20160260 Ver 1_Buffer Determination Request_20160311

North Carolina
Pat McCrory �0SID01
Governor COIN
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NCDENR
Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Thomas A. Reeder
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WoPsaUw� 5ice
Fn Origin/Buffer
Director
John E. Skvarla, III
Secretary
DWQ Use Only: Project #
Applicability Determination
Required Information
1. Owner Information (corporation/individual who is legally responsible for the property and its compliance')
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1a. Name(s) on Recorded Deed �r IL [� /' (, cy t �(✓9 M l/ LLC
1 b. Responsible Party (for LLC) D Sc 14-
'1c.MailingAddress
1 c. Mailing AddressOO ftw,wrorr C✓f,c �l35�"/ Tj� �, Z7b�
1d. Telephone Number ZjL- 7K `y�7° " V07--Yk;-°'
I 1e. Email Address
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2 -Location of Project Site - lease include the county, nearest named town 8nd highway number:
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3. Has anyone from DWQ visited the site? / N I
Staff Name
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Date of Visit?
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Additional Requested Information
4. Agent/Consultant Information (if applicable)
4a. Name, Company
4b. Mailing address
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4c. Telephone no.
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4d. Email address
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5. Project and Site Information �e- M
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5a. Name of project
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5b. County
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5c. Nearest Named Stream
5d. River Basin
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5e. Provide a brief description of this project (attach site plan ifailable): *`f1,f.f C -CA
7 7'
Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo and/or NRCS Soil Survey.
If you are unable to locate either of these maps, please contact the Regional Office for assistance.
DWQ Use Only: Is this stream call for the purpose of: buffer mitigation nutrient offset credit
Please return form to: Anthony Scarbraugh
943 Washington Square Mall
Washington, NC 27889 Note: Submittals on Friday after 12:00 pm
will be stamped as received on the
Fax: [phone] next business day.
Email: anthonv.scarbraughancdenr.gov
Please contact Anthony Scarbraugh at [phone] if you have any questions.

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Date: ()3•l /1(,Project/Site:
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Latitude: 35.q2.,,,
Evaluator:
County:
Longitude: 7�,D4Slf
Total Points:
4&sarn Determination (circle one)
Other
Stream is at least intermittent rV
Epheme i Intermittent Perennial
e.g. Quad Name:
if z 19 or perennial if t 30'
0 1
2
A. Geomorphology (Subtotal=
Absent Weak
Moderate
Strong
18. Continuity of channel bed and bank
0 1
2
3
2. Sinuosity of channel along thalweg
0 1
2
3
3. In -channel structure: ex. riffle -pool, step -pool,
ripple -pool s uence
0 1
2
3
4. Particle size of stream substrate
0 1
2
3
5. Active/relict floodplain
0 1
2
3
6. Depositional bars or benches
1
2
3
7. Recent alluvial deposits
2
3
8. Headcuts
jojgO.
2
3
9. Grade control
5
1
1.5
10. Natural valley
5
1
1.5
11. Second or greater order channel
No = 0
Yes = 3
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a artificial ditches are not rated; see discussions in manual
V. 11 VI VIV VUVWIG,-
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteria
0
1
2
3
14. Leaf litter
1.5
1
0.5
0
15. Sediment on plants or debris
0
0.5
1
1.5
16. Organic debris lines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table.
No = 0
Yes = 3
Notes:
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18. Fibrous roots in streambed
3 2 1
0
19. Rooted upland plants in streambed
3 2 1
0
20. Macrobenthos (note diversity and abundance)
0 1 2
3
21. Aquatic Mollusks
0 1 2
3
22. Fish
0 0.5 1
1.5
23. Crayfish
0 0.5 1
1.5
24. Amphibians
0 0.5 1
1.5
25. Algae
0 0.5 1
1.5
26. Wetland plants in streambed
FACW = 0.75; OBL = 1.5 Other = 0
'perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
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WASHINGTON QUADRANGLE
NORTH CAROLINA
7.5 -MINUTE SERIES
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SCALE 1:24 000
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MILES
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FEET
CONTOUR INTERVAL 5 FEET
NORTH AMERICAN VERTICAL DATUM OF 1998

N6/201a _ ConrectGIS Featre Report

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U. S. DEPARTMENT OF AGRICULTURE
SOIL CONSERVATION SERVICE
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