20160923 Ver 1_NLEB-streamlined checklist Br 251 on Bradshaw Rd_20160922

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Federal agencies should use this form for the optional streamlined consukation framework for the northem long-eazed
bat (NLEB). This framework allows federal agencies to rely upon the U.S. Fish and Wildlife Service's (USF'WS)
January 5, 2016, intra-Service Programmatic Biological Opinion (BO) on the final4(d) rule for the NLEB for section
7(a)(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined framework; (2)
describing the project with sufficient detail to support the required deternvnation; and (3) enabling the USFWS to track
effects and determiue if reinitiation of consultation is required per 50 CFR 402.16.
Tlus form is not necessary if an agency detemunes that a proposed action will have no effect to the NLEB or if the
USFWS has concurred in writing with an agency's detemrination that a proposed action may affect, but is not likely to
adversely affect the NLEB (i.e., the standard informal consultation process). Actions that may cause prohibited
incidental take require separate fornial consultation. Providing this information does not address section 7(a)(2)
compliance for any other listed species.
Information to Determine 4(d) Rule Compliance: YES NO
1. Does the project occur wholly outside of the WNS Zone'? ❑ x
2. Have you contacted the appropriate agency2 to detetxnine if your proj ect is near X �
lmown lubernacula or matemity roost trees?
3. Could the project disturb hibernating IVI,EBs in a lmown hibernaculum? ❑ x
4. Could the project alter the entrance or interior environment of a lmown � X
hibernacuium?
5. Does the project remove any trees within 0.25 miles of a lmown lubernaculum at � X
any time of year?
6. Would the project cut or destroy lmown occupied matemity roost trees, or any
other trees within a 150-foot radius from the maternity roost tree from June 1 � x
throu Jul 31.
You aze eligible to use this form if you have answered yes to question #1 �yes to question #2 �io to questions 3,
4, 5 and 6. The remainder of the form will be used by the USFWS to track our assumptions in the BO.
Agency and Applicant� (Name, Email, Phone No.): NCDOT Division
9, [e-mail], 336-747-7802
Proiect Name:
Project Localion: SR 1549 (Bradshaw Road), China Crrove, Rowan County (35.610673, -80.672259)
Basic Project Description: Replace bridge over Kerr Creek with a new bridge
' hrip://www.fws.gov�midwesUendangered/mammals/nleb/pdf/WNSZone.pdf
Z See http://www.fws.gov/midwesdendangered/mammals/nleb/nhisites.html
3 If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are parry to the consuitation.

General Proiect Information YES NO
AQencv Determination:
By signing this form, the action agency determines that this project may affect the NLEB, but that any
resulting incidental take of the NLEB is not prohibited by the fina14(d) rule.
If the USFWS does not respond within 30 days from submittal of this form, the acrion agency may presume
that its determination is informed by the best available information and that its project responsibilities under
7(a)(2) with respect to the NLEB are fulfilled through the USFWS January 5, 2016, Programmatic BO. The
action agency will update this determinarion annually for mulri-year activities.
The action agency understands that the USFWS presumes that all activities are implemented as described
herein. The acrion agency will prompdy report any departures from the described activities to the appropriate
USFWS Field Office. The action agency will provide the appropriate USFWS Field Office with the results of
any surveys conducted for the NLEB. Involved parties will promptly notify the appropriate USFWS Field
Office upon finding a dead, injwed, or sick NLEB.
Signature:
Date Submitted:
° Any acGvity that temporarily or permauently removes suitable forested habitat, including, but not limited to, uee removal from
development, energy production and transmission, mining, agriculture, eta (see page 48 of the BO).
5 If the project removes less than 10 trees and the acreage is unknown, report the acreage as less than 0.1 acre.
6 If ffie activity includes tree clearing in June and July, also include those acreage in April to October.