20231200 Ver 1_Final Package_401 WQC_Line 4 Exposure, RockinghamNC_20230825

corblu
ECOLOGY GROUP
August 25, 2023
NC DWR, 401 & Buffer Permitting Branch
512 North Salisbury Street
Raleigh, NC 27604
Subject: Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company Maintenance
Rockingham County, North Carolina
Line 4 Exposure
Corblu Project No. 02-041901-786
To Whom It May Concern:
On behalf of our client, Colonial Pipeline Company (CPC), Corblu Ecology Group, LLC (Corblu) is pleased
to submit this Section 401 water quality Pre -Construction Notification (PCN) for preventative maintenance
on Line 4, needed to restore required pipeline protective cover within an unnamed perennial stream in
CPC's right-of-way (ROW). The pipeline exposure is located within CPC's existing and maintained ROW
southeast of the Pecan Road and West Harrison Street intersection in Rockingham County, North
Carolina (36.358547,-79.694905; Figure 1; Appendix A).
Based on our evaluation of the subject site and proposed maintenance design, we believe that
disturbances to waters of the U.S. associated with this maintenance activity are authorized by the U.S.
Army Corps of Engineers (USACE) under Nationwide Permit (NWP) No. 3 (a) and (c) — Maintenance.
This NWP does not require notification to the USACE prior to initiation of the work as the maintenance
activities result in less than 0.02-acre of perennial stream loss (i.e., 0.0044-acre); however, disturbance
to the perennial streambed exceeds 40 linear feet (LF), which requires 401 Water Quality Certification
from the North Carolina Department of Environmental Quality (DEQ) prior to the initiation of the proposed
work.
Background
Corblu inspected the above referenced exposure maintenance location for the presence of jurisdictional
waters of the U.S. on July 5, 2023. Jurisdictional features (one unnamed perennial stream) were observed
id

Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company — Line 4 Exposure
August 25, 2023
Corblu Project No. 02-041901-786
within the project area (Photograph Nos. 1-3; Figure 2). No additional features were observed, and the
remainder of the project area is comprised of uplands (Photograph Nos. 4-5).
Recent significant precipitation events have resulted in bed and bank erosion in the unnamed perennial
stream within CPC's ROW, exposing Line 4. The lack of required pipeline protection at this location has
resulted in conditions that have left Line 4 vulnerable to potential damage. Further, these conditions are
not consistent with CPC's or the U.S. Department of Transportation's (USDOT) regulatory requirements
for pipeline protection.
CPC is committed to operating their pipelines and support facilities in a manner that protects the safety
of the public, the environment, and its workforce. The proposed preventative pipeline maintenance is a
component of CPC's ongoing Integrity Management Program (IMP) as required by the USDOT [49 CFR
Part 195 — "Pipeline Safety: Pipeline Integrity in High Consequence Areas (Hazardous Liquid Operators
with 500 or More Miles of Pipeline); Final Rule."] The IMP provides an important means of achieving spill -
free, error -free operations. The purpose of the IMP is to improve/maintain the integrity of CPC's system
— including CPC's pipelines, facilities, equipment, tanks, and delivery lines.
CPC's IMP and the referenced USDOT regulations include prescriptive requirements for inspection of
pipeline systems and requires excavation and repair of certain pipeline defects according to specific
schedules and regulatory guidelines. It should be noted that USDOT has completed an Environmental
Assessment (EA) under the National Environmental Policy Act (NEPA) concerning repairs that an
operator would have to make to its pipeline following an integrity assessment. The EA and corresponding
Finding of No Significant Impact concluded that these actions would not significantly affect the quality of
the human environment (Docket No. RSPA-00-6355).
In accordance with 49 CFR § 195.401 and CPC's IMP, CPC must take prompt action to address
anomalous conditions, to include pipeline exposures and shallow cover areas that are discovered through
the integrity assessment process. CPC must, in maintaining its pipeline systems, ensure that repairs are
made in a safe and timely manner and are conducted in a way to prevent damage to persons, property,
and the environment. Additionally, CPC's IMP follows USDOT's requirements with respect to addressing
possible unsafe conditions; specifically, the USDOT - Pipeline and Hazardous Materials Safety
Administration's (PHMSA) Interpretation Response No. PI-84-0103 which explains with respect to the
regulatory provisions of 49 CFR Part 192, Subpart M and Part 195, Subpart F, whenever an operator
discovers any condition that could adversely affect the safe operation of its pipeline system, the operator
must correct the condition within a reasonable time.
2

Section 401 Water Quality Pre -Construction Notification August 25, 2023
Colonial Pipeline Company — Line 4 Exposure Corblu Project No. 02-041901-786
Proposed Activities in Jurisdictional Waters
The maintenance location will be accessed through CPC's existing, mowed, and maintained ROW from
West Harrison Street (Figure 3). Temporary prefabricated mats will be used to cross the unnamed
perennial stream, if necessary, within CPC's ROW to access the maintenance location and operate
equipment (Figure 3; Appendix B). CPC intends to inspect Line 4 and replace the required minimal
protective cover over the pipeline using Submar revetment mats and riprap to remediate the perennial
streambed/bank erosion associated with the pipeline exposure (Appendix A). To re-establish the required
pipeline protective cover, CPC intends to conduct the following: 1) excavate Line 4; 2) inspect and make
repairs to Line 4, as necessary; 3) grade the site for mat installation; 4) install the pre -cast revetment
mats and riprap above and below the mats, which will be "keyed" into the perennial streambed/banks in
a manner that will re-establish pre -erosional contours and elevations of the streambed, providing the
required pipeline cover and maintain existing flow conditions; and 5) re -seed with native seed mix and
straw the surrounding disturbed area (Appendix A).
To minimize sedimentation to the unnamed perennial stream during the above -mentioned maintenance
activity, dams constructed of sandbags, steel plates, or water -inflatable plastic dams (i.e., no earthen
dams) will be temporarily placed from top -of -bank to top -of -bank upstream of the maintenance area to
conduct maintenance activities "in -the -dry". The stream flow will be pumped around the maintenance
area, discharging immediately downstream via an energy dissipater to prevent stream scour. The
pump(s) used will be sufficiently sized to accommodate the anticipated stream flow (Appendix C). The
excavated ordered soils will be temporarily stored on geotextile (or similar) material in the adjacent
wetland area within CPC's ROW.
Riprap placed on an erosion control blanket (geotextile fabric) will be employed to stabilize the revetment
mats in a manner where the finished top elevation of the riprap does not exceed that of the streambed
elevation. Once the required minimal protective pipeline cover (pre -cast revetment mats) is keyed into
the perennial streambed/banks in a manner that maintains existing grade and low and normal flow
conditions of the stream, the temporary dams will be removed and normal streamflow will be restored
(Appendix A).
CPC's standard erosion control practices will be employed (Appendix D). Specifically, as stated above
the disturbed areas along the perennial stream banks will be reseeded with native seed mix and straw to
stabilize the recently disturbed soils.
3

Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company — Line 4 Exposure
August 25, 2023
Corblu Project No. 02-041901-786
The proposed maintenance activity includes work within the unnamed perennial stream. Specifically, the
above -described maintenance activity will require unavoidable impacts to approximately 90 linear feet
(LF; 0.0067-acre) of unnamed perennial stream [approximately 55 LF (0.0044-acre) of permanent
impacts (riprap and revetment mats) and 35 LF (0.0023-acre) of temporary workspace] within CPC's
existing and maintained ROW (Appendix A). Corblu respectfully requests 401 Water Quality Certification
for the required maintenance activities and the aforementioned, unavoidable minimal perennial stream
impacts. The appropriate figures and photographs are enclosed for your review.
401 & Buffer Permitting PCN Submittal Checklist
We have provided the following information to document compliance with the requirements outlined in
the PCN Submittal Checklist (Appendix E). Each item is discussed below.
Application Fee
A $240.00 payment for a 401 Water Quality Certification with minor impacts will be made electronically
once the project has been assigned a project number.
Pre -filing Meeting Request
A pre -filing meeting request was submitted to 401 [e-mail] on July 25, 2023. A copy of the
request is attached to the USACE Wilmington District PCN Form.
PCN Application
A complete copy of the USACE Wilmington District PCN Form and supporting documentation have been
included with this submittal (Appendix F).
Stormwater Management Plan
Not Applicable - This is a maintenance activity for an existing petroleum pipeline and does not involve the
construction of any roads or structures and is exempt from the Jordan Lake Water Supply Watershed
Buffer Rule as a "present and ongoing use" [North Carolina Administrative Code 15A NCAC 02B
.0267(6)].
If your project is located within a State implemented Riparian Buffer Rule Area, submit the following along
with site plans and PCN form: Details for on -site diffuse/dispersed flow provisions
Not Applicable — The maintenance project is located within the Roanoke River Basin which does not have
a state riparian buffer protection program.
DWR Stream Determination Forms for streams on property and DWR determination letter for wetlands
or streams (if applicable)
Not Applicable — The referenced forms are for buffer determinations. The proposed required maintenance
activity is not within a riparian buffer rule area.
11

Section 401 Water Quality Pre -Construction Notification August 25, 2023
Colonial Pipeline Company — Line 4 Exposure Corblu Project No. 02-041901-786
Maps and Plans
• The most recent version of the 1:24,000 USGS Topographic Map:
See Figure 1.
• The most recent version of the bound and published County NRCS Soil Survey Map - (required
for projects within the Neuse River Basin, Tar -Pamlico River Basin, Randleman Lake Watershed
and the Catawba River Basin, also recommended for all projects):
See Figures 4A and 4B.
• Vicinity map:
See Figure 3.
• The Site Plan:
See Appendix A.
• Pre-construction/Pre-existing conditions:
See Appendix A.
• Proposed conditions:
See Appendix A.
• Drainage Plans:
Not Applicable.
• Proposed Impacts:
See Appendix A.
• Wetland Impacts:
See Appendix A.
• Stream Impacts:
See Appendix A.
Summary and Conclusion
In summary, the above -described pipeline maintenance activity will result in unavoidable permanent
impacts to approximately 55 LF (0.0044-acre) of unnamed perennial stream as authorized under the
USACE NWP No. 3(a) and (c). The project was designed to avoid and minimize stream impacts to the
5

Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company — Line 4 Exposure
August 25, 2023
Corblu Project No. 02-041901-786
maximum extent practicable and represents the least environmentally damaging, practicable alternative
that satisfies the project purpose for preventative pipeline maintenance and protection.
Based on this submittal, we respectfully request written authorization of Section 401 Water Quality
Certification. If you have any questions or comments regarding this PCN submittal, please contact the
undersigned at [phone].
Sincerely,
CORBLU ECOLOGY GROUP, LLC
Mackenzie S. Wallace, CAE
Project Ecologist
Richard W. Whiteside, PhD, CWB, CSE
President
Enclosures: Figure 1 — Site Location
Figure 2 — Jurisdictional Features and Photo Locations
Figure 3 — Vicinity and Access Map
Figure 4A— USDA NRCS Soils Map
Figure 4B — USDA Web Soil Survey Map
Photographs (5)
Appendix A: Submar Design Plans
Appendix B: Typical Prefabricated Mat Crossing for Streams
Appendix C: Typical Dam and Pump Maintenance Dig
Appendix D: CPC Soil Erosion and Sediment Control Plan
Appendix E: 401 & Buffer Permitting PCN Submittal Checklist
Appendix F: USACE Wilmington District PCN Form, with Attachments A - F
c: Mr. David Foust, CPC Project Manager, via email
Mr. John Wyatt, CPC Environmental Lead-SED, via email
Mr. David Reedy, CPC Environmental Specialist, via email
AJ

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ECOLOGY GRO JP
Project No. 02-041901-786

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Rockingham County, North Carolina ECOLOGY GROUP Project No. 02-041901-786

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ECOLOGY GROUP
Project No. 02-041901-786

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Section 401 Water Quality Pre -Construction Notification Photos taken on 7/5/2023
Colonial Pipeline Company— Line 4 Exposure, Rockingham County, NC Corblu Project No. 02-041901-786
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Photograph • North facingview•the unnamed perennial streamflowing • 1 into
ROW at the Line 4 exposure location.

Section 401 Water Quality Pre -Construction Notification Photos taken on 7/5/2023
Colonial Pipeline Company— Line 4 Exposure, Rockingham County, NC Corblu Project No. 02-041901-786
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Photograph • North facing view of unnamed perennial • • off of
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Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company— Line 4 Exposure, Rockingham County, NC
Photos taken on 7/5/2023
Corblu Project No. 02-041901-786
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Photograph No. 5: Representative view of upland soils in the access route to the Line 4
exposure maintenance location within CPC's ROW.

APPENDIX A
SUBMAR DESIGN PLANS

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APPENDIX B
TYPICAL PREFABRICATED MAT CROSSING FOR STREAMS

50'PERMANENTROW
° °
1 z z
,7 o .'° ,° o 0
0
°
1 w w
1
' '
o o
o o
PREFABRICATED , D
MAT
v o ,D v o
1 v o , v o ,D v
Q 0 ;, °
Q Q0,
I RETAIN A MINIMUM 10' , ;, Q ;, Q
•� ND Q 1,
I VEGETATIVE BUFFER
I
�..
TO EXTENT POSSIBLE ° 7 ° o 7
o o
� o � o
REAM
° 7 v v '%D v
1 CE�TERC/NE .+......
,11
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1 MAT
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I
TOP OF WATER BANK
I
ORDINARY HIGH
o
WATER MARK
20 10 0 20 Feet
Typical
Colonial Pipeline Company
Stream Crossing Typical
corblu
Prefabricated Mat
ECOLOGY GROUP
Stream Crossing

APPENDIX C
TYPICAL DAM AND PUMP MAINTENANCE DIG

PUMP
SUMP W/INTAKE HOSE
FILTER/SCREEN OR
SUBMERSIBLE PUMP
- WATERBODY -
SPOIL CONTAINMENT BERM
(SILT FENCE, HAY BALES
OR OTHER APPLICABLE
MATERIALS)
� All
SPOIL
II
II
- ;III III
I I I I
,II II
FILTER BAG
V/ TROW ENGINEERING CONSULTANTS INC.
T - MEOi0P0uiPN BLYO., $OIM 2W rHLN1ASSEE, R., OSP 323M
Trout PHONE: (-5 385_5441
REVISION DATE
CALE DATE DRAWN APPROVED
NTS 01-29-2004
RETAIN A MIN. 25'
VEGETATIVE BUFFER TO
THE EXTENT POSSIBLE
ENERGY DISSIPATOR/
SCOUR PROTECTION
1.7\IT, I
FLOW
MAINTAIN A MINIMUM 25' I
VEGETATIVE BUFFER TO
THE EXTENT POSSIBLE
FOR STREAM EQUIPMENT
CROSSINGS, SEE NOTE 14
SEE SHEET 2 FOR NOTES
COLONIAL PIPELINE COMPANY
ATUWA, GEORGIA
TYPICAL DAM AND PUMP
MAINTENANCE DIG
AT WATERBODY LESS THAN 15'
TROW PROJ. NO.1 DRAWING SHEET
THES0050362 COL-0003 1 OF 2

DAM AND PUMP CROSSING
THE FOLLOWING IS A SEQUENCE OF CONSTRUCTION AND MITIGATION
MEASURES TO BE FOLLOWED AT ALL "DAM AND PUMP" TYPE CROSSINGS.
SEQUENCE OF ACTIVITIES
STEP 1. IMPLEMENT THE TEMPORARY EROSION AND SEDIMENT CONTROLS.
STEP 2. INSTALL DRY STREAM CROSSING MATERIALS.
STEP 3. EXCAVATE TRENCH AND INSPECT OR REPLACE PIPE.
STEP 4. BACKFILL AND RESTORE STREAM BANKS.
STEP 5. REMOVE DAMS.
STEP 6. IMPLEMENT PERMANENT EROSION AND SEDIMENTATION CONTROLS.
I►[01:4
I • SCHEDULE INSTREAM ACTIVITY FOR LOW FLOW PERIODS AND
FOR THE APPROPRIATE TIMING WINDOW.
2. MARK OUT AND MAINTAIN LIMITS OF AUTHORIZED WORK
AREAS WITH FENCING OR FLAGGING TAPE TO AVOID
UNNECESSARY DISTURBANCE OF VEGETATION. ENSURE
EQUIPMENT OPERATORS WORKING ON THE CROSSING HAVE
BEEN BRIEFED ABOUT THIS PLAN AND THE MEASURES
NEEDED TO PROTECT WATER QUALITY. INSTALL PRE —WORK
SEDIMENT CONTROL MEASURES AS SPECIFIED IN THE PLAN.
ALL NECESSARY EQUIPMENT AND MATERIALS TO BUILD THE
DAMS AND TO PUMP WATER MUST BE ON SITE OR READILY
AVAILABLE PRIOR TO COMMENCING IN —WATER CONSTRUCTION.
3. CONTRACTOR SHALL SUPPLY, INSTALL AND MAINTAIN SEDIMENT
CONTROL STRUCTURES, AS DEPICTED AND ALONG DOWN GRADIENT
SIDES OF WORK AREAS AND STAGING AREAS SUCH THAT NO
HEAVILY SILT LADEN WATER ENTERS WATERBODY.
a. NO HEAVILY SILT LADEN WATER SHALL BE DISCHARGED DIRECTLY
OR INDIRECTLY INTO THE WATERBODY.
b. EROSION AND SEDIMENT CONTROL STRUCTURE LOCATIONS AS
DEPICTED ARE APPROXIMATE AND MAY BE ADJUSTED AS DIRECTED
BY THE COMPANY INSPECTOR TO ACTUAL SITE CONDITIONS.
c. SILT FENCE OR HAY BALE INSTALLATIONS SHALL INCLUDE
REMOVABLE SECTIONS TO FACILITATE ACCESS DURING
CONSTRUCTION. UTILIZE HAY BALE BARRIERS ONLY IN LIEU
OF A SILT FENCE WHERE FREQUENT ACCESS IS REQUIRED.
d. SEDIMENT LADEN WATER FROM TRENCH DEWATERING SHALL BE
DISCHARGED TO A WELL VEGETATED UPLAND AREA, INTO A HAY
BALE DEWATERING STRUCTURE OR GEOTEXTILE FILTER BAG.
e. SEDIMENT CONTROL STRUCTURES MUST BE IN PLACE AT ALL
TIMES ACROSS THE DISTURBED PORTIONS OF THE RIGHT—OF—WAY
EXCEPT DURING EXCAVATION/INSTALLATION OF THE CROSSING PIPE.
4. TO THE EXTENT POSSIBLE, MAINTAIN A MINIMUM 25 FEET
VEGETATIVE BUFFER STRIP BETWEEN DISTURBED AREAS AND THE
WATERBODY. INSTALL AND MAINTAIN A SILT FENCE UPSLOPE
OF THE BUFFER STRIP ON EACH SIDE OF THE WATERBODY.
THE SILT FENCE SHOULD INCORPORATE REMOVABLE "GATES" AS
REQUIRED TO ALLOW ACCESS WHILE MAINTAINING EASE OF
REPLACEMENT FOR OVERNIGHT OR DURING PERIODS OF RAINFALL.
5. CONSTRUCT A TEMPORARY SUMP UPSTREAM OF THE DAM AND
LINE WITH ROCKFILL IF A NATURAL POOL DOES NOT EXIST.
INSTALL THE PUMP OR PUMP INTAKE IN THE POOL OR SUMP.
DISCHARGE WATER ONTO AN ENERGY DISSIPATOR DOWNSTREAM
OF THE WORK AREA.
6• EXCAVATED MATERIAL MUST NOT BE STOCKPILED WITHIN 10 FT.
OF THE WATERBODY. THIS MATERIAL MUST BE CONTAINED
WITHIN BERM CONTAINMENT, WITH SECONDARY SILT FENCE
PROTECTION TO PREVENT SATURATED SOIL FROM FLOWING
BACK INTO THE WATERBODY.
7. CHEMICALS, FUELS, LUBRICATING OILS SHALL NOT BE STORED
AND NOR SHALL EQUIPMENT BE REFUELED WITHIN 100 FT. OF THE
WATERBODY. PUMPS ARE TO BE REFUELED AS PER THE SPCC PLANS.
MAINTENANCE OF STREAMFLOW
IF THERE IS ANY FLOW IN THE WATERBODY, INSTALL
PUMPS TO MAINTAIN STREAMFLOW AROUND THE ISOLATED
SECTIONS OF CHANNEL. THE PUMP IS TO HAVE 1.5
TO 2 TIMES THE PUMPING CAPACITY OF ANTICIPATED FLOW.
A SECOND STANDBY PUMP OF EQUAL CAPACITY IS TO BE
READILY AVAILABLE AT ALL TIMES. AN ENERGY DISSIPATOR
IS TO BE BUILT TO ACCEPT PUMP DISCHARGE WITHOUT
STREAMBED OR STREAMBANK EROSION. IF THE WORK
IS PROLONGED BEYOND ONE DAY THE AREA NEEDS
TO BE MONITORED OVERNIGHT.
8. IF A REPLACEMENT, PIPE MAKE—UP AREAS ARE TO BE
LOCATED AT LEAST 50 FT. FROM THE WATER'S EDGE
(WHERE TOPOGRAPHIC CONDITIONS PERMIT) AND SHALL
BE THE MINIMUM AREA NEEDED.
9. DAMS ARE TO BE MADE OF STEEL PLATE, INFLATABLE PLASTIC
DAM, SAND BAGS, COBBLES, WELL GRADED COARSE GRAVEL FILL,
OR ROCK FILL. DAMS MAY NEED KEYING INTO THE BANKS AND
STREAMBED. ENSURE THAT THE DAM AND VEHICLE CROSSING (IF
NEEDED ARE LOCATED FAR ENOUGH APART TO ALLOW FOR A WIDE
EXCAVATION. CAP FLUMES USED UNDER VEHICLE CROSSING
DURING DRY CROSSING.
10. DEWATER AREA BETWEEN DAMS IF POSSIBLE. DEWATERING
SHOULD OCCUR IN A STABLE VEGETATIVE AREA A MINIMUM OF
50 FT. FROM ANY WATERBODY. THE PUMP DISCHARGE SHOULD
BE DISCHARGED ONTO A STABLE SPILL PAD, FILTER BAG OR
HAY BALE STRUCTURE TO PREVENT LOCALIZED EROSION.
THE DISCHARGE WATER SHOULD ALSO BE FORCED INTO SHEET
FLOW IMMEDIATELY BEYOND THE SPILL PAD BY USING HAY BALES
AND THE NATURAL TOPOGRAPHY. DISCHARGED WATER SHALL NOT
BE ALLOWED TO FLOW INTO ANY WATERBODY OR WETLAND. IF IT
IS NOT POSSIBLE TO DEWATER THE EXCAVATION DUE TO SOILS
WITH A HIGH HYDRAULIC CONDUCTIVITY, THE EXCAVATION IS TO BE
CARRIED OUT IN THE STANDING WATER. PUMP ANY DISPLACED WATER
AS DESCRIBED ABOVE TO PREVENT OVERTOPPING OF DAMS.
11. INSPECT/REPAIR PIPELINE AS NEEDED.
12. CONTRACTOR SHALL RESTORE THE STREAM BED AND BANKS TO
APPROXIMATE PRE —CONSTRUCTION CONTOURS, BUT NOT TO
EXCEED 2:1 SLOPE.
a. CONTRACTOR SHALL INSTALL PERMANENT EROSION AND
SEDIMENT CONTROL STRUCTURES AS INDICATED ON A SITE
SPECIFIC BASIS. IN THE ABSENCE OF SITE SPECIFIC INFOR—
MATION, A FLEXIBLE CHANNEL LINER SUCH AS NAG C125 OR
C350 WHICH IS CAPABLE OF WITHSTANDING ANTICIPATED FLOW
SHALL BE INSTALLED. ALTERNATIVELY, ROCK RIP —RAP SHALL
BE INSTALLED.
b. ANY MATERIALS PLACED IN THE STREAM TO FACILITATE
CONSTRUCTION SHALL BE REMOVED DURING RESTORATION.
BANKS SHALL BE STABILIZED AND TEMPORARY SEDIMENT
BARRIERS INSTALLED AS SOON AS POSSIBLE AFTER IN —STREAM
WORK BUT WITHIN 24 HOURS OF COMPLETING IN —STREAM WORK.
c. MAINTAIN A SILT FENCE OR HAY BALE BARRIER ALONG
THE WATERBODY UNTIL VEGETATION IS ESTABLISHED IN
ADJACENT DISTURBED AREAS.
13. WHEN THE STREAMBED HAS BEEN RESTORED, THE CREEK BANKS
ARE TO BE CONTOURED TO A STABLE ANGLE AND PROTECTED
WITH EROSION RESISTANT MATERIAL COMPATIBLE WITH FLOW
VELOCITY BETWEEN DAMS (E.G., EROSION CONTROL BLANKETS,
CRIBBING, ROCK RIP —RAP, ETC.). THE DAMS ARE TO BE REMOVED
DOWNSTREAM FIRST. KEEP PUMP RUNNING UNTIL NORMAL FLOW
IS RESUMED. COMPLETE BANK TRIMMING AND EROSION PROTECTION.
IF SANDBAGS ARE USED FOR THE DAMS, PLACE AND REMOVE BY
HAND TO AVOID EQUIPMENT BREAKING BAGS.
14. TEMPORARY EQUIPMENT CROSSING CAN BE CONSTRUCTED USING EITHER
A FLUME CROSSING OR A TEMPORARY BRIDGE. FOR BRIDGE CROSSING
DETAILS, REFER TO THE TYPICAL RAILCAR BRIDGE CROSSING OR
TYPICAL MAT CROSSING DRAWINGS.
IMO ENGINEERING CONSULTANTS INC. COLONIAL PIPELINE COMPANY
1300 MEfROP011iPN BLYa.P ONE: (850) ]85-5441 "ASSEE, R., IISP ]f308
M
ATLANTA, GEORGIA
TYPICAL DAM AND PUMP
MAINTENANCE DIG
REVISION °�'0°` ,� R. AT WATERBODY LESS THAN 15'
CALF I DATE DRAWN APPROVED TROW PROJ. NO.1 DRAWING SHEET
NTS 1 01-29-2004 ALS I — I I THES0050362 I COL-0003a 2 OF 2

APPENDIX D
CPC SOIL EROSION AND SEDIMENT CONTROL PLAN

Colonial Pipeline Company
Soil Erosion and Sediment Control Plan
For
Pipeline Maintenance Activities
Objective
Disturbed areas are to be restored as close as practical to their original contours and
conditions so that once vegetation is reestablished, erosion will be reduced to the same
or lower level that existed prior to disturbance.
Description
This section defines the soil erosion and sediment control measures that Colonial
Pipeline Company will implement during and after inspection and repairs of the pipeline
are complete. The objectives of this plan are to establish general guidelines for
controlling erosion and sedimentation and to specify criteria for sensitive orparticularly
susceptible soil areas. The plan incorporates measures to control erosion and
sedimentation, including minimizing cover removal, limiting the time of exposure,
limiting the flow of water onto the disturbed right-of-way, and filtering or settling out
sediment from water flowing from the right-of-way.
The primary objective of the soil erosion and sediment control plan is to reduce the area
and duration of soil disturbance and reestablish permanent vegetation as soon after
construction as possible, thereby minimizing long-term erosion and sedimentation.
Some erosion is inevitable during construction; however, the plan includes measures to
reduce erosion to the minimum practical.
Colonial Pipeline Company plans to reduce soil erosion and provide sediment control
during the repair of the pipeline at the project site by incorporating the following
measures:
• Water pumped from the construction area as part of the dewatering operation
from the excavation will be filtered through silt filtration bags and discharged to
a well -vegetated area.
• All work will be confined within the existing right-of-way. Staked hay bales and silt
fence will be installed around the worksite and maintained until vegetation is established.
Proper controls will be added ifnecessary during construction.
• All terms and conditions within Nationwide Permit 3 will be followed.
• Erosion control measures will be installed prior to conducting any soil disturbing
activities associated with the pipeline maintenance activity.
• Clearing of vegetation will be kept to an absolute minimum and confined to the
existing pipeline easement area. The easement area is 50 feet in width and devoid

oflarge trees. The right of way is vegetated with undergrowth grasses and other
short vegetation.
• Vegetation will be reestablished within disturbed areas and along stream banks
as soon as possible upon completion of work. Disturbed areas will be seeded
with a wetland seed mixture
• All erosion and sediment control measures will be inspected every two weeks at a
minimum and after every significant rainfall event of 0.5 inch or more until
disturbed areas have been stabilized. Identified damages to control measures
must be repaired immediately.
Refuse and Waste Disposal
Colonial's representative will not allow the Contractor to discard any litter, including
paper, bottles, cans, rags, sacks, welding rod stubs, fuel, crankcase draining, coating
materials, equipment, and junk pipe in the ditch or along the right-of-way. All refuse
must be collected and disposed in accordance with company specifications. Personnel
will be instructed regarding the correct procedure for waste disposal.
Maintenance/Inspection Procedures
The following inspection and maintenance practices will be implemented to maintain
erosion andsediment controls:
i. All control measures will be inspected every two weeks at a minimum and following
any storm event of 0.5 inch or greater.
2. All control measures will be maintained in good working order. If a repair is
necessary, it will be initiated within 24 hours of the report.
3. Built-up sediment will be removed from silt fences when it has reached one-third the
height ofthe fence.
4. Silt fences will be inspected for depth of sediment, tears, secure attachment ofthe
fabric to the fence posts, and firm placement of the fence posts in the ground.
5. Temporary and permanent seeding and planting will be inspected for bare spots,
washouts, and healthy growth.
6. Colonial Pipeline Company will select individuals to be responsible for inspections,
maintenance and repair activities, and completion of the inspection and
maintenance report. Personnel selected for inspection and maintenance
responsibilities will receive training from Colonial Pipeline Company or its
representative. Personnel must be trained in all practices necessary for maintaining
the erosion and sediment controls used on -site.

APPENDIX E
401 & BUFFER PERMITTING PCN SUBMITTAL CHECKLIST

Version 4.3
Updated April 20, 2022
401 & Buffer Permitting PCN Submittal Checklist
The application fee (Checks may be made out to "N.C. Division of Water Resources"
- $240.00 for 401 Water Quality Certification with minor impacts
- $570.00 for 401 Water Quality Certification with major impacts
- Express Review Fee (Amount requested on Acceptance Letter)
El Pre -filing meeting request documentation or receipt demonstrating that at least 30 days
prior to submitting a certification request, a pre -filing meeting was requested with the
certifying agency.
El One complete copy of the PCN Application and supporting documentation (no larger than
11 X 17 plans if submitting paper copies)
N/A Stormwater Management Plan (if applicable — see PCN Form Help File Section F)
1) Please provide the stormwater management plan along with all supporting information
pertaining to this project including the following:
a. Entire site development/layout plans delineating all drainage areas;
b. Design calculation sheets for all proposed SCM(s) sized for both on -site and
off -site drainage;
c. Application form SWU-101, the $505 application fee and last two signature
pages may be omitted;
d. Supplemental form for each proposed SCM and Required Items Check List
(https://deg.nc.gov/about/divisions/energv-mineral-and-land-
resources/stormwater/stormwater-program/stormwater-design) along with all
required items;
e. A Notarized Operation & Maintenance Agreement for each proposed SCM ;
f. Detailed construction drawing sheets shall include
(i) Erosion and sediment control plans;
(ii) Installation and planting schedules for the proposed SCMs;
(iii) Appropriately scaled plan views and cross sectional details of all
SCMs and associated components — inlet and outlet structures,
forebay, respective zones and pertinent elevations;
(iv) Collection system routing stormwater to the proposed SCMs;
(v) Any energy dissipator and vegetated area (if provided);
(vi) Maintenance access/easement for the proposed SCMs.
N/A If your project is located within a State implemented Riparian Buffer Rule Area, submit the
following along with site plans and PCN form:
1) Details for on -site diffuse/dispersed flow provisions, (refer to
https://deg.nc.gov/about/divisions/energv-mineral-and-land-
resources/stormwater/stormwater-program/stormwater-design).
N/A DWR Stream Determination Forms for streams on property and DWR determination
letter for wetlands or streams (if applicable).
The following is the most critical of all the information that you must provide. The quality and
detail of the information will often determine the expeditiousness of the review. The following is
a checklist of the types of pertinent information required at a minimum:

Version 4.3
Updated April 20, 2022
Maps and Plans:
The most recent version of the 1:24,000 USGS Topographic Map - Please cleanly draw or
delineate the site boundaries on the topographic map.
El The most recent version of the bound and published County NRCS Soil Survey Map -
(required for projects within the Neuse River Basin, Tar -Pamlico River Basin, Randleman
Lake Watershed and the Catawba River Basin, also recommended for all projects) - Please
clearly delineate the site boundaries, etc. on the map. If the delineation obscures any of the
features, it is recommended that a clean copy be provided. Copies of the current soil survey
and/or soil survey map sheets can be obtained from the local NRCS County Office
(http://www.nc.nres.usda.gov/). GIS soil layers are not acceptable.
El Vicinity map - Please clearly mark the location and approximate boundaries of the property
and project on the map. Please indicate north arrow and scale. Please include applicable road
names or State Road numbers.
El The Site Plan - The most critical map to be provided is the site plan. The following is the
minimum list of plans that are typically needed.
El Pre-construction/Pre-existing conditions - This sheet (or sheets) must include:
• All jurisdictional and non -jurisdictional wetland, stream, water features, State regulated
buffers (delineated into Zones 1 and 2)
• Topographic contours with elevations
• Any existing structures and impervious areas
• Existing utility lines and easements
• Existing roads, culverts, and other pertinent features
• North arrow and the scale (1":50' scale is recommended).
Proposed conditions - This sheet (or sheets) must include:
• All jurisdictional and non -jurisdictional wetland, stream, water features, State regulated
buffers (delineated into Zones 1 and 2)
• Lot layout (if a subdivision or commercial development is proposed) - lots must be
developable without further impacts to jurisdictional and non -jurisdictional wetlands,
streams, water features, and State regulated buffers. Building envelopes must be provided
when streams, wetlands, riparian buffers, or water features exist on a lot
• All built -out structures and impervious cover
• Final grading contours with elevations
• All utilities and easements (including septic fields on all lots within 100 feet of stream,
wetland, or water features - if applicable)
• Impacted areas — these should correspond with the Impact numbers listed on your PCN
form.
N/A Drainage Plans - Final drainage plans must include the following:
• Locations and pertinent elevations and sizes of the stormwater collection system and
drainage ways
• All inlets and outlets must also be shown with pertinent elevations (All outlets to wetlands
must be at a non -erosive velocity, generally less than 2 ft/sec during the peak flow from
the 10-yr storm)
• Scaled stormwater BMPs must also be indicated as required by DWR rules and policies

Version 4.3
Updated April 20, 2022
• In certain cases (see Section F of PCN form), final stormwater management plan must
also be provided (see Stormwater Management Plan Checklist)
Proposed Impacts - All impacts to jurisdictional and non -jurisdictional wetland, stream, water
features, and State regulated buffers must be shown and labeled on the site plans at a scale
no smaller than 1" = 50'. All excavation, fill, flooding, stabilization, and other impacts that will
be conducted in or near jurisdictional and non -jurisdictional wetland, stream, water features,
and State regulated buffers must be indicated. Please provide cross sectional details showing
the provisions for aquatic life passage (burial of culvert 20% for culverts <_ 48 inches, and 1-
foot for culverts > 48 inches).
Wetland Impacts:
10 Precise grading and final elevation contours must be provided. Existing vegetation
and any clearing must be specified.
N/A All subsurface utility lines must indicate the location of anti -seep collars.
Construction detail for anti -seep collars must be provided.
N/A Roadway or other crossings of riparian wetlands may require floodway culverts to
maintain existing hydrological conditions.
N/A Plans should show that the hydrology of remaining wetlands on the site will be
maintained.
Stream Impacts:
0 Stream impacts must be clearly shown on the plans. The centerline as well as the
banks of the stream must be surveyed or located by GPS for the portion of the
stream to be impacted.
N/A The inlet and the outlet of all culverts should be aligned with the stream as much
as possible. Inlet and outlet elevations and streambed elevations should be
indicated. Any inlet or outlet protection must be shown and enumerated on the
impact map(s).
N/A For bottomless culverts or other spans, a vertical cross section should be
provided that shows the minimum distance from each span to each stream bank,
the stream cross section, the height of the span above the stream and the
minimum distance from the edge of each footer to each stream bank.
Additionally, please provide a signed and sealed geotechnical report of
subsurface soils at the proposed bottomless culvert location. The report must
comply with the Division of Highways — Guidelines for Drainage Studies and
Hydraulic Design, prepared by A.L. Hankins, Jr., State Hydraulics Engineer -
1999.

Version 4.3
Updated April 20, 2022
N/A Multiple culverts or sectioned box culverts typically require the use of sills, off-
setting or other means to match the cross section of the existing stream (in order
to maintain stream stability and provide aquatic life passage). A vertical cross
section of the culverts should be shown overlain with the up and downstream
stream cross section including the stream flood -prone area.
N/A Impacts associated with dam construction must indicate and enumerate all fill
associated with the dam footprint, spillway and any bank stream bank stabilization.
The length of stream impounded must also be indicated and enumerated.

APPENDIX F
USACE WILMINGTON DISTRICT PCN FORM, WITH ATTACHMENTS A - F

NORTH CARCLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action I D no. [Click to enter.] Date received: [Click to enter.]
DWR project no. Dlick enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 36.358547
Longitude (DD.DDDDDD): 79.694905
Form Version 4.3, April 20, 2022
Pre -Construction Notification (PCN) Form
(Ver. 4.2, January 31, 2022))
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
httos://edocs.dea. nc.aov/WaterResources/DocView.asox?dbid=0&id=2196924&cr=1
Please ensure you have submitted a pre -filing meeting request at least 30 days prior to submitting this
form, as DWR will not be able to accept your application without documentation of this important first step.
The Division has developed a Pre -filing Meeting Request email address 401 PreFile(a)ncdenr.gov to accept
the federally required pre -filing meeting request and provide confirmation receipt of submittal . This receipt
or similar documentation will satisfy 40 C.F.R. Section 121.4(a) which states "At least 30 days prior to
submitting a certification request, the project proponent shall request a pre -filing meeting with the certifying
agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all certification requests must
include documentation that a pre -filing meeting request was submitted to the certifying authority at least 30
days prior to submitting the certification request.
Attach documentation of Pre -Filing Meeting Request to this Application.
Date of Pre -filing Meeting Request (MM/DD/YYYY) : 7/25/2023
Page 1 of 22 PCN Form Version 4.3- April 20, 2022

A. Processing Information
County (counties) where project is located: *
Rockingham Additional (if needed).
Is this an ARPA project? *
❑ Yes ❑x No
If yes, ARPA project number:
* The project number can be found on the "Letter of Intent to Fund'
(LOIF) or "Offer and Acceptance Letter". If you are unable to locate
Click or tap here to enter text.
your DWI ARPA Funding Project Number, please contact Corey
Basinger at core y.basingera(Mcdenr.gov for further assistance.
Is this a NCDMS project? *
(Click yes only if NCDMS is the applicant or co-
❑ Yes ❑x No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes ❑x No
or airport project)
Is this a NCDOT project? *
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number: *
Click to enter.
❑ Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
1 a. Type(s) of approval sought from the Corps: *
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted? *
❑ Yes ❑x No
Please provide the date of the previous submission. *
Click to enter a date.
❑ Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
❑ Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps? *
❑ Yes ❑x No
NWP number(s) (list all numbers ):
Click to enter.
RGP number(s) (list all numbers ):
Click to enter.
Are you a federal applicant?
❑ Yes ❑x No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text.
1 d. Type(s) of approval sought from DWR (check all that apply):
❑x 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes ❑x No
Page 2 of 22 PCN Form Version 4.3- April 20, 2022

1 e.
Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: *
❑ Yes
❑x No
For the record only for Corps Permit: *
® Yes
❑ No
1f.
Is this an after -the -fact permit/certification application? *
❑ Yes
❑x No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
❑ Yes
❑x No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties? *
❑ Yes
❑x No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)? *
❑ Yes
❑x No ❑ Unknown
1j.
Is the project located in a designated trout watershed? *
❑ Yes
❑x No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 22 PCN Form Version 4.3- April 20, 2022

B. Applicant Information
1 a.
Who is the primary contact?
David Foust
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner ❑x Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
See Attached Easements
2b.
Deed Book and Page No.:
click to ent�
2c.
Contact Person (for corporations):
Click to enter.
2d.
Address
Street Address:
Click to ente,
Address line 2:
Click to enter.
City:
Click to enter.
State/ Province/ Region:
Click to enter.
Postal/ Zip Code:
Click to enter.
Country:
Click to enter.
2e.
Telephone Number: (###)###-####
Click to enter.
2f.
Fax Number: (###)###-####
Click to enter.
2g.
Email Address:
Click to enter.
3.
Applicant Information (if different from owner)
3a.
Name:
David Foust
3b.
Business Name (if applicable):
Colonial Pipeline Company (CPC)
3c.
Address:
Street Address:
411 Gallimore Dairy Road
Address line 2:
Click to entE
City:
Greensboro
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27409
Country
USA
3d.
Telephone Number: (###)###-####
[phone]
3e
Fax Number: (###)###-####
Click to entr
3f.
Email Address:
[e-mail]
Page 4 of 22 PCN Form Version 4.3- April 20, 2022

4. Agent/ Consultant (if applicable)
4a. Name:
Mackenzie Wallace
4b. Business Name:
Corblu Ecology Group, LLC
4c. Address:
Street Address:
3225 S. Cherokee Lane
Address line 2:
Bldg. 800
City:
Woodstock
State/ Province/ Region:
Georgia
Postal/ Zip Code:
30188
Country:
USA
4d. Telephone Number: (###)###-####
[phone]
4e Fax Number: (###)###-####
Click to entc
4f. Email Address:
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw.usace.army. mil/Missions/Reg ulatory- Perm it-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 22 PCN Form Version 4.3- April 20, 2022

C. Project Information and Prior Project History
1. Project Information
1 a. Name of project: *
Line 4 Exposure
1 b. Subdivision name (if appropriate):
Click to enter.
1 c. Nearest municipality/town: *
Reidsville
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
144870 and 143108
2b.
Property size (in acres):
Click to enter
2c.
Project Address:
Street Address:
Click to enter.
Address line 2:
Click to enter.
City:
slick to enter.
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
27320
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): * 36.358547
Longitude (-DD.DDDDDD): *-79.694905
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
Unnamed Tributary to Wolf Island Creek
3b. Water Resources Classification of nearest receiving
C
water: *
The Surface Water Classification map may be found at this link:
https:Hncdenr.maps.arcqis.com/apps/webappviewer/index.html?id=6e125ad7628f494694e259c80dd64265
Roanoke
3c. In what river basin(s) is your project located? *
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030101030904
located: *
The Find Your HUC map may be found at this link:
https:Hncdenr.maps.arcgis.com/apps/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cd069db238ac3
Page 6 of 22 PCN Form Version 4.3- April 20, 2022

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 is comprised of CPC's existing mowed and maintained petroleum pipeline right-of-way (ROW).
Significant precipitation events have created increased stream flows resulting in bed and bank erosion in the
unnamed perennial stream within CPC's ROW, exposing Line 4. The lack of required pipeline protection at this
location resulted in conditions that have left Line 4 vulnerable to potential damage.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes ❑x No ❑ Unknown
project (including all prior phases) in the past? *
If yes, please give the DWR Certification number and/or Corps
[Click to enter.]
Action ID (ex. SAW-0000-00000):
jClick to enter.]
Attach any pertinent project history documentation
4b2. Is any portion of the work already complete? *
❑ Yes ❑x No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
Click to enter text.
4d. Attach an 8'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
0 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
90 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
Click to enter. acres
property:
4h. Explain the purpose of the proposed project:
Significant precipitation events have created increased stream flows, resulting in bed and bank erosion in the
unnamed perennial stream within CPC's ROW, exposing Line 4. The lack of required pipeline protection at this
location resulted in conditions that have left Line 4 vulnerable to potential damage. Further, these conditions are
not consistence with CPC's or the U.S. Department of Transportation's (USDOT) regulatory requirements for
pipeline protection. CPC proposes to replace the protective pipeline cover over Line 4 using Submar revetment
mats and rip rap. These actions serve to protect the existing pipeline and prevent a future exposure from
occurring within the unnamed perennial stream.
Page 7 of 22 PCN Form Version 4.3- April 20, 2022

4i. Describe the overall project in detail, including the type of equipment to be used: *
The maintenance location will be accessed through CPC's existing, mowed, and maintained ROW from West
Harrison Street (Figure 3). Temporary prefabricated mats will be used to cross the unnamed perennial stream
within CPC's ROW to access the maintenance location if necessary, and operate equipment (Figure 3; Appendix
B). CPC intends to inspect Line 4 and replace the required minimal protective cover over the pipeline using
Submar revetment mats and riprap to remediate the perennial streambed/bank erosion associated with the
pipeline exposure (Appendix A). To re-establish the required pipeline protective cover, CPC intends to conduct
the following: 1) excavate Line 4; 2) inspect and make repairs to Line 4, as necessary; 3) grade the site for mat
installation; 4) install the pre -cast revetment mats and riprap above and below the mats, which will be "keyed"
into the perennial streambed/banks in a manner that will re-establish pre -erosional contours and elevations of the
streambed, providing the required pipeline cover and maintain existing flow conditions; and 5) re -seed with native
seed mix and straw the surrounding disturbed area (Appendix A).
To minimize sedimentation to the unnamed perennial stream during the above -mentioned maintenance activity,
dams constructed of sandbags, steel plates, or water -inflatable plastic dams (i.e., no earthen dams) will be
temporarily placed from top -of -bank to top -of -bank upstream of the maintenance area to conduct maintenance
activities "in -the -dry". The stream flow will be pumped around the maintenance area, discharging immediately
downstream via an energy dissipater to prevent stream scour. The pump(s) used will be sufficiently sized to
accommodate the anticipated stream flow (Appendix C). The excavated ordered soils will be temporarily stored
on geotextile (or similar) material in the adjacent wetland area within CPC's ROW.
Riprap placed on an erosion control blanket (geotextile fabric) will be employed to stabilize the revetment mats in
a manner where the finished top elevation of the riprap does not exceed that of the streambed elevation. Once
the required minimal protective pipeline cover (pre -cast revetment mats) is keyed into the perennial
streambed/banks in a manner that maintains existing grade and low and normal flow conditions of the stream,
the temporary dams will be removed and normal streamflow will be restored (Appendix A).
CPC's standard erosion control practices will be employed (Appendix D). Specifically, as stated above the
disturbed areas along the perennial stream banks will be reseeded with native seed mix and straw to stabilize the
recently disturbed soils.
The proposed maintenance activity includes work within the unnamed perennial stream. Specifically, the above -
described maintenance activity will require unavoidable impacts to approximately 90 LF (0.0067-acre) of
unnamed perennial stream [approximately 55 LF (0.0044-acre) of permanent impacts (riprap and revetment
mats) and 35 LF (0.0023-acre) of temporary workspace] within CPC's existing and maintained ROW (Appendix
A).
Equipment will include: an excavator, rock truck (for material transport), properly sized dams and pumps,
temporary access mats (if necessary), and a welding truck (to conduct pipe repairs as necessary).
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters? *
❑ Yes ❑x No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text.
Page 8 of 22 PCN Form Version 4.3- April 20, 2022

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
See Figure 2 for delineation of streams. Temporary prefabricated mats, if necessary, will be used to cross
the unnamed perennial stream within CPC's ROW to access the maintenance location and operate
equipment (Figure 3; Appendix B).
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑ Approved ❑ Emailed concurrence
what type of determination was made?
❑x Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
Click to enter
Name (if known): Mackenzie Wallace
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Corblu Ecology Group, LLC
areas?
Other: Click to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
,lick to enter.
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑x No
6b. If yes, explain.
:lick to enter
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
No other NWP(s), regional general permit(s), or individual permit(s) will be used to authorize any part of the
proposed project or related activity.
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
See attached easements.
8. Scheduling of activity:
Activity will be scheduled in 2023/2024 after approval of this certification.
Page 9 of 22 PCN Form Version 4.3- April 20, 2022

D. Proposed Impacts Inventory
Impacts Summary
❑ Wetlands ❑x Streams - tributaries
1 a. Where are the impacts associated with your project ❑ Buffers ❑ Open Waters
(check all that apply):
❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site #
2a1.
Impact
Reason/Type
2b.
Impact
Duration
2c.
Wetland Type
2d.
Wetland Name
2e.
Forested
?
2f.
Jurisdiction
Type
2g.
Impact Area
(ac)
W1
Choose one
i emp/ Perm
Choose one
Click to enter
Y/I\
;hoose one
W2
Choose one
Temp/ Perm
Choose one
:,lick to enter
Y/N
Choose one
W3
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W4
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose onE
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
2g1. Total temporary wetland impacts
Click to enter. ac
2g2. Total permanent wetland impacts
Click to enter. ac
2g3. Total wetland impacts
Click to enter. ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Click to enter text.
2i. Comments:
Click to enter text.
Page 10 of 22 PCN Form Version 4.3- April 20, 2022

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3a
3b.
3c.
3d.
3e.
3f.
3g.
3h.
Site #*
Impact Reason*
Impact
Impact
Stream Name*
Stream
Jurisdiction
Stream
Impact length
Duration*
Type*
Type*
Type*
Width (avg
(linear ft)
ft)
S1
Protective pipeline
Permanent
Fill (Incl.
Unnamed
Perennial
Both
3
55
covering
Riprap)
perennial
replacement
stream
S2
Grading/workspace
Temporary
Other
Unnamed
Perennial
Both
3
35
perennial
stream
S3
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S4
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S5
Click to enter
Temp/
Choose
Click to ente�
rer/Int
Choose
Click to enter
Click to enter
Perm
one
one
S6
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S7
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S8
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S9
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S10
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S11
Click to enter
Temp/
Choose
Click to erns
rimer/Int
Choose
Click to enter
Click to enter
Perm
one
one
S12
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S13
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S14
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S15
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S16
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S17
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S18
Click to enter
Temp/
Choose
Click to erI«
er/Int
Choose
Click to enter
Click to enter
Perm
one
one
Page 11 of 22 PCN Form Version 4.3- April 20, 2022

S19
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S20
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
3i1.
Total jurisdictional ditch
0 linear ft
impact:
3i2. Total permanent stream
55 linear ft
impacts:
M. Total temporary stream
35 linear ft
impacts:
34. Total stream and ditch
90 linear ft
impacts:
3j.
Comments:
Click to enter.
Page 12 of 22 PCN Form Version 4.3- April 20, 2022

4.
Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other
open water of the U.S., individually list all open water impacts in the table below.
4a.
Site #*
4a1.
Impact Reason
4b.
Impact
Duration*
4c.
Waterbody Name*
4d.
Activity Type*
4e.
Waterbody
Type*
4f.
Impact area
(ac)*
01
dick to ent(
Temp/ Perm
Click to enter.
Choose one
:hoose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
-hoose one
Click to enter.
03
dick to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Click to enter.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table below. (*This
does NOT include offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts (ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
ente
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
ente,
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Clicl
enter.
enter.
enter.
enter.
enter.
enter.
enb
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter.
Page 13 of 22 PCN Form Version 4.3- April 20, 2022

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Click to ente
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
UICK to enter.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 22 PCN Form Version 4.3- April 20, 2022

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
The Submar mat system was designed to minimize disturbance to aquatic resources while restoring the required
protective pipeline cover.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
The area will be temporarily de -watered with a dam and pump, which will allow for the project to take place
without contacting flowing water, thus reducing downstream sedimentation. Installation of the Submar mat
system will be completed in the minimal time necessary so that normal stream flow may continue. Further, the
articulating revetment mats are pre -cast, which eliminates the need to use live concrete.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? ❑ DWR ❑ Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? (check all that apply) ❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity 'ick to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to enter. linear feet
4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.miI/ribits apex/f?p=107:27:2734709611497::NO:RP:P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
Click to enter. acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
4g.
Coastal (tidal) wetland mitigation requested:
Click to enter. acres
Page 15 of 22 PCN Form Version 4.3- April 20, 2022

4h. Comments:
lick to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
,lick to enter
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes ❑x No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑ Yes ❑ No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
Click to enter.
Page 16 of 22 PCN Form Version 4.3- April 20, 2022

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes ❑x No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.,qov/about/divisions/energy-mineral-land-resources/energy-mineral-land-Permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
❑ Yes ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑ Yes ❑ No
To look up low density requirements, click here:
http://reports.oah.state.nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environ mental%20manage ment/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑ Yes ❑ No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑x n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
❑ Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
❑ Phase II ❑ USMP
Local Government Stormwater Programs
❑ NSW ❑ Water Supply
Page 17 of 22 PCN Form Version 4.3- April 20, 2022

Please identify which local government stormwater program you are using.
Click to enter.
State Stormwater Programs * ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Project does not require a stormwater management plan.
Page 18 of 22 PCN Form Version 4.3- April 20, 2022

G. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes ❑x No
funds or the 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 (North Carolina) Environmental
El Yes El No
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
❑ Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
Click to enter.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes ❑x No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
UlICK to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
❑ Yes ❑x No
downstream water quality? *
3b. If you answered "no", provide a short narrative description:
The Submar articulating revetment mat system has been designed to provide the required protective cover over
Line 4 and remain stable in the stream system. Additional repairs to the area are not anticipated. Further, the
proposed maintenance activities will be conducted within an existing and maintained pipeline ROW and the
proposed streambed/bank stabilization is anticipated to minimize erosion, improving downstream water quality.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? * ❑ Yes ❑ No ❑x N/A
Page 19 of 22 PCN Form Version 4.3- April 20, 2022

4b. If yes, 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.
Click to enter.
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? (IPAC weblink: htti3s://www.fws.ciov/ii3ac/ ffws.govl)
❑ Yes ❑x 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 ❑x No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8? *
❑ Yes ❑x No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.? *
❑ Yes ❑x No
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes ❑x No
5g1.
If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
❑ Yes ❑ No
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)? *
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
mechanized pile drivers, etc.? *
❑ Yes ❑x No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdf)
Page 20 of 22 PCN Form Version 4.3- April 20, 2022

5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
The USFWS Information for Planning and Consultation (IPaC) website was used to generate a site specific
official species list. The IPaC Official Species List suggests the following two (2) listed species potentially occur
within the project area:
1. Atlantic pigtoe (Fusconaia masoni). The Atlantic pigtoe (Threatened) occupies mostly medium to large streams
with clean, swift waters and stable gravel or sand substrate. The perennial stream within the project area is a
small tributary (2-3 feet in width) with moderate flows. A moderate silt layer was observed over the stream's
substrate. The perennial stream did not appear to have adequate size, flow -speed, or clean, stable substrates
necessary to support Atlantic pigtoe. No individuals or suitable habitat for Atlantic pigtoe was observed within the
proposed project area.
2. Roanoke logperch (Percina rex). The Roanoke logperch (Endangered) prefers medium -to -large, clear streams
with warm water temperatures, riffle -run structure, and sand, gravel or boulder substrates. As stated above, the
perennial stream within the project area is a small tributary (2-3 feet in width) with a moderate silt layer over its
substrate. Further, adequate riffle -run structure was not observed within the perennial stream through CPC's
ROW. Therefore, no individuals or suitable habitat for Roanoke logperch was observed within the proposed
project area.
In summary, no protected species individuals or their suitable aquatic habitats were observed within the
proposed project area. Based on the evaluation of available habitats within the project area and the proposed
maintenance techniques, we anticipate the proposed maintenance project will have "No effect" on the above -
referenced species. Please see the attached IPaC.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat?
❑ Yes ❑x No
Is there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes ❑x No ❑ Unknown
Explain: Click to entr
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat mapping application
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://,qis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural ❑ Yes ❑x No
preservation status (e.g., National Historic Trust designation or
properties significant in North Carolina history and archaeology)?
Page 21 of 22 PCN Form Version 4.3- April 20, 2022

7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources?
NCHPO and NRHP mapping applications. See attached NCHPO and NRHP Map.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.,qov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes ❑x No
8b. If yes, explain how the project meets FEMA requirements.
ACK io enter.
8c. What source(s) did you use to make the floodplain determination?
FEMA Floodplain National Flood Hazard GIS layer. See attached FEMA Floodplain Map.
H. Miscellaneous
Comments:
See PCN Form Attachments A— F.
Attach pertinent documentation or attachments not previously requested
I. Signature *
❑x By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• 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;
• The project proponent hereby agrees that submission of this PCN form is a "transaction" subject to Chapter
66, Article 40 of the INC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the INC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: Mackenzie Wallace
Signature: * J��,d
Date: 8/25/2023 c�
Page 22 of 22 PCN Form Version 4.3- April 20, 2022

PCN FORM ATTACHMENT A
PRE -FILE MEETING REQUEST

Mackenzie Wallace
From: Mackenzie Wallace
Sent: Tuesday, July 25, 2023 4:25 PM
To: 401 [e-mail]
Cc: Shanna Cahill; [e-mail]
Subject: 401/Buffer Pre -filing Meeting Request
Attachments: Delineation Results_LN4_Expo_Rockingham_NC_RF.pdf
Please fill out the following information:
Project Name: Colonial Pipeline Company Line 4 Exposure
County: Rockingham
Applicant Name: David Foust
Applicant Email: [e-mail]
Agent Name: Mackenzie Wallace (Corblu Ecology Group, LLC)
Agent Email: [e-mail]
**Please note that multiple projects may be submitted within the same email by supplying all the above information for
each project.
***In the event your email is not allowing auto -responses, please save a copy of your sent email for your records and if
necessary use that copy in application/form submittal.

Mackenzie Wallace
From: 401 PreFile <401 [e-mail]>
Sent: Tuesday, July 25, 2023 4:25 PM
To: Mackenzie Wallace
Subject: Automatic reply: [External] 401/Buffer Pre -filing Meeting Request
This email confirms receipt of your pre -filing meeting request. Please retain this email for your records and
submit this documentation as part of your 401 application (PCN Application) as required by federal law. DWR
will not be able to accept your application without this federally required documentation. 401 applications
received without documentation that a pre -filing meeting request was submitted at least 30 days prior will be
returned as incomplete.
Responses to this email are not monitored.
If you need to contact 401/Buffer Permitting Staff, please use the following link(s) to access of staff contact
list(s).
For Non -Transportation Central Staff:
https://link.edgepilot.com/s/02b5a254/OsvYLD7RrkWCMWGS8g5vTw?u=https://deg.nc.gov/about/divisions/
water-resources/water-quality-permitting/401-buffer-permitting/401-buffer-permitting-contacts
For Non -Transportation Regional
Staff: https://link.edgepilot.com/s/9b5la756/bekdyNk3LUmeiAV3JMfWwA?u=https://edocs.deg.nc.gov/Wate
rResources/DocView.aspx?dbid=0%26id=2162034%26cr=1
For all Transportation Projects Including NCDOT Projects:
https://link.edgepilot.com/s/fe928bb6/SgWdBTnyROKKAAmBT-
xCtQ?u=https://deg.nc.gov/about/divisions/water-resources/water-resources-permits/transportation-
permitting/staff-contacts
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized
state official.

PCN FORM ATTACHMENT
AGENT AUTHORIZATION LETTER

John M. Wyatt
Southeast Distric'
Environmental Program Manager
March 20. 2020
US Army Carps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
NC DWR, 401 S Buffer Permiting Branch
1617 Mail Service Center,
Raleigh, NC 27699-1617
Subject: Authorization Letter
To Whom It May Concern:
Colonial Pipeline Company
Tel. [phone]
Colonial Pipeline Company {CPC} gives authorization to Corbiu Ecology Group to serve as our agent
regarding North Carolina Division of Water Quality (DWQ)IIJ_S. Army Corps of Fngineers (USACF) Pre -
Construction Notification (PCN) Application Farms. Should you have any Questions or concerns please
contact me at the letterhead address or telephone number.
Sincerely,
1
Jahn M. Wyatt
Southeast Distrint
Environmental Program Manager
ColonW Pipoirie Company 5251 Hvey 153 Suite C #365 Hixrwn, TN 37343

PCN FORM ATTACHMENT C
EASEMENT AGREEMENT

125
Not Drawn in Rockingham County
LL #13:41
Map #1b0
RIGHT OF WAY EASEMENT
FOR AND IN CONSIDERATION OF One IhIndred Forty Six and No/100 - - - - - - - - - DOLLARS,
the receipt of which is hereby acknowledged G. E. Smith and wife. Evelyn V. Smith; P. D. McMichael
and wife. Lucile P. McMichael
hereinafter referred to as Grantors (whether one or more), do hereby grant and convey unto COLONIAL PIPELINE COMPANY,a
Delaware corporation, its successors and assigns, hereinafter referred to as Grantee, an easement for a pipeline right of way with the
right to construct, maintain, inspect, operate, protect, repair, replace, change the size of, and remove a pipeline for the transportation of
liquids and/or gases on, over, and through the following described lands, of which Grantors warrant they are the owners in fee simple,
situated in Roekingiaul County, State of- North Carolina to -wit:
33.1 Acres, more or legs., described in a Deed from P W. Glidewell Sr., and Claude
S. Scurry. Go=i_ssiowprs to G lL Smith and P D McMichael dated. June 2$. 1954,
recorded in'Ronk 454, Page 145, in the office of the Regigter of Deeds of _
Ronlri ngbom County, North Cflrnl i nA..� wl _
cannier. in Plat Book, 7 Page SO in the office of the Register n-P Damns, of
— R —
together with the right of unimpaired access to said pipeline and the right of ingress and egress on, over, and through the above -described
land for any and all purposes necessary and incident to the exercise by said Grantee of the rights granted hereunder.
The said Grantors shall have the right to use and enjoy the above -described land except as the same may be necessary for the
purposes herein granted to the said Grantee. Grantors agree not to build, create, or construct any obstructions, engineering works, or other
structures over said pipe line nor permit the same to be done by others.
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be done to growing
crops, I timber, fences, buildings, or other structures directly caused by Grantee exercising any rights herein granted.
Any pipe line constructed by Grantee across any portion of the above -described land which is under cultivation shall, at the time
of the construction thereof, be buried to such depth as will not interfere with Grantors' use of said land for normal cultivation required
for the planting and tending of crops; except that Grantee, at its option, may construct its pipe line above the channel of any natural or
man-made stream, ravine, ditch, or other water course.
As a part of the consideration hereinabove set forth, Grantors hereby grant unto said Grantee, its successors and assigns, the right at
any time to construct, operate, and maintain an additional pipeline or pipelines substantially parallel to the first pipeline constructed
by Grantee on Grantors' land, above described and Grantee agrees to pay Grantors the sum of $ 14.6-00 for each additional
pipeline constructed, said payment to be made before construction commences. Said additional pipeline or pipelines shall be subject to
the same rights, privileges, and conditions as set forth in this Right of Way Easement.
It is agreed that any payment hereunder may be made direct to said Grantors, or any one of them, or by depositing such payment to
the credit of said Grantors, or any one of them, in theEank of ReiGsyille 2g&XX of e1C.wvi l:Le. North Carolina
and payment so made shall be deemed and considered as payment to each of said Grantors.
The rights herein granted may be assigned in whole or in part.
The terms, conditions, and provisions of this right of way easement shall extend to and be binding upon the heirs, executors,
administrators, personal representatives, successors, and assigns of the parties hereto.
This Night of Way shall be restricted to 751 in wic.th during construction and
the Right of Way shall be reduced to 50t in width after the pipeline is laid.
IN WITNESS WHEREOF, the Grantors herein have hereunto set their hands and seals this 9 day of January , 1963—.
tIC11MENTARY'
Ff �
n y
r'
GraatorsLucile P. McMichael
8a31l�(�

126
CPC-96
INDIVIDUAL ACKNOWLEDGMENT
STATE OF NORTH CAROLINA 1
COUNTY OF
Rockingham SS
I, ,
I, S. L. Fairchild do hereby certify that G. E. Smith and Wife
Evelync V. Smith; and P. D. McMichael and wife Lucile P. McMichael _
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this, the 9 day of January 19
My term of office expires on the 15th day of
Notary Public • "
February ,19 63 S. L. Fairchild
INDIVIDUAL ACKNOWLEDGMENT
STATE OF NORTH CAROLINA l
COUNTY OF } SS
do hereby certify
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this, the day of - 19.
My term of office expires on the day of
Notary Public
. 19 .
STATE OF NORTH CAROLINA
COUNTY OF
PROOF BY SUBSCRIBING WITNESS
} SS
, state
certify that
personally appeared before me this day, and being duly sworn, state that in his presence
cigne
Witness my hand and official seal, this day of_ 19—.
My term of office expires on the day of
Notary F
19.
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STATE OF NORTH CAROLINA
0 19�; 0
LOC. AND TRACT NO.
803:114
COUNTY OF Rockingham -
SUPPLEMENTAL RIGHT OF WAY AGREEMENT
SUPPLEMENTAL RIGHT OF WAY AGREEMENT, made the � day of A ��� ' , 19 '7 L_, between _ G. E. Smith and
�Jr (Co -executors of the Estate
wife Evelyn V. Smith; P. D. McMichael/and wife Lucil .e P. McMichael�f g D McMip apli S —r
hereinafter called Grantors (whether one or more), aril 7% A4 PIPELINE COMPANY, a Delaware corporation, hereinafter called Grantee;
WITNESSETH
There has heretofore been conveyed to Grantee, by an instrument recorded in Book 596 Page 125 , in the Office of the Register of Deeds of
Rockingham County, North Carolina, a 50 foot wide right of way and easement across land owned by
Grantors, for pipelines for the transportation of liquids and/or gases, upon the terns and conditions contained in said instrument, reference to which is hereby made, and
Grantee has heretofore constructed and installed a single pipeline therein.
In consideration of the sum of SEVEN HUNDRED _Qpllazs ($ 700. 00 )
,,(( an. �. cozhvearce o g ac an o ee tr
paid to Grantors by Grantee, ,tne receipt o w rch is ere ac ovule ged, Grantors ere y grant, azg , se and convey o tan ee, t s successors and assigns an
additional and perpetual Twenty —Five (25)
perpe feet in width running parallel and contiguous to the above -mentioned existing
Fifty (50) foot wide right of way and easement and being on the Easterly
side thereof upon the same terms and conditions as are contained in said instrument referred to above, together with the right to temporarily use a strip of land
Twenty —Five (25) feet in width adjacent to the total right of way of the existing easement and the easement hereby granted upon the
Easterly side and running the full length thereof and such other additional temporary work space as is needed in making
highway, railroad, stream, etc., crossings during construction of the second pipeline.
A tract or parcel of land located in Reidsv lie Township, Rockingham County, North Carolina
containing 33.1 acres, more or less, more particularly described in a deed from P. W.
Glidewell, Sr., and Claude S. Scurry, Commissioners to G. E. Smith and P. D. McMichael
dated June 28, 1954, recorded in Book 454, at Page 145, in the Office of the Register of
Deeds in Rockingham County, State of North Carolina.
P. D. McMichael, Jr. and wife, Lucile P. McMichael, co -executors of the Estate of
P. D. McMichael, Sr., execute this instrument pursuant to powers of sale contained
in the Will of P. D. McMichael, Sr, filed in the office of the Clerk of Superior
Court for Rockingham County.
STATE OF " Real Estate =
OR 4 „ .o
0� _ pLH
NINA Excis1.e Tax =
�G
00
o _ P.B.10720
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be done to growing crops, timber, fences, buildings, or other
structures directly caused by exercising any rights herein granted.
The rights herein granted are divisible and assignable in whole or in part.
The terms, covenants, and provisions of this Agreement shall extend to and be binding upon the heirs, executors, administrators, personal representatives, successors,
and assigns of the parties hereto.
TO HAVE AND TO HOLD said rights and right of way, easement, estate and privileges over, in, through, and to the above -described land unto the said Grantee, its
successors and assigns, forever; and Grantors do hereby bind themselves and their respective heirs, successors, executors, administrators, and assigns to warrant and forever
Aefend all and singular said rights and easements unto said Grantee, its successors and assigns, and against every person whomsoever lawfully claiming or to claim the same
or my part thereof. except as to restrictions and easements of record, if anv.
IN WITNESS WHEREOF, the Grantors herein have hereunto set their hands a
Sigled, seated and
GRANTAsiS &CMiCI1ael,e�r.cSLatetOr
1�
(SEAL)
(Seal)
Seal)
Seal)
NC 3495 (449)
?')a

s.
ACKNOWLEDGEMENT ,to
BY INDIVIDUAL GRANTOR(S) o�
STATE OF NORTH CAROLINA
COUNTY OF
h ----.a Notary Public for said County and State, do hereby certifv that
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
W ITN rSS my hand and, notarial seal, this X day of
Notary Public
;a
-,Iy 6ttrini5sio� expires
l Y
'IAff Ntarial .jrell- ��-�
ptJ1!; ACKNOWLEDGEMENT
BY INDIVIDUAL GRANTOR(S)
STATE OF NORTH CAROLINA
COUNTY OF j
I. aL�, a Notary Public for said County and State, do hereby certify that
Co.Executors P D McMichael Sr Estate
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
W ITN F.SS my hand and notarial seal, this e7�, d day of , 192r -
61
f r
Notary Public
IM"I. Not-W S all =.G
ACKNOWLEDGEMENT
BY SUBSCRIBING WITNESS (ONLY ONE REQUIRED)
STATE OF NORTH AROLINA
COUNTYOF j
1, , a Notary Public for said County and State, do hereby certify that
tYS[=�(7L t personally appeared before me this day. and being sworn. stated that in h,fE presence
signed (acknowledged the execution otl' the foregoing instrument.
' WITNESS my hand and notarial seal the C� Z day of .19
fri jf�.
My r s ion
IA{c lot-rialS it L.., •..�
� VO'�. St-.'i.e pltt tlteaord�„not�
''�
Notary Public
STATE OF NORTH CAROLINA—Rockingham County.
The foregoing certificate of......t�.w....+......k:s;i.a,]��k).�.1d.,...,a....Nca.terry....Public ....of..16= ing.ham...C.oLu z jry.........
-State .... of... North Caro.],jm. a . gee ........................ .0
5
v
7i$certified to be correct. This instrument was presented for registration at 9.�........ o'clock A.M.3 4U., on the...9tb..... day of........N ..0„.e.tube..„.,.r ..........
19....7.8 and recorded in Book ......7.25 Page..196.. Office of Register of Deeds for Rockingham County, N. C.
This the....9th.. day of ..... NQ..eMb.e..K..................... . 197..Y..
+1
$ 5.00 ,FOE Pd. IREN PR//l ister Zre�eo�rkmg.. unty, N. C.
Mail to: Colonial Pipiline Co.
P 0 Box 9983
G'boro, N C 27408
By............................................................................
Asst.-Deputy Register of Deeds
0
0

1
RIGH11 04P WAY EASE00ENf Map# 160
N07' PRAWN IN
ROC6QNGyAi>7 CCS�yT�
FOR AND IN CONSIDERATION OF One Hundred Twelve and No/100 — — — — — — — — — — HOLLARS,
the receipt of which is hereby acknowledged, Nora E. Pearman, A Widow
hereinafter referred to as Grantors (whether one or more), do hereby grant and convey unto COLONIAL PIPELINE
COMPANY, a Delaware corporation, its successors and assigns, hereinafter referred to as grantee, an easement for a
pipe line right of way with the right to construct, maintain, inspect, operate, protect, replace, repair, change the size
of, and remove a pipe line for the transportation of liquids and/or gases, upon and along a route to be selected by
Grantee, said right of way being 75 feet in width and extending feet from either side of the
center line of the first pipe line installed hereunder, on, over, and through the following described lands, of which
Grantors warrant they are the owners in fee simple, situated in Rockingham County, State of
North (arnl inn , to —wit:
23.26 Acres more or less, described in a need from W. T Moore, et ux, to
John D Pearman and wife, Nora E PParman, dated Au st l lg�3t rernrriarl
in Book 233, Page 240, in the office of the Register of Deeds of R.ockin,,ham
County, North. Carolina,
together with the right of unimpaired access to said pipe line and the right of ingress and egress on, over, and
through Grantors' above -described land for any and all purposes necessary and incident to the exercise by said
Grantee of the rights granted hereunder, with the further right to maintain said right of way herein granted clear of
trees, undergrowth, and brush.
Grantors covenant and agree that they will not impound water or construct buildings or structures of any type
whatsoever on the above described right of way strip. This shall be a covenant running with the land and shall be
binding on Grantors, their heirs and assigns.
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be
done to growing crops, timber, fences, buildings, or other structures directly caused by Grantee exercising any rights
herein granted; provided, however, after the first pipe line has been installed, Grantee shall not be liable for damages
caused on the right of way by keeping said right of way clear of trees, undergrowth, brush, structures, and obstruc-
tions in the exercise of its rights granted herein.
Any pipe line constructed by Grantee across any portion of the above -described land which is under cultivation
shall, at the time of the construction thereof, be buried to such depth as will not interfere with Grantors' use of said
land for normal cultivation required for the planting and tending of crops; except that Grantee, at its option, may
construct its pipe line above the channel of any natural or man-made stream, ravine, ditch, or other watercourse.
As a part of the consideration hereinabove set forth, Grantors hereby grant unto said Grantee, its successors
and assigns, the right at any time to construct, operate, and maintain an additional pipe line or pipe lines sub-
stantially parallel to the first pipe line constructed by Grantee on Grantors' land, above described and Grantee
agrees to pay Grantors the sum of $ 2_on per rod for each additional pipe line constructed, said payment
to be made before construction commences. Said additional pipe line or pipe lines shall be subject to the same
rights, privileges, and covenants as set forth in this Right of Way Easement.
It is agreed that any payment hereunder may be made direct to said Grantors, or any one of them, or by depositing
such paymeut to the credit of said Grantors, or any one of them in theReidsyi.11e, N'Shctk of Reidsville
and payment so made shall be deemed and considered as payment to each of said Grantors.
The rights herein granted are divisible and assignable in whole or in part.
The terms, covenants, and provisions of this right of way easement shall extend to and be binding upon the
heirs, executors, administrators, personal representatives, successors, and assigns of the parties hereto.
TO HAVE AND TO HOLD said rights and right of way, easements, estates, and privileges unto the said Grantee,
its successors and assignees, so long as said right of way and easements are used for the purposes granted herein.
This Right of Way shall be restricted to 75t in width during construction and
the Right of Way shall be reduced to 501 in width after the pipeline is laid.
INLZrITNESS WHEREOF, the Grantors herein have hereunto set their hands and seals this 2 j day of
Signed, sealed, and
de ' ed in the prese ce of: L d
G,-11
i
Walter C. Gille ie
,vtz- (!�
Grantors
E. Pearman, A widow
(Seal)
(Seal)
`z30 3 • IIS

^a n--
•
INDIVIDUAL ACKNOWLEDGMENT
STATE OF NORTH CAROLINA l
J}
COUNTY OF ss
I do hereby certify thaf — ...
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this, the day of 19.
My term of office expires on the day of
Notary Public
19
INDIVIDUAL ACKNOWLEDGMENT
STATE OF NORTH CAROLINA
COUNTY OF SS
I NORTH CAROLINA
RO . ' CHAN ,CO
personally appeared before me this day and acknowledged the du
Mate oL _. _._. ._..___.... .._........... ..._....... ie (+r) '.deed to 6e correct.
Witness my hand and official seal this, the Let theainatr. t and rttne.t h et tend.
This �`.-.-. d y f . - .._ _ ...... . 19_�
My term of office expires on the day of ----� - -- -- -
�� a �5 CLERK i1ER10 00l�RTn�
Filed for regist at t...�: o'clock.- M on the -. _. dayJ,f
,19 tT nary /S^19. CEFz3®andrljeyeY�or yPy/in Rook N �94
Yag T.L..(�LGI� ,�TEfi OF DEEDS........
PROOF BY SUBSCRIBING WITNESS
STATE OF NORTH CAROLINA l
COUNTY OF Ro c k i ng ham J} SS
1 Ann "T. Fooper of Rockingham C unt state f DT. C.
certify that J a 17 • (1111tland
personally appeared before me this day, and being duly sworn, stated t
Witness my hand, and official seal, this 2 8 day of_
My term of: office-exp,ites; of .the 5 day of
— OC {ilia''
�a
W
z
O
U
W
z
F W
a
0
a
O
U
o y, e o —.
hat in his presence Nora E. Pearman (a Widow)
igned the foregoing instrument.
cember lg 62
N61ary Public
a
7
I
r`(
C/
acts

STATE OF NORTH CAROLINA LOC. AND TRACT NO.
803:115
COUNTY OF
Rockingham
SUPPLEMENTAL RIGHT OF WAY AGREEMENT
i
SUPPLEMENTAL RIGHT OF WAY AGREEMENT, made the 1-a,— day of 19 Z�(, between
Amos E. Butler and wife, Velna H. Butler
hereinafter called Grantors (whether one or more), and COLONIAL PIPELINE COMPANY, a Delaware corporation, hereinafter called Grantee:
WTTNESSETH
There ha; hpretofpre been conveyed to Grantee, by an instrument recorded in Book 594 Page 462 in the Office of the Register of Deeds of
ROC Inglhlam County, North Carolina, a �— foot wide right of way and easement across land owned by
Grantors, for pipelines for the transportation of liquids and/or gases, upon the terms and conditions contained in said instrument, reference to which is hereby made, and
Grantee has heretofore constructed and installed a single pipeline therein.
Ej
In consideration of the sum of / ' o Mars ($ y )
paid to Grantors by Grantee, the receipt of which is hereby acknowledgged, Grantors hereby t, bargain, sell and convey to Grantee, its successors and assigns an
additional and perpetual easement Twenty -Five ( 2 5) feet in width running parallel and Contiguous to the above -mentioned existing
Fifty (5 0) foot wide right of way and easement and being on the Easterly
side thereof upon the same terms and conditions as are contained in said instrument referred to above, together with the right to temporarily use a strip of land
Thirty -Five (3 5) feet in width adjacent to the total right of way of the existing easement and the easement hereby granted upon the
Easterly side and running the full length thereof and such other additional temporary work space as is needed in making
highway, railroad, stream, etc., crossings during construction of the second pipeline.
A tract or parcel of land located in Reidsville Township, Rockingham
County, North Carolina, containing 6.07 acres, more or less, more
particularly described in a deed from C. Penn Pearman, Executor of
the Estate of Nora B. Pearman to Amos E. Butler and wife, Velna H.
Butler dated August 11, 1969, recorded in Book 665, at Page 793, in
the Office of the Register of Deeds in Rockingham County, State of
North Carolina.
Drawn By: Colonial Pipeline Co.
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be done to growing crops, timber, fences, buildings, or other
structures directly caused by exercising any rights herein granted.
The rights herein granted are divisible and assignable in whole or in part.
The terms, covenants, and provisions of this Agreement shall extend to and be binding upon the heirs, executors, administrators, personal representatives, successors,
and assigns of the parties hereto.
TO HAVE AND TO HOLD said rights and right of way, easement, estate and privileges over, in, through, and to the above -described land unto the said Grantee, its
successors and assigns, forever; and Grantors do hereby bind themselves and their respective heirs, successors, executors, administrators, and assigns to warrant and forever
defend all and singular said rights and easements unto said Grantee, its successors and assigns, and against every person whomsoever lawfully claiming or to claim the same
or any part thereof, except as to restrictions and easements of record, if any. --�
IN WITNESS WHEREOF, the Grantors herein have hereunto set their hands and seals this J_ day of , 19 �.
Signed, sealed and �'�cf
del' a in the presence o � �j (Seal)
os Esy ut
/ (Seal)
Velna H. Butler
14
(Seal)
GRANTORS
NC 3495 (4-79)

STATE OF NORTH CAROLINAA
ACKNOWLEDGEMENT
BY INDIVIDUAL GRANTOR(S)
COU NTY OF
a Notary Public for said Countv and State, do hereby certiN that
appeared before me this day and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and notarial seal, this day of , 19
My commission expires
I Affix Notarial Seal I
STATE OF NORTH CAROLINA
COUNTYOF
ACKNOWLEDGEMENT
BY INDIVIDUAL GRANTOR(S)
WITNESS my hand and notarial seal, this day of
My commission expires
I.Affix Notarial Seall
Notary Public
a Notary Public for said County and State, do hereby certify that
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
19
Notary Public
ACKNOWLEDGEMENT
BY SUBSCRIBING WITNESS IONLY ONE REQUIRED)
STATE OF NORTH CAROLINA� J'
COUNTY'O�Ff•- �&44�
I��.��-{�t(/Ii-�o-& aY1Mi V �v Cnf W / , a Notary Public for said County and State. do hereby certify that
Nt'' ! �/ M • personally appeared before me this day, and being sworn, stated that in h_ -04'✓ presence
r , _ w �✓ V • n T �+�.��'Y��OV%% • ^^+^� signed* (acknowledged the execution off* the foregoing instrument.
WITNESS my hand and notarial seal the day of19".
Notary Public
Mc commission expires
I.Vfix Ncwrial
*VOTE.: Strike out thr ­,ds-not ❑pplicable.
STATE OF NORTH CAROLINA-Rockingham County.
The foregoing certificate of........iiarQl..Ann... Ba.,SQ.r....(Flynt.),...a... N.Q.tart'.... Public ...Qf.........................................
Guilford...Count�'... S.ta:te....of...North...Ca.rolina...................................................................................................
is certified to be correct. This instrument was presented for registration atl .09o'clock Ate. P.M., on the..14th.. day of......a7.U,AP.......................... .
19.28.. and recorded in Book.22.1.... , Page .292. Office of Register of Deeds for Rockingham County, N. C.
This the ...1.4th. day of.......JuneJune ................................ . 19 .....78 �¢ �
$ 3.50 .Fee Pd. IR N PRUITT, Register of Deeds, Rcekingham County, N. C.
Mail to: Colonial PipPlinP Co_ By...........................................................................................................
P 0 BOX 9983 Asst.-Deputy Register of Deeds
Greensboro N C 27408

BOND C ONTRACT�
KNOW ALL MEN B7 THESE YRrSENTSt That the Colonial Pipeline Company,
a corporation of the State of Delaware, having its offices ir. ktlanta,
Georgia, as principal and FMFRAT ICI+rReur- .OMPANY
as surety, are firmly bound unto the North Carolina State Highway Commission
in the just and full sum of SIXTY TFOUSAND ($60,000.00) DOLLARS, for the
payment whereof they hereby bind themselves, their successors and assigns,
Jointly and severally, by these presents.
IN TESTIMONY WHEREOF, the said Colonial Pipeline Company has signed
and sealed the same, and FEDERAL IIISURANCE COMPANY
has caused these presents to be signed in its corporate name and its seal
to be hereunder affixed by its duly authorized representative this the
lih DAY OF myglART, , 1963.
WHEREAS, the North Carolina State Highway Commission will by agreements
authorize the Colonial Pipeline Company to install a 36" petroleum products
pipeline across public roads in Rockingham County, 8" petroleum products
pipeline from West of Greensboro to Apex across public roads in Guilford,
Alamance, Chatham and Wake counties, 6" petroleum products pipeline from
Apex to Selma across public roads in Wake and Johnston Counties, 6" petro-
leum products pipeline from Apex to Fayetteville across public roads in
Wake, Harnett and Cumberland Counties of North Carolina in accordance with
lithe agreements, conditions and stipulations set forth in the said agreements
which are by reference made a part hereof;
iNOW, THVKR FORF, the condition of this obligation is such that if the
above bounden Colonial Pipeline Company, their successors and assiFne, shall
for a period of Two (2) years after the date when the construction of said
!!pipelines are completed and said pipelines are placed in operation, comply
Ilwith, carry out and perform all of the agreements, conditions and stip.
�iulations of the said agreements in accordance with the terms and provisions
!'thereof, then this obligation is to be null and void; otherwise to remain
in fell force and effect„
W7.
_ �ret.�;
i[ T.FELDMAKBy ASSISiAh' L P. r.urr►tiw he ColMn Pipeline Compan
X iAMQ'SMBtDW i0 f 0. MCNI'',TY
WITI1W3St,
C. �unters+gned
Principal
FFT)FRAT TNS'(RANCF CONF'ANY
Surety
ATTORNEY -TN -FACT I
Paken and approved tt;is _ day of
r,oxr, C,,iOLI\,A STAir 'i •^.e;,
By:
02U ). CGr i .1

0 0
ROCK) N6doy, eoaNTY
NUMBt
h! M C9 TYPf- VAL
F
Tl
DIRecTTOW
1.
Black Top Road
8,600,
s
Highway #158
Northwest
3
U. S. Higkiway #158
529'
Road
East
6
Road 2406 (Black Tops
2971
Road #2423
Southeast
9
Black Top
2,7501
�
Road
Northwest
lU
Highway 65 & 87
1 500'
�
U. S. #29
Southeast
12
Concord highway
2,900
U. S. 29
Southeast
13
State Highway #14
500
Intersection
South
800'
Interstate Sub —Div St.
South
14
Black Top
15
Black Top 1941
123'
Road
South
17
Black Tap
6231
Road
South
18
h1ack Top
3,800 1
Road
West
19
�_acK Top
4,5cio
Road
Vest
21,
;Late night+ay 0700
1,787'
Road
East
JRA`Tc3. ROADS
Gravel Road
4,100'
To Highway #58
Northwest
4
'3ravel Road
1 900l
,
Highway #158
South
.5
gravel Road
300'
Road #2423
Southeast
328 ,
Road #24�
jouthea<,t
7
Gravel Road
350'
Road #2406
Southeast
$
Gravel Road
11
Gravel Road
2,300
U. S. #29
East
16
Gravel Road
1,400
Road
Fi°t
10
3ravel Road
!,400
Road
Southeast
21
Gravel Roca
s40 2 01
Highway #700
North
23
Gravel Road
2,0001
Highway #700
Southeast
24
Gravel Road
802'
Road
Northwest
?5
';ravel Road
933'
Road
West

NORTH GAROLINA STATE HlI .tiWAY (()MMIS.lION
SPECIAL PROM, IUNS :'OVr;??ING PIPL LIN ,o i,i�:, 0'.H' F� ''GNDUIT UNDER
STATE HIGHWAYS AND CrIlINTY ROAD:? AND TH ,IR EXTE'N:'IONt IN MUNICIPALITIES
7PECIAL FROVISIONS
1 The top of the pipe lire or casing shall he irstalled at a minimum depth
of 30 inches below the s-irfac.,e of the pavemerr and/or 18 inches below the
flow line of side d:tc.hes. Division F:rg.neers are authcrized to reduce the
minimum depth when the _.ocal water table sail _r otner c or,di tions make this
depth impractical,.
2, All crossings of hlvhwa_v, shall be as near right angles to the center line
of thr- highway as is prticticable,,
3., All pipe line crossinrrF of paved ,conrrPte or b-t im r.ous surfacei highways or
county roads shall c•e made by means of acki.ng boring or drilling, If this
is not possible or feasible due to r•ccr cr ether cause permissi-n from the
Commission s Division Engineer must be ottair-d before the pavement may be
trenched, On a small local installat-i)r where Pquipment for hacking., boring
or drilling is not reasonably available a trench insta-l_.ation may be approved-
4� Pipe line crossings of unpav-d (graver crushed stone, and soil type surfaces)
highways and county roads may oe made by trenching, 'See paragraph 9).
5Gas and liquid fuel pipe dines crossing under paved lconcrete or bituminous
surface) highways; county roads or roads scheduled for early paving must be
placed in a pipe or casing of larger diameter than tile carrier pipe line, as
outlined under "Policy on Pape Encasement", a cagy of which will be furnished
upon request Such casings wherever possible are to be jacked, bored or
drilled under the roadway for the full widtr of trip roadbed including shoulders,
and where future dual -lane highways are p'annpd the ;acing shall be carried
the full, width of The proposed roadbed.,
6, All trenches across- h_LFhways must be backfilled in lavers not exceeding four
(4) inches and Pach layer must be thorougnly tamped by a mechanical tamp before
the next layer is raced A pr:eumat...:, tamp e- a vtb.rat1hF, tamp w.:ii be re-
quired to meet the s.;e._fl-ation of .a "mecha.r. .:a tamp" On small local in-
stallations where m-chan-L,,.al tamping equipmen- is not reasonably available the
Highway Division Engi veer will either furnish +,he tampi.ng equipment on a rental
ba<,is or recommend ct,,er means fe.- obt�in_n? =htLF•`'actor_r compaction.
7., All excess excavated material' ey;ail, r.r removed and disposed of cuts.i_de the
limits Of the ri_k''::t of Wa.y In suc:i a !r,�irnet3s nc)t to i0erfere with the drain-
age of hi,7hwa;• , ]ni'• ;: ]'ttlP Wl_: 1: Yr' � by 3 r-'presF'n?car:.vp of t.�e Com-
missinn
•
C7
C7g03. OGC-(. i

r Aft
2-
8. Where it is necessary to trench across concrete pavement or concret, base
pavement, a section of pavement of minimum length of ten (10) feet shall be
removed and replaced with new concrete. Where the edge of the patch or
section of removed pavement is less than ten (10) feet from a transverse ex-
pansion or contraction joint or crack the entire section of pavement shall be
removed up to the joint or crack and replaced with new concrete, When prac-
tical the pavement cuts for a patch shall be made by the use of a concrete
saw. All replaced concrete shall have a depth of one inch greater than the
depth of the original slab. Immediately under the replaced concrete there
shall be placed a thoroughly compacted three-inch layer of topsoil, sang,
screenings or other granular material, All replaced concrete, joint filler,
and subgrade reir.forc'ing material shall meet the spec.ifi^ations of the Com-
mission, both as to material and performance of work. Where the existing
pavement is badly cracked or has been patched to a state where a resurfacing
will be required in the immediate future the Division Engineer may authorize
the use of a bituminous patch to meet the State Highway Commissions patching
procedure,
9. Where it is necessary to trench across roads with surfaces other than concrete
the same type and thickness of surface and/or base as formerly existed or
equivalent shall be replaced. The thickness of the replacement material
shall be sufficient to provide a base and surface of equivalent strength to
the undisturbed base and surface. All replaced surfacing shall meet the speci-
fications of the Commission, both as to material and the performance of work,
10. Openings in the shoulders,, side ditches and cut or filled slopes of road shall
be repaired to the satisfaction of the Commissions Division Engineer,
11. On sections of road that have a natural sod or growth or have been landscaped,
care shall be taken to remove and replace shrubs and sod to the satisfaction
of the Commission's Lar,ds:,ape Engineer. No orramertal trees may be cut or re
moved without the prior approval of the Lards:ape Engineer.
12. If mutually satisfactioi• arrangements can be made with the Division Engireer
through whose division the pipe line passes; pavement may be restored by the
Commission's maintenanr..e forces with the pipe line owner assuming the cost of
such replacement,
13, In rural areas the pipe line owner shall place sait.able markers at each side
of the highway at locations to be deeigc.ated by the Commission showing the
exact location of the pipe line,
14, Plans showing deta—'s of any proposed pipe line installations which will en-
croach upon bridges or culverts (over, unler, in, or attached thereto) shall
be furnished the Bridge Engineer for approvai before ;he erc-oachmert ,ortrar.t
is submitted. P;•pe 1:.nes shall r,o; he ,-.ailed in 1­'vert.s nr Arder bridges
without the Wr-tteT: COC a'1` the B adge Eng;-e=.. .
15o When it is neces5ar,i f-. die pip.- 11',le OFs o:er highways o_' :vl^.t•V roaaz
by means of overhea _ irefi plan. of s 'j h z. trta.", t Ai e.s shall be .3-ibmi'. teci
to the Commis_on s Ar edge an i r-_ approval :se. _ired befo-e su h
structures may be ere,t-,
Y
ogo3.v61-r. 1
v w ci• � �• • • -

16. Where the roadway is cut or trenched adequate barricades and warning signe
are to be placed and, if necessarywa:chmer or flagmen are .o be employed to
control traffic„ If trenches are left open overnight a. sufficient number of
barricades, signs and torches or light: must be prominently displayed so that
the traveling public will be adequately prcte_*.ed�
17. Wherever the traveled portion of the roadway is cut only one-half of the road
width shall be opened at. one time., Before the other half is :ut, the first
opening shall be made usable, safe and maintained for traffic.,
18. Where one-way traffic is being maintained, it shall be flagged twenty-four
(24) hours per day, Flagmen shall be instructed to follow State Highway Com-,
mission Flagman Regulations, they shall be equipped with the standard "STOP"
and "SLOW" signs and a red flag during daylight and a red light or a torch
at night, The Flagman shall wear dist'_nctive apparel as helmet, light
colored coat, Sam Browne belt or white arm band,. A pilot vehicle shall be
used when in the opinion of the Division. Engineer such assistance to traffic
is advisable.
19. Traffic is not to be blocked or re-=rou*.ed without the written permission of
the Commission"s Division Enginee-r,
20, Where traffic is re ---routed adequate State Highway Commission standard detour
signs shall be provided and maintained,. Upon request the Highway Commission
may furnish standard detour signs at the established price,
21. Before any crossing of a highway or county road is made notice must be given
forty-eight (48) hours in advance to the Commission's Divisicn Engineer so
that an Inspector may be assigned to the work, if in his opinion inspection
is necessary-
22. Any Inspectors assigned to the pipe laying operations will have full authority
to act in behalf of the Commission and to stop any work affecting highways,
provided the work is not being performed in accordance with this agreement and
the Commission-s standard specifications.
23. The costs of such inspection and the cost of barricades signs, lights; flag-
men and pilot cars are to be borne by the pipe line owner.
24+ The cost of re -doing or repa_.ring ty the Commission's forces of any roadway
openings not satisfactor-,ly restored by the pipe line company is to be borr.k
by the pipe line owner,
25. When a pipe instaliat.ior. _8 made while a road is finder contrast for const-r:;ct-
ion the pipe owner must make :;3,isfact.ory arrangement with the Highway Con-
tractor so as nc)' - iriteri'ere with or decay the cont._a_tor
26. Prior tO crossing any highway G' cour'y road. ttie Comm;-ss,or s Division Eng-*
neer shall be c,)ns;Al-ed to de*erm-_n- if the Conm,_:sion anticipates changes in
grade or al:gnmen• .. W,.ero c:nanp-e• are con* ertpiated ..he r,, - e _ine sviall be so
lard as to conf:,-m tc, *.he p� opo e,-i change,; .
(!:) QZ03. 06-Lr . I

27, Where parallel encroachments are made, (1) excavation material that is tem-
porarily placed on the pavement must be moved off of the pavement as quickly.
as practical; (2) excavation in the immediate vicinity of drainage structures
shall be made with special care so as not to damage or interfere with the
use of the existing drainage facility; (3) drainage facilities that are in-
advertently damaged must be repaired immediately- (4) where a pipe line or
a structure for a pipe line is to be placed across or near the intake or
discharge of a highway drainage facility, plans for such installation must
be submitted to and approved by the Commissions Bridge Engineer before in-
stallation, and (5) the bottom of the excavation fcr a parallel installation
in rural areas, or elsewhere when space will permit; shall not be nearer
the edge of the pavement (measured in a horizontal plane) than the depth
of the excavation so that the eheoretical slope from the edge of the pave-
ment tc the bottom of the ditch will be no steeper than a 1 to 1 slope,
Past experience causes the Commission to believe it is not in
its best interest tc continue the practice of allowing parallel encroach
ments by gas and liquid fuel pipe lines on highway rights of way. If
parallel encroachments are found to be desirable or necessary each encroach-
ment will be individually considered on its own merits by the Commission's
Principal Right of Way Engineer or his representative. Consideration will
be given to the approval of encroachments involving necessary extensions to
distribution systems within towns and in adjacent developed areas,
-o-o-o-o-o-o-o-o-o-o•-o-
BWDavis-ebj
February 27, 1957
April 3, 1957
August 19, 1958
•
C)WB.o(,C-(.I

PCN FORM ATTACHMENT
USFWS IPAC OFFICIAL SPECIES LIST

United States Department of the Interior
FISH AND WILDLIFE SERVICE
Raleigh Ecological Services Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Phone: [phone] Fax: [phone]
In Reply Refer To:
Project Code: 2023-0118923
Project Name: CPC SE Line 4 Exposure, Rockingham Co., NC
August 18, 2023
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The enclosed species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and final designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The species list fulfills the
requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1973, as amended (16 U.S.C. 1531 et seq.). If your project area
contains suitable habitat for any of the federally -listed species on this species list, the proposed
action has the potential to adversely affect those species. If suitable habitat is present, surveys
should be conducted to determine the species' presence or absence within the project area. The
use of this species list and/or North Carolina Natural Heritage program data should not be
substituted for actual field surveys.
New information based on updated surveys, changes in the abundance and distribution of
species, changed habitat conditions, or other factors could change this list. Please feel free to
contact us if you need more current information or assistance regarding the potential impacts to
federally proposed, listed, and candidate species and federally designated and proposed critical
habitat. Please note that under 50 CFR 402.12(e) of the regulations implementing section 7 of the
Act, the accuracy of this species list should be verified after 90 days. This verification can be
completed formally or informally as desired. The Service recommends that verification be
completed by visiting the IPaC website at regular intervals during project planning and
implementation for updates to species lists and information. An updated list may be requested
through the IPaC system by completing the same process used to receive the enclosed list.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of the
Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered

08/18/2023
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A Biological Assessment is required for construction projects (or other undertakings having
similar physical impacts) that are major Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2)
(c)). For projects other than major construction activities, the Service suggests that a biological
evaluation similar to a Biological Assessment be prepared to determine whether the project may
affect listed or proposed species and/or designated or proposed critical habitat. Recommended
contents of a Biological Assessment are described at 50 CFR 402.12.
If a Federal agency determines, based on the Biological Assessment or biological evaluation, that
listed species and/or designated critical habitat may be affected by the proposed project, the
agency is required to consult with the Service pursuant to 50 CFR 402. In addition, the Service
recommends that candidate species, proposed species and proposed critical habitat be addressed
within the consultation. More information on the regulations and procedures for section 7
consultation, including the role of permit or license applicants, can be found in the "Endangered
Species Consultation Handbook" at:
https://www.fws. gov/sites/defaultlfiles/documents/endangered-species-consultation-
handbook.pdf
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Endangered Species Act (ESA), there are additional responsibilities under the
Migratory Bird Treaty Act (MBTA) and the Bald and Golden Eagle Protection Act (BGEPA) to
protect native birds from project -related impacts. Any activity, intentional or unintentional,
resulting in take of migratory birds, including eagles, is prohibited unless otherwise permitted by
the U.S. Fish and Wildlife Service (50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)). For more
information regarding these Acts, see https://www.fws.gov/program/migratory-bird-permit/what-
we-do.
The MBTA has no provision for allowing take of migratory birds that may be unintentionally
killed or injured by otherwise lawful activities. It is the responsibility of the project proponent to
comply with these Acts by identifying potential impacts to migratory birds and eagles within
applicable NEPA documents (when there is a federal nexus) or a Bird/Eagle Conservation Plan
(when there is no federal nexus). Proponents should implement conservation measures to avoid
or minimize the production of project -related stressors or minimize the exposure of birds and
their resources to the project -related stressors. For more information on avian stressors and
recommended conservation measures, see https://www.fws.gov/library/collections/threats-birds.
In addition to MBTA and BGEPA, Executive Order 13186: Responsibilities of Federal Agencies
to Protect Migratory Birds, obligates all Federal agencies that engage in or authorize activities
that might affect migratory birds, to minimize those effects and encourage conservation measures
that will improve bird populations. Executive Order 13186 provides for the protection of both
migratory birds and migratory bird habitat. For information regarding the implementation of
Executive Order 13186, please visit https://www.fws.gov/partner/council-conservation-
migratory-birds.

08/18/2023
3
We appreciate your concern for threatened and endangered species. The Service encourages
Federal agencies to include conservation of threatened and endangered species into their project
planning to further the purposes of the Act. Please include the Consultation Code in the header of
this letter with any request for consultation or correspondence about your project that you submit
to our office.
Attachment(s):
• Official Species List
• Migratory Birds
OFFICIAL SPECIES LIST
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Raleigh Ecological Services Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
[phone]

08/18/2023
4
PROJECT SUMMARY
Project Code: 2023-0118923
Project Name: CPC SE Line 4 Exposure, Rockingham Co., NC
Project Type: Pipeline - Onshore - Maintenance / Modification - Below Ground
Project Description: Required pipeline exposure repair
Project Location:
The approximate location of the project can be viewed in Google Maps: https:
www. google.com/maps/(a)36.35892095,-79.69448759115463,14z
F
Counties: Rockingham County, North Carolina

08/18/2023 5
ENDANGERED SPECIES ACT SPECIES
There is a total of 5 threatened, endangered, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
MAMMALS
NAME STATUS
Tricolored Bat Perimyotis subflavus Proposed
No critical habitat has been designated for this species. Endangered
Species profile: https:Hecos.fws.gov/ecp/species/10515
FISHES
NAME STATUS
Roanoke Logperch Percina rex Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/1134
CLAMS
NAME STATUS
Atlantic Pigtoe Fusconaia masoni Threatened
There is final critical habitat for this species. Your location does not overlap the critical habitat.
Species profile: https:Hecos.fws.gov/ecp/species/5164
Green Floater Lasmigona subviridis Proposed
There is proposed critical habitat for this species. Threatened
Species profile: https:Hecos.fws.gov/ecp/species/7541

08/18/2023
11
INSECTS
NAME STATUS
Monarch Butterfly Danaus plexippus Candidate
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
CRITICAL HABITATS
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.
YOU ARE STILL REQUIRED TO DETERMINE IF YOUR PROJECT(S) MAY HAVE EFFECTS ON ALL
ABOVE LISTED SPECIES.
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Actz.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
1. The Migratory Birds Treaty Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the
USFWS Birds of Conservation Concern (BCC) list or warrant special attention in your
project location. To learn more about the levels of concern for birds on your list and how this
list is generated, see the FAQ below. This is not a list of every bird you may find in this location,
nor a guarantee that every bird on this list will be found in your project area. To see exact
locations of where birders and the general public have sighted birds in and around your project
area, visit the E-bird data mapping tool (Tip: enter your location, desired date range and a species
on your list). For projects that occur off the Atlantic Coast, additional maps and models detailing
the relative occurrence and abundance of bird species on your list are available. Links to
additional information about Atlantic Coast birds, and other important information about your
migratory bird list, including how to properly interpret and use your migratory bird report, can be
found below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.

08/18/2023
BREEDING
NAME SEASON
Bald Eagle Haliaeetus leucocephalus Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
Chimney Swift Chaetura pelagica Breeds Mar 15
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA t0 Aug 25
and Alaska.
Eastern Whip -poor -will Antrostomus voci ferns Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA t0 Aug 20
and Alaska.
Prairie Warbler Dendroica discolor Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Jul 31
and Alaska.
Red-headed Woodpecker Melanerpes erythrocephalus Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA t0 Sep 10
and Alaska.
Rusty Blackbird Euphagus carolinus Breeds
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions elsewhere
(BCRs) in the continental USA
Wood Thrush Hylocichla mustelina Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA t0 Aug 31
and Alaska.
PROBABILITY OF PRESENCE SUMMARY
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week
months.) A taller bar indicates a higher probability of species presence. The survey effort (see
below) can be used to establish a level of confidence in the presence score. One can have higher
confidence in the presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
The probability of presence for each week is calculated as the number of survey events in
the week where the species was detected divided by the total number of survey events for
that week. For example, if in week 12 there were 20 survey events and the Spotted Towhee

08/18/2023
was found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is
0.25.
2. To properly present the pattern of presence across the year, the relative probability of
presence is calculated. This is the probability of presence divided by the maximum
probability of presence across all weeks. For example, imagine the probability of presence
in week 20 for the Spotted Towhee is 0.05, and that the probability of presence at week 12
(0.25) is the maximum of any week of the year. The relative probability of presence on
week 12 is 0.25/0.25 = 1; at week 20 it is 0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the
probability of presence score.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across
its entire range. If there are no yellow bars shown for a bird, it does not breed in your project
area.
Survey Effort (1)
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.
No Data (—)
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on
all years of available data, since data in these areas is currently much more sparse.
SPECIES
Bald Eagle
Non -BCC
Vulnerable
Chimney Swift
BCC Rangewide
(CON)
Eastern Whip -poor -
will
BCC Rangewide
(CON)
— probability of presence breeding season I survey effort — no data
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
■�� =�Mi
l ��il. 1. .1.11 1
+++-i i +++ +M R11 i i i i i' 1111 IN His loll IN* ++++ ++++
++++ ++++ +++0 ++4 11 1 1 +++ ++++ ++++ ++++ ++++ ++++ ++++

08/18/2023 9
Prairie Warbler ++++
BCC Rangewide ++++ ++++ ++T+ ++++ ++++ ++++ ++++ ++++ ++++
NONE N.
(CON)
Red-headed ME
11" "
Woodpecker + *++*+ +,+� +��, ++++ ++�+ ++++ ++ 0+ 0++0 +21' ,,,,
BCC Rangewide
(CON)
Rusty Blackbird
BCC -BCR
Wood Thrush
BCC Rangewide
(CON)
I11`11 IIII II+01111 IIII IIII IIII 1111 1111 1111 111
++++ 4 I I�++++ ++*I d1101-000-ft I I I I I I I A +++ ++++ ++++
Additional information can be found using the following links:
• Birds of Conservation Concern https://www.fws.gov/program/migratory-birds/species
• Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library
collections/avoidinv--and-minimizins--incidental-take-mip-ratorv-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
MIGRATORY BIRDS FAQ
Tell me more about conservation measures I can implement to avoid or minimize impacts
to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize
impacts to all birds at any location year round. Implementation of these measures is particularly
important when birds are most likely to occur in the project area. When birds may be breeding in
the area, identifying the locations of any active nests and avoiding their destruction is a very
helpful impact minimization measure. To see when birds are most likely to occur and be breeding
in your project area, view the Probability of Presence Summary. Additional measures or permits
may be advisable depending on the type of activity you are conducting and the type of
infrastructure or bird species present on your project site.
What does IPaC use to generate the list of migratory birds that potentially occur in my
specified location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCQ and other species that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian
Knowledge Network (Network (AKN). The AKN data is based on a growing collection of survey, banding
and citizen science datasets and is queried and filtered to return a list of those birds reported as
occurring in the 10km grid cell(s) which your project intersects, and that have been identified as
warranting special attention because they are a BCC species in that area, an eagle (Eagle Act
requirements may apply), or a species that has a particular vulnerability to offshore activities or
development.

08/18/2023 10
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your
project area. It is not representative of all birds that may occur in your project area. To get a list
of all birds potentially present in your project area, please visit the Rapid Avian Information
Locator (RAIL) Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?
The probability of presence graphs associated with your migratory bird list are based on data
provided by the Avian Knowledge Network (AKN). This data is derived from a growing
collection of survey, banding, and citizen science datasets.
Probability of presence data is continuously being updated as new and better information
becomes available. To learn more about how the probability of presence graphs are produced and
how to interpret them, go the Probability of Presence Summary and then click on the "Tell me
about these graphs" link.
How do I know if a bird is breeding, wintering or migrating in my area?
To see what part of a particular bird's range your project area falls within (i.e. breeding,
wintering, migrating or year-round), you may query your location using the RAIL Tool and look
at the range maps provided for birds in your area at the bottom of the profiles provided for each
bird in your results. If a bird on your migratory bird species list has a breeding season associated
with it, if that bird does occur in your project area, there may be nests present at some point
within the timeframe specified. If "Breeds elsewhere" is indicated, then the bird likely does not
breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern:
1. "BCC Rangewide" birds are Birds of Conservation Concern (BCC) that are of concern
throughout their range anywhere within the USA (including Hawaii, the Pacific Islands,
Puerto Rico, and the Virgin Islands);
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation
Regions (BCRs) in the continental USA; and
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on
your list either because of the Eagle Act requirements (for eagles) or (for non -eagles)
potential susceptibilities in offshore areas from certain types of development or activities
(e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made,
in particular, to avoid and minimize impacts to the birds on this list, especially eagles and BCC
species of rangewide concern. For more information on conservation measures you can
implement to help avoid and minimize migratory bird impacts and requirements for eagles,
please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects
For additional details about the relative occurrence and abundance of both individual bird species
and groups of bird species within your project area off the Atlantic Coast, please visit the
Northeast Ocean Data Portal. The Portal also offers data and information about other taxa besides

08/18/2023
11
birds that may be helpful to you in your project review. Alternately, you may download the bird
model results files underlying the portal maps through the NOAA NCCOS Integrative Statistical
Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Outer Continental Shelf project webpage.
Bird tracking data can also provide additional details about occurrence and habitat use
throughout the year, including migration. Models relying on survey data may not include this
information. For additional information on marine bird tracking data, see the Diving Bird Study
and the nanotag studies or contact Caleb Spiegel or Pam Loring.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid
violating the Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of
birds of priority concern. To learn more about how your list is generated, and see options for
identifying what other birds may be in your project area, please see the FAQ "What does IPaC
use to generate the migratory birds potentially occurring in my specified location". Please be
aware this report provides the "probability of presence" of birds within the 10 km grid cell(s) that
overlap your project; not your exact project footprint. On the graphs provided, please also look
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no
data" indicator (a red horizontal bar). A high survey effort is the key component. If the survey
effort is high, then the probability of presence score can be viewed as more dependable. In
contrast, a low survey effort bar or no data bar means a lack of data and, therefore, a lack of
certainty about presence of the species. This list is not perfect; it is simply a starting point for
identifying what birds of concern have the potential to be in your project area, when they might
be there, and if they might be breeding (which means nests might be present). The list helps you
know what to look for to confirm presence, and helps guide you in knowing when to implement
conservation measures to avoid or minimize potential impacts from your project activities,
should presence be confirmed. To learn more about conservation measures, visit the FAQ "Tell
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

08/18/2023
IPAC USER CONTACT INFORMATION
Agency: Corblu Ecology Group, LLC
Name: Mackenzie Wallace
Address: 3225 S. Cherokee Lane
Address Line 2: Bldg. 800
City:
Woodstock
State:
GA
Zip:
30188
Email
[e-mail]
Phone:
7705919990

PCN FORM ATTACHMENT E
NCHPO AND NRHP MAP

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ECOLOGY GROUP

PCN FORM ATTACHMENT F
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Base Map Source: ESRI Aerial Imagery
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