20240263 Ver 1_Colonial Pipeline Company NCDEQ 401 Submittal Line 23 Exposure Liberty Rd NC_20240209

corblu
ECOLOGY GROUP
February 9, 2024
NC DWR, 401 & Buffer Permitting Branch
512 North Salisbury Street
Raleigh, NC 27604
Subject: Section 401 Water Quality Pre -Construction Notification
Colonial Pipeline Company Maintenance
Guilford County, North Carolina
Corblu Project No. 02-041901.864 - Line 23 Exposure
To whom it may concern
On behalf of our client, Colonial Pipeline Company (CPC), Corblu Ecology Group, LLC (Corblu) is pleased
to submit this Section 401 water quality Pre-Const,uction Notification (PCN) for required maintenance on
their Line 23 petroleum pipeline. Specificalyy. ar, G}:: Eire of CPC's Line 23 has been detected which
requires restoration within an unnamed inteirn,ttenT tributary to Big Alamance Creek within CPC's right-of-
way (ROW). The pipeline exposure is located within CPC's existing ROW north of the Cade Road and
Liberty Road intersection in Guilford County, North Carolina (35.95746,-79.68906; Figure 1).
Based on our evaluation of the subject %,^re believe that the temporary and permanent disturbances to
waters of the U.S. associated with this mai ilera!,ce activity are authorized by the U.S. Army Corps of
Engineers (USAGE) under Nationwide Permit (N'vVP) No. 3 (a) and (c) — Maintenance. Based on the limited
disturbance to the unnamed intermittent tributary (i.e., jurisdictional waters), the required pipeline
maintenance does not require notification to the USAGE prior to initiation of the work; however, it has been
dete,miined that written approval is required from the North Car0l!! Dt spa tment of Environmental Quality
(DE0 ) ',a.. Sect. cri - 1 :'Y-ater Quality Certification prior to the ir- a t (., %:v()rk.
Background
Corblu inspected the above referenced pipeline maintenance location for the presence of jurisdictional
waters of the U.S. on December 19, 2023. Specifically, Corblu surveyed the above maintenance location in

:;r 3 Fr;l8 GD n':_ : i:; - L 23 Expcs
February 9, 2024
Cordd a Project No. 02-041901-864- Guilford Co. NC
accordance v,-Ith re 1987 Corps of Engineers Wetlands Delineation Manual', and the appropriate U.S. Army
Corps of Engineers I USACE) Regional Supplement2. Streams were assessed using the North Carolina
Division of Water Quality (NCDWQ) Identification Methods for the Origins of Intermittent and Perennial
streams3 (Appendix A). Jurisdictional features [an unnamed intermittent tributary to Big Alamance Creek (11),
and a-, -a5utting emergent wetland (W1)] were observed within the maintenance area (Photograph Nos. 1-5;
F gure 2).
Recent storm events have resulted in the upstream migration of a headcut within 11, which has displaced
the protective cover (i.e., stream substrate) within CPC's ROW resulting in the exposure of Line 23. The lack
of pipeline protection at this location has resulted in conditions where the pipeline is currently vulnerable to
potential damage. Further, these conditions are not consistent with CPC's or the U.S. Department of
Transportation's (USDOT) regulatory requirements for pipeline protection.
CPC is committed to operating their pipelines and support facilities in a manner that protects the safety of
the public, the environment, and its workforce. The proposed preventative pipeline maintenance is a
component of CPC's ongoing Integrity Management Program (IMP) as required by the USDOT requirements
[49 CFR Part 195 — "Pipeline Safety: Pipeline Integrity in High Consequence Areas (Hazardous Liquid
Operators with 500 or More Miles of Pipeline); Final Rule"]. The IMP provides an important means of
achieving spill -free, error -free operations. The purpose of the IMP is to improve/maintain the integrity of
CPC's system — including CPC's pipelines, facilities, equipment, tanks, and delivery lines.
CPC's IMP and the referenced USDOT regulations include prescriptive requirements for inspection of
pipeline systems and requires excavation and repair of certain pipeline defects according to specific
schedules and regulatory guidelines. It should be noted that USDOT has completed an Environmental
Assessment (EA) under the National Environmental Policy Act (NEPA) concerning repairs that an operator
would have to make to its pipeline following an integrity assessment. The EA and corresponding Finding of
No Significant Impact concluded that these actions would not significantly affect the quality of the human
environment (Docket No. RSPA-00-6355).
In accordance with 49 CFR § 195.401 and CPC's IMP, CPC must take prompt action to address anomalous
conditions, to include pipeline exposures and shallow cover areas that are discovered through the integrity
assessment process. CPC must, in maintaining its p .reline systems, ensure that repairs are made in a safe
' Endircninental Laboratory. Corps of Engineers Wetlands Delineation 1-.1a ival. U.S_ Army Corps of En "-e s as ;_Dn, D.C. 100 pp. plus
aone:x:ices 1987
U.S. Arm •i Gc-ps o` En ;sneers. 2012. Reg;onal Supplement to the Corps of Engineers 1,1i- ;a, : - :: _:, ;. ual: Eastern Mountains and
P,eC:mor.t Reg;o:, b'. ;on 2.0I.F Berkov•fitz, J.S. Wakeley, R.W. Lichvar, C.V. No:-:e. ERG:-. EL TR-12-9. V'r-s"..rrg, MS: U.S. Army
En,,:ireer Research and Dedelopr-ie it Ce iter.
r Cr:I Carol na i; s,ori cf,'r'a e- Qual :y 2010- NC DWG? Stream Identification Form Version 4.91. North Care ra = Dn of Water Quality.
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C.DLsr,;a: Fi:::einle C Dnipa: I - L;"e 23 Expcsu: e
February 9, 2024
:u Project No- 02-041901-864- Guilford Co- NC
and timely manner a; -id are conducted to prevent damage to persons, property, and the environment.
Additionally, CPC's IMP follows USDOT's requirements with respect to addressing possible unsafe
conditions; specifically, the USDOT - Pipeline and Hazardous Materials Safety Administration's (PHMSA)
Interpretation Response No. PI-84-0193 which details the regulatory provisions of 49 CFR Part 192, Subpart
M and Part 195, Subpart F, stating that whenever an operator discovers any condition that could adversely
affect the safe operation of its pipeline system, the operator must correct the condition within a reasonable
time.
Proposed Activities in Jurisdictional Waters
The maintenance location will be accessed from Liberty Road onto CPC's existing, mowed, and maintained
ROW (Figure 3). Prefabricated mats will be used to temporarily cross W1 and 11 as necessary to conduct
the required maintenance from either bank of 11 (Appendix B). CPC intends to inspect Line 23 and replace
the required minimal protective cover over the pipeline using Submar pre -cast revetment mats and rip rap to
remediate the lack of protective pipeline cover from stream erosion. To re-establish the pipeline protective
cover, CPC intends to conduct the following: 1) temporarily isolate the maintenance location from stream
flow (i.e., dam and pump around the stream); 2) excavate the eroded area on Line 23; 3) inspect and make
repairs to Line 23 as necessary; 4) backfill the excavation area; and 5) restore the streambed to approximate
pre -erosion contours and elevations over Line 23 using Submar mats and rip rap. These pre -cast mats and
rip rap will be keyed/imbedded int.9'he stream bed and banks in a manner that maintains grade and normal
stream flow conditions x C i.
To minimize sedimentation to 11 during the above -mentioned maintenance activity, dams constructed of
sandbags, steel plates, or water -inflatable plastic dams will be temporarily placed upstream of the
maintenance area to conduct maintenance activities "in -the -dry". The stream flow will be pumped around the
maintenance area, discharging immediately downstream via an energy dissipater to prevent stream scour.
The pump(s) used will be sufficiently sized to accommodate the anticipated stream flow (Appendix ❑). All
excavated soils will be temporarily stored in the adjacent upland area on geotextile fabric or similar material
within the CPC ROW.
Rip rap will be used above and below the mat system along the stream banks and within the stream channel
for additional stabilization. Further, rip rap within the stream channel will be placed on an erosion control
blanket (geotextile fabric) in a manner where the finished top elevation of the rip rap does not exceed that of
the original stream bed elevation. Once the required minimal protective pipeline cover (pre -cast revetment
mats) is keyed into the streambed in a manner that maintains existing grade and flow conditions of the
stream, the temporary dams will be removed, and normal streamflow will be restored.
3

Section 4Gi water Quality Pre -Construction Notification
Colonial Pipeline Company — Line 23 Exposure
February 9: 2024
Corblu Project No. 02-041901-864 — Guilford Cc NC
The exposure maintenance activity will require unavoidable permanent and temporary impacts to 11, and
W1. Permanent impacts include approximately: 1) 60 linear feet (LF; 0.0036-acre) of 11 [45 LF (0.003-acre)
of Submar mats and 15 LF (0.0006-acre) of rip rap]: and 2) 0.0021-acre of wetland (0.0019-acre Submar
mats and 0.0002-acre rip rap). Temporary impacts include approximately 60 LF [30 LF (0.0006-acre)
upstream; and 30 LF (0.0003-acre) downstream] of 11 for temporary workspace/grading associated with
providing the required protective cover over Line 23.
CPC's standard erosion control practices will be employed (Appendix E). Specifically, the disturbed areas
along the stream bank and disturbance within the adjacent emergent wetland area will be reseeded with a
native wetland seed mix and strawed. No monofilament erosion control matting will be used.
Corblu respectfully requests 401 Water Quality Certification for the required Line 23 exposure repair and the
unavoidable permanent impacts of: 1) 60 LF (0.0036-acre: Submar mats/rip rap) within II; and 2) 0.0021-
acre of wetland (0.0019-acre Submar mats and 0.0002-acre rip rap). As mentioned above, temporary
impacts include approximately 60 LF (0.0009-acre) of 11 for workspace/grading (Appendix C).
401 and Buffer Permitting PCN Submittal Checklist
We have provided the following Information to document compliance with the requirements outlined in the
PCN Submittal Checklist (Appendix F). Each item is discussed below.
M,RT 1119M. iC7ii�7_
A $323.00 payment for a 401 Water Quality Certification with minor impacts will be made electronically once
the project has been assigned a project number.
Pre -filing meeting request
A profiling meeting request was submitted to 401 [e-mail] on December 27, 2023, A copy of the
email request is attached to the USACE Wilmington District PCN Form.
PCN Application
A complete copy of the USACE Wilmington District PCN Form and supporting documentation which includes
an IPaC Official Species List have been included with this submittal (Appendix G).
Stormwater Management Plan
Not Applicable - This is a maintenance activity for an existing petroleum pipeline and does not Involve the
construction of any roads or structures.
4

Section 4Gi Water Quality Pre -Construction Notification February 9: 2024
Colonial Pipeline Company — Line 23 Exposure Corblu Project No. 02-041901-864 — Guilford Cc NC
If vour oroiect is located within a State implemented Riparian Buffer Rule Area. submit the followina alon
with site plans and PCN form: Three Q) copies of the details for on -site diffuse flow provisions.
The proposed required maintenance activity is located within the Cape Fear River Basin within the Jordan
Lake Watershed, which is a Riparian Buffer Rule Area. The project is exempt from the Jordan Lake Buffer
Rules since the pipeline was existing prior to the adoption of the rule and its use is present and ongoing [15A
NCAC 02B .0267(6)(a)]
DWR Stream Determination Forms for streams on Drooertv and ❑WR determination letter for wetlands or
streams (if aeelicable
A North Carolina ❑WQ Stream Identification Forms have been included (Appendix A)
Maps and Plans
• The most recent version of the 1:24,000 USGS Topographic Map:
See Figure 1.
• The most recent version of the bound and published County NRCS Soil Survey Map - (required for
projects within the Neuse River Basin, Tar -Pamlico River Basin, Randleman Lake Watershed and
the Catawba River Basin, also recommended for all projects):
See Figures 4A and 4B.
• Vicinity map:
See Figure 3.
• The Site Plan:
See Appendix C.
• Pre-construction/Pre-existing conditions:
See Appendix C.
• Proposed conditions:
See Appendix C.
• Drainage Plans:
Not. Applicable.
• Proposed Impacts:
See Appendix C.
• Wetland Impacts:
See Appendix C.
5

cfC .• 7a-_e- .�L: 1- -'•._-.��I15- -L1' rJ:?i itb.�aa �+l'
GID101}IQI Pipeline LDihpw-iv — Lin- 2y ExposuU a
February 9, 2024
Corblu Project No 02-041901-864 — Guilford Go. NC
Stream Impacts.
See Appendix C.
Summary and Conclusion
In summary, the pipeline maintenance activity will result in permanent impacts to 60 LF of 11 [45 LF (0.003-
acre) of Submar mats and 15 LF (0.0006-acre) of rip rap] and 0.0021-acre of wetland (0.0019-acre Submar
mats and 0.0002-acre rip rap). The project was designed to avoid and minimize stream and wetland impacts
to the riaximum exie it racticable and represents the least environmentally damaging, practicable
al`e° �:i`v .t s Ju = tl)e project purpose fcr the pipeline maintenance and protection as required by
USDCT. PHSMA and CPC's IMP.
Based on this submittal, we respectfully request written authorization of Section 401 Water Quality
Certification. If you have any questions or comments regarding this PCN submittal, please contact the
undersigned at [phone]_
Sincerely,
CCRBLU ECOLOGY GROUP, LLC
ice'.
Michael A. Barfield, CWB, CE Richard W. Whiteside, PhD, CWB, CSE
Senior Ecologist President
Enclosures: Figure 1 —Sig L ocation Map
Figure 2 — Jurisdi:_-Tic)nal Features and Photograph Locations
Figure 3 — Vicinity i.lap
Figure 4A — USDA MRCS Soils Map
Figure 4B — USDA Soils Map
Photographs (5)
Appendix A. NCDWQ Stream Form Version 4.11
Appendix B: Typical Prefabricated Mat Wetland and Stream Crossing
Appendix C: Submar Design Plans
Appendix D: Typical Dam and Pump Maintenance Dig
Appendix E: CPC Soil Erosion and Sediment Control Plan
Appendix F. 401 & Buffer Permitting PCN Submittal Checklist
Appendix G: USACE Wilmington District PCN Form
c: Ms. Jennifer Price, CPC Project Manager, via email
Mr. John Wyatt, CPC Environmental Lead-SED, via email
Mr. David Reedy, CPC Environmental Specialist, via email

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Base Map Source: USA Topo Maps
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
1:24,000
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orblu
ECOLOGY GROUP
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Figure 1
Site Location Map
Project No. 02-041901-864

Base Map Source: ESR1 Aerial Imagery 75 _ _
GPS Data Collected: 12.1912023 1:1 500 ic
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
Figure 2
Jurisdictional Features and
Photograph Map
Project No. 02-041901-864

Base Map Source: ESRI Aena1 In-iaaery --
GPS Data Collected: 12 19.2023 1 ; 1 500 -
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
Figure 3
Vicinity Map
Project No. 02-041901-864

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Base Map Source: ESRI Ae-iel In,egery
Soils Data: Natural Resources Conservation Service (MRCS), NCDOT Project ATLAS SWEEP group
1:24,000 i
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
corblu
Guilford County, North Carolina ECOLOGY GROUP
1,200 2,400 4,800 Feet I
Figure 4A
USDA NRCS Soils Map
Project No. 02-041901-864

Base Map Source: ESRI Aerial Imagery a 75 150 300 Feet
Soils Data: USDA MRCS Web Soil Survey Download 21W2024 1 ; 1 500
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
Figure 4B
USDA Soils Map
Project No. 02-041901-864

Sec.,:_: • =G1 `,'. ater Quality Pre-Cons;racUci n N:_+. = c,_
Colc-i=l":=!�eCompany —Line 23ExposureLi:.-t, ?
Photographs taken on 12/1912023
Cc r'!_ G- No. 02-041901-864- Guilford Co. NC
W NW
270 Boa 33D u

Section 401 Water Quality Pre -Construction Notification Photographs taken on 12/1912023
Colonial Pipeline Company — Line 23 Exposure Liberty Rd Corblu Project No. 62-641901-864- Guilford Co. NC

Section 401 Water Quality Pre -Co: s:r_ictici IJ ,i -:c_:i - -. Photcc ra:�I-,s ken on 12/19/2023
Colonial Pipeline Company — Line 23 Exposure Lil e -t.. = 1 Corblu Project No. 02-041 K' -8a4- Guilford Co. NC

APPENDIX A
NCDWO STREAM FORM VERSION 4.11

NC DWQ Stream Identification Form Version 4.11
Date: 12/1912023
ProlecVSite: LN 23 Exp Liberty Rd
Latitude: 35.95745
Evaluator: Michael Barfield
County: Guilford
Longitude:-79.68906
Total Points:
Stream Determination (circle one)
Other
ar. -, .eu r. 22.5
Ephemeral intermittent Perennial
e.g. Quad Name:
J,•
A. Geomorphology (Subto.2l =
Absent
Weak
Moderate
Strong
- Contln_,Ity of channel 'bed and ba
0
1
X
3
2. Sinucs.-ty cf ,-hanriei aionc: tha:,"VGg
0
X
2
3
I in-charne str a^t ,re; ex. riffle -pool, step -pool,
, Ye-;]ool sequence
0
X
2
3
4. Partide size o� st-eao� subsTrate
0
X
2
3
5. ActiverreGct rloodpla•T
6. Depositii_Mal bars;,,. retrcne
0
X
2
3
X
1
2
3
7. Recent alluval deposits
X
1
2
3
0.-!eodc.i cts
0
1
X
3
y• (�raae c•:_�nt of
0
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1
1.5
fJai ,, a va'Jey
0
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1
1.5
1. Second o ,:,,:-eater crc'er channel
NX 0
Yes =
al-1, �,m^e5 are not rated see discussions in manual
B. Hydrology (Subtotal 6.5 )
12. Presence of Baseflow
0
1
X
3
? Irnn oxidizing bacteria
X
1
2
3
"4 Lraf litter
1.5
X
0.5
0
'5. on p:ants iir debris
X
0.5
1.5
6, Orwi- c debris ines o' piles
0
1
1
1.5
" 7. So°' -based ev Bence of high water table?
No = 0
Yeo 3
C. Blology isul)t❑tal = 7 }
" . Fibr ij--, roots it-, streannbed
X
2
1
0
Rooted upland plants in streambed
X
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`Jac•obenthos ,.nc.: • ,,e s:tv an at :;-i-1a'-,.:_e}
X
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_2,_;,
21 Aquatic w' i Il _,sks
X
1
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22 Fis
0.5
1
1.5
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1.5
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0
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1.5
25. A a
X
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1
1.5
2t . `s"Jet,ar,d plants in strearrber_l
m , a c- re .e-v^ s,ng
FACW = 0.75; OBL = 1.5 O er = 0
other methods. See p 35 of manual
Nates.
Skelch:

APPENDIX B
TYPICAL PREFABRICATED MAT WETLAND AND STREAM CROSSING

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APPENDIX C
SUBMAR DESIGN PLANS

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APPENDIX D
TYPICAL DAM AND PUMP MAINTENANCE DIG

PUMP
SUMP W'/INdTAKE HOSE
FILTER/SCREEN OR
SUBMERSIBLE PUMP'
WATERBODY
SPO ; CO( ITAINVFNT �FRM
(SI-F FENCE, 1-,AY BALES
OR ,-)THER APPLICABLE
MATERIALS)
I III III i
I I I ICI
I
04,
f,-
l t I
!S II 1
SPOIL I
II
� I I III
I I III
I _II II
=11 -FR RA,,--' ---------
� I I
TROW ENC:NEE.RINC CONSILLTANTS INC.
-= -Ell-l-,TAB. e,o . ,,. TE ?. � ;e�.J,-,n� i:..._. $, 7Y
Trove A" ia- M-fui
RENseow
CAU aaTE owww
WTS 01-29-2004
RET.-.IN A.. MIN. 25'
V'EGETAT:VE BUFFER TO
THE EXTENT POSSIBLE
-NERGY DISSiI AiOR/
'_:OUR PRCTI-C:TiON
FLOW
E!: '..I.
P IrI A P, i� 14INIVIUM 2S
THE XIL'1T=')`_`IBLE
?A.CKHOE
FOR STREAM EQUIPMENT
CROSSINGS, SEE NOTE 14
SEE SHEET 2 FOR NOTES
COLONIAL PIPELINE COMPANY
(Ko ATLANTA, GEDRGIA
TYPICAL DAM AND PUMP
MAINTENANCE DIG
AT WATERBODY LESS THAN 15'
maw PROD. Naj ORAMNG -f ET
Ti4ESAa503$2 COL-0005 1 0F' 2

DAM AND PUMP CROSSING
THE FOLLOWING IS A SEQLENCE OF CONSTRUCTION AND MITIGATION
MEASURES TO BE FOLLOWED AT ALL 'DAM AND PUMP" TYPE CROSSINGS
SEQUENCE OF ACTIVITIES
STEP I. IMr1_EaeEn1T THE TEMr-:':- =1:=F:":•SION AND SEDIMENT CONTROLS
STEP 2, INST.^,, I DRY STPFAV - '; rn: MA`_`RlN5,.
STEP 1 EXCAVA I L .. -:11 !V 11, I "- - --':_ I :J'( I-:'L `l,ACE PIPE_
STEP 4. BACKfILL AND RESTORE S. c'AM
STEP 5. REMOVE GAMS,
STEP 6. IMlt_FMEIJI PERMANENT ER''SION AND SEDIMENTATION CONTROLS,
NOTES:
SCHEDULE INSTRFAM ACTIVITY FOR LOW FLOW PERIODS AND
FuR THE APFF'JFR'ATF TIMING ''WINDOW.
_, MARIK OUT AND MA.:NTA!rJ I.- I-;F AI.ITHORI?ED WORK
AREAS 'a'IT1=ENC1NC= OR R-AGGING TAPE TO .AVOID
JNNJ Ca'_;SARY LIIS1URBANC'r: IG� vL;LlAiICb. LINS :_;RI'
EQ1_115yFNi, OPERATORS W'iRKINC ON THE %Rrl^g1hJG' HAVE
f R'LfC'] ABOul 11IIS P-AN' Allu TI IL MCAS'uk-_
hFFC'FC• TI. ,RCTF,-1. .WAFER. QUAI•ir. INv,TAIl PRE--WCiRK
SEDIME':I :"''+`:TROL MEASLI?ES AT SPECIFiEC' IN THE FLAN,
ALI_ TO GUI:_C THE
DAM5 AN'! 1) PIJhAP 'NA_ -F M,::ST BE (-IIV =ITE C'R RcADILY
N.'A'LA3_E rrtl R TO COMMENCING IN -WATER CCI•;STRIJCTION.
OrJTFrAi'TUR cFALL 4UF'F'Lr INSTAL, AN I.JAI ; AI"J SEDIMENT
t.OINTROL. ;TRUCTURES, AS CEPO'E_' AND A:. �Nl: LO.ti^: t-R;',GIENT
511DES IF WC)E V APFA'3 ANG STAI.;INF: A.RE.AC: a'JCH T`AT [10
"EAVi_r ._ LT 'WATER ENTERS YvA-FRLOFs'r
❑. rJO '-E. 'r:L; .`.:LT 1-1CFN WATER S-IAL_ 9F DISCHARGED DIRECTLY
I''.,. I WLC% , _l HL 'N.AI �,: •7 '. Cl 1.
u ERCSI':` ,. _F.J!IalrJT CO:,1TRC_ STRUCTURE LOCATIONS AS
DEPICTED .ti=T AP,-?,;?JUATE A`:D MAY RE A.D.IL!STFCI AS DIRECTEC
13) LIL r,::_ P.? P.. I'.Ci=TOI? 'L: Al' II_IAL SIT` CO'rD111G14S.
SILT F`\.CC •"'ie L:A'_' d4STALLATIOnig S:IAL�_ INcLuC_
RFMf V.ABLF SFi: li�'d`_, T':J FACII 'ATF ?C.�_F::S DLJRIh'3
CC!`;STRUCTIC'l:. '.:TI_ ZF 1-14;r BALE BARRIERS ONL'r I`+ LIEU
^. SIL-T FFr•:LF •.:I-IHL. FRt-C'UENT ACCEISS IS RE•JUIRw.
J SEG;MENf LAI_i a1VAfEFa FPuM .FF'•:'CH DLWATrw'Ir•.L SHALL. GE
I�I'.;CHARGE;I TO A WELL'JEC;ETATFD IiFL.ANF7 AREA, INTI-1 ;� HAY
BALE CEW:ATERII =`ORE OF. ;:EO'EXTILE FILTER BAG,
=-IMENT CCNT+ !RES MUST 5 rN PLACE A- ALL.
II`,1- :.3CSS Ills `)I„ ,.I r 12['i-iILNS 1F I;i' 1-; ,4i' Vf-WAY
EKCr�T DURIX , EY,O,A.. �1; 1tJ•'A.IATlgti OF THE "RI-`SSING PIPE.
cL TO THE : >;lFh1T F( S`.FI = ki-XITAIN A Ml.,IM IV ?� -FF1
VEC;ETATIVE 31JrF_R 47,,VEEN u!STURBED AREAS .AND THE.
WArFPe0Di:. 1NS'ALL i+.PIV t0i;,!NfAIN A. S;- "ENCE UP LOPE
OF THC E90-FER ;:R1P i;iF1 F.."::N yl@= :^FIHF- YdA- R:9i?D'r,
THE SILT FENCE SHOULD I',,•.�RPORATE REMCVABLE-"rATES" A5
i1:.i]I_11PE.D 1'JCL]S WI I!_L MAI't' I`:!NS F.AS-L rY=
R 1_ACEMFNT Ft)R OVER MCI HT pI IRl`:O FRIOFiS C- F'A;IJFAL ..
5. CONSFRI..IC.T A, TFMPr:RAR'f 51!MP LIPSi^F.AM OF iHF -;AM Ar:F•.
LINE 'N'TH ROCKF' L. IF NATURAL F-OOI_ DOES NOT EN ST.
INSTALL TII'- PIJM= -iR �'LIMF IF1T, IL, -!'C POOL Cif SUMP.
DoSCHARGF W'ATFF, i:UlTG AN FR1=R"Y 1-,ISSIr ATGF ^•iiWP-ISTYF«M
OF THE WC''RK AREA..
g EXCAVA_ 'C MATERIAL ML15T NO aE r'•t'F'''ll_FG WITH!N' I() =-
OF THE WATEF&C.D'r. TI-I;S MA-ERAL MLICT BE COrlTANED
WIIHIk LF_Hlsl 0H4JrdMErdl, l4"-- i'rl+}GAPf SILI FLNCL
PRO7FC7I0i4 TO PRF,Erli �A.TUR.ATcV SOIL 7F".-1I,,1 FI il'N!NG
BACK TIP 111,' - A1LRDODY.
7. CHEM,IF;,ALS, 71JELa L'JBF:'-A.TIN•:l I'•ILS SHALL rlrJ- BE STI'1RED
ANC' P1 +F' SIIA.I_L LI;JIPMENT BL FEF'_jEI.FD WITHI+s IC:i) fi. uF 111E
WATERB:-)DI. FL.MP7. ARE TC .E. REFLIFLrU A 1='ER T-E SP C �LA.NS
MAINTENANCE OF STREAMFLOW
1F THFR- IS ANT"=I-C'Jr' IN THE w, ERSICF', :aTALL
rLMP'S T_I MAINTAIN STi:=A.FAfLOW .AI?LIUNL' fllE :Su'rSCD
7FrTIC,dS OF C:HANNIFI. THE PUMP ', TO HA'VF .
O G -1NIE5 THE r'Ut•,"PlldC CAFAC:ITr (IF AIlTICaF'ATED FLOW,
A=;CCY:'rID .TAI4DP)' PUM^ C- EQUAL CAFACIT', i� TO G-
RFAF,1. 1 .AVA.II AIR F AT AI 1, TIMES. AN FNFP':,Y DISSIFAT'-'R
I TO BE BOIL- Tr, ACCEPT rUN.iP DI F'HARCE WtT�iOUT
STREA419^,'I Uf: TPA kMB,AJK iOGIC'H I* THE
5='Rh;."ddL ED FEYCND ONE DAY THE AREA NEEDS
MWJI T r1RE_ ^VERNI'`_HT,
S. IF A REPLACEMENT, FIFE VAKE-UP AREAS ARE TO BE
LOi�.AfEO - : _ �_F?7'J IHL N'AL'J .?LD L
(WHERE ''^�•F •:' IR.-_'H...rl :.:•I%:'FiI1"R:':.,_= ?FRMIT) AND `,HAL:.
JL IIIC MINIMUM 4PLA !:LLL-LC'.
9, DAr•.lS ARE TCl BE MALE OF =TEEL PLATE, INFLATABLE PLA=TIi
DAM, `:ANC E1AG7, [7CSF3l.=S, WELL GRADc.:`_1 COARSE GRAVr I_ IL[_,
DR ROCK FILL. 1.-AMS MAY NFFr) KFYFJG INTO iH' 71ANK AND
STREAMBE!:). ENSI_!RE TF,AT THE D.AM ANLI VEHL:,'_E = 1%1C: IF
NEEDED) AFC LOCA`ED BAR ENOUGH APART A!_
EXIAVA?.IUI'J. CAP FLUMES USED UNDER VE-1CLE
DURING DRY CROSSING.
10, DEWA.TEP AREA BET,NEEt LAVA' IF - FI F.
SI.1i0L,LD "ICC11R IN % S1AL++.LE VEG I I:1 AIL= 1;,NI/!1,I
5C -T. FROM ANC' WATTRHC-:�. THE r11M:' - toII
BE J!SL;HARGEJ ONTO A 'A.BLE ' ILL FA ;, -1 TER BA IDR
HA 8ii,_r _=TPLi;"�rNL rC�rRLVF-_I`IT I.Oi_ALI[I_I_ ;:OrJiC'N.
THE. O!S"HARGE WATER 5H74.11_C' ALSO a'E TORCEC' INFO SHEET
FLOW IMMEDIATELY EEYOND TII'_ SPILL -AD =iY L!SING HAY BALES
AN:1 IHL r•IA.IURAI_ TCI G;RAPH'. DISC,-Ak.r;P_D 'MA � ,,q.. NOT
B* AI10W'FC' TC =LCW [ITO AN'T WATF.RPODY OR WE71 �AN'1, IF IT
S NOT=,-rSSIBLE Tr, CEhATEP TF,E E 'AVATIC•i L`_.E 'O Sr. LS
W111 A. �IGII H,DhAULI F'LN_,I,_fIVIT,IHL Lk�.AVAlION IS IC 3E
CA.RRIFC' OUT I.,. T'HF STAriDING '!' =.-. -lu F Ai-O DiQ-LACED WATER
a,5 J_`LC!tIGEL'' AUuvC T+_'' FREVLNI ERIOFPING r_; DAM ,
> > IIdSFFC:T,`RF'�AIR' FI`F 1 'r:L rJkF 1-!F G.
2. ONIRsCIO _Ff :TRLAM RE6 AND CLANKS TO
APPROxIM,A,, R'F-._.
LXI L.LI_• ? .. ..
CA• CU!. ?=1. !I ';I-I`.L1, I';":,IA!_I. PEIYMANF.I'•1' R.CSI.iI'I `:L'
5EC I'FI IT ,:C?dTR. - R S Ac. IIJ: ICATFC -lf,l ,I T F
SPD L I I,r- SIrC CIFIC INI ''F-
MA11n[. I F;' rl F °,r;=' r1FR SUCH AS h AG C1 J,`: e'-3
C35C W-ICH F. c: E :F 'V%- 175TAIdDINL^ ANTI AT E Ci = r6v
SIIAI L G 1A AI .. I.. ':'A:i1VELr ROCK RI
BE INJ [A'_LF
b. ANY UATERIAL-`.: ''l_AI::Fr• IrJ THc 4T'=F:Ar1 -n FAC6-'.ATE
CONSTRLCTON SHALL E•E REMOVED URIfdC RESTDRATIOfJ.
BANKS S"A....L III- :S:IAdlLILL:' AND '.LtJH_'RAW, SIEUIMLWi
BARReER5 IN TA_!_ED A5 SOON A, F'LS,.-1BLE AFTER IN -STREAM
WOR.< BUT WITHIN 24 HI=:,IRS OF COMPLETING IN -STREAM WORK,
C. MAINTAIN A SILT FEHCE (1m :1A, HALE BAR.R;ER ALONu
THE •.w1'EF:9GC`'f L1rd`II_ 'V-,— TAT ON EST-AFLIF:HED IN
ADIACErJT DISTUR9c AREAS.
13. WHFN THF- SiRFAMRFI) HAS RFFN FFSFUPFF!, THE. C:RFFK RAN•;S
ARE _0 GC CONTnu3ED TC' .A -; AJLE ANGLE AIDE; PRO FCTED
WITH FROSiO?r PF SIS,TANT MAT,--'SIAi I:;IX'- ATI'9LE 'h'I'i" F, O'o!
VEL&',T)' BETWEEN DAMS i_E.G-, ER05ION �ONTROI_ EH_ANK7_11
CR:BB'NG. ROCK RIP -RAT', ETC.). THE CAV_, ARE TO H ECr'=':CC:'
CDWN` :r:EAM F FSl IiLI:P N,JOP -11•111_ h,Ol.•t.,:..1. I'-:;'•P:
IS RESLjl.4FD. COMPLFTF BANk: TRI OAIN'G FF-:i''',rl
f ;3A` DDA 7;� ARE PS'- POI, L CAMS _ H11L %LP ; : L L'r
r,AND TC A.Vt-.117 Fr:,I!PMFNT Fa✓�r,/!n;C, aF�I"-:=.
14: TE J OG:IRY C'.'L'I''J ! Cic
A R IJMF FU' I 'I L ti. RRIDGF F .k .. ..
-E-,AiLA S. REF== T. TH= - - RA;I_:,AR BR!UGF CROSSI _'R.:
,ALMAT CROSSING DRAWI'�:-
"ROW EN:..INEEF'INi; CC;r c;L1_TA"�dT ; IfJC�
Trow P iaw, ,�-.,.r
NTS. 1 O 1-20-2004 1 AI.S
( 00 D) COLONIAL PIPELINE COMPANY
ATLANTA, GEORGIA
TYPICAL DAM AND PUMP
MAINTENANCE DIG
AT WATERBODY LESS THAN 15'
TKW PROJ. N0: Cll .*N;; I SAEET
THESDD5038$ I COL-00030 1 2 OF 2

APPENDIX E
CPC SOIL EROSION AND SEDIMENT CONTROL PLAN

Colonial Pipeline Company
Soil Erosion and Sediment Control Plan
For
Pipeline Maintenance Activities
Objective
Disturbed areas are to be restored as close as practical to their original contours and
conditions so that once vegetation is reestablished, erosion will be reduced to the same
or lower level that existed prior to disturbance.
Description
This section defuses the soil erosion and sediment control measures that Colonial
Pipeline Company will implement during and after inspection and repairs of the pipeline
are complete. The objectives of this plan are to establish general guidelines for
controlling erosion and sedimentation and to specify criteria for sensitive or particularly
susceptible soil areas. The plan incorporates measures to control erosion and
sedimentation, including minimizing cover removal, limiting the time of exposure,
limiting the flow of water onto the disturbed right-of-way, and filtering or settling out
sediment from water flowing from the right-of-way.
The primary obj ective of the soil erosion and sediment control plan is to reduce the area
and duration of soil disturbance and reestablish permanent vegetation as soon after
construction as possible, thereby minimizing long-term erosion and sedimentation.
Some erosion is inevitable during construction, however, the plan includes measures to
reduce erosion to the minimum practical.
Colonial Pipeline Company plans to reduce soil erosion and provide sediment control
during the repair of the pipeline at the project site by incorporating the following
measures:
Water pumped from the construction area as part of the dewatering operation
from the excavation will be filtered through silt filtration bags and discharged to
a area.
• Al! �.,,-orlL «il II),- contrnecl «•itllitl the existin; ti _?11t-E,f-« �� - StE3ked hay bales and silt
te:1C' 1_:.':::i i i1:.C1 . 1'G:'lllli:i Cliff � l ili`:is Giilti]`ni,"i:li`ill:ieJ .:i`:1 �-egetation is established.
PrOpeI: colltLoIS \� ili Lie adcieci I i II e•sary CilIi-III ti !IIstl ll�il��ll.
• All -kenns and conditions within Nationwide Permit 3 will be followed.
• Erosion control measures will be installed prior to conducting any soil disturbing
activities associated with the pipeline maintenance activity.
• Clearing of vegetation will be kept to an absolute minimum and confined to the
existing pipeline easement area. The easement area is 50 feet in width and devoid

of large trees. The right ofway is vegetated with undergrowth grasses and other
short vegetation.
Vegetation will be reestablished within disturbed areas and along stream banks
as soon as possible upon completion of work. Disturbed areas will be seeded
with a wetland seed mixture
• All erosion and sediment control measures will be inspected every two weeks at a
minimum and after every significant rainfall event of 0.5 inch or more until
disturbed areas have been stabilized. Identified damages to control measures
must be repaired immediately.
Refuse and Waste Disposal
Colonial's representative will not allow the Contractor to discard any litter, including
paper, bottles, cans, rags, sacks, welding rod stubs, fuel. crankcase draining. coating
materials, equipment, and junk pipe in the ditch or along the right-of-way. All refuse
must be collected and disposed in accordance with company specifications. Personnel
will be instructed regarding the correct procedure forwaste disposal.
Maintenance/]Inspection Procedures
The following inspection and maintenance practices will be implemented to maintain
erosion andsediment controls:
i. All control measures will be inspected every two weeks at a minimum and following
any storm event of 0.5 inch or greater.
2. All control measures will be maintained in good working order. If a repair is
necessary, it will be initiated within 24 hours of the report.
3. Built-up sediment will be removed from silt fences when it has reached one-third the
Height ofthe fence.
4. Silt fences will be inspected for depth of sedunent, tears, secure attachment of the
fabric to the fence posts, and firm placement of the fence posts in the ground.
5. Temporary and permanent seeding and planting will be inspected for bare spots,
washouts, and healthy growth.
6. Colonial Pipeline Company will select individuals tobe responsible for inspections,
maintenance and repair activities, and completion of the inspection and
maintenance report. Personnel selected for inspection and maintenance
responsibilities will receive training from Colonial Pipeline Company or its
representative. Personnel must be trained in all practices necessary for maintaining
the erosion and sediment controls used on -site.

APPENDIX F
401 & BUFFER PERMITTING PCN SUBMITTAL CHECKLIST

Version 4.3
Updated December 6, 2023
401 & Buffer Permitting PCN Submittal Checklist
The application fee (Checks may be made oiit to "N.C. Division of Water Resources"
- $323.00 for 401 Water Quality Certification with minor impacts
- $767.00 for 401 Water Quality Certificatir}n with major impacts
Express Review Fee (Amount requested on Acceptance
Letter)
One complete cagy of the PCN Application and supporting documentation (no larger
than 11 X 17 plans if submitting paper copies)
Stormwater Management Plan (if applicable — see PCN Form Help File Section F)
❑ 1) Please provide the stormwater management plan along with all supporting information
pertaining to this project including the following:
a. Entire site development/layout plans delineating all drainage areas;
b. Design calculation sheets for all proposed SCM(s) sized for both on -site and
off -site drainage;
c. Application form SWU-101, the -1505 application fee and last two signature
pages may be omitted;
d. Supplemental form for each proposed SCM and Required Items Check List
(https://deg. nc.cioviabout/div[sions/energy-mineral-and-land-
resources/stormwater/stormwater-program/stormwater-design) along with all
required items;
e. A Notarized Operation & Maintenance Agreement for each proposed SCM ;
f. Detailed construction drawing sheets shall include
(i) Erosion and sediment control plans;
(ii} Installation and planting schedules for the proposed SCMs;
(iii) Appropriately scaled plan views and cross sectional details of all
SCMs and associated components — inlet and outlet structures,
forebay, respective zones and pertinent elevations;
(iv) Collection system routing stormwater to the proposed SCMs;
(v) Any energy dissipator and vegetated area (if provided);
(vi) Maintenance access/easement for the proposed SCMs.
If your project is located within a State implemented Riparian Buffer Rule Area, submit the
following along with site plans and PCN form:
1) Details for on -site diffuse/dispersed flow provisions, (refer to
https://deg.nc.gov/abouVdivisions/energy-mineral-and-land-
resou rces/stormwater/stormwater-prog ra m/stormwate r-design ).
DWR Stream Determination Forms for streams on property and DW R determination
letter for wetlands or streams (if applicable).
The following is the most critical of all the information that you must provide. The quality and
detail of the information will often determine the expeditiousness of the review. The following is
a checklist of the types of pertinent information required at a minimum:.

Version 4.3
Updated Der -ember 6, 2023
Maps and Plans:
The most recent version of the 1:24,000 USES Topographic Map - Please cleanly draw or
delineate the site boundaries on the topographic map.
The most recent version of the !)oui,rl and published County NRCS Sail Survey Map -
(required for projects within the Ne,.ise River Basin, Tar -Pamlico River Basin, Randleman
Lake Watershed and the Catawba. River Basin, also recommended for all projects) - Please
clearly delineate the site boundaries'. etc. on the map. If the delineation obSCUres any of the
features, it is recommended that a clean copy be provided. Copies of the current soil survey
and/or soil survey map sheets can be obtained from the local NRCS County office
(http://www.nc.nres.usda.gov/). G1S soil layers are not acceptable.
❑/ Vicinity map - Please clearly mark the location and approximate boundaries of the property
and project on the map. Please indicate north arrow and scale. Please include applicable road
names or State RiOad n,,m'ibers.
❑ The Site Plan - The most critical map to be provided is the site plan. The following is the
minimum list of plans that are typically needed.
W1Pre-construction/Pre-existing conditions - This sheet (or sheets) must include:
• X! ,U'-is,,ai'-'�ional and non -jurisdictional wetland, stream, water features, State regulated
l,r� trers (de 1--eate•d into Zones 1 and 2)
• TopograpNc conto�. s with elevations
• Any existing structures and impervious areas
• Existing utility lines and easements
• Existing roads, culverts, and other pertinent features
• North arrow and the scale (1":50' scale is recommended).
0 Proposed conditions - This sheet (or sheets 1 must include:
• All jurisdictional and non jurisdictional vvetiand, stream, water features, State regulated.
buffers (delineated into Zones 1 and ?)
* Lot layout (if a subdivision or comr-:rrcial development is proposed) - lots must be
developable without further impacts ,o jurisdictional and non -jurisdictional wetlands,
streams, water features, and State regulated buffers. Building envelopes must be provided
when streams, wetlands, riparian buffers, or water features exist on a lot
All built -out structures and impervious cover
• Final grading contours with elevations
* All utilities and easements (including septic fields on all lots within 100 feet of stream,
wetland, or water features - if applicable)
• Impacted areas —these should cc), vvAl, the Impact numbers listed on your PCN
form.
Drainage Plans - Final drainage plans rnu-,t iclt.ide the following:
• Locations and pertinent elevations and sizes of the stormwater collection system and
drainage ways
• All inlets and outlets must also be shown with pertinent elevations (All outlets to wetlands
must be at a non -erosive velocity, generally less than 2 ft/sec during the peak flow from
}he 1Q-vr storm)
• Scaled stormwater BMPs must also be indicated as required by DW R rules and policies

Version 4.3
Updated December 6, 2023
• In certain cases (see Section F of PCN form), final stormwater management plan must
also be provided (see Stormwater Management Plan Checklist)
Proposed Impacts -All impacts to jurisdictional and non -jurisdictional wetland, stream, water
features. and State regulated buffers must be shown and labeled on the site plans at a scale
no smaller than 1" = 50'. All excavation, fill, flooding, stabilization, and other impacts that will
be conducted in or near jurisdictional and non -jurisdictional wetland, stream. water features.
and State regulated buffers must be indicated. Please provide cross sectional details showing
the provisions for aquatic life passage (burial of culvert 20% for culverts !� 48 inches, and 1-
foot for culverts > 48 inches).
Wetland Impacts:
Precise grading and final elevation contours must be provided. Existing vegetation
and any clearing must be specified.
All subsurface utility lines must indicate the location of anti -seep collars.
Construction detail for anti -seep collars must be provided.
Roadway or other crossings of riparian wetlands may require floodway culverts to
maintain existing hydrological conditions.
® Plans should show that the hydrology of remaining wetlands on the site will be
maintained.
Stream Impacts:
Stream impacts must be clearly shown on the plans. The centerline as well as the
banks of the stream must be surveyed or located by GPS for the portion of the
stream to be impacted.
The inlet and the outlet of all culverts should be aligned with the stream as much
as possible. Inlet and outlet elevations and streambed elevations should be
indicated. Any inlet or outlet protection must be shown and enumerated on the
impact maps).
For bottomless culverts or other spans, a vertical cross section should be
provided that shows the minimum distance from each span to each stream bank,
the stream cross section, the height of the span above the stream and the
minimum distance from the edge of each footer to each stream bank.
Additionally, please provide a signed and sealed geotechnical report of
subsurface soils at the proposed bottomless culvert location. The report must
comply with the Division of Highways — Guidelines for Drainage Studies and
Hydraulic Design, prepared by A.L. Hankins. Jr., State Hydraulics Engineer -
1999.

Version 4.3
Updated December 6, 2023
Multiple culverts or sectioned box culverts typically require the use of sills, off-
setting or other means to match the cross section of the existing stream (in order
to maintain stream stability and provide aquatic life passage). A vertical cross
section of the culverts should be shown overlain with the up and downstream
stream cross section including the stream flood -prone area.
0 Impacts associated with dam construction must indicate and enumerate all fill
associated with the dam footprint, spillway and any bank stream bank stabilization.
The length of stream impounded must also be indicated and enumerated.

APPENDIX G
USACE WILMINGTON ❑ISTRICT PCN FORM

STATE
NORTH CAROLINA
EnWronmenraf Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. [Click enter.] ❑ate received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.95746
Longitude (DD.DDDDDD): 79.68906
Farm Version 4.3, 1210412023
Pre -Construction Notification (PCN) Form
(Ver. 4.2; 1210412023)
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note. fields marked with a red asterisk ` are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
https:lledocs.deg. nc.govfWaterResourcesf DocView.aspx?dbid=0&id=2196924&cr=1
Page 1 of 23 PCN Form Version 4-3- December 4, 2023

A. Processing Information
County (counties) where project is located:
Guilford Additional (if needed,,
Is this an ARPA project? '
D Yes -K-1 No
If yes, ARPA project number:
'The oe foundr:-.,.— Fund"
4
--k or Lap here tc, ---itei ke�-t
14,ARPA Corey
Is this a N4--.DMS project?
(Click yes only if NC DIVIS is the applicant or co-
E-1 Yes M Na
applicant)
Is this a public transportation project?
(Publicly funded municipal. state, or federal road, rail,
El Yes MY' No
or airport project)
D Yes v— No
Is this a NC DOT project?
If. yes. Ni DOT TIP or state project nUrnI.Der:
Click to enter.
Click to enter.
If yes, NCDOT WBS nun-iber-
--I Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
1 a- Type(s) of approval sought from the Corps:
Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted?
:0 Yes EK, No
Please provide the date of the previous submission.
Click to enter a date -
El Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
'
71 Regional General Permit (RGP)
authorization?
-1 Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please COMaCt \,'OL)r Coi'os
representative concerning submittals for standard permits. All required
items can be included as attachments and
submitted with this form.
1 c. Has t h E., NWP o GP number been verified by the Corps?
El Yes EK, No
u, r. s; (.list all numbers
3(a) and (c)
RGF l:Qi ;umbers
Click to enter.
Are you a feclefal applicant?
01 Yes IM No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text.
ld- Type(s) of approval sought from DWR (check all that apply):
X 401 Water Quality Certification — Regular
El 401 Water Quality Certification— Express
El Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
71 Individual 401 Water Quality Certification
Is this a courtesy copy notification
El Yes M No
Page 2 of 23 PCN Form Version 4.3- December 4, 2023

1e.
Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: "
❑ Yes
7� No
For the record only for Corps Permit: *
0 Yes
71 No
1f.
Is this an after -the -fact permit/certification application? '
❑ Yes
Z No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
❑ Yes
M No
mitigation of impacts?
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties? ` ❑ Yes
EX No
1i.
Is the project located within an NC ACM Area of Environmental
❑ Yes
El No ❑ Unknown
Concern (AEC)? "
1j.
Is the project located in a designated trout watershed? '
❑ Yes
M No
If yes, you must attach a copy of the approval letter from the approprlate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 23 PCN Form Version 4.3- December 4, 2023

B. Applicant Information
1a,
Who is the primary contact?
Jennifer Price
1b.
Primary Contact Email:
jeprice�z-ca[pipe.corn
1c.
Primary Contact Phone: (###)
[phone]
1d.
Who is applying for the permit/certification? ` (check
all that apply)
❑ Owner 0 Applicant (other than owner)
1e.
is there an agent/consultant for this project?'
® Yes F-1 No
2.
2a.
Landowner Information
Name(s) on Recorded Deed: '
See attached easements
2b.
Deed Book and Page No.:
Click to enter
2c.
Contact Person (for corporations):
Click to enter.
2d.
Address "
Street Address:
Click to enter
Address line 2:
Click to enter
City:
Click to enter
State/ Province Region:
Postal/ Zip Code:
Click to enter.
Click to enter
2e.
Country:
Telephone Number: - #
Click to enter.
Click to enter.
2f.
Fax Number: (###}#t #-####
Cic;:. to enter
2g.
Email Address:
3.
Applicant Information (if different from owner)
3a.
3b.
Name: "
Business Name (if applicable):
Jennifer Price
Colonial Pipeline Company (CPC)
3c.
Address:
Street Address:
7524 Kenstead Circle
Address line 2:
City:
Click to enter.
Charlotte
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
28214
Country
USA
3d.
Telephone Number: i TM} = -R# #
(704) 42 1 -3924
3e
Fax NU11,1 der: ( )
Click to ente.
3f.
Email Address: "
[e-mail]
Rage 4 of 23 PC Form Version 4.3- December 4, 2023

4. Agent/ Consultant (if applicable)
4a. Name: `
4b. Business Name:
Michael Barfield
Corblu Ecology Group, LLC
4c. Address:
Street Address: 3225 South Cherokee Lane
Address line I
Citv:
Click to eater
Woodstock
State/ Provincel Region:
Georgia
Postal/ Zip Code:
30188
Country:
USA
4d. Telephone Number: " (###)###-##+#
[phone]
4e Fax Nur uer: (##1#)###-##I #
4f. Email Address: `
Click to enter
mbarfield@,corblu.com
Agent Authorization Letter:'
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www. saw. usace. army.mil/Missions/Reg ulatory- Permit-Program/Permitsl2O l 7-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 23 PCN Form Version 4.3- December 4, 2023

C. Project Information and Prior Project History
1. Project Information
f a. Name of project:' I Line 23 Exposure Liberty Road Guilford Co. NG
1 b. SuadMsion nan,,e Of appiopnatek. Click to enter.
1c. Nearest municipality/town: * Climax
2.
Project Identification
2a.
Pr:::;) sty identification number (tax PIN or parcel ID).
7890547404-000; 7890538886-000; 7890642222-
000
2b.
Prope,ty si e ( 11 acres):
Click to enter
2c.
Proier:: A(: jiess:
S-d eet Ad -dress:
Click to enter.
Address line 2:
Click to enter
City:
Climax
State/ Province/ Region:
North Carolina
27233
Postal/ Zip Code:
Country:
USA
Latitude (DD.DDDDDD): " 35.95746
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): `
Longitude (-DD.DDDDDD): *-79.68906
3. Surface Waters
3a. Name of nearest body of water to proposed project. '
Big Alamance Creek
3b. Water Resources Classification of nearest receiving
WS-IV; NSW
water: *
The Surface Water Classification map may be found at this link:
https:/incdenr. ma ps.arcgis. comlapps/webapoviewer/i ndex.htm I? id=6e l 25ad 7628f494694e259c80dd64265
Cape Fear
3c. In what river basin(s) is your project located? `
Choose additional of needed)
3d. Please provide the 12-digit HUC in which the project is
030300020301
located:
The Find Your HUC map may be found at this link:
hops://ncdenr. maps.arcgis. comlapps/Pu bl icl nfor,mation/index. html?appid=ad 3a85aOc6d644aQb97cdO69db238aG3
Page 6 of 23 PCN Form Version 4.3- December 4, 2023

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
toi, applicat,-
.•;lowed and ,i, ;•,t e:i p.ntroieum pipeline right-of-way (ROW). The strearri)ed.lb -',,* erosion within the unnamed
-; r it;r ° 'n�:nit=r •; is t, . esult of headcut migration from storm flows, whir:h ', .:7 r-,-i o':�.fad/displaced the
iir d jl AeCTl've coder over CPC's Line 23.
ive Cc i ps permits or DWR certifications t een obtained for this ::I Yes No Mx Unknown
_
project (including all prior phases) in the past^
if y.:v. ;-:!ease g : �'- the DVVP Cc-J `icatio-, number andlor Corps (Click to enter.]
nct,r;r, IC, ,Bx. U•.-'•r'�'_(7r�nr;_.::�i)i::�:����.. [Click to enter.]
Attach an',. -ieo.. ri nt ':_Jc,.,;
4b2.
Is any po i :oil c„ ti l vc, ri: ai:. ady comp le-e V ` LJ Yes Nx No
If yes. descrjdre the coriipieted work.
4c.
List of atner certifications or approvalsideni4s received from other federal, state or local agencies for work
described in This application rot related to the 404 or 401.
4d.
Attach an 81.,2' x 11 excerpt from the rnost recent version of the LISGS topographic map indicating tree location of
the project site.
4e.
Attach an 8'lz x 11'" excerpt from the most recent version of the published County MRCS Soil Survey map
depicting the project site.
4f-
L st the total estimated acreage of all existing wetlands on the
0.01 acres
property-
4g.
List the total estimated linear feet of all existing streams (intermittent
65 linear feet
and perennial) on the property:
4gl .
L+st the total estimated acreage of all existing open waters on the
Click to antei acres
property:
4h-
Fxplair -,he purpose of the r oposed project:
Recer1t .�-orm events have resulted ir, tiie jpstream migration of a headcut withi- ". ,vhich h:::s displaced the
pralec',, z. cover (i.e.. stiearn Substrate) within CPC s ROW resulting in the exp::s;.,re: _,f Line ?3 TI1e lark of
pipeline protection) at this location has resulted in conditions where the pipeline s cu, ently v,.:lne riahle to potential
damage_ Further, these conditions are not consistent vdith CPC's or the U.S. Departn-,t?i i T, ai r }io s
(USDDT) regulatory requirements for pipeline protection. CPC proposes to replace th W t e
line using Submar articulating revetment mats and rip rap. These actions serve to replace ',he i ! w e (E!c.-Jve
cover over the existing pipeline and prevent future conditions from occurring within the inter nitteiit ,r;:r.itary that
may leave Line 23 vulflerable to potential damages.
Page 7of23 PC[A rofEl V'P_r" ioil1 __ Ue_:Et',..=1--" 2u13

4i. Describe the overall project in detail, including the type of egi.,ipment to be used: "
The miaintenance location will be accesses; `1 _::-I- Liberty Road onto CPC.. = ex.isting, mowed.. and maintained
ROW tFiguie 3i Prefabricated mats wil: be uwec: `o temporar,ly cross Vv l sric: 11 as necessary to conduct the
required maintenance from either bank of 11 ( 11 'i:ii ricii,`:. B). CPC intends to i aspect Line 23 and replace the
required mar l'r•a protective cover over the pipeli�-!r usling Siuhr-i;ar pre-ca s; s 1'etment ri :` i-d •'p rap to
rernediate ti;.e i,c:1: ref protective pipeline saver from st rt.,,r :r-:sinn. To re-.. si: lish the pipeline :i ,.-restive cover.
CPC intends h. _ .:x7r dUC[ to 'Ci1C:'d.lal 11 temporarily i c-i s' :the I` iaintenan - ;ccs°ion from Strecld I' :-'•,v [Le., dam
and purri::=;r::.;r •a ;he stye ;,r �; ,:�avate the erode;: ,,.ea on Li._,n i`i=;I,:e repair- to Line 23
as necessa' )': 41 1:;ackfill it ie ,ex,'— ,-. atlon area: and 5) r stni'e 417e streairi:r r, to :l :,f rt]xlm i"c i)ir -e; o ::on contours
and elevations aver Line 23 using Submar mats and r ; i a::,. These nre- .asr rats and ri1: r;aID vi!, be
keyediin-iioedded into the stream bed and dariks In a rnanr.ei tnat mairitalns tgiaide and norn-al stream flow
conditions (Appendix C).
To minimize sedimentation to 11 durinet the at----) :i--i-.-ientioned maintenance activity, darns constructed of
sandbags, steel plates, or water-i,ir'i�t, e ,'� ast�c dams will be temporarily i7 �-�r-ed ups:rer,rn of the ri,=;i� e •,-.ii? e
area to conduct maintenance act -s in-1.+;e-dry". T.ie stream flow will be pull l'-ieC cil : i- 1Id :hi- lai '-.,Lfi l :e
area, discharging immediately dr_i.'jnstre, i ' i is an enerr;.; dissipater to prevent 11 eWT1 sCoui • The purnp(s) used
will be sufficiently sized to accommodate -i ie anticli:iated st. can i T ow fAnpel i- •,i.:.: D i All exc s vated soils will be
temporarily stored in the adjacent upland a :=a on clvo;r:;ti,e rdLi ac ui - i ,-Ji ai 1 c aterial with=ri tF1e CPC ROW,
Rip rap will be used above and below the n-iat s•; steim .along the strean-i bariks and within the stream channel for
additional stabilization. Further, rip rap •;:it ,ir: tli� °:re;,'n channel will be placed on an erosion -.:antral blanket
(geotextile fabric) in a manner where the " ni h ::i tciD elevation of the rip rap does not exceed that of the original
stream bed elevation. Once the required rni--iw -il j:iiotective pipeline cover (pre -cast rev-etntent macs.) is keyed
into the streambed in a manner that maintains existing grade and flow conditions of the stream- the tei-inporary
dams will be removed, and normal streamflow will be restored.
The :--rposu, maintenance activity will require unavoidable permanent and temporary impacts to 11, and W1.
Pe.'I-.=i,'e-n-' ;!irpacts include approximately: 1) 60 linear feet (.LF; 0.0036-acre) of 11 [45 LF (0.003-acre of Submar
;i 1 -1,. LF (0.0006-acre) of rip rapt: and 2) 0.0021-acre of wetland (0.0010-acre Submar mats and 0.0002-
a:: i- =,� :. Temporary impacts include 7:::i: r-xin�.ately Lei) i F i30 LF (0.0006-acre; ,apstream, and 30 LF
C; tii:1Ci?-= ie] downstream] of 11 for tempo.=a _; .:. r;space;'gradirg associated with providing ;he required
live cover over Line 23.
-_andard erosion control practices will be ewiployed (Appendix E). Specifically, the disturl)ed areas along
:l ie ,::re _:ri7 bank arci distuii bance vo t h Ili the adjacent emergent wetland area wiII l-)e reseeded with a native
vVet arid seed n)ix =rd strawed. No monofiIament erosion control matting wi11 be used.
Equipment wi11 inc i,.:: ie: a ek'c.avator. rock truck (for material transport), properly sized pumps, and a welding
truck (to cr., nd.i•.::: 1; 1: re,r"i ._ .-._. r,e essary).
;i. Attc-i•::i1 I::i Lied ii ::15. re : i rart;ilI&"Je[::ir:r s ;aaot areas for the proposed project.
4k_ VViil this activity involve dredging in wetlands or vniters? -
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Cliok to enter tent.
Page 8 of 23 PCN Form Version 4-3- December 4, 2023

5.
Jurisdictional Determinations
5a.
Have rh ,;, tl ,i11c:s �,I "ei near •J un ti ,Yes ❑ No
3�, F rw_ o �h= project • -Ire, ; and Figure 3 for site access
5l .
`h•% :=:c: ;:s l i:1e a Jurist ::ti iar�r,ri ;atYor�, ❑ Prelimn.ary ❑ Approved ❑ Emalled concurrence
t. r of :_fie , , I- i,,a1 " ,-as rl,- de'' � Not Verified ❑ Unknown ❑ n/a
Corps AID riun'ibe; 3A',.V-0000-00000): Click to enter
Name (if known): Michael Barfield
_..
If ',: :..,; s, who deline.,t,&,::' -i;e :II
Agency/Consultant Company: Corblu Ecology Group, LLC.
areas?
Other. Click to enter.
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
elthel agency.
J.;144'- �i.CfRtw
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
ua. Is this a phased pro;erT, ❑ Yes L No
i3b. If yes.. explain.
Are any other 1VWP(s), regional general permiti.s1. or individual permiUs i used; or intended to be used, to
authorize any part of the proposed project or related activity? This inc odes other separate and distant crossings
for iinear projer:ts that require department of the Am)auth',nZatlon bLJt don't require pre -construction
notification,
Ctick tc
7. Addresses of adjoining property owners. lessees. etc. whose property adjoins the waterbody [:if more than can be
entered here, please attach a supplemenia+ list
Iyde Scott
5721 Liberty Rd
i Climax, NC 27233 (access)
Thomas Hilliard
3054 State Route 93
Ironton. OH 415638 (adjoins waterbody)
Bruce and Lori t%nibb
4-325 Cane Ro
Climax, NC 27233
8. Scheduling of activity:
Activity will be scheduled in 2024 after approval of this certification and is not expected to exceed 20 days.
Page 9 of 23 PCN Form Version 4-3- December 4, 2023

D. Proposed Impacts Inventory
Impacts Summary
M Wetlands
la. Where are the impacts associated with your project d Buffers
(check all that apply):
Pond Construction
�57, Streams - tributaries
Open Waters
2. Wetland Impacts
If there are wetland impacts proposed on the site. complete this table for each wetland area impacted.
2a.
Site #-
2a1.
Impact
ReasonfType'
2b.
Impact
Duration"
2c.
Wetland Type`
2d,
Wetland Name'
2e.
Forested
?"
2f.
Jurisdiction
Type'
2g.
Impact Area
(ac)"
W1
Fill (Incl.
Riprap)
Permanent
Seep
W1
Na
Both
0.0021
W2
Choose one
Temp/ Perm
Choose one
Click to eater
YIN
Choose one
Click to enter
W3
W4
Choose one
Choose -)ne
Tempi Perm
Tempi Perm
Choose one
Choose One
Click to enter
Click to eater
YIN
YIN
Choose one
Choose one
Click to enter
Click to enter
W5
Choose one
Tempi Perm
Choose one
Click to enter
YIN
Choose one
Click to enter
W6
Choose one
Ternp/ Perm
Choose one
Glick to enter
YIN
Choose one
Click to enter
W7
WS
Choose one
Choose one
Tempi Perm
Tempi Perm
Ch,_,+- S one
Chooss cz-,e
c _ lick to r ter
cll., i* tc. er,twr
YIN
YIN
f-hoose one
d`jooFe one
Click to enter
Click to enter
W9
Choose one
Tempi Perm
Choose one
'` lick to enter
YIN
Choose --,ne
Click to enter
W10
Choose one
Tempi Perm
Choose one
Click to enter
YIN
Choose one
Click to enter
W11
W12
Choose one
Choose one
Tempi Perm
Tempi Perm.
Choose one
Choose one
Click to enter
Click to enter
YIN
YIN
Choose one
Choose one
Click to enter
Click to enter
W13
Choose one
T�nmp, P=-rro
Choose one
r-, ; entr
i.!
Choose one
Click to enter
W 14
:t a _use ,)ne
i emp/ Perm
Choose one
i i
Choose one
Click to enter
W15 i=:l: a, :r: r:)ne Tempi Perni Choose one Click to enter
2g1. Total temporary wetland impacts
YIN Choose one Click to enter
0 ac
2g2. Total permanent wetland impacts
0.0021 ac
2g3. Total wetland impacts
0.0021 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
k.JIcK to eater *eA[
2i. Comments:
Click to enter text.
Page 10 of 23 PCN Form Version 4.3- December 4, 2023

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
" All Perennial or Intermittent streams must be verified by DWR or delegated local government
3a 3b. 3c. 3d. 3e. 3f. 3g. 3h.
Site $V Impact Reason' Impact Impact Stream Name* Stream Jurisdiction Stream Impact
Duration* Type` Type` Type* Width (avg length
ft) ` (linear ft)
S1
Fill
Permanent
Fill (Ind.
11
Intermittent
Both
2
60
Riprap)
S2
Grading/Workspace
Temporary
Other
11
Intermittent
Both
2
60
S3
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enrer
S4
Click to enter
Ternp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
S5
Click to enter
Temp/
Choose
Click to enter
Perllnt
Choose
Click to
Click to
Perm
one
one
enter
enter
SF
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
S7
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
S8
Click to enter
Temp/
Choose
Clink; to enter
Perlint
Choose
Click to
Click to
Perm
one
one
enter
enter
S9
Click to enter
Temp/
Choose
Click to enter
Per/lot
Choose
Click to
Click to
Perm
one
one
enter
enter
S10
Click to eater
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Clink to
Perm
one
one
enter
enter
S11
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
S12
Click to enter
Temp/
Choose
Click' o enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
S13
Click to enter
Temp/
Choose
Click to enter
Perllnt
Choose
Click to
Click to
Perm
one
one
enter
enter
S14
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click io
Click to
Perm
one
one
enter
enter
S15
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
0-�!Or=
enter
enter
S16
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to
Click: lcG
Perm
one
one
enter
enrer
S17
Click to enter
Ternp/
Choose
Click to enter
Perllnt
Choose
Click to
Click to
Perri
one
one
enter
enter
S18
Click to enter
Temp/
Choose
Click to enter
Perllnt
Choose
Click to
Clink to
Perm
one
one
enter
enter
Sig
Click to enter
Temp/
Choose
Click to enter
Perllnt
Choose
Click to
Click to
Perrn
01-16
one
enter
enter
Page 11 of 23 PCN Form Version 4-3- December 4, 2023

S20
Click to enter
Ternp/
Choose
Click to enter
Per/Int
Choose
Click to
Click to
Perm
one
one
enter
enter
3i1.
Total jurisdictional ditch
Click to enter. linear ft
impact:
3i2.-rt-.,i ;permanent stream
60 linear ft
in -pacts:
M. T :^tal temporary stream
60 linear ft
impacts:
3A. Total stream and ditch
120 linear ft
impacts:
3j.
Comments:
Click to enter.
Page 12 of 23 PCN Form Version 4.3- December 4, 2023

4.
Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, tt,.e ni!antic Ocean, or any other
open water of the U.S., individually
list all open water impacts in the
table Belo,":.
4a.
4a1. 4b.
4c,
4d.
4e.
4f.
Site #*
Impact Reason Impact
Waterbody Narne-
Activity Type*
Waterbody
Impact area
Duration'
Type"
(ac)'
01
Click to enter.
Ternl,l Peim
{:lick to anter
Y :f-1 , e onc-
Choose one
Click to enter
02
Click to enter.
Tempi Perm
Click to enter.
CTI,_ ' e one
Choose one
Click to enter.
03
Click to enter.
Ter! ii:, P-;iiii
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
T enip+' F&nn
Click to eritel
Y1`hocis& one.
Choose csne
C°lick to enter.
05
Click to eater.
Ternpl Perri
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Cilcrc to enter ac
4g.
Total permanent open water impacts
Click to eater. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Commients:
Click to enter,
5.
Pond or Lake Construction
If pond or la`<:.- c:: str.iction is proposed. complete the table below. (*This does NOT include tiffline stormwater
5a.
5c.
5d.
5e.
Pond ID
Prop:::sJ x e or Wetland Impacts (ac)
Stream Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded Filled
Excavated
Flooded
Filled Excavated
Pf
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
`:lick to
enter,
enter-
enter.
enter.
enter-
enter.
enter.
Click to
Click to
Click to
Click to
Click to
Click to
Click to
P2
Choose one
enter.
eater.
enter.
enter.
enter,
enter.
enter.
Click to
Click to
Click to
Ciirk to
Click to
Click to
Click to
P3
Choose one
enter,
enter.
enter
enter,
enter.
enter
enter
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Mick to
enter
enter.
enter
erGter.
enter
enter
enter.
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
D Yes ❑ No
If yes, permit ID no.:
Click to eater.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter-
5k_
Method of construction:
Click to enter.
Page 13 of 23 PCN Form Version 4-3- December 4, 2023

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
Other: Cape Pear — Jordan Lake
6d. 6e. 6f. 6g.
Stream Name` Buffer Zone 1 Impacts` Zone 2 Impact*
Mitigation (sq ft) (sq ft)
Required?`
Site #*
6b.
Impact Type*
6c.
Impact Duration*
B1
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to eater.
Click to enter
B2
Choose one
Templ Perri
Click to enter.
YIN
Click to enter.
Click to enter
B3
Choose one
Templ Perm
Click to enter.
YIN
Click to enter.
Click to eater.
B4
Choose one
Ternp/ Perm
Click to enter.
'Y/N
Click to
Click to enter.
B5
Choose one
Temp/ Perm
Click to enter
YIN
Click to enter.
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter
Y/N
Click to enter
Click to enter.
B7
Choose one
Temp/ F eii-i
Click to enter.
Y/N
Click to enter
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
YIN
Click to enter
Click to enter.
139
B10
r'hnose nne
Choose. one
Temp/ Perm
Temp/Perth
Click to enter.
Click to enter
Y/N
Y/N
Click to enter.
Click to enter
Click to enter..
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
YIN
Click to enter
Click to enter.
B13
Choose one
Temp/ Perm
Mick to enter.
Y/N
Click to enter
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter,
B16
B17
Choose one
Choose one
Temp/ Pearl
Temp/ Perm
dick to enter.
Click to enter.
Y/N
Y/N
Mick to enter.
Click to enter.
Click to enter.
Click to enter.
B18
Choose one
Temp/ Pena
Click to enter.
Y/N
Click to enter
Click to enter.
B19
Cho,.rse zne
T Emr,? P rm
Click to enter
Y/N
Click to enter
Click to enter.
S21-1
Chcj: �, e -ine
T onp/ Pena
Click to enter.
Y/N
Click to enter.
Click to enter.
"li. T�)tal temporary; Impacts:
Total permanent impacts:
Zone 1: sq ft
Zone 2: Click to enter. sq ft
Zone 1: Click to enter sq ft
Zone 2: Click to enter, sq ft
fah. Total combined buffer impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
15A NCAC 02B .0267(6)(a) Exemption when existing uses are present and ongoing
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 23 PCN Form Version 4.3- December 4, 2023

E. Impact Justification and Mitigation
1. .Avoidance and Minimization
1a. Specifically describe measures taken to avoid of minimize the proposed impacts thrnur ::;i fi'ect design:
The Submar mat system was designed ?o minimize disturbances to aquat r n: e.=. vlh i� arl,,iev ng the
required protective coverage.
1 b. Snecific:ally describe measures taken to avoi(j or minimize proposes: impacts
The area veil) be temporarily de -watered with a dam and pump, whin-, vgill a.lio:%: fC;r r ::,i : k-, take place
without contacting flowing water, thus reducing downstream sedimF;:-ai.c,r. Further, the articulating revetment
mats are pre -cast, which eliminates the need to bring live concrete
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is ra ,hired, by whom is it required? " ❑ DWR ❑ Corps
(check all that apply)
2b. if yes, which mitigation options) will be used for this - Mitigation Bank
project? ' (check all that apply) - In Lieu Fee Program
- Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute 143-214.11 (dl ).)
3a. flame of -nitigation bark:
3b. Credits purchased: requested:
Click to enter
Type: !A_ =v one
Quantity Click to enter
Type: Chccs•t� one
Quantity Click to enter
Type: Chc-use one
Quantity Click to enter_
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
4c.
Stream mitigation requested: Click to enter. linear feet
If using stream mitigation.. ha` is t ,:- }'Iea1n temperatrire: Choose one
NC Stream Temperature Classif::atien P.I cps can i)e found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=1 Q7:27:2734709611497:-,NO:RP:P27 BUTTON KEY.0
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
4f.
Riparian wetland mitigation rect.iested:
Nan -riparian wetland mitigation requested:
Click to enter. acres
Click to enter acres
4g.
Coastal ftidal7 wetland mitigation requested:
Click to enter acres
Page 15 of 23 PCN Form version 4.3- December 4. 2023

4h. Comments:
Click to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
including mitigation credits generated.
Click to enter.
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes ❑ No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
fib.
if yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
fie.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
if buffer mitigation is required. is po ,i a--' to a mitigation bank or Yes El No
-FEI
NC Division of Mitigation Services ,proposed?
6h.
If yes, attach the acceptance !et4e- Iron-, the mitigation bank or NC Division of (,litigation
Services.
6i.
Comments:
15A NCAC 02B .0267f6i(a) Exemp:icn vvhen existing uses are present and ongoing
Page 16 of 23 PCN Form Version 4.3- December 4, 2023

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to h-ctecteu a, ai-; buffers
Cs
identified within one of the NC Riparian Buff1r Protec-i::r, Rules? —
r
1 b. II buffer impacts an highground impacts require c:;;ruse ;ovw cr vtr�er f�7 o, -, ❑: scorn w;:.+ter tr e t,
project is subject to a state implemertIpci riparian buffer protection program, include a p.a :i):r:- f-,I..,
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the INC Stormwater Design
Manual(https://deci.nc.gov/about/divisions/energy-mineral-land-resourcesren ergo-mineral-land-permit-
qu idance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
�a.
Is Th,s an r4CDc:::,T is> f::;ect suojel_t o compliance with NCDGT's
Individual N=GsS ��frsit NCS000250? ' El Yes El No
p;
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)? `
❑ Yes ❑ No
To look up low density requirements, click here:
htttp://reports.oah.state.nc. us/ncac/title%2015a%m20-°/a20environmenta1%20gualitylchapter%a2002%020-
% �20environmental%m20management/subchapter%20h/15a%©20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP) r] Yes ❑ No
reviewed and approved under a state stormwater program or state-
,rr.ved local government stormwater program? * ❑ n/a — project d;Qt:..:rl-,,- < ' acre
t ts, exemptions, or grandfathering from state or locallv in;ple,i-e- .e1,
Pra ects that have v-i:J r ;: ,
I orr i vater programs or p c i.&c,' :hat satisfy state or locally -implemented stormwater pro gra.r - h, c7.i h use of
in -lieu pa ogrants should answer ' ne" to this question.
2d.
Whic;,-. cl� ,he following stormwater management prograni(s) apply? ❑ Local Governn-ient.
(rt'i. ;a;l thatapply.)' ❑ State
It you nave local government approval. please include the Sh1P on their overall impact map.
❑ Phase II ❑ USMP
Local Government Stormwater Programs '
El NSW ❑ Water Supply
Page 17 of 23 PCN Form Version 4.3- December 4, 2023

Please identify which local government stormwater program you are using,
Dick to enter_
State Storrnwater Programs "
El Phase II _ HOW or CRW
❑ Coastal Counties Other
Comments:
Project will not result in increased stormwater and does not require a stormwater management plan.
Page 16 of 23 PCN Form Version 4.3- December 4, 2023

G. Supplementary Information
1.
Environmental Documentation
1a.
Does the project involve an exaendlture of public (federal/state/local)
0 Yes N No
funds o• the use of public ?ederal:'statei land? '
1b.
If you ans,,%,ered yes io the above. does the project require
rep@rauon of an environmental document pursuant to the
re,,::Jrernents of the National or State (North Carolina) Environmental
Yes El No
Policy Act (NEPA/SE-PA)?
1C.
If you answered eves.. to the above. has the document review been
finalized by the State Clearing House? (if so, attach a copy of the El Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
Click to enter.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR �Nater Quality Certification Rules (15A
NCAC 2H .0500), lsolated �Netland Rules (;15A NCAC 2H .1300),
Federally Non-Jurisd ctio:�al %Vetlands ;'Classified Surface Waters ❑ Yes M No
i 15A NCAC 2H. 1400, D1,NR Surface %Natei ar',Netland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200}?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on vast and reasonably anticipated future
impacts) result in additional development, which could impact nearby
0 Yes x Na
downstream water quality? '
3b. If you answered "no", provide a short narrative description:
The Submar articulating revetn7ent mat system has been designed to provide the required protective cover over
the pipeline and remain stable in the stream system. Additional repairs to the area are not anticipated.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
43. Is sewage disposal required by DWR for this project?' I ❑ Yes El No Z NIA
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
genefated from the proposed project. If the wastewater will be treated at a treatment pant, list the capacity
available at that plant.
Click to entef
Page 19 of 23 PCN Form Version 4.3- December 4, 2023

5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
❑ Yes ® No
species or habitat? (IPAC weblink: https://www.fws.(iov/ipac/ Kws.govl) "
5b.
Have you checked with the USFWS concerning Endangered Species
® yes L7 No
Act impacts?
5c.
If yes, Indicate the USFVVS Field Office YOU I a .'E Contacted.
Raleigh
5d.
Is another federal agency involved? '
El Yes M No El Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8?
❑ Yes M No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.?
❑ Yes M No
5g.
Does this project involve bridge maintenance or removal? '
❑ Yes S1 No
5g , .
If yes, have you inspected the bridge for signs of bat use such as
staining. guano. bats, etc.? Representative photos of signs of bat use
-1 Yes 11 No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed
NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? '
❑ Yes ❑ No F-1 Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)? *
El Yes ' No
If yes. please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
51.
Does tNs pfojeet invc;ve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
a Yes © No
mechan;7ed Haile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose,
duration, and specific location of this
activity on the property (attach .pdf)
Page 20 of 23 PCN Form Version 4.3- December 4, 2023

5j
What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat? "
The USFWS Information for Planning and Consultation (iPaC} website was used to generate a site -specific
species list. The IPaC species list suggests five (5) protected species may occur in the project area. Each
species and their specific habitat requirements in relation to available habitat in the project area has been
discussed below.
1. Schweinitz's sunflower (He'ianthus schweinitzii). The Sch�v. ,ii Sunfiower (Endangered) historically
occurred along the edges of u[� ,land oak -hickory woods and ii.angleaf trine forests in moist to dry sandy loan; soils
that were burned and nnainta;,-let. r„v Native Americans. Most ❑ccurf,:2-1.es are row con` ned to roadsides and
utility line clearings. Although uiil..: life right-of-way (ROVVj areas h,-i�ie r een known to provide suitable habitat
for the Schweinitz's su flower- the ROW at the above referenced location is regularly rna;ntained; therefore, it is
not anticipated Schwei n wer occurs in the area. Further, there are no proposed changes to land use;
therefore, we anticipate the project will have "No effect" on Schweinitz's sunflower.
2. S{-1 :_-•I ia (Isotria medeoloides), The small whorled pog:_ •i; (Threatened) is a perennial herb
typi -laI ic:-• ''d iq ciei:iduous or deciduous -coniferous forests within an open -.G,rhaceous layer. The project is
lui:ated v: °f,, i ;-i and maintained utility ROW, which does not prow:- V ie forested habitat for the small
w h !;ea 4:c ;o - , E-iased on the lack of suitable habitat we anticipate the projeci ,r•. H ;save "No effect" on the small
3. Michaux's sumac ('Rhos michauxiil. Mlchaux's sumac (Endangered) This species occurs in sandy or rocky
open woods s,. ni—iin.4_ assr:.c,ation with circumneutral soils. This species is often found in artificially disturbed
areas, such i'r:r �,, -E;ilroad ROW, pine plantations, edges of cultivated fields, and other cleared lands.
No kli,^hau 1; = ;.:r v- as observed growing within the CPC ROW; therefore, we anticipate the project will have
"No effect'- on Michaux s sumac.
a. Monarch Butterfly (Danaus plexippus). The monarch butterfly (Candidate) is not afforded protection under the
Endangered Species Act of 1973. Further, the monarch butterfly is associated with milkweed (Asclepius sp.),
which o,,as not observed growing within the CPC ROW; therefore, the project will have "No effect" on the
monarch bulerfly.
5. Tricolored Bat (Perimyolis subPavus). Th,? lri­ln•eri .:,at (Proposed Endangered) is nal iffor(jGd nrn!ar'ion
under the Endangered Species Act of 1973..F,u- NNE; . the tricolored bat hibernates in caves rr roc-jaway culv , r,
and roosts in trees under exfoliating bark. -!-::0)in and in tree snags during the sum.)-- e - r;,onths. No
caves, culverts, or suitable roosting trees ',^.ill k:. JiS;Urned during the maintenance activity: t!7ere{:.: e, the proje:;t
will have "No effect" on the tricolored bat should it or-- listed as endangered prior to the con-eiencement of the
maintenance project.
Based on our observations clUring the .site inspection, no suitable habitats for the above protected species were
observed within the maintenance location: therefore. the project will have "No effect" on the above listed species.
Attach consultation doc.crnentation. I
6. Essential Fish Habitat (Corps Requirement)
Ga. LA/ill this project occur in or near an area designated as
an Essential Fish Habitat? x L l Yes X No
Is there submerged aquatic vegetation, {SAV1 around
the project vicinity? El Yes Na - Unknown
Will this project affect subn)efgec aquatic vegetation? ' ❑ Yes X No D Unknown
Explain: Click to eater.
Page 21 of 23 PCN Form Version 4-3- December 4, 2023

6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat? "
NOAA
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):.
http-//qis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal
gove-'-�ments have designated as Laving historic or cultural
y- vation status :F ;.. Nation:; Historic Trust designation or Yes 7 No
- I-(j;'e't e.S Sirinif;C:_rllt ,r; `fpftt-i C- :l-iij"a history and archaeology)? "
7c.
Qcu ,:.s i : i J you use to (et : mine whether your site would impact historic or archeological
resoia
North Cai'oii�-'a Slate Historic Preservatio- off+ce GIS Download 2/1/2024
Attac1) i'jst,-)rj - c '(-lr . . _.Cl.!'T "a on.
8Flood Zone Designation (Corps Requirement)
Link tIo the FENAA F;ioodpiain Maps: https://msc.fema.gov/portaUsearch
Sa. Will this project occur in a FEMA-designated I00-year floodplain? ' ❑ Yes X No
Sb. if yes, explain how the project meets FEMA requirements.
---K to enter-
Sc. What source(s) did you use to make the floodplain determination?
FEMA ArcGIS floodplain base layer.
H. Miscellaneous
Comments:
Click to enter.
Attach pertinent documentation or attachments not previously requested
Page 22 of 23 PCN Form Version 4.3- December 4, 2023

I. Signature *
['-I By checking the box and signing below. I, as the project proponent, certify to the following;
• The protect proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief,
• 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:
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act"),
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature, AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name:. Michael Barfield
Signature:. Click to enter.
Date; • Click to enter.
Page 23 of 23 PCN Form Version 4.3- beoember 4, 2023

From: Michael Barfield
To: 441PreHIPddea_nc.aoy
Cc: Rick Whiteside: Price, Jennifer
Subject: 401/&uffer Pre -filing Meeting Request Colonial Pipeline Company Line 23 Exposure Liberty Road
Date: Wednesday, December 27, 2023 2:41:00 PM
Attachments: LN 23 Exra Liberty Rqj�d Delineation Results,
Please fill out the following information:
Project Name: Colonial Pipeline Company Line 23 Exposure Liberty Road
County: Guilford
Applicant Name, Jennifer Price
Applicant Email: JepriceCfcolpine.com
Agent Name: Michael Barfield Corblu Ecology Group, LLC
Agent Email: Mbarfieldl%corblu.com
"Please note that multiple submissions can be submitted within the same email by supplying
all the abo,.-e information for each project.
'In dic event N°oiir einall is auto -responses. please save a copy of your sent
email for -our records all,' is r::= e _,, include that copy in application/form submittal. This
email stibinission is not ti_ _ tlltared. If v ou need direct assistance please use our contact list to
notify proper staff.
This email is intended to fulfill the pre -filing meeting request requirement put in place on
Thursdav April 7, 2072 when the Environmental Protection Agency's 'Clean Water Act
Section 401 Certification Rule' (`Federal Rule') was reinstated to its previous version which
originally became effective on September 11. 2022. In accordatice with 40 C.F.R. Section
121.4(a) 'At least 30 days prior to submitting a certificati011 request. the pr01-ect 1)1`01)o1letlt
sliall request a pre -filing meeting wit11 the certify in- agency'. In accordance tii itll -lei C .F. R
section 121.7(b)(7), and (c)(5 ) all certification regilests shall include dociiinentatlo11 tliat a pre-
filin�� meeting request was submitted to the certifying authority at least 0 days prior to
submittma the certification request.

m
Jahn M. Wyatt
Southeast District
Environmental Program Manager
March 20, 2020
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
NC DWR, 401 & Buffer Permitting Branch
1617 Mail Service Center.
Raleigh, NC 27699-1617
Subject: Authorization Letter
To Whom It May Concern
Colonial Pipeline Company
Tel. [phone]
Colonial Pipeline Company (CPC) gives authorization to Corblu Ecology Group to serve as our agent
regarding North Carolina Division of Water Quality (DWQ)IU.S. Army Corps of Engineers (USACE) Pre -
Construction Notification (RCN) Application Forms. Should YOU have any questions or concerns please
contact me at the letterhead address or telephone number.
Sincerely.
John M. Wyatt
Southeast District
Environmental Program Manager
Colonial Pipeline Company 5251 Hwy 153 Suite C #365 Hinson, TN 37343

PCN FORM ATTACHMENT A — Easement Agreement

R[* OF WAY EASEMENT OPT9A§ 8 OCO' W
LL #G-79
mAP #14
FOR AND IN CONSIDERATION OF 'e'en and nozi0O ------------ ($10.00) DOLLARS,
the receipt of which Is hereby acknowledged, and the further consideration of GD a dollar per _rod _- ix3Lzxw
to be paid within the period hereinafter provided, (Shen Wyatt Cox and Wife, Mdttie A. Cox
hereinafter referred to as Grantors (whether one or, more), do hereby grant and convey unto COLONIAL PIPELINE COMPANY,
a Delaware corporation, Its successors and assigns, hereinafter referred to as Grantee, an easement for a pipe line right of way
with the right to construct, maintain, inspect, operate, protect, replace, repair, change the size of, and remove a pipe line
for the transportation of liquids and/or gases, upon and along a route to be selected by Grantee, said right of way being
50 feet in width `t iat�t�ril�nj` ^7 X5 X%7(ri�;�j{ r y u
hYb. o on, over, and through the following described lands, of which Grantors warrant taey are the owners in fee simple,
situated in Guilford Courity, state of North C'.urol ins to —wit:
26.5 Acres, more or less,, as described in a Deed dated February 21, 1919,
recorded in Deed Book 905, Page 460;
AND 6.07 Acres, more or .less, as described in a Deed dated January 15, 1930,
recorded in Deed Book 905, Page 458, both instruments being recrrded in the
Office of the Register of Deeds of Guilford County, North Carolina.
together with the right of unimpaired access to said pipe line and the right of Ingress and egress on, over. and through Grantors'
above - described land for any and ail purposes necessary and incident to the exercise by said Grantee of the rights granted
hereunder, with the further right to maintain said right of way herein granted clear of trees, undergrowth, and brush.
Grantors covenant and agree that they wilt not impound water or construct buildings or structures of any type whatsoever
on the above described right of way strip. This shall be a covenant running with the land and shall be binding on Grantors,
their heirs and assigns.
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be done to
growing crops, timber, fences, buildings, or other structures directly caused by Grantee exercising any rights herein granted;
provided, however, after the first pipe line has been Installed. Grantee shall net be liable for damages caused on the right of
way by keeping said right of way clear of trees, undergrowth, brush, structures, and obstructions In the exercise of its rights
granted herein.
Any pipe line constructed by Grantee across any portion of the above -described land which is under cultivation shall,
at the time of the constuction thereof, be buried to such depth as will not interfere with Grantors'use of said land for normal
cultivation required For the planting and tending of crops; except that Grantee, at its option, may construct its pipe line above
the channel of any natural or man - made stream. ravine, dlic'h, or other watereourset
As a part of the consideration hereinabove set forth, Grantors hereby grant unto said Grantee, Its successors and
assigns, the right at any time to construct, operate, and maintain an additional pipe line or pipe lines substantially parallel
to the first pipe line constructed by Grantee on Grantors' land, above described and Grantee agrees to pay Grantors the sum of
1.00
S per rod for each additional pipe line constructed, said payment to be made before construction commences.
said additional pipe line or pipe lines shall be subject to the same rights, privileges, and covenants as set forth In this Right
of Way Easement.
This Option shall extend for a period of 12 months from the date hereof, during which time Grantee may enter upon
the premises for making surveys and performing work Incidental thereto to locate the route of the Initial pipe line to be con-
structed. Grantee may exercise this Option at any time during such period by paying to Grantors the aforesald further consider-
Atlon of $ 1.00/1od , and upon making sucb payment this option Shall become an indefeasible right of way easement to
be held by Grantee, its successors and assigns. If Grantee fails to pay said further consideration within said l2 month
period, this option shall cease and terminate.
It is agreed that any payment hereunder may be made direct to said Grantors, or any one of them, or by depositing such
Payment to the credit of said Grantors, or any one of them, in the Sank of
and payment so made shall be deemad and considered as payment to each of said Grantors.
The rights herein granted are divisible and assignable In whole or in part.
The terms, covenants. and provisions of this right of way easement shall extend to and be binding upon the heirs, ex-
ecutors. administrators, personal representatives, successors, and assigns of the parties hereto.
TO HAVE AND TO HOLD said rights and right of way, easements, estates, and privileges unto the said Grantee, its
successors and assignees, so long as said right of way and easements are used for the purposes granted herein.
IN WITNESS WHEREOF'', the Grantors herein have hereunto set their bands and seals this " day of ILL4162,4._. 18,'--
Signed,sealed, and
deli in of
a--Tc..,-
[r1 2 �tll t GLf G car (Seal)
yt-,f% 1_�gr3)CU)
Nattie A. `CoXL'ox
(Seat)
Grantors
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R1* OF WAY EASEMENT OPTIC LL# G-80
MAP #14
FOR AND IN CONSIDERATION OF Ten .and no/100 ($10.00) .1L,ARB,
the receipt of which is hereby acknowledged, and the further consideration of One dollar per rod 6,
to be paid within the period hereinafter provided, Roy W. Coble and wife, Martha Coble
hereinafter referred to as Grantors (whether one of, more), do hereby grant and convey unto COLONIAL PIPELINE COMPANY,
a Delaware corporation, its successors and assigns, hereinafter referred to as Grantee, an easement for a pipe line right of way
with the right to construct, maintain, inspect, operate, protect, replace, repair, change the size of, and remove a pipe line
for the transportation of liquids and/or gases, upon and along a route to be selected by Grantee, said right of way being
50 feet in width AEiC;earanwnr xxx x_,Xxxxxxxaxxxrfxl�y�
h$dld _ on, over, and through the following described lands, of which Grantors warrant tney are the owners in fee simple,
situated in Guilford County. State of North Carolina to —wit:
21 Acres more or less as described in a Deed dated June 5, 1946, recorded in
Deed Book 1123, Page 640, recorded in the Office of the Register of Deeds of
Guilford County, North Carolina
together with the right of unimpaired access to said pipe line and the right of Ingress and egress on, over, and through Grantors"
above -described land for any and all purposes necessary and incident to the exercise by said Grantee of the rights granted
hereunder, with the further right to maintain said right of way herein granted clear of trees, undergrowth, and brush.
Grantors covenant and agree that they will not impound water or construct buildings or structures of any type whatsoever
on the above described right of way strip. This shall be a covenant running with the land and shall be binding on Grantors,
their heirs and assigns.
In addition to the above consideration, Grantee agrees to repair or to pay for any actual damage which may be done to
growing crops, timber, fences, buildings, or other structures directly caused by Grantee exercising any rights herein granted;
Provided. however, after the first Aloe line has been installed. Grantee shall not be liable for damages caused on the right of t
way by keeping said right of way clear of trees, undergrowth, brush, structures, and obstructions in the exercise of its rights
granted herein.
Any pipe line constructed by Grantee across any portion of the above -described land which is under cultivation shell, ►
at the time of the constuction thereof, be buried to such depth as will not interfere with Grantors' use of said lend for normal
cultivation required for the planting and tending of crops; except that Grantee, at its option, may construct its pipe line above
the channel of any natural or man-made stream, ravine, ditch, or other watercourse+
As a part of the consideration hereinabove set forth. Grantors hereby grant unto said Grantee, its successors and
assigns, the right at any time to construct, operate, and maintain an additional pipe line or pipe lines substantially parallel
to the first pipe line constructed by Grantee on Grantors' land, above described and Grantee agrees to pay Grantors the sum of
$ 1.00 per rod for each additional pipe line constructed, said payment to be made before construction commences.
Said additional pipe line or pipe lines shall be subject to the same rights, privileges, and covenants as set forth In this Right
of Way Easement.
This Option shall extend for a period of-12 _months from the date hereof, during which time Grantee may enter upon
the premises for making surveys and performing work incidental thereto to locate the route of the initial pipe line to be con-
structed, Grantee may exercise this option at any time during such period by paying to Grantors the aforesaid further consider-
1.00 �/
dtion of $ 7apd upon making such payment this Option shall become an indefeasible right of way easement to
be held by Grantee, Its successors and assigns. If Grantee fails to pay said further consideration within said 12 month
period, this Option shall cease and terminate.
It is weed that any payment hereunder may be made direct to said Grantors, or any one of them, or by depositing such
Payment to the credit of said Grantors, or any one of them, in the XxxJ XXC '-X Bank or ]rx xxx xxX
and payment so made shall be deemed and considered as payment to each of said Grantors.
The rights herein granted are divisible and assignable In whole or in part,
The terms, covenants, and provisions of this right of way easement shall extend to and be binding upon the heirs, ex-
ecutors, administrators, personal representatives, successors, and assigns of the parties hereto.
TO HAVE AND TO HOLD said rights and right of way, easements, estates, and privileges unto the said Grantee, its
successors and assignees, so long as said right of way and easements are used for the purposes granted herein.
IN WITNESS wHEREOF, the Grantors herein have hereunto set their hands and seals this —_day of, 18 ti?
©� W. i (Seal)
9
11,
(Seal)
Martha Coble
Signed, sealed, and
delivered in the presen of
r
Grantors
(Seal)

INDIVIDUAL ACKNOWLEDGMENT
STATE OF NORTH CAROLINA
SS
COUNTY OF
I , do hereby certify
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal this, the— day of 19 .
My term of office expires on
STATE OF NORTH CAROLINA
COUNTY OF
of
INDIVIDUAL ACKNOWLEDGMENT
I SS
do hereby certify that
Notary Public
personally appeared before me this day and acknowledged the due execution of the foregoing instrument.
Witness. my hand and official seal this, the day of . 19.
My term of office expires on the day of
19�
PROOF BY SUBSCRIBING WITNESS
Notary Public
t
STATE OF NORTH CAROLINA }
COUNTY OF
Guilford J} Ss
.I Frank R. Coble of Guilford County, state ofNo Carolina.____,
certify that R B SCLIddeT
ersonally appeared before me this day, and being duly sworn, stated that in his presence
Roy W. Cable and Martha Coble _ signed the foregoing, instrument.
t / J
Witness my hand and official seal, this '�` daY o� t y 19 y
My term of office expires on theday of - ----
�^ Notary Public
Ica_ NORTH C, ROUN' GIJII.FORD COWITY
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PCN FORM ATTACHMENT B — IPaC Official Species List

United States Department of the Interior
FISH AND WILDLIFE SERVICE
RJ h i,, E c Iniical Sen ices Field Office
F',ite Bn\ 33726
F ilei I'. NE_ 1-6 6-3726
Fix: [phone]
In Reply Refer To:
Project Code: 2024-0043397
Project Name: CPC Line 23 Exposure Liberty Road
January 31, 2024
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The enclosed species list identifies threatened. endangered, proposed and candidate species, as
well as proposed and final designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by \,our proposed project. The species list fulfills the
requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1971 a,, amended (16 U.S.C. 1531 et seq.). If your project area
contains suitable habitat for any of the federally -listed species oii this species list, the proposed
action has the potential to adversely affect those species. It Suitable habitat is present, surveys
should be conducted to determine the species' presence or absence within the project area. The
use of this species list and/or North Carolina Natural Heritage program data should not be
substituted for actual field surveys.
New information based on updated surveys, changes in the abundance and distribution of
species, changed habitat conditions, or other factors could change this list. Please feel free to
contact us if you need more current information or assistance regarding the potential impacts to
federally proposed, listed, and candidate species and federally designated and proposed critical
habitat. Please note that under 54 CFR 402.12(e) of the regulations implementing section 7 of the
Act, the accuracy of this species list should be verified after 90 days. This verification can be
completed formally or informally as desired. The Service recommends that verification be
completed by visiting the IPaC website at regular intervals during project planning and
implementation for updates to species lists and information. An updated list may be requested
through the IPaC system by completing the same process used to receive the enclosed list.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of the
Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered

Project code: 2024-0043397
01/31/2024
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A Biological Assessment is required for construction projects (or other undertakings having
similar physical impacts) that are major Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2)
(c)). For projects other than major construction activities, the Service suggests that a biological
evaluation similar to a Biological Assessment he prepared to determine whether the project may
affect listed or proposed species and/or designated or proposed critical habitat. Recommended.
contents of a Biological Assessment are described at 50 CFR 402.12.
If a Federal agency determines, based on the Biological Assessment or biological evaluation, that
listed species and/or designated critical habitat may be affected by the proposed project, the
agency is required to consult with the Service pursuant to 50 CFR 402. In addition, the Service
recommends that candidate species, proposed species and proposed critical habitat be addressed
within the consultation. More information on the regulations and procedures for section 7
consultation, including the role of permit or license applicants, can be found in the "Endangered
Species Consultation Handbook" at:
https://www.fws.gov/sites/defaultlf Iles/documents/endangered-species-consultation-
handbook.pdf
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Endangered Species Act (ESA), there are additional responsibilities under the
Migratory Bird Treaty Act (META) and the Bald and Golden Eagle Protection Act (BGEPA) to
protect native birds from project -related impacts. Any activity, intention4i': 1Y unintentional,
resulting in take of migratory birds, including eagles, is prohibited unleSS i,(:ierwise permitted by
the U.S. Fish and Wildlife Service (50 C.F.R. Sec. 10.12 and 16 U.S.C.-c. ,_lf (a)). For more
information regarding these Acts, see https://www.fws.gov/prograiii: rriigratcry-bird-permit/what-
we-do.
The MBTA has no provision for allowing take of migratory birds that may be unintentionally
killed or injured by otherwise lawfuI activities. It is the responsibility of the project proponent to
comply with these Acts by idrtit; _� i,i�_, potential impacts to migratory hirds and eagles within
applicable NEPA documents (,,.lien tli-r-e is a federal nexus) or a Bird Eagle Conservation Plan
(when there is no federal nexus). Propon-nts should implement conservation measures to avoid
or minimize the production of project -related stressors or minimize the exposure of birds and
their resources to the project -related stressors. For more information on avian stressors and
recommended conservation measures, see https://www.fws.gov/library/collections/threats-birds.
In addition to META and BGEPA, Executive Order 13186: Responsibilities of Federal Agencies
to Protect Migratory Birds, obligates all Federal agencies that engage in or authorize activities
that might affect migratory birds, to minimize those effects and encourage conservation measures
that will improve bird populations. Executive Order 13186 provides for the protection of both
migratory birds and migratory bird habitat. For information regarding the implementation of
Executive Order 13186, please visit https://v ww.fws.gov/partner/council-conservation-
migratory-birds.
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Project code: 2024-0043397
01131 /2024
We appreciate your concern for threatened and endangered species. The Service encourages
Federal agencies to include conservation of threatened and endangered species into their project
planning to further the purposes of the Act. Please include the Consultation Code in the header of
this letter with any request for consultation or correspondence about your project that you submit
to our office.
Attachment(s):
■ Official Species List
■ USFWS National Wildlife Refuges and Fish Hatcheries
■ Bald & Golden Eagles
■ Migratory Birds
OFFICIAL SPECIES LIST
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Raleigh Ecological Services Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
[phone]
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Project code: 2024-004339 i
01/31/2024
PROJECT SUMMARY
Project Code: 2024-0043397
Project Name: CPC Line 23 E-,potiure Liberty Road
Project Type: Pipeline - Onshore - Maintenance / Modification - Below Ground
Project Description: Pipeline exposure maintenance
Project Location:
The approximate location of the project can be viewed in Google Maps: https://
www.google.com/maps/@35.957394,-79.68930441978804,14z
r
Counties: Guilford County, North Carolina
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Project code: 2024-1-„ 0113112024
ENDANGERED SPECIES ACT SPECIES
There is a total of 4 threatened, endan;-ei ed, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
lPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesl, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
MAMMALS
NAME
Tricolored Bat Perimyotis sub flavus
No critical habitat has been designated for this species.
Species profile: https:/?ecos.fws.Qovlecpispecies;10515
INSECTS
NAME
Monarch Butterfly Donaus plexippus
i\:o cl itical habitat has been designated for this species.
Species profile: https:/Jecos.fws.gov/ecp,species/9743
FLOWERING PLANTS
NAME.
ScIi\. einitz's Sunflower HeIianthus schweinitzii
No cr itical habitat has been designated for this species.
Species profile: https:/lecos.fws.gov/ecplspecies/3849
SimdI Whorled Pogonia Isotria medeoloides
F'op�latian:
No c? itical habitat has been designated for this species.
S� ecies profile: hops://ecos.fws.ggvleep; species.i189O
STATUS
Proposed
Endangered
STATUS
Candidate
STATUS
Endangered
Threatened
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Project code. 2024-004:39 i 011311202d
CRITICAL HABITATS
THERE ARE N(=) CRITICAL HABITATS WITHIN YOUR PROJECTAREA UNDER THIS OFFICE'S
JURISDICTIOLN.
YOU ARE STILL REQUIRED TO DETERMINE IF YOUR PROTECT(S) NLal' I LAVE EFFECTS ON :ALL
ABOVE LISTED SPECIES.
USFWS NATIONAL WILDLIFE REFUGE LANDS
AND FISH HATCHERIES
Any activity proposed on lands managed by the National Wildlife Refine system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS OR FISH FLATCHERIES WITHIN YOUR PROJECT AREA.
BALD & GOLDEN EAGLES
Bald and golden eagles are protected under the Bald and Golden Eagle Protection Act1 and the
Migratory Bird Treaty Acts.
Any person or organization who plans or conducts activities that may result in impacts to bald or
golden eagles, or their habitats3, should follow appropriate regulations and consider
implementing appropriate conservation measures, as described in the links below. Specifically,
please review the "Supplemental Information on Migratory Birds and Eagles".
1. The Bald and Golden Eaule Protection Act of 1940.
2. The Migratory Birds Treaty Act of 1918.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
THERE ARE NO BALD AND GOLDEN EAGLES WITHIN THE VICINITY OF YOUR PROJECT AREA.
MIGRATORY BIRDS
Certain birds are protected under the Migratory Bird Treaty Actl and the Bald and Golden Eagle
Protection Acts.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described in the links below. Specifically,
please review the "Supplemental Information on_Migratory Birds and Eagles".
1. The Migratory Birds Treaty Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.1.2 and 16 U.S.C. Sec. 668(a)
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Project code: 2024-004339 i
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For guidance on when to schedule activities or implement avoidance and minimization pleasures
to reduce impacts to migratory birds on your list, see the PROBABILITY OF PRESENCE
SUMMARY below to see when these birds are most likely to be present and breeding in your
project area.
NAME
Chimney Swift Chaetura pelagica
This is a Bird of Conservation Concern (BCC) throughout its range in the
continental USA and Alaska.
https: //e c o s. fws. gov/ a cpi spe Gies/9406
Prairie Warbler Dendroica discolor
This is a Bird of Conservation Concern (BCC) throughout its range inthe
continental USA and Alaska.
httns: // ec as. fws. gov/ a cp/so ecies/9513
Prothonotary Warbler Protonotaria citrea
This is a. Bird of Conservation Concern (BCC) throughout its range in the
continental USA and Alaska.
https:/,Iecos.fws.gov/ecl2/species/9439
Red-headed Woodpecker Melanerpes erythrocephalus
This is a Bird of Conservation Concern (BCC) throughout its range in the
continental USA and Alaska.
https: /1 ecos. fws. gov/ e cpZ sp ecies/9398
BREEDING SEASON
Breeds Mar 15 to Aug
25
Breeds May 1 to Jul
31
Breeds Apr 1 to Jul 31
Breeds May 10 to Sep
10
Rusty Blackbird Euphagus carolinus Breeds elsewhere
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation
Regions (BCRs) in the continental USA
https:;!'ecos.fws.2ov/ecp/species/94/ 8
Wood Thrush Hylocichla mustelina Breeds May 10 to
This is a. Bird of Conservation Concern (BCC) throughout its range in the Aug 31
continental USA and Alaska.
https:// ec o s. fws. gov/ ecp/species/9431
PROBABILITY OF PRESENCE SUMMARY
The graphs beloS\ ;)rovide our best understanding of when birds of concern are most likely to be
present in vo.ir :)roject area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read "Supplemental
Information on Migratory Birds and Eagles", specifically the FAQ section titled "Proper
Interpretation and Use of Your Migratory Bird Report" before using or attempting to interpret
this report.
Probability of Presence (s)
Green bars; the bird's relative probability of presence in the 10km grid cell(s) your project
overlaps during that week of the year.
Breeding Season( )
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Project code: 2024-0043397
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Yellow bars; liberal estimate of the timeframe inside which the bird breeds across its entire
range.
Survey Effort (1)
Vertical black lines; the number of surveys performed for that species in the TOkm grid cell(s)
your project area overlaps.
No Data (—)
A week is marked as having no data if there were no survey events for that week.
probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Chimrev Sigift
3CC Ran�e�ride
: CON i
- -� i 0
CO�t
�.o=,oz�tary
-CC R._. geuide
CO-` 1
3CC Re. c�t-,ide
(CO-)
RustyBlacl,bi_c
Wood Thrush
BCC Rangewide—
(CON)
Additional information can be found using the following links:
■ Eagle Management htips://ww w.ftivs.goy/program.. eagle -many eg ment
■ Measures for avoiding and minimizing impacts to birds https://www.fws.yov/library/
collections/avoiding-and-minimizing-incidental-take-migratory-birds
■ Nationwide conservation measures for birds https://www.fws.pov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
■ Supplemental Information for Migratory Birds and Eagles in IPaC https://www.fws.P-ov/
media/sunnlemental-inf ormation-mip-ratorv-birds-and-bald-and- eolden-ea v-les-mav-occur-
roject-action
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Project code: 2024-0043397
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IPAC USER CONTACT INFORMATION
Agency: Corblu Ecclo-v Group
Name: Michael Barfield
Address: 3225 South Cherokee Lane, Bldg. 800
City: WOODSTOCK
State: GA
Zip: 30188
Email [e-mail]
Phone: [phone]
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PCN FORM ATTACHMENT C — NRHP Map

Base Map Source: ESRI Aerial Imagery 1 2oc 2 400 Fat
1:12,000
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
NC HPO and NRHP Map
Project No. 02-041901-864

PCN FORM ATTACHMENT 0 - FEMAIFIRM Map

Base Map Source:ESRI hiagery
1:12,000 0 600 1.200 z sac F-3,1
Colonial Pipeline Company, SE
Line 23 Exposure - Liberty Road
Guilford County, North Carolina
FEMA/FIRM Map
Project No. 02-041901-864