20151150 Ver 1_401 Application_20151115

CLearW,,, aLer
C1earVVater Environmental Consultants, Inc.
www.cwenv.com
October 29, 2015
Mr. David Brown PAD
US Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801 -2638
Ms. Karen Higgins
NC DWR, 401 & Buffer Permitting Unit
512 North Salisbury Street, 9h Floor
Raleigh, North Carolina 27604
RE: Pardee Memorial Hospital ( +/- 3 Acres)
Nationwide Permit 39 Application
Henderson County, North Carolina
Dear Mr. Brown and Ms. Higgins,
20151150
The attached Pre - Construction Notification (PCN) is being submitted on behalf of Henderson
County represented by Mr. Marcus Jones. The project site is located off North Oak Street in
Henderson County, North Carolina. Henderson County is seeking a Nationwide Permit 39 for the
construction of a parking lot and installation of a sewer line.
A copy of this package has been sent to Ms. Andrea Leslie of the NC Wildlife Resources
Commission and Mr. Bryan Tompkins of the U.S. Fish and Wildlife Service for review. A copy
of this application has also been submitted to Mr. Zan Price of the N.C. Division of Water
Resources, Asheville Regional Office. Please do not hesitate to contact me at 828 - 698 -9800 if
you have any questions or comments.
Sincerely,
76�
Kevin Mitchell
Biologist
Copy Fumished:
NC Wildlife Resources Commission — Andrea Leslie
US Fish and Wildlife Service — Bryan Tompkins
NC Division of Water Resources, Asheville — Zan Price
32 Clayton Street
Asheville, NC 28801
828- 698 -9800 Tel
R. a ent Riddle j
Principal

Preliminary ORM Data Entry Fields for New Actions
SAW — 201 - BEGIN DATE [Received Date]:
Prepare file folder F-1 Assign Action ID Number in ORM
1. Project Name [PCN Form A2a): Pardee Memorial Hospital
2. Work Type: Private R institutional Government Commercial
3. Project Description / Purpose [PCN Form 133d and 133e]:
The project includes the construction of a parking lot and installation of a new sewer line ,for Pardee
Memorial Hospital.
4. Property Owner / Applicant [PCN Form A3 or A41:
Henderson County
5. Agent / Consultant [PCN Form A5 — or ORM Consultant ID Number]: ClearWater Environmental Consultants
6. Related Action ID Number(s) [PCN Form 135b]: N/A
7. Project Location - Coordinates, Street Address, and /or Location Description [PCN Form 131b]:
35.320654, - 82.469456; Site is located off North Oak Street in Hendersonville, NC.
8. Project Location -Tax Parcel ID [PCN Form 131a]: 9568 -59 -1656
9. Project Location —County [PCN Form A2b]: Henderson
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Hendersonville
11. Project Information — Nearest Waterbody [PCN Form 132a]: Unnamed Tributaries t0 Britton Creek
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form 62c]: French Broad /06010105
Authorization: Section 10 F� Section 404 17 Section 10 & 404
Regulatory Action Type:
Standard Permit Pre - Application Request
✓ Nationwide Permit # 39 Unauthorized Activity
Regional General Permit # Compliance
Jurisdictional Determination Request F_� No Permit Required
Revised 20150602

Ater
Department of the Army NCDENR
Wilmington District, Corps of Engineers NC DWR, Webscape Unit
Attn: Scott McLendon, Chief Regulatory Division Attn: Karen Higgins
PO Box 1890 512 North Salisbury Street
Wilmington, NC 28402 -1890 Raleigh, North Carolina 27604
1, the current landowner /managing partner of the property identified below, hereby
authorize Cleat-Water Environmental Consultants, Inc. (CEC) to act on my behalf as my
agent during the processing of jurisdictional determination requests and permits to impact
Wetlands and Water of the US subject to Federal jurisdiction under Section 404 of the
Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. CEC is
authorized to provide supplemental information as needed at the request of the USACE
or DWR.
Additionally, I authorize representatives of the Wilmington District, US Army Corps of
Engineers to enter upon the property herein described for the purposes of conducting on-
site investigations and issuing a determination associated with Wetlands and Waters of
the US subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act of 1899.
Property Owner of Record:
Henderson County
Property Owner of Address:
1 Historic Courthouse Sq
Hendersonville, NC 28792
Phone Number:
828 697 -4809
Property Location:
Conner Ave, Hendersonville NC
Owner/Managing Partner
Printed Name:
Marcus A. Jones
Owner/Managing Partner Signature: _ &�
D-�
on. xu Ioa7 iawoi a,oc
Date:
224 South Grove Street, Suite F
Hendersonville, NC 28792
Phone: 828 - 698 -9800
www.cwenv.com

Parcel Information

Henderson County, NC Tax Parcel Report Wednesday, October 14, 2015
_ • nr 1
1 4
I rm
i
•w
rr
no r1
71t
91 91
lot
F--7-.1
971
� eoe
t
w -
! m 917.
HendersoriCounty WARNING: THIS IS NOT A SURVEY.
Geographic Information Systems (GIS)
200 North Grove Street All Informabon or data provided (whether subu robed, purchased or otherwise distributed) is provided as is, wdhoul any
Hendersonville, NC 29792 warranties, Including the wananbes of merdhantab9lty or of Mass for a particular purpose. Henderson County and its
R (029) 99&5124 employees make no warranties or guarantees, adhher express or implied. Use of the information or date subscribed,
F (929) 999 -5122 purchased or otherwise dlsbibuied, whether in hard copy or d9tal macho, shall be at he user's own nak.
WARNING: THIS IS NOT A SURVEY
rPnrcellrtromlefbn''`_1
Parcel Number.
9946583
Pin:
9568591656
Listed to:
HENDERSON COUNTY
Neighborhood:
HOSPITAL AREA
Mailing Address:
800 N JUSTICE ST
Township:
Hendersonville
Mailing City, State, Zip:
HENDERSONVILLE, NC
Municipality:
HENDERSONVILLE
28791
Physical Address:
0 NO ADDRESS ASSIGNED
Fire District:
Deed:
1620/591
Plat:
Not Available
Date Recorded:
06/19/2015
Elementary School
District:
BRUCE DRYSDALE
Revenue Stamps:
600
Middle School District:
ME DD NDERSONVILLE
Property Description:
Lot # CONNOR AVE
High School District:
HENDERSONVILLE
HIGH
Soil:
Hayesville loam, 7 to 15
Map Sheet
9568.07
percent slopes
Assessed Acreage:
2.7200
Voting Precinct:
Hendersonville 1
Building Value:
$0.00
Commissioner District
3
Land Value:
$94,800.00
Agricultural District
None Found
Value To Be Billed:
$0.00
HendersoriCounty WARNING: THIS IS NOT A SURVEY.
Geographic Information Systems (GIS)
200 North Grove Street All Informabon or data provided (whether subu robed, purchased or otherwise distributed) is provided as is, wdhoul any
Hendersonville, NC 29792 warranties, Including the wananbes of merdhantab9lty or of Mass for a particular purpose. Henderson County and its
R (029) 99&5124 employees make no warranties or guarantees, adhher express or implied. Use of the information or date subscribed,
F (929) 999 -5122 purchased or otherwise dlsbibuied, whether in hard copy or d9tal macho, shall be at he user's own nak.

O�0� W A 7' fg
h r
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre- Construction Notification PC Form
A. AppHeant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
® Section 404 Permit ❑Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
❑Yes
® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1 f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in4leu
fee program.
❑ Yes
® No
1g. Is the project located in any of NC's twenty coastal counties. if yes, answer 1 h
below.
❑ Yes
® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2. Project Information
2a. Name of project:
Pardee Memorial Hospital
2b. County:
Henderson
2c. Nearest municipality / town:
Hendersonville
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed;
Henderson County
3b. Deed Book and Page No.
1620/591
3c. Responsible Party (for LLC if
applicable):
Marcus Jones
3d. Street address:
1 Historic Courthouse Square
3e. City, state, zip:
Hendersonville, NC 28792
3f. Telephone no.:
828 -697 -4809
3g. Fax no.:
N/A
3h. Email address:
majones @hendersoncounty.org
Page 1 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
R. Clement Riddle
5b. Business name
(if applicable):
CiearWater Environmental Consultants, Inc.
5c. Street address:
32 Clayton Street
5d. City, state, zip:
Asheville, NC 28801
5e. Telephone no.:
828 -698 -9800
5f. Fax no.:
n/a
5g. Email address:
clement @cwenv.com
Page 2 of 10
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
9568591656
1b. Site coordinates (in decimal degrees):
Latitude: 35.320654 Longitude: - 82.469456
(DD.DDDDDD) (- DD.DDDDDD)
1c. Property size:
+/- 3 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
UTs to Britton Creek
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
French Broad 06010105
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project site is currently forested /undeveloped. Land use within the surrounding area is primarily commercial hospital.
3b. List the total estimated acreage of all existing wetlands on the property: 0.0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: Approximately 968
linear feet.
3d. Explain the purpose of the proposed project: The project includes construction of a 110 space parking lot and
realignment of an existing sewer line. The sewer line is being realigned in order to accommodate the proposed parking
lot for a new Pardee Memorial Hospital building.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project includes the construction of a parking lot and realignment of an existing sewer line for Pardee Memorial
Hospital. Typical construction and earth moving equipment will be used (i.e. backhoe). The sewer line will join an
existing sewer line on the northeast side of an unnamed tributary to Britton Creek.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:
❑ Yes ® No ❑ Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency /Consultant Company:
I Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number—
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W2 []PEI T
❑ Yes
❑ No
❑ Corps
❑ DWO
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
❑ Yes
❑ Corps
W4 ❑ P ❑ T
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary Impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
1 ®P ❑ T
Impact #1
Culvert
UT Britton Creek
® PER
❑ INT
® Corps
® DWQ
3
148
2 ❑ P ®T
Impact #2
Utility Crossing
UT Britton Creek
® PER
❑ INT
® Corps
® DWQ
3
20
3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
5 ❑P ❑T
❑PER
El Corps
❑ INT
❑ DWQ
6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
168
31. Comments:
Page 4 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
02 ❑P ❑T
03 []PDT
04 ❑P ❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If Pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
number
of pond
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse E] Tar-Pamlico ❑Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number-
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
El Yes
131 ❑P ❑T
❑ No
El Yes
B2 ❑P ❑T
❑ No
❑ Yes
B3 ❑ P ❑ T
❑ No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form - Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Stream impacts were avoided to the maximum extent practicable. The sewer line will be placed beneath the stream. The line
will be trenched in and contours will be returned to preexisting conditions.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Equipment will be operated from high ground during construction. Sediment and erosion controls will be utilized to prevent
sediment from leaving the site. Stream banks will be restored to existing conditions (Figures 3.2 -3.3).
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in4ieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non - riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 7 of 10
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project?
57%
2b. Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
A stormwater management permit application was approved by the city of Hendersonville on August 18, 2015. The
permit is for the construction, operation, and maintenance of the subject project and the stormwater BMPs (Attachment
A).
® Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
Hendersonville
® Phase II
3b. Which of the following locally4mplemented stormwater management programs
❑ NSW
El
apply (check all that apply):
El ❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
® Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a. Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006 -246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
❑Yes ❑ No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form = Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ❑ No
use of public (federal /state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes El No
letter.)
Comments:
J
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B.0200)?
2b. Is this an after - the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Wastewater generated from the new medical facility will use the new sewer crossing to connect to an existing sewer line.
Wastewater will be treated by the existing local municipal facility.
Page 9 of 10
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
FWS County data and the Natural Heritage Program GIS data. Potential habitat for the Northern long -eared bat may exist
within the project boundary. However, necessary tree clearing will occur outside of the May 15- August 15 tree clearing
moratorium.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
South Atlantic Habitat and Ecosystem IMS. Impact will not occur in a marine system.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Register of Historic Places records maintained by the NC State Historic Preservation Office (SHPO) and available
on SHPO's HPOWEB GIS Service. The West Side Historic District (HN0250), the Cedars (HN0046), and the Oakdale
Cemetery (HN0114) are located within approximately 0.25 miles of the proposed sewer line. It is the opinion of CEC that
project construction will not negatively affect the integrity of these historic sites.
& Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA - designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA Map Service Center; map number 3706956800.1
panel 9568 (effective 1012/2008).
R. Clement Riddle
1
A)"
,
Applicant/Agent's Printed Name
Date
Applicant/Agenfs Signature
(Agent's signature Is valid only if an authorization letter from the applicant
Is rovided.
Page 10 of 10
PCN Form — Version 1.3 December 10, 2008 Version

Pardee Memorial Hospital ( +/- 3 AC)
'oi '.,
0
C1.
'La �S1
er4ch11Ln "° s!
3 ok Ter P all',rt
to Iligate Rd par
Patt: n
�t 191 Park
``RI >
0 A 'cW r
4,
c 1.1
c H� 9e ' � 0
p` y� ° °v Ra a; /J0a 9yc gal
PV E c;
01 9`
rhePPegre1l sylvap $!` y� 1Jh Sullivan
h 4U93�° t)r d y c Park 6 King
n91two ° 5� '� M ernori al
00, c� r, o Park
P"i,�c to O iho� �. �
on PI
o Project Boundary t►
�oodtc 9th Ave W
n n o — 4
c 0
6 lh e s s! r 5�
4v s Jonas
a
e W 7th Ave Wg u _ v N S
(i Ikdl lie 0- 1'6
cemetery y i64? Z 71hAveW �1 y^
z 6lh Ave W
c i � �� 0 5th Ave E� r
°v Z N 4th Av c
o
rn
a 4L N ? Sth Ave W 4th Ave W r tA
N f
Hendersgnville
r
:s! Z
51h Ave w Ave W c a
A pt A 4 ►'
YV3 "J'. ti 31dA++eW a ist Ave E
Or�k pr N : r
Hendersonville
Jordan St 1st Ave W Allen 5t
t�
ly Toms N
Perk s '
°.� osler Or s /
egveen4,� Arnrstrong9c o gt °y 16 .' 0 9 n
+ e P� 0
�ly01 o V Date St N o H S G
T _ N
deb +va�r patk DI v..
x 2
�
Legend s� le
'4epron Rd while 0 500 1,000 2,000
C. M J Project Boundary Feet a►
n d rawn Wl VVY 10. 21-20 ; C EC ro7W INU Q a
Henderson County, CLea y Ae r Site Vicinity
North Carolina
32 Clayton street Figure 1
Asheville, North Carolina 28801

Pardee Hospital Memorial Hospital ( +/- 3 AC)

Figure 3
Impact Maps /Site Plans

w
w
0
c�
PROI
1
S
I f'
CONNOR AVENUE i
I .
I I.
I
SUMMARY
PROPOSED PERMANENT
STREAM IMPACTS 148 LF
®PROPOSED TEMPORARY
STREAM IMPACTS 20 LF
TY
,R Y
SED 20 LF
RARY
A IMPACT
ED
TI ON
KISTING
TREAM
1111111 !/
Q.92
Preli�nin�r�
Not fdtr d8 Atncction
WGLA Engineering, PLLC PARDEE MEMORIAL HOSPITAL
CONSULTING ENGINEERS do LAND PLANNERS STREAM IMPACTS
NC License No: P -1342 CITY OF HENDERSONVILLE FIGURE 3.1
24 N. King Street
Hendersonville, NC 28792 HENDERSON COUNTY JOB #: 15152
(828) 687 -7177 DATE: 10/23/2015
LRva wglo.com NORTH CAROLINA SCALE: 1" =80'

To be used for minor stream
crossing locations
NOTES:
1.) MATTING SHALL BE COIR FIBER, 750 GRAM PER SO. METER WITH
NOMINAL 0.50 IN. OPENING SIZE,
2.) SEEDING FOR RIPARIAN AREAS SHALL COMPLY WITH SECTION 6.24 OF
THE NC EROSION AND SEDIMENTATION CONTROL MANUAL. SEE CHART BELOW
FOR TEMPORARY SEEDING. PERMANENT SEED MIX WILL BE RECOMMENDED BY
THE INSTALLER AND REVIEWED FOR COMPLIANCE BY THE ENGINEER.
3.) BACKFILL STREAMBED WITH +/— 6" OF NATURAL STREAM SUBSTRATE.
ANCHOR MATTING
IN 8" TRENCH � 1' MIN.
SMOOTH SURFACE, REMOVE ALL
DEBRIS AND SEED /MULCH BEFORE
PLACING MATTING
MATTING PLACED FLUSH WITH BANK SURFACE,
LAP OVER DOWNSTREAM /DOWN SLOPE SEAMS
12' WOOD STAKE PLACED IN
3' O.C. DIAMOND PATTERN
STREAM BED
" I EXTEND MATTING A MIN. OF
MATTING ANCHORED DEPTH VARIES BELOW STREAM BED.
1' BELOW STREAM BED
PROPOSED UTILITY
PIPE LINE
Temporaqv Seeding
Recommendations
Rate per
Common Name
Sclentiric Name
Acre
MounlWns
Rye grain
Secale cereale
30 Ibs
Aug. 15 . May 15
Wheat
Trificum aestiwm
30 Ibs
Aug. 15 - May 15
German mlUet
Selaria ilalica
10 Ibs
May 15 - Aug. 15
Brownlop mlllel
Urochloa ramosa
10 Ibs
May 15 • Aug. 15
CA,' Q
Fr?eliminary
Not fir d6iffitriction
WGLA Engineering, PLLC PARDEE MEMORIAL HOSPITAL STREAM BANK
CONSULTING ENGINEERS do LAND PLANNERS STABILIZATION
NC License No: P -1342 CITY OF HENDERSONVILLE FIGURE 3.2
24 N. King Street
Hendersonville, INC 28792 HENDERSON COUNTY
W9 (828) 687 -7177 NOT TO SCALE
wglc.com NORTH CAROLINA

4 YIN -- NATURAL
NATURAL GROUND
GROUND
I. J,
3 EXTEND FILTER FABRIC
17" NTO CHANNEL BAN(
/`. CLASS B RPPRAP
(18" M NIYUY THICRNSS)
TEMP, 10" CUP FILTER FABRIC BLANKET
FOR STREAM FLOW (MIRA� 14ON OR APPROVED EQUAL)
SECTION AA
TEMP. 16' C
FOR STREAM FLOW
ff B' OF /57
WASHED STONE SANDBAGS
1'
7 BE
I DFCAVATED
7. �wTEalu
TRCN WD
FILTER FABR'C VA ES
CLASS B RPRAP (REMOVE AFTER
CONSTRUCTION OR REUSE FOR
STREAM BANK STABILIZATION) TOP STREAM BANK
PROPOSED
WATER OR SEWER UN_
SECTION AB
Z SANOBACS
TDAP. 15' CMP
NOTE. STABILIZE STREAM BANK PER FOR STREAM ROW
DETAL AFTER PIPE INSTALLATION
0
# N
a<
FL Ow
PROPOSED
WATER OR SEWER
6' OF 157 LINE
WASHED STONE
PIPRAP CAM
`r I
1
A \ 1 A
VVTLT11111111 +/`
CAR
Pre�irniria'r� PLAN
Not Mr d6 i9trgc_tion VOTE. ALL DISCHARGE FROM DEWATERING THE WORK
• AREA SMALL BE PUMPED 10 DT-ER A TEMPORARY
��•. �E'N�IN ��,,0(v�`� SEDKENT TRAP ON DEWATERNG SLi BAG PER DElAIS
,'I,}^,J�0 L DER���•``� SMALL STREAM CROSSING DETAIL
+ +H 1111 T1,1 N.T.S.
WGLA Engineering, PLLC PARDEE MEMORIAL HOSPITAL SMALL STREAM
CONSULTING ENGINEERS & LAND PLANNERS CROSSING DETAIL
NC License No: P -1342 CITY OF HENDERSONVILLE FIGURE 3.3
24 N. King Street
Hendersonville, NC 28792 HENDERSON COUNTY JOB #: 15152
(828) 687 -7177 DATE: 10/23/2015
wglo.com NORTH CAROLINA SCALE: N.T.S.

A a IV AL
� ` � „•.o. i� : rte. � �f.� !�
i
r
i•
W1
ILegend
L. r!
Boundary Project
Project Boundary rf
k -
- f
f-
[U.J
(Y VI
0 62.5 125 250
L- 6
L

Pardee Memorial Hospital ( +/- 3 AC)
Legend
HyC - Hayesville Loam
L Project Boundary
Henderson County,
North Carolina
w
rip-
r
� r
HyC
CLearWater
32 Clayton Street
Asheville, North Carolina 28801
1
l
f _ N
0 50 100 200
Feet
USDA Soils Map
Figure 5

Pardee Memorial Hospital ( +/- 3 AC)
r-;
` Project Boundary
) 100 -Year Floodplain
d N
Legend
I
® 100Year Floodplain
0 250 500 1,000
�_______� Project Boundary '� _ Feet
10.22.2oi ; ss4 7
CLear\/ater FEMA Floodplain Map
Henderson County, FEMA Map Service Center
North Carolina 32 Clayton Strccl Map Panel 3700956800)
Asheville. North Carolina 28801 Figure 6

Pardee Memorial Hospital ( +/- 3 AC)
Potentially iunadicbonal wetlands and waters Identified on this map have been
located Within wbdheler axuracy utilizing a Trimble mapping grade Global
Positioning System (GPS) and the subsequent differential correction of that dale.
GPS points may demonstrate unconreclable errors due to topography, vegetative
cover, enWor mulbpath signal error
Nob The illustrated wetland and stream locations are appro>umele These areas
have been flogged in the field, however, they have not been surveyed Although
Clearwater Environmental Conwltants, Inc (CEC) is confident in our assessment.
the US Army Corps of Engineers (Corps) Is the only agency that can make final
decisions regarding jurisdictional wetland and waters of the US delineations
Therefore. all preliminary determinations are subject to change until written
verification is obtained. CEC strongly recommends that written verification be
obtained from me Corps prior to closing on the property, beginning any site work, or
making any legal reliance on this determination
This map was prepared by CEC using the best information available to CEC at the
time of production This map Is for informational purposes only and should not be
used to determine prease boundaries, roadways, property boundary lines, nor legal
descriptions This map shall not be construed to be an i>Rtial survey of any dais
d"cled
Source Data Topo is from Henderson County.
Potentially Jurisdictional Water
Streams (LF)
S1
525
S2
S3
`
252
Tote I
/
Legend
Contours
-- Culvert
Stream
. -_ _ J Project Boundary
try 1 0.71201 5; CEIDPlojectS 934
Henderson County,
North Carolina
t�
i�
r
i
7— --
Project Boundary
i
. �- -
\\ t
^!_ !
It V: N
0 62.5 125 250
Feet
CLear VV A aaIC er L Stream & Wetland
Delineation Map
Delineated October 22, 2015
32 Clayton Street
Asheville, North Carolina 28801 Figure 7
r
525
�t
191
`
252
/
968
Legend
Contours
-- Culvert
Stream
. -_ _ J Project Boundary
try 1 0.71201 5; CEIDPlojectS 934
Henderson County,
North Carolina
t�
i�
r
i
7— --
Project Boundary
i
. �- -
\\ t
^!_ !
It V: N
0 62.5 125 250
Feet
CLear VV A aaIC er L Stream & Wetland
Delineation Map
Delineated October 22, 2015
32 Clayton Street
Asheville, North Carolina 28801 Figure 7

Approved Jurisdictional Determination Forms
"Rapanos Forms"

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION is BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
PROJECT LOCATION AND BACKGROUND INFORMATION:
State:Norih Carolina County /parish/borough: Henderson City: Hendersonville
Center coordinates of site (]at/long in degree decimal format): Lat. 35.320654° N, Long. - 82.469456° W.
Universal Transverse Mercator:
Name of nearest waterbody: UT Britton Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: French Broad
Name of watershed or Hydrologic Unit Code (HUC): French Broad 06010105
® Check if map /diagram of review area and/or potential jurisdictional areas istare available upon request.
® Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date:
91 Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RNA SECTION 10 DETERMINATION OF JURISDICTION.
There M�eno "navigable waters ojthe U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required)
® Waters subject to the ebb and flow of the tide.
® Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There 0 "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): r
® TNWs, including territorial seas
Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
® Non -RPWs that flow directly or indirectly into TNWs
® Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
® Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional•waters
Isolated (interstate or intrastate) waters, including isolated wetlands
Identify (estimate) size of waters of the U.S. in the review area:
Non - wetland waters: 968 linear feet: 3 width (ft) and/or acres.
Wetlands: 0.00 acres.
c. Limits (boundaries) of jurisdiction based on:
Elevation of established OHWM (if known):
Non - regulated waters/wetlands (check if applicable):3
® Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
' Boxes checked below shall be supported by completing the appropriate sections in Section III below.
2 For purposes of this form, an RP W is defined as a tributary that is not a TN W and that typically flows year -round or has continuous flow at least "seasonally"
(e.g.. typically 3 months).
3 Supporting documentation is presented in Section III.F.

SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and
and Section III.D.1.; otherwise, see Section HIM below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent':
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes Information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non - navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year -round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year -round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section II1.DA.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that Is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine'if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and,all of its adjacent wetlands is used whether the review area identified In the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Secdon III.B.2 for any onsite wetlands, and Section III.B3 for all Wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.0 below.
1. Characteristics of non -TNWs that now directly or indirectly into TNW
(1) General Area Conditions:
Watershed size: rl tJc'tLlat
Drainage area: ck+Llst
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
❑ Tributary flows through M tributaries before entering TNW.
Project waters are river miles from TNW.
Project waters are IMM river miles from RPW.
Project waters are aerial (straight) miles from TNW.
Project waters are Mrs aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNWS:
Tributary stream order, if known:
4 Note that the Instructional Guidebook contains additional information regardingswales, ditches, washes, and erosional features generally and in the and
West.
s Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(b) General Tributary Characteristics (check all that apply):
Tributary is: ❑ Natural
❑ Artificial (man- made). Explain:
❑ Manipulated (man - altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: P[e] ER.
Primary tributary substrate composition (check all that apply):
❑ Silts ❑ Sands
❑ Cobbles ❑ Gravel
❑ Bedrock ❑ Vegetation. Type/% cover:
❑ Other. Explain:
❑ Concrete
❑ Muck
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry:
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for:_Liat
Estimate average number of flow events in review area/year: Wc�tLpi"et
Describe flow regime:
Other information on duration and volume:
Surface flow is: �le3tl[.le. Characteristics:
Subsurface flow: '�?I.ist. Explain findings:
❑ Dye (or other) test performed:
Tributary has (check all that apply):
❑ Bed and banks
❑ OHWM6 (check all indicators that apply):
❑ clear, natural line impressed on the bank
❑ the presence of litter and debris
❑ changes in the character of soil
❑ destruction of terrestrial vegetation
❑ shelving
❑ the presence of wrack line
❑ vegetation matted down, bent, or absent
❑ sediment sorting
❑ leaf litter disturbed or washed away
❑ scour
❑ sediment deposition
❑ multiple observed or predicted flow events
❑ water staining
❑ abrupt change in plant community
❑ other (list):
❑ Discontinuous OHWM .7 Explain:
If factors other than the OHWM were used to determine
lateral extent ofCWA jurisdiction (check all that apply):
® High Tide Line indicated by: ®
Mean High Water Mark indicated by:
❑ oil or scum line along shore objects
❑ survey to available datum;
❑ fine shell or debris deposits (foreshore)
❑ physical markings;
❑ physical markings/characteristics
❑ vegetation lines/changes in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
6A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g.. flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
id.
°Ib

(iv) Biological Characteristics. Channel supports (check all that apply):
❑ Riparian corridor. Characteristics (type, average width):
❑ Wetland fringe. Characteristics:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatictwildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non -TNW that flow directly or indirectly into TNW
(f) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Nan -TNW:
Flow is; ]Let. Explain:
Surface flow is: POWER
Characteristics:
Subsurface flow: P11 Msst. Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non -TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ Separated by berm/barrier. Explain:
(d) Proximity Relationshin) to TNW
Project wetlands are WA river miles from TNW.
Project waters are ILis_tt aerial (straight) miles from TNW.
Flow is from: List.
Estimate approximate location of wetland as within the �I —M -Lif floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(111) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average width):
❑ Vegetation type/percent cover. Explain:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally- sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis:lek <,I t
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? [Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists If the tributary, in combination with all of'its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non -RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
Significant nexus findings for non -RPW and its adjacent wetlands, where the non -RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
® TNWs: linear feet width (ft), Or, acres.
® Wetlands adjacent to TNWs: acres.
RPWs that flow directly or indirectly into TNWs.
® Tributaries of TNWs where tributaries typically flow year -round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: Continuous bed and bank, prescence of flow without precipitation.
® Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section II1.B. Provide rationale indicating that tributary flows
seasonally:

Provide estimates for jurisdictional waters in the review area (check all that apply):
® Tributary waters: 968 linear feet 3 width (ft).
® Other non - wetland waters: acres.
Identify type(s) of waters:
Non -RPWs8 that flow directly or Indirectly into TNWs.
E Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
® Tributary waters: linear feet width (fl).
Other non - wetland waters: acres.
Identify types) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
® Wetlands directly abutting an RPW where tributaries typically flow year- round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
0 Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: 0.00 acres.
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
® Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are juAsidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: 0.00 acres.
6. Wetlands adjacent to non -RPWs that now directly or indirectly into TNWs.
® Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
Impoundments of jurisdictional waters .9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Q Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
® Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA- STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
® from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
® which are or could be used for industrial purposes by industries in interstate commerce.
® Interstate isolated waters. Explain:
® Other factors. Explain:
Identify water body and summarize rationale supporting determination:
sSee Footnote # 3.
9 To complete the analysis refer to the key in Section, III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described In the Corps/EPA Memorandum Regarding CWA Ad Jurisdiction Following Rapanes.

Provide estimates for jurisdictional waters in the review area (check all that apply):
Q Tributary waters: linear feet width (ft).
Other non - wetland waters: acres.
Identify type(s) of waters:
® Wetlands: acres.
F. NON - JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
® Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non- wetlarid waters (i.e., rivers, streams): linear feet width (ft).
d Lakes/ponds: acres.
Q Other non - wetland waters: acres. List type of aquatic resource:
® Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
® Non - wetland waters (i.e., rivers, streams): linear feet, width (ft).
® Lakes /ponds: acres.
® Other non - wetland waters: acres. List type of aquatic resource:
® Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
® Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
® Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
® U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name: 1:24K Hendersonville Quad.
USDA Natural Resources Conservation Service Soil Survey. Citation:
® National wetlands inventory map(s). Cite name:
® State/Local wetland inventory map(s):
® FEMA/FIRM maps:
® 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
® Photographs: ® Aerial (Name & Date): NCCGIA (2011).
or ❑ Other (Name & Date):
Q Previous determination(s). File no. and date of response letter:
® Applicable/supporting case law:
Applicable/supporting scientific literature:
® Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD: This JD form applies to all streams on site (S 1, S2, S3).

Attachment A
Stormwater Management Plan

CITY COUNCIL:
BARBARA G. VOLK
Mayor
RON STEPHENS
Mayor Pro Tern
STEVE CARAKER
JERRY A. SMITH, JR.
JEFF MILLER
Jared Deridder, PE
WGLA Engineering, PLLC
214 N. King Street
Hendersonville, NC 28792
Dear Mr. Deridder:
CITY OF HENDERSONVILLE
The City of Four Seasons
ENGINEERING DEPARTMENT
Brent G. Detwiler, P.E.
City Engineer
OFFICERS:
JOHN F. CONNET
City Manager
SAMUEL H. FRITSCHNER
City Attorney
TAMMIE K. DRAKE
City Clerk
August 18, 2015
Re: 15617 —Oak St Parking Lot - Pardee Stormwater Management Plan - Approval
The Engineering Department has reviewed the Stormwater Management Plan for the proposed Oak St Parking Lot. Upon
review of the stormwater plan submitted 8/6/2015 and supporting documents submitted through 8/18/2015, the Engineering
Department has granted approval of the stormwater management plan.
Please note that upon completion of the project: and before a certificate of occupancy (CO) is granted, the following must be
provided to the Engineering Department for rEmew:
Surveyed "as- built" plans for all stormwater management facilities or practi ces (to be: provided after final construction is
completed). The "as- built" plarisistiall show the final design; specifications fort all stormwater management facilities and
* k�
practices and the field locatioh, size, .depth, elevation, and planted vegetation of all measures, controls, and devices, as
installed. --
A certification, under seal, that the completed,project is, in accordance with th6,'approved stormwater management plans and
designs and that the as-built stormwater, measures, controls, aril devices:,compty "4 ''the approved stormwater
management plans and designs. ;
If you have any questions„ do, nohhesitate to contact Brent Detwiler or myself.
1,• ,
Sincerely,
CITY OF HENDERSONVILLE
Brendan Shanahan, P.E.
Civil Engineer
t
Cc: Susan Frady, City of Hendersonville
Sue Anderson, City of Hendersonville
Dave Hazzard, City of Hendersonville
Brent Detwiler, City of Hendersonville
Keith Fogo, City of Hendersonville
H \Site Plan Stormwater Reviews \plan rewews\2015 \15617 PardeeParkingLotOakSt\Aoaroval\20150818 SWPIanAooroval doc
305 Williams Street bdetwiler @cityofhendersonville.org Phone: [phone]
Hendersonville. NC 28792 -4461 www.cityofhendersonville.org Fax: [phone]