20110424 Ver 3_NCDOT_R-4416_Clay_404 and 401 Modification Request_Dec 14 2016_20161215

Trnnsportation
December 14, 20I6
Ms. Loretta Beckwith, NCDOT Regulatory Project Manager
U.S. Anny Corps of Engineers
I51 Patton Avenue, Room 208
Astieville,NC 28801-2714
�nT M�caoav
Coveinor
NICHOLASf.TENNYSON
src,rrmy.
Subject: Natiomvide I4 Permit Modification Request for TiP No. R-4416
Action ID. 2011-01145 and DWQ Project No.20110424 (WBS 38908.11)
US G4 — Climbing Lane on Chunky Gal Mountain, Clay County
Dear Ms. Beckwith:
Tl�e Noith C�rolina Dep�rtment of Transportation (NCDOT) recently began construction of R-
4416 which involves a 12-foot wide truck climbing laue addi[ion to US Highway 64 on Chunky
Gal Nlountain in Clay County. Note, that this poition of the highway is an easement tliat �vas
widened many years ago to accommodate the possibility of a 4-lane roadway, A permit and
corresponding WQ certification �vere issued for the climbing lane project in 201 I in order to
relocate 278 feet of a roadside stream (ditch) (Actim� ID. 2011-01145 and DWQ Project No.
20110424, re-vm•ified blercl� 28, 2013)(Site 1). During survey work this past summer, anotlier
unavoidable conflict with a rondside stream reach, which was not shown in the plans, was
discovered. Therefore, we are requesting modificatiou of tl�e permit to cover this additional
unanticipated impact.
ln addition to the stream relocations, we recently detemiined that the lower portions of at least
hvo corrugated metal culverts in jw�isdictional streTms under tl�is section of US 64 �rill Iikely
need replacement We would prefer to pennit all stream impacts for the project collectively,
including any authorization that may be necessa�y for cnlvert maintenance, but the scope and
approach of that work is iutcertain. Therefore, to be ready for the upcoming paving season in
early 2017, we are only seeking authorizatiou for the additional stream relocation at this time.
t have enclosed a PCN, PJD Form, selected plan sheets, a q�pical road section, a detail of the
proposed channel relocations, NCSAM slieets for botl� sites, pl�otographs, and a m�rked USGS
topographic map.
The NCSAM evaluatians returned ratings of `9ow" for both relocation sites. The reloc�ted
reaches with be relatively straight, similar to the esisting channels, but more stable due to the use
of coir matting end rock sills to reduce the down-cutting foimd in the esisting cl�annels. The
banks will also be seeded with native grasses. For these reasons, we have not requested the
�Nothing Compares�
SmlxotNorthCaulim I I].panmenloi'Tnnsportalfonl Di�i.ionlJ
2>3 Web9e�lioad I S}�Ica,NurihCamlina28779
Phone S2&536-2141 I Fav S2&SS6-10J3

R-4416, Clay Page 2 December 14, 2016
purchase of compensatory mitigation credits from the Division of Mitigation Se�vices for the
stream relocations (mitigation for Site l�vas not required when penuitted).
The North Carolina Natural Heritage Database �vas rechecked for records of federally-listed
threatened and endangered species. Tl�ere are uo records for listed species near the project and
there are no records for listed aquatic species downstream in Tliompson Creek or Shooting Creek.
About 2,000 feet of tlte upper, �ioithern eud of the project is within the Buck Creek �vatershed,
�vl�icli is a HUC where northern long-eared bats (NLEB) have documented liibernacula and/or
maternity roost sites. However, the nearest records for NLEB caphues are over one mile away
from the project near Buck Creek proper. Moreover, the trees have aheady been cleared for tlie
project, there are uo shvchires or caves nearby, and �ve do not anticipate any rock hammering or
blasting iit tl�e Buck Creek HUC. So, we believe this project sl�ould have no adverse effect oii
Indiana bats or northern long-eared bats.
Historic and cultural resources will not be affected because the project will occur �vitl�in an
ah'eady widened 4-lane wide easement gra��led to NCDOT by tlie US Forest Service (USFS).
This project also has been reviewed and approved by the USFS.
Tlie best management practices will be used and maintained to minitnize and conh�ol
sedimentation and erosion at the sites.
I�upacts to Waters of the United Strtes
The unnamed h'ibutaries of Thompsou Creek (DWR Class: C) and Shooting Creek (DWR Class:
C) are not shown on tlie USGS topographic map. They likely represeut stream channels that were
created by the ditching and grading for tlie wideniug of this section of US Highway 64 many
years ago. The streams are L-2 foot �vide with well-defined cltaunels and subsh'ates of gravel,
sancl, and silt. The channel at Site 1 coutaiued some vegetatio�t and �vas partially dry during tlie
recent extreme dirought It flows (usually) approtiimately 300 feet to Tliompson Creek, which
Hien flows approsimately 2 miles to Sl�ooting Creek. The unna��ied tributary at Site 2�vas
flowing dtu�ing the drought and is about 03 mile upstream of Shootuig Creek. Shooting Creek
flows several miles to Chahige Lake, which meets the definition of a Traditional Navigable Water
(TNW). Por these reasons, we believe the unnamed tributaries of Thompson Creek and Sliooting
Creek are Relatively Permauent Wate�s (RPW) that are under tliejurisdiction of the U.S. Arnry
Corps of Engineers. In order ro complete improvements to US 64, it will be necessary to impact
�vaters of tlie United States i�� the Hiwassee River Basin (HCU 06020002). The proposed impacts
are listed in the table below.
Site No. �r�sting Cm�ditim� Proposed Conditim� Net
St�tion Impact
Site 1 278 feet of fiee flowing roadside Relocated 278 feet of fiee Flowing 278,
136+22 sh'eam chanuel (ditcl�) roadside stream channel
Site lA Free Flowing Channel ��»Pervious Dike and Teiuporary 300'
136+22 Flow Diversion
Site 2 300 feet of free flowing roadside Relocated 300 Yeet of fi�ee tlowing
200+00 stream chaimel (ditcl�) roadside stre�m channel 300"`
Site 2A Free Flo�� in Channel ��nPervious Dike ���d Temporary 310'"
200+00 g Plo�v Diversion
"New Impacts

R-4416, Clay
Permits Requested
Page 3 December 14, 2016
NCDOT reqnests modification of its permit under Section 404 of the Clean Water Act to proceed
with the construction project outlined above. By copy of this letter, I am asking Mrs. Marla
Chambers, Western DOT Review Coordinator with the North Carolina Wildlife Resources
Commission (NCWRC), to comment directly to you and myself concerning this request.
NCDOT also requests modification of the Water Quality Certification for this project under
Section 401 of the Clean Water Act.
I also request that IVL�. Reid Whitehead, Roadside Environmental Field Operations Engineer
(NCDOT), comment directly to me �vith any recommendations.
Please contact me at [phone] ifyou have any questions or need additional infonnation
about this requesL Your prompt review and consideration of these requests would be much
appreciated.
Co ally, � ,
�
Dave McHenry
Division 14 Environmental O�cer
Endosures
cc: Ms. Amy Chapman, Division of Water Resources, DEQ, Raleigh
Ms. Kristie Lynn Carpenter, Division of Water Resources, DEQ Raleigh
Ivfit Kevin Barnett, Division of Water Resouroes, DEQ, Asheville
IvLt Andrew Henderson, Biologist, US Fish & Wildlife Service, Asheville
Mrs. Marla Chambers, Western NCDOT Review Coordinator, NCWRC
IvL•. Reid Whitehead, Roadside Enviromnental Field Operations Engineer, NCDOT
Mr. Graham Raxter, District 3 Assistant Resident Engineer, NCDOT

o�pF W ATF9Oc
N r
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O T
OKce Use Only:
Corps action ID no.
OWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Noti�cation PC Form
A. A licant Information
1. Processing
1a. Type(s) of approval sought from the
� Seclion 404 Permit ❑ Section 10 Permit
Corps:
1b. Speciiy Natianwide Permit (NWP) number. 14 Modification or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
� 401 Water Quality Certificalion — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Ceriification — 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 mitigation bank or in-lieu fee program proposed for mitigation � yes � No
of impacts? If so, attach the acceptance letter from mitlgation bank or in-lieu
fee program.
1g. Is the project located in any of NC's twenly coastal counties. If yes, answer 1h ❑ Yes � No
below.
1h. Is the project located within a NC DGM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of p�oject: US 64 Climbing Lane on Chunky Gal Mountain
2b. County: Clay
2c. Nearest municipality! town: Hayesville
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or State R-4416
Project No:
3. Owner Information
3a. Name(s) on Recorded Deed: US Forest Service easement granted to NCDOT along US 64
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if N�A
applicable):
3d. Streetaddress: N/A
3e. City, state, zip: N/A
3f. Telephone no.: N/A
3g. Fax no.: N/A
3h. Email address: N/A
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: Dave McHenry, Division 14 Environmental Officer
4c. Business name NCDOT, Division 14
(if applicable):
4d. Street address: 253 Webster Road
4e. City, stake, zip: Sylva, NC 28779
4f. Telephone no.: 828-586-2141
4g. Fax no.: 828-586-4043
4h. Email address: [e-mail]
5. AgenUConsultant Information (if applicable)
5a. Name: N/A
5b. eusiness name N/A
(if applicable):
5c. Street address: N/A
5d. Gity, state, zip: N/A
5e. Telephone no.: N/A
5f. Fax no.: N/A
5g. Emall address: N/A
Page 2 of 10 PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identificatlon
1a. Property identification no. (tax PIN or parcel ID): N!A
1 b. Site coordinates (in decimal degrees): Latitude:35.057921 Longitude: -83.613720
(DD.DDDD�LI) (-DD.DDDDDD)
1 c. Property size: N!A acres
2. Surtace Waters
2a. Name of nearest body of water (stream, river, etc.) to Shooting Creek
proposed projecl:
2b. Water Qualily Classification of nearest receiving water: C
2c. Riverbasin: Hiwassee
3. Project Description
3a. Describe ihe existing condilions on lhe site and the general land use in the vicinity of the project at the time of this
application:
The streams are in ditch-lines at bases of cut-slopes along a maintained easement through USFS property.
3b. List the total estimated acreage of all existing wetlands on the property:
N/A
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
N/A
3d. Explain the purpose of the proposed project:
The purpose of the project is to add a truck climbing lane on a steep 2-lane seciion of US 64 to improve safeiy and lraffic.
3e. Describe lhe overall project in detail, including the lype of equipment to be used:
The overall project will involve grading along a previously cleared right of way; installing drainage as needed; install(ng
stone for the road base and paving. To facilitate this work, two sections of roadside streams will require relocation. A
small track hoe, dump truck, various hand tools, sandbags, and diversion pipe will be used in the channel reclocations.
The cut slopes will be removed and new channels will be excavated away from the road. Rock sills will be installed as
needed along the channel to create step pools in the new channels and to act as grade control. The streambanks and
channels will be seeded wilh native seed mix and matted wilh coir fiber malting for slabilization.
4. Jurisdlctlonal Determinations
4a. Have jurisdictional wetland or stream determinalions by the
Corps or State been requested or obtained for this property / � Yes � No ❑ Unknown
project (including all prior phases) in lhe past?
Comments: N!A
4b. If the Corps made the jurisdictional determinalion, what type � preliminary 0 Final
of determination was made7
4c. If yes, who delineated the jurisdictlonal areas? Agency/Consultant Company: N/A
Name (if known): NfA Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and atlach documentalion.
N/A
5. Project History
5a. Have permits or certifications been requested or o6tained for � Yes ❑ No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file' instructions.
Impacts at Site 1 and 1A are permitted (Action ID 2011-01146 and DWQ 20110424, re-verified March 28, 2013.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. If yes, explain.
N/A
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 lhat apply):
❑ Wellands � Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on ihe site, lhen complete lhis queslion for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiclion
number — Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ — non-404, olher) (acres)
Tem orar T
W1 ❑ P❑ T N/A N/A ❑ Yes ❑ Corps N/A
❑ No ❑ DWQ
W2 � P� T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W3 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W4 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W5 ❑ P 0 T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W6 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
2g. Totnl wetland impacts
2h. Comments: N/A
3. Stream Impacts
If lhere are perennial or intermittent stream impacts (including temporary impacts) proposed on lhe site, then complete lhis
question for all stream sites impacted.
3a. 3 b. 3 c. 3 d. 3 e. 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 intermiltent DWQ — non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 � P❑ T Slream UT Thompson � PER � Corps 1.5 278
Relocation Creek ❑ INT � DWQ
S1A ❑ P� T Temp. Flow UT Thompson � PER � Corps � 5 300
diversion Creek ❑ INT � DWQ
S2 � P❑ T Stream Relocation UT Shooting � PER � Corps 1.5 300 �
Creek ❑ INT � DWQ
S2A ❑ P� T Temp. Flow UT Shoofing � PER � Corps 1.5 310 '�
Diversion Creek ❑ INT � DWQ
S3 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S4 � P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h��y. �U� .�A�)Gi�%�.S 'j'�t�/" /)Jnl�'f�i[t:.i 7an
�� ��/P
3i. 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, iributaries, sounds, the Atlanlic Ocean, or any other open water of
ihe 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 Tem ora
01 ❑ P � T N/A N/A N!A N/A
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts N/A
4g. Comments: N/A
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete lhe chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Fllled Excavated Flooded Filled Excavated Flooded
P1 N!A N/A N/A N/A N/A N!A N/A N/A
P2
SL Total N/A NtA N/A N/A N/A N/A N/A
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no: NfA
5i. Expected pond surface area (acres): NIA
5j. Size oi pond watershed (acres): N/A
5k. Method of consiruction: NIA
6. Buffer Impacts (for DWQ)
If project will impact a protected �iparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im acts re uire mili atton, then ou MUST fill out Section D of lhis 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) for Stream name mitigation (square feet) (square feet)
or Tem ora im act re uired?
61 ❑ P❑ T N/A N/A ❑ Nos N/A N/A
B2 ❑P❑T ❑Yes
❑ No
B3 ❑P❑T ❑Yes
❑ No
66. Total buffer impacts NIA N/A
6i. Comments: N/A
Page J of 10 PCN to�m — Version 1.3 Uecemner �u, zuuu ve�sion

D. Impact Justification and Mitigation
1. Avoldance and Minimization
1a. Specifically describe measures taken to avoid or minimize lhe proposed impacts in designing project.
The project is being built on an existing disturbed 4-lane capable right of way corridor through USFS land. Only lwo short
sections of streams need to be moved to accommodate lhe truck climbing lane.
1 b. Speci(ically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
BMPs will be installed to minimize effects on aquatic habitats. Temporary flow diversions will be used or the existing channel
will remain while the new stream channels are constructed and stabilized.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigafion for ❑ Yes � No
impacts to Waters of lhe U.S. or Waters of the State7
2b. If yes, mitigation is reqaired by (check all that apply): ❑ DWQ ❑ Co�ps
❑ Mitigation bank
2c. If yes, which miligation option will be usad for this project? ❑ Payment to in-lieu fee program
� Permiltee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Miligation Bank: N/A
3b. Credits Purchased (attach receipt and letter) Type N/A Quantity N/A
3c. Comments: N/A
4. Complete if Making a Payment to In-Ileu Fee Program
4a. Approval letter from in-lieu fee program is attached. ❑ Yes
4b. Siream mitigation requested:
4c. If using stream miligation, slream temperature: ❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only): N/A square feet
4e. Riparian wetland mitigaiion requested: N!A acres
4f. Non-riparian weHand mitigation requested: N/A acres
4g. Coastal (tidal) wetland mitigation requested: N/A acres
4h. Comments: N/A
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permiltee responsible mitigation plan, provide a description of lhe proposed mitigafion plan.
The channels will be relocated into fairly straighl new channels, like the existing, but they should be more stable due to
the use of coir maiting and rock sills to prevent down-cutting. The banks will be reseeded with native seeds as well.
Page 6 of 10 PCN Form — Version 1.3 December 10, 2008 Version

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

E. Stormwater Management and Dlffuse 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
wifhin one of the NC Riparian Buffer Protection Rules7
1 h. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: N/A ❑ Yes ❑ No
2. Stormwater Mana ement Plan
2a. What is lhe overall percent imperviousness of lhis project? N/A %
2b. Does this project requfre a Stormwater Management Plan? � Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: N/A
2d. If fhis project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
The plan is covered under the NCDOT General Stormwater Permit No. NCS000250
2e. Who will be responsible for the review of the Stormwater Management PIan7 ❑ Certified Local Government
NCDOT ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certffled Local Government Stormwater Review
3a. In which local govemmenYs jurisdiction is this project? N/A
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
❑ USMP
apply (check all that apply): ❑ Water Supply Watershad
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
altached7
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
altached? ❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does lhe 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. Envfronmental 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 requlrements of the National or State ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPAlSEPA)?
1c. If you answered "yes'to the above, has ihe document review been finalized by the
State Clearing House? (If so, attach a copy of ihe NEPA or SEPA final approval
letter.) ❑ Yes ❑ No
Comments: N!A
2. Violations (DWQ Requlrement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .7300), DWQ Surtace Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permil application7 ❑ Yes � No
2c. If you answered "yes' to one or both of the above questions, provide an explanation of the violation(s): N/A
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated fulure impacts) resuit in � yes � No
addilional devetopment, which could impact nearby downstream water quality?
3b. If you answered "yes' to ihe above, submit a qualitative or quanlitative cumulative impact analysis in accordance wilh the
most recent DWQ policy. If you answered'no," provide a short narrative description.
This project consists of adding a truck climbing lane to a�4 mile section of an existing 2-lane US highway. There will be
no additional through lanes with this project. And land adjacent to the highway is moslly USFS property. For these
reasons, the project will not foster additional development.
4. Sewage Disposal (DWQ Requlrement)
4a. Clearly detail lhe ultimate treatment methods and disposilion (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of ihe subject facility.
N!A
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
impacts7
❑ 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 Program Database and site visits during and after the field scoping process.
6. Essential Fish Habitat (Corps Requirement)
6a. Will thfs 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 Habitat9
N/A--There are no marine or estuarine habitat within the Blue Ridge Physiographic Province
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., Natlonal 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?
The project was reviewed and approved by the USFS, which requires, in part, consideration of possible cultural resource
impacts. Also, the work wlll occur in already disturbed areas that were widened many years ago to possibly
accommodate a 4-lane US Highway 64.
8. Flood 2one 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? NC Floodplain Mapping Program
Dave McHenry
Division 14 Environmental Officer �� �' /2 �`�%/:
Applicant/Agent's Signature Date
AppliCanUAgent'S Pfinted Name (AgenPs signature is valid only if an aulhorization letter Uom the applicant
is provided.)
Page 10 of 10 PCN Form — Version 1.3 December 10, 2008 Version

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R-4416 - Stream Relocation Sites 1 and 2
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R-4416
US 64
CLAY COUNTY
Si:i!- 278 LF WET DITCH RELOCATION
FROM STA 133+44 TO STA 136+22
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AT`20' INTERVALS FOR GRADE CONTROL 7 �� � --�__�_
�d/�? -e6-R�E FIBER MATTING AND VEGETATION �
WILL BE USED FOR BANK STABILIZATION \�`�� �
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3154.0680 ft, msf

R-4416 Stream Relocation Sites—October 7, 2016 and November 18, 2016
, �_
Site 1 facing southeast (Stream hidden in herbaceous vegetation about S feet from edge of pavement)
Site 1 stream channel (Dry during site visit on October 7, 2016)

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USACE AID #:
NC SAM FIELD ASSESSMENT FORM
Accompanies User Manual Version 2
Rating Calculator Version 2
NCDWR #:
INS7RUC7loN5: Attach a sketch of ihe assessment area and photographs. Altach a copy of the USGS 7.5-minute topographic
quadrangie, and circle ihe localion of the stream reach under evaluation. If multiple stream reaches wili be evaluated on the same property,
identify and number all reaches on the attached map, and indude a separate form for each reach. See ihe NC SAM User Manual for
detailed descriptions and explanations of requested information. Record in the'Notes/Sketch' section if supplementary measurements were
performed. See the NC SAM User Manual for examples o( addilional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT/SITE INFORMATION:
1. Projeci name (if any): R-4412 US 64 Chunky Gal 2. Date of evaluation: 10-7-16
3. Applicantlowner name: NCDOT Division 14 4. Assessor name/organization: Dave McHenry
5. County: Clay 6. Nearest named water body
7. River basin: Hiwassee on USGS 7.5-minule quad: Thompson Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.057921, -83.613720
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): 1(lower reloc.) 10. Length of assessment reach evaluated (feet): 300
11. Channel deplh (rom bed (in riffle, if present) to top of bank (feet): 2 ❑Unable to assess channel dep
12. Channel width at top of bank (feei): 2 13. Is assessment reach a swamp steam? ❑Yes �No
14. Feature lype: �Perennial flow ❑Intermittent 9ow ❑7ida1 Marsh Siream
STREAM CATEGORY INFORMATION:
15. NC SAM Zone: � Mounlains (M) ❑ Piedmonl (P) ❑ Inner Coaslal Plain (I) ❑ Outer Coastal Plain (0)
16.Estimatedgeomorphic �A\ V /
valley shape (skip for
Tidal Marsh Slream): (more sinuous slream, flalter valley slope)
�B`1�
(less sinuous stream, steeper valley slope)
17. Walershed size: (skip �Size 1(< 0.1 mi2) ❑Size 2(0.1 to < 0.5 mi�) ❑Size 3(0.5 to < 5 mi�) ❑Size 4(>_ 5 mi2)
forTidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? ❑Yes �No If Yes, check all that apply to the assessment area.
❑Section 10 waler ❑Classified Trout Walers ❑Water Supply Watershed (❑I ❑II ❑III ❑IV ❑V)
❑Essential Fish Habitat ❑Primary Nursery Area ❑ High Quality WatersfOutstanding Resource Waters
❑Publicly owned property ❑NCDWR Riparian buffer rule in effect ❑Nutrient Sensitive Waters
❑Anadromous fish ❑303(d) List ❑CAMA Area of Environmental Concem (AEC)
❑Documented presence of a federal and/or slate listed protected species wilhin ihe assessment area.
List species:
❑Designated Critical Habilat (list species)
measuremenls induded in'NoteslSketch' section or attached?
1. Channel Water- assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
❑A Water throughout assessment reach.
�B No Flow, water in pools only.
OC No water in assessmenl reach.
2. Evidence of Flow Restriction -assessment reach metric
❑A Al least 10% of assessment reach in-stream habitat or riffle-pool sequence is severely affected by a Flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impoundment on flood or ebb wilhin
fhe assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, lidal gates, debris jams,
beaver damsj.
�B NotA
3. Feature Pattern - assessment reach metric
�A A majority of the assessment reach has altered pattern (examples: s(raightening, modificalion above or below culvert).
❑6 NotA
4. Peature Longitudinal Profile -assessment reach metric
�A Majority of assessment reach has a subslaniially altered stream profile (examples: channel down-cutting, exisling damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
ihese distur6ances).
❑B NotA
5. Signs of Active Instability -assessment reach metric
Consider only current instabiltty, not past events Trom which the stream has currenlly recovered. Examples oF inslabilily include
active bank failure, active channel down-cutting (head-cut), active widening, and aRifcial hardening (such as concrete, gabion, rip-rap).
❑A < 10% of channel unslable
�B 10 to 25% of channel unstable
❑C > 25% of channel unstable

6. Streamside Area Interaction — streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
❑A ❑A Little or no evidence o( conditions that adversely affect reference interaction
�B �B Moderate evidence of conditions (examples: berms, levees, down-cutling, aggradation, dredging) that adversely affecl
reference interaction (examples: limited sUeamside area access, disruption of Oood Flows lhrough streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriclion, minor ditching [including mosquilo ditching])
❑C �C EMensive evidence of conditions lhat adversely affect reference interaction (liflle to no Floodplain/intertidal zone access
[examples: causeways with floodplain and channel consiriction, bulkheads, relaining walls, fill, stream incision,
disruption of Flood flows ihrough slreamside area] or too much Floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or Floodplain/intertidal zone unnaWrally absent or assessmenl reach is a
man-made feature on an interstream divide
7. Water Quality Stressors —assessment reach/intertidal zone metric
Check all that apply.
�A Discolored water in stream or intertidal zone (milky white, blue, unnatural waler discoloration, oiI sheen, stream foam)
�B Excessive sedimentation (burying of siream features or intertidai zone)
❑C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quaiity problem
❑D Odor (not including natural sulfide odors)
❑E Current published or collected data intlicating degraded waler quality in the assessment reach. Cite source in 'Notes/Sketch°
section.
❑F Livestock with access lo slream or inlertidal zone
❑G Excessive algae in stream or intertidal zone
❑H Degraded marsh vegetalion in the inteAidal zone (removal, burning, regular mowing, deslruction, etc)
❑I Other: (explain in'Notes/Sketch° section)
❑J Little to no stressors
8. Recent Weather—watershed metric (skip for Tidal Marsh Streams)
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 slreams, D2 drought or higher is considered a
drought.
�A Drought wnditions and no rainfall or rainfall not exceeding 1 inch within the lasi 48 hours
❑B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
❑C No drought conditions
9. Large or Dangerous Stream — assessment reach metric
❑Yes �No Is sfream is too large or dangerous to assess? If Yes, skip to Mettic 13 (Streamside Area Ground Surface Condilion).
10. Natural In•stream Habftat Types —assessment reach metric
10a. �Yes ❑No Degraded in-siream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavalion, in-siream hardening [for example, rip-rapj, recent dredging, and snagging)
(evaluate for Size 4 Coastal Plain streams only, then skip to Metric 72)
tOb. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
❑A Multiple aquatic macropbytes and aquatic mosses „ ❑F 5% oysters or other natural hard bottoms
(include liverworls, lichens, and aigal mats) �,�, �G Submerged aquatic vegetation
�8 Multiple sticks and/or leaf packs and/or emergent o=_' ❑H Low-tide refugia (pools)
vegetation �' ❑I Sand botlom
❑C Multiple snags and logs (including lap irees) �„ ❑J 5% vertical bank along lhe marsh
❑D 5% undercut banks and/or root mats and/or roots �� ❑K LitUe or no habitat
in banks extend to lhe normal welted perimeter
❑E Little or no habital
"••""**"'""*:""""""••`•"'REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS""`""'•'•""•"""•""
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
1 ta. ❑Yes �No Is assessment reach in a natural sand-bed stream? (skip for Coastal Plain streams)
11b. Bedform evaluated. Check the appropriate box(es).
�A Riffle-run seclion (evaluate 11c)
�8 Poolytide section (evaluate 17d)
❑C Nalural bedform absent (skip to Metric 12, Aquatic Life)
11c. In riffle sections, check all lhat occur below the normal wetted perimeter of lhe assessment reach — whether or not submerged.
Check at least one box In each row (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams). Not Presenl (NP) _
absent, Rare (R) = presenl but < 10%, Common (C) _> 10-40%, Abundant (A) _> 40-70%, Predominant (P) _> 70%. Cumulalive
percenlages should nol exceed 100% for each assessment reach.
NP R C A P
� ❑ ❑ ❑ ❑ sedrock/saprolite
� ❑ ❑ ❑ ❑ Bou�der (256 — 4096 mm)
� ❑ ❑ ❑ ❑ Cobble (64 — 256 mm)
❑ ❑ � ❑ ❑ Gravel (2 — 64 mm)
❑ ❑ ❑ � ❑ Sand (.062 — 2 mm)
❑ ❑ � ❑ ❑ SilUday (< 0.062 mm)
� ❑ ❑ ❑ ❑ Delritus
❑ ❑ � ❑ ❑ nrtificia� (rip-rap, concrete, etc.)
1 td. ❑Yes �No Are pools flled with sedimentl(skip for Size 4 Coastal Plain streams and 7idal Marsh Streams)

12. Aquatic Life — assessment reach metric (skip for Tidal Marsh Streams)
12a. ❑Yes �No Was an in-stream aquatic life assessment performed as desaibed in the User Manual?
If No, select one of the following reasons and skip to Metric 13. �No Water ❑Other:
12b. ❑Yes �No Are aquatic organisms present in the assessment reach (Iook in rifFles, pools, then snagsj? li Yes, check all that
apply. If No, skip to Melric 13.
1 >t Numbers over columns refer to °individuals' for Size 1 and 2 streams and "ta�ca' for Size 3 and 4 streams.
❑ �Adult frogs
❑ ❑Aquatic reptiles
❑ �Aquatic macrophytes and aquatic mosses (include livenvorts, lichens, and algal mats)
❑ ❑BeeUes
❑ �CaddisFly larvae (T)
❑ ❑Asian clam (Corbicula)
❑ �Crustacean (isopod/amphipod/crayfish/shnmp)
❑ ❑Damselfly and dragonFly Iarvae
❑ ❑Dipterans
❑ ❑MayFly larvae (E)
❑ ❑Megaloptera (aiderfly, fishfly, dobsonFly larvae)
❑ ❑Midges/mosquito larvae
❑ ❑Mosquito fish (Gambusia) or mud minnows (Umbra pygmaeaJ
❑ ❑Mussels/Clams {not Corbicula)
❑ ❑Olher fish
❑ ❑Salamandersltadpoles
❑ ❑Snails
❑ ❑StoneFly larvae (P)
❑ ❑Tipulid larvae
❑ ❑Worms/leeches
13. Streamside Area Ground Surface Condition —streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity wilh regard to both overbank Flow and upland
runoff.
LB RB
❑A ❑A Little or no alteration to water storage capacity over a majoriry of the streamside area
❑6 ❑B Moderate alteration to water storage capacity over a majority of the streamside area
❑C ❑C Severe alteration to water storage capacity over a majority of the streamside area (examples: ditches, fill, soil
compaclion, livestock disturbance, buildings, man-made levees, drainage pipes)
74. Streamside Area Water Storage — streamside area metric (skip for Size 1 sireams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
❑A ❑A Majority of streamside area with depressions able to pond water? 6 inches deep
❑8 ❑B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
❑C �C Majority of streamside area with depressions able to pond waler < 3 inches deep
16. WeOand Presence —streamside area medic (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider we(lands outside of the streamside area or within ihe normal
welted perimeter of assessmenl reach.
LB RB
❑Y ❑Y Are wellands present in lhe streamside area?
�N �N
16. Basetlow Contributors — assessment reach metric (skip for Size 4 slreams and Tidal Marsh Streams)
Check all conlributors wilhln the assessment reach or within view of and draining to the assessment reach.
�A Slreams andlor springs (jurisdiclional discharges)
❑B Ponds (include wel detenlion basins; do not include sediment basins or dry detention basins)
❑C Obstruction passing Flow during low-Oow periods within the assessment area (beaver dam, leaky dam, bollom-release dam, weir)
�D Evidence of bank seepage or swealing (iron in water indicates seepage)
❑E Slream bed or bank soil reduced (dig through deposited sediment if present)
❑F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
❑A Evidence of subslantial water withdrawals from lhe assessment reach (includes areas excavated for pump installation)
�B Obstruction not passing Flow during low-fiow periods affecting the assessment reach (ex: watertight dam, sedimenl deposit)
�C Urban stream (>— 24% impenious surface for watershed)
�D Evidence lhat the streamside area has been modified resulting in accelerated drainage into lhe assessmenl reach
�E Assessment reach relocated to valley edge
❑F None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf-on' condilion.
❑A Slream shading is appropriate for sUeam category (may include gaps associated with nalural processes)
�B Degraded (example: scattered trees)
❑C SVeam shading is gone or largely absent

19. Buffer Width —streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately far left 6ank (LB) and right bank (RB) starting at the top of bank out
to the ffrst break.
Vegetated Wooded
LB RB LB RB
�A ❑A �A DA ? 100 feet wide or extends to the edge of the watershed
❑B ❑B ❑B ❑B From 50 to < 100 feet wide
❑C ❑C ❑C �C From 30 to < 50 feet wide
❑D ❑D ❑D ❑D From 10 to < 30 feet wide
❑E �E ❑E �E < 10 feet wide or no trees
Z0. Buffer Structure —streamside area metric (skip for Tidal Marsh Streams)
Consider for lek bank (LB) and right bank (RB) for Melric 19 ("Vegetated" Butfer Widlh).
LB RB
❑A ❑A Malure forest
�B ❑B Non-malure woody vegelation or modified vegetation structure
❑C �C Herbaceous vegetation with or without a sUip of trees < 10 feet wide
❑D ❑D Maintained shrubs
❑E ❑E Little or no vegetation
27. Buffer Stressors —streamside area metric �skip for Tidal Marsh Streams)
Check all appropriate boxes for lek 6ank (LB) and right 6ank (RB). Indicate if listed stressor abuls siream (Abuts), does not abut bul
is within 30 feel of slream (< 30 feet), or is belween 30 to 50 feet of slream (30-50 feel).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: ❑
Abuls < 30 feel 30-50 feet
LB RB LB RB LB RB
❑A ❑A ❑A ❑A ❑A ❑A Row crops
❑B �B ❑B ❑B ❑8 ❑B Maintained turf
❑C ❑C ❑C ❑C ❑C ❑C PasWre (no liveslock)/commercial horticullure
❑D ❑� ❑D ❑o ❑o ❑o Pasture (active �ivestock use)
22. Stem Density —streamside area metric (skip for Tidal Marsh Streams)
Consider for left 6ank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
�A �A Medium to high stem densi(y
�B ❑B Lowstemdensily
❑C �C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. ConUnufty of Vegetated Buffer—streamside area metric (skip forTidal Marsh Streams)
Consider wheiher vegetated butfer is continuous along stream (parallel). Breaks are areas ladcing vegetation > 10 feet wide.
LB RB
❑A ❑A The total length of buffer breaks is < 25 percent.
�B ❑B The total length of buffer breaks is between 25 and 50 percent.
❑C �C The tolal length of buffer breaks is > 50 percent.
24. Vegetative Composition — streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominanl vegetation wilhin 100 feet of each bank or to the edge of the walershed (whichever comes first) as it conlributes to
assessmenl reach habitat.
LB RB
❑A ❑A Vegelation is close lo undislurbed in species preseni and lheir propoAions. Lower sltata composed of native species,
with non-native invasive species absent or sparse.
�B ❑B Vegetation indicates disturbance in lerms of species diversity or proportions, but is slill largely composed of native
species. This may include communi�ies oi weedy native species ihat develop after dear-cutting or ciearing or
communities wilh non-native invasive species present, but not dominant, over a large portion of the expected strala or
communilies missing underslory bul retaining canopy irees.
❑C �C Vegetation is severely disturbed in terms of species diversity or proportions. Malure canopy is absent or communities
with non-nalive invasive species dominant over a large portion of expected slrala or communilies composed of planted
stands of non-characteristic species or communities inappropriately wmposed of a single species or no vegetalion.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. �Yes �No Was wnductivity measuremenl recorded?
If No, select one oi the following reasons. ❑No Water ❑Olher:
25b. Check lhe box wrresponding to lhe conductivily measurement (units of microsiemens per centimeler).
�A < 46 ❑B 46 lo < 67 ❑C 67 to < 79 ❑D 79 to < 230 ❑E >_ 230
NoteslSketch:

Draft NC SAM Stream Rating Sheet
Accompanies User Manual Version 1
Rating Calculator Version 2
Stream Site Name R-4412 US 64 Chunky Gal Date of Assessment 10-7-16
Stream Category Mbt Assessor Name/Organization Dave McHen
Notes of Field Assessmenl Form (Y/N) NO
Presence of regulatory considerations (Y/N) NO
Additional siream in(ormation/supplementary measurements included (Y/N) NO
NC SAM feature lype (perennial, intermittent, Tidal Marsh Stream) Perennial
USACE/ NCDWR
Function Class Rating Summary All Streams Intermittent
(1) Hydrology LOW
(2) Baseflow MEDIUM
(2) Flood Flow LOW
(3) Slreamside Area Attenuation LOW
(4) Floodplain Access MEDIUM
(4) Wooded Riparian Buffer LOW
(4) Microtopography NA
(3) Stream Stability LOW
(4) Channel Stability MEDIUM
(4) Sediment TranspoR MEDIUM
(4) Slream Geomorphology LOW
(2) Stream/Inlertidal Zone Interaction NA
(2) Longitudinal Tidal Flow NA
(2) Tidal Marsh Slream Stability NA
(3) Tidal Marsh Channel Stability NA
(3) Tidal Marsh Stream Geomorphology NA
(1) Water Quality LOW
(2) Base(low MEDIUM
(2) Streamside Area Vegetation LOW
(3) Upland Pollutant Fillration LOW
(3) Thermoregulation MEDIUM
(2) Indicators of Slressors NO
(2) Aquatic Life Tolerance OMITTED
(2) Inlerfidal Zone Filtration NA
(1) Habitat LOW
(2) In-siream Habitat LOW
(3) Base(low MEDIUM
(3) Subslrate MEDIUM
(3) Stream Stability MEDIUM
(3) Irnstream Habitat LOW
(2) Stream-side Habilat MEDIUM
(3) Stream-side Habitat MEDIUM
(3) Thermoregulation MEDIUM
(2) Tidal Marsh In-stream Habiiat Nq
(3) Flow Restnclion NA
(3) Tidal Marsh Siream Stabilily NA
(4) Tidal Marsh Channel Stability NA
(4) Tidal Marsh Stream Geomorphology NA
(3) Tidal Marsh In-siream Habilat NA
(2) Inlertidal Zone NA
Overall LOW

R-4416 Stream Relocation Sites— October 7, 2016 and November 18, 2016
Site 2 facing north (Stream channel about 5 feet to right of silt fence)
Site 2 stream channel (Wet channel visible bottom left next to shadow)

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300
� Feet

USACE AID #:
NC SAM FIELD ASSESSMENT PORM
Accompanies User Manual Version 2
Ratina Calculator Version 2
NCDWR #:
INS7RUC71oN5: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute lopographic
quadrangle, and cirde fhe location of the stream reach under evaluation. If muitiple stream reaches wi�l be evaluated on the same property,
identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User Manual For
delailed descriplioos and expianations of requesled informalioa Record in the °Noles/Sketch' section if supplementary measuremenls were
performed. See fhe NC SAM User Manual for examples of additional measuremenls lhat may be relevanl.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area].
PROJECT/SITE INFORMATION:
1. Project name (if any): R-4412 US 64 Chunky Gal 2. Date of evaluation: 10-7-16
3. ApplicanUowner name: NCDOT Division 14 4. Assessor name/organization: Dave McHenry
5. County: Clay 6. Nearest named water body
7. River basin: Hiwassee on USGS 7.5-minute quad: Shooting Creek
8. Sile coordinates (decimal degrees, al lower end of assessment reach}: 35.067113, -83.629228
STREAM INFORMATION: (depth and width can be approxfmations)
9. Sile number (show on altached map): 2(upper reloc.) 10. Length of assessmenl reach evaluated (feet): 300
11. Channel depth from bed (in riHie, if present) to top of bank (feet): 2 ❑Unable to assess channei dep
12. Channel width at top of bank (feeQ: 3 13. Is assessment reach a swamp steam? ❑Yes ❑No
14. Feature type: �Perennial flow ❑Intermittent Flow ❑Tidal Marsh Stream
STREAM CATEGORY INFORMATION:
15. NC SAM Zone: � Mountains (M) ❑ Piedmont (P) ❑ Inner Coastal Plain Q) ❑ Outer Coastai Plain (0)
16. Eslimated geomorphic
valley shape (skip for
Tidal Marsh Stream):
(more sinuous stream, Flalter valley slope)
�B`1�
(less sinuous slream, steeper vailey slope)
17. Watershed size: (skip �Size 1(< 0.1 mi2) ❑Size 2(0.1 lo < 0.5 mi2) ❑Size 3(0.5 to < 5 mi�) ❑Size 4(z 5 miz)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaivated? QYes �No I( Yes, check all that apply to ihe assessment area.
❑Seclion 10 water ❑Classified Troul Waters �Water Supply Watershed (❑I ❑II ❑III ❑IV ❑�
❑Essential Fish Habital ❑Primary Nursery Area ❑ High Quality WaterslOutslanding Resource Waters
❑Publicly owned property ❑NCDWR Riparian buffer rute in effect ❑Nutrient Sensitive Walers
❑Anadromous fish �303(d) List ❑CAMA Area of Environmental Concem (AEC)
❑Documented presence of a federai and/or state lisled protected species wilhin ihe assessment area.
Lisl species:
❑Designated Critical Habitat (list species)
measurements
1. Channel Water—assessment reach metric (skip forSize 1 streams and Tidal Marsh Streams)
�A Water thtoughout assessment reach.
❑6 No flow, waler in pools only.
❑C No water in assessment reach.
or altached?
2. Evidence of Flow Restriclion — assessment reach metric
�A At least 10% oF assessment reach in-slream habital or riffle-pool sequence is severely atfecled by a Flow resiriction or fill to lhe
point of obstrucling flow or a channel choked wilh aqualic macrophytes or ponded water or impoundment on flood or ebb within
the assessment reach (examples: undersized or perched culveAs, causeways thal constricl the channel, tidal gates, debris jams,
beaver dams).
�B Not A
3. Feature Pattern — assessment reach metric
�A A majority of the assessment reach has altered paltern (examples: straightening, modification above or below culvert).
❑B NotA
4. Feature Longitudinal Protile—assessment reach metric
�A Majority of assessmeni reach has a substantially altered stream profile (examples: channei down-cutting, existing damming,
over widening, aclive aggradation, dredging, and excavation where appropriale channel profile has not reformed from any of
these dislurbances).
❑B NotA
5. Signs of Active Inslability — assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instabi�ity include
aclive bank faiiure, active channel down-cutting (head-cut), active widening, and artificial hardening (such as concrete, gabion, rip-tap).
❑A < 70%of channel unstable
�B 1010 25%of channel unstable
❑C > 25% of channel unstable

6. Streamside Area Interaction — streamside area metric
Consider for the Left Bank (L8) and the Right 6ank (RB). �
LB RB
DA ❑A Little or no evidence of condilions that adversely affect reference interaction
�B ❑B Moderate evidence of condifions (examples: berms, levees, down-cutling, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood Flows through streamside area,
leaky or intermittent bulkheads, causeways with Floodplain constriction, minor ditching [inGuding mosquito ditching])
�C �C EMensive evidence o( conditions that adversely affect reference interaction (little lo no FloodplaiNintertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walis, fill, stream incision,
disruption of Bood fiows lhrough streamside area] or too much floodplainlintertidal zone access [examples:
impoundmenls, intensive mosquito ditching]) or Floodplainfintertidal zone unnaturally absent or assessmeni reach is a
man-made feature on an interslream divide
7. Water Quality Stressors —assessment reach/intertidal zone metric
Check all that apply.
❑A Discolored water in siream or intertidal zone (milky white, blue, unnaWral waler discoloration, oil sheen, sUeam foam)
❑8 Excessive sedimentation (burying of stream features or intertidal zone)
❑C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality probiem
❑D Odor (not including nalural sulfide odors)
❑E Current pubiished or collected data indicaling degraded water quality in lhe assessment reach. Cite source in "Notes/Sketch'
section.
❑F Liveslock with access to stream or intertidal zone
❑G Excessive aigae in stream or intertidal zone
❑H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, desUuclion, etc)
❑I Olher: (explain in'Notes/Sketch' section)
�J Little to no stressors
8. Recent Weather—watershed metric (skip for Tidal Marsh Streams)
For Size 1 or 2 slreams, D1 drought or higher is considered a drought; for Size 3 or 4 slreams, D2 drought or higher is considered a
drought.
�A Drought conditions and no rainfall or rainfall nol exceeding 1 inch within the last 48 hours
❑B Droughl conditions and rainfall exceeding 1 inch within the last 48 hours
❑C Nodroughtconditions
9. Large or Dangerous Stream — assessment reach metric
❑Yes �No Is sUeam is too large or dangerous lo assess? If Yes, skip to Metric 13 (Slreamside Area Ground Surface Condilion).
10. Natural In•stream Habitat Types — assessment reach metric
70a �Yes ❑No Degraded in-slream habilal over majority of lhe assessment reach (examples of siressors inciude excessive
sedimentation, mining, excavalion, in-slream hardening [for example, rip-rap], recent dredging, and snagging)
(evaluate for Size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all lhat occur (occurs if> 5%coverage of assessmenl reach) (skip for Size 4 Coastal Plain streams)
❑A MWliple aquatic macrophyles and aqualic mosses h ❑F 5°/a oysters or olher natural hard bolloms
(include livenvorts, lichens, and algal mals) �@ ❑G Submerged aquatic vegetalion
�8 Multiple sticks and/or leaf packs and/or emergent o� ❑H Low-tide re(ugia (pools)
vegetation Y t ❑I Sand bottom
❑C Multiple snags and logs (including lap irees) t,�, �J 5% vertical bank along lhe marsh
�D 5% undercut banks and/or root mats and/or rools �� ❑K Little ot no habilat
in banks exlend to ihe normal wetled perimeler
DE Litlle or no habitat
*_'+__„"_""_""""""""""""*'REMAINWG QUESTIONS ARE NOTAPPLICABLE FOR TIDAL MARSH STREAMS"'t"""""'•"`""*""'
11. Bedform and Substrate —assessment reach metric (skip for Size 4 Coastal Plafn streams and Tidal Marsh Streams)
11a. ❑Yes �No Is assessment reach in a natural sand-bed sUeam? (skip for Coastal Plain streams)
11b. Bedform evaluated. Check the appropriate box(es).
�A Riffle-run section (evaluate 11c)
�B Pool-glide section (evaluate 11d)
❑C Nalural bedform absent (skip to Mel�ic 12, Aquatic Life)
1 tc. In riPoe sections, check all thal occur below the normal wetled perimeter of lhe assessment teach — whelher or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain slreams and Tidal Marsh Streams). Not Present (NP) _
absent, Rare (R) = present but < 10%, Common (C) _> 10-40%, Abundant (A) _> 40-70%, Predominant (P) _> 70%. C�mulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
� ❑ ❑ ❑ ❑ Bedrock/saprolite
� ❑ ❑ ❑ ❑ Boulder(256-4096mm)
� ❑ ❑ ❑ ❑ Co6ble (64 — 256 mm)
❑ ❑ ❑ � ❑ Gravel (2 — 64 mm)
❑ ❑ � ❑ ❑ Sand (.062 — 2 mm)
❑ ❑ � ❑ ❑ Silticlay (< 0.062 mm)
� ❑ ❑ ❑ ❑ DeUitus
❑ ❑ � ❑ ❑ Artificial (rip-rap, wncrete, etc.)
t 1d. ❑Yes �No Are pools filled with sedimenl? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)

12. Aquatic Life — assessment reach metric (skip for Tidal Marsh Streams)
12a. �Yes ❑No Was an in-siream aquatic life assessment performed as described in lhe User Manual7
If No, select one oi the following reasons and skip to Metric 73. ❑No Water �Other.
12b. �Yes ❑No Are aqualic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check all that
apply. If No, skip to Mefric 13.
1 >t Numbers over columns refer lo'individuals' for Size 1 and 2 streams and 9aua' for Size 3 and 4 sUeams.
❑ ❑Adult frogs
❑ DAquatic repliles
❑ ❑Aquatic macrophytes and aqualic mosses (include liverworts, lichens, and algal mats)
❑ ❑Beetles
❑ ❑Caddistly larvae (T)
❑ QAsian clam (Corbicula)
❑ ❑Cruslacean (isopod/amphipod/crayfishlshrimp) �
❑ ❑DamselFly and dragonfly larvae
❑ ❑Dipterans
❑ �May(ly larvae (E)
❑ ❑Megaloplera (alderfly, fish�y, dobsonily larvae)
❑ ❑Midges/mosquito larvae
❑ ❑Mosquito fish (Gamb�sia) or mud minnows (Um6ra pygmaea)
❑ �Mussels/Clams (not Corbicula)
❑ �Olher fish
❑ ❑Salamanders/tadpoles
❑ ❑Snails
❑ ❑StoneOy larvae (P)
❑ �Tipulid larvae
❑ ❑Wormslleeches
13. Streamside Area Ground Surface Condition —streamside area melric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity wilh regard to bolh overbank Oow and upland
runoff.
LB RB
❑A ❑A LitUe or no alteration to water storage capacity over a majority of the streamside area
❑B ❑B Moderate alteration to water slorage capacity over a majoriry ot the sUeamside area
❑C ❑C Severe alleralion to water storage capacily over a majorily of �he slreamside area (examples: ditches, fill, soil
compaclion, livestock dislurbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage —streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Lek Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
�A �A Majority of slreamside area with depressions able lo pond water Z 6 inches deep
❑B ❑B Majonty of sireamside area with depressions able lo pond water 3 to 6 inches deep
❑C ❑C Majority of sireamside area with depressions able to pond water < 3 inches deep
16. Welland Presence — streamside area melric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do nol consider wetlands outside of the slreamside area or within the norma�
wetted perimeter of assessment reach.
LB RB
�Y ❑Y Are wetlands present in the sireamside area?
�N �N
16. Base(low Contri6utors — assessment reach metric (skip for Sfze 4 streams and Tidal Marsh Streams)
Check all contributors wilhin the assessment reach or wtthin view of and drainfng to the assessment reach.
�A Slreams and/or springs (jurisdictional discharges)
❑B Ponds (include wel detention basins; do not include sediment basins or dry detention basins)
�C Obstruclion passing flow during low-Flow periods within the assessment area (beaver dam, leaky dam, bottom-release dam, weir)
❑D Evidence o( bank seepage or swealing (iron in waler indicates seepage)
❑E Stream bed or bank soii reduced (dig through deposited sediment if present)
❑F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all lhat apply.
�A Evidence of substantial waler withdrawals from the assessment reach (inGudes areas excavated for pump installation)
❑B Obsiruction not passing Flow during low-flow periods affecting the assessmenl reach (ex: watertight dam, sediment deposit)
❑C Urban stream (>_ 24% impervious surface for watershed)
�D Evidence that the streamside area has been modified resulting in accelerated drainage into the assessment reach
�E Assessmenl reach relocated to valley edge
❑F None of lhe above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspecL Consider °leaf-on' condilion.
❑A Stream shading is appropriate for slream category (may inGude gaps associaled with natural processes)
�B Degraded (example: scattered trees)
❑C Stream shading is gone or largely absent

19. Buffer Widlh —streamside area melric (skip for Tidal Marsh Streams)
Consider "vegetated butfer" and "wooded butfer" separately for le(t bank (LB) and right bank (RB) starting at the top of bank out
to the first break.
Vegetated Wooded
LB RB LB R8
�A ❑A �A �A >_ 100 feet wide or eMends to the edge of the walershed
❑B ❑8 ❑B ❑B From 50 to < 100 feel wide
�C ❑C ❑C ❑C From 30 to < 50 feet wide
❑D ❑D ❑D ❑D From 10 to < 30 feet witle
❑E �E ❑E �E < 10 teet wide or no trees
20. Buffer Structure —streamside area metric (skip for Tldal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metrfc 19 ("Vegetated" Buffer Widlh).
LB RB
�A ❑A Mature forest
❑B ❑B Non-mature woody vegetalion or modified vegetalion structure
❑C �C Herbaceous vegetation wilh or without a strip of lrees < W feet wide
❑D ❑D Maintained shrubs
❑E ❑E Liltle or no vegetation
27. Buffer Slressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for lek 6ank (LB) and right bank (RB), Indirate if listed stressor abuts siream (Abuts), does not abut but
is within 30 feet of siream (< 30 feet), or is belween 30 to 50 feet of slream (30-50 feet).
If none of the following stressors occurs on either bank, check here and sktp to Metric 22: ❑
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
�A ❑A ❑A ❑A �A ❑A Row crops
❑B �8 ❑8 ❑B ❑B ❑B Maintained turf
❑C ❑C ❑C ❑C ❑C ❑C Pasture (no livestock)/wmmercial horticulture
❑D ❑D ❑D ❑D ❑D ❑D Pasture (active livestock use)
22. Stem Densiry—streamside area metric (skip for Tidal Marsh Streams)
Consider for lek 6ank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
�A ❑A Medium to high stem density
❑B ❑B Lowstemdensily
�C �C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer—streamside area metric (skip forTidal Marsh Streams)
Consider whelher vegetated buffer is conlinuous along siream (parallei). Breaks are areas ladcing vegetation > 70 feet wide.
LB RB
�A ❑A The lotal length of buffer breaks is < 25 percent.
❑B ❑B 7he totai length of buffer breaks is belween 25 and 50 percent.
❑C �C The total lenglh of buffer breaks is > 50 percent.
24. Vegetative Composition — streamside area metric (skip for Tldal Marsh Streams)
Evaivate lhe dominant vegetation within 100 feet ot each bank or to the edge of the watershed (whichever comes first) as it contributes to
assessment reach habilai.
L8 RB
�A ❑A Vegetalion is close to undislurbed in species present and their proportions. Lower slrata composed of native species,
with non-nalive invasive species absent or sparse.
❑B ❑B Vegetation indicates disWrbance in tertns of species diversity or proportions, but is s(ill largely composed of nalive
species. This may indude communities of weedy nalive species ihat develop after clear-culting or ciearing or
communities with non-native invasive species present, but not dominant, over a iarge poAion of the expecled strata or
communities missing understory bul relaining canopy trees.
�C �C Vegetation is severely dislurbed in terms of species diversily or proportions. Mature canopy is absenl or communities
wiih non-nalive invasive species dominant over a large portion of expected slrata or communities composed of planted
slands of non-characterislic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. ❑Yes �No Was conductivity measurement recorded?
If No, select one of the following reasons. ❑No Water ❑Other:
25b. Check lhe box corresponding to lhe conductivity measurement (units of microsiemens per centimeter).
❑A <46 ❑8 46to<67 ❑C 6710<79 ❑D 79to<230 ❑E ?230
NoteslSketch:

Draft NC SAM Stream Rating Sheet
Accompanies User Manual Version 1
Rating Calculator Version 2
Stream Sile Name R-4412 US 64 Chunky Gal Date of Assessment 10-7-16
Stream Category Mb1 Assessor Name/Organization Dave McHenry
Notes of Field Assessment Form (Y/N) NO
Presence of regulatory considerations (Y/N) Np
Additional stream information/supplementary ineasurements included (Y/N) NO
NC SAM feature lype (perennial, intermiltent, Tidal Marsh SVeam) Perennial
USACEI NCDWR
Function Class Rating Summary All Streams Intermittent
(1) Hydrology LOW
(2) Baseflow MEDIUM
(2) Flood Flow LOW
(3) Streamside Area Attenuation LOW
(4) Floodplain Access LOW
(4) Wooded Riparian Buffer MEDIUM
(4) Microtopography NA
(3) S�ream Stabilily LOW
(4) Channel Stability MEDIUM
(4) Sediment Transport MEDIUM
(4) Sireain Geomorphology LOW
(2) Siream/Inlerlidal Zone In�eraction NA
(2) Longitudinal Tidal Flow NA
(2) Tidal Marsh Siream Stability NA
(3) Tidal Marsh Channel Stability NA
(3) Tidal Marsh SUeam Geomorphology NA
(1) WalerQuality MEDIUM
(2) Base(low MEDIUM
(2) Sireamside Area Vegetation LOW
(3) Upland Pollutant Filtration LOW
(3) Thermoregulalion MEDIUM
(2) Indica�ors of Siressors NO
(2) Aquatic Life Tolerance MEDIUM
(2) Inlertidal Zone Fillration NA
(1) Habitat LOW
(2) In-stream Habitat MEDIUM
(3) Baseflow MEDIUM
(3) Subsirete MEDIUM
(3) Slream Stabilily MEDIUM
(3) In-stream Habitat MEDIUM
(2) Siream-side Habilat LOW
(3) Stream-side Habital LOW
(3) Thermoregulation MEDIUM
(2) Tidal Marsh In-siream Habitat NA
(3) Flow Restriction NA
(3) Tidal Marsh SVeam Slability NA
(4) Tidal Marsh Channel Stability NA
(4) Tidal Marsh Slream Geomorphology NA
(3) Tidal Marsh Ins�ream Habitat Nq
(2) Intertidal Zone NA
Overall LOW

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): �z-i4-2ois
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
NC DepaAment of Transportalion, Dave McNenry, Division 14 Environmenlal Officer
253 Webster Road, Syiva, NC 28779
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Add iruck Gimbing lane to section o( US Highway 64 up Chunky Gal Mountain
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC Countylparish/borough: ciey Cj(y; Hayesville
Center coordinates of site (lat/long in degree decimal format):
Lat. as.os�sz� °N; Long. -as.s�s�zo °W,
Universal Transverse Mercator: Zs�sss.s,saezsso.szo�an
Name of nearest waterbody: snoo��9 c�eek
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
s�o linear feet: 7-2 width (ft) and/or acres.
Cowardin Class: Raus�
Stream Flow:
Wetlands: Na acres.
Cowardin Class: �a
Name of any water bodies on the site that have been identified as Section 10
waters:
Tldal: �a
Non-Tidal: �a

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
� Office (Desk) Determination. Date: �2-�a-2ois
� Field Determination. Date(s): �o-�-zo�s
SUPPORTING DATA. Data reviewed for preliminary JD
(check aIl 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: Ncoor
❑ Data sheets prepared(submitted by or on behalf of the
app�nt/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: ��24ksnoor�9c�eak
❑ 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): or
Q Other (Name & Date): s�ie o�� �, zois a�d No� is, 2o�s
� Previous determination(s). File no. and date of response letter:
� Other information (please specify):
2

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 preliminary 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 permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional 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 terms 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 applicanYs 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 jurisdiction in any administrative or judicial 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 administrative 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 "may be" waters of the United States on ihe
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
Signature and date of
Regulatory Project Manager
(REQUIRED)
r�
/� -/y /6
ignature and date
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estlmated
amount of
aquatic Class of
resourcein aquatic
Site Numher Latitude Longitude Cowardin Class review area resource
1 35.057921 -83.613720 R3UB1 300 linear feet Non Section 10
— non-wetland
2 35.067113 -83.629228 R3UB1 310 Iiner feet Non Section 10
— non-wetland