20230153 Ver 1_ePCN Application_20230124

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
9/27/2022
BIMS # Assigned* Version#*
20230153 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Sue Homewood:eads\slhomewood:[e-mail]
Information for Initial Review
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
la. Name of project:
COURTESY COPY City of King - Muddy Creek Pump Station and Force Main
la. Who is the Primary Contact?*
Joseph Sullivan
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
1/24/2023
Nearest Body of Water
Barkers Creek / Parkers Creek / Muddy Creek
Basin
Yadkin-PeeDee
Water Classification
C/C/C
Site Coordinates
Latitude:
36.2634
A. Processing Information
County (or Counties) where the project is located:
Stokes
Forsyth
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Longitude:
-80.3371
Yes No

la. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 58 - Utility Line Activities for Water and Other Substances (frequently used)
NWP Numbers (for multiple NWPS):
ld. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
ld. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
City of King ROW
2b. Deed book and page no.:
N/A
2c. Contact Person:
Scott Barrow
2d. Address
Street Address
P.O Box 1132
Address Line 2
City
King
Postal /Zip Code
27021
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
US
Yes No
Yes No

2e. Telephone Number:
[phone]
2f. Fax Number:
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Scott Barrow
3b. Business Name:
City of King
3c. Address
Street Address
P.O Box 1132
Address Line 2
City
King
Postal / Zip Code
27021
3d. Telephone Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Joseph Sullivan
4b. Business Name:
KCI Technologies, Inc.
4c. Address
Street Address
4505 Falls of Neuse Road Suite 400
Address Line 2
City
Raleigh
Postal / Zip Code
27609
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
US
3e. Fax Number:
State / Province / Region
NC
Country
US
4e. Fax Number:
[phone]
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
King
2. Project Identification
2a. Property Identification Number:
City of King ROW
2b. Property size:
49.8

2c. Project Address
Street Address
814 Spainhour Road
Address Line 2
City
King
Postal / Zip Code
27021
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Barkers Creek / Parkers Creek / Muddy Creek
3b. Water Resources Classification of nearest receiving water: *
C/C/C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401011302
4. Project Description and History
State / Province / Region
NC
Country
US
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
Land use within and adjacent to the proposed interceptor and force main is primarily roadside, forest land, existing sewer right-ofway, agriculture, and residential properties. The
surrounding area is mostly residential development, agriculture, forest land, and the RJ Renolds Manufacturing Facility
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past? *
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.82
4g. List the total estimated linear feet of all existing streams on the property:
2198
4h. Explain the purpose of the proposed project: *
This project will provide sewer capacity for the City of King for areas that are currently in development.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will involve abandonment of the existing Spainhour Mill Road/Muddy Creek Pump Station, to a location approximately one mile away, and the construction of additional force
main and gravity sewer that will connect to the Dora! Drive Force Main Interconnect. Construction will be accomplished using typical equipment including excavators, backhoes, pans, and
dumptrucks.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
Comments:
Delineation was completed on 3/15/22. JD Request is attached
No Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
Joseph Sullivan
KCI Assiciates of NC
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory

1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
2. Wetland Impacts
Streams -tributaries
Pond Construction
Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
29. Impact
area*
W-1
Excavation and Backfill
T
Bottomland Hardwood Forest
W2
No
Corps
0.026
(acres)
W-2
Excavation and Backfill
T
Bottomland Hardwood Forest
W1
No
Corps
0.120
(acres)
2g. Total Temporary Wetland Impact
0.146
2g. Total Wetland Impact
0.146
2g. Total Permanent Wetland Impact
0.000
2i. Comments:
The wetlands impacted by the project are non -forested emergent wetlands. They will be excavated for the installation of the sewer line. The impacted
wetlands will be returned to existing grade.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
A larger corridor was initially examined to determine locations of wetlands and streams, and other constraints. Based on that information, the proposed
corridor was chosen and balances avoidance/minimization of stream and wetland impacts with conflicts arising from existing infrastructure and
residences. Easement acquisition with the RJ Renolds facility was completed in order to significantly reduce the total of force main required to complete
the route.
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Sediment and erosion control measures will be implemented according to NC requirements. Jurisdictional areas within the construction limits that are not
permitted to be impacted will be clearly marked with protection fencing or other similar method to avoid inadvertent encroachment. All wetlands will be
returned to existing grade. Construction corridors and maintained easements have been reduced as much as practical in wetland areas. Cleared forests,
outside of the maintained corridor, will be allowed to transition to mature forest. All stream impacts will be avoided by the use of hydraulic directional
boring. Copies of the permits and impact areas will be provided to the prime contractor and all subcontractors working in or near jurisdictional areas.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The project will not permanently impact any streams or wetlands
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no, explain why:
The project is not located withing an area protected by the NC Riparian Buffer Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
G. Supplementary Information

1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land? *
Yes No
1 b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes No
Comments: *
N/A
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
The relocated pump station will serve a community that is already in development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
The wastewater from this project will discharge into the existing Muddy Creek interceptor, which flows to the Muddy Creek Wastewater Treatment Plant,
which has adequate capacity for this project.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
A Species list was obtained through the USFWS IPaC system and official consultation with the USFWS Asheville office was completed.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
EFH Mapper Website: https://www.habitat.noaa.gov/apps/efhmapper/?page=page_8

7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
HPOWEB Map Service in addition to consultation with the SHPO.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c. What source(s) did you use to make the floodplain determination?*
NC Floodplain Mapping Program: https://fris.nc.gov/fris/Home.aspx?ST=NC
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
King_MuddyCreek_PCN_Attachments.pdf 45.96MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Joseph Sullivan
Signature
Date
1/24/2023

MMMMW4�
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KCI
ASSOCIATES OF NC
ISO 9001:2008 CERTIFIED
ENGINEERS • PLANNERS • SCIENTISTS • CONSTRUCTION MANAGERS
4505 Falls of Neuse Rd., Suite 400 • Raleigh, NC 27609 • Phone [phone] • Fax [phone]
January 24, 2023
Jean Gibby
Charlotte Regulatory Field Office
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Subject: Record PCN: Nationwide Permit 58 & General Certification No. 4276
City of King - Muddy Creek Pump Station
Forsyth and Stokes Counties, North Carolina
Jean Gibby;
KCI Associates of NC, on behalf of the City of King, has prepared, for your records, the attached pre -
construction notification for the above referenced project for a Clean Water Act Section 404
Nationwide Permit 58 and a Section 401 Water Quality Certification No. 42376. The project will
involve abandonment of the existing Spainhour Mill Road/Muddy Creek Pump Station, to a location
approximately one mile away, and the construction of additional force main and gravity sewer that
will connect to the Doral Drive Force Main Interconnect.
The attached PCN form provides information for your records of the project. Additional information
is contained in the attachments including a Vicinity map, USGS map, Impact Locations map, and
Impact Details. KCI has provided the attached overall site plan for your review of this project.
Proposed Impacts
Impacts to waters of the U.S. total 0.146 acre of temporary wetland impacts. A breakdown of the
impacts is provided in the attached PCN. Temporary wetland impacts are associated with the
excavation and backfill during the construction of the sewer line. The wetlands impacted are non -
forested emergent wetlands. Impacts to all stream crossing areas will be avoided by the use of
hydraulic directional boring.
THE MOST INCREDIBLE THING WE'VE ENGINEERED IS OUR TEA{ WWW.KCI. COM

If you have any questions or need additional information, please contact me at [phone] or
Joe. [e-mail].
Sincerely,
KCI Associates of North Carolina
Joseph Sullivan
Environmental Scientist
THE MOST INCREDIBLE THING WE'VE ENGINEERED IS OUR TEAM WWW.KCI. COM

Attachments to PCN
A. Figures
• Figure 1: Vicinity Map
• Figure 2: USGS Map
• Figure 3: Impact Locations Map
• Impact Details
B. Pre -Filing Meeting Date Request
C. Preliminary Jurisdictional Determination
Request
D. USFWS Documentation
E. SHPO Documentation
F. Project Drawings

A. Figures

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B. Pre -Filing Meeting Date Request

Joe Sullivan
From: Joe Sullivan
Sent: Tuesday, September 27, 2022 8:17 AM
To: 401 [e-mail]
Subject: City of Ming Muddy Creek Sewer - Pre -Filing Request
Attachments: KingMuddyCreekPS_JD_Figure1_Vicinity.pdf, KingMuddyCreekPS_JD_Figure2_USGS.pdf,
KingMuddyCreekPS_JD_Figure3_Aerial.pdf
To whom it may concern,
KCI is planning a project for The City of King in Forsyth and Stokes Counties. The project will involve installation of a
sewer line. Attached are a vicinity map, USGS map, and potential jurisdictional features that have not been field verified
by the USACE. We are planning to submit a NWP 58 that will require 404/401 authorization. If you need any additional
information please let me know.
Thank you,
Joseph Sullivan
KCI Technologies
4505 Falls of Neuse Rd; Suite 400
Raleigh, NC 27609
919-278-2533 (office phone)
516-286-1080 (mobile phone)

C. Preliminary Jurisdictional Determination
Request

MMMMW4�
MMMAMMEM
MMW4�
KCI
ASSOCIATES OF NC
ISO 9001:2008 CERTIFIED
ENGINEERS • PLANNERS • SCIENTISTS • CONSTRUCTION MANAGERS
4505 Falls of Neuse Rd., Suite 400 • Raleigh, NC 27609 • Phone [phone] • Fax [phone]
December 30, 2022
Jean Gibby
Charlotte Regulatory Field Office
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Subject: Request for Preliminary Jurisdictional Determination
City of King - Muddy Creek Pump Station and Force Main
Forsyth and Stokes Counties, North Carolina
Jean Gibby;
KCI has completed a delineation of streams and wetlands for the above referenced project. The attached
information, including required forms, tables, and figures, is submitted for your review and determination
of jurisdiction under the Clean Water Act (CWA).
Project Description & Methodology
As shown in Figure 1, the City of King - Muddy Creek Pump Station and Force Main project is located in
Forsyth and Stokes Counties, NC within the Yadkin River Basin (USGS HUC 03040101). This delineation
was performed in compliance with methodology set forth in the U.S. Army Corps of Engineers (USACE)
Wetland Delineation Manual (USACE 1987) and subsequent guidance including the Eastern Mountains
and Piedmont Regional Supplement. Streams were assessed for potential jurisdiction under the CWA using
field indications of ordinary high water mark and the North Carolina Division of Water Quality (NCDWQ)
Stream Identification Form, Version 4.11.
Wetlands and surface waters were delineated using survey flagging at regular locations along the wetland -
upland boundary. All boundaries either form complete polygons, tie to surface water features such as
streams or ponds, or tie to the edge of the project area. Streams points were collected using sub -meter GPS
technology at representative points to depict center lines. Wetland Determination Forms were completed
for each type of wetland community encountered.
Delineation Results
Figure 2 is presented using the King and Rural Hall US Geological Survey 1:24,000 Quadrangle Maps.
Figure 3 presents the results of the delineation, including streams and wetlands overlaid on 2018 Statewide
Aerial Photographs.
THE MOST INCREDIBLE THING WE'VE ENGINEERED IS OUR TEA{ WWW.KCI. COM

Table 1 presents detailed information on each potential stream within the project area, including status
(ephemeral, intermittent or perennial), length, width, NCDWQ Score, and latitude/longitude. Based on
field data, approximately 2,198 linear feet of stream are present within the project area.
Table 2 presents detailed information on each potential wetland feature including NC Wetland Assessment
Method type, Hydrologic Class, Cowardin Class, size, representative wetland delineation form
identification, and latitude/longitude. Based on field data, there are approximately 0.82 acres of wetlands
present within the project area.
We respectfully request your review of this information, so that a preliminary jurisdictional determination
under the CWA may be obtained. If you have any questions, need additional information, or would like to
schedule a site visit, please contact me at your earliest convenience at [phone] or
j oe. [e-mail].
Sincerely,
KCI Associates of North Carolina
9a'-'K *P�-'
Joseph Sullivan
Environmental Scientist
Attachments:
- Jurisdictional Determination (JD) Request Form
- Preliminary Jurisdictional Determination Form
- Table 1: Stream Summary Table
- Table 2: Wetland Summary Table
- Figure 1: Vicinity Map
- Figure 2: USGS Map
- Figure 3: Potential WOTUS Map
- Stream and Wetland Data Forms
- Site Photographs
THE MOST INCREDIBLE THING WE'VE ENGINEERED IS OUR TEAM WWW.KCI. COM

urisdictional Determination Reauest
US Army Corps
of Engineers.
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www.saw.usace.aimy.mil/Missions/Re ul�atoiyPermitProi4ram/Contact/CountyLocator.aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
INSTRUCTIONS:
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: N/A
City, State: King, NC
County: Forsyth and Stokes
Parcel Index Number(s) (PIN): Multiple - ROW to be acquired
B. REQUESTOR INFORMATION
Name: Joe Sullivan. KCI Technoloaies Inc.
Mailing Address: 4505 Falls of Neuse Rd, Suite 400
Telephone Number:
Electronic Mail Address
Select one:
Raleigh, NC 27609
919-278-2533
[e-mail]
I am the current property owner.
I am an Authorized Agent or Environmental Consultanti
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: Scott Barrow (City of King)
Mailing Address: PO BOX 1132
Telephone Number:
Electronic Mail Address:
King, NC, 27021
336-983-8265
[e-mail]
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

urisdictional Determination
D. PROPERTY ACCESS CERTIFICATION3,4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on -
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
.Joseph Sullivan
Print Name
Capacity: ❑ Owner Q Authorized Agents
12/30/22
Date
E. REASON FOR JD REQUEST: (Check as many as applicable)
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
0 I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
HI believe that the site may be comprised entirely of dry land.
Other:
s For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
4 If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
s Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERNIINATION (JD) TYPE (Select One)
7 I am requesting that the Corps provide a preliminM JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
❑ I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
❑ I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 50 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates (Decimal Degrees): Latitude: 36.2523
Longitude:-80.3481
A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 1 Ix 17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. hM2://www.saw.usace.4rmy.mil/Missions/Regulatoly-Permit-
Pro gram/Jurisdiction/
Version: May 2017 Page 5

Jurisdictional Determination Request
F4Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDS• please complete an Approved Jurisdictional Determination Form'.
F4 Vicinity Map
zAerial Photograph
z USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
❑✓ NC Division of Water Resources Stream Identification Forms
hJ Other Assessment Forms
' www.saw.usace.4rmy.mil/Portals/59/docs/regulatory/readocs/JD/RGL 08-02_App A Prelim _JD_Form fillable.pdf
8 Please see hM2://www.saw.usace.4M.mil/Missions/Regulatory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federaljurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD:
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Joseph Sullivan, 4505 Falls of Neuse Rd; suite 400, Raleigh, NC 27609
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Forsyth/Stokes City: King
Center coordinates of site (lat/long in degree decimal format):
Lat.: 36.2523 Long.:-80.3481
Universal Transverse Mercator:
Name of nearest waterbody: Barkers Creek / Parkers Creek / Muddy Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date: 12/30/22
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a
Nationwide General Permit (NWP) or other general permit verification requiring "pre -
construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) the
applicant has the right to request an individual permit rather than accepting the terms
and conditions of the NWP or other general permit authorization; (4) the applicant can
accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has
determined to be necessary; (5) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps permit
authorization based on a PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives any challenge to such jurisdiction in any administrative or judicial compliance
or enforcement action, or in any administrative appeal or in any Federal court; and (7)
whether the applicant elects to use either an AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, a proffered individual permit (and all terms
and conditions contained therein), or individual permit denial can be administratively
appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be" waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
■❑ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Vicinity Map
❑ Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
■❑ U.S. Geological Survey map(s). Cite scale & quad name: Rural Hall and King 1:24K
❑ Natural Resources Conservation Service Soil Survey. Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
■❑ Photographs: ■❑ Aerial (Name & Date): 2018 Statewide Aerial Photographs
or ❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
' Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

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NC DWQ Stream Identific.
Date: w l /
Evaluator: C ,
iC
Total Points:
Stream is at least intermittent
If z 19 or penenniat if a 3o*
Form Version 4.11
Projecusite: I r
County: > .
vM. '��� Latitude: �� a �13
,. Longitude: _ ` 3 LJ
(circle one) Other
it Perennial e.g. Quad Name:
A. Geomorphology (Subtotal = 5
Absent
W ak
Ia' Continuity of channel bed and bank
0
2. Sinuosity of channel along thalweg
0
3. In -channel structure: ex. riffle -pool, step -pool,
rl le-
ool se uence
4. Particle size of stream substrate
0
1
S. Active/relict floodplain
1
6. Depositional bars or benches
7. Recent alluvial deposits
1
8. Headcuts
0
9. Grade control
0
0.5
10. Natural valley
0
0
11. Second or greater order channel
No =
artificial ditches are not rated; see disions in manual
B. H drolo (Subtotal =� )
12. Presence of Basefiow
0
13. Iron oxidizing bacteria
{
1
14. Leaf litter
1.5
15. Sediment on plants or debris
0.5
16.Organic debris lines or piles
0.5
1 T Soil -based evidence of high water table?
No = 0
C. Biology (Subtotal =
18. Fibrous roots in streambed _
3
2
19. Rooted upland plants in streambed
If3
2
20. Macrobenthos (note diversity and abundance)
0
1
21. Aquatic Mollusks
1
22: Fish
0
0.5
23.-Crayfish
a>(
0.5
24. Amphibians
0.5
25. Algae
10
0.5
26. Wetland plants in streambed
FACW = 0.7
'perennial streams may also be identified using other methods. See
p. 35 of manual.
Notes:
Sketch:
2
3
2
3
2
3
2
3
2
2
3
3
2
3
2
3
1
1.5
1
1.5
Yes = 3
2 3
- j2 3
0.5 ..0._
1 1.5
1 1.5
Yes
1
p
1
0
2
.3
2
3
1
1.5
1
1.5
1
1.5
1.5
i; OBL = 1.5 (Other = 0

SS
NC DWQ Stream Identification Form Version 4.11
Date:
ProjecttSite:Ur�p Latitude: {
Evaluator., -?�
County:r-i: r Longitude._� Points:,
Stream is at least intermittent Stream Determination _(circle one) Other
ifk 19 orperennial if 30 Ephemeral Imtermitten Perennial e.g. Quad Name:
A. Geomorphology (Subtotal = 1
"Continuity
Absent
Weak
Madera
of channel bed and bank
0
1
2. Sinuosity of channel along thalweg
0
2
3. In -channel structure: ex. riffle -pool, step.pggl,
2
ripple -pool sequence
0
2
4. Particle size of stream substrate
0
(1' j
2
5. Active/relict floodplaink
1
6. Depositional bars or benches
ir0�
2
1
7. Recent alluvial deposits
0
2
8. Headcuts
(0..
1
2
1
9. Grade control
0
2
0.5>
1
10. Natural valley
0
A5,�
1
11. Second or greater order channel
No =
artificial ditches are not rated; see discussions in manual
B. H drolo (Subtotal
12. Presence of Basetiow
0
2
13. Iron oxidizing bacteria
14. Leaf litter
- ---
1.5
1
2
- ---- - --
15. Sediment on plants or debris
- -
0
0.5
16. Organic debris lines or plies
0
0.
1
17. Soil -based evidence of high water table?
No = 0
0.5
1
C. Biology Subtotal = -
18. Fibrous roots in streambed
3
2)
1
19. Rooted upland plants in streambed
3
2
20. Macrobenthos (note diversity and abundance)
1
21. Aquatic Mollusks
'
1
1
2
22- Fish
2
23.-Crayfish
'
0'S
1
24. Amphibians
0.5
1
25. Algae
U j
0 5 F71
0.5
26. Wetland plants in streambed
'perennial
FAGW = 0.75; OBL =1.5 =tr►thei
streams may also be identified using other methods. See P. 35 of manual.
Notes: : ,; :a .0;
Sketch:
Yes =3
3
3
3
3
3
3
3
3
1.5
1.5
3
3
0
1.5
1.5
0
0
3
3
1.5
1.5
1.5
1.5

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: City of King - Muddy Creek Pump Station City/County: Stokes Sampling Date: 3/15/22
Applicant/Owner: City of King State: NC Sampling Point: W1-Wet
Investigator(s): J. Sullivan Section, Township, Range:
lain ° °
Landform (hillslope, terrace, etc.): FloodpLocal relief (concave, convex, none): none Slope (/o): °
Subregion (LRR or MLRA): P-136 Lat: 36.2625 Long:-80.3360 Datum: NAD83
Soil Map Unit Name: Dan River and Comus soils NWI classification: PEM
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation X Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No
Is the Sampled Area
Hydric Soil Present? Yes x No within a Wetland? Yes X No
Wetland Hydrology Present? Yes x No
Remarks:
Vegetation is periodically mowed. The ares is located along a transmission line.
HYDROLOGY
Primary
Indicators minimum of one is re uired
all that amply)
"Surface
❑Sparsely
Soil Cracks (B6)
Vegetated Concave Surface (138)
❑
Surface Water (Al) LJ True Aquatic Plants (1314)
0
High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1)
❑
Drainage Patterns (B10)
Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3)
❑
Moss Trim Lines (B16)
❑
Water Marks (B1) ❑ Presence of Reduced Iron (C4)
❑
Dry -Season Water Table (C2)
❑
Sediment Deposits (B2) ❑ Recent Iron Reduction in Tilled Soils (C6)
❑
Crayfish Burrows (C8)
❑
❑
Drift Deposits (133) ❑ Thin Muck Surface (C7)
Algal Mat Crust in Remarks)
❑Stunted
Saturation Visible on Aerial Imagery (C9)
Stressed Plants
or (B4) ❑Other (Explain
Iron Deposits
❑✓
or (D1)
Geomorphic Position
(135)
Inundation Visible on Aerial Imagery (137)
❑Shallow
(D2)
Aquitard (D3)
❑
❑
Water -Stained Leaves (139)
❑
Microtopographic Relief (D4)
❑
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X Depth (inches):
Water Table Present? Yes X No Depth (inches): 2
Saturation Present? Yes X No Depth (inches): 2 Wetland Hydrology Present? Yes X No
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
Sampling Point: W1-wet
Absolute Dominant Indicator
Dominance Test worksheet:
Tree Stratum (Plot size: 30,
) % Cover Species? Status
Number of Dominant Species
1 none
That Are OBL, FACW, or FAC: 3 (A)
2.
Total Number of Dominant
3.
Species Across All Strata: 4 (B)
4.
Percent of Dominant Species
5.
That Are OBL, FACW, or FAC: 75% (A/B)
6.
Prevalence Index worksheet:
7
= Total Cover
Total % Cover of: Multiply by:
50% of total cover: 20% of total cover:
OBL species x 1 =
Sarolina/Shrub Stratum (Plot size:
15' )
FACW species x 2 =
1 Rubus argutus
5 X FACU
FAC species x 3=
2
FACU species x 4 =
3
UPL species x 5 =
4
Column Totals: (A) (B)
5.
Prevalence Index = B/A =
6.
Hydrophytic Vegetation Indicators:
7.
— 1 - Rapid Test for Hydrophytic Vegetation
8.
_ 2 -Dominance Test is >50%
9.
3 - Prevalence Index is :53.0'
5 = Total Cover
_
4 -Morphological Adaptations (Provide supporting
50% of total cover: 2.5 20% of total cover: I
-
5-
data in Remarks or on a separate sheet)
Herb Stratum (Plot size:
)
Problematic Hydrophytic Vegetation' (Explain)
1 Juncus effusus
60 X FACW
—
2 Panicum sp.
20 X FAC
Indicators of hydric soil and wetland hydrology must
3 Canicrex sp.
20 X FACW
be present, unless disturbed or problematic.
4.
Definitions of Four Vegetation Strata:
5.
6
Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
7.
height.
8.
Sapling/Shrub — Woody plants, excluding vines, less
9.
than 3 in. DBH and greater than or equal to 3.28 ft (1
10
m) tall.
11.
Herb —All herbaceous (non -woody) plants, regardless
100 = Total Cover
of size, and woody plants less than 3.28 ft tall.
50% of total cover: 50 20% of total cover: 20
30
Woody vine —All woody vines greater than 3.28 ft in
Woody Vine Stratum (Plot size:
)
height.
1 none
2.
3.
4.
Hydrophytic
5.
Vegetation
= Total Cover
Present? Yes X No
50% of total cover: 20% of total cover:
Remarks: (Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

SOIL
Sampling Point: W1-wet
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth
Matrix
Redox Features
(inches)
Color (moist)
%
Color (moist) % Type,
Loc
Texture Remarks
0-2
7.5YR 4/4
100
L
2-4
10YR 4/2
80
7.5YR 4/6 20 C
PL
CL
4-6
10YR 4/2
90
7.5YR 4/6 10 C
PL
CL
6-10
10YR 4/1
90
7.5YR 4/6 10 C
PL
C
10-18+
10YR 4/1
100
C
'Type: C=Concentration, D=Depletion, RM=Reduced
H dric Soil Indicators:
Histosol (Al)
❑ Histic Epipedon (A2)
❑ Black Histic (A3)
❑ Hydrogen Sulfide (A4)
❑ Stratified Layers (A5)
❑2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
❑ Thick Dark Surface (Al 2)
❑ Sandy Mucky Mineral (S1) (LRR N,
P
MLRA 147,148)
Sandy Gleyed Matrix (S4)
Sandy Redox (S5)
0 Stripped Matrix (S6)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
MS=Masked Sand Grains. 2 Location: PL=Pore Lining, M=Matrix.
cators for Problematic Hydric Soil
Dark Surface (S7) 2 cm Muck (A10) (MLRA 147)
Polyvalue Below Surface (S8) (MLRA 147, 148) Coast Prairie Redox (A16)
Thin Dark Surface
p ( )
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122) 3Indicators of hydrophytic vegetation and
Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic.
(S9) (MLRA 147, 148)
(MLRA 147, 148)
Hydric Soil Present? Yes X No
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: City of King - Muddy Creek Pump Station City/County: Stokes Sampling Date: 3/15/22
Applicant/Owner: City of King State: NC Sampling Point: W1-up
Investigator(s): J. Sullivan Section, Township, Range:
loe °
Landform (hillslope, terrace, etc.): hillspLocal relief (concave, convex, none): none Slope (/o): ° °
Subregion (LRR or MLRA): P-136 Lat: 36.2628 Long:-80.3361 Datum: NAD83
Soil Map Unit Name: Fairview -Poplar Forest complex NWI classification: -
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation X Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No X
Is the Sampled Area
Hydric Soil Present? Yes No x within a Wetland? Yes No X
Wetland Hydrology Present? Yes No x
Remarks:
Vegetation is periodically mowed. The area is located along a transmission line and adjacent to a
new residential development.
HYDROLOGY
Primary
Indicators minimum of one is re uired
all that amply)
"Surface
❑Sparsely
Soil Cracks (B6)
Vegetated Concave Surface (138)
❑
Surface Water (Al) LJ True Aquatic Plants (1314)
❑
ID
High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1)
❑
Drainage Patterns (B10)
Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3)
❑
Moss Trim Lines (B16)
❑
Water Marks (B1) ❑ Presence of Reduced Iron (C4)
❑
Dry -Season Water Table (C2)
❑
Sediment Deposits (B2) ❑ Recent Iron Reduction in Tilled Soils (C6)
❑
Crayfish Burrows (C8)
❑
❑
Drift Deposits (133) ❑ Thin Muck Surface (C7)
Algal Mat Crust in Remarks)
❑Stunted
Saturation Visible on Aerial Imagery (C9)
Stressed Plants
or (B4) ❑Other (Explain
Iron Deposits
❑Geomorphic
or (D1)
Position
(135)
Inundation Visible on Aerial Imagery (137)
❑Shallow
(D2)
Aquitard (D3)
❑
❑
Water -Stained Leaves (139)
❑
Microtopographic Relief (D4)
❑
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X Depth (inches):
Water Table Present? Yes No X Depth (inches):
Saturation Present? Yes No X Depth (inches): Wetland Hydrology Present? Yes No X
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

VEGETATION (Four Strata) - Use scientific names of plants.
Sampling Point:W1-up
Absolute Dominant Indicator Dominance Test worksheet:
Tree Stratum (Plot size: 30, ) % Cover Species? Status Number of Dominant Species
1 none That Are OBL, FACW, or FAC: 0 (A)
2.
Total Number of Dominant
3. Species Across All Strata: 2 (B)
4.
Percent of Dominant Species
5. That Are OBL, FACW, or FAC: 0% (A/B)
6.
7.
50% of total cover: _
Saolina/Shrub Stratum (Plot size: 15' )
1 Rubus argutus
3.
4.
5.
6.
7.
8.
9.
50
50% of total cover: 25
Herb Stratum (Plot size: 5- )
1 Schedonorus arundinaceus 80
2.
4.
5.
6.
7.
8.
9.
10.
11.
50% of total cover: 40
Woody Vine Stratum (Plot size: 30, )
1 none
2.
3.
5.
50% of total cover
numners nere or on a
= Total Cover
20% of total cover:
= Total Cover
20% of total cover: 10
X FACU
80 = Total Cover
20% of total cover: 16
= Total Cover
20% of total cover:
Prevalence Index worksheet:
Total % Cover of:
Multiply by:
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals:
(A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
_ 3 - Prevalence Index is :53.0'
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tall.
Herb -All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine -All woody vines greater than 3.28 ft in
Hydrophytic
Vegetation
Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont -Version 2.0

SOIL
Sampling Point: W1-up
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type Loc Texture Remarks
0-5 7.5YR 4/4 100 L
5-18+ 7.5YR 4/6 100
'Type: C=Concentration, D=Depletion,
H dric Soil Indicators:
Histosol (Al)
❑ Histic Epipedon (A2)
❑ Black Histic (A3)
❑ Hydrogen Sulfide (A4)
❑ Stratified Layers (A5)
❑2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11;
❑ Thick Dark Surface (Al 2)
❑ Sandy Mucky Mineral (S1) (LRR N,
P
MLRA 147,148)
Sandy Gleyed Matrix (S4)
Sandy Redox (S5)
0 Stripped Matrix (S6)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
RM=Reduced
C
MS=Masked Sand Grains. Location: PL=Pore Lining, M=Matrix.
cators for Problematic Hydric Soil
Dark Surface (S7) 2 cm Muck (A10) (MLRA 147)
Polyvalue Below Surface (S8) (MLRA 147, 148) Coast Prairie Redox (A16)
Thin Dark Surface (S9) (MLRA 147, 148) ❑ (MLRA 147, 148)
Loamy Gleyed Matrix (F2) Piedmont Floodplain Soils (F1
Depleted Matrix (F3) � (MLRA 136, 147)
Redox Dark Surface (F6) ❑Very Shallow Dark Surface (T
(Explain in Remarks)
Redox Depressions(F8)
9)
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122)
Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: City of King - Muddy Creek Pump Station City/County: Forsyth Sampling Date: 3/15/22
Applicant/Owner: City of King State: NC Sampling Point: W4-up
Investigator(s): J. Sullivan Section, Township, Range:
e °
Landform (hillslope, terrace, etc.): HillslopLocal relief (concave, convex, none): none Slope (/o): ° °
Subregion (LRR or MLRA): P-136 Lat: 36.2485 Long:-80.3588 Datum: NAD83
Soil Map Unit Name: Pacolet fine sandy loam NWI classification: -
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation X Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No
Is the Sampled Area
Hydric Soil Present? Yes X No within a Wetland? Yes X No
Wetland Hydrology Present? Yes X No
Remarks:
Wetland located under a transmission line and area is frequently mowed
HYDROLOGY
Primary
Indicators minimum of one is re uired
all that amply)
"Surface
❑Sparsely
Soil Cracks (B6)
Vegetated Concave Surface (138)
❑
Surface Water (Al) LJ True Aquatic Plants (1314)
❑
ID
High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1)
❑
Drainage Patterns (B10)
Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3)
❑
Moss Trim Lines (B16)
❑
Water Marks (B1) ❑ Presence of Reduced Iron (C4)
❑
Dry -Season Water Table (C2)
❑
Sediment Deposits (B2) ❑ Recent Iron Reduction in Tilled Soils (C6)
❑
Crayfish Burrows (C8)
❑
❑
Drift Deposits (133) ❑ Thin Muck Surface (C7)
Algal Mat Crust in Remarks)
❑Stunted
Saturation Visible on Aerial Imagery (C9)
Stressed Plants
or (B4) ❑Other (Explain
Iron Deposits
❑Geomorphic
or (D1)
Position
(135)
Inundation Visible on Aerial Imagery (137)
❑Shallow
(D2)
Aquitard (D3)
❑
❑
Water -Stained Leaves (139)
❑
Microtopographic Relief (D4)
❑
Aquatic Fauna (1313)
FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No X Depth (inches):
Water Table Present? Yes No X Depth (inches):
Saturation Present? Yes No X Depth (inches): Wetland Hydrology Present? Yes No X
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
Sampling Point: W4-up
Absolute Dominant Indicator
Dominance Test worksheet:
Tree Stratum (Plot size: 30,
) % Cover Species? Status
Number of Dominant Species
1 none
That Are OBL, FACW, or FAC: 2 (A)
2.
Total Number of Dominant
3.
Species Across All Strata: 2 (B)
4.
Percent of Dominant Species
5.
That Are OBL, FACW, or FAC: 100% (A/B)
6.
Prevalence Index worksheet:
7
= Total Cover
Total % Cover of: Multiply by:
50% of total cover: 20% of total cover:
OBL species x 1 =
Sarolina/Shrub Stratum (Plot size:
15' )
FACW species x 2 =
1 none
FAC species x 3 =
2
FACU species x 4 =
3
UPL species x 5 =
4
Column Totals: (A) (B)
5.
Prevalence Index = B/A =
6.
Hydrophytic Vegetation Indicators:
7.
_ 1 - Rapid Test for Hydrophytic Vegetation
8.
_ 2 -Dominance Test is >50%
9.
3 - Prevalence Index is :53.0'
= Total Cover
_
4 - Morphological Adaptations' (Provide supporting
50% of total cover: 20% of total cover:
5-
data in Remarks or on a separate sheet)
Herb Stratum (Plot size:
)
Problematic Hydrophytic Vegetation' (Explain)
1 Schedonorus arundinaceus
100 X FACU
—
2.
' Indicators of hydric soil and wetland hydrology must
3.
be present, unless disturbed or problematic.
4.
Definitions of Four Vegetation Strata:
5.
6
Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
7.
height.
8.
Sapling/Shrub — Woody plants, excluding vines, less
9.
than 3 in. DBH and greater than or equal to 3.28 ft (1
10
m) tall.
11.
Herb —All herbaceous (non -woody) plants, regardless
100 = Total Cover
of size, and woody plants less than 3.28 ft tall.
50% of total cover: 50 20% of total cover: 20
30
Woody vine —All woody vines greater than 3.28 ft in
Woody Vine Stratum (Plot size:
)
height.
1 none
2.
3.
4.
Hydrophytic
5.
Vegetation
= Total Cover
Present? Yes No X
50% of total cover: 20% of total cover:
Remarks: (Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

SOIL
Sampling Point: W4-up
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Type Loc Texture Remarks
0-4 7.5YR 4/4 100 SL
4-18+ 10YR 4/6 100
'Type: C=Concentration, D=Depletion,
H dric Soil Indicators:
Histosol (Al)
❑ Histic Epipedon (A2)
❑ Black Histic (A3)
❑ Hydrogen Sulfide (A4)
❑ Stratified Layers (A5)
❑2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11;
❑ Thick Dark Surface (Al 2)
❑ Sandy Mucky Mineral (S1) (LRR N,
P
MLRA 147,148)
Sandy Gleyed Matrix (S4)
Sandy Redox (S5)
0 Stripped Matrix (S6)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
RM=Reduced
C
MS=Masked Sand Grains. Location: PL=Pore Lining, M=Matrix.
cators for Problematic Hydric Soil
Dark Surface (S7) 2 cm Muck (A10) (MLRA 147)
Polyvalue Below Surface (S8) (MLRA 147, 148) Coast Prairie Redox (A16)
Thin Dark Surface (S9) (MLRA 147, 148) ❑ (MLRA 147, 148)
Loamy Gleyed Matrix (F2) Piedmont Floodplain Soils (F1
Depleted Matrix (F3) � (MLRA 136, 147)
Redox Dark Surface (F6) ❑Very Shallow Dark Surface (T
(Explain in Remarks)
Redox Depressions(F8)
9)
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122)
Piedmont Floodplain Soils (F19) (MLRA 148)
Red Parent Material (F21) (MLRA 127, 147)
3Indicators of hydrophytic vegetation and
wetland hydrology must be present,
unless disturbed or problematic.
Hydric Soil Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: City of King - Muddy Creek Pump Station City/County: Forsyth Sampling Date: 3/15/22
Applicant/Owner: City of King State: NC Sampling Point: W4-wet
Investigator(s): J. Sullivan Section, Township, Range:
lain ° °
Landform (hillslope, terrace, etc.): FloodpLocal relief (concave, convex, none): none Slope (/o): °
Subregion (LRR or MLRA): P-136 Lat: 36.2484 Long:-80.3586 Datum: NAD83
Soil Map Unit Name: Pacolet fine sandy loam NWI classification: PEM
Are climatic / hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegetation , Soil or Hydrology significantly disturbed? Are "Normal Circumstances" present? Yes X No
Are Vegetation , Soil or Hydrology naturally problematic? (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes X No
Is the Sampled Area
Hydric Soil Present? Yes x No within a Wetland? Yes X No
Wetland Hydrology Present? Yes x No
Remarks:
Wetland located under a transmission line
HYDROLOGY
Primary
Indicators minimum of one is re uired
all that amply)
"Surface
❑Sparsely
Soil Cracks (B6)
Vegetated Concave Surface (138)
❑
Surface Water (Al) LJ True Aquatic Plants (1314)
0
High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1)
❑
Drainage Patterns (B10)
Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3)
❑
Moss Trim Lines (B16)
❑
Water Marks (B1) ❑ Presence of Reduced Iron (C4)
❑
Dry -Season Water Table (C2)
❑
Sediment Deposits (B2) ❑ Recent Iron Reduction in Tilled Soils (C6)
❑
Crayfish Burrows (C8)
❑
Drift Deposits (133) ❑ Thin Muck Surface (C7)
❑Stunted
Saturation Visible on Aerial Imagery (C9)
❑
Algal Mat or Crust (B4) ❑Other (Explain in Remarks)
Iron Deposits
❑✓
or Stressed Plants (D1)
Geomorphic Position
(135)
Inundation Visible on Aerial Imagery (137)
❑Shallow
(D2)
Aquitard (D3)
❑
❑
Water -Stained Leaves (139)
❑
Microtopographic Relief (D4)
❑
Aquatic Fauna (1313)
FAC Neutral Test (D5)
Field Observations:
Surface Water Present? Yes X No Depth (inches): 2
Water Table Present? Yes X No Depth (inches): 0
Saturation Present? Yes X No Depth (inches): 0 Wetland Hydrology Present? Yes X No
(includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
Sampling Point: W4-wet
Absolute Dominant Indicator Dominance Test worksheet:
Tree Stratum (Plot size: 30, ) % Cover Species? Status Number of Dominant Species
1 none That Are OBL, FACW, or FAC: 2 (A)
2.
Total Number of Dominant
3. Species Across All Strata: 2 (B)
4.
Percent of Dominant Species
5. That Are OBL, FACW, or FAC: 100% (A/B)
6.
7.
50% of total cover: _
Saolina/Shrub Stratum (Plot size: 15' )
1 none
3.
4.
5.
6.
7.
8.
9.
50% of total cover:
Herb Stratum (Plot size: 5- )
1 Typha angustifolia 90
2 Polygonum sp. 10
4.
5.
6.
7.
8.
9.
10.
11.
50% of total cover: 50
Woody Vine Stratum (Plot size: 30, )
1 none
2.
3.
5.
50% of total cover
numners nere or on a
= Total Cover
20% of total cover:
= Total Cover
20% of total cover:
X OBL
X FACW
100 = Total Cover
20% of total cover: 20
= Total Cover
20% of total cover:
Prevalence Index worksheet:
Total % Cover of:
Multiply by:
OBL species
x 1 =
FACW species
x 2 =
FAC species
x 3 =
FACU species
x 4 =
UPL species
x 5 =
Column Totals:
(A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
_ 1 - Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
_ 3 - Prevalence Index is :53.0'
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation Strata:
Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub — Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft (1
m) tall.
Herb —All herbaceous (non -woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine —All woody vines greater than 3.28 ft in
Hydrophytic
Vegetation
Present? Yes X No
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

SOIL
Sampling Point: W4-wet
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth
Matrix
Redox Features
(inches)
Color (moist)
%
Color (moist) % Type, Loc Texture Remarks
0-2
7.5YR 4/4
100
L
2-12
10YR 4/2
70
7.5YR 4/6 30 C PL CL
12-18+
10YR 411
100
7.5YR 4/6 10 C PL C
'Type: C=Concentration, D=Depletion, RM=Reduced
H dric Soil Indicators:
Histosol (Al)
❑ Histic Epipedon (A2)
❑ Black Histic (A3)
❑ Hydrogen Sulfide (A4)
❑ Stratified Layers (A5)
❑2 cm Muck (A10) (LRR N)
Depleted Below Dark Surface (A11)
❑ Thick Dark Surface (Al 2)
❑ Sandy Mucky Mineral (S1) (LRR N,
P
MLRA 147,148)
Sandy Gleyed Matrix (S4)
Sandy Redox (S5)
0 Stripped Matrix (S6)
Restrictive Layer (if observed):
Type:
Depth (inches):
Remarks:
MS=Masked Sand Grains. 2 Location: PL=Pore Lining, M=Matrix.
cators for Problematic Hydric Soil
Dark Surface (S7) 2 cm Muck (A10) (MLRA 147)
Polyvalue Below Surface (S8) (MLRA 147, 148) Coast Prairie Redox (A16)
Thin Dark Surface
p ( )
Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
Umbric Surface (F13) (MLRA 136, 122) 3Indicators of hydrophytic vegetation and
Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic.
(S9) (MLRA 147, 148)
(MLRA 147, 148)
Hydric Soil Present? Yes X No
US Army Corps of Engineers Eastern Mountains and Piedmont —Version 2.0

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KCI
TECHNOLOGIES
Site Visit Photo Record
City of King - Muddy Creek Pump Station, Forsyth and Stokes Counties, NC
March 15, 2022
1. Stream S 1 looking upstream.
2. Wetland W 1 looking east.
Page 1 of 4

====ri
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MMW46�
...ram
KCI
TECHNOLOGIES
Site Visit Photo Record
City of King - Muddy Creek Pump Station, Forsyth and Stokes Counties, NC
March 15, 2022
3. Ephemeral Channel S2 looking upstream as it enters the study area.
4. Stream S4 (UT to Muddy Creek) looking downstream as it exits the study area.
Page 2 of 4

====ri
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MMW46�
...ram
KCI
TECHNOLOGIES
Site Visit Photo Record
City of King - Muddy Creek Pump Station, Forsyth and Stokes Counties, NC
March 15, 2022
5. Parkers Creek looking upstream.
6. Wetland W4.
Page 3 of 4

K C I
TLCLiNOL.OGIE:5
Site Visit Photo Record
City of King - Muddy Creek Pump Station, Forsyth and Stokes Counties, NC
March 15, 2022
N�.
Y
Page 4 of 4

LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: NIA Page: NIA County: Stokes & Forsyth
Parcel ID Number: City of Kina ROW
Street Address: Moore Road ROW
Property Owner (please print):
Property Owner (please print):
City of King, NC
The undersigned, registered property owner(s) of the above property, do hereby authorize
Joseph Sullivan of KCl Associates of NC
to take all actions necessary for the purposes of conducting on -site environmental consulting
services, including conducting stream and/or wetland determinations and delineations, as well as
issuance and acceptance of any required permit(s) or certification(s). I agree to allow regulatory
agencies, including the US Army Corps of Engineers, to visit the property as part of these
envirnnrnentn1 rPviPWc.
Property Owners(s) Address:
(if different from above)
PO Box 1132
King, North Carolina 27021
Property Owner Telephone Number:
Property Owner Email:
336-983-8265
sbarrow@ci. king, nc.us
We hereby certify the above information to be true and accurate to the best of our knowledge.
Owner Authorized Signature)
(Date)
(Property Owner Authorized Signature) (Date)

D. USFWS Documentation

BNT OR Tye' FISHSERVICE
�o United States Department of the Interior
FISH AND WILDLIFE SERVICE
gRCH 3 1Asheville Field Office
160 Zillicoa Street Suite B
Asheville, North Carolina 28801
September 29, 2022
Mr. Joseph Sullivan
KCI Associates of NC
4505 Falls of Neuse Road, Suite 400
Raleigh, North Carolina 27609
Subject: Muddy Creek Sewer Line and Pump Station in King, Forsyth and Stokes Counties, North
Carolina.
Dear Mr. Sullivan:
On August 31, 2022, we received (via email) your information requesting our review of the subject
project. We have reviewed the information that you presented for this request and the following
comments are provided in accordance with the provisions of the National Environmental Policy Act (42
U.S.C.§ 4321 et seq.) and section 7 of the Endangered Species Act of 1973, as amended (16 U.S.C. 1531
- 1543) (Act).
Proiect Description
According to the information provided, the City of King proposes infrastructure improvements to their
wastewater system in Forsyth and Stokes Counties, North Carolina. A new force main will be installed
along the floodplain of an unnamed tributary to Muddy Creek and in the right -of way of Moore Road
connecting the Spainhour Road Pump Station to the Doral Road Pump Station.
Federally Listed Species
An assessment of suitable habitat and potential impacts to six species was conducted by environmental
specialists with KCI Associates of NC on August 30, 2022. The findings were compiled and included in
the review request submitted to our office on August 31, 2022. The following species and their associated
habitats were evaluated.
Species
Status'
Bog turtle
Glyptemys muhlenbergii
T(S/A), ARS
Gray bat
Myotis grisescens
E
Monarch butterfly
Danaus plexippus
CAN
Northern long-eared bat
Myotis septentrionalis
T, PE
Schweinitz's sunflower
Helianthus schweinitzii
E
Small-anthered bittercress
Cardamine micranthera
E
'E = endangered, PE = proposed endangered, T= threatened, and CAN =
candidate.

The review request states that no suitable habitat is present for gray bat or small-anthered bittercress.
Based on the information provided, we agree with the assessment that no suitable habitat is present for
these species. As such, section 7 consultation is not required for these species.
Bog turtle is federally listed as threatened (due to similarity of appearance) and was petitioned for listing,
resulting in an at -risk species (ARS) designation, on January 13, 2022. Bog turtle is not currently subject
to section 7 consultation; therefore, an effects determination is not necessary. However, it is a species of
concern for our office, and we appreciate the project proponent Is consideration of bog turtle when
evaluating the action area for impacts to federally listed species and their habitats. If bog turtle or suitable
habitat is identified on future projects within the proposed action area or proposed activities will impact
hydrology of suitable habitat (i.e., changing drainage patterns to/from wetlands), we recommend
coordinating the project with the U.S. Fish and Wildlife Service (Service) and the NC Wildlife Resources
Commission.
Monarch butterfly is a candidate species, and we appreciate the project proponent Is consideration of
monarch butterfly when evaluating the action area for impacts to federally listed species and their
habitats. The species is not subject to section 7 consultation, and an effects determination is not necessary.
General recommendations for pollinators can be provided and would be protective of monarch butterfly
should the project proponent like to implement them in the future.
On September 21, 2022, the consultation range for northern long-eared bat was updated based on the best
available scientific data. The action area for this project is now outside of the species' consultation range.
Therefore, we believe the project will have no effect on the northern long-eared bat.
The review request states that suitable habitat for Schweinitz's sunflower is present on site; however, the
species was not observed during surveys. Based on negative results of visual surveys conducted on
August 30, 2022, we would concur with a "may affect, not likely to adversely affect" determination from
the lead federal action agency for this species.
Suitable habitat for tricolored bat (Perimyotis subflavus) may present at the site. On September 14, 2022,
the Service published a proposal in the Federal Register to list the tricolored bat as endangered under the
Act. The Service has up to 12 months from the date the proposal published to make a final determination,
either to list the tricolored bat under the Act or to withdraw the proposal. The Service determined the bat
faces extinction primarily due to the range -wide impacts of WNS. Because tricolored bat populations
have been greatly reduced due to WNS, surviving bat populations are now more vulnerable to other
stressors such as human disturbance and habitat loss. Species proposed for listing are not afforded
protection under the Act; however, as soon as a listing becomes effective (typically 30 days after
publication of the final rule in the Federal Register), the prohibitions against jeopardizing its continued
existence and "take" will apply. Therefore, if you suspect your future or existing project may affect
tricolored bats after the potential new listing goes into effect, we recommend analyzing possible effects of
the project on tricolored bats and their habitat to determine whether consultation under section 7 of the
Act is necessary. Conferencing procedures can be followed prior to listing to ensure the project does not
jeopardize the existence of a species. Projects with an existing section 7 biological opinion may require
re -initiation of consultation to provide uninterrupted authorization for covered activities. Please contact
our office for additional guidance or assistance.
We believe the requirements under section 7 of the Act are fulfilled for the federally listed species
discussed above. However, obligations under section 7 of the Act must be reconsidered if (1) new
information reveals impacts of the identified action may affect listed species or critical habitat in a
manner not previously considered, (2) the identified action is subsequently modified in a manner that was

not considered in this review, or (3) a new species is listed or critical habitat is determined that may be
affected by the identified action.
Fish and Wildlife Resource Recommendations
We offer the following general recommendations for the benefit of fish and wildlife resources:
Equipment Use in Riparian Areas and In -Stream. Equipment should be operated from the
streambank. If in -stream work is necessary, stone causeways, work bridges, or mats (designed for
the specific location and type of equipment) should be used. Work pads on streambanks or
approaches to in -stream work areas should minimize disturbance to woody vegetation. Equipment
operated in riparian areas and in/near aquatic resources should be inspected daily and maintained
regularly to prevent contamination of surface waters from leaking fuels, lubricants, hydraulic
fluids, or other toxic materials. Construction staging, toxic material storage, and equipment
maintenance, including refueling, should occur outside of the riparian area. The project proponent
should report any toxic material spills in riparian areas and/or aquatic resources to the Service
within 24 hours.
Erosion and Sedimentation Control. Construction activities near aquatic resources, streams,
and wetlands have the potential to cause bank destabilization, water pollution, and water quality
degradation if measures to control site runoff are not properly installed and maintained. In order
to effectively reduce erosion and sedimentation impacts, best management practices specific to
the extent and type of construction should be designed and installed prior to land -disturbing
activities and should be maintained throughout construction. Natural fiber matting (coir) should
be used for erosion control as synthetic netting can trap animals and persists in the environment
beyond its intended purpose. Land disturbance should be limited to what can be stabilized
quickly, preferably by the end of the workday. Once construction is complete, disturbed areas
should be revegetated with native riparian grass and tree species as soon as possible. For
maximum benefits to water quality and bank stabilization, riparian areas should be forested;
however, if the areas are maintained in grass, they should not be mowed. The Service can provide
information on potential sources of plant material upon request.
A complete design manual that is consistent with the requirements of the North Carolina
Sedimentation and Pollution Control Act and Administrative Rules, can be found at the following
website: https:lldeq.nc.govlabout/divisions/energy-mineral-land-resources.
• Utility Line Crossings. In the interest of reducing impacts to natural resources, utility crossings
(i.e., sewer, gas, and water lines) should be kept to a minimum, and all utility infrastructure
(including manholes) should be kept out of riparian buffer areas. If a utility crossing is necessary,
we recommend that you first consider the use of directional boring. Directional boring under
streams significantly minimizes impacts to aquatic resources and riparian buffers.
If directional boring cannot be used and trenching is determined to be the only viable method,
every effort should be made to ensure that impacts to in -stream features are minimized and
stabilized upon completion of the project. Our past experiences with open -trench crossings
indicate that this technique increases the likelihood for future lateral movement of the stream
(which could undercut or erode around the utility line), and the correction of such problems could
result in costly future maintenance and devastating impacts to natural resources. Therefore, as
much work as possible should be accomplished in the dry, and the amount of disturbance should
not exceed what can be successfully stabilized by the end of the workday. In -stream work should
avoid the spring fish spawning season and should consider forecasted high flow events.

Regardless of the crossing method, all utility lines should cross streams perpendicularly. We
strongly encourage that a qualified biologist monitor the work area until the work is complete in
order to identify any additional impact -minimization measures. The Service may be available to
assist you in this effort.
To determine if any maintenance is required, the work site should be monitored at least every 3
months during the first 24 months and annually thereafter. Moreover, we recommend the
development of a riparian monitoring and maintenance program that would outline procedures for
the prompt stabilization of streambanks near the utility crossing (should any streambank erosion
or destabilization occur) throughout the life of this project.
The Service appreciates the opportunity to provide these comments. Please contact Ms. Rebekah Reid of
our staff at rebekah reid(afws.gov, if you have any questions. In any future correspondence concerning
this project, please reference Log Number 4-2-22-726.
Sincerely,
- - original signed - -
Janet Mizzi
Field Supervisor
4

E. SHPO Documentation

North Carolina Department of Natural and Cultural Resources
State Historic Preservation Office
Ramona M. Bartos, Administrator
Governor Roy Cooper
Secretary D. Reid Wilson
October 18, 2022
Joe Sullivan
KCI Technologies
4505 Falls of Neuse Road, Suite 400
Raleigh, NC 27609
Office of Archives and History
Deputy Secretary, Darin J. Waters, Ph.D.
Re: Construct Muddy Creek sewer line and pump station, Moore Road, King,
Forsyth and Stokes Counties, ER 22-1967
Dear Mr. Sullivan:
j oe. sullivangkci . com
Thank you for your email of August 20, 2022, concerning the above -referenced undertaking. We have
reviewed the submittal and offer the following comments.
We have conducted a review of the project and are aware of no historic resources which would be affected
by the project. Therefore, we have no comment on the project as proposed.
The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation's Regulations for Compliance with Section 106 codified at 36
CFR Part 800.
Thank you for your cooperation and consideration. If you have questions concerning the above comment,
contact Renee Gledhill -Earley, environmental review coordinator, at 919-814-6579
or environmental.reviewgncdcr.gov. In all future communication concerning this project, please cite the
above referenced tracking number.
Sincerely,
Ramona Bartos, Deputy
State Historic Preservation Officer
Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, Raleigh NC 27699-4617 Telephone/Fax: [phone]-6898

F. Project Drawings

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