20150962 Ver 1_Buffer Determination Request_20150916

LT F WA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Donald R. van der Vaart
Governor Secretary
Stream Origin/Buffer Applicability Determination
Applicant/Owner's Name (corporation/individual who is legally responsible for the property and its compliance):
Applicant/Owner Address: M4 S )�,sr
Applicant's phone number: r FCC Cc\ number: Nc�s C�bxxz�
Applicant's email address: c['pb" \,Jzme �_A1
Consultant/Contact person Name (if applicable):
Consultant address (if applicable):
Consultant's phone number: Fax number:
Consultant's email address:
Name of Project: CSC P WN\l t\`\ ro>
County:S C)
Nearest Named strekm + River Basin (from USGS topographic map):
(-
Please ,provide a brief description of this project attach site plan if available): ` 1
C�EG�. —c3J� t`Ql -A �Y� a: n
Please attach a map of site location indicating project boundaries using USGS 1:24,000 tope map and NRCS county soil survey.
Location of project site - please include reference to the court y, nearest named town and highway number:
"k",_ 1`1 �k ,� r� Lc�t Nth � N 35 ��?4 �(C,`,,n7
J W —rp l L� 4, 1 r s -1
Has any DWQ staff visited the site ?L4Igtz,, if yes, please provide DWQ staff name, '�A)erlth and date of
visit 0160>
This form may be submitted via email (roberto.scheller @ncdenr.gov), faxed (252- 946 - 9215), mailed or hand - delivered to:
943 Washington Square Mall, Washington; -NC .27889. (Note: Submittals of the review packages on Friday after 12:00 pm will
be stamped as received on the next business day).
Please contact Roberto Scheller at 252- 948 -3940 if you have any questions regarding this form.
Water Quality Regional Program
943 Washington Square Mall
Washington, NC 27889
Internet wwwmewateroualimore
Phone: 252 - 946-6481
FAX [phone],
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NC DWQ Stream Identification Form Version 4.11
Date: "�/�1 n - Project/Sit�^� a4 U I� Latitude:
Evaluator: .G el �� County: L�-� ` Longitude:
Total Points: i
Stream is at least intermittent 1�2�
it z 79 or perennial if z 30'
A. Geomorpholoqy (Subtotal= S )-
1a. Continuity of channel bed and bank
2. Sinuosity of channel along thalweg '
3. In- channel structure: ex. rife -pool, step -pool,
ripple -pool sequence
4. Particle size of stream substrate
5. Active /relict floodplain
6. Depositional bars or benches
7. Recent alluvial deposits
8. Headcuts
9. Grade control
10. Natural valley
11. Second or greater order channel
a artificial ditches are not ra d; discussions in manual
B. Hydrology (Subto�T - --I. S )
12. Presence of Baseflow
Stream Determination (circle one) Other
Ephemeral Intermittent Perennial e.g. Quad Name:
Absent Weak
Moderate
Strong
l6 )._ - �
2
3
0 CD
2
3
0 CD
2
3 l
23. Crayfish
0
3
0
2
3
rl
2
3
i2
2
3
2
3
ni�) 0.5
1
1.5
`0 0.5
{i)
1.5
tNoO
Yes = 3
0
13. Iron oxidizing bacteria 0 `
14. Leaf litter tLJ
15. Sediment on plants or debris 0
16. Organic debris lines or piles. 0
17. Soil -based evidence of high water table? No = 0
C. Bioloqy (Subtotal = A. S'
1
18. Fibrous roots in streambed
1
19. Rooted upland plants in streambed
,,U
13-
20. Macrobenthos (note diversity and abundance)
0
21. Aquatic Mollusks
I tee'
22. Fish
0
23. Crayfish
0
24, Amphibians
0
25. Algae -
�0
26. Wetland plants in streambed
'perennial streams may also be identified using other methods.
See p. 35 of manual.
Notes:
�� 1D -- - - -c
1 2
1 0.5
_ 1
0.5.J 1
(Y 'F= 7
2
1
-2
1
LL_>-
7
1
�
/1tTSt
1
1
1
1 I
FACW = 0.75; OBL = 1.5 Other = 0
Sketch: _
3
3
0
1.5
1.5
0
0
3
3
1.5
1.5
1.5
1.5