20160315 Ver 1_401 Application_20160316

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Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant information
2
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NWP 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):
N 401 Water Quality Certification - Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification - Express ❑ Riparian Buffer Authorization
1 e. 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
1f. 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 in -lieu
fee program.
❑ Yes
® No
1 g. 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:
Iga Solar Farm
2b. County:
Franklin
2c. Nearest municipality / town:
Bunn
2d. Subdivision name
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a Name(s) on Recorded Deed.
Harris Woodrow
3b. Deed Book and Page No
1771/321
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
2315 Lincoln Street
3e. City, state, zip.
Columbia SC, 29201
3f. Telephone no.
803 376 4859
3g. Fax no.:
3h. Email address:
'
!0M2 9 2016
DEQ- gTER RESOURCES
Page 1 of 12
PCN Form - Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is-
❑ Agent ® Other, specify Developer
4b. Name:
Ms. Lonlee Mather
4c Business name
(if applicable).
Tate Solar, LLC
4d. Street address:
One Cate Street, Suite 100
4e. City, state, zip
Porthsmouth NH, 03801
4f. Telephone no.:
603.319.4400
4g. Fax no..
603.546.4006
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
Bradley S. Luckey
5b. Business name
(if applicable)-
Pilot Environmental Inc.
5c Street address.
PO Box 128
5d. City, state, zip:
Kernersville, NC 27285
5e. Telephone no.:
336.708.4997
5f. Fax no..
5g. Email address.
[e-mail]
Page 2 of 12
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).
001899
1 b. Site coordinates (in decimal degrees):
Latitude. 35 93802 Longitude: - 78.21878
(DD DDDDDD) (-DD DDDDDD)
1 c Property size.
60 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Crooked Creek
proposed project
2b. Water Quality Classification of nearest receiving water:
Class C, NSW
2c River basin-
Tar -Pamlico
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 site contains undeveloped wooded land. Structures are not located on the site. The site is located in a
residential/rural area of Bunn
3b List the total estimated acreage of all existing wetlands on the property:
3.53 Ac
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1,913 LF
3d. Explain the purpose of the proposed project:
The purpose of the proposed project is to provide access during development and long term maintenance of the site as a
solar farm.
3e. Describe the overall project in detail, including the type of equipment to be used.
The overall project consists of development of the site with a proposed solar farm. In order to provide safe access to the
site, an access road and stream crossing are necessary. To faciltate development of the site and construction of the
proposed stream crossing, clearing and grading the site is necessary. Graders, haulers, excavators and other heavy
equipment will be used during site construction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments' USACE site visit 11/17/15
4b. If the Corps made the jurisdictional determination, what type
®Preliminary El Final
of determination was made?
4c If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: Pilot Enviromental, Inc.
Name (if known). Michael Brame
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
USACE JD=11/17/15
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
The project is not part of a phased project Impacts to streams/wetlands, outside of those proposed in this application,
are not anticipated as a result of the proposed project.
Page 4 of 12
PCN Form — Version 1.3 December 10, 2008 Version

C Proposed Impacts Inventory
1. Impacts Summary
la 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
Culvert/Fill
Bottomland
Hardwood
® Yes
❑ No
® Corps
❑ DWQ
0.02/0.01
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
0.02/0.01
2h. Comments: The proposed road crossing will permanetly impact 0.02 acres (835SF) and temporarily impact 0.01 acres
(55SF) of wetlands assoicated with the installation of the culvert Areas of temporary impact will be restored to simdair pre -
construction conditions.
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)
S1 ®P ®T
Culvert/Rip-
Rap/Pump Around
Unnamed
® PER
❑ INT
® Corps
❑ DWQ
4
65/42/26
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
65/42/26
3i. Comments: The proposed stream crossing will permanetly impact 104 linear feet and temporarily impact 26 linear feet of
stream. Permanent impacts include 65 linear feet of stream impact by culvert fill and 42 linear feet by rip -rap dissipator fill
Temporary impacts include 26 linear feet of stream impact by the assoicated pump around. Areas of temporary impact will be
Page 5 of 12
PCN Form — Version 1.3 December 10, 2008 Version

restored to similar pre -construction conditions.
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.
Open water
impact number —
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
01 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 LIP ❑T
4f. Total open water impacts
4g. Comments: Open water impacts are not being proposed.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below
5a
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
511 Total
5g. Comments: Construction of ponds/lakes are not being proposed
5h Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i Expected pond surface area (acres):
51 Size of pond watershed (acres):
5k Method of construction:
Page 6 of 12
PCN Form — Version 1 3 December 10, 2008 Version

6. Buffer Impacts (for DWQ)
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 ® 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
im act
required?
131 ❑P❑T
El Yes
❑ No
B2 ❑P
❑Yes
❑ No
B3 ❑P
El Yes
❑ No
6h. Total buffer impacts
6i. Comments: Buffer impacts are not being proposed
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Due to the development and use of the site as a solar farm, a road must be constructed to provide access to the site during
construction and long term maintenance of the site as a solar farm The road has been designed in a location where wetland
impact would be as minimal as possible. An alternate design that included crossing the intermittent portion of the stream was
evaluated However, the alternative design was not determined viable due to the increased amount of wetland impact. The
stream crossing location has been designed in an area of the stream that is relatively straight. Additionally, the road width has
been reduced to the maximum extent possible, while maintaining safety concerns and considering the topographic gradients.
The solar array and necessary infrastructure (overhead/underground voltage lines, inverters, etc.) have been designed to
avoid impacts to jurisdictional streams, wetlands and ponds.
There is approximately 1,913 linear feet of stream channel and approximately 3 53 acres of wetlands located on the site The
remaining 1,809 linear feet of stream channel and 3 51 acres of wetlands are being avoided
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The clearing limits will be staked and silt fence will be used. A temporary coffer dam will be installed upgradient of the
proposed culvert. During construction, water will be pumped around the construction footprint Appropriate stream bank
protection will be provided in the channel during construction and all excess excavated material will be immediately removed
from the stream bank crossing area. Upon completion of the culvert installation, the temporary sand bag coffer dams will be
removed and flow will be diverted through the culvert. Following construction, disturbed banks will be restored to similair pre -
construction conditions, matted and seeded/live staked.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply)
❑ DWQ - ❑ Corps
❑ Mitigation bank
2c If yes, which mitigation option will be used for this
❑ Payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
Page 7 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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 in -lieu 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.
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 8 of 12
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ®No
Comments. Stormwater flow is not being concentrated
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
<2 %
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Based on the % impervious, a
stormwater management plan is not requried.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ 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?
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ 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
attached?
❑ Yes ❑ No
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 9 of 12
PCN Form — Version 1 3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. 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)?
1 c. 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 ® No
letter.)
Comments- A NEPA or SEPA is not required as part of this project.
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
El 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.
We are not aware of additional development that will impact nearby downstream water quality
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 will not be generated by the proposed project.
Page 10 of 12
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?
PEI consulted the NC Natural Heritage Program Database for known T/E occurences on the NC quadrangle that contains
the site, the Bunn East NC Quadrangle. The NC NHP identified the Dwarf wedgemussel and the Tar River spinymussel
as a federally endangered species that have been Identified on the quadrangle that contains the site. Based on our
observations, the stream and area of stream Impact would not be considered suitable habitat for this species. Therefore,
it is our opinion that the proposed project would have no effect determinations for the Dwarf wedgemussel and the Tar
River spinymussel.
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?
Based on our knowledge of the site, the site is not located in or near an area designated as essential fish habitat. Best
management practices and the use of temporary sediment and erosion control devices will prevent sediment from entering
down -gradient waterbodies which may contain fish.
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?
SHPO reviewed the proposed project as part of a state clearinghouse review of the project. SHPO Letter dated 3/30/15
(attached)
8. 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 FIRM 3720273900K (attached)
�I Digitally signed by Bradley S Luckey
DN- cn=Bradley S. Luckey, o=Pilot
1' Enwronmental, Inc, ou,
',email=biuckey@pdotenwro
Bradley S. Luckey
1, J com, c=US
3/28/16
U� Date 2016 03 28 14:38 27 -04'00'
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature Is valid only If an authorization letter from the applicant
Isprovided.)
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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NORTH CAROLINA STATE CLEARINGHOUSE
DEPARTMENT OF ADMINISTRATION
INTERGOVERNMENTAL REVIEW
COUNTY: FRANKLIN H11:ENERGY RELATED
FACILITIES/AC? ZVIT-1-F
N111
MS RENEE GLEDHILL-EARLEY
CLEARINGHOUSE COORDINATOR
DEPT OF CULTURAL, RESOURCES
STATE HISTORIC PRESERVATION OFFICE
MSC 4617 - ARCHIVES BUILDING
RALEIGH NC
REVIEW DISTRIBUTION
CC&PS - DIV OF EMERGENCY MANAGEMENT"'
DENR LEGISLATIVE AFFAIRS
DEPT OF AGRICULTURE
DEPT OF CULTURAL RESOURCES
DEPT OF TRANSPORTATION
KERR TAR REGIONAL COG
PROJECT INFORMATION
APPLICANT: N.C. Department of Commerce
TYPE: State Environmental Policy Act
Environmental Review
ONC
DESC: Application of Iga Solar, LLC for Certificaze to construct a 5 MW Solar
Photovoltaic Electric Generating Facility in Franklin Co. Docket 4SP-5048 Sub 0.
- View document at
http://starwi.ncuc.net/NCUC/portal/ncuc/page/Dockers/portal.aspx, Type SP -5048
Sub 0 in the Docket Number search line.
Located at 908 NC 98 Hwy E. Bunn, NC
The attached project has been submitted to the N. C. State Clearinghouse for
intergovernmental review. Please review and submit your response by the above
indicated date to 1301 Mail Service Center, Raleigh NC 27699-1301.
If additional review time is needed, please contact this office at [phone].
AS A RESULT OF THIS REVIEW THE FOLLOWING IS SUBMITTED: [K NO COMMENT ❑ COMMENTS ATTACHED
SIGNED BY: ,Q,�„ DATE: -3 ' 3n I S
APR 2015
WA
MAR 1 3 2015
Ln
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0
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Of
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CL
L4
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STATE NUMBER: 15-E-4600-0450
DATE RECEIVED: 03/05/2015
J
AGENCY RESPONSE: 04/01/2015
Q
REVIEW CLOSED: 04/06/2015
FJ
IL
U.
4;
ONC
DESC: Application of Iga Solar, LLC for Certificaze to construct a 5 MW Solar
Photovoltaic Electric Generating Facility in Franklin Co. Docket 4SP-5048 Sub 0.
- View document at
http://starwi.ncuc.net/NCUC/portal/ncuc/page/Dockers/portal.aspx, Type SP -5048
Sub 0 in the Docket Number search line.
Located at 908 NC 98 Hwy E. Bunn, NC
The attached project has been submitted to the N. C. State Clearinghouse for
intergovernmental review. Please review and submit your response by the above
indicated date to 1301 Mail Service Center, Raleigh NC 27699-1301.
If additional review time is needed, please contact this office at [phone].
AS A RESULT OF THIS REVIEW THE FOLLOWING IS SUBMITTED: [K NO COMMENT ❑ COMMENTS ATTACHED
SIGNED BY: ,Q,�„ DATE: -3 ' 3n I S
APR 2015
WA
MAR 1 3 2015
Ln
r
0
N
Of
O
V
CL
L4

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AGENT AUTHORIZATION
This form authorizes PEI to act as our agent in stream/wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address: uav_ U -C
Owner/Applicant Information:
Name: Loi 1 (-ce Md�ef'I VC
Cele �j-�re�{ Pill
Address: 1 C04e D' i `�U1�,� loo
16(-Lwo� I�H obbo
1
Telephone Number: (00b,) jCj, q y0p
Fax Number: W) • Jy (0 , y -pp �,
E-mail Address: Wo_t-,or t, a„er„ ,„ ,+&A Coyn
Signature: Date: C>5- 2�1 , 0-0

PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL DETERMINATION (JD): November
17, 2015
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Pilot Environmental
Attn: Michael Brame
PO Box 128
Kernersville, NC 27285
C. DISTRICT OFFICE, FiLE NAME, AND NUMBER: _Wilmington, iga Solar/PiN 001899/NC Highway 98/Franklin
CountyBunn, SAW -2015-02420
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: The project is approximately 60 acres within a
108 acre tract identified by PiN 001899, adjacent to NC Hwy 98 near Bunn, Franklin County, North Carolina. Please
refer the attached waters location table and map for the approximate location jurisdictional features location on site.
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT SITES)
State NC County/parish/borough Franklin
Center coordinates of site (lat/long in degree decimal format)
Universal Transverse Mercator
Name of nearest water body Crooked Creek
City Bunn
Lat 35 9380233416974° N, Long -78 2187876230823° W
identify (estimate) amount of waters in the review area
Non -wetland waters 2,000 linear feet. 2-4 width (ft) and/or acres
Cowardm Class- Rrverme
Stream Flow Intermittent and Perennial
Wetlands approximately 2 acres
Cowardm Class Forested
Name of any water bodies on the site that have been identified as Section 10 waters
Tidal
Non -Tidal
E. REVIEW PERFORMED FOR SiTE EVALUATION (CHECK ALL THAT APPLIES):
❑ Office (Desk) Determination Date
® Field Determination Date(s) November 17, 2015
1 The Corps of Engineers believes that there may be Jurisdictional waters of the United States on the subject site, and the permit
applicant or other affected party who requested this prelimmary JD is hereby advised of his or her option to request and obtain an
approved jurisdictional determination (JD) for that site Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in this instance and at this time
2 in any circumstance where a permit applicant obtains an individual permit, or a Nationwide General Permit (NWP) or other
general permit verification requiring "pre -construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an approved JD for the activity, the permit applicant is hereby
made aware of the following (1) the pernut applicant has elected to seek a permit authorization based on a preliminary JD, which
does not make an official determination of junsdictional waters, (2) that the applicant has the option to request an approved JD
before accepting the terms and conditions of the permit authorization, and that basing a permit authorization on an approved JD
could possibly result in less compensatory mitigation being required or different special conditions, (3) that the applicant has the
right to request an individual permit rather than accepting the terns and conditions of the NWP or other general permit
authorization, (4) that the applicant can accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has determined to be necessary, (5) that
undertaking any activity in reliance upon the subject permit authorization without requesting an approved JD constitutes the
applicant's acceptance of the use of the preliminary JD, but that either form of JD will be processed as soon as is practicable,
(6) accepting a permit authorization (e g , signing a proffered individual permit) or undertaking any activity in reliance on any
form of Corps permit authorization based on a preliminary JD constitutes agreement that all wetlands and other water bodies on
the site affected in any way by that activity are jurisdictional waters of the United States, and precludes any challenge to such
junsdiction in any administrative orjudicial compliance or enforcement action, or in any administrative appeal or in any Federal

court, and (7) whether the applicant elects to use either an approved JD or a preliminary JD, that JD will be processed as soon as
is practicable Further, an approved JD, a proffered individual permit (and all terms and conditions contained therein), or
individual permit denial can be administratively appealed pursuant to 33 C F R. Part 331, and that in any administrative appeal,
Jurisdictional issues can be raised (see 33 C F R 331.5(a)(2)) If, during that adrmnistrative appeal, it becomes necessary to make
an official determination whether CWA Jurisdiction exists over a site, or to provide an official delineation of Jurisdictional waters
on the site, the Corps will provide an approved JD to accomplish that result, as soon as is practicable
This preliminary JD finds that there "rnay be" waters of the United States on the subject project site, and identifies all aquatic
features on the site that could be affected by the proposed activity, based on the following information
SUPPORTING DATA. Data reviewed for preliminary JD (check all that apply - checked items should 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 Pilot Environmental
® 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 Simsuite
® USGS NHD data
❑ USGS 8 and 12 digit HUC maps
® U S. Geological Survey map(s) Cite scale & quad name.
® USDA Natural Resources Conservation Service Soil Survey Citation USDA web soil survey
® National wetlands inventory map(s) Cite name Simsurte.
❑ State/Local wetland inventory map(s)-
FEMA/FIRM maps Simsmte NFHL .
❑ 100 -year Floodplain Elevation is (National Geodetic Vertical Datum of 1929)
® Photographs ® Aerial (Name & Date)
or ❑ Other (Name & Date).
❑ Previous determination(s) File no and date of response letter
❑ Other information (please specify).
IMPORTANT NOTE: The information recorded on this form has not necessarily been verified by the Corps and should
not be relied upon for later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
2
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining the signature is
Impracticable)

SAMPLE
Site
Cowardin
Estimated amount of
Class of aquatic
Latitude
Longitude
aquatic resource in
number
Class
resource
review area
Stream
35 9388
-782175
Rivenne
1,200 linear feet
non -section 10 — non -
SA
wetland
Stream
35 940
-782174
Rrvenne
400 linear feet
non -section 10 — non -
SAA
wetland
Stream SB
359363
-782208
Rivenne
500 linear feet
non -section 10 — non -
wetland
Wetland
359330
-782174
Palustrine
0 8 acre
non -section 10 — wetland
WA/WAA
Wetland
359362
-782210
Palustrme
0 5 acre
non -section 10 — wetland
WB

FLAG NUMBERS/INFO
WETLAND FLAGS= V11
STREAM/JT/POND FLAGS =
Stream Flags = 7 (Surveyor to Locate Streams)
Wetland Flags = 117
Total Flags = 124
SA 2; Surveyor To
Locate Stream
LEGEND
Site Boundary
■ ■ ■ • • ■ Intarmittant Straam
SAA 1-2; Surveyor
To Locate Stream
SB 1; Surveyor To
Locate Stream
WB 1-22
SB 2; Surveyor To
Locate Stream
THE LOCATIONS OF FEATURES SHOWN ON THIS MAP ARE APPROXIMATE. THEY WERE VERIFIED BY Mr. JAMES LASTINGER,
REGULATORY SPECIALIST WITH THE USACE, ON NOVEMBER 10, 2015. THEY HAVE NOT BEEN SURVEYED.
F Drawing 3 Wetland Map
2014 Aerial Photograph
Iga Solar Farm
Google Earth and Approximate 60.3 Acre Tract
PEI Field Notes Bunn East, North Carolina
41PEI No. 1611
Scale: 1" = 400' a

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant- Pilot Environmental Attn: Michael Brame File Number SAW -2015-02420
Date: November 17 2015
Attached is:
See Section below
❑ INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission)
A
❑ PROFFERED PERMIT Standard Permit or Letter ofpermission)
B
❑ PERMIT DENIAL
C
MI APPROVED JURISDICTIONAL DETERMINATION
D
ZI PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION 1 - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information maybe found' at http://www.usace army mil/inet/functtons/cw/cecwo/red or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT- You may accept or object to the permit.
• ACCEPT: if you received a Standard Permit, you may sign the permit document and return it to the distnct engineer for final
authorization. if you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terns and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: if you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly You must complete Section ii of this form and return the form to the district
engineer. Your objections must be received by the distnct engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the pen -nit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered pennit for your reconsideration, as indicated in
Section B below.
B• PROFFERED PERMIT• You may accept or appeal the pen -nit
• ACCEPT- If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization if you received a Letter of Pennission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
penrut.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer This form must be received by the division engineer within 60 days
of the date of this notice
C. PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION. You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION• You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION 11- REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record )
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record Neither the appellant nor the Corps may add new information or analyses to the record
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION -
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division,
Mr. Jason Steele, Administrative Appeal Review Officer
Attn: James Lastinger
CESAD-PDO
3331 Heritage Trade Dr., suite 105
U.S. Army Corps of Engineers, South Atlantic Division
Wake Forest, NC 27587
60 Forsyth Street, Room 10M15
Atlanta, Georgia 30303-8801
Phone: [phone]
RiGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportum to participate in all site mvesti rations
Date..
Telephone number-
umber•Si
Signature
nature of appellant oragent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: , 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]