20231154 Ver 1_SAW-2023-01051 PCN Rev 4 Jan 24_20240104

DWR
O lv Isla of water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 Ver 4.3
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.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https:Hedocs.deq.nc.govNVaterResources/DocView.aspx?dbid=0&id=2196924 (https:Hedocs.deq.nc.govNVaterResources/DocView.aspx?dbid=0&id=2196924)
A. Processing Information
If this is a courtesy copy, please fill in this with the submission date.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?"
0 Yes 0Q No
Is this project connected with ARPA funding?"
0 Yes * No
County (or Counties) where the project is located:"
Halifax
Add additional county
Is this a NCDMS Project"
0 Yes 0Q No
Click Yes, only if NCDMS is the applicant or co -applicant.
DO NOT CHECK YES, UNLESS YOU ARE DMS OR CO -APPLICANT.
Is this project a public transportation project?"
0 Yes 0Q No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
la. Type(s) of approval sought from the Corps:"
Q Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Q Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?"
0Q Yes
0 No
Please provide the date of the previous submission."
8/16/2023 d
1b. What type(s) of permit(s) do you wish to seek authorization?"
0 Nationwide Permit (NWP)
Q Regional General Permit (RGP)
Q Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?"
O� Yes 0No

Nationwide Permit (NWP) Number: 12 - Utility Lines
Add additional NWP
NWP Numbers (for multiple NWPS):
List all NW numbers you are applying for not on the drop down list.
lid. Type(s) of approval sought from the DWR:"
check all that apply
0 401 Water Quality Certification - Regular
❑ Non-404 Jurisdictional General Permit
❑ Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?"
Q Yes Co) No
❑ 401 Water Quality Certification - Express
❑ Riparian Buffer Authorization
Q Yes QQ No
Q Yes QQ No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from mitigation bank or in -lieu fee program.
O� Yes O No
Acceptance Letter Attachment
Click the upload button or drag and drop files hereto attach document
Upload
PNG- Roseburg Lumber DIMS Acceptance. pdf 244.56KB
FILE TYPE MUST BE PDF
v
1h. Is the project located in any of NC's twenty coastal counties?"
Q Yes QQ No
1j. Is the project located in a designated trout watershed?"
Q Yes QQ No
Linkto trout information: http://wvvw.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx (http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Prog ram/Agency-Coo rdi n atio n/Trout. aspx)
B. Applicant Information
la. Who is the Primary Contact?"
Adam Pollak
1b. Primary Contact Email:"
[e-mail]
lid. Who is applying for the permit?"
Q Owner
(Check all that apply)
le. Is there an AgentlConsultant for this project?"
O� Yes 0No
2. Owner Information
2a. Name(s) on recorded deed:"
Piedmont Natural Gas Company, Inc.
2b. Deed book and page no.:
easements can be provided
1c. Primary Contact Phone:"
(xxx)xxx-xxxx
[phone]
❑ Applicant (other than owner)
x

2c. Contact Person:
(for Corporations)
Adam Pollak
2d. Address"
525 South Tryon Street
Address Line 2
City State / Province / Region
Charlotte NC
Postal /Zip Code Country
28202
2e. Telephone Number:"
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:"
[e-mail]
Add another owner
4. Agent/Consultant (if applicable)
4a. Name:"
John Farmer, PE
4b. Business Name:
(if applicable)
Energy Land and Infrastructure, PLLC
4c.Address"
Street Address
745 S. Church St. Suite 801
Address Line 2
City State / Province / Region
Murfreesboro TN
Postal /Zip Code Country
37130
4d. Telephone Number:" 4e. Fax Number:
[phone]
(xxx)xxx-xxxx (xxx)xxx-xxxx
4f. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
la. Name of project:"
PNG- Roseburg Lumber

1b. Subdivision name:
(if appropriate)
1c. Nearest municipality) town:"
Weldon
2. Proiect Identification
2a. Property Identification Number: 2b. Property size:
(tax PIN or parcel ID) (in acres)
multiple multiple
2c. Project Address
Street Address
multiple
Address Line 2
City State / Province / Region
Postal /Zip Code Country
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as appropriate, based on how the location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude:" Longitude:"
36.43494-77.61408
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
Roanoke River
3b. Water Resources Classification of nearest receiving water:"
C
Surface Water Lookup (https://experience.arcgis.com/experience/7073e9l22ab74588b8c48ded34c3df55/)
3c. What river basin(s) is your project located in?"
Roanoke
Add another river basin
3d. Please provide the 12-digit HUC in which the project is located."
030101070103
River Basin Lookup (http://ncdenr.maps.arcgis.com/apps/Publicinformation/index.html?appid=ad3a85a Oc6d644a Ob97cdO69db238ac3)
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 project site and its immediate vicinity are composed of woodlands, streams, wetlands, residential acreage, campground,
industrial acreage, a wastewater treatment plant, and the historic Roanoke Canal Trail.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?"
O Yes OQ No O Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.35 acres within the project corridor
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
1,135 ft. within the project corridor
4h. Explain the purpose of the proposed project:"
The purpose of the project is to construct 2,900 ft. of new 4-inch steel natural gas pipeline and a new M&R facility in Halifax
County, NC. The need for the project is associated with the request for natural gas supply by Roseburg Lumber, LLC, to operate
their lumber facility at 290 Power Place.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:"
The pipeline will be placed below ground utilizing one of two methods: horizontal directional drill (HDD) or open -cut trenching. The
HDD method will involve the use of small entrance/exit pits at either end of the span and advancing the pipeline beneath water
resources, roadway, railroad, and/or utilities, as designated. The pits will be returned to pre -development conditions. Trees will be
felled along the HDD path to create sight lines necessary for the process. Open -cut methods involve the preparation of a trench,
laying the pipe, and back -filling to pre -development conditions using the sidecast soils. The proposed project will also consist of
the construction of a new regulator station within the existing Roseburg Lumber facility. Access to the project will be along existing
driveways and/or roads contiguous to the project corridor. A laydown yard within the bounds of the existing project limits of
disturbance will be utilized by the project. The project will receive final stabilization in all disturbed areas. Equipment to be utilized
for the construction of the project may be but is not limited to: graders, backhoes, bulldozers, cranes, dump trucks, and pick-up
trucks.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
OQ Yes
Comments:
O No
5b. If the Corps made a jurisdictional determination, what type of determination was made?"
OQ Preliminary O Approved O Not Verified O Unknown O N/A
Corps AID Number:
Example: SAW-2017-99999
SAW-2023-01051
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): ,Joey Lawler
O Unknown

Agency/Consultant Company: S&ME
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
The PJD was submitted by S&ME on June 14, 2023, and approved on August 2, 2023.
6. Future Project Plans
6a. Is this a phased project?"
Yes QQ No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed projector related activity? This includes other
separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification.
There are no other permits to be used to authorize any part of the proposed project or related activity.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Q Wetlands 0 Streams -tributaries Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
"W." will be used in the table below to represent the word "wetland".
2a1 Reason" (?)
2b. Impact type" (?)
2c. Type of W."
2d. W. name"
2e. Forested"
2f. Type of Jurisdicii7
(�)
2g. Impact
area"
ff:::]
HDD
P
Bottomland Hardwood Forest v
WA
Yes �
Corps �
0.090
(acres)
Add
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.090
2g. Total Wetland Impact
0.090
2i. Comments
Permanent impact is permanent conversion of forested wetland to non -forested wetland from sight -line
requirements for the HDD process. No net loss of wetlands is anticipated.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites impacted.
"S." will be used in the table below to represent the word "stream".

3a. Reason for impact" (?)
3b.lmpact type"
3c. Type of impact"
3d. S. name"
3e. Stream Type"]3f
.Type of
3g. S. width"
3h. Impact
?)
Jurisdiction"
length"
S1
HDD
Temporary v
Other
S1
ntermittent v
Both v
31
Average (feet)
(linear feet)
S2
HDD
Temporary v
Other
S3
Perennial v
Both
14
10
Average (feet)
(linear feet)
S3
open cut, Cro
Excavation
Intermittent
Both
__]
Average (feet)
(linear feet)
Add another impact
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total temporary stream impacts:
123
3i. Total stream and ditch impacts:
123
3j. Comments:
If access is needed to complete the HDD process, a stream crossing shall be utilized for the affected area.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:"
The proposed natural gas pipeline will cross jurisdictional resources as close to 90 degrees as possible.
Horizontal directional drill (HDD) methods will be used to minimize impacts to water resources. The
pipeline alignment has been reviewed and positioned to minimize impacts to water resources.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:"
Horizontal directional drill (HDD) methods will be used to cross beneath water resources; therefore,
reducing impacts. In addition, best management practices (BMPs) to prevent erosion and control
sediment movement will be used to reduce the potential for indirect impacts to water resources.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Q Yes v No
2c. If yes, mitigation is required by (check all that apply):
Q DWR Q Corps
2d. If yes, which mitigation options) will be used for this project?
❑ Mitigation bank Q Payment to in -lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
OQ Yes 0No

4b. Stream mitigation requested:
(linear feet)
4c. If using stream mitigation, what is the stream temperature:
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS (https://ribits.usace.army.mil/ribits_apex/f?
p=107:27:2734709611497::NO:RP:P27_BUTTON_KEY:0) website.
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
0.13
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
Compensatory mitigation for 0.13 acres of wetland impacts was secured for the original PCN submitted on
August 16, 2023. Permanent wetland impacts have been reduced to 0.09 acres which is below the 0.10-
acre threshold for nationwide permits. Therefore, no mitigation is required as amended.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Q Yes
QQ No
For a list of options to meet the diffuse flow requirements, click here
(https://files.nc.gov/ncdeq/Water% 20Quality/Surface / 2OWater/ 2OProtection/401 /Buffer% 20Clarification % 20Memos/Options % 20for% 20Meeting % 20Diffuse % 20FIow% 20Provisions % 20of % 20the % 20Storwm
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?"
Q Yes QQ No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?"
Q Yes QQ No
To look up low density requirement click here 15A NCAC 02H .1003(2) (http:Hreports. oah.state. nc. us/ncac/title% 2015a % 20- % 20environ mental % 20qu a I ity/ch apte r%2002% 20-
20environmental % 20management/subchapter% 20h/15a / 20ncac / 2002h / 20.1003.pdf).
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?"
O Yes Q No
Q N/A - project disturbs < 1 acre
Hint: 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.
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause degradation of
downstream surface waters."
QQ Stormwater Management Plan 0 Antidegradation Calculations

Comments:
There are no proposed built -upon areas associated with the pipeline project. The new regulator station will be placed within an
area on the existing Roseburg Lumber facility which is currently impervious. Erosion control approvals and construction
stormwater permitting under the National Pollutant Discharge Elimination System (NPDES) Program will be obtained from the
NCDEQ prior to construction.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federallstatellocal) funds or the use of public (federallstate) land?"
C) Yes QQ No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?"
C Yes No
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 downstream water quality?"
0 Yes QQ No
3b. If you answered "no," provide a short narrative description.
The need for the project is associated with the request for natural gas supply by Roseburg Lumber, LLC,
to operate their lumber facility at 290 Power Place. There is no direct cause -and -effect between the new
pipeline and future development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?"
O Yes * No O N/A
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?"
QQ Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?"
O� Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?"
O Yes No Unknown
5e. Is this a DOT project located within Division's 1-8?"
C) Yes QQ No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?*
QQ Yes 0No
5g. Does this project involve bridge maintenance or removal?"
0 Yes QQ No

Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf(http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf)
5h. Does this project involve the constructionlinstallation of a wind turbine(s)?*"
O Yes OQ No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?*
O Yes OQ No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?"
The IPaC List was obtained and the US Fish and Wildlife Service (USFWS)- Raleigh Office was contacted
through the determination key process for impacts to listed bat species. See the documentation attached
at the end of the PCN application.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?"
O Yes U No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?"
NOAA Fisheries Essential Fish Habitat Mapper (www.habitat.noaa.gov)
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/ (http://gis.ncdcr.gov/h/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 preservation status (e.g., National Historic Trust
designation or properties significant in North Carolina history and archaeology)?"
OQ Yes U No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
NC State Historic Preservation Office (NCSHPO) Historic Properties Map (http://gis/ncdnr.gov/hpoweb)
indicates that the project may impact the Roanoke Canal (HX009) which was listed in the National '
Register of Historic Places in 1976. The NCSHPO reviewed the project and issued a "no adverse effect" _
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https:Hmsc.fema.gov/portal/search (https:Hmsc.fema.gov/portal/search)
8a. Will this project occur in a FEMA-designated 100-year floodplain?"
OQ Yes O No
8b. If yes, explain how project meets FEMA requirements:
There are no additional impervious (built -upon) areas proposed within the pipeline corridor; therefore, the
current storage volumes will not be impacted within the floodplains.
8c. What source(s) did you use to make the floodplain determination?"
FEMA mapping website indicates that the project will be constructed within regulated floodplains as
mapped on Map 3720490700J, effective July 7, 2007, and Map 3720490800K, effective February 4, 2009.

Miscellaneous
Comments
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files hereto attach document
Upload
File must be PDF or KMZ
Signature
0 By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief', and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form,
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act"),
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act"),
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature, AND
• I intend to electronically sign and submit the PCN form.
Full Name:"
Adam Pollak
This is a required field.
Signature* Digitally signed by
Adam Poa Sign
--Date; 2024,01.04
14:40:43-05'00'
Date
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