20230828 Ver 1_ePCN Application_20230608

i 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:
12/16/2022
BIMS # Assigned
20230828
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:
Deep Creek Flood Control Dam # 21 riser repair
la. Who is the Primary Contact?*
Gerald Pottern
1b. Primary Contact Email: *
[e-mail]
Date Submitted
6/8/2023
Nearest Body of Water
South Deep Creek, unnamed tributary
Basin
Yadkin-PeeDee
Water Classification
Class C
Site Coordinates
Latitude: Longitude:
36.0927-80.7210
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Yadkin
Is this a NCDMS Project
Yes No
Version#*
1
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
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: 03 - Maintenance
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
401 Water Quality Certification - Express
Riparian Buffer Authorization
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
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:
Yadkin Soil & Water Conservation District
2b. Deed book and page no.:
** Yadkin SWCD owns dam and easement
2c. Contact Person:
Jason Walker

2d. Address
Street Address
2051 Agricultural Way, Suite 207
Address Line 2
city
Yadkinville
Postal / Zip Code
27055
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Gerald Pottern
4b. Business Name:
Mogensen Mitigation Inc.
4c.Address
Street Address
104 East Chestnut Ave
Address Line 2
city
Wake Forest
Postal / Zip Code
27587
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Yadkinville
2. Project Identification
2a. Property Identification Number:
154243
2c. Project Address
Street Address
2225 Helton Rd
Address Line 2
City
Yadkinville
Postal / Zip Code
27055
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
South Deep Creek, unnamed tributary
3b. Water Resources Classification of nearest receiving water:
Class C
3c. What river basins) is your project located it *
Yadkin-PeeDee
State / Province / Region
NC
Country
us
2f. Fax Number:
State / Province / Region
INC
Country
us
4e. Fax Number:
2b. Property size:
199
State / Province / Region
NC
Country
us

3d. Please provide the 12-digit HUC in which the project is located.
03040101-1103
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application: *
This flood control dam was built in the 1960s by the USDA Soil Conservation Service (now Natural Resources Conservation Service). The spillway riser gate and other structures are
corroded and in need of repair or replacement. The impoundment above the dam is partially drained. Lands adjacent to the dam and lake pool are in agricultural and forestry use. The
nearest residence is approximately 700 feet from the dam.
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:
unknown; no wetland in proposed limits of disturbance
4g. List the total estimated linear feet of all existing streams on the property:
6,400 feet
4h. Explain the purpose of the proposed project: *
The purpose of the proposed work is to preserve the dam's existing flood control benefits by repairing or replacing corroded and clogged spillway riser components.
4L Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
1. Install the temporary construction entrance (crushed rock) along the route to the riser work area and establish the staging area and erosion and sediment control measures in
accordance with the construction drawings and technical specifications.
2. Plug the principal spillway conduit pipe to maintain full pool elevation. Outflow will be routed over the auxiliary spillway during the construction work. Install a temporary turbidity curtain
in the plunge pool area below the dam..
3. Use a boat -mounted hydraulic dredge to remove sediment within the designated area around the principal spillway riser to the depth needed to facilitate replacement of the riser slide
gate. Sediment slope around the riser after dredging shall be no steeper than 5 horizontal to 1 vertical to prevent slumping, as shown on the sediment removal plan sheet.
4. The hydraulic dredged sediment and water mixture will be pumped into sediment filter bags set up along the shore of the lake with erosion control measures to retain the sediment and
allow nearly sediment -free water to flow back into the lake.
5. The dewatered sediment will be trucked to the designated sediment disposal site and spread on existing farmland. The sediment disposal site plan also includes erosion and
sedimentation control measures. No streams, wetlands, or forest lands will be directly affected by the sediment disposal.
6. The low-level gate replacement work will be conducted under water. Remove the existing low stage trash rack and cut all old anchor bolts to be flush with riser concrete surfaces.
Remove the existing slide gate, steel stem, stem guides, and operator. Install new stainless steel wedge type anchor bolts and new cast iron slide gate, stainless steel stem, and operator.
New stem guides, bolts, and anchors shall be located at least 6-in from any existing stem guide bolt/hole.
7. Replaced structures and demolition debris will be disposed of at a construction debris facility regulated by the Division of Solid Waste Management.
S. Remove all temporary erosion and sediment control devices and filter bags. Apply seeding to all disturbed areas in the work area and along the access road in accordance with the
technical specifications.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas? *
Yes No
Comments:
Dam and pool areas delineated in April 2021
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): Gerald Pottern
Agency/Consultant Company: Mogensen Mitigation Inc
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes O No
O Unknown
6b. If yes, explain.
Additional repair work on the dam embankment and sediment excavation in the lake bed will likely be conducted within the next few years. A USDA Watershed Plan Environmental
Assessment is presently in review. Yadkin SWCD is the sponsor.
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 O

1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries O Buffers
Open Waters Pond Construction
4. Open Water Impacts
4a. Site #
4a1. Impact Reason 11
4b. Impact type
4c. Name of waterbody
ii
4d. Activity type
4e. Waterbody type
4f. Impact area
O-1
sediment dredge
T
Lake at Deep Cr Dam 21
Dredging
Lake
0.16
O-2
cofferdam
T
_11
Lake at Deep Cr Dam 21
Fill
_11
Lake
0.00
4g. Total temporary open water Impacts: 4g. Total permanent open water impacts:
0.16 0.00
4g. Total open water impacts:
0.16
4h. Comments:
Hydraulic dredging or mechanical excavation of sediment around spillway intake riser; finished slope on lake bed will not exceed 5:1 horizontal to
vertical. Temporary cofferdam (0.005 acre) is within the excavation area.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Access road, staging area, and sediment filter bags will be sited in previously disturbed non -wooded areas; no streams or wetlands will be affected.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation controls will be installed along the access road, staging and filter bag areas, and a temporary turbidity curtain will be installed
in the plunge pool area.
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:
Impacts are in open waters only; no direct impacts to streams or wetlands.
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
If no, explain why:
Yadkin River basin does not have Riparian Buffer Protection 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:
Not applicable; no new development.
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
1b. 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
L

Comments:*
Intake riser repairs do not trigger NEPA or SEPA thresholds. However, the future dam embankment repair work does require a NEPA EA which is
presently in review.
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 project will preserve existing flood protection levels that have been in place since the 1960s and will not likely result in new development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
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 No
What Federal Agency is involved?
USDA
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
Unknown
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?
The FWS-IPaC search tool lists three federally endangered or threatened species in Yadkin County: northern long-eared bat, tricolored bat, and
Schweinitz's sunflower. The NC Natural Heritage Program (NHP) database has no record of these species within three miles of the project area. The
northern long-eared bat and tricolored bat could be present at times, but no trees will be cut and therefore adverse impacts to bats are unlikely. The
areas to be disturbed do not contain suitable habitat for Schweinitz's sunflower. There is no designated critical habitat in the project area.
The NC Wildlife Resources Commission (WRC) has recent records of the state endangered creeper mussel in the stream below Dam 21. The proposed
erosion and sedimentation control measures will mitigate potential adverse impacts to mussels. The applicant has been consulting with WRC fisheries
biologists to protect this population.
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 National Marine Fisheries Essential Fish Habitat Mapping Tool shows no EFH in Yadkin County.
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?"
The NC State Historic Preservation Office online database includes two historic houses on Helton Rd 0.2 to 0.3 mile east of the dam, but both of these
no longer exist. Other historic homes along Arnold Rd are more than 0.5 mile from the site and not visible from the site. USDA cultural resource
specialist Jim Errante conducted an archaeological survey on the site (NEPA EA for the future dam repair) and found no significant resources.
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-FRIS Map # 3710488400K indicates 100-year flood -hazard zone AE downstream of Dam 21. The dam footprint, lake, and auxiliary spillway are
all upslope of the mapped flood hazard zone.
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
ePCN Support Binder Dam-21.pdf
File must be PDF or KMZ
2.24MB
Comments
Amanda Jones of USACE stated in an email on March 7, 2023 that the project meets the conditions for Nationwide Permit #3 and does NOT require submittal of a PCN to USACE. Saran
Homer of NCDWR stated in an email on March 8, 2023 that the project DOES require a PCN submittal to NCDWR. Therefore, the attached support file (PDF) does not include a JD
Request form, PJD appendix forms, or wetland delineation data forms typically required by USACE. Please let me know if you need these or any other information to process this permit
application.
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:
Gerald Pottern
Signature
,LN fi•t;-
Date
6/8/2023
O