2023009 Ver 1_Determination Request_20230720

Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Name:*
Is this a transportation project?*
Is this request for a mitigation site?
What type of request is this?*
Owner Information
Wallace Wastewater Treatment Plant
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
Name on the Recorded Deed: * Town of Wallace
Responsible Party : Lisa Cottle, [e-mail]
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: [phone]
Email Address: * [e-mail]
How would you like to received your determination?*
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * AgentAuthForm_VHB_Rob Taylor.pdf
PDF only
Agent/Consultant Information
How would you like to receive your USPS
determination letter?* Email
Name of Agent:* Miguel Ortiz
Company Name:* VHB
Email Address: * [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
Yes
No
Other
IP Stream Determination
Stream
23.92KB

Date of Visit: 6/27/2023
Site Information
Nearest Highway/Street: * Old Wilmington Road
Nearest Town: *
Nearest Named Stream:*
River Basin:
County:
Duplin
Wallace
Little Rockfish Creek
Cape Fear
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.
Click the upload button or drag and drop files here to attach document
FIG2_StudyAreaUSGS.pdf 866.22KB
Pdf file type only
TOPO map look up: https://viewer.nationalmap.gov/basic/
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.
Click the upload button or drag and drop files here to attach document
FIG_3_SoilSurvey.pdf
Pdf file type only
1.13MB
Soil Survey Link: https://www.nres.usda.gov/wps/portal/nres/surveylist/soils/survey/state/?stateld=NC
Latitude and Longitude
Please provide the Latitude and Longitude for physical location for the determination that. If you have a physical
address you can look up the Latitude and Longitude by typing in an address or filling out the information
manually.
Choose below how you would like to provide this information.
Address Lookup
Manually
Latitude: 34.730892
Longitude:-77.982921
Misc attachments:
By digitally signing below, I certify that:
Wallace_WWTF_SOBAD_Request.pdf 9.59MB
pdf or kmz file types only
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act)
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the "Determination Request' form."

Signature
e;?«t AlwotlzZ
Date Submitted: 8/7/2023
Initial Review
.................................................
ID#* 2023009
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Michael Meilinger: Michael. Meilinger
Select Regional Office: * Wilmington Regional Office - [phone]