HomeMy WebLinkAbout20240215 Ver 1_Determination Request_20240205Please 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
Wayne County Landfill RNG Pipeline
Yes No
Yes No
Buffer
Isolated Wetland
Check all that apply.
IP Stream Determination
Stream
Name on the Recorded Deed: * County of Wayne
Responsible Party : ATTN: Randy Rogers; Solid Waste Director
(for LLC, Corporations, businness, agency, etc.)
Telephone Number: 919-689-2994
Email Address: * Tim. Rogers@waynegov.com
How would you like to received your determination?*
Is there an agent or consultant responsible for the request?*
Yes
No
Attach agent authorization letter: * 02_SIGNED_AgentAuthorization_20240... 536.7KB
PDF only
Agent/Consultant Information
How would you like to receive your LISPS
determination letter?* Email
Name of Agent:* Emma Radford, WPIT, CA
Company Name:* Kimley-Horn
Email Address: * Emma.Radford@kimley-horn.com
Project Information
.........
Has anyone form DWR done a previous site visit?*
Yes
No
Other
Date of Visit:
Site Information
Nearest Highway/Street: * South Landfill Road
Nearest Town: * Goldsboro
Nearest Named Stream:* Edwards Branch
River Basin: * Neuse
County: *
Wayne
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_Wayne_County_Rettew_USGS.pdf 1.13MB
Pdf file type only
TOPO map look up: https://viewer.nationaImap.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
Fig4_Wayne_County_Rettew_NRCS.pdf 1.17MB
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: 35.296539
Longitude:-78.063395
Misc attachments: Fig 1_Wayne_County_Rettew_RNG_Vic... 1.13MB
Fig3_Wayne_Cou nty_Rettew_RNG_J D.... 1.13MB
pdf or kmz file types only
By digitally signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• 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")
• 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 "Determination Request' form."
Signature
�,Owa �
Date Submitted: 2/5/2024
Initial Review
ID#* 20240215
Version *
Do you want to send for review?* Yes No
Select Reviewer: * Robert Tankard:robert.tankard
Select Regional Office: * Washington Regional Office - (252) 946-6481