20221599 Ver 1_ePCN Application_20221109

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
11/9/2022
BIMS # Assigned* Version#*
20221599 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Zachary Thomas:eads\ztthomas
Information for Initial Review
la. Name of project:
COURTESY COPY Take Five Oil Change
la. Who is the Primary Contact?*
Zack Holland
Reviewing Office*
Raleigh Regional Office - [phone]
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
11/9/2022
Nearest Body of Water
Buffalo Creek
Basin
Neuse
Water Classification
C, NSW
Site Coordinates
Latitude: Longitude:
35.520940 -78.308860
A. Processing Information
County (or Counties) where the project is located:
Johnston
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No

la. Type(s) of approval sought from the Corps:
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?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
ld. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
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:
1f. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
ld. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Smithfield Take Five, LLC
2b. Deed book and page no.:
06255 and 0098
2c. Contact Person:
Zack Holland
2d. Address
Street Address
305 Foster Avenue
Address Line 2
City
Charlotte
Postal /Zip Code
28203
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
North Carolina
Country
USA
Yes No
Yes No

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Zack Holland
3b. Business Name:
Smithfield Take Five, LLC
3c. Address
Street Address
305 Foster Avenue
Address Line 2
City
Charlotte
Postal / Zip Code
28203
3d. Telephone Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Michelle Measday
4b. Business Name:
ECS Southeast, LLC
4c. Address
Street Address
5260 Greens Dairy Road
Address Line 2
City
Raleigh
Postal / Zip Code
27616
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
North Carolina
Country
USA
3e. Fax Number:
State / Province / Region
North Carolina
Country
USA
4e. Fax Number:
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Smithfield
2. Project Identification
2a. Property Identification Number:
260411-55-6272 and 260411-55-9256
2b. Property size:
2.19

2c. Project Address
Street Address
1309 North Brightleaf Blvd
Address Line 2
City State / Province / Region
Smithfield North Carolina
Postal / Zip Code Country
27577 USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Buffalo Creek
3b. Water Resources Classification of nearest receiving water: *
C, NSW
3c. What river basin(s) is your project located in?*
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030202011105
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 site currently consists of undeveloped grass land and wooded areas. Surrounding areas consist of commercial properties.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past? *
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
137
4h. Explain the purpose of the proposed project: *
The site will be developed with a Take 5 Oil Change with associated parking/drive areas, landscaping, lighting and stormwater management measures. The subject stream impact is
located at the center of the 2.19 acre site. The Take 5 Oil Change is an approximate 1,250 SF building with three bays, office and bathroom facilities. Take 5 Oil Change will provide a
location within the community for drive -through oil change service.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
Appropriate erosion control measures will be used while the site is prepared and leveled to the desired building elevation. Standard construction equipment such as cranes, excavators,
dump trucks, and similar vehicles would be used for the project. Proper erosion and sedimentation control measures would be employed throughout the project. Typical materials and
machinery will be used on -site during the construction process.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
Comments:
No Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2022-00993
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Michelle Measday
ECS Southeast LLC
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
7/13/2022: State determination
10-5-2022: Corps JD/email concurrence
6. Future Project Plans
6a. Is this a phased project?*
Yes 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.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
3. Stream Impacts
Streams -tributaries
Pond Construction
Buffers
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S7
Pipe and Rip -Rap Fill
Permanent
Culvert
Stream 1
Intermittent
Corps
4
Average (feet)
110
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
110
3i. Total stream and ditch impacts:
110
3j. Comments:
Impacts: 530 LF or 0.012 Ac. streambed
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
Neuse
Catawba
Goose Creek
Other
3i. Total temporary stream impacts:
0
Tar -Pamlico
Randleman
Jordan Lake
6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Minor grading/veg removal
T
UNT Buffalo Creek
No
0
250
6h. Total buffer impacts:
Zone 1
Total Temporary impacts: 0.00
Zone 1
Total Permanent impacts: 0.00 0.00
Zone 2
250.00
Zone 2
Zone 1 Zone 2
Total combined buffer impacts: 0.00 250.00
6i. Comments:
Minor impacts in Zone 2 associated with grading adjacent to the channel to further stabilize the channel at the outlet location.
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:
The intermittent stream is located in the center of the property which makes development without disturbing the feature unavoidable. The depth of the
existing pipe that discharges stormwater to the channel prevents impacting the 137 LF of the entire channel. The section of channel that daylights at the
proposed retaining wall requires armoring with rip rap to stabilize the channel and prevent sediment eroding and impacting unnamed tributary to Buffalo
Creek which flows offsite along the northwestern boundary of the PSA. A retaining wall is proposed to minimize impacts to the riparian buffer of the
unnamed tributary to Buffalo Creek.

1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Impact to the stream cannot be avoided with this project. Site disturbance shall be minimized to the maximum extent practicable in order for the proper
installation of the project elements. The construction techniques shall be conducted in accordance with NCDENR standards. Temporary and additional
erosion control measures shall be maintained throughout the construction process. Silt fencing will be placed at the bottom of the slopes to deter
sediment and erosion control during development activities. Temporary erosion, sedimentation, and pollution controls will be installed prior to and
maintained during the entire construction duration and until final stabilization is established.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The project meets the requirements and conditions of NWP 18 for minor discharges. Less than 0.10 acre of impact and less than 10 cy of material below the OHWM.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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 No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30% nitrogen
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? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
2d. Which of the following stormwater management program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Smithfield and Johnston County
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.
No other regulated features exist on site.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Public utilities through Johnston County.
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 concerning Endangered Species Act impacts?*
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved? *
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes 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?
IPaC and NC NHP. A request for concurrence was sent to USFWS on 10/28/2022.
The information below was sent to USFWS for concurrence.
Bald Eagle: The PSA contains a small stormwater driven channel that eventually flows into a larger offsite unnamed tributary to Buffalo Creek. Buffalo
Creek is located approximately 1,800 feet south of the site. The PSA is unlikely to offer valuable habitat for the Bald Eagle as the area is highly disturbed
with intense commercial and industrial activity and limited fishery resources in the vicinity. Additionally, bald eagles or eagle nests were not observed
during the site reconnaissance. Based on our knowledge and site observations, ECS concluded that suitable habitat for the bald eagle is not located on
site and development within the PSA would have no effect on the bald eagle.
Red -cockaded woodpecker: The PSA is predominantly developed with cleared area, commercial buildings and a small wooded area adjacent to the
onsite channel. This forest does not provide viable habitat for the Red -cockaded woodpecker. Therefore, it has been concluded that habitat for the Red -
cockaded woodpecker does not exist within the PSA and the proposed project will have no effect on the species.
Atlantic Pigtoe: The intermittent stream onsite is small, one to two foot wide, with inconsistent flow levels. Based on the observed stream habitat within
the PSA, it has been concluded that viable habitat does not exist to support Atlantic Pigtoe. Therefore, ECS has concluded that the development will
have no effect on the Mollusk.
Dwarf Wedgemussel: Based upon the stream size and substrate, ECS concluded that habitat is not present for the dwarf wedgemussel. Therefore,
development of this property would have no effect on the dwarf wedgemussel.
Carolina Madtom: The main unnamed tributary on site is a small, intermittent, stormwater driven stream with a substrate predominantly consisting of silts
and sands. Therefore, based upon our knowledge of suitable habitat for the Carolina Madtom and site observations, ECS concludes that suitable habitat
does not exist within the PSA. Therefore, development within the PSA would have no effect on the Carolina madtom.
Neuse River Waterdog: The tributary onsite originate from stormwater directed to the site, cutting a channel to the unnamed tributary along the
northwester boundary of the PSA. The tributary is mostly one to two feet wide and approximately a half to one foot deep. Buffalo Creek is located
approximately 1,800 feet downstream of the PSA. Based on their habitat requirements and site observations, suitable habitat for the Neuse River
waterdog is not located on site. Therefore, proposed development within the PSA would have no effect on the Neuse River waterdog.
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 No

7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC HPO Web Mapper. A request for concurrence was submitted to the SHPO on 10/28/2022.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b. If yes, explain how project meets FEMA requirements:
A portion of the site is located within the FEMA-designated 100-year floodplain. The FFE of the building is set at 146.0 ft above mean sea level., which is
above the BFE of 145.5 ft above mean sea level.
8c. What source(s) did you use to make the floodplain determination?*
FEMA MSC Mapping
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
1 ORM Form - Take 5 Oil.pdf 45.34KB
3a Figurel_proj_vicinity_Smithfield.pdf 2.75MB
3b Figure2_topo_Smithfield.pdf 1.47MB
4 Appraisal Card.pdf 116.07KB
4a ECS Agent Auth_.pdf 131.07KB
4b ECS Agent Auth. 1.pdf 94.04KB
5a SAW-2022-00993 2022-Oct-05.pdf 73.94KB
5b SAW-2022-00993_Delineation Exhibit.pdf 375.72KB
6 Buffer Determination Letter 2022-July-26.pdf 3.74MB
7a 210621 - Take 5 Smithfield NC Rev x-Stream Impact (Proposed) (003).pdf 586.05KB
7b 210621 - Take 5 Smithfield NC Rev x-C2.2 (003).pdf 525.42KB
8 Species List_ Raleigh Ecological Services Field Office- Smithfield Take 5.pdf 646.67KB
9 Smithfield Take 5 NHP Report.pdf 899.3KB
10 SHPO Figure - Smithfield.pdf 711.35KB
File must be PDF or KMZ
Comments
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:
Michelle Measday
Signature
IChf LLB 4 (04.5PP4Y
Date
11/9/2022