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Mitigation Project Evaluations: Information Table
NC Division of Water Qualit
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Date of Office Review Zy 6 Evaluator's name(s): G , ~1-
Date of Report: Report for Monitoring Year:
Date of Field Review J Evaluator' name(s): Z
Other individuals/age r s iN ILL `
Weather conditions (today recent): Jllzd,~ rt O? f f
Directions to site: MO~~UILC~ ~1~ ~ ~~l ~ ~~) J \2~U~
I. Office Review Information: ~1
Project Number: ~~ ®~~ Proiect History:
Project Name: ,,rqp ~)Z~ ~,~ P~~ Event Date
County(ies): A,/,lh 3~~020! /Q3d~~
Basin 8~ Subbasin: ~(~ U I
Nearest Stream: ~~~BjR£~ L%C,~r~I~
Water Quality Class of Ne st Stre :C~ ~~
Mitigator Type:~1~,4~ ~~~,/~/ 6~/-'I pNZISV/L~~
DOT Status: `~/~
Total Mitigation on Site
Wetland:/1/./~
Stream: ~~ ~~
Buffer:/~J ~C
Approved mitigation plan available? Yes No
Monitoring reports available? a No
Problem areas identified in reports?
Problem areas addressed on site? Yes
Mitigation required on site: ~ *Add significant project-related events: reports
Associated impacts: ~ received, construction, planting, repairs, etc.
During office review, note success criteria and evaluate each component based on monitoring report
results. Record relevant data in Sections II & III.
On back of sheet, note other information found during office review or to be obtained during site visit.
n. aurnrnar vi RCSUILS:
Monit Success Success
Miti ation Com onent Year re ort field Resolved
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MITIGATION SUCCESS:
Compared to the mitigation plan, this project is: successful artially ~cces not successful
List specific reasons for lack of uccess fort 's p ject:
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Additional Comments e.g. DWQ follow-up actions, recommendations, etc.):
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Version 1.0 (August 22, 2007) Page 1 of 1

Stream Mitigation Project Evaluations: Information Table
NC Division of Water Quality
Component:
Location within project:
III. Data Reported from Site Visit
STREAMBANK STABILITY -Approved Success Criteria:
Are Streambanks Stable? Yes No
If no, provide cription and notes regarding stability issu s:
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STRUCTURES -Approved Success Criteria:

List all Types of structures present on site:
Are the structures installed correctly? No
Are the structures made of acceptable material?
(Unacceptable materials include: railroad ties, concrete w/rebar, etc.) Ygs No
Are the structures located approximately where shown on the plan? Y.~ No
Are the structures stable (e.g. erosion, deposition, etc.)? Yes No
Provide description and notes regarding problematic tructures:
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FEATURES -Approved Success Criteria:
Are riffles and pools in approximately the correct locations? Yes No
Is the final sinuosity and gradient designed approximately to plan specifications? Yes No
Any evidence of vegetation growing on the stream bed or in the Thalweg? Yes No
Percentage of the restoration reach that has: Flowing water Ponded areas
Describe any stream features that provide evidence of unstable stream reaches (e.g. mid-channel bars,
downstream meander migrat~ ,chute cutoff formation, etc.):
AQUATIC BIOTA -Approved Mitigation Criteria:
Is aquatic life present in the channel? Yes No ,.~i'~.~/I~ ~
Description of taxa observed, incl. quantities of individuals and general distribution of biota. Include a
brief description of the a ing m hodology.
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List any remaining aquatic biota issues to address (e.g. erosion ,discharges or toxicants, etc):

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Version 1.0 (August 22, 2007) ~J Page 1 of 2

Google Map
Stream Mitigation Project Evaluations: Information Table
NC Division of Water Quality
VEGETATION -Approved Scuccess Criteria:
~os~i4 ~N y~R -~
Monitoring report indicates success? Yes No
Average TPA for entire site (per re
Observational field data agrees? Yes
based on community composition? ~e No
based on TPA and/or % cover? ~ No
Vegetation planted on site? ~ No
Date of last planting:
Dominant Plant Species
Species Story TPA/'~ Cover
rnos~~
Vegetation growing successfully? Yes No '' ~J911~~
General observations on condition of riparian/buffer areas (e.g. buffer width, overall health of vegetation,
etc. )
Specific vegetation plots or site locations with little to no vegetation:
Estimated acreage or site percentage of unvegetated areas:
Invasive species on site (species, location(s),- and % cover):
List any remaining vegetation issues to address (e.g. plant survival, concerns, etc.):
MITIGATION SUCCESS:
Compared to the mitigation plan, this component is: successful
List specific reasons for lack of success for this component:
partially successful not successful
Additional Comments (e.g. DWQ follow-up actions, recommendations, etc.):
Use the definitions in the joint state/federal stream mitigation guidelines to determine the correct type of
mitigation used for this project.
During site visit, document representative conditions and areas of concern. Observe preservation and
enhancement areas that may not have specific success criteria. Label and attach photos to this report.
Attach maps showing photo locations, problem areas, and/or important stream features.
Additional notes related to evaluation of this component:
Version 1.0 (August 22, 2007) Page 2 of 2

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