20160502 Ver 1_Application_20160517

Transportation
May 16, 2016
US Army Co�ps of Engineers
Raleigh Regulato�y Pield Office
Attn; Mr. David Bailey
3331 Heritage Trade Dr., Ste. 105
Wake Forest, NC 27587
PAT McCRORY
cavernor
NICHOLAS J. TENNYSON
Secremry
NC Division of Water Resources
Winston-Salem Regional Office
Attn: Mr. Brian Wrenn _
450 V✓. Hanes Mill Kd., Ste. 103
Winston-Saletn, NC 27105
Subject: Nationwide 14 Permit Applicatiou for the Replacement of Bridge No. 40 on SR 1116 (Bisliop
Road) over Hickoiy Creek, Guilford County, North Carolina, WBS Element No. 17BP.7.R.81
Dear Mr. Bailey and NL. Wrenn:
The North Carolina Depaitment of Transportation (NCDOT) is proposing to replace the subject bridge.
The purpose of the project is to replace a functionally oUsolete 34' L x 23' W, dual span timber bridge witli
a new, double barrel box culvert (2 at 14'XI2' RCBC). An off-site detour will be used to convey traffic
during consh-uction. The project will also include some minor approach work on the e�sting roadway.
The North� Carolina Natural Heritage Database was checl<ed for records of threatened and endangered
species. A survey for the Sinall Wl�orled pogonia species and habitat was conducted and as there was no
habitat, a"No EffecY' biological conclusion was rendered. Bald eagle is protected in eveiy county in North
Carolina under the Bald and Golden Eagle Protection Act. No suitable feeding/water source is located
within one mile of tlie project study area to suppoit Bald eagle habitat. Fuither, Mr. Gary Jordan (USFWS)
recently released the Programmatic Conference Opinion (PCO) for the recently listed Northern Long Eared
Bat (NL�B). This opinion, states in part, that "... it is the Swvice's coi�ference opinion that NCDOT
actrvrties in eastern Nort17 Cm•o[i»a (Divisions !-8), as proposed, are �aot li7cely to jeopm�dize tl�e continaeed
exrstence of tl�e NLEB. "
This projec[ was reviewed by NCDOT's Human Envn�onmeut Unit in 2013 for potential affects to
lustorica] architecture and archaeology. It was determined there would be no eligible architectural or
archaeological resources present within the project study area.
The project study atea is comprised of a mix of hardwood to the north and south of the project area with
commerciaUheavy industrial and a landfill adjacent There is one small (<0.10 ac) wetland within the
project study area,
NCDOT best management practices (BMPs) will be used to minimize and control sedimentation and
erosion. The construction foreman will review the BMPs daily to ensure erosion and sedimentation is
being effectively controlled. If the foreman determines the devices are not functioning as intended, they
will be replaced imtnediately with better devices.
Impacts to Waters of the United States
Hickory Creek (DWR Class: WS-IV) is shown on the USGS topographic map as a peremiia] stream. The
cl�annel is well defined witli a subsh�ate priinarily composed of sand, silt, aud gravel and is approximately
�Nothing Compares�.�_.
State ofNmth Camlina I Depatlment ofTransportaiion I Division ofldighways, Division 7 0ffice
I584 Yance}n�ille Sheet, Greensbom, NC 27405� P. O. Box 1A996, Greensborq NC 27415-4996
33G487-0000

>::.; .
Transportation
PAT McCRORY
Govemor
NICHOLASJ.TENNYSON
Secretary
l]-18 feet in width. Frmn the project site, Hickory Creel< flows south to its confluence with tlie Decp River
which then continues south and east to iYs confluence with tl�e Cape Pear River. Tl�e Cape Fear River
meets the definition of a Traditional Navigable Water. For these reasons, we believe Aickoiy Creek is a
Relatively Pennanent Water and is under the jurisdiction of the U.S. Army Cmps of Engineers. Io order to
conshvct the project, it will be necessaty to impact waters of the United States in tlie Cape Fear River
Basin (HUC 03030003). Specifically, NCDOT is requesting to replace Bridge No. 40 with a new, double
barrel, reuzforced concrete Uox culvert. The impacts are listed 'ui tl�e table below:
Temp. Perm. Temp.
Perm. SW SW Existing Existing Temp. FiII Hand Clearing
St�veture Size / Type Impacts Impacts Channel Channel 1° �'etlands in Wetlands
�a°� ac Im acts 1 Im acts 1 (ac) (ac)
2@ 14'X12' RCBC 0.02 0 51 0 0 0
Inlet/Outlet Bench Fill 0.01 0 40 0 0 0
Bank Stabilization 0.01 <0.01 57 20 0 0
Temporary 0 0 0 0 0 0.015
Construction Access
Impacts to Riparian Bnffers
The proposed pr'oject wIll also necessitate i�npacts to the protected riparian area of Hickory Creelc Hickory
Creek drains to Deep River wMch drains to Randleman Lake. Therefore, Randle�nan Lake Buffer Rules
are in effect for this project. The impacts are listed in the Eable below:
Impact Zone 1(sq. ft.) Zone 2(sq, ft.) Wetlands in Zone 1 Wetlands in Zone 2
Road Crossing 5,679 2,539 63 83
�Nothing Compares���_.
S�ate ofNorth Carolina � Depatlment of'fransponation � Division ofHigh�vays, Division 7 Office
1584 Yanceyville Street, Greensboro, NC 27A05� P. O. Box 14996, Gmensboro, NC 2 741 5-4 9 9G
336-487-OOUO

Transportation
Permits Requested
PAT McCRORY
Governor
NICHOLASJ.7ENNYSON
Seaetary
NCDOT is hereby requesting a revised authorization under Section 404 of the Clean Water Act to proceed
with the construction project outlined above. We are also requesting a revised authorization under Section
401 of the Clean Water Act from the No�th Carolu�a Department of Environment and Natural Resources
(DENR), Division of Water Resources (DWR).
If you have any questions or need additional information, please contact Jerry Parker at [phone] or
jpar]<er(c�ncdot.eov. Your review and consideration are greatly appreciated.
Sincerely,
� �% f�� /�
J.M. Mills, PE
Division Engineer, Division 7
Enclosures
cc: Tun Powers, NCDOT
Bany Harrington, Roadside Environmenta] Field Operations Engineer, NCDOT
Jeremy Warren, NCDOT
Bobby Norris, District 2 Engineer, NCDOT
File Copy
�Nothing Compares��
StateofNo`ihCamlina I DepartmentofTransporta�ion � DivisionofHighways,Division70�ce
1584 Yanceyville Stree�, Greensboro, NC 27405I P. O. Box 14996, Greensboro, NC 27415�4996
336-487-0000

o2oF WAr�9oG Office Use Only:
� � Corps action ID no.
��. �� o - � DWQ project no.
Form Version 1.3 Dec 1 D 2008
Pre-Construction Notification PC Form
A. A licant Information
1. Processing
1a. Type(s) of approval sought from the
� Section 404 Permif ❑ Section 10 Permit
Corps:
1b. Specify Nationwide Permit (NWP) number: 14 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
1 e. Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit:
because written approval is not required? Certification:
❑ Yes � No ❑ Yes � No
1f. Is payment into a mitigatfon bank or in-Ileu fee program proposed for mitigation � Yes ❑ Mo
of impacts7 If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1 g. Is the project located in any of NC's twenty coasfal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)7 ❑ Yes � No
2. Project Information
2a. Name of project: Replace Bridge No. 40 on SR 1116 over Hickory Creek
2b. County: Guilford
2c. Nearest municipality / town: Sumner
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state 17BP.7.R.81
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book a�d Page No. NIA
3c. Responsible Party (for LLC ff Division Engineer NC DOT Division 7, Mr. Mike MiIIs, PE
applicable):
3d. Street address: PO Box 14996
3e. City, state, zip: Greensboro, NC 27415
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
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PCN Farm — Version 1.3 December 10, 2008 Version

4. Applicant Infarmation (if different from owner)
4a. Applicant is: ❑ Agent � Other, specify: NC DOT Highway Division 7
4b. Name: Division Engineer NC DOT Divisfon 7, Mr. Mike Mills, PE
4c. Business name NC OOT
(if applicable):
4d. Street address: PO Box 14996
4e. City, state, zip: Greensboro, NC 27415
4f. Telephone no.: [phone]
4g. Fax no.: [phone]
4h. Emailaddress: mmillsd�'incdot.gov'note:pleasealsocapyMr,JerryParker,HighwayDivision7Environmental
Supervisor on al/ correspondence — [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Mr. Jerry Parker
5b. Business name NC DOT Highway Division 7, Division Environmenta� Supervisor
(if applicable):
5c. Street address: PO Box 14996
5d. City, state, zip: Greensboro, NC 27415
5e. Telephone no.: (336) 256-2p63
5f. Fax no.: [phone]
5g. Email address: [e-mail]
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PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identificatfon
1a. Property identification no. (tax PIN or parcel ID): N/A
1b. Site coordinates (in decimal degrees): Latitude 35.992362 Longitude: -79.849362
(DD.DDDDDD) (-DD.DDDD�D)
1 c. Property size: N/A acres
2. Surtace Waters
2a. Name of nearest body of water (stream, river, etc.) to Hickory Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-IV; 17-5.5-(1); 03-06-08
2c. River basin: Cape Fear (HUC 03030003)
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 study area is mostly comprised of forested Iand immediately to the north and south of the bridge. Adjacent to
those areas are commerciallheavy industrial and a landfill. In addition to Hickory Creek, there is also a small (>0.10 ac)
wetland within the project boundaries (that is also coincident with the Randleman Riparian buffer).
3b. List the total estimated acreage of all existing wetlands on the property:
> 0.10 acre
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
—150 LF of stream within the projed boundaries
3d. Explain the purpose of the proposed project:
To replace a structurally deflcient and functionally obsolete timber bridge.
3e. Describe the overall project in detail, including the type of equlpment to be used:
Traffic will be detoured off-site. Erosion and sedimentation control measures will be installed. Water will be diverted around the
construction area. The old, 2 span bridge (2@ 17' L X 23' W timber deck on I-beams with timber abutments) will be removed.
The proposed structure will be replaced on its existing alignment. The new culvert structure will be 2@ 14' X 12' RCBC with a
high flow sill provided (no sill proposed in low flow barrel due to flat slope). During construction, impervious dikes will be
installed up and downstream of the bridge and the stream will be placed in a 24" temporary pipe while the low flow barrel of the
culvert is installed. Once completed, stream flow will be placed into low flow barrel and the high flow barrel will be constructed
(see attached sequencing plan). Equipment to be used includes a track hoe, dump truck, paving equipment, pumps and various
hand tools.
4. Jurisdictional peterminations
4a. Have jurisdictional wet�and 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: N/A
4b. If the Corps made the jurisdictional determination, what type
of determination was made7 ❑ Preliminary � Final
4c. If yes, who delineated the jurisdictional areas7 Agency/Consultant Company: Arcadis
Name (if known): Robert Lepsic Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State detertninations and attach documentation.
SAW-2014-00891, dated 5/16/2014; DWR buffer letter dated 1/2/2014, revised 4/25/2016
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.
N1A
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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.
N/A
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PCN Form — Version 1.3 December 10, 20D8 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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)
Tem ora T
W7 ❑ P� T Hand Clearing Riparian, ❑ Yes � Corps 0.015
Floodplain � No ❑ DWQ
2g. Total wetland impacts 0.015
2h. Comments: N/A
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.
3 a. 3 b. 3 c. 3 d. 3 e. 3f. 3 g.
Stream impact Type of impact Stream name Perennial Type ofjurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ — non-404, width (linear
Temporary (T) ��NT)� other) (feet) feet)
4-sided culvert,
temporary pipe, � PER � Corps P: 148
S1 � P� T and impervious Hickory Creek � INT � DWQ 10-18 T: 20
dikes
S2 ❑ P[� T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h. Total Permanent Stream and Tributary Impacts 148'
3i. Comments: Of the 168 LF of stream impacts, only 91 LF are associated with permanent impacts to the stream for the
purpose of the culvert installation. There is also an additional 57 LF of bank stabilization, however, the rip rap will only be
along the stream banks (i.e. will not fill the thalweg of the channel). The 20 LF of temporary impacts are associated with the
impervious dikes that will be used upstream and downstream of the proposed crossing. The dewatering of the stream will run
concurrently with the construcfion activitles (i.e. the temporary impacts associated with dewatering are within the permanent
stream impact footprint locatlon).
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 11.S. then individually list aIl 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 Tem ora
01 ❑P❑T
4f. Total open water impacts
4g. Comments: No open water impacts
5. Pond or Lake Construction
If ond or Iake construction ro osed, then com lete the chart below.
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PCN Form — Version 1.3 December 10, 2008 Version

5a. 5b. 5c. 5d. 5e,
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments: There are no ponds created for this project
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 DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im acts re uire miti ation then ou MUST fill out Section D of this form.
6a.
❑ Neuse ❑ TarvPamlico ❑ Other:
Project is in which protected basin7 ❑ Catawba � Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number— Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) for Stream name mitigation (square feet) (square feet)
orTem ora im act re ulred?
Road fill ❑ Yes
B1 � P � T and Hickory Creek � No 5,679 2,539
dearing
6h. Total buffer impacts 5,679 2,539
6i. Comments: The impacts associated with the roadway crossing and culvert installation fall under the "potentially allowable"
category per the Randleman Lake Water Supply Buffer Rules Table of Uses {15A NCAC 02B .0250 (9)}
Also note: There is 63 sq. ft. of wetland within Zone 1 and 83 sq. ft. of wetland in Zone 2
D. Impact Justification and Mitigatfon
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project is to remove and replace a structurally deficient bridge and replace it with a bottomless culvert.
Roadway approach work is minimized as much as Is practical to reduce the overall project footprint. Impacts to the
associated protected riparian buffers have also been reduced by promoting sheet flow as well as providing grass shoulders to
promote infiltration. An off-site detour will be employed to avoid the need for a temporary parallel structure. Bank stabilizatlon
will be minimized to those areas where deemed necessary.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMPs will be installed prior to construction. Water will be diverted around the work area to prevent
sedimentation of downstream aquatic resources. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of surface waters, restrictions against the staging of equipment in or adjacent to waters of the US
and coordination (including a pre-construction meeting) with the Division Environmental Supervisor.
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PCN Form — Version 1.3 December 10, 2008 Version

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 project7 � 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 In-lieu fee program is attached. � Yes
4b. Stream mitigation requested: 182 LF
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: NCDOT proposes 2:1 mitigation ratio for the impacts to the stream associated with the culvert installation and
the floodplafn flll (91 LF). NCDOT does not feel that mitigation should be required for the stream bank stabilization as the rip
rap is limited to the sides of the channel and the thalweg of the channel will not be permanently impacted.
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.
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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
While there are impacts to the protected Randleman Lake Water Supply Riparian
area, these impacts are °allowable" per the Table of Uses (15A NCAC
02B.0250(9)}
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.
6c. 6d. 6e.
Zona Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3(2 for Catawba)
Zone 2 1.5
6f. Totat 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 riparfan buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
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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 fdentified � 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.
Comments: The proposed structure will be 2@ 14' X 12' RCBC. There is a slight ❑ Yes � No
increase in impervious surtace but treatment is not required.
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this projed? N/A %
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:
Plan is attached.
❑ Certified Local Government
2e. Who wlll be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Stormwater Fieview
3a. In which local governmenYs Jurisdiction is this project?
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Pro ram 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
attached7 ❑ Yes ❑ No
5. DWQ 407 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriaie requirements7 � yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met7 ❑ Yes ❑ No
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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)?
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 flnal approval
letter.) ❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violatlon of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NGAC 2H .1300), DWQ Surtace 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. WiII this project (based on past and reasonably anticipated future impacts) result in � yes � No
additional development, which could impact nearby downstream waier 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.
Per the NC DWQ April 10, 2D04 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such
as widening projects, bridge replacements and intersecfion improvements — have a"low potential for cumulative impact
since little (if any) new impervious surface is added and the projects are usually in already developed locales." 7his
proposed project is within a somewhat developed landscape (i.e. existing residential homes in the vicinity), this is not a
road on a new location (i.e. there is an existing road and bridge structure and thus, the area already contains impervious
surtaces) and the project drains to Hickory Creek, which is Class WS-IV (i.e. not HWQ or ORW). We anticipate the NC
DWR will advise us if a qualitative or quantitative analysis is needed.
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.
It is not anticipated that this project will generate any wastewater as it is a roadway project.
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PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Specfes and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or � yes � No
habitat9
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?
North Carolina Natural Heritage Database and onsite investigation.
6. Essential Ftsh 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?
This bridge replacement project takes place in Guilford County which is not near any coastal or tidal habitat that would
support EFH (i.e. salt marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requlrement)
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 designatlon 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?
This project was submitted to the North Carolina Department of Transportation's Human Environment Unit for review In
2013. It was determined that no survey was required for historic architecture or for archaeological resources (see
attached letters).
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain7 � Yes ❑ No
Sb. If yes, explain how project meets FEMA requirements: MOA
Sc. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Mike Mills, PE /) ���� /� 1
ApplicanUAgenPs Printed Name ��/ S}�/ S• i�• /c,
ApplicanUAgenYs Sign ur Date
(AgenCs signature is valid only if an authorization letter from the
a Ifcantis rovided.
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PCN Form — Version 1.3 December 10, 2008 Version