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Home My WebLink About20150177 Ver 1_401 Application_201502152 01 50 1 . � " � ' 0 0� NVN4 A ��"? $ RA Office Use Only 7- Corps action ID no DWQ project no Form Version 1 3 Dec 10 2008 Pre-Construction Notification (PCN) Form A. Applicant Information 1c Has the NWP or GP number been verified by the Corps? FE] Yes No ld Type(s) of approval sought from the DWQ (check all that apply) 401 Water Quality Certification - Regular n Non-404 Jurisdictional General Permit 401 Water Quality Certification - Express El Riparian Buffer Authorization le Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification El Yes 0 No F.7ort* reco(4�01� 1f Is payment into a mitigation bank or in-lieu fee program proposed for m 't'gatlon of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu fee program El Yes No 1g Is the project located in any of NC's twenty coastal counties If yes, answer 1 h below El Yes Z No 1h Is the project located within a NC DCM Area of Environmental Concern (AEC)? E] Yes Z No �k!-,',R6iiFeiof�j6 FOC�t David Rice Project project no - WATER R L 4Q1 A R1 IpFzr- I ESOURCFq William T. Rice & Katherine G Rice, Trustees of the William T. Rice Revocable Trust 3b Deed Book and Page No Deed Book 423, page 2114 3c" RdspdnsibfePjak�� William T Rice 3d Street add�e§s, 135 Rutledge Road �e'Ciiy;,�staitdl,'�zip, Greenwood SC 29649 3g Fax no N/A Page 1 of 11 PCN Form - Version 13 December 1O.2O08Version 4. -,kkpplicant Infoirnaii6n (if different from owner) 4')��" �6nwfis'" pil 4 Jb N am e__' Chelsea Blount ,4'c'I,IIbnIu'si ness -name New River Conservancy ,4d 'Street addr 1 North Jefferson Street 0 �E, C-,�t 7yrs fE Wt�,, -�� i West Jefferson NC 28694 M`77141eofione no 336-846-6267 4g Fax no 336-846-6433 4h Email address, chelsea@newriverconservancy org 6`6t/,dwdwn'si%i 'fififfiffifff p p VUWW), 5a Name Glen Sullivan 5b Business name (if applicable) Foggy Mountain Nursery 5c Street address 2251 Ed Little Road 5d City, state, zip Creston NC 28615 5e Telephone no 336-384-5323 5f Fax no 336-384-3764 5g Email address foggymtn @skybest com Page 2 of 11 BL; P rd t, nf rrr atiori' and Prior ProjectHistor¢y, I Property Identification la Property identification no (tax PIN or parcel ID) 03080-002 Elb �Sitecoordinqt grees Latitude - R.Longitude" (411E U4�L9) pg�rty §'ize. 52 1 Or 2. S u ff a c e :'Maiti—i of fa', ,NamE�6fnear&s_t:Epdy` jal!ij;h L4E i�M Mop osdom!� �ct Creston 2b Water Quality Classification of nearest receiving water C,Tr,ORW _River _ _ b_�_s _k9':T" s�avaifib"Wiit m. _' , , - .1 aia'p'_J�! New h, b state'n c _U-s4d m i n/m40"Q/ 3 Project Description 3a conditions tq.n,, The project site is located in a rural farm area, 2 03 river miles up stream from the bridge where Three Top Road (NCSR 1100) crosses the North Fork of the New River Sediment deposits in the center of the stream has directed the thalwag to the bank The bank is severely eroded due to the pressure of the water and the lack of vegetation b a p P o"tqwlys ti ffi =ae feet of,all e x i s t i n g�t ras(ne T i t t irl, r6n6a—l— fh m rc 4, Qs_tJtqe7.J qrt�p(6pqs@d �Ez—pa=ihfieTpTrp—"- _h 'j"6 _pg.qF 2'0�ro e_f To repair and stabilize eroding banks by reestablishing proper bank profiles through bank reshaping and with two in- stream structures, to improve water quality To improve habitat for aquatic fauna and to improve the overall condition of the riparian areas at the site 3—e�-L7D—&s—cri—be— the ToV—er—al--o—(ZtT— _tkf iiicluding' the type _6f 6--b-p- u-s'_eT ��_�pLjq_ tR!d7ot , -_ - Eroding banks will be reshaped to approximately 2 1, and planted with native vegetation Two (2) rock vanes will be constructed to divert the thalwag back to the center of the stream The existing point bar will be re-shaped to relieve pressure from eroding bank During construction a track hoe will do the work from the bank, although the track hoe may have to access the stream to construct the end of the rock vanes After construction the bank will be seeded with native grass seed and sloped bank will be covered with erosion control matting and anchored with live stakes and landscape staples Flat areas will be seeded and mulched with straw All areas will be planted with live stakes (Silky Willow, Salix Sencea) (Silky Dogwood, Cornus amomum) (Elderberry, Sambucus canadensis) along with native rhododendron mtn laurel and river birch 4 Jurisdictional Determinations 4a Have �-ffiffi-9,Ttn-f n i t naliwep Is15j, e idlorlstreaT.� d —et i the r �een""Ilrequ ested or obtained for this property t' 6'g�:aIII_Ikp_rrrior,,O !�es),Ln thLe ste _�a _,pg_ E1,Yes__ ____t_Oenb.I,4qt r-9inatipmwhattyp ,,p,s mad, the�jurisdic i E1,P(e16 mi �Ory47LFinal off tijbt c' If yes �6=eli___fed _thb jurisdictional areas? Agency %Cons`ultant Company .hmp= ,gwn) ffi=me,(ify" Other �d� 4d if yes Qffith qte rm n ationsan6bttac i� Ze;'dIjt'e7— j 09did d determinations i n ati o p s b r Sate qpq mpg ati on q,, oft K C � r7 i *, Page 3 of 11 PCN Form —Version 1 3 December 10, 2008 Version 5. Ft9i-bLetit-i CON in e _ :fi44e,p �-(7 tsr7Ze — �k�p _ns, �eeh,r �q7—�t�01,167b0--t � dlfdr,�,,, N ❑Y�i ❑ U khcw n 5b l y s,exir�, n5e 'ifordin' —I-ql 6&ns j7� pja j__T4_qqq__6 :7 q�p Ca,j—lsjRis'a'%phii-e—d,L ro—ecf—'? El Yes Nom 27M, ,I 7-- T--, - - I Page 4 of 11 C. Proposed Impacts Inventory 1 Impacts Summary El — �aWth-i (ih -ii k f i bf i -s ow y, jT-wer - ' for ou rqject,'(cNdqk,�all"tha-t,p�-gcCmp =eted-bejl W D, �efl—anCs Mlotreams - tributaries F-1 Buffers e, era nstruction 2. MW Rfl 74 60! -r AO--i acts If there areawetland j — Lc daphop then complete this question '6fi A d'%_j ad6d :2a:! 215� 2c, 2dl 2e4 2P I a t LT,,yp &offjuns,giqtion Type of imp df T Zfj' 16'ffd' Forested " WN, �011111�- �-r "404r (Corps! -0 0 "i AOF"I'Mr," p6let " n J( 1� 1I (if known) - Eiswlll,Q �,�'4 (acres) " 9 ora W1 ❑ P F-1 T ❑ Yes [-I Corps [:1 No ❑ DWQ W2 ❑ P F-1 T ❑ Yes ❑ Corps [:1 No [:1 DWQ W3 ❑ P ❑ T ❑ Yes ❑ Corps [-] No ❑ DWQ W4 ❑ P ❑ T ❑ Yes [:1 Corps ❑ No ❑ DWQ W5 ❑ P ❑ T ❑ Yes [-] Corps ❑ No [:1 DWQ W6 ❑ P F-1 T ❑ Yes ❑ Corps ❑ No ❑ DWQ 2g Efl_& A I _.Wiflandjm°,c 6 C �bra -c 3.' - ,S t r earn � Impacts Cs lVthe '6 4f*' Fenniallo-i.,i-r�t-6�r�i-fien�fitreza--m-impgr-,tq-(-[-rlcludingtempgrq-ryimp@gCs)—�-os d7P6ZnttHe-s`ite_ pLo the) �c6nip �ef ii � 2� Lyj�fE .questi�o�tnfo'rp'clell-�'fr'gam-'si-tes-i-m'Da'c'ted�--- - 3a :3�bl -30 3 7q :3: ]f 1g ! trea a ct LTp i �fi 6 PaLt- Stream n ame Pere nnial T�Lo f j6hidibti` �V—er,— ge pact e,- '(PERybe, —Q-" , length (Inear ,Per rf6nQ ,e or intermittent D- W-'- h`oW-4M width a feet) S1 OPFjT Stabilization North Fork New PER Corps 30 180 River E:1 INT ❑ DWQ S2 EPFjT Rock Vane North Fork New [I PER Corps 30 10 River ❑ INT ❑ DWQ S3 HP❑T Rock Vane North Fork New H PER M Corps 30 10 River [-I INT [-] DWQ S4 F-1 P ❑ T E:1 PER ❑ Corps ❑ INT [-] DWQ S5 [:] P F-1 T PER ❑ Corps ❑ INT [:1 DWQ S6 [:I PFT [-] PER [:1 Corps ❑ INT ❑ DWQ ,3h ,,,,,T, -Mo 31 Comments Page 5 of 11 4 lm �p Acts if ther py ' qp �ie-d`imp VEI � i�7 jks —,p 6ffd, Ws f dir 6b'6_f k e�s : cq_ 9_ water of 4a 4b 4c 4d 4e Open water Name of waterbody impact number - (if applicable) Type of impact Waterbody type Area of impact (acres) Permanent (P) or Temporary (T) 01 ❑P❑T 02 ❑P❑T 03 ❑P❑T 04 ❑P❑T .ijt7a_J1Lop m p` �n %�Ea:te r L_ _ac i 4g Comments ik :6_.�_ ',Pond oi-JL�; &,.Cofistr�_c�fion If p6nd,"br-[aIZ6Eddin% rrbc-t-io'-n-'brb-p6ie;d;-tt `en-'6o m_p!-efe-:Fhech_a_rT,`b&Iow 5a 5b 5c 5d 5e Wetland Impacts (acres) Stream Impacts (feet) Upland Pond ID Proposed use or purpose (acres) number of pond Flooded Filled Excavated Flooded Filled Excavated Flooded Pi P2 me:mTotil 5g Comments 5h Is a dam high hazard permit required? ❑ Yes 0 No If yes, permit ID no 51 Expected pond surface area (acres) 5j Size of pond watershed (acres) 5k Method of construction 6 Buffer Impacts (for DWQ) If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts below If any impacts require mitigation, then you MUST fill out Section D of this form 6a ❑ Neuse El Tar-Pamlico El Other 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 131 [:1 P E:1 T -required El Yes ❑ No B2 [:1 P Fj T El Yes [0:1 No B3 [:1 P [_1 T ❑ Yes ❑ No 6h Total buffer impacts 0 61 Comments Page 6 of 11 Page 7of11 PCN Form — Version 1 3 December 10, 2008 Version This project will stabilize 200 If of eroding stream bank, reduce stream bank erosion, reduce in-stream sediment loads and improve in-stream aquatic habitats Stream aesthetics will be improved with the establishment of a well vegetated and functioning riparian zone During construction, equipment will only access the stream when absolutely necessary For this project, it is anticipated that most of the track hoe work can be accomplished from the top of the bank However, equipment may need access the stream during the construction when no other construction alternative exists Soil disturbance will be limited to what can seeded and stabilized in one day Banks will seeded and coir matting will be placed and anchored with wooden stakes Flat areas will be seeded and covered with straw impacts to-Waters of the U S at'dfs'O'f'the-State?, 2b If yes, mitigation is required by (check all that apply) E] DWQ El Corps 2c 6ption option will be used f-or'61i 3a Name of Mitigation Bank 3b Credits Purchased (attach receipt and letter) Type Quantity 3c Comments 4a Approval letter from in-lieu fee program is attached El Yes 4b Stream mitigation requested linear feet 4c If using stream mitigation, stream temperature El warm El cool Elcold 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 Page 7of11 PCN Form — Version 1 3 December 10, 2008 Version 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? If yes, you will have to fill out this entire form — please contact the State for more information ❑ 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 Page 8 of 11 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? % 2b Does this project require a Stormwater Management Plan? ❑ Yes ® No 2c If this project DOES NOT require a Stormwater Management Plan, explain why 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 3b Which of the following locally - implemented stormwater management programs ❑ NSW ❑ 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 ❑ Yes ❑ No attached? 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 9 of 11 PCN Form — Version 1 3 December 10, 2008 Version F. Supplementary Information 1 Environmental Documentation (DWQ Requirement) la 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)? 1c 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 ❑ Yes ® No letter ) Comments 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= factpermit�a"pplication?� [3 5X, 'i E 4No 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 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 Page 10 of 11 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? El 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? US Fish and Wildlife Service website http / /www fws gov /nc -es /es /countyfr html 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? http //ocean flondamanne org /efh_coral /ims /viewer htm 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? National Register of Historic Places athttp / /www hpo ncdcr gov /nrlist htm 8 Flood�(6 Designation (Corps Requirement) 8a Will this' roect occur i °n FEM'A tlesi` an ted 100- ear flood lain? Pa� 1_,am � 9 ti Y pw� Oyes _�� ❑ No 8b if yes,,aexplam.how,prolect meets FEMArequirements The project will not impede flood waters 8c�Whatsource(s} -did you use to, make, thea�floodplaind `e °terirnnation� "http / /ashegis ashecountygov com /webgis/ Glen Sullivan January 14, 2015 Applicant/Agent's Printed Name Date �A , P pcani A 9 ean� t ,s Signature nature ris vai- y f m (A`g'ent'�sgaue d on ia ohpplicant is: rovided) Page 11 of 11 I, William T Rice, designate Glen Sullivan of Foggy Mountain Nursery to act as my duly authorized agent concerning all US Army Corps of Engineers and NC DENR permitting regarding the streambank restoration project on my property in Ashe County, NC. Name cil Address _ _ .> Phone number Fax number d , E -mail address ,� USX lFt 1 r�L V c /.- 2 Signature Date FORD, SIMPSON, LIVELY & RICE PEDIATRICS ROBERT V FORD, M D MARTHA K SIMPSON, M D DAVID G RICE M D WILLIAM P STEWART M D MARGARET L SILKSTONE M D KAREN S CANNON, M D MARY E ARMENTPOUT, M D CARRIE J ERICKSON M D GWYN E KOOY, M D AMY B YODER, V D Winston Salem (336) 794 3380 • Fax (336) 194 -3378 Kernerswlle (336) 992 -3414 • Fax (33G) 992 3467 INSTRUCTIONS Z_ S .- 2c ( S Lv�•�; �� tin «� -�'�,.�. s ��- �- �bc�l�...... Lit t ZI '9� x .� H 11 2 1 1 7NI. a a r •eP' i tr ' � a !i Vd, � n ' a a m�Z °4 ol U a l� 4 U�V ldJ _ a 1� 11 a I � � � 111C 1 II I �+ II tI � N � I r' _ �rtf FIGURE S. Typical bank reshaping and revegetation plan. Cross - section view before work (existing condition) Pasture grasses, little valve for bank stabilization or stream shading. 1�t,1 lye , ll,� •'�1�� X � �i��,�s. Vertical bank showing area to be ................. ............................... �� reshaped. A. or YA 1 Ilk W, Cross - section view after work Rooted trees, 2' to 6' tall. Herbaceous vegetation Live stakes 18" to 24" in length. Erosion control blanket 4 - 8 ft wide, anchored with wooden stakes /live stakes. Water level 1� FIGURE 6. Typical rock vane structure showing plan and cross - section views. Photograph shows a rock vane constructed in the South Fork New River at the Wagoner Road Access, New River State Park. 1 ;1 W:VIMA I DVA le CROSS - SECTION VIEW 77 Footer rocks Top rocks Bankfull bench 4 VICINITY MAP sm KEY Bank resloping Rock Vane Toe Rock Note All work areas are approx 60 0 60 120 180 GRAPHIC SCALE FEET ■ �w■■■;■�t° :�-� - , .,sue NOTE 200 feet of re- sloped bank will be planted with Ilvestakes and native plants �c 0 ov U C WILLIAM & KATHERINE RICE DEED BOOK 423 PAGE 2114 o WILLIAM & KATHERINE RICE v C'' DEED BOOK 423 PAGE 2114 �a 0 Xd O 00 UWE PLAN David Rice Project amp 0 urea me cmm m mm 16 prep no-4m Rock Vane @ Large Roc \ � \ 97 4 \ �X \ 1 lRock Vane @ s w ,�w Y ,2 o WILLIAM & KATHERINE RICE v C'' DEED BOOK 423 PAGE 2114 �a 0 Xd O 00 UWE PLAN David Rice Project amp 0 urea me cmm m mm 16 prep no-4m APPROVED JURISDICTIONAL DETERMINATION FORM U.S. Army Corps of Engineers This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook SECTION I: BACKGROUND INFORMATION A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD). B. DISTRICT OFFICE, FILE NAME, AND NUMBER.Western Peidmont Region Coordinator 3855 Idlewild Road Kernerville NC 27284 -9180 C. PROJECT LOCATION AND BACKGROUND INFORMATION: State NC County /parish/borough Ashe City West Jefferson Center coordinates of site (lat/long in degree decimal format) Lat 36 43790 N, Long -816449' W Universal Transverse Mercator Name of nearest waterbody New River Name of nearest Traditional Navigable Water (TN W) into which the aquatic resource flows Name of watershed or Hydrologic Unit Code (HUC) ® Check if map /diagram of review area and /or potential Jurisdictional areas is /are available upon request ® Check if other sites (e g , offsite mitigation sites, disposal sites, etc ) are associated with this action and are recorded on a different JD form D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY) F9 Office (Desk) Determination Date 0 Field Determination Date(s) January 14`h 2015 SECTION II: SUMMARY OF FINDINGS A. RHA SECTION 10 DETERMINATION OF JURISDICTION There are dmr n "navigable waters of the US "within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review area [Required] Waters subject to the ebb and flow of the tide ® Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce Explain Waters used for recreational canoeing/kayaking and fishing B CWA SECTION 404 DETERMINATION OF JURISDICTION. There Are ,waters of the US " within Clean Water Act (CWA) Jurisdiction (as defined by 33 CFR part 328) in the review area [Required] 1. Waters of the U S a. Indicate presence of waters of U.S. in review area (check all that apply):' ® TNWs, including territorial seas Wetlands adjacent to TNWs Relatively permanent waters (RPWs) that flow directly or indirectly into TNWs Non -RPWs that flow directly or indirectly into TNWs ® Wetlands directly abutting RPWs that flow directly or indirectly into TNWs Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs ® Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs Impoundments of jurisdictional waters Isolated (interstate or intrastate) waters, including isolated wetlands b. Identify (estimate) size of waters of the U S in the review area Non - wetland waters 200 linear feet 30 width (ft) and /or 0 14 acres Wetlands 0 acres c. Limits (boundaries) of Jurisdiction based on §tatilistieilb"y®HWM: Elevation of established OHWM (if known) 2. Non - regulated waters /wetlands (check if applicable) 3 ❑ Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional Explain i Boxes checked below shall be supported by completing the appropriate sections in Section III below 2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year -round or has continuous flow at least "seasonally" (e g , typically 3 months) 3 Supporting documentation is presented in Section IIi F SECTION III• CWA ANALYSIS A TNWs AND WETLANDS ADJACENT TO TNWs The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW, complete Section III A 1 and Section III.D.1. only, if the aquatic resource is a wetland adjacent to a TNW, complete Sections III A 1 and 2 and Section III.D.1 , otherwise, see Section III.B below 1 TNW Identify TNW North Fork New River Summarize rationale supporting determination 2. Wetland adjacent to TNW Summarize rationale supporting conclusion that wetland is "adjacent" B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY) This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps determine whether or not the standards for jurisdiction established under Rapanos have been met The agencies will assert jurisdiction over non - navigable tributaries of TNWs where the tributaries are "relatively permanent waters" (RPWs), i.e tributaries that typically flow year -round or have continuous flow at least seasonally (e g , typically 3 months). A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW, but has year -round (perennial) flow, skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow, skip to Section III D 4. A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and EPA regions will include in the record any available information that documents the existence of a significant nexus between a relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even though a significant nexus finding is not required as a matter of law. If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines, for analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III B 1 for the tributary, Section III B 2 for any onsite wetlands, and Section III B 3 for all wetlands adjacent to that tributary, both onsite and offsite. The determination whether a significant nexus exists is determined in Section iII C below. 1. Characteristics of non -TNWs that flow directly or indirectly into TNW (i) General Area Conditions- Watershed size PiPi k_I& t Drainage area PMk ist Average annual rainfall inches Average annual snowfall inches (u) Physical Characteristics. (a) Relationship with TNW ❑ Tributary flows directly into TNW ❑ Tributary flows through ic� st tributaries before entering TNW Project waters are Pick List river miles from TNW Project waters are PicA &st river miles from RPW Project waters are ick List aerial (straight) miles from TNW Project waters are Pick ist aerial (straight) miles from RPW Project waters cross or serve as state boundaries Explain Identify flow route to TNW5 Tributary stream order, if known 4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and West 5 Flow route can be described by identifying, e g , tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW (b) General Tributary Characteristics (check all that apply) Tributary is ❑ Natural ❑ Artificial (man -made) Explain ❑ Manipulated (man - altered) Explain Tributary properties with respect to top of bank (estimate) Average width feet Average depth feet Average side slopes Plek List. Primary tributary substrate composition (check all that apply) ❑ Silts ❑ Sands ❑ Cobbles ❑ Gravel ❑ Bedrock ❑ Vegetation Type /% cover ❑ Other Explain ❑ Concrete ❑ Muck Tributary condition/stability [e g, highly eroding, sloughing banks] Explain Presence of run/riffle/pool complexes Explain Tributary geometry 1FA (st Tributary gradient (approximate average slope) % (c) Flow Tributary provides for Ptckist Estimate average number of flow events in review area/year PtekL Describe flow regime Other information on duration and volume Surface flow is tkk Est Characteristics Subsurface flow Ptck L it Explain findings ❑ Dye (or other) test performed Tributary has (check all that apply) ❑ Bed and banks ❑ OHWM6 (check all indicators that apply) ❑ clear, natural line impressed on the bank ❑ the presence of litter and debris ❑ changes in the character of soil ❑ destruction of terrestrial vegetation ❑ shelving ❑ the presence of wrack line ❑ vegetation matted down, bent, or absent ❑ sediment sorting ❑ leaf litter disturbed or washed away ❑ scour ❑ sediment deposition ❑ multiple observed or predicted flow events ❑ water staining ❑ abrupt change in plant community ❑ other (list) ❑ Discontinuous OHWM 7 Explain If factors other than the OHWM were used to determ High Tide Line indicated by El ❑ oil or scum line along shore objects ❑ fine shell or debris deposits (foreshore) ❑ physical markings /characteristics ❑ tidal gauges ❑ other (list) me lateral extent of CWA jurisdiction (check all that apply) Mean High Water Mark indicated by ❑ survey to available datum, ❑ physical markings, ❑ vegetation lines /changes in vegetation types (m) Chemical Characteristics- Characterize tributary (e g , water color is clear, discolored, oily film, water quality, general watershed characteristics, etc ) Explain Identify specific pollutants, if known 6A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e g , where the stream temporarily flows underground, or where the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody's flow regime (e g , flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break 'Ibid (iv) Biological Characteristics. Channel supports (check all that apply): ❑ Riparian corridor Characteristics (type, average width) ❑ Wetland fringe Characteristics ❑ Habitat for ❑ Federally Listed species Explain findings ❑ Fish /spawn areas Explain findings ❑ Other environmentally - sensitive species Explain findings ❑ Aquatic /wildlife diversity Explain findings 2. Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW (i) Physical Characteristics (a) General Wetland Characteristics Properties Wetland size acres Wetland type Explain Wetland quality Explain Project wetlands cross or serve as state boundaries Explain (b) General Flow Relationship with Non -TNW Flow is ick,fList Explain Surface flow is: Pi� ck L si t Characteristics Subsurface flow Pi k Lnt Explain findings ❑ Dye (or other) test performed (c) Wetland Adjacency Determination with Non -TNW ❑ Directly abutting ❑ Not directly abutting ❑ Discrete wetland hydrologic connection Explain ❑ Ecological connection Explain ❑ Separated by berm/barrier Explain (d) Proximity (Relationship) to TNW Project wetlands are Pick List river miles from TNW Project waters are ack List aerial (straight) miles from TNW Flow is from PickList Estimate approximate location of wetland as within the rlgk List floodplam (u) Chemical Characteristics Characterize wetland system (e g, water color is clear, brown, oil film on surface, water quality, general watershed characteristics, etc ) Explain Identify specific pollutants, if known (iii) Biological Characteristics. Wetland supports (check all that apply) ❑ Riparian buffer Characteristics (type, average width) ❑ Vegetation type /percent cover Explain ❑ Habitat for ❑ Federally Listed species Explain findings ❑ Fish /spawn areas Explain findings ❑ Other environmentally - sensitive species Explain findings ❑ Aquatic /wildlife diversity Explain findings 3 Characteristics of all wetlands adjacent to the tributary (if any) All wetland(s) being considered in the cumulative analysis Pick List Approximately ( ) acres in total are being considered in the cumulative analysis For each wetland, specify the following Directly abuts9 (YIN) Size (in acres) Directly abuts9 (Y/N) Size (in acres) Summarize overall biological, chemical and physical functions being performed C. SIGNIFICANT NEXUS DETERMINATION A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent wetlands, has more than a speculative or insubstantial effect on the chemical, physical and /or biological integrity of a TNW. Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent wetlands It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g between a tributary and its adjacent wetland or between a tributary and the TNW) Similarly, the fact an adjacent wetland Iles within or outside of a floodplain is not solely determinative of significant nexus Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and discussed in the Instructional Guidebook. Factors to consider include, for example. • Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW9 • Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and hfecycle support functions for fish and other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW9 • Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that support downstream foodwebs9 • Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or biological integrity of the TNW9 Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented below. 1. Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III D 2. Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to Section III D 3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to Section III D D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL THAT APPLY). I TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area TNWs 200 linear feet 30 width (ft), Or, 0 14 acres Wetlands adjacent to TNWs 0 acres 2 RPWs that flow directly or indirectly into TNWs. EU Tributaries of TNWs where tributaries typically flow year -round are jurisdictional Provide data and rationale indicating that tributary is perennial Q Tributaries of TNW where tributaries have continuous flow "seasonally" (e g , typically three months each year) are jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows seasonally Provide estimates for jurisdictional waters in the review area (check all that apply) ® Tributary waters linear feet width (ft) ® Other non - wetland waters acres Identify type(s) of waters 3 Non -RPWss that flow directly or indirectly into TNWs Q Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a TNW is jurisdictional Data supporting this conclusion is provided at Section III C Provide estimates for jurisdictional waters within the review area (check all that apply) (] Tributary waters linear feet width (ft) Other non - wetland waters acres Identify type(s) of waters 4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs. ® Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands Q Wetlands directly abutting an RPW where tributaries typically flow year -round Provide data and rationale indicating that tributary is perennial in Section III D 2, above Provide rationale indicating that wetland is directly abutting an RPW ® Wetlands directly abutting an RPW where tributaries typically flow "seasonally " Provide data indicating that tributary is seasonal in Section III B and rationale in Section III D 2, above Provide rationale indicating that wetland is directly abutting an RPW Provide acreage estimates for jurisdictional wetlands in the review area acres 5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs. Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent and with similarly situated adjacent wetlands, have a significant nexus with a TNW are, jurisidictional Data supporting this conclusion is provided at Section III C Provide acreage estimates for jurisdictional wetlands in the review area acres 6 Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs. ❑ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional Data supporting this conclusion is provided at Section III C Provide estimates for jurisdictional wetlands in the review area acres 7. Impoundments of jurisdictional waters 9 As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional Q Demonstrate that impoundment was created from "waters of the U S ," or MV Demonstrate that water meets the criteria for one of the categories presented above (1 -6), or F1 Demonstrate that water is isolated with a nexus to commerce (see E below) E ISOLATED [INTERSTATE OR INTRA - STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE, DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY SUCH WATERS (CHECK ALL THAT APPLY)•10 Q which are or could be used by interstate or foreign travelers for recreational or other purposes M from which fish or shellfish are or could be taken and sold in interstate or foreign commerce Q which are or could be used for industrial purposes by industries in interstate commerce a Interstate isolated waters Explain Q Other factors Explain Identify water body and summarize rationale supporting determination, 'See Footnote # 3 To complete the analysis refer to the key in Section Ili D 6 of the Instructional Guidebook 10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for review consistent with the process described in the Corps /EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos Provide estimates for jurisdictional waters in the review area (check all that apply) F1 Tributary waters linear feet width (ft) ❑ Other non - wetland waters acres Identify type(s) of waters ® Wetlands acres F. NON - JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)- If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers Wetland Delineation Manual and/or appropriate Regional Supplements Q Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce ❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the "Migratory Bird Rule" (MBR) r n Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction Explain Q Other (explain, if not covered above) Provide acreage estimates for non - jurisdictional waters in the review area, where the sole potential basis ofjurisdiction is the MBR factors (i e , presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional Judgment (check all that apply) Q Non - wetland waters (i e , rivers, streams) linear feet width (ft) G Lakes /ponds acres ® Other non - wetland waters acres List type of aquatic resource MW Wetlands acres Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such a finding is required for Jurisdiction (check all that apply) ® Non - wetland waters (i e , rivers, streams) linear feet, width (ft) Q Lakes /ponds acres Other non - wetland waters acres List type of aquatic resource ® Wetlands acres SECTION IV DATA SOURCES A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked and requested, appropriately reference sources below) 0 Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant El Data sheets prepared /submitted by or on behalf of the applicant/consultant ❑ Office concurs with data sheets /delineation report ❑ Office does not concur with data sheets /delineation report ED Data sheets prepared by the Corps ❑ Corps navigable waters' study U S Geological Survey Hydrologic Atlas ❑ USGS NHD data ❑ USGS 8 and 12 digit HUC maps U S Geological Survey map(s) Cite scale & quad name USDA Natural Resources Conservation Service Soil Survey Citation ❑ National wetlands inventory map(s) Cite name ❑ State /Local wetland inventory map(s) QA FEMA/FIRM maps Q 100 -year Floodplam Elevation is (National Geodectic Vertical Datum of 1929) Photographs ❑ Aerial (Name & Date) or ❑ Other (Name & Date) Previous determination(s) File no and date of response letter na Applicable /supporting case law Q Applicable /supporting scientific literature Q Other information (please specify) B. ADDITIONAL COMMENTS TO SUPPORT JD.