20150696 Ver 1_401 Application_20150715

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Form Version 1.3 Dec 10 2008
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
®Section 404 Permit El Section 10 Permit
Corps:
.1U Specify Nationwide Permit_(NWP) number: 13 & 27 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corpse ❑ Yes ® No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ 401 For'the record only for Corps Permit:
because written approval is not required? Certification:
❑ Yes ® No T Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation ❑ Yes
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
2. Project Information
2a.
Name of project:
Lambert Project
2b.
County:,
Watauga
26,,
Nearest - municipality, down;
Boone
2d
Su,bdivision`name:
N/A
2e.
NCDOT only, T.I.P. or state
N/A
project no:
3.
Owner Information
34
_Name(sj -on Recor_de'd Deed:
Dennis Keith Lambert and wife Willie Bauc
3b.
Deed Book and Page No.
Deed Book 1473, page 247
3c.
Responsible Party (for, U.0 if
applicable);
Dennis Keith Lambert
3d.
Street address:;
3609 Meat Camp Road
3e.
City, state, zip:
Boone NC 28607
3f.
Telephone no.:
252- 241 -2613
3g
Fax no.:
N/A
3h.
Email_ address;
shinvardearthworks(a amail.com
❑ Yes
►/
/1
►.1 •
�F 1101
Page 1 of 11
PCN Form —Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a.
Applicant_is,
El Agent - , ®.,Other, specify:
4b.
Name:
Chelsea Blount
,4c.
Business, name'
New River Conservancy
_(if applicable):
4d.
Street address:
1 North Jefferson Street
4e.
City,'state,nzip;
West Jefferson NC 28694
4f.
Telephone no.,"
336- 846 -6267
4g.
Fax no..
336- 846 -6433
4h.
Email address:
chelsea @newriverconservancy.org
5.
,AgentlConsultani,lnfo-rmation (if app,ljcatile)
5a.
Name:
Glen Sullivan
5b.
Business name
Foggy Mountain Nursery
(if applicable):
5c.
Street address:
2251 Ed Little Road
5d.
City, state, zip:
5e
Telephone no.:
5f.
Fax no.:
5g.
Email address:
Creston NC 28615
336- 384 -5323
336- 384 -3764
foggymtn @skybest.com
Page 2 of 11

B. Project Information and Prior Project History,
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID)
1b. Site-coordinates (in decimal_degreps):
1 c. Property size:;
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
pro posed,project.
2b Water Quality Classification of nearest receiving water:
2c. River'basin: map is available at
http: / /h2o.enr.state.nc :us /ad-min /maps%
3. Project Description
2904 -81- 0742 -000
Latitude - _ Longitude:
(36:3082)
2.768�acrep
Meat Camp Creek
C;Tr:+
New
3a Describe the,existing conditions on the site and the general land_use in the vicinity of the project at the time of this
- t- - --
application:
The project site is located in a rural farm area, on Meat Camp Road (1340), The project site is located 3.45 miles from the
intersection of NC 194 and Meat Camp Road and is located just down stream from intersection of Proffit Road (1384) and
Meat Camp Road (1340). Sediment deposits in the center of the stream has directed the thalwag to the bank. The bank is
severely eroded due to the pressure of the water and the lack of vegetation.
3b. List the total estimated acreage of all existing wetlands on the property:
0
36. List the total estimated linear feet of al( existing streams (intermittent and perennial) on the property_:
.-- -
186 feet,of Meat Camp,Creek and 333 feet of'an UN Trib on,the west,of the property,
3d. Explain the purpose, of. the, proposed.project;
To repair and stabilize eroding banks of Meat Camp Creek by reestablishing proper bank profiles through bank reshaping
and with two in- stream structures, to improve water quality. To improve habitat for aquatic fauna and to improve the
overall condition of the riparian areas at the site
3e. Describe.the_overall proje -6fin detail,Jincluding the type of equipment to-be- used:
Eroding banks will be reshaped to approximately 2.1 or less, and planted with native vegetation. One (1) rock cross vane
and (1) rock vane will be constructed to divert the thalwag back to the center of the stream. During construction a track
hoe will do the work from the bank, although the track hoe may have to access the stream to construct the end of the rock
vanes After construction the bank will be seeded with native grass seed and sloped bank will be covered with erosion
control matting and anchored with live stakes and landscape staples. Flat areas will be seeded and mulched with straw.
All areas will be planted with live stakes (Silky Willow, Salix Sencea) (Silky Dogwood, Cornus amomum) (Elderberry,
Sambucus canadensis) along with native rhododendron mtn laurel and river birch.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps.or State been:''r'equested or obtained for this,property /
ro ect mcludin all phases) in the past?,
El Yes'- ®No Unknown
Comments:
4b. If,the, Corps made the. jurisdictional ,determination,,what_type Prelimiria Final
of�determinationiwas made ?, E] rY ��
4c. If yes, who delineated the_ jurisdictional areas? Agency /Consultant Company:
Name (if known): Other:
4d. If yes,- list the,dates "of fhe Corps jurisdictional determinations:or' ateTdeterminations'andw attach documentation;
Page 3of11
PCN Form — Version 1.3 December 10, 2008 Version

5. Projpct Hisioryi
5a. Have permits cxuertifcnUnnabeonrequeob*dnrobtainadhr
this pnojkt/induding all prior phases) indhepgst?
5b. 1fy�a. oxp|ainjndetai|:a'cpprdinito.1?e|pji|e,ino1rucUons.
_ ne
8b. U' yes, explain.,
Page 4 of 11
No '

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which,sectionswere completedI below -for your project_(check all that apply):
❑ Wetlands ® Streams - tributaries` ❑ Buffers
❑ ,Open,Waters ❑ Pond °Co,nstructon
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete_tliis question for each wetland area impacted:
2a: 26.` 2c: 2d: 2e., 2f,
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ — non -404, other) (acres)
Temporary'(T)
W1 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
fir , ..6U�..._ �..
If there are, perennial or intermittent stream "i n' pacts .(including - temporary's impacts)
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W6 ❑ P ❑ T
❑ Yes _
❑ Corps
3c.
❑ No
❑ DWQ
3f.
3g.
2g. Total wetlarid­impacts 0
2h. Comments:
3; Stream Impacts
fir , ..6U�..._ �..
If there are, perennial or intermittent stream "i n' pacts .(including - temporary's impacts)
proposed on,the site, then,complete this
question for -all stream sites impacted.
3a. '3b:
3c.
3d.
3e.,
3f.
3g.
Stream impact Type,, :of,impact
Stream name,
Perennial
Type of jurisdiction
Average
Impact
number -,
(PER) or',
(Corps- =404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404;
width
(linear
Temporary_ (T)
(INT)7
other)
(feet)`
feet)
S1 ®P ❑ T Stabilization
Meat Camp Creek
® PER
❑ INT
® Corps
❑ DWQ
10
100
S2 ® P ❑ T Rock Cross Vane
Meat Camp Creek
® PER
❑ INT
® Corps
❑ DWQ
10
10
S3 ®P ❑ T Rock Vane
Meat Camp Creek
® PER
❑ INT
® Corps
❑ DWQ
10
10
❑ PER
❑ Corps
S4 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S5 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S6 ❑ P ❑ T
❑ INT
❑ DWQ
3i. Comments:
Page 5 of 11
3h. Total stream and tributary impacts, 120

4: TQpen_ Water Impacts`
If there are proposed impacts to lakes,"ponds, estuaries, tributaries, sourids;.the Atlantic Ocean, or any other open'uvater of
the U S. then individually_ list all open water
impacts below.
4a. 4b.
4c 4d. 4e
Open water Name of waterbody
impact number — (if applicable)
Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary (T)
i
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f. Total open water impacts
4g. Comments:
I
5. Pond or Laki Co _ struction
If pond, or, lake construction proposed, then complete the chart below.
5a. 5b.
5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose
(acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
I
P1
P2
5f. Total
b
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes No If yes, permit ID no: 1
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k Method of construction:
1
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑Tar- Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b. 6c 6d.
6e. 6f. 6g.
Buffer impact
number — Reason
Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary (T) impact
required?
F-1 Yes 1
61 ❑P ❑T
❑ No
F-1 Yes 1
B2 ❑P ❑T
❑ No
F-1 Yes 1
B3 ❑P ❑T
❑ No
6h. Total buffer impacts 0 1
6i. Comments:
j
Page 6 of 11

D.- Impaci"`Justification and Mitigation
1. Avoidance and'Minimization
1a. Specific, y_describe measures taken to avoid or minimize the proposed impacts in designing project:p
This project will stabilize 120 If of eroding stream bank, reduce stream bank erosion, reduce in- stream sediment loads
and improve in- stream aquatic habitats. Stream aesthetics will be improved with the establishment of a well vegetated
and functioning riparian zone
b. Specifically describe measure-s_taken to avoid, or minimize the proposed impacts through construction techniques:
During construction, equipment will only access the stream when absolutely necessary. For this project, it is anticipated
that most of the track hoe work can be accomplished from the top of the bank. However, equipment may need access the
stream during the construction when no other construction alternative exists. Soil disturbance will be limited to what can
seeded and stabilized in one day. Banks will seeded and coir matting will be placed and anchored with wooden stakes.
Flat areas will be seeded and covered with straw.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. -Does the project require Compensatory Mitigation for
impactswto,Waters,.of.the,U.S. or Waters of ,,the State?
2b If yes, mitigation is required by (check all that apply)
2c If yes, which mitigation_ o will be used for this
project?
3. Complete if Using a Mitigation Bank
3a Name of Mitigation Bank:
3b Credits Purchased (attach receipt and letter)
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached,
4b Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
4d. Buffer mitigation requested (DWQ only):
4e. Riparian wetland mitigation requested:
4f. Non - riparian wetland mitigation requested -
4g. Coastal (tidal) wetland mitigation requested:
4h. Comments:
❑ Yes Z No
❑ DWQ ❑ Corps
❑ Mitigation bank
❑ Payment to in -lieu fee program'
❑r''PefmitteO Responsible' Mitigation
Type
Quantity
❑ Yes
linear feet
❑ warm ❑ cool
square feet
acres
acres
acres
❑cold
Page 7 of 11
PCN Form — Version 1 3 December 10, 2008 Version

5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires n Yes ® No
buffer mitigation? If ves, you will have to fill out this entire form — please
contact the State for more information.
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8 of 11

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ❑ Yes
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑Yes
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
2b. Does this project require a Stormwater Management Plan? ❑ Yes
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
No.
❑ No
//
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan-
F-1 Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally - implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes
❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply)-
❑ Session Law 2006 -246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes
❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes
❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes
❑ No
Page 9 of 11
PCN Form —Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the ® Yes ❑ No
use of public (federal /state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA /SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ Yes ® No
Comments:
2. Violations (DWQ Requirement)
2a Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)? .
2b. Is this an after-the-fact _permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ❑ Yes ® No
additional development, which could impact nearby downstream water quality? ,
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or ® Yes
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ❑ Yes
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Raleigh
❑ Asheville
❑ No
® No
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
US Fish and Wildlife Service website: http,// www .fws.gov /nc- es /es /countyfr.html
6. Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat? I ❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http- // ocean. floridamarine .org /efh_coraI /ims /viewer htm
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Register of Historic Places athttp : / /www.hpo.ncdcr.gov /nrlist htm
8. Flood-Zone Designation, (Corps Requirement)
8a. Will this project occur in a FEMA - designated 100 -year floodplain?
8b. If yes, explain how project meets FEMA requirements:.
8c. What source(s)_did you use to make the,floodplain determination?
❑ Yes
Glen Sullivan - �A�plican A;.,
Applicant/Agent's Printed Name _ Agent's Signature,
(Agent's signature is valid only if an, authorization letter from, the applicant
is.�ro'vided.)
Pagel 1 of 11
►1
July 13, 2015
Date

07/08/2015 11:37 FAX [phone] CCBS SIGN SHOP
w
1, esignate Glen Sullivan of Foggy Mountain
Nursery to act as my duly authorized agent concerning all US Army Corps of
Engineers and NC DENR permitting regarding the stream bank restoration project
on my property inW@� u�lounty, NC.
Name
C� C-�
Address
�310 —R& (
Phone number Fax number
ma i l address
1
Signature ``�-J Date

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1k 1335 k
194
1336
HOUSE
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324 35
0y.
00 NOTE
120 feet of re-sloped
bank will be planted
II CL with livestakes and
V:0 native plants.
SHOP
y
SHOP -'0
CROSS VANE
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V
ROCK VA\NE'
0+60
x No
ti y
91V .
50 0 50 100
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Rock Vane
Cross Rock Vane
mote All work areas are approximate
F41:1-L 0MI.
LAMBERT PROJEA
F"W WmUlln
=I a um F" aaro� = 36"m

FIGURE 5. Typical bank reshaping and revegetation plan.
Cross - section view before work (existing condition)
- Pasture grasses, little valve for bank
4 stabilization or stream shading.
1�L1
INX Vertical bank showing area to be
��� reshaped.
Cross - section view after work
Y R
i1tr� w . • � .
' J : .. %
Rooted trees, 2' to 6' tall
Herbaceous vegetation.
Live stakes 18" to 24" in length.
Erosion control blanket 4
- 8 ft wide, anchored with
wooden stakes /live stakes.
Water level
1
INX Vertical bank showing area to be
��� reshaped.
Cross - section view after work
Y R
i1tr� w . • � .
' J : .. %
Rooted trees, 2' to 6' tall
Herbaceous vegetation.
Live stakes 18" to 24" in length.
Erosion control blanket 4
- 8 ft wide, anchored with
wooden stakes /live stakes.
Water level
1

FIGURE 6. Typical rock vane structure showing plan and cross - section views. Photograph
shows a rock vane constructed in the South Fork New River at the Wagoner Road Access, New
River State Park.
PLAN VIEW
le
CROSS - SECTION VIEW
nkfull elevation
�: (Pi -
Footer rocks
Top rocks
Bankfull bench
2

FIGURE 15. Typical cross -vane showing plan and cross - section views. NOTE: There should be
no gaps between the rocks in the cross -vane.

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:Western Peidmont Region Coordinator 3855 Idlewild Road Kernerville
NC 27284 -9180
C. PROJECT LOCATION AND BACKGROUND INFORMATION:
State:NC County /parish /borough: Watauga City: Boone
Center coordinates of site (lat/long in degree decimal format): Lat. 36.3082° N, Long. - 81.6875° W.
Universal Transverse Mercator:
Name of nearest waterbody: Meat Camp Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: New River
Name of watershed or Hydrologic Unit Code (HUC):
El Check if map /diagram of review area and /or potential jurisdictional areas is /are available upon request.
R Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date:
Field Determination. Date(s): June 22nd 2015
SECTION I1: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Ace o ,navigable waters ofthe U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Q Waters subject to the ebb and flow of the tide.
F-1 Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B..CWA SECTION 404 DETERMINATION OF JURISDICTION.
There A�4 "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CPR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
E TNWs, including territorial seas
[] Wetlands adjacent to TNWs
Relatively permanent waters (RPWs) that flow directly or indirectly into TNWs
M Non -RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Eg Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
R Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
Q Impoundments of jurisdictional waters
Q Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non - wetland waters: 120 linear feet: 10 width (fl) and /or 0.03 acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Establkhedu6yy %Q WM
Elevation of established OHWM (if known):
2. Non - regulated waters /wetlands (check if applicable) :3
Potentially jurisdictional waters and /or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below
Z For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year -round or has continuous flow at least "seasonally"
(e g , typically 3 months).
' Supporting documentation is presented in Section 111 F.

SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.I and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW: Meat Camp Creek.
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent':
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Raponos have been met.
The agencies will assert jurisdiction over non - navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year -round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year -round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4. ,
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.0 below.
1. Characteristics of non -TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 1943 acrei
Drainage area: 1943 tae►e
Average annual rainfall: 50 inches
Average annual snowfall: 30 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
® Tributary flows directly into TNW.
❑ Tributary flows through 'Wfist tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick tist river miles from RPW.
.j „_ xF. szR
Project waters are F'ick,L►st aerial (straight) miles from TNW.
nm
Project waters are Pickhist aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West
5 Flow route can be described by identifying, e g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(b) General Tributary Characteristics (check all that avvlv):
Tributary is: ® Natural
❑ Artificial (man- made). Explain:
❑ Manipulated (man - altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 10 feet
Average depth: .5 feet
Average side slopes: `'eta „rtleal'(tla or I ess).
Primary tributary substrate composition (check all that apply):
® Silts ® Sands ❑ Concrete
® Cobbles ® Gravel ❑ Muck
® Bedrock ® Vegetation. Type /% cover:
❑ Other. Explain:
Tributary condition /stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run /riffle /pool complexes. Explain:
Tributary geometry: iVieandering
Tributary gradient (approximate average slope): 4 %
(c) Flow:
Tributary provides for: P ei st
Estimate average number of flow events in review area/year: Pick Dist
Describe flow regime:
Other information on duration and volume:
Surface flow is: D,screterandconfned. Characteristics:
Subsurface flow: Unknown. Explain findings:
❑ Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
❑ OHWM6 (check all indicators that apply):
❑ clear, natural line impressed on the bank
®
the presence of litter and debris
® changes in the character of soil
®
destruction of terrestrial vegetation
❑ shelving
❑
the presence of wrack line
® vegetation matted down, bent, or absent
®
sediment sorting
® leaf litter disturbed or washed away
®
scour
® sediment deposition
❑
multiple observed or predicted flow events
® water staining
®
abrupt change in plant community
❑ other (list):
❑ Discontinuous OHWM.7 Explain:
If factors other than the OHWM were used to determ
® High Tide Line indicated by: ED
❑ oil or scum line along shore objects
❑ tine shell or debris deposits (foreshore)
❑ physical markings /characteristics
❑ tidal gauges
❑ other (list):
ine lateral extent of CWA jurisdiction (check all that apply):
Mean High Water Mark indicated by:
❑ survey to available datum;
❑ physical markings;
❑ vegetation lines /changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film-, water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
6A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e g , where the stream temporarily flows underground, or where
the OI-IWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e g , flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid

(iv) Biological Characteristics. Channel supports (check all that apply):
❑ Riparian corridor. Characteristics (type, average width):
❑ Wetland fringe. Characteristics:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish /spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatic /wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non -TNW:
:^r - ;.<
Flow is: P�ckList. Explain:
Surface flow is: P c T&4
Characteristics:
Subsurface flow: Pick List. Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Ad_iacencv Determination with Non -TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ Separated by berm /barrier. Explain:
(d) Proximitv (Relationship) to TNW
-i
Project wetlands are Pick<Lisf river miles from TNW.
Pi
Project waters are ck List aerial (straight) miles from TNW.
Flow is from: fiic' ke TV
Estimate approximate location of wetland as within the PickLst floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average width):
❑ Vegetation type /percent cover. Explain:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish /spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatic /wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any,)
All wetland(s) being considered in the cumulative analysis: POT,
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and /or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section IILD:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
F TNWs: linear feet width (ft), Or, acres.
,. Wetlands adjacent to TNWs: 0 acres.
2. RPWs that flow directly or indirectly into TNWs.
Z Tributaries of TNWs where tributaries typically flow year -round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
❑ Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section II1.13. Provide rationale indicating that tributary flows
seasonally:

Provide estimates forjurisdictional waters in the review area (check all that apply):
® Tributary waters: 120 linear feet 10 width (ft).
Q Other non - wetland waters: acres.
Identify type(s) of waters:
3. Non -RPWs8 that flow directly or indirectly into TNWs.
Q Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Q Tributary waters: linear feet width (ft).
0_ Other non - wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
R Wetlands directly abutting an RPW where tributaries typically flow year- round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
® Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates forjurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
® Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs.
M Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TN W are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates forjurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Q Demonstrate that water meets the criteria for one of the categories presented above (1 -6), or
Q Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA- STATES WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):'o
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
® from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
Q which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
To complete the analysis refer to the key in Section II[LD 6 of the Instructional Guidebook
Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps /EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.

Provide estimates for jurisdictional waters in the review area (check all that apply):
® Tributary waters: linear feet width (ft).
Q Other non - wetland waters: acres.
Identify type(s) of waters:
® Wetlands: acres.
F. NON - JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
€U If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and /or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Q Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
"] Other: (explain, if not covered above):
Provide acreage estimates for non - jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non - wetland waters (i.e., rivers, streams): linear feet width (ft).
RE Lakes /ponds: acres.
® Other non - wetland waters: acres. List type of aquatic resource:
D Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required forjurisdiction (check all that apply):
Non - wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes /ponds: acres.
i Other non - wetland waters: acres. List type of aquatic resource:
0 Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for ,JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
0 Maps, plans, plots or plat submitted by or on behalf of the applicant /consultant:
® Data sheets prepared /submitted by or on behalf of the applicant /consultant.
❑ Office concurs with data sheets /delineation report.
❑ Office does not concur with data sheets /delineation report.
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:
0 USDA Natural Resources Conservation Service Soil Survey. Citation:
R National wetlands inventory map(s). Cite name:
Fal State /Local wetland inventory map(s):
R FEMA/FIRM maps:
® 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
® Photographs: ❑ Aerial (Name & Date):
or ❑ Other (Name & Date):
Previous determination(s). File no. and date of response letter:
El Applicable /supporting case law:
B Applicable /supporting scientific literature:
® Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD: