20240156 Ver 1_Determination Request_20231108

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
Rocking F Farms Restoration Site
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
Name on the Recorded Deed: * Rocking F Farm LLC
Responsible Party : Steven Fields and Marguerite Fields
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: [e-mail]
Email Address: * [e-mail]
How would you like to received your determination?*
IP Stream Determination
Stream
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * Signed MOC_Rocking F_6-13-2023.pdf 72.8KB
PDF only
Agent/Consultant Information
How would you like to receive your USPS
determination letter?* Email
Name of Agent:* Joseph Sullivan
Company Name:* KCI Technologies
Email Address: * [e-mail]
Project Information
Has anyone form DWR done a previous site visit?*
Yes
No
Other

Date of Visit:
Site Information
Nearest Highway/Street: * Monnett Road
Nearest Town: * Climax
Nearest Named Stream: * Climax Creek
River Basin: * Cape Fear
County: *
Guilford
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
Rocking FFarms_Fig02_USGS.pdf 223.84KB
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
Rocking FFa rms_Fig04_N RCS. pdf 440.76KB
Pdf file type only
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: 35.9178
Longitude:-79.7047
Misc attachments: Rocking FFarms_Fig03_Aerial.pdf 350.99KB
Rocking FFarms_Fig01_Vicinity_Map.pdf 317.5KB
Stream_Forms.pdf 525.15KB
pdf or kmz file types only
By digitally signing below, I certify that:
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
Date Submitted: 11/8/2023
Initial Review
ID#* 20120366
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Samantha Wooten:Samantha.Wooten
Select Regional Office:* Central Office - [phone]