buildings or districts affected by the project/action?:
No
3. If known, please contact the Base Archaeologist/Cultural Resources Program
Manager for assistance at [phone].:
Enclosure (1)
6

g. UTILITIES AND SERVICES
1. Will new/modified utilities be required? Select all that apply.: Wastewater
If other is selected, please describe below.:
h. SOCIAL ECONOMIC CONSIDERATIONS
1. Will the project cause an increase/decrease in on -base or off -base military
population? : No
2. Will there be any increased demand on a local or state government to provide
services? : Unknown
3. Will there be any changes to traffic flow and patterns on or off base?: No
4. Will the project cause noise or safety issues that could potentially impact off -base
persons or property either during construction or from the project itself?: No
i. GENERAL CONSIDERATIONS
1. Are alternative procedures, practices, or technologies available to minimize
environmental impact or utility use? : Unknown
2. Are there likely effects on the human environment that:: d. N/A
Explain YES answers here::
Enclosure (1)
7

Enclosure 2: Site Map
Figure A: Project Location
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Figure B: Piney Green to Hubert
11 9',ore RAP'
STAThWITS MEADOWS
ONWASA NC-24 Force Main - Area di Interest
Gerald Pottern, Mogensen Mitigation Inc.
919-556-8845 gerald@mogrnitcom
St. ol .111 ceokna 1,01,11, lif RI. Gsrm, n, USGS. NSA, el.: USA& N?A
8
Enclosure (2)

Figure C: Hubert to Swansborro
20E2
Figure D: PJD Piney Green to Hubert Page 1
9
Enclosure (2)

Enclosure 3: Applicable Conditions
AST/UST/IR/MRP (Soil):
1. If contaminants are suspected through odors or visual observation during
construction activities, immediately stop work, call 911, and contact EQB at
910-451-9641 for further instructions.
2. There are no known monitoring wells in the project areas but if an unmarked well is
discovered and inadvertently damaged, immediately contact EQB at 910-451-9641 for
further instructions.
3. 3R UXO Safety Awareness Training is recommended for all construction workers as a
precaution given that Camp Lejeune has been an active military base since the 1940s. 3R
Safety Awareness Training is available online at the following link:
http://www.lejeune.marines.mil/Offices-Staff/Environmental-Mgmt/Training-Video/. Should
a munitions -related item be found during construction, follow appropriate notifications
as detailed in the 3R training. Any munitions related item found during project
construction should additionally be reported to EMD within 10 days (T.Richard,
910-451-9641) to determine if additional evaluation and precautions are necessary
(Explosives Safety Submission, UXO Tech Support, etc). Additional UXO safety resources
available at: Construction - DENIX (osd.mil)
https://www.denix.osd.mil/uxo/for-work-crews/construction/index.htm l
4. All work conducted in an identified EPL NPL OU or RCRA SWMU must adhere to the
provisions detailed in CFR 1970.120 Occupational Safety and Health Standards, Hazardous
Materials, Hazardous waste operations and emergency response.
5. If drilling fluids or other substances/compounds/products are injected into the
ground surface, Safety Data Sheets must be sent to EQB for review and screening of
potential contaminants.
Contact Info:
IR Program, 910-451-9641/9610
AST/UST Program,910-451-9641
Historic Ranges:
1. There are no known Installation Restoration issues associated with the subject
project. However, these projects are within historic and/or known operational range
areas and it is recommended (although not regulatorily required) that the area be
assessed for possible surface or buried UXO before construction begins. Recommend
coordinating with Range Control on appropriate safety requirements for construction.
Water Quality Program/ECB:
1. All construction should be at least 50 feet from any existing or proposed drinking
water supply wells. Coordinate with Water Quality Manager.
2. Reduction of Lead in Drinking Water Act:
Installation or repair of any piping, fittings, fixtures, solder or flux providing water
for possible human consumption must be "lead-free" as defined by the Reduction of Lead
Enclosure (3)
16

in Drinking Water Act (RLDWA). The RLDWA revised the definition of lead free to a
weighted average of 0.25% of the wetted surfaces of plumbing products. A methodology
for calculating the weighted average of wetted surfaces can be found at www.epa.gov.
7. Any variances to the applicable minimum design criteria of 15A NCAC 02T for new
sewer line extensions, to include minimum separation distances from stormwater lines,
must be approved by the State during the permitting process. Please note this may take
at least 30 days once received by the State.
Contact info:
Water Quality Manager, 910-451-9518
Public Works Design Branch, 910-451-2212
Public Works Utilities Director, 910-451-5024
Air Quality:
1. Ensure that any fugitive dust emissions generated by
construction/renovation/demolition are appropriately controlled.
AQ program contacts:
Katherine Proffitt, 910-451-5836
Kiana Heitzman, 910-451-9017
Land and Wildlife Resources Section (Tree cutting/clearing):
1. To reduce the incidental take of migratory birds and their nests, trees with active
nests should not be cleared. If tree clearing is proposed between April and July,
contact the LWRS Biologist for additional guidance. Call 910-451-7235 for more info.
Threatened and Endangered Species:
The narrow strip of trees/shrubs to be cleared for this project falls to the north of
any timber stands that are managed by the forestry section. There are some pine trees in
these areas but most are too young or heavily encroached with hardwood for red -cockaded
woodpeckers to utilize. We do not count these areas as forage habitat for the
red -cockaded woodpecker clusters that occur adjacent to them to the south. Therefore we
do not feel that this project needs to be consulted on with USFWS.
Contact Info:
Gary Haught, 910-451-7229
Streams and Wetlands:
1. There are jurisdictional features within the project area. Although wetland and
stream impacts will be avoided using HDD, delineations will be required to identify
areas to avoid. ON WASA needs to coordinate with the USACE and DEQ for the appropriate
permits for installing the utility and maintain compliance during installation. If the
project changes to include any stream or wetland impacts, please coordinate with the
wetlands SME at 910-451-6287 or [e-mail].
Note 1: In accordance with MCIEAST-MCB CAMLEJO 11013.4, projects that include
Enclosure (3)
17

construction will require site approval from G-F. Please contact Asset Management Branch
(AMB) at 910-451-0982.
Note 2: The following sections reviewed the REIR, replied to it and have no concerns:
Explosive Safety, Asbestos, Forest Management, G-7, UST/AST, Air Quality, RTAM
Enclosure (3)
18

Jurisdictional Determination Request
US Army Corps
of Engineers.
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www. saw.usace. army.mil/Missions/RegulatoryPermitProgram/Contact/CountyLocator. aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
INSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Depaitiuent of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: NC-24 from Piney Green Rd to Hubert
City, State: Jacksonville to Hubert, NC
County: Onslow
Parcel Index Number(s) (PIN): 532504949834, 436000377695
B. REQUESTOR INFORMATION
Name: Gerald Pottern, Mogensen Mitigation lb
Mailing Address: 104 E Chestnut Ave
Telephone Number:
Electronic Mail Address:
Select one:
o
❑
EI
o
Wake Forest NC 27587
919-556-8845, 919-649-6506 cell
[e-mail]
I am the current property owner.
I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION2
Name: David Mohr, ONWASA Chief Operatior
Mailing Address: 228 Georgetown Road
Telephone Number:
Electronic Mail Address:
Jacksonville, NC 28540
910-937-7521
[e-mail]
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3'4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Gerald Pottern
Print Name
Capacity: ❑ Owner fl Authorized Agents
05/19/2022
Date
Gerald Pottern (agent authorization letter attached)
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
n I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
n I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
n A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
n Other:
3 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization faun/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
n
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
Size of Property or Review Area — 65 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017
Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
z
Project Coordinates (Decimal Degrees): Latitude: 34.7143 (W end), 34.
Longitude: -77.3214 (W end), -7
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x 17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
• North Arrow
• Graphical Scale
• Boundary of Review Area
• Date
• Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
• Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
• Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
• Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
• Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
n
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Pro gram/Jurisdiction/
Version: May 2017
Page 5

Jurisdictional Determination Request
0
Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs, please complete an Approved Jurisdictional Determination Forma
Vicinity Map
Aerial Photograph
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
Other Assessment Forms
' www.saw.usace.army.mil/Portals/59/docs/regulatory/regdocs/JD/RGL 08-02 App A Prelim JD Form fillable.pdf
s Please see http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Pro gram/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federaljurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6