20210529 Ver 1_401 Application_20221118

Staff Review Form
NORTH CAROLINA
Envlronm¢ntcl Qvofiry
Updated September 4, 2020
Staff Review
Does this application have all the attachments needed to accept it into the review process?*
Yes No
ID# *
20210529
Version* 1
Is this project a public transportation project?*
Reviewer List:*
Select Reviewing Office: *
Submittal Type:*
Yes
• No
Sue Homewood:eads\slhomewood
Winston-Salem Regional Office - [phone]
401 Application
Does this project require a request for payment to be sent?*
Yes
No
How much is owed?* $240.00
$570.00

Project Submittal Form
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type: *
For the Record Only (Courtesy Copy)
New Project
Modification/New Project with Existing ID
More Information Response
Other Agency Comments
Pre -Application Submittal
Re-Issuance\Renewal Request
Stream or Buffer Appeal
Pre -Filing Meeting Date Request was submitted on:
3/9/2021
Project Contact Information
Name:
Heather LaGamba
Who is submitting the information?
Email Address: [e-mail]
Project Information
...................................
Project Name: Healing Springs
Is this a public transportation project?
Yes
No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
County (ies)
Davidson
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
5109.5_Healing Springs_PCN_11.17.22.pdf 12.38MB
Only pdf or kmz files are accepted.
Describe the attachments or
comments:
PCN for 401 WQC
Sign and Submit
............................................................................................................................................................................................................................
By checking the box and signing box below, I certify that:
• I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief.

• I, 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 agree that submission of this online 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 online form.
Signature:
rif 00. �Zaf.
Submittal Date: 11/18/2022
Is filled in automatically.

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- SAW-2019-02101 Begin Date (Date Received):
Prepare file folder ❑ Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: Healing Springs Solar, LLC
2. Work Type: ❑✓ Private ❑ Institutional ❑ Government ❑ Commercial
3. Project Description / Purpose [PCN Form B3d and B3e]:
Please see attached
4. Property Owner / Applicant [PCN Form A3 or A41: Please see attached
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Scott Edwards, Pilot Enviromental, Inc
6. Related Action ID Number(s) [PCN Form 135b]:
7. Project Location— Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
Flat Swamp Road
35.63247/80.16046
8. Project Location— Tax Parcel ID [PCN Form Bla]: Please see attached
9. Project Location — County [PCN Form A2b]: Davidson
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Healing Springs
11. Project Information — Nearest Waterbody [PCN Form B2a]: Lick Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]: Yadkin River/03040103
Authorization: Section 10 ❑ Section 404 ❑✓
Regulatory Action Type:
❑ Standard Permit
✓ Nationwide Permit #
Regional General Permit #
Jurisdictional Determination Request
Section 10 and 404 ❑
❑ Pre -Application Request
❑ Unauthorized Activity
❑ Compliance
❑ No Permit Required
Revised 20150602

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1.
Processing
1a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: NWP 51 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
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
® No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Healing Springs Solar Farm
2b.
County:
Davidson
2c.
Nearest municipality / town:
Healing Springs
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Multiple --See Attached
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
3e.
City, state, zip:
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ® Other, specify: Developer
4b.
Name:
Mr. Harrison Cole
4c.
Business name
(if applicable):
Healing Springs Solar, LLC
4d.
Street address:
3402 Pico Blvd
4e.
City, state, zip:
Santa Monica, CA 90405
4f.
Telephone no.:
919-813-7990
4g.
Fax no.:
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Scott Edwards
5b.
Business name
(if applicable):
Pilot Environmental Inc.
5c.
Street address:
PO Box 128
5d.
City, state, zip:
Kernersville, NC 27285
5e.
Telephone no.:
336.310.4527
5f.
Fax no.:
5g.
Email address:
[e-mail]
Page 2 of 12
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
6658-01-36-1420, 6658-01-48-4135, 6658-01-49-7169,
la. Property identification no. (tax PIN or parcel ID):
6658-02-56-8333, 6658-02-58-9440, 6658-02-68-4581,
6658-02-77-3943, 6658-02-86-0315
1 b. Site coordinates (in decimal degrees):
Latitude: 35.63247 Longitude: - 80.16046
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size:
516.6 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Lick Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
WS-IV
2c. River basin:
Yadkin
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:
The site contains wooded land, timbered land and fields. Several dilipdated structures are located on the site. An
overhead high-tension power line and associated easement cross the eastern portion of the site. The site is located in a
rural area of Healing Springs, Davidson County, North Carolina.
3b. List the total estimated acreage of all existing wetlands on the property:
13.93 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
16,185 LF
3d. Explain the purpose of the proposed project:
The purpose of the proposed project is to provide access and interconnection during development and long term
maintenance of the site as a solar farm.
3e. Describe the overall project in detail, including the type of equipment to be used:
The overall project consists of development of the site with a proposed solar farm. In order to provide safe access and
interconnection to the site, a stream crossing is necessary. To facilitate development of the site and construction of the
proposed stream crossing, clearing and grading the site is necessary. Graders, haulers, excavators and other heavy
equipment will be used during site construction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes El No El Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
El Preliminary ®Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: Pilot Environmental, Inc.
Name (if known): Bradley Luckey/David Brame/Michael
Other:
Brame
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
SAW-2019-0210 1 3.5.20 & 1.30.21
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ❑ No ® Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
The project is not part of a phased project. Impacts to streams/wetlands, outside of those proposed in this application,
are not anticipated as a result of the proposed project.
Page 4 of 12
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments: Wetland impacts are not proposed.
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.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ® T
De -watering
CSC
® PER
❑ INT
® Corps
❑ DWQ
6.1
54
S2 ®P ❑ T
Road Fill
CSC
® PER
❑ INT
❑ Corps
❑ DWQ
6.1
30
S3 ®P ❑ T
Keyed In Rip -Rap
CSC
® PER
❑ INT
❑ Corps
❑ DWQ
6.1
26
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
110
3i. Comments: Stream Impact S1 will temporarily impact 54 LF (330SF) of stream channel assoicated with de -watering. Areas
of temporary impact willl have stream bed and banks restored to similair pre-contruction grade and stablized with natural fiber
matting and herbaceous vegetaion.
Stream Impact S2 will permanently impact 30 LF (183SF) of stream channel assoicated with road fill.
Page 5 of 12
PCN Form — Version 1.3 December 10, 2008 Version

Stream Impact S3 will permanently impact 26 LF (159SF) of stream channel assoicated with rip -rap energy dissipaters that
will be installed at existing stream elevation.
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 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4L Total open water impacts
4g. Comments: Open water impacts are not proposed.
5. Pond or Lake Construction
If pond or lake construction proposed, the 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
Flooded
P1
P2
K Total
5g. Comments: Construction of ponds/lakes are not proposed.
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:
Page 6of12
PCN Form — Version 1.3 December 10, 2008 Version

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.
❑ Neuse El Tar -Pamlico ®Other: Yadkin
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
131 ❑P❑T
El Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments: Buffer impacts are not proposed.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Due to the development and use of the site as a solar farm, an access road must be constructed to provide access to the site
during construction and long term maintenance of the site as a solar farm. The road width has been designed to the minimal
width necessary to safely accommodate heavy equipment and tractor trailers. The road alignment has been designed to
cross in a narrow segment of the stream that has few meanders. The applicant has designed the crossing to utilize head and
end walls, thus avoiding more net loss impact than proposed within this application. The applicant is utlizing direction drill
techniques to avoid the temporal impact to streams and wetlands assoicated with utility interconnection of the site.
The solar array and necessary infrastructure (overhead/underground voltage lines, inverters, etc.) have been designed to
avoid impacts to jurisdictional streams, wetlands and ponds.
The remaining 13.93 acres of wetlands and 16,129 linear feet of stream channel are being avoided.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The clearing limits will be staked and surveyed in the field. Sediment and erosion control devices and other best management
practices will be utilized during site development activities to prevent down -gradient sedimentation into waters. The applicant
will divert stream flow during culvert installation using sand bag coffer dam and pump around. The proposed culvert will be set
in the dry. Following culvert installation, the sand bag coffer dams will be removed to divert flow through the culvert.
Temporary impacts to streams associated with the temporary pump around and dewatering will be restored to similar pre -
construction grade and stabilized with matting and herbaceous seed mixture.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
El Payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
Page 7of12
PCN Form — Version 1.3 December 10, 2008 Version

3.
Complete if Using a Mitigation Bank
3a.
Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments: Mitigation is not proposed.
4.
Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b.
Stream mitigation requested:
linear feet
4c.
If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d.
Buffer mitigation requested (DWQ only):
square feet
4e.
Riparian wetland mitigation requested:
acres
4f.
Non -riparian wetland mitigation requested:
acres
4g.
Coastal (tidal) wetland mitigation requested:
acres
4h.
Comments:
5.
Complete if Using a Permittee Responsible Mitigation Plan
5a.
If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
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 ® 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: Buffer mitigation is not proposed.
Page 8 of 12
PCN Form — Version 1.3 December 10, 2008 Version

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
low density %
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: Based on the % impervious, a
stormwater management plan is not requried.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
❑ Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
® DWQ Stormwater Program
❑ DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
❑ Phase II
❑ NSW
3b.
Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ 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 9of12
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
® No
use of public (federal/state) land?
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
❑ Yes
® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
❑ Yes
® No
Comments: We are not aware of a NEPA or SEPA being requried.
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes
® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
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.
We are not aware of additional development that will impact nearby downstream water quality.
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.
Wastewater will not be generated by the proposed project.
Page 10 of 12
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The attached IPac dated 11.07.22 identifies the tri colored bat (Proposed Endangered) and Schweinitz's sunflower
(Endangered) as potentially occurring within the project area. The proposed stream crossing is located in an area that
has been timbered within the previous three years. Trees or saplings are not present within the proposed crossing
location and the herbaceous layer contains extremely dense vegetation. Therefore, we have made the determination the
proposed project will have no effect to the tri colored bat or Schweinitzs sunflower.
During preliminary planning, the USFWS reviewed the proposed project and issued a response letter dated 1.14.22
(attached).
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Based on our knowledge of the site, the site is not located in or near an area designated as essential fish habitat. Best
management practices and the use of temporary sediment and erosion control devices will prevent sediment from entering
down -gradient waterbodies which may contain fish.
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
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
SHPO letters dated 12.20.19 and 1.4.21 (attached).
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:
8c. What source(s) did you use to make the floodplain determination? FEMA NFHL (Drawing 4, attached)
Scott Edwards
Q 5
X) C•
11.17.22
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 12 of 12
PCN Form — Version 1.3 December 10, 2008 Version

DocuSign Envelope ID: E2FCODOD-C7EF-4F3B-9FE2-07D65A5077F9
AGENT AUTHORIZATION
This form authorizes Pilot to act as our agent in stream/wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address:
Applicant Information:
Healing Springs Solar, LLC
2518 Flat Swamp Rd.
Denton. NC 27239
Name: Healing Springs Solar, LLC
Address: 3402 Pico Blvd.
Santa Monica, CA 90405
Telephone Number: [phone]
Fax Number:
E-mail Address: [e-mail]
DocuSigned by:
�Ya?itivlos�. (/OF,� 11/1/2022
Signature: Date:

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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2019-02101 County: Davidson U.S.G.S. Quad: NC- Grist Mountain
NOTIFICATION OF JURISDICTIONAL DETERNIINATION
Requestor:
Healing Springs Solar, LLC
Tyler Norris
Address:
3402 Pico Boulevard
Santa Monica, CA 90405
Telephone Number:
828-399-9304
E-mail:
tvler.norris(&ccrenew.com
Size (acres) 530 Nearest Town Denton
Nearest Waterway Lick Creek River Basin Upper Pee Dee
USGS HUC 03040103 Coordinates Latitude: 35.637293
Longitude:-80.154946
Location description: The review area is located on the south side of Flat Swamp Road; approximately 2.7 miles west of the
intersection of Flat Swamp Road and Glenn Street. PINs: 6658-02-68-4581, 6658-01-36-1420, and 6658-02-77-3943. Reference
review area descrintion shown in Jurisdictional Determination Request nackage entitled "Drawing 1, USGS Tonotmanhic
Map".
Indicate Which of the Following Apply:
A. Preliminary Determination
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters, including wetlands have been delineated, and the delineation has been verified by the Corps to be sufficiently accurate
and reliable. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. Therefore
this preliminary jurisdiction determination may be used in the permit evaluation process, including determining compensatory
mitigation. For purposes of computation of impacts, compensatory mitigation requirements, and other resource protection
measures, a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any
way by the permitted activity on the site as if they are jurisdictional waters of the U.S. This preliminary determination is not an
appealable action under the Regulatory Program Administrative Appeal Process (Reference 33 CFR Part 331). However, you may
request an approved JD, which is an appealable action, by contacting the Corps district for further instruction.
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403).
However, since the waters, including wetlands have not been properly delineated, this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is
merely an effective presumption of CWA/RHA jurisdiction over all of the waters, including wetlands at the project area, which
is not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the waters,
including wetlands on your project area/property delineated. As the Corps may not be able to accomplish this wetland
delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in law or our published regulations, this determination may be relied upon for
a period not to exceed five years from the date of this notification.
® There are waters, including wetlandson the above described project area/property subject to the permit requirements of Section
404 of the Clean Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ We recommend you have the waters, including wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.

SAW-2019-02101
❑ The waters, including wetlands on your project area/property have been delineated and the delineation has been verified by
the Corps. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once
verified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided
there is no change in the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The waters, including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below onDATE. Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact Bryan Roden -Reynolds at 704-510-1440 or
brvan.roden-reynolds(&u sace.army.mil.
C. Basis For Determination: Basis For Determination: See the approved iurisdictional determination
form dated 01/30/2021.
D. Remarks: None.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination 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 request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B.
above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Phillip Shannin, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303-8801
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by 03/31/2021.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
RODEN Digitally signed by RODEN
REYN OLDS.BRYAN.KE N N ETH.1263385574
Corps Regulatory Official: REYNOLDS.BRYAN.KENNETH,1263385574 _
Date of JD: 01/30/2021 Expiration Date of JD: 01/29/2026

SAW-2019-02101
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete the Customer Satisfaction Survey located at
http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0
Copy furnished:
Agent:
Pilot Environmental, Inc.
Scren Homer
Address:
743 Park Lawn Court
Kernersville, NC 27284
Telephone Number:
336-712-7459
E-mail:
shomer(&yilotenviro.com

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Healing S wings Solar LLC, T ler Norris File Number: SAW-2019-02101
Date: 01/30/2021
Attached is:
See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
PERMIT DENIAL
C
❑X
APPROVED JURISDICTIONAL DETERMINATION
D
❑
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.army.miUMissions/CivilWorks/ReaulatoryProgramandPenuits.asi)
OZI& Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Phillip Shannin, Administrative Appeal Review Officer
Attn: Bryan Roden -Reynolds
CESAD-PDO
Charlotte Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 1 OM15
8430 University Executive Park Drive, Suite 615
Atlanta, Georgia 30303-8801
Charlotte, North Carolina 28262
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15-day
notice of any site investigation, and will have the opportum to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Bryan Roden -Reynolds, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Phillip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

U.S. ARMY CORPS OF ENGINEERS
REGULATORY PROGRAM
APPROVED JURISDICTIONAL DETERMINATION FORM (INTERIM)
NAVIGABLE WATERS PROTECTION RULE
I. ADMINISTRATIVE INFORMATION
Completion Date of Approved Jurisdictional Determination (AJD): 01/30/2021
ORM Number: SAW-2019-02101
Associated JDs: SAW-2019-02101 (issued 03/05/20)
Review Area Location': State/Territory: NC City: Dentor, County/Parish/Borough: Davidson
Center Coordinates of Review Area: Latitude 35.637293 Longitude-80.154946
II. FINDINGS
A. Summary: Check all that apply. At least one box from the following list MUST be selected. Complete the
corresponding sections/tables and summarize data sources.
J The review area is comprised entirely of dry land (i.e., there are no waters or water features, including
wetlands, of any kind in the entire review area). Rationale: N/A or describe rationale
❑ There are "navigable waters of the United States" within Rivers and Harbors Act jurisdiction within the
review area (complete table in Section 11.13).
❑x There are "waters of the United States" within Clean Water Act jurisdiction within the review area
(complete appropriate tables in Section II.C).
DX There are waters or water features excluded from Clean Water Act jurisdiction within the review area
(complete table in Section II.D).
B. Rivers and Harbors Act of 1899 Section 10 (§ 10)2
§ 10 Name § 10 Size § 10 Criteria Rationale for § 10 Determination
N/A I N/A
C. Clean Water Act Section 404
Territorial Seas and Traditional Navi able Waters a 1 waters :3
a 1 Name
a 1 Size
a 1 Criteria
Rationale fora 1 Determination
Tributaries a 2 waters):
(a)(2) Name
(a)(2) Size
(a)(2) Criteria
Rationale fora 2 Determination
Stream
20
linear
(a)(2) Perennial
Stream CSA1 flow regime was verified during the
CSA1
feet
tributary
Corps site visit.
contributes
surface water
flow directly or
indirectly to an
(a)(1) water in a
typical year.
Stream
200
linear
(a)(2) Perennial
Stream CSA2 flow regime was verified during the
CSA2
feet
tributary
Corps site visit.
contributes
' Map(s)/figure(s) are attached to the AJD provided to the requestor.
' If the navigable water is not subject to the ebb and flow of the tide or included on the District's list of Rivers and Harbors Act Section 10 navigable waters list, do
NOT use this document to make the determination. The District must continue to follow the procedure outlined in 33 CFR part 329.14 to make a Rivers and Harbors
Act Section 10 navigability determination.
s A stand-alone TNW determination is completed independently of a request for an AJD. A stand-alone TNW determination is conducted for a specific segment of river
or stream or other type of waterbody, such as a lake, where upstream or downstream limits or lake borders are established. A stand-alone TNW determination should be
completed following applicable guidance and should NOT be documented on the AJD Form.
Page 2 of 2 Form Version 10 June 2020 updated

U.S. ARMY CORPS OF ENGINEERS
REGULATORY PROGRAM
APPROVED JURISDICTIONAL DETERMINATION FORM (INTERIM)
NAVIGABLE WATERS PROTECTION RULE
Tributaries a 2 waters):
(a)(2) Name
(a)(2) Size
(a)(2) Criteria
Rationale fora 2 Determination
surface water
flow directly or
indirectly to an
(a)(1) water in a
typical year.
Stream DSA
80
linear
(a)(2) Perennial
Stream DSA flow regime was verified during the
feet
tributary
Corps site visit.
contributes
surface water
flow directly or
indirectly to an
(a)(1) water in a
typical year.
Lick Creek
2,300
linear
(a)(2) Perennial
Lick Creek flow regime was verified during the
feet
tributary
Corps site visit.
contributes
surface water
flow directly or
indirectly to an
(a)(1) water in a
typical year.
Lakes and ponds, and impoundments of jurisdictional waters ((a)(3 waters):
a 3 Name
a 3 Size
a 3 Criteria
Rationale fora 3 Determination
N/A
I
N/A.
N/A.
Adjacent wetlands ((a)(4) waters):
(a)(4) Name
(a)(4) Size
(a)(4) Criteria
Rationale fora 4 Determination
Wetland
0.016
acre(s)
(a)(4) Wetland
Wetland CWB abuts perennial stream CSA2.
CWB
abuts an (a)(1)-
(a)(3) water.
Wetland
0.182
acre(s)
(a)(4) Wetland
Wetland DWA abuts perennial stream DSA.
DWA
abuts an (a)(1)-
(a)(3) water.
Wetland
0.008
acre(s)
(a)(4) Wetland
Wetland DWB abuts perennial Stream CSA1.
DWB
abuts an (a)(1)-
(a)(3) water.
Page 2 of 2 Form Version 10 June 2020 updated

U.S. ARMY CORPS OF ENGINEERS
REGULATORY PROGRAM
APPROVED JURISDICTIONAL DETERMINATION FORM (INTERIM)
® NAVIGABLE WATERS PROTECTION RULE
D. Excluded Waters or Features
Excluded waters b)(1) — b 12 :4
Exclusion Name
Exclusion Size
Exclusions
Rationale for Exclusion Determination
Wetland DWC
0.327
acre(s)
(b)(1) Non-
Wetland DWC has no connection to
adjacent
downstream jurisdictional waters.
wetland.
III. SUPPORTING INFORMATION
A. Select/enter all resources that were used to aid in this determination and attach data/maps to this
document and/or references/citations in the administrative record, as appropriate.
Information submitted by, or on behalf of, the applicant/consultant: Drawings 1-5.3
This information is sufficient for purposes of this AJD.
Rationale: N/A
❑ Data sheets prepared by the Corps: -le(s) and/or date(s).
0 Photographs: Aerial and Other: Drawings 5-5.3, Wetland Map (Dated 11/11/20) and Photographs
1-6
0 Corps site visit(s) conducted on: 01/20/21
❑ Previous Jurisdictional Determinations (AJDs or PJDs): ORM Number(s) and date(s).
❑ Antecedent Precipitation Tool: provide detailed discussion in Section 111.B.
0 USDA NRCS Soil Survey: Drawing 2, Web Soil Map (Web Soil Survey of Davidson County) and
Drawing 2A, Published Soil Map (Soil Survey of Davidson County Sheets 10 and 12 Dated 1994)
0 USFWS NWI maps: Drawing 3, NWI Map (USFWS NWI Mapper)
0 USGS topographic maps: Drawing 1, USGS Topographic Map (7.5-minute quadrangle Grist
Mountain and High Rock, NC)
Other data sources used to aid in this determination:
Data Source select
Name and/or date and other relevant information
JSGS Sources
N/A.
USDA Sources
N/A.
NOAA Sources
N/A.
USACE Sources
N/A.
State/Local/Tribal Sources
N/A.
Other Sources
Drawing 4, FEMA FIRM National Flood Hazard Layer)
B. Typical year assessment(s): The consultant (i.e., Pilot Environmental, Inc.) conducted a site visit on
11/06/20. The Antecedent Precipitation Tool (APT) was used for this date and determined the site
was under wetter than normal conditions. The Corps conducted a site visit on 01/20/21. The APT
was used for this date and determined the site was under normal conditions.
C. Additional comments to support AJD: See Section II(D) Excluded Waters or Features for further
analysis on Wetland DWC202.
4 Some excluded waters, such as (b)(2) and (b)(4), may not be specifically identified on the AJD form unless a requester specifically asks a Corps district to do so.
Corps districts may, in case -by -case instances, choose to identify some or all of these waters within the review area.
s Because of the broad nature of the (b)(1) exclusion and in an effort to collect data on specific types of waters that would be covered by the (b)(1) exclusion, four sub-
categories of (b)(1) exclusions were administratively created for the purposes of the AJD Form. These four sub -categories are not new exclusions, but are simply
administrative distinctions and remain (b)(1) exclusions as defined by the NWPR.
Page 2 of 2 Form Version 10 June 2020 updated

Site Boundary
Perennial Stream
Intermittent Stream
Wetland
-- - - - - Q
Culvert
Data Point
Wq Feature ID
i
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON 1/20/21.
THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION CONDUCTED BY PILOT PERSONNEL 11/6/20.
Drawing 5
Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 1,000'
Date: 11.11.20
Revised: 1.25.21
• �tiaYV -
PIL®'i
P I L 0 T E N Y I R 0 N M E N T A e I N C
Wetland Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

}
DWA
0.182 ac.
DWA
DP-2
�DW/
DP-:
DSA
30 LK_-�
AREA VERIFIED BY USACE
(J ❑ SAW-2019-02101, DATED 3/5/2020)
mk-,�
r
LEGEND
Site Boundary
Perennial Stream
---•
Intermittent Stream
Wetland
Culvert
Data Point
WA
Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON 1/20/21.
THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION CONDUCTED BY PILOT PERSONNEL 11/6/20.
M
Drawing 5.1 Wetland Map
Satellite Imagery from ESRI _1 �.` :. Healing Springs Solar, LLC
and Pilot GPS Data
tea,. Approximate 530-Acre Tract
Scale: 1" = 400'
'~ Healing Springs, Davidson County, NC
Date: 11.11.20 PILOT
Revised:1.25.21 PILOT ENYIRONMEN TAe,INC Pilot Project5109.2

AREA VERIFIED BY U ACE
(1D A1-2019-02101, DATED .3/5 2020)
LEGEND
Site Boundary
Perennial Stream
Intermittent Stream
Wetland
Culvert
Q Data Point
WA Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON 1/20/21.
THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION CONDUCTED BY PILOT PERSONNEL 11/6/20.
Drawing 5.2
Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 400'
Date: 11.11.20
Revised: 1.25.21
• �tiaYV -
PIL®'i
P I L 0 T E N Y I R 0 N M E N T A e I N C
Wetland Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

DWC(Excluded f,
U DW B
0.327 ac. X OA48 arc.
171
AREA VERIFIED BY U A E
(J D SAW-2019-02101, DATED .3/5/2020)
Site Boundary
Perennial Stream
Intermittent Stream
Wetland
Culvert
Q Data Point
WA Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP WERE VERIFIED BY MR. BRYAN RODEN-REYNOLDS WITH THE USACE ON 1/20/21.
THIS EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION CONDUCTED BY PILOT PERSONNEL 11/6/20.
Drawing 5.3
Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 400'
Date: 11.11.20
Revised: 1.25.21
PIL®'�
P I L 0 T E N Y I R 0 N M E N T A e I N C
Wetland Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
Phone: [phone] Fax: [phone]
In Reply Refer To:
Project Code: 2023-0013111
Project Name: Healing Springs Solar
November 07, 2022
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The enclosed species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The enclosed species list
fulfills the requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1973, as amended (16 U.S.C. 1531 et seq.).
Please note that new species information can change your official species list. Under 50 CFR
402.12(e) of the regulations implementing section 7 of the Act, the accuracy of this species list
should be verified after 90 days. The Service recommends you visit the ECOS-IPaC website at
regular intervals during project planning and implementation to ensure your species list is
accurate or obtain an updated species list.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of the
Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A biological assessment (BA) or biological evaluation (BE) should be completed for your
project. A BA is required for major construction activities (or other undertakings having similar
physical impacts) considered to be Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2) (c))
(NEPA). For projects other than major construction activities, the Service suggests that a BE be
prepared to determine effects of the action and whether those effects may affect listed species
and/or designated critical habitat. E?ects of the action are all consequences to listed species or
critical habitat that are caused by the proposed action, including the consequences of other

11/07/2022
activities that are caused by the proposed action. A consequence is caused by the proposed action
if it is reasonably certain to occur and would not occur "but for" the proposed action..
Recommended contents of a BA/BE are described at 50 CFR 402.12. More information and
resources about project review and preparing a BA/BE can be found at the following web link:
https://www.fws. gov/office/asheville-ecological-services/asheville-field-office-online-review-
process-overview.
If a Federal agency determines listed species and/or designated critical habitat may be affected
by the proposed project, the agency is required to consult with the Service pursuant to 50 CFR
402. The Service is not required to concur with "no effect" determinations from Federal action
agencies. If consultation is required, the Service recommends that candidate species, proposed
species, proposed critical habitat, and at -risk species be addressed within the consultation. More
information on the regulations and procedures for section 7 consultation, including the role of
permit or licensed applicants, can be found in the "Endangered Species Consultation Handbook"
at the following web link: https://www.fws.gov/media/endangered-species-consultation-
handbook.
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Act, there are additional responsibilities under the Migratory Bird Treaty Act (MBTA)
and the Bald and Golden Eagle Protection Act (BGEPA) to protect native birds from project -
related impacts. Any activity, intentional or unintentional, resulting in take of migratory birds,
including eagles, is prohibited unless otherwise permitted by the Service (50 C.F.R. Sec. 10.12
and 16 U.S.C. Sec. 668(a)). More information about MBTA and BGEPA can be found at the
following web link: https://www.fws.gov/program/migratory-birds.
We appreciate your consideration of Federally listed species. The Service encourages Federal
agencies to include conservation of threatened and endangered species in their project planning
to further the purposes of the Act. Please contact our staff at 828-258-3939, if you have any
questions. In any future correspondence concerning this project, please reference the
Consultation Code which can be found in the header of this letter.
Attachment(s):
• Official Species List
• USFWS National Wildlife Refuges and Fish Hatcheries
• Migratory Birds
• Wetlands

11/07/2022
Official Species List
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
[phone]

11/07/2022
KA
Project Summary
Project Code: 2023-0013111
Project Name: Healing Springs Solar
Project Type: Power Gen - Solar
Project Description: Site being considered for development of solar farm.
Project Location:
Approximate location of the project can be viewed in Google Maps: https://
www.google.com/maps/035.6317624,-80.16042393747077,14z
SIN
Counties: Davidson County, North Carolina
OE rr

11/07/2022 3
Endangered Species Act Species
There is a total of 3 threatened, endangered, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
Mammals
NAME STATUS
Tricolored Bat Perimyotis subflavus Proposed
No critical habitat has been designated for this species. Endangered
Species profile: https:Hecos.fws.gov/ecp/species/10515
Insects
NAME
STATUS
Monarch Butterfly Danaus plexippus
Candidate
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
Flowering Plants
NAME
STATUS
Schweinitz's Sunflower Helianthus schweinitzii
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3849
Critical habitats
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.

11/07/2022
USFWS National Wildlife Refuge Lands And Fish
Hatcheries
Any activity proposed on lands managed by the National Wildlife Refuge system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS OR FISH HATCHERIES WITHIN YOUR PROJECT AREA.

11/07/2022
Migratory Birds
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Actz.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
1. The Migratory Birds Treat. Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the
USFWS Birds of Conservation Concern (BCC) list or warrant special attention in your
project location. To learn more about the levels of concern for birds on your list and how this
list is generated, see the FAQ below. This is not a list of every bird you may find in this location,
nor a guarantee that every bird on this list will be found in your project area. To see exact
locations of where birders and the general public have sighted birds in and around your project
area, visit the E-bird data mapping tool (Tip: enter your location, desired date range and a species
on your list). For projects that occur off the Atlantic Coast, additional maps and models detailing
the relative occurrence and abundance of bird species on your list are available. Links to
additional information about Atlantic Coast birds, and other important information about your
migratory bird list, including how to properly interpret and use your migratory bird report, can be
found below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.
BREEDING
NAME SEASON
Bald Eagle Haliaeetus leucocephalus Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
Chimney Swift Chaetura pelagica Breeds Mar 15
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 25
and Alaska.
Prairie Warbler Dendroica discolor Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Jul 31
and Alaska.

11/07/2022
BREEDING
NAME SEASON
Wood Thrush Hylocichla mustelina Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 31
and Alaska.
Probability Of Presence Summary
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week
months.) A taller bar indicates a higher probability of species presence. The survey effort (see
below) can be used to establish a level of confidence in the presence score. One can have higher
confidence in the presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
The probability of presence for each week is calculated as the number of survey events in
the week where the species was detected divided by the total number of survey events for
that week. For example, if in week 12 there were 20 survey events and the Spotted Towhee
was found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is
0.25.
2. To properly present the pattern of presence across the year, the relative probability of
presence is calculated. This is the probability of presence divided by the maximum
probability of presence across all weeks. For example, imagine the probability of presence
in week 20 for the Spotted Towhee is 0.05, and that the probability of presence at week 12
(0.25) is the maximum of any week of the year. The relative probability of presence on
week 12 is 0.25/0.25 = 1; at week 20 it is 0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the
probability of presence score.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across
its entire range. If there are no yellow bars shown for a bird, it does not breed in your project
area.
Survey Effort (1)
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.

11/07/2022
3
No Data (—)
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on
all years of available data, since data in these areas is currently much more sparse.
SPECIES
Bald Eagle
Non -BCC
Vulnerable
■ probability of presence breeding season I survey effort — no data
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Chimney Swift
BCC Rangew de ++++ +—�� —III IIII IIII IIII IIII IIII
(CON)
Prairie warbler IIII IIII IIII ----
BCC Rangewide ++++ +-- —
(CON)
Wood Thrush
BCC Rangewide +++++--- — — — — — — — — —III IIII IIII IIII
(CON)
Additional information can be found using the following links:
—+--
-4—. .—. .
• Birds of Conservation Concern https://www.fws.gov/program/migratory-birds/species
• Measures for avoiding and minimizing impacts to birds https://www.fws.gov/librq�r/
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
Migratory Birds FAQ
Tell me more about conservation measures I can implement to avoid or minimize impacts
to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize
impacts to all birds at any location year round. Implementation of these measures is particularly
important when birds are most likely to occur in the project area. When birds may be breeding in
the area, identifying the locations of any active nests and avoiding their destruction is a very
helpful impact minimization measure. To see when birds are most likely to occur and be breeding
in your project area, view the Probability of Presence Summary. Additional measures or permits
may be advisable depending on the type of activity you are conducting and the type of
infrastructure or bird species present on your project site.

11/07/2022 4
What does IPaC use to generate the list of migratory birds that potentially occur in my
specified location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCQ and other species that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian
Knowledge Network (AKN). The AKN data is based on a growing collection of survey, banding,
and citizen science datasets and is queried and filtered to return a list of those birds reported as
occurring in the 10km grid cell(s) which your project intersects, and that have been identified as
warranting special attention because they are a BCC species in that area, an eagle (Eagle Act
requirements may apply), or a species that has a particular vulnerability to offshore activities or
development.
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your
project area. It is not representative of all birds that may occur in your project area. To get a list
of all birds potentially present in your project area, please visit the Rapid Avian Information
Locator (RAIL)Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?
The probability of presence graphs associated with your migratory bird list are based on data
provided by the Avian Knowledge Network (AKN). This data is derived from a growing
collection of survey, banding, and citizen science datasets.
Probability of presence data is continuously being updated as new and better information
becomes available. To learn more about how the probability of presence graphs are produced and
how to interpret them, go the Probability of Presence Summary and then click on the "Tell me
about these graphs" link.
How do I know if a bird is breeding, wintering or migrating in my area?
To see what part of a particular bird's range your project area falls within (i.e. breeding,
wintering, migrating or year-round), you may query your location using the RAIL Tool and look
at the range maps provided for birds in your area at the bottom of the profiles provided for each
bird in your results. If a bird on your migratory bird species list has a breeding season associated
with it, if that bird does occur in your project area, there may be nests present at some point
within the timeframe specified. If "Breeds elsewhere" is indicated, then the bird likely does not
breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern:
1. "BCC Rangewide" birds are Birds of Conservation Concern (BCC) that are of concern
throughout their range anywhere within the USA (including Hawaii, the Pacific Islands,
Puerto Rico, and the Virgin Islands);
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation
Regions (BCRs) in the continental USA; and

11/07/2022 5
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on
your list either because of the Eagle Act requirements (for eagles) or (for non -eagles)
potential susceptibilities in offshore areas from certain types of development or activities
(e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made,
in particular, to avoid and minimize impacts to the birds on this list, especially eagles and BCC
species of rangewide concern. For more information on conservation measures you can
implement to help avoid and minimize migratory bird impacts and requirements for eagles,
please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects
For additional details about the relative occurrence and abundance of both individual bird species
and groups of bird species within your project area off the Atlantic Coast, please visit the
Northeast Ocean Data Portal. The Portal also offers data and information about other taxa besides
birds that may be helpful to you in your project review. Alternately, you may download the bird
model results files underlying the portal maps through the NOAA NCCOS Integrative Statistical
Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Outer Continental Shelf project webpage.
Bird tracking data can also provide additional details about occurrence and habitat use
throughout the year, including migration. Models relying on survey data may not include this
information. For additional information on marine bird tracking data, see the Diving Bird Study
and the nanotag studies or contact Caleb Spiegel or Pam Loring.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid
violating the Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of
birds of priority concern. To learn more about how your list is generated, and see options for
identifying what other birds may be in your project area, please see the FAQ "What does IPaC
use to generate the migratory birds potentially occurring in my specified location". Please be
aware this report provides the "probability of presence" of birds within the 10 km grid cell(s) that
overlap your project; not your exact project footprint. On the graphs provided, please also look
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no
data" indicator (a red horizontal bar). A high survey effort is the key component. If the survey
effort is high, then the probability of presence score can be viewed as more dependable. In
contrast, a low survey effort bar or no data bar means a lack of data and, therefore, a lack of
certainty about presence of the species. This list is not perfect; it is simply a starting point for
identifying what birds of concern have the potential to be in your project area, when they might
be there, and if they might be breeding (which means nests might be present). The list helps you
know what to look for to confirm presence, and helps guide you in knowing when to implement
conservation measures to avoid or minimize potential impacts from your project activities,
should presence be confirmed. To learn more about conservation measures, visit the FAQ "Tell

11/07/2022
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

11/07/2022
Wetlands
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under Section
404 of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army Corps of
Engineers District.
Please note that the NWI data being shown may be out of date. We are currently working to
update our NWI data set. We recommend you verify these results with a site visit to determine
the actual extent of wetlands on site.
RIVERINE
• Riverine
FRESHWATER POND
• Palustrine

11/07/2022
IPaC User Contact Information
Agency: Pilot Environmental, Inc
Name: Scott Edwards
Address: 428 Park Lawn Court
City:
Kernersville
State:
NC
Zip:
27285
Email
[e-mail]
Phone:
3362794683

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SEUUnited States Department of the Interior
V7
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H 3 'a Asheville Field Office
160 Zillicoa Street Suite B
Asheville, North Carolina 28801
January 14, 2021
Ms. Seren Homer
Pilot Environmental, Inc.
P.O. Box 128
Kernersville, North Carolina 27285
Dear Ms. Homer:
Subject: Listed Species Assessment, for Proposed 530-Acre Solar Array Site (Healing Springs
Solar Farm), adjacent to Flat Swamp Road, in Healing Springs, Davidson County,
North Carolina (Pilot Project No. 5109.2)
On December 22, 2020, we received (via e-mail) a letter from you requesting our review of the
subject project. Included with your letter was a copy of the threatened and endangered species
assessment (conducted by Pilot Environmental, Inc. personnel) for the project site. We
originally provided comments on a 474-acre proposal for this project on November 14, 2019.
Since then, your client has increased the project size by adding an additional 56-acres to the
project proposal. We have reviewed the information that you presented and the following
comments are provided in accordance with the provisions of the National Environmental Policy
Act (42 U.S.C.§ 4321 et seq.); the Fish and Wildlife Coordination Act, as amended (16 U.S.C.
661-667e); the Migratory Bird Treaty Act, as amended (16 U.S.C. 703); and section 7 of the
Endangered Species Act of 1973, as amended (16 U.S.C. 1531-1543) (Act).
Project Description. According to the information presented, your client is proposing to
construct a solar array on a 530-acre site. The proposed project site consists primarily of planted
loblolly pine stands and agricultural fields. A portion of the site appears to have been clear-
cut/logged in the recent past. The site contains several un-named tributaries to Lick Creek.
About 12-acres of wetlands occur on the site and are found primarily along the un-named
streams. Your letter did not include any information as to proposed or potential impacts to
aquatic resources on the site.
Federally Listed Endangered and Threatened Species. According to our records and a review
of the information you provided, no federally listed species or their habitats occur in the project
area. Therefore, we believe the requirements under section 7 of the Act are fulfilled. However,
obligations under section 7 of the Act must be reconsidered if: (1) new information reveals
impacts of this identified action that may affect listed species or critical habitat in a manner not
previously considered, (2) this action is subsequently modified in a manner that was not

Ms. Homer — Pilot Env. 2
considered in this review, or (3) a new species is listed or critical habitat is determined that may
be affected by the identified action.
We have records of monarch butterfly (Danaus plexippus plexippus) in the area, a federal
candidate for listing'. There are many potential reasons for the butterfly's decline, including
those listed above, pesticide use, logging at overwintering sites, and climate change. Adults use a
wide variety of flowering plants throughout migration for nectar and breeding. However,
milkweed plants (Asclepias spp.) are essential to monarch breeding as these are the only genus of
plants that can host monarchs in their larval form. For a regional and season list of plants
important to monarch butterflies visit the Xerces Society website at:
htip://www.xerces.org/monarch-nectar-plants/. Although the provisions of section 7 of the Act
do not currently apply to candidate species or other non -listed pollinators, we would greatly
appreciate your assistance in determining if monarch butterflies or suitable habitat for this
species is present on the proposed project site. If individuals or suitable habitat is present,
impacts should be avoided. More specific information about monarch butterfly can be found at
the Service website dedicated to the species at https://www.fws.gov/savethemonarch/.
We appreciate the opportunity to provide comments on this project. We request that you refer to
our original November 14, 2019 comment letter for additional conservation measures and
recommendations for the project. Please contact Mr. Bryan Tompkins of our staff at
828/258-3939, Ext. 42240, if you have any questions. In any future correspondence concerning
this project, please reference our Log Number 4-2-20-014.
1 "Taxa for which the [Fish and Wildlife] Service has on file enough substantial information on biological
vulnerability and threat(s) to support proposals to list them as endangered or threatened. Proposed rules have not yet
been issued because this action is precluded at present by other listing activity. Development and publication of
proposed rules on these taxa are anticipated. The Service encourages State and other Federal agencies as well as
other affected parties to give consideration to these taxa in environmental planning" (Federal Register, February 28,
1996). Taxa formerly considered as "Category 1" are now considered as "candidates."

Control No.: 21-E-4600-0795 Date Received: 12/3/2020
County.: DAVIDSON Agency Response: 1/4/2021
Review Closed: 1/4/2021
DEVON BORGARDT
Clearinghouse Reviewer
DEPT OF NATURAL & CULTURAL
RESOURCE
Project Information
Type: State Environmental Policy Act ironmental Review
Applicant: North Carolina Department of Commerce
Project Desc.: Application of Healing Springs Solar, LLC for Certificate to construct a 55 MW Solar Facility
Davidson Co. Docket # SP-19877 Sub 0. View document at
http://starwl.ncuc.net/NCUC/portal/ncuc/page/Dockects/portal.aspx, Type SP-19877 Sub 0 in
the Docket Number search line. Located off of Flat Swamp Road, at its intersection with
Daniel Pierce Drive, near the Town of Denton, NC.
As a result of this review the following is submitted:
❑� No Comment ❑Comments Below ❑Documents Attached
Reviewed By: DEVON BORGARDT Date: 12/21/2020

Oovl-��a&�
NORTH CAROLINA STATE CLEARINGHOUSE
DEPARTMENT OF ADMINISTRATION
INTERGOVERNMENTAL REVIEW
(V
COUNTY: DAVIDSON 1411: ENFRGY RELATED STATE NUMBER: 20-E-4600 0099
FACILITIES/ACTIVITIES DATE RECEIVED: 11/13/2019
AGENCY RESPONSE: 12/09/2019
REVIEW CLOSED:
`� 12/13/2019
MS RENE:E GLEDHILL-EARLEY Received: 11/"""`'"/201 `
CLEARINGHOUSE COORDINATOR State Historic Preservation Office
DEPT OF NATURAL & CULTURAL RESOURCE
STATE: HISTORIC PRESERVATION OFFICE
MSC 4617 - ARCHIVES BUILDING ER 19-5111
RALEIGH NC
REVIEW DISTRIBUTION
DEPT OF AGRICULTURE
DEPT OF ENVIRONMENTAL QUALITY
DEPT OF NATURAL & CULTURAL, RESOURCE
DEPT OF TRANSPORTATION
DNCR - NATURAL HERITAGE PROGRAM
DPS - DIV OF EMERGENCY MANAGEMZN'a
PIEDMONT TRIAD REGIONAL COUNCIL
Due 12/5/19
A
PROJECT INFORMATION Due
APPLICANT. North. Carolina Department of Commerce ��
TvPF. State Environmental Policy Acthg
nvirc�n:nental Review �- l�
DESC: Application of Healing Springs Solar, LLC for Certificate to construct a 50 MW
Solar Facility in Davidson Co. Docket # SP-19877 Sub 0. - View document at
http://stazwl.ncuc.net/NCUC/portal/ncuc/page/Dockets/portal.aspx, Type SP-1987'r
Sub 0 in the Docket Number search line.
Located off of Flat Swamp Road, at its intersection with Daniel Pierce Drive,
near the Town of ,Dentor:, NC
':ha attached project has been submitted to the N. C. State Clearinghouse for
intergovernmental review. Please review and submit your response by the above
indi,.ated date to 1301. Mail Service Center, Raleigh NC 27699--1301.
If additional review time is needed, please contact this office at [phone],
AS A RESULT OF THI"S REVIEW THE FOLLOWING IS SUBMITTED:10 NO COMMENT F-] COMMENTS ATTACHED
SIGNED BY: "- DATE: _Q
NOV 2 6
0
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LEGEND
Site Boundary
Drawing 1 USGS Topographic Map
USGS Topographic Map Healing Springs Solar, LLC
Grist Mountain and High Rock, _ Approximate 530-Acre Tract
NC Quadrangles PQD.01v Healing Springs, Davidson County, NC
Scale: 1"-2,000' PILOT ENVIRONMENTAL. Pilot Project5109.2

Drawing 2
USDA Web Soil Survey
of Davidson County, NC
Scale: 1" = 1,100'
N
IdLLl
E•�� Lam!
20
gym yam,-{
M
iv
ft oni
at az
Site Boundary
i
_ Web Soil Map
Healing Springs Solar, LLC
�� ~t Approximate 530-Acre Tract
PILOT � -- Healing Springs, Davidson County, NC
PILOT ENVIRONMENTAL.INC Pilot Project5109.2

UwD
/=J
Err3
GC8 CO
1 Ba K
E BaDY
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w y v o BAD 4KVB BaB
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Ra
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4 j
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gaD i Ba©
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�a(f cri,s 4 c -�— LEGEND
f3aF 1 Bap
FAD kau Site Boundary
1 RaR 3 G2B B3 _
L Co b Jr„n 1 ,\ ` I _ _ �• . i) — �J
Drawing 2A Published Soil Map
USDA Soil Survey of ` Healing Springs Solar, LLC
Davidson County, NC , �� . ? Approximate 530-Acre Tract
Published 1994, Sheets 10 and 12 � -- Healing Springs, Davidson County, NC
Not to Scale PILOT ENViR0NMENTAL.INC Pilot Project5109.2

0
Drawing 3
USFWS NWI
Wetlands Mapper
Scale: 1" = 1,100'
0
r, r
P I L O T E N V I R O N M E N T A L. I N C
LEGEND
Site Boundary
Freshwater Emergent
Freshwater Forested/Shrub
Estuarine and Marine Deepwater
Estuarine and Marine
Freshwater Pond
Lake
Riverine
Other
A
NWI Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

.4
Cr}
£ ,2 4,
Drawing 4
National Flood Hazard Layer
From FEMA Web Map Service
Scale: 1" = 1,100'
P I L 0 T E N V I R 0 N M E N T A L. N C
LEGEND
Site Boundary
1 %Annual Chance Flood Hazard
R egulatory Floodw@y
Sped al Floodway
Area of Undetermined Flood Hazard
0.2%Annual Chance Flood Hazard
Future Conditions 1 '¢Annual Chance Flood Hazard
► Area with R educed Risk Due to Levee
FEMA FIRM
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

=1y +�J x+~/ OPT # L
Drawing 5.2
- I Drawing 5.3 I
Drawing 5.1
LEGEND
r� Site Boundary
— Perennial Stre]rea
--- Intermittent S
Wetland
Culvert
Data Point
WA Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP HAVE BEEN VERIFIED BY THE USACE (JD SAW-2019-02101, DATED 1/25/21).EXHIBIT INCL
UDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION OF "TRACT A" CONDUCTED BY PILOT PERSONNEL 110/18/19. DELINEATION OF "TRACT B" CONDUCTED BY PILOT PERSONNEL 11/6/20.
Drawing 5
Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 1,100'
Date: 11.11.20
Revised: 2.2.21
:f
P I L O T ENVIRONMENTAL. INC
Wetland Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

Drawing 5.1
Satellite Imagery from ESRI
and Pilot GPS Data
Scale: 1" = 400'
Date: 11.11.20
Revised: 2.2.21
Wetland Map
Healing Springs Solar, LLC
Approximate 530-Acre Tract
Healing Springs, Davidson County, NC
Pilot Project 5109.2

CWF 1-11
0.021 ac.
1980 LF
CWH 1-131
0.065 ac.
t
:....
CWG 1-26
0.201 ac.
LSA
,"830 LF
LWD 1-i1
0.087 ac.
qq
LSC
.*-' 810 LF
LWC 1-2 '*
0.011 ac.
LWB 1-10
CSF 0.077 ac.
25 LF
CWE 1-12
0.267 ac.
ISID
1350 LF
LEGEND LwA
Site Boundary CSC LWA 1-57
10.458 a c.
Perennial Stream 6500 LF
----- Intermittent Stream a .y
Wetland CWD 24 31 rr
Culvert 0.525 ac.
Q Data Point -
WA Feature ID
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP HAVE BEEN VERIFIED BY THE USACE (JD SAW-2019-02101, DATED 1/25/21). THIS
EXHIBIT INCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION OF "TRACT A" CONDUCTED BY PILOT PERSONNEL 10/15-
10/18/19. DELINEATION OF "TRACT B" CONDUCTED BY PILOT PERSONNEL 11/6/20. ,
rwn 11.?1
Drawing 5.2 _ Wetland Map
Satellite Imagery from ESRI.: Healing Springs Solar, LLC
-'
and Pilot GPS Data _ Approximate 530-Acre Tract
Scale: 1" = 400' - �' p �,, =- Healing Springs, Davidson County, NC
Date: 11.11.20 PLO
Revised:2.2.21 PILOT ENYIRONNENTAL.INC Pilot Project5109.2

LWA 1-57
10.458 ac.
CS-C
00 LF
40
6 M0
OWIdC ( EKE lu ij ed
from CWA)
0.3 27 RC,
CWA 1-8
0.026 ar.
C4VA !�-16
0.022 ac.
O
CW CWA
DP-1
CWA i7-30
0.368 ar-
C5A
2400 LF
CWB
0.027
- CWC 1-5 (Exrfuded
from CWA)
0.022 a c.
` ..�
DSB/Lick
Cr 2300 LF
CSB'
CWD 11-23
15 LF LEGEND
0.933 ac. .
Site Boundary
Perennial Stream
f CUWD 1-10
3A50 ac
Intermittent Stream
Wetland
Culvert
Q Data Point
WA Feature ID
LOCATIONS OF FEATURES SHOWN ON THIS MAP HAVE BEEN VERIFIED BY THE USACE
(JD SAW-2019-02101,■DATED 1/25/21). THIS
LEXHIBITINCLUDES GPS LOCATIONS OF DELINEATED FEATURES. DELINEATION OF "TRACT A"
CONDUCTED BY PILOT PERSONNEL 10/15-
18/19. DELINEATION OF "TRACT B" CONDUCTED BY PILOT PERSONNEL 11/6/20.
Drawing 5.3 _
Wetland Map
Satellite Imagery from ESRI
Healing Springs Solar, LLC
and Pilot GPS Data
Scale: 1" - 400' _ _Approximate
tl
530-Acre Tract
Date: 11.11.20�����Healing
Springs, Davidson County, NC
Revised:2.2.21 LOT ENYIRONNEN1AL.1 1:
Pilot Project5109.2

8/26/2019
Davidson County Map Output Page
avidson County GIS
Parcel Number: 0901900000011 Land Units:
Pin Id : 6658-01-36-1420 Deed Book:
CARROLLTON INC OF LEXINGTON NC
Owner: PO BOX 497 Deed Date:
LEXINGTON NC 27293-0497
Property Address: NEWSOM LN Account Number:
Township: 09 Exempt Code:
Building Value: $0 Other Building Value:
Land Value: $407,020 Market Value:
Assessed Value: $45,760 Deferred Value:
Legal Description: L 11 BK545-992&653-881 NEWSOM RD
203.51 AC
0545 Pg: 0992
03/15/1977
1300515
$0
$407,020
$361,260
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
B aB
Badin channery silt loam
Channery silt loam
2 to 8 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

r W:iN11N
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901900000010
Land Units:
40 AC
Pin Id :
6658-01-48-4135
Deed Book:
0311 Pg: 0109
SMITH D LEE HEIRS
Owner:
5403 LARK CT
Deed Date:
09/06/1956
WILMINGTON NC 28409-7535
Property Address:
NEWSOM LN
Account Number:
7268000
Township:
09
Exempt Code:
Building Value:
$0 Other Building Value:
$0
Land Value:
$126,000 Market Value:
$126,000
Assessed Value:
$8,920 Deferred Value:
$117,080
ILegal Description: L10 PRIOR BK311-109 OFF NEWSOM RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
CmB
Cid-Misenheimer complex
Complex
0 to 4 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

8/26/2019
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901400000004
Land Units:
22 AC
Pin Id :
6658-01-49-7169
Deed Book:
2199 Pg: 1213
WORLEY KEITH ALLEN
Owner:
2657 FLAT SWAMP RD
Deed Date:
10/21/2015
DENTON NC 27239
Property Address:
2657 FLAT SWAMP RD
Account Number:
9220524
Township:
09
Exempt Code:
Building Value:
$87,360 Other Building Value:
$7,560
Land Value:
$70,400 Market Value:
$165,320
Assessed Value:
$165,320 Deferred Value:
$0
Legal Description:
L4 BK2199-1213 FLAT SWAMP RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
OkA
Oakboro silt loam
Silt loam
0 to 2 percent slopes
4
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

8/26/2019
Davidson County Map Output Page
avidson County GIS
Parcel Number: 0901800000006 Land Units: 87.61 AC
Pin Id : 6658-02-56-8333 Deed Book: 2101 Pg: 1960
WHELESS LARRY WAYNE
Owner: 1139 SANDLEWOOD DR Deed Date: 05/10/2013
DURI IAM NC 27712
Property Address: DENTON RD Account Number: 9206669
Township: 09 Exempt Code:
Building Value: $0 Other Building Value: $0
Land Value: $188,360 Market Value: $188,360
Assessed Value: $34,240 Deferred Value: $154,120
Legal Description: L6 BK707-1291 HIGH ROCK RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
KyB
Kirksey silt loam
Silt loam
2 to 6 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

r W:iN11N
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901400000029
Land Units:
31.75 AC
Pin Id :
6658-02-58-9440
Deed Book:
0600 Pg: 0179
BOWLING BILLY R
BOWLING SARAH T
Owner:
Deed Date:
04/13/1982
211 GRIMES PARK DR
THOMAS VILLE NC 27360-5513
Property Address:
FLAT SWAMP RD
Account Number:
837250
Township:
09
Exempt Code:
Building Value:
$0 Other Building Value:
$0
Land Value:
$152,400 Market Value:
$152,400
Assessed Value:
$7,140 Deferred Value:
$145,260
Legal Description:
L29 BK600-179 FLAT SWAMP RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
9
Additional Attributes
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
KyB
Kirksey silt loam
Silt loam
2 to 6 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

8/26/2019
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901400000031
Land Units:
11.23 AC
Pin Id :
6658-02-68-4581
Deed Book:
2076 Pg: 1500
FORD ILA H
Owner:
1200 BURKHARI' RD
Deed Date:
10/23/2012
LEXINGTON NC 27292-8335
Property Address:
FLAT SWAMP RD
Account Number:
2642200
Township:
09
Exempt Code:
Building Value:
$0 Other Building Value:
$0
Land Value:
$67,380 Market Value:
$67,380
Assessed Value:
$3,650 Deferred Value:
$63,730
Legal Description:
L31 BK1078-554&2076-1500 FLAT
SWAMP RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
KyB
Kirksey silt loam
Silt loam
2 to 6 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

r W:iN11N
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901400000012
Land Units:
Pin Id :
6658-02-77-3943
Deed Book:
PIEDMONT HARDWOOD LUMBER
COMPANY INC
Owner:
Deed Date:
P O BOX 535
MT PLEASANT NC 28124-0000
Property Address:
FLAT SWAMP RD
Account Number:
Township:
09
Exempt Code:
Building Value:
$0 Other Building Value:
Land Value:
$269,060 Market Value:
Assessed Value:
$16,240 Deferred Value:
Legal Description:
L12 SWAMP RD BK1784-1915 FLAT
SWAMP
72.72 AC
R1784 Pg: 1911
05/04/2007
9090239
$0
$269,060
$252, 820
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 1 /2

r:W:if 11N
Davidson County Map Output Page
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
9
Additional Attributes
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
KyB
Kirksey silt loam
Silt loam
2 to 6 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

8/26/2019
Davidson County Map Output Page
avidson County GIS
Parcel Number:
0901500000001 Land Units:
94.06 AC
Pin Id :
6658-02-86-0315 Deed Book:
2204 Pg: 0207
GRICE DAVID S
Owner:
2156 SOUTH MAIN ST EXT Deed Date:
12/04/2015
DENTON NC 27239
Property Address:
660 BUIE RD Account Number:
9221185
Township:
09 Exempt Code:
Building Value:
$76,370 Other Building Value:
$5,500
Land Value:
$296,290 Market Value:
$378,160
Assessed Value:
$135,900 Deferred Value:
$242,260
Legal Description:
L 1 BK2204-207 BUIE RD
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx
1/2

r:W:if 11N
Davidson County Map Output Page
Additional Attributes
ire Service Districts
q.Miles
fame
:)wnships
q. Miles
fame
ounty Zoning Districts
oil Types
ISL Name
oil Name
ercent Sl
yaric
unicipal Boundary
o Features Found
1 inch — 945 feet
0
37.17
HEALING SPRINGS FD
38.61
HEALING SPRINGS
KyB
Kirksey silt loam
Silt loam
2 to 6 percent slopes
0
The information contained on this map does not replace information that may be obtained by
consulting the official source of the information. In no event shall Davidson County, NC or the
consultants of Davidson County, NC be liable for any damages, direct or consequential, from the use
of the information contained on this map.
https://webgis.co.davidson.nc.us/website/DavidsonGIS/printpage.aspx 2/2

Contact Name*
Heather LaGamba
Contact Email Address*
[e-mail]
Project Owner*
Multiple
Project Name*
Healing Springs Solar
Project County*
Davidson
Owner Address:*
Street Address
Multiple
Address Line 2
aty
Multiple
Postal / Zip axle
Multiple
Is this a transportation project?*
(- Yes c: No
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
F- Individual Permit F- Modification
F- Shoreline Stabilization
Does this project have an existing project ID#?*
(- Yes c: No
State / Province / Pegion
NC
Country
USA
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below.*
The applicant does not request a meeting. The applicant may submit
a
request for 401 WQC.
Please give a couple of dates you are available for a meeting.
Please attach the documentation you would like to have the meeting about.
pdf only
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 Icannot submit myapplication 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 3/9/2021