20220210 Ver 2_ePCN Application_20230322

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
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:
2/22/2023
BIMS # Assigned
20220210
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
Information for Initial Review
la. Name of project:
415 Gallimore Dairy Road Project
la. Who is the Primary Contact?*
Richard Vanore
1b. Primary Contact Email: *
[e-mail]
Date Submitted
3/22/2023
Nearest Body of Water
East Fork Deep River
Basin
Cape Fear
Water Classification
WS-IV
Site Coordinates
Latitude: Longitude:
36.067676-79.949423
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Guilford
Is this a NCDMS Project
Yes No
Version#*
2
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Seren Homer:[e-mail]
1c. Primary Contact Phone: *
[phone]
O

Is this project a public transportation project?*
Yes No
1a.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
Please provide the date of the previous submission.
2/3/2022
1b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
39 - Commercial/Institutional Developments
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
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. 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
1d. 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:
Koury Corp LLC
2b. Deed book and page no.:
02620/008513
2c. Contact Person:
Richard Vanore
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No
O

2d. Address
Street Address
2275 Vanstory St, Ste 200
Address Line 2
city
Greensboro
Postal / Zip Code
27403
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Richard Vanore
3b. Business Name:
Koury Corp LLC
3c.Address
Street Address
2275 Vanstory St, Ste 200
Address Line 2
city
Greensboro
Postal / Zip Code
27403
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Michelle Measday
4b. Business Name:
ECS Southeast LLP
4c.Address
Street Address
5260 Greens Dairy Road
Address Line 2
city
Raleigh
Postal / Zip Code
27616
4d. Telephone Number:
[phone]
0. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Greensboro
2. Project Identification
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
O

2a. Property Identification Number:
7814-94-3873
2b. Property size:
20.66
2c. Project Address
Street Address
415 Gallimore Dairy Road
Address Line 2
city
Greensboro
Postal / Zip Code
27409
3. Surface Waters
3a. Name of the nearest body of water to proposed project: "
East Fork Deep River
3b. Water Resources Classification of nearest receiving water:'
WS-IV
3c. What river basin(s) is your project located it *
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300030102
4. Project Description and History
State / Province / Region
NC
Country
USA
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application: *
The site is currently undeveloped and consists of maintained field and wooded lands. One unnamed tributary flows east to west across the site originating from a headwater wetland.
Commercial and industrial properties are located adjacent to and in the vicinity of the site.
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:
0.48
4g. List the total estimated linear feet of all existing streams on the property:
618
4h. Explain the purpose of the proposed project:*
The purpose of the project is to develop the site with four commercial buildings including a 126,000-SF warehouse building, a 52,500-SF warehouse building, a 12,000-SF commercial
building and a 10,800-SF commercial building. Driveway access points are located along Gallimore Dairy Road and Chimney Rock Road. In addition to the commercial buildings, other
improvements to the property include vehicular parking, tractor trailer parking, loading dock area, fire safety lanes, interior access drives, infrastructure improvements, landscaping,
lighting, and stormwater management measures.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The proposed project will introduce approximately 10.38 acres of impervious cover to the 20.9-acre site or 49.7 % of built upon area/impervious cover. Stormwater management measures
include the construction of two wet detention basins that will collect stormwater from the newly created impervious areas introduced by the project. Design of the stormwater management
measures meet State design standards and will be reviewed and approved by the City of Greensboro. Greensboro has been delegated authority to review the proposed stormwater
management measures by the State.
The development will be constructed via standard construction procedures. Proper erosion and sediment control measures would be utilized and maintained throughout the project. Typical
materials and machinery will be used on -site during the construction process.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2021-00395 PJD
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Michelle Measday
Agency/Consultant Company: ECS Southeast LLP
Other:
G Unknown

5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
4/21/2021
6. Future Project Plans
6a. Is this a phased project?*
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
I1
0
2a1 Reason (?)
2b. Impact type * (?)
2c. Type of W. *
2d. W. name
2e. Forested *
2f. Type of Jurisdicition *
(?)
2g• Impact
area *
W1
Grading
P
fedwater Forest
W1
Yes
Corps
0.210
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.210
2g. Total Wetland Impact
0.210
2i. Comments:
Fill necessary for leveling the site for the 126,000 building and vehicular parking lot.
E. Impact Justification and Mitigation O
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Evans Engineering was tasked with avoiding/minimizing impacts to onsite wetland and stream resources, while creating level areas for the proposed
commercial structures. Impacts to the onsite stream and associated riparian buffer have been avoided. Impacts to the wetland were unavoidable in that
leveling of the site to support the 126,000-SF warehouse required grading into the wetland. Grading was set at a 2:1 slope minimizing further grading
into the wetland.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Appropriate construction techniques will be used, and erosion control measures will be implemented to minimize siltation, sedimentation, and other
impacts. Efforts will be made before, during, and after construction to minimize the extent and duration of project -related disturbances to downstream
water resources.
The construction techniques shall be conducted in accordance with North Carolina Department of Environment and Natural Resources standards.
Temporary and additional erosion control measures shall be maintained throughout the construction process. Silt fencing will be placed at the bottom of
the slopes to deter sediment and erosion control during roadway development activities. Temporary erosion, sedimentation, and pollution controls will be
installed prior to and maintained during the entire construction duration and until final stabilization is established.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2c. If yes, mitigation is required by (check all that apply):
DWR Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
Yes No

4b. Stream mitigation requested:
(linear feet)
4c. If using stream mitigation, what is the stream temperature:
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
0.42
4g. Coastal (tidal) wetland mitigation requested:
(acres)
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
2d. Which of the following stormwater management programs) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Greensboro/Guilford
Comments:
The Stormwater Management Plan is currently under review in Greensboro.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 28 .021
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.
This is a stand alone project and complete project.
01
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.
Guilford County and City of Greensboro Public Utilities
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
Yes No Unknown
5e. Is this a DOT project located within Division's 1-8?
Yes No
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?
See USFWS IPaC letter dated 12/3012021. See below for further evaluation and conclusions.
Schweinitz's Sunflower, Survey Window: late August to October
Description: Schweinitz's Sunflower is a perennial herb that produces solitary stems, up to 2 m tall and bears yellow flower heads in late summer and
early autumn.
Habitat: Schweinitz's Sunflower occurs in clearings, and edges of, upland oak -pine -hickory woods and piedmont longleaf pine forests in moist to dryish
sandy loams. The sunflower requires full to partial sun of an open habitat, which was formerly maintained over the species' range by wildfires and
grazing by herds of bison and elk. Now most occurrences are confined to roadsides and powerline clearings.
Conclusions: The site consists of wooded land and maintained fields to the forest edge. The surrounding land use includes industrial and commercial
properties.
A targeted survey was performed on site to identify Schweinitz's sunflower, but was not during the appropriate flowering window. The field is
aggressively maintained and mowed. Field edges along cleared areas were examined for Schweinitz's sunflower or any sunflower species and none
were identified. Therefore, ECS concluded that habitat does not exist on site for Schweinitz's sunflower and the project proposed for the site would have
no effect on Schweinitiz's sunflower.
Small -whorled pogonia, Survey Window: mid -May to early July
Description: Small -whorled pogonia has a greenish -white stem that grows between 3 — 13 inches tall.
Habitat: Small whorled pogonia can be limited by shade. The species seems to require small light gaps, or canopy breaks, and generally grows in areas
with sparse to moderate ground cover. Too many other plants in an area can be harmful to this plant. This orchid typically grows under canopies that are
relatively open or near features that create long -persisting breaks in the forest canopy such as a road or a stream. It grows in mixed -deciduous or mixed-
deciduous/coniferous forests that are generally in second- or third -growth successional stages. The soils in which it lives are usually acidic, moist, and
have very few nutrients.
Habitat: Small -whorled pogonia is found sporadically across the eastern United States and Canada. In North Carolina, this species is extant in Burke,
Cherokee, Guilford, Jackson, McDowell, Rutherford, and Transylvania counties. It is considered historic in Haywood, Henderson, Macon, and Surry
counties.
Conclusions: ECS concluded no effect due to lack of habitat on site. The tree canopy was moderate to dense with very little canopy breaks for light to
reach the ground.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat? *
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)

7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status? "
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
NC HPO Web Mapper and response letter.
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?"
FEMA MSC Mapping
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to allach document
ORM Form Gallimore Dairy 2022-Jan-28.pdf
36.46KB
401 Pre -File Email 2023-02-22.pdf
73.13KB
49-11545-C Gallimore Dairy Road 404-401 Wetland Permit Report.pdf
7.21 MB
415 GALLIMORE DAIRY WETLAND IMPACT MAP-02-01-23.pdf
1.14MB
File must be PDF or KMZ
Comments
The same application was previously submitted to the Corps in February 2021 and withdrawn. Documentation is included in the attached 404/401 Wetland Permit Report.
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction' subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
I intend to electronically sign and submit the PCN form.
Full Name:
Michelle Measday
Signature
"1"i'll4f
Date
3/22/2023
O