20230908 Ver 1_ePCN Application_20230622

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:
4/19/2023
BIMS # Assigned
20230908
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Zachary Thomas:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Global SUQ Gas Station & Market
1a. Who is the Primary Contact?*
S&EC, PA - Bob Zarzecki
1b. Primary Contact Email: *
[e-mail]
Date Submitted
6/22/2023
Nearest Body of Water
Third Fork Creek [Stream Index: 1641-1-12-(12)]
Basin
Cape Fear
Water Classification
WS-IV: NSW
Site Coordinates
Latitude:
35.965342
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Durham
Is this a NCDMS Project
Yes No
Longitude:
-78.920251
Version#*
1
Reviewing Office`
Raleigh Regional Office - [phone]
1c. Primary Contact Phone: *
[phone]
a
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:
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
fig. 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:
Abdulla Alqasem and Yusra Abdelrahman
2b. Deed book and page no.:
2c. Contact Person:
2d. Address
Street Address
626 Swift Creek Crossing
Address Line 2
City
Durham
Postal / Zip Code
27713
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
USA
Yes No
Yes No

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Bob Zarzecki
4b. Business Name:
Soil & Environmental Consultants, PA
4c. Address
Street Address
8412 Falls of Neuse Road
Address Line 2
Suite 104
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27615
USA
4d. Telephone Number: 4e. Fax Number:
[phone] [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:
Durham
2. Proiect Identification
2a. Property Identification Number:
0820-36-62-7520, 0820-36-62-3538, & 0820-
2b. Property size:
36-52-9838
0.82
2c. Project Address
Street Address
103, 105, & 107 Cornwallis Road
Address Line 2
City
State / Province / Region
Durham
NC
Postal / Zip Code
Country
27707
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Third Fork Creek [Stream Index: 16-41-1-12-(12)]
3b. Water Resources Classification of nearest receiving water:
WS-IV; NSW
3c. What river basin(s) is your project located in?
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300020602
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: *
The site currently has an existing gas station and market (Global SUQ; www.globalsuq.com). The property to the northwest is vacant land with trees and the small wetland pocket. General
land use in the vicinity of the project includes another gas station, oil change shop, and restaurant in the northern quadrant of Roxboro Road and Cornwallis Road, another gas station in
the eastern quadrant, and a church in the southern quadrant. The intersection and project is surrounded by single family residential homes.

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:
0.0772
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
The purpose of the project is to expand the business with a new fuel canopy and four new fuel pumps
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The existing building will essentially remain the same, however the rest of the property and additional property to the north will be improved to include the new fuel canopy and pumps,
underground stormwater vault SCM, and other elements depicted on the attached plans. Fill and retaining walls will be used to level the project site. Heavy equipment and other civil
construction equipment will be used.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
S&EC delineated all potentially jurisdictional wetlands and waters on the site & submitted a JD
request to the USACE.
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
The USACE assigned # SAW-2023-00616 to the attached JD Request, but have not yet verified the
JD.
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Kevin Murphrey
Agency/Consultant Company: Soil & Environmental Consultants, PA
Other: City of Durham Stream Buffer Exemption COD Jordan #2023-015
(attached)
6. Future Project Plans
O Unknown
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 other permits or impacts are anticipated.
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
W1
2a1 Reason (?)
Fill
2b. Impact type * (?)
P
2c. Type of W. *
Head water Forest
2d. W. name
W1
2e. Forested* ��2f.
Yes
Type of Jurisdicition *
?)
Both
2g• Impact
area *
0.058
(acres)
ff77771
nstruction Access
T
Headwater Forest
W1
Yes
Both
0.006
acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.006 0.058
2g. Total Wetland Impact
0.064

2i. Comments:
Per the attached impact maps, the project requests permanent impacts to 0.0572 acres (rounded up to 0.058 acres in the PCN table) and 0.0055 acres
(rounded up to 0.006 acres in the PCN table) for temporary construction access to build the retaining wall. A wetlands bypass pipe is proposed to
provided hydrologic connection between the remaining 0.0199 acres of remaining wetlands and downstream waters.
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:
The applicant hired S&EC to delineate all potentially jurisdictional wetlands on the property and designed the project to minimize impacts by proposing a
retaining wall.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The project will obtain a construction permit from the City of Durham which will include erosion control measures such as silt fencing during construction
and a stormwater management plan to include the proposed underground stormwater vaults to help protect downstream waters into the future from
stormwater runoff from the project.
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 proposed impacts are well below the typical 0.1 acres of permanent wetland loss mitigation threshold and as such no mitigation is proposed for the project.
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:
The project obtained a Jordan stream buffer determination from the City of Durham which found that there are no streams or other waters subject to riparian buffers.
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 program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Durham
Comments:
The project will obtain a stormwater management plan from the City of Durham to include the proposed underground stormwater vaults.
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 2B .0200)? *
Yes No
a
Q
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 is an infill / redevelopment project within an already developed and urbanized area and as such is not anticipated to result in additional
development which could impact nearby downstream water quality.
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.
Wastewater from the site will be sent to the City of Durham sanitary sewer system (as it does currently). The City will ensure that any potential increase
in capacity is available the plant.
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?
USFWS IPAC & NC NHP; see attached T&E Report & self -certification biological determinations which has been submitted to the USFWS.
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 EFH Mapper - The project is located within the piedmont of NC far from any NOAA EFH areas.
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?
SHPO HPO-WEB; The project does not border any historic structures and will not impact any potentially historic structures (50 yrs or older).
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 DFIRM
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
Cornwallis Gas Station (Global SUQ)_PCN Attachments_22June2023.pdf 14.83MB
File must be PDF or KMZ
Comments
Attachments include: Agent Authorization Form, Pre -filing Meeting Request, USGS, Soil Survey, JD Request, CoD Stream Determination, Impact Maps, T&E Report, and SHPO Screen
Shot.
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:
S&EC, PA - Bob Zarzecki
Signature
Date
6/22/2023