SR 1008 West Market Street

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STATE OF NORTH CAROLINA
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DEPARTN MNT OF TRANSPORTATION
MICHAEL F EASLEY
GOVERNOR
Mr David Wainwright
NC Division of Water Quality
1650 Mail Service Center
Raleigh NC 27699-1650
D
LYNDo TIPPETT
SECRETARY
DI
SUBJECT Request for Jurisdictional Determination for the proposed
widening of SR 1008 (West Market Street) from SR 2007
(Bunker Hill Drive) in Colfax to NC 68 in Greensboro,
Guilford County, Division 7, Federal Aid Project No STP-
1008(9), State Project No 8 2497401, WBS # 34482 1 1,
T I P No R-2611
Dear Sir
The North Carolina Department of Transportation (NCDOT) Natural Environment Unit
(NEU) has completed the delineation of "Waters of the United States," for the above
referenced improvement projects NEU has requested an on-site jurisdictional
determination of the wetland delineations and stream determinations for this project
R-2611 involves four perennial streams (SA, SH, SI, and SK) four wetlands (wetland A
0 01 acres, wetland B 0 05 acres, wetland C 0 02 acres, and wetland D <0 01 acres
approximately), and six ephemeral streams (SB, SC, SE, SF, SG, and SJ)
Design for R-2611 is in the beginning stages, therefore specific impacts are unknown at
this time Preliminary roadway plans are available and have been provided
Please see the attached supporting documents
1) Project vicinity map
2) Topographic map with site location
3) Approved Jurisdictional Determination From (Rapanos form)
4) Wetland Data Sheets
5) Wetland and stream delineation map
6) Preliminary Roadway Plans

MAILING ADDRESS
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
NATURAL ENVIRONMENT UNIT
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
March 18, 2008
TELEPHONE [phone] or
919-715-1335
FAX [phone]
WEBSITE WWW NCDOT ORG
LOCATION
2728 CAPITAL BLVD SUITE 240
RALEIGH NC 27604
If you have any questions or require additional information please contact me at (919)
715-7217 orjrpflaum@dot state nc us
Sincerely,
James Pflaum
Environmental Specialist, NCDOT
CC R-2611 file
2
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site F- -,?, 6 (( Date `7 ` -?'- 7 ` U 7
Applicant/Owner 96 po'r County % ? , f d
Investigator t Sg rr? s v, vti, /] (, n r --A „ 1, , n h State N (f-

Do normal circumstances exist on the site? Yes 1-1/ No Community ID
Is the site significantly disturbed (Atypical situation)? Yes No? Transect ID
Is the area a potential problem area? Yes No ? Plot ID
(explain on reverse if needed)
\//
W f W ?
VEGETATION
Dominant Plant Soecie
s Stratum Indicator Dominant Plant Species Stratum Indicator
/
/
1 ' V h yn 1 I°? h ?.w? y"' 1 Q !? L 9
2 CL'ers ,g oeV2,0 c) ?5 =ss 09L 10
3 M k?>1 ; ?«,.den S V ht- F Gq I.,.i ? 11
4 B,d??,s (s f?) 6r6 Q.i 12
13
6 14
7 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-) I OC)7-15
Remarks
HYDROLOGY
- Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators
Other _ Inundated
? Saturated in Upper 12"
No Recorded Data Available Water Marks
Drift Lines
Field Observations Sediment Deposits
? Drainage Patterns in Wetlands
Depth of Surface Water (in) Secondary Indicators
Depth to Free Water in Pit (in Oxidized Roots Channels in Upper 12"
Water-Stained Leaves

Depth to Saturated Soil b (in.) _ Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
k)
C)
3 P
SOILS
Map Unit Name
(Series and Phase)
?I rip ;an dv 4o w- Drainage Class `'i'f/i Cf r':!"n-2C?
Taxonomy (Subgroup) /1" d" 4 i'5 Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors
(inches) Horizon (Munseil Moist) Mottle Colors Mottle Texture, Concretions,
(Munseii Moist) Abundance/Contrast Structure. etc
o- 1 5' 7, s
y
UA r, 41 G

3 i
R
W l
? /
N o
N
U
/
L7
Y
(j
L qa
/V 6 ^
Hydric Soil Indicators
_ Histosol - Concretions
Histic Epipedon _ High Organic Content in Surface Layer in Sandy Sods
Sulfidic Odor -Organic Streaking in Sandy Soils
Aquic Moisture Regime
7 -Listed On Local Hydric Soils List
Reducing Conditions -Listed on National Hydric Soils List
?Gieyed or Low-Chroma Colors -Other (Explain in Remarks)
Remarks
t?
-5 e?s
rrC 1 I.-MMU UC 1 CINIVII VA I IUN
Hydrophytic Vegetation Present? Yes 'a'e No Is the Sampling Point
Wetland Hydrology Present? Yes A, No Within a Wetland? Yes No kl?
Hydric Soils Present? Yes No
Remarks
L?I,i Le- 5c, 15 Jo nc-1 Yn,;-?4 Q??c we>ti?.? c:? r rrarl?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project/Site. g-.2611 L-v /-) Llf Pn (J Date ?/ 2 i/3-'
Applicant / Owner ),/ G 0 OT County: ,4; T _f clr c/
Investigator Sg me 5 P-t l4µ n, )`_?tA ACq n CvL?, n h State A) C
Do normal circumstances exist on the site? Yes k No Community ID
Is the site significantly disturbed (Atypical situation)? Yes No X Transect ID
Is the area a potential problem area? Yes Nom Plot ID w A
(explain on reverse if needed) U/ A N p /0 61

VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 L ,-7 w,d'- M SS, "ui,:Ac 4/wa -1 FAc.+ 9
2 /acer rcbrrnM T FAC- 10
31-,XN, damla, 5-tyr1G1_4 ua 5 F, L+ 11
4 f4cer rti h,i.. nA 5 PAC 12
6 !L-0hLi 5 a r3ttluS H FAGU + 13
6 r4?, c rogue, N ?7 N r-AC-+ 14
7 tsn,c2? 9 ag fen C? V FAC- 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-) %
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators
Other _ Inundated
-Saturated in Upper 12"
No Recorded Data Available Water Marks
Drift Lines
Field Observations _ Sediment Deposits

%l _ Drainage Patterns in Wetlands
Depth of Surface Water N
(in.) Secondary Indicators
Depth to Free Water in Pit ?V (in) - Oxidized Roots Channels in Upper 12"
Water-Stained Leaves
Depth to Saturated Soil A.) X (,n
) Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks `? r
1
SOILS
Map Unit Name
(Series and Phase) ?0 , n c yt
re ?at? y, ?a A "^ Drainage Class ?v eH d ?? he
Taxonomy (Subgroup) ?+ 1lGP?t,?c 1-?5 Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moistl (Munsell Moist) Abundance/Contrast Structure, etc
12 `? '? , /VOA C_ ).i y
Hydric Soil Indicators
_ Histosol _ Concretions
Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed On Local Hydric Sods List
Reducing Conditions Listed on National Hydric Soils List
Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes No X
Wetland Hydrology Present? Yes No
Hydric Soils Present? Yes No
Is the Sampling Point
Within a Wetland? Yes_ NoZ
rks
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project/ Site _ /2 - a6 ll t v 1? ?,e_.1 Ane) Date a 2z 0 F
Applicant / Owner /r- Da T County ?"'J 04-c?
Investigator -TR kh'? IaW M A h tP y Cry X State /U L
Do normal circumstances exist on the site? Yes X No Community ID
Is the site significantly disturbed (Atypical situation)? Yes No X Transect ID
Is the area a potential problem area? Yes No_ Plot ID l-y
(explain on reverse if needed)
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 Frnx', ? ? 5 nn svi vin c 9 FAC,W 9.
21,r.orle.r/,e. f°aJ prE41 T FAC 10
3O,Cyde_Jr,m ar?are_- 1 Na 11
4 Ac-&,r rt bru, Yn 7 FAC 12
5 1b i4 r n" m de,.h s F-ACFW 13
6 PrL,nk5 Sero,+, r19 5 /-'q C_ 14
7 CR,p;nu5 Carcl ni9hC( S FAC_ 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-) 6 3 ?a
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
Stream, Lake, or Tide Gauge
Aerial Photographs Primary Indicators
Other __ Inundated
Saturated in Upper 12"
No Recorded Data Available _ Water Marks
Drift Lines
Field Observations Sediment Deposits
le Drainage Patterns in Wetlands
Depth of Surface Water G ?/-Z (in)
Secondary Indicators
Depth to Free Water in Pit -Ir- I (in _ Oxidized Roots Channels in Upper 12"
X Water-Stained Leaves
Depth to Saturated Soil Q (in.) Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
SOILS
Map Unit Name
(Series and Phase) nl-). Fno r, ; • tip. 5Gi v I oQ m Drainage Class w e 1 dry n2?
Taxonomy (Subgroup) U 4, c_ k QjL4 do f "S Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc
0-,!) IoYIZ 3, IVaAI E- 'd Y, /aQ 1-n
10 Iok't2L 2 N0lUl= 5A ?y e--I-\ X
/OQ w)
ly - l 2 lOY6? zl? I ,
/a ®Jv ;.?t y A c 14y. Ie 4 1M
Hydric Soil Indicators
_ Histosol _ Concretions
- Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
-Sulfidic Odor -Organic Streaking in Sandy Soils
Aquic Moisture Regime -Listed On Local Hydric Soils List
_ Reducing Conditions -Listed on National Hydric Soils List
Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks
?1 )rI r1ct-,LC n IF55 fi,??
1UI not °? y dr,Z 5o

/
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes -X No Is the Sampling Point
Wetland Hydrology Present? Yes No Within a Wetland? Yes_ No
Hydric Soils Present? Yes 'y No
,
Remarks /
5 a , 5 ci ?? Y1 t h) ems, ? Y a' r, _C a h s can - s '4
r???? c/ ?r ?? ?'evnC h i?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site k , Z 6 // W
Applicant/Owner A C- 13 =?T
Investigator _ J-4 ow- f, LIJ In ti r~ Ac
h? Date ) 0 2& /0 4
County* 9 4c rc,)
State ./W C
e
Do normal circumstances exist on the site? Yeses No
Is the site significantly disturbed (Atypical situation)? Yes No -Y
Is the area a potential problem area? Yes ', No V

(explain on reverse if needed) Community ID
Transect ID
Plot ID L-)
1
VEGETATION

Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 rL.,erc? 5 r$ T MAGI) s
2 ornn5 r/o? Aq T FACU 10
3 Ace r r L? h r in Yt, 'T FAG 11
4 Corn"S Flor d n s jcA CU 12
6J- 111dCA. OG+r s+vfeC fka 5 )CAC- t 13
6\6L4 rnL,Yy\ n?t dt,n- 14
7 57m, 4? u rr.o,,nd +a?,a \I rAC 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-)?b
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
Stream, Lake, or Tide Gauge
- Aerial Photographs Primary Indicators
Other _ Inundated
_Saturated in Upper 12"
_ No Recorded Data Available Water Marks
_ Drift Lines
Field Observations _ Sediment Deposits
Drainage Patterns in Wetlands
Depth of Surface Water (?n•) Secondary Indicators
Depth to Free Water in Pit 7 1 Z (in) - Oxidized Roots Channels in Upper 12"
Water-Stained Leaves
n
Depth to Saturated Soil 7 1 - (in) Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
SOILS
Map Unit Name
(Series and Phase) Fn n, r"'non,
5 L Drainage Class
Taxonomy (Subgroup) L-1 I-, e- a l ?S Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors
(inches) Horizon (Munsell Moist) Mottle Colors Mottle Texture, Concretions,
(Munsell Moist) Abundance/Contrast Structure
etc
- 2 I0/1Z 4?
2 ,
/
ki ? as ^Lg v
J
w
- ?w J ? s
/? ? 1f?
o v'e S our\.C y 15 Ci YYl
Hydric Soil Indicators
_ Histosol _ Concretions
_ Histic Epipedon _ High Organic Content in Surface Layer in Sandy Sods
Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed On Local Hydric Soils List
- Reducing Conditions Listed on National Hydric Soils List
Gleyed or Low-Chroma Colors -Other (Explain in Remarks)
Remarks
%Aff T¦ A
vvr_ I L.ANU ut I CKMINA 1 IUN
Hydrophytic Vegetation Present? Yes
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes
No Is the Sampling Point
No Within a Wetland? Yes No
No
Remarks
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site (2--2411 w?- W L+/an c) Date ) 0 ZZ ® -4
Applicant/ Owner c O i' County- C to rd
Investigator S ,,,P 5 Ar/4A,M YOU nc.oA qSh y )( State A) C
Do normal circumstances exist on the site? Yes_?L_ No Community ID
Is the site significantly disturbed (Atypical situation)? Yes No- Transect ID
Is the area a potential problem area? Yes No ) Plot ID \,/) C
(explain on reverse if needed) ?t/0 C/
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 L , s' d""" .- s-ty M, F"AC--+ 9 50' 14 rc l u ti d'. f c! a FAC
2C^r4,&4S Cam/,n,enoS FAC 10
3 AIPL,s serr/Ak+q 5 f A(-Wi- 11
4 V ,bH rn? dent4 tt,. M S fAC 12
5V bNrn?,m r?c?a1km S FA F 13
6 -ray +cocren c/ror, v?(.J;c4n s H A 14
7 A+A y rw, m ?, Joe -re r, r,' H FAC 15
8 L?,,,c4< ?A 1?)*A, C V FAC- 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-)
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
Stream, Lake, or Tide Gauge
Aerial Photographs Primary Indicators
Other X Inundated
XSaturated in Upper 12"
No Recorded Data Available k Water Marks
Drift Lines
Field Observations _ Sediment Deposits
Drainage Patterns in Wetlands
Depth of Surface Water Q fin.) Secondary Indicators
Depth to Free Water in Pit 1 (in.) Oxidized Roots Channels in Upper 12"
Water-Stained Leaves
Depth to Saturated Soil (in
) Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks

SOILS
Map Unit Name
(Series and Phase) _ &D, ":?'Oo n
? S L Drainage Class
Taxonomy (Subgroup) V 0 ; C_. ?c , ?ti d? S Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc
-3 10'12 2,11 AviJ/UE
3 - :2 SY Gj 2 ?, S-/ 4A Fe w.? df;54.nct So?-d
_-1Z 10YPI L) I 10yR 6Af Few) d-)54;nc_? 5? dY , c/? y ?aAYh
Hydric Soil Indicators
_ Histosol _ Concretions
- Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor -Organic Streaking in Sandy Soils
_ Aquic Moisture Regime -Listed On Local Hydric Soils List
-Reducing Conditions -Listed on National Hydric Soils List
? Gleyed or Low-Chroma Colors Other (Explain in Remarks)
Remarks
WE I L.ANU DETERMINATION
Hydrophytic Vegetation Present? Yes -? No
Wetland Hydrology Present? Yes 'r No
Hydric Soils Present? Yes No
Is the Sampling Point
Within a Wetland? Yes Y No
Remarks
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project/ Site R-2-411 L (-c?/?? Date
®f?'
Applicant / Owner /VC_ Do 7- County &tA 4or d
Investigator "Tcr4os n A 6 b Co i Ce3 X 0LAn04n inn State PVC
Do normal circumstances exist on the site? Yes _X No Community ID
Is the site significantly disturbed (Atypical situation)? Yes No X Transect ID
Is the area a potential problem area? Yes Nom Plot ID 1 (7-
(explain on reverse if needed)
? ?'Q
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 L qa , eS n, s P 5 4V /CC ,-V lei T F`4C + 9
21-, 4,, I o, ?rc, T F14 e: 10
3 Are r r b? `jr?n r? 7' -AC 11
4'Sc n ,4?r?rs ?', r@ ,n ,CShC T, 4-'L4 _ 12
5L',g? ?Q, ygr '4"Z''? 9 5 FAC-i 13
6Lcn,GEr, /70n)c<t F G - 14
7 Sim , J a y r-47 /=,A C 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-)
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
Aerial Photographs Primary Indicators
Other _ Inundated
-Saturated in Upper 12"
No Recorded Data Available Water Marks
Drift Lines
Field Observations _ Sediment Deposits
Drainage Patterns in Wetlands
Depth of Surface Water 2 (in•) Secondary Indicators
Depth to Free Water in Pit 2 din - Oxidized Roots Channels in Upper 12"
Water-Stained Leaves

Depth to Saturated Soil (in.) _ Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
SOILS
Map Unit Name
(Series and Phase) Enos
;5 L Drainage Class w e ?l d?a n e?d
Taxonomy (Subgroup) L11? ?'?? ?k d t ?°t 5 Confirm Mapped Type? Yes_ No_
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc
p-I )oliA ti, 3 )aawt
1- 10 loyp S? 0/ loam
?O - ? z )C) C to Y/; common ,,4 jag M
Hydric Soil Indicators
_ Histosol _ Concretions
Histic Epipedon High Organic Content in Surface Layer in Sandy Sods
_Sulfidic Odor -Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed On Local Hydric Soils List
_ Reducing Conditions -Listed on National Hydric Soils List
Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes
rks U p f ,,t r\ d po -11
No A- Is the Sampling Point v
No X Within a Wetland? Yes_ No
No
$)1C in e1 Cr v ctrl ' 1V G7
?,, -R-- + / cA,\ Cp
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project/ Site )2 _ 2- 1? Ly Date bv/? 2-
Applicant / Owner ,ha C 1)07 County (.- (- , 1 ? r x
Investigator .i Q r ?"e 4 s1 ) ie lr C' OY iY1? n (r L- Ah State /VC
Do normal circumstances exist on the site? Yes No X Community ID
Is the site significantly disturbed (Atypical situation)? Yes No X Transect ID
Is the area a potential problem area? Yes x No Plot ID l.? D
(explain on reverse if needed)
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 StynL??5 c5p q 9
2 6g re k 10
3 Leer,; g b 13L 11
41- 4,,, d-s ho- 5-fr+rac, rlviw s I-A c 12
5 13
6 14
7 15
8 16
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-)
Remarks
HYDROLOGY
_ Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators
Other X Inundated
C Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines
Field Observations Sediment Deposits
Drainage Patterns in Wetlands
Depth of Surface Water in Secondary Indicators
)
Depth to Free Water in Pit Q fin Oxidized Roots Channels in Upper 12"
, Water-Stained Leaves
Depth to Saturated Soil (3 (in) Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
SOILS
Map Unit Name
(Series and Phase) P j)
P Q - iOo di/ IC - Drainage Class kle ll JrG ?') &d
Taxonomy (Subgroup) Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc
C- 2,5 ? 2 A1041 E IC>C" I V S?,n!7
(, - ? 2 (? , C,? r a ,P
Hydric Soil Indicators
_ Histosol _ Concretions
- Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_Sulfidic Odor Organic Streaking in Sandy Sods
- Aquic Moisture Regime Listed On Local Hydric Soils List
_ Reducing Conditions Listed on National Hydnc Soils List
Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks j 1
Luc ", r?nQ
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes X No Is the Sampling Point
Wetland Hydrology Present? Yes X No Within a Wetland? Yes_ No
Hydric Soils Present? Yes No
Remarks
uen -?AGltis dr G 5o.115 ?c+ dQ :e'ej7`iR1cl
c. v a r- s I l j a( E' ro'? C' C °^ J 1,
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site 12 - 2- 6 /1 L d , 3 V p Date 10 2 Z 16
Applicant / Owner 3 County. C u I r
Investigator ? ?/q -F To x ti n L4 n u n State tiC
Do normal circumstances exist on the site? Yes No X Community ID'
Is the site significantly disturbed (Atypical situation)? Yes X No Transect ID
Is the area a potential problem area? Yes Nom Plot ID w u
(explain on reverse if needed)
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 L c ,a)Qm?J?+i 5+H/rcc4W.9 9
2L,{Iocl?nd?cn +?.?Iplre(? T FAC 10
3L.gG dQrnSP? swraclaa S [- 11
4C.?4s+rNM s,nNnse FAC 12
6 U bu r A C. 13
6 ±r+,,, va a -,e ro t- r 5 FA C _U 14
7 ton,cerg toIrv i[..r, V FA C_ 16
8TM5tCe,deredren r k d;(,gn S V F.AC 16
11
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-) 7C,
Remarks
HYDROLOGY
Recorded Data (Describe In Remarks) Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
Aerial Photographs Primary Indicators
Other _ Inundated
_Saturated in Upper 12"
No Recorded Data Available Water Marks
Drift Lines
Field Observations Sediment Deposits
_ Drainage Patterns in Wetlands
Depth of Surface Water ? ] 2 (in,)
Secondary Indicators
Z
Depth to Free Water in Pit (in
) Oxidized Roots Channels in Upper 12"
. Water-Stained Leaves

Depth to Saturated Soil (in.) -Local Soil Survey Data
FAC-Neutral Test
Other (Explain in Remarks)
Remarks
SOILS
Map Unit Name
(Series and Phase) ?O Agol ',-e) 4
Drainage Class L e P aIrO; 0_1 v
L
Taxonomy (Subgroup )7??,Z kS n ka,
p /"i dLA145 Confirm Mapped Type? Yes_ No
Profile Description
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc
O- 2 )0Y9 W 3 IG l),9 A Yr1?n ? ?d (_4
m
Hydric Soil Indicators
_ Histosol _ Concretions
Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_Sulfidic Odor -Organic Streaking in Sandy Soils
Aquic Moisture Regime -Listed On Local Hydric Soils List
-Reducing Conditions -Listed on National Hydric Soils List
- Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes _ No A'
Wetland Hydrology Present? Yes No --
Hydric Soils Present? Yes _ No Y
Is the Sampling Point
Within a Wetland? Yes_ NoA_
Remarks
VTLAND RATING WORKSHEET Fourth Version
Project Name 2 o j/ L, e4a,,d Q Nearest Road
County ?- , I ? _?r r J Wetland area - o i acres
Name of evaluator )?; 1c' v)? ,`r? i?
/UC. 6 V

Wetland width 1- feet
Tlata c-7 /'? -I! 7,
Wetland location
on pond or lake
on perennial stream
on intermittent stream
within interstream divide
other
Soil series:
predominantly organic - humus, muck, or
peat
predominantly mineral - non-sandy
predominantly sandy
Hydraulic factors
- steep topography
ditched or channelized
total wetland width > 100 feet
Adjacent land use
(within th mile upstream, upslope, or radius)
_ forested/natural vegetation b 0 %
agriculture, urban/suburban 3%
impervious surface to %
Dominant vegetation
(1) S-/ i-n 41 1>rq
(2) Pru, rl",S Scrod-, Y14,
(3) L-frs %Q 6, y ?A r 6? S
Flooding and wetness
semipermanently to permanently flooded or
mundated
Y? seasonally flooded or inundated
intermittently flooded or temporary surface water
no evidence of flooding or surface water
Wetland type (select one)*
_ Bottomland hardwood forest
_ Headwater forest
_ Swamp forest
_ Wet flat
_ Pocostn
Bog forest
_ Pine savanna
_ Freshwater marsh
_ Bog/fen
_ Ephemeral wetland
_ Carolina bay j
Other _' P6 r?
The rating system cannot be applied to salt or braclash marshes or stream channels
R Water storage _--
x400 = L? -- - --A Bank/Shoreline stabilization S x 4 00 = zo Wetland
T Pollutant removal rating
5 00 =
I Wildlife habitat '-
x200 =
N Aquatic life value x 4 00 = ® 7
G Recreation/Education j
x100=
**Add 1 point if in sensitive watershed and >10% nonpoint source disturbance within 1/2 mile upstream, upslope, or radius
WETLAND RATING WORKSHEET Fourth Vernon t'/ 6
Project Name - 2 r
Nearest Road eS? N) Gr {?p
i , -r rP-O_ ?-
county G 1 r d Wetland area 4 ©5 acres Wetland width feet
Name of evaluators),,5 ?G to h 1 narP iG /'7 1 /Pi2
Wetland location
on pond or lake
on perennial stream
on intermittent stream
within interstream divide
other
Soil series
predommantly organic - humus, muck, or
peat
predominantly mineral - non-sandy
predominantly sandy
Hydraulic factors
_ steep topography
` ditched or channelized
total wetland width ? 100 feet
Adjacent land use
(within ih mile upstream, upslope, or radius)
r' forested/natural vegetation Tl C %
agriculture, urban/suburban 41 G %
_i impervious surface ?_'3 %
Dominant vegetation
(1) r1-4>e ink4 5 a Mer, care
(2) L r; o?ert dra n -f k/ ??? i re r s
(3)
Flooding and wetness
- semipermanently to permanently flooded or
inundated
X seasonally flooded or inundated
- mtermittently flooded or temporary surface water
no evidence of flooding or surface water
Wetland type (select one)`
Bottomland hardwood forest
_ Headwater forest
_ Swamp forest
_ Wet flat
_ Pocosin
- Bog forest
_ Pme savanna
_ Freshwater marsh
_ Bog/fen
- Ephemeral wetland
- Carolina bay
Other
The rating system cannot be applied to salt or brackish marshes or stream channels
K
Water storage
---- --- -- ---- ----
- ---- -- - --
x400 =
A Bank/Shoreline stabilization x 4 00 = y Wetland
T Pollutant removal **x 5 00 = b rating
j Wildlife habitat 3 x200
=
0
- j-
N Aquatic life value Z
x400 =
G Recreation/Education / x 1 00 =
** Add k point if in sensitive watershed and >10 % nonpomt s ource disturbance within 1/2 mile upstream, upslope, or radius
WETLAND RATING WORKSHEET Fourth Version
Project Name <
County C-- L- !
Name of evaluator ?c 5
Nearest Road
Wetland area =o acres
fS IQLA Y-11
?'J L
Wetland width 15 feet
Date t «-<'
Wetland location
- on pond or lake
on perennial stream
_ on intermittent stream
_ within mterstream divide
other
Adjacent land use
(within ih mile upstream, upslope, or radius)
forested/natural vegetation L40 %
agriculture, urban/suburban Ll 0 %
? impervious surface z10 %
Soil series. Dominant vegetation
predominantly organic - humus, muck, or (1) e -,e,4 G--cA M
peat
X predominantly mineral - non-sandy (2) A"' ??cr/`fir
_ predominantly sandy (3)
Hydraulic factors
- steep topography
y ditched or channelized
total wetland width > 100 feet
Flooding and wetness
semipermanently to permanently flooded or
mundated
_ seasonally flooded or mundated
intermittently flooded or temporary surface water
no evidence of flooding or surface water
Wetland type (select one)`
Bottomland hardwood forest
.Headwater forest
_ Swamp forest
_ Wet flat
_ Pocosin
Bog forest
_ Pine savanna
_ Freshwater marsh
_ Bog/fen
- Ephemeral wetland
Carolina bay
Other
The rating system cannot be applied to salt or brackish marshes or stream channels
R Water storage (
x400= - -
0 - -
Bank/Shoreline stabilization x 4 00 = 0 Wetland
T Pollutant removal 2 +? x 5 00 = ratinb
I I

N Wildlife habitat
x200 = -` - -
Aquatic life value Z x 4 00 =
G

** Recreation/Education
1
x100=
Add 1 point if in sensitive watershed and >l0% no npotnt source disturbance within 1/z mile upstream, upslope, or radius
WETLAND RATING WORKSHEET Fourth Version
Project Name Nearest Road
County Wetland area'---' °' 1 acres
Name of evaluator ?rc w,

W I?
Wetland width 2 6 feet
Tlata 1: /-") /a

Wetland location
- on pond or lake
on perennial stream
_ on intermittent stream
within mterstream divide
X other j) 2. ???, ? f r14{ e
Adjacent land use
(within 1/2 mile upstream, upslope, or radius)
forested/natural vegetation 'I %
1 agriculture, urban/subuiban ? J %
impervious surface z C) Soil series: %

predommantly organic - humus, muck, or
peat
predommantly mineral - non-sandy
- predominantly sandy
Hydraulic factors
_ steep topography
ditched or channelized
total wetland width > 100 feet
Dominant vegetation
(1) ?T k n?rr 3?? i
(2) CG r e aC (S (a )
(3) S ?„ e G- c^ vl?
Flooding and wetness
semipermanently to permanently flooded or
inundated
_ seasonally flooded or inundated
intermittently flooded or temporary surface water
- no evidence of flooding or surface water
Wetland type (select one)*
Bottomland hardwood forest
Y Headwater forest
_ Swamp forest
_ Wet flat
_ Pocosin
Bog forest
_ Pine savanna
_ Freshwater marsh
_ Bog/fen
_ Ephemeral wetland
Carolma bay
Other
The rating system cannot be applied to salt or brackish marshes or stream channels
rc Water storage x4 00 = 0
A Bank/Shoreline stabilization I x 4 00 = Wetland
T rating
Pollutant removal ..x 5 00 =
I Wildlife habitat / x 2 00 = 0 ^
N Aquatic life value
x400=
' G Recreation/Education
x100=
**Add 1 point if in sensitive watershed and >10% nonpoint source disturbance within '/z mile upstream, upslope, or radius
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date L/ 2 3 J ?'
Evaluator, 1c- ?- yy`
Total Points-
Stream is at least intermittent .
if a 19 or perennial if z 30
Project ` Z6
j
site
County
- Latitude
Longitude
Other
e g Quad Name

A Geomorphology (Subtotal - 7 )
1a Continuous bed and bank Absent Weak
1 Moderate
2 Strong
3
2 Sinuosity 0 1 2
3 In-channel structure nffle-pool sequence 0 1 2 3
4 Soil texture or stream substrate sorting 0 1 3
5 Active/relic floodplain 1 3
6 Depositional bars or benches 0 1 2 3
7 Braided channel 0 1 2 3
8 Recent alluvial deposits 0 1 2 3
9 a Natural levees 2 3
10 Headcuts 0 1 2 3
11 Grade controls 0 CO 5 1 15
12 Natural valley or drainageway 0 1 15
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
a.
No = 0
Yes = 3

_
••"" ,,......, ...•....c.? a,c „tea -U, - UIQbUaalVl la 111 IT IGIIUdI
R Hvrirnlnnv Mi Ihtntol =
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or rowin season 1 2
3
16 Leaflitter 1 5 1 05
17 Sediment on plants or debris 0 05 1
18 Organic debris lines or piles (Wrack lines) 0 0 5 1 5
19 Hydnc soils (redoximorphic features) present? No = Yes =1 5
C Biology (Subtotal = 6 ) _J
20° Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 3 2 1 0
22 Crayfish 0) 05 1 15
23 Bivalves 0 1 2 3
24 Fish CO
) 05 1 15
25 Amphibians -
0 05 1 15
26 Macrobenthos (note diversity and abundance) 05 1 15
27 Filamentous algae, penphyton 0 1 2 3
28 Iron oxidizing bacteria/fungus 0 05 1 15
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, her = 0 \
hems .du ano C7 locus on me presence of upland plants, Item 29 focuses on the presence of aquatic or wetland plant
Notes (use back side of this form for additional notes ) Sketch
100 tAp5-tr(fa u o
i
0
'w --
?f
?1
Jr\
-tO
U

North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date Project - 6 l Latitude
"T n9?,r st??n ti,f< ?c
Evaluator C?,, P.F(q Site P
A Longitude
Total Points
Stream is at least intermittent 3 2 County 6 Other
if Z 19 or perennial if a 30 e g Quad Name
r ? .
A Geomo holo (Subtotal = l )
8 Absent Weak Moderate Strong
1
Continuous bed and bank 0 1 2 3
2 Sinuosity 0 1 2 3
3 In-channel structure riffle-pool sequence 0 2 3
4 Soil texture or stream substrate sorting 0 1 2 3
5 Active/relic floodplain 0 1 2 3
6 Depositional bars or benches 0 1 2 3
7 Braided channel 1 2 3
8 Recent alluvial deposits 0 1 2 3
9 a Natural levees 0 1 2 3
10 Headcuts 0 1 2 3
11 Grade controls 0 05 1 1 5
12 Natural valley or drainageway 0 0 5 1 1 5
13 Second or greater order channel on existing

USGS or NRCS map or other documented O
No - 0
Yes = 3
evidence
a `•-- -
R Hvrirninnv Mi thtntol = 9 , -4' \
14 Groundwater flow/discharge
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0
0 1
1 2

2 3

3
16 Leaflitter 1 5 1 0 5 0
17 Sediment on plants or debris 0 0 1 15
18 Organic debris lines or piles (Wrack lines) 0 0 5 1 1 5
19 Hydnc soils (redoxlmorphic features) present? No = 0 Yes =1 5
C Bioloav (Subtotal = 7 1
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 2 _1 _0
22 Crayfish 05 1 15
23 Bivalves T 1 2 3
24 Fish 05 1 15
25 Amphibians O 0 5 1 1 5
26 Macrobenthos (note diversity and abundance) 0 0 1 1 5
27 Filamentous algae, penphyton 0 1 2 3
28 Iron oxidizing bacteria/fungus 0 65 1 1
29 Wetland plants in streambed
If- )n -q 9, fnn. R.,. .t . FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other 0
-• - -• • .. ........... ....... - I--- u to Ni asance of aquauc or weuana plants
Notes (use back side of this form for additional notes ) Sketch

M0, tia
54 d5:
APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook
SECTION I BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD)
B DISTRICT OFFICE, FILE NAME, AND NUMBER R-2611
C PROJECT LOCATION AND BACKGROUND INFORMATION
State NC County/pansh/borough Guilford City Greensboro
Center coordinates of site (lat/long in degree decimal format) Lat 36 0952° N, Long 79 9685°
Universal Transverse Mercator
Name of nearest waterbody East Fork of the Deep River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows High Point Lake
Name of watershed or Hydrologic Unit Code (HUC) 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request
Check if other sites (e g , offsite mitigation sites, disposal sites, etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
? Office (Desk) Determination Date
? Field Determination Date(s)
SECTION II SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There Are no "navigable waters of the U S " within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) in the
review area [Required]
? Waters subject to the ebb and flow of the tide
? Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There W R "waters of the U S" within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area [Required]
1 Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) '
TNWs, including territorial seas
Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
B Non-RPWs that-flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
? Impoundments of Junsdictional waters
0 Isolated (interstate or intrastate) waters, including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non-wetland waters linear feet width (ft) and/or acres
Wetlands acres
c Limits (boundaries) of jurisdiction based on 11987 Delineation Manna>i
Elevation of established OHWM (if known)
2 Non-regulated waters/wetlands (check if applicable) 3
? Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional
Explain
' Boxes checked below shall be supported by completing the appropriate sections in Section III below
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e g , typically 3 months)
1 Supporting documentation is presented in Section III F
SECTION III CWA ANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW, complete
Section III A 1 and Section III D 1 only, if the aquatic resource is a wetland adjacent to a TNW, complete Sections III A 1 and 2
and Section III D 1 , otherwise, see Section III B below
1 TNW
Identify TNW
Summanze rationale supporting determination
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent"
B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i e tributaries that typically flow year-round or have continuous flow at least seasonally (e g , typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both If the JD covers a tributary with adjacent wetlands, complete Section III B 1 for
the tributary, Section III B 2 for any onsite wetlands, and Section III B 3 for all wetlands adjacent to that tributary, both onsite
and offsite The determination whether a significant nexus exists is determined in Section III C below
1 Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size 19018ac ens
Drainage area 238 nacres
Average annual rainfall 43 1 inches
Average annual snowfall 9 1 inches
(u) Physical Characteristics
(a) Relationship with TNW
? Tnbutary flows directly into TNW
® Tributary flows through 2 tributaries before entenng TNW
Project waters are 2-5 river miles from TNW
Project waters are 1(or less) river miles from RPW
Project waters are 2-5 ai erial (straight) miles from TNW
Project waters are 1 (or less) aerial (straight) miles from RPW
Project waters cross or serve as state boundanes Explain No
Identify flow route to TNW5 SI and Sk discharge into East Fork of the Deep River which discharges into High Point
Lake (TNW)
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West
s Flow route can be described by identifying, e g , tributary a, which flows through the review area, to flow into tributary b, which then flows into TN W
Tributary stream order, if known
(b) General Tributary Characteristics (check all that apply)
Tributary is ® Natural
? Artificial (man-made) Explain
? Manipulated (man-altered) Explain
Tributary properties with respect to top of bank (estimate)
Average width 3-6 feet
Average depth 1 feet
Average side slopes 1
Primary tributary substrate composition (check all that apply)
® Silts ® Sands
? Cobbles ® Gravel
? Bedrock ? Vegetation Type/% cover
® Other Explain np rap
? Concrete
? Muck
Tributary condition/stability [e g , highly eroding, sloughing banks] Explain SK headwaters highly erodable banks, Sl
urbanized stream with some wooded buffer
Presence of run/nffle/pool complexes Explain Si has riffle pool sequence, sedimentation evident, SK some nffle pool
sequence
Tributary geometry Relatively 'straight
Tributary gradient (approximate average slope) 5 %
(c) Flow
Tributary provides for Seaso_nal flow _
Estimate average number of flowevents in review area/year 20 (orgreater)
Describe flow regime perennial
Other information on duration and volume
Surface flow is Disc ete Characteristics
Subsurface flow Ack>I isL Explain findings
? Dye (or (Aer) test performed
Tributary has (check all that apply)
® Bed and banks
? OHWM6 (check all indicators that apply)
? clear, natural line impressed on the bank
? changes in the character of soil ?
? shelving
? vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
® sediment deposition ?
? water staining ?
? other (list)
? Discontinuous OHWM 7 Explain
If factors other than the OHWM were used to determ
® High Tide Line indicated by
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/charactenstics
? tidal gauges
? other (list)
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
me lateral extent of CWAjunsdiction (check all that apply)
Mean High Water Mark indicated by
? survey to available datum,
? physical markings,
? vegetation lines/changes in vegetation types
(m) Chemical Characteristics
Characterize tributary (e g, water color is clear, discolored, oily film, water quality, general watershed characteristics, etc )
Explain
Identify specific pollutants, if known
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e g, where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e g , flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break
'Ibid
(w) Biological Characteristics Channel supports (check all that apply)
® Riparian corridor Characteristics (type, average width) vegetated and urban
? Wetland fringe Characteristics
? Habitat for
? Federally Listed species Explain findings
® Fish/spawn areas Explain findings supports Centrarchidae spawning habitat
? Other environmentally-sensitive species Explain findings
® Aquatic/wildlife diversity Explain findings macro invertebrates, crayfish, and fish
2 Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain
Wetland quality Explain Sion)
Project wetlands cross or serve as state boundaries Explain no
(b) General Flow Relationship with Non-TNW
Flow is Perennial flow Explain SI and SK directly discharge into East Fork of the Deep River
Surface flow istscre_te
Characteristics
Subsurface flow Fick Lisf Explainfindings
? Dye (or other) test performed
(c) Wetland Adjacency Determination with Non-TNW
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection Explain
? Ecological connection Explain
? Separated by berm/bamer Explain
(d) Proximity (Relationship) to TNW
Project wetlands are PicKliSt river miles from TNW
Project waters are Pi '-- i?List aerial (straight) miles from TNW
Flow is from Pick List
Estimate approximate location of wetland as within the Pick ListList floodplam
(u) Chemical Characteristics
Characterize wetland system (e g , water color is clear, brown, oil film on surface, water quality, general watershed
characteristics, etc ) Explain urbanized area with minimal wooded buffer All wetlands receive significant stormwater
Identify specific pollutants, if known
(iii) Biological Characteristics Wetland supports (check all that apply)
? Riparian buffer Characteristics (type, average width)
? Vegetation type/percent cover Explain
? Habitat for
? Federally Listed species Explain findings
? Fish/spawn areas Explain findings
? Other environmentally-sensitive species Explain findings
? Aquatic/wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis Fick List
Approximately ( ) acres in total are being considered in the cumulative analysis
For each wetland, specify the following
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed
C SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW For each of the following situations, a significant nexus exists if the tributary, ?n combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands It ?s not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly, the fact an adjacent wetland lies within or
outside of a floodplain ?s not solely determinative of significant nexus
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook Factors to consider include, for example
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note the above list of considerations ?s not inclusive and other functions observed or known to occur should be documented
below
I Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III D
Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III D
Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III D
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY)
TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area
TNWs linear feet width (ft), Or, acres
Wetlands adjacent to TNWs acres
RPWs that flow directly or indirectly into TNWs
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional Provide data and rationale indicating that
tributary is perennial Both streams show flow even during significant drought
[7 Tributaries of TNW where tributaries have continuous flow "seasonally" (e g , typically three months each year) are
jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows
seasonally
Provide estimates for jurisdictional waters in the review area (check all that apply)
Tributary waters linear feet width (ft)
? Other non-wetland waters acres
Identify type(s) of waters
Non-RPWss that flow directly or indirectly into TNWs
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional Data supporting this conclusion is provided at Section III C
Provide estimates for junsdictional waters within the review area (check all that apply)
? Tributary waters linear feet width (ft)
? Other non-wetland waters acres
identify type(s) of waters
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs
? Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands
Wetlands directly abutting an RPW where tributaries typically flow year-round Provide data and rationale
indicating that tributary is perennial in Section III D 2, above Provide rationale indicating that wetland is
directly abutting an RPW Pond maintains water even at extreme drought
? Wetlands directly abutting an RPW where tributaries typically flow "seasonally " Provide data indicating that tributary is
seasonal in Section III B and rationale in Section III D 2, above Provide rationale indicating that wetland is directly
abutting an RPW
Provide acreage estimates for junsdictional wetlands in the review area <0 01 acres
5 Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
? Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are junsidictional Data supporting this
conclusion is provided at Section III C
Provide acreage estimates for junsdictional wetlands in the review area acres
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional Data supporting this
conclusion is provided at Section III C
Provide estimates for jurisdictional wetlands in the review area acres
Impoundments of jurisdictional waters 9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional
? Demonstrate that impoundment was created from "waters of the U S ," or
? Demonstrate that water meets the cntena for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below)
ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) 10
? which are or could be used by interstate or foreign travelers for recreational or other purposes
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
? which are or could be used for industrial purposes by industries in interstate commerce
? Interstate isolated waters Explain
? Other factors Explain
Identify water body and summarize rationale supporting determination
8See Footnote # 3
9 To complete the analysis refer to the key in Section III D 6 of the Instructional Guidebook
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapano&
Provide estimates for jurisdictional waters in the review area (check all that apply)
? Tributary waters linear feet width (ft)
Other non-wetland waters acres
Identify type(s) of waters
Wetlands acres
F NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)
? If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR)
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction Explain
? Other (explain, if not covered above)
Provide acreage estimates for non-lunsdichonal waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i e, presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply)
Non-wetland waters (i e, rivers, streams) linear feet width (ft)
Lakes/ponds acres
? Other non-wetland waters acres List type of aquatic resource
? Wetlands acres
Provide acreage estimates for non-lunsdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for Jurisdiction (check all that apply)
Non-wetland waters (i e, rivers, streams) linear feet, width (ft)
Q Lakes/ponds acres
? Other non-wetland waters acres List type of aquatic resource
Q Wetlands acres
SECTION IV DATA SOURCES
A SUPPORTING DATA Data reviewed for JD (check all that apply - checked items shall 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
Data sheets prepared/submitted by or on behalf of the applicant/consultant
? Office concurs with data sheets/delineation report
? Office does not concur-with data sheets/delineation report
Q 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
® USDA Natural Resources Conservation Service Soil Survey Citation Guilford County 1977
? 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 ? Other (Name & Date)
? Previous determination(s) File no and date of response letter
? Applicable/supporting case law
[3 Applicable/supporting scientific literature
[] Other information (please specify)
B ADDITIONAL COMMENTS TO SUPPORT JD
541,5A, s,t3 w?, wl3,w? wD
l
APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook
SECTION I BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD)
B DISTRICT OFFICE, FILE NAME, AND NUMBER R-2611
C PROJECT LOCATION AND BACKGROUND INFORMATION
State NC County/pansh/borough Guilford City Greensboro
Center coordinates of site (]at/long in degree decimal format) Lat 36 0952° N, Long 79 9685° W
Universal Transverse Mercator
Name of nearest waterbody East Fork of the Deep River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows High Point Lake
Name of watershed or Hydrologic Unit Code (HUC) 03030003
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request
? Check if other sites (e g , offsite mitigation sites, disposal sites, etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
? Office (Desk) Determination Date
? Field Determination Date(s)
SECTION II SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There Arm e no "navigable waters of the U S " within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) to the
review area [Required]
? Waters subject to the ebb and flow of the tide
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There Are "waters of the U S " within Clean Water Act (CWA) Jurisdiction (as defined by 33 CFR part 328) in the review area [Required]
1 Waters of the U S
a Indicate presence of waters of U S to review area (check all that apply) '
? TNWs, including territorial seas
? Wetlands adjacent to TNWs
? Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
? Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
[] Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
® Impoundments of junsdictional waters
d Isolated (interstate or intrastate) waters, including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non-wetland waters linear feet width (ft) and/or 30 feet across acres
Wetlands <0 01 acres
c Limits (boundaries) of jurisdiction based on ; 98? 7Ineetion7Mani al
Elevation of established OHWM (if known)
2 Non-regulated waters/wetlands (check if applicable) 3
? Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not junsdictional
Explain
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e g , typically 3 months)
' Supporting documentation is presented in Section III F
SECTION III CWA ANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW, complete
Section III A 1 and Section III D 1 only, if the aquatic resource is a wetland adjacent to a TNW, complete Sections III A 1 and 2
and Section III D 1 , otherwise, see Section III B below
1 TNW
Identify TNW
Summarize rationale supporting determination
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent"
B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i e tributaries that typically flow year-round or have continuous flow at least seasonally (e g , typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both If the JD covers a tributary with adjacent wetlands, complete Section III B 1 for
the tributary, Section III B 2 for any onsite wetlands, and Section III B 3 for all wetlands adjacent to that tributary, both onsite
and offsite The determination whether a significant nexus exists is determined in Section III C below
1 Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size 19015'acres
Drainage area 238 icrq
Average annual rainfall 43 1 inches
Average annual snowfall 9 1 inches
(n) Physical Characteristics
(a) Relationship with TNW
? Tributary flows directly into TNW
® Tributary flows through ,_2 tributaries before entering TNW
Project waters are S river miles from TNW
Project waters are 1 (or less river miles from RPW
Project waters are 2=5 -aerial(straight) miles from TNW
Project waters are 1(or less) aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain No
a Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West
Identify flow route to TNW5 Wetland A receives water from the PTAA pond, PTAA pond drains into SA, SA flows into
wetland B into East Fork of the Deep River, East Fork of the Deep River flows into High Point Lake Wetland C flows
into SB, SB flows into SA
Tributary stream order, if known Impoundment
(b) General Tributary Characteristics (check all that apply)
Tributary is ? Natural
? Artificial (man-made) Explain
® Manipulated (man-altered) Explain 1 impoundment, 2 roadside drainages, 1 piped perennial
stream
Tributary properties with respect to top of bank (estimate)
Average width 3-6 feet
Average depth 1 feet
Average side slopes Kill
Primary tributary substrate composition (check all that apply)
® Silts ® Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation Type/% cover
® Other Explain np rap
Tributary condition/stability [e g, highly eroding, sloughing banks] Explain SA fairly stable, SB and SH unstable
highly erodable banks
Presence of run/nffle/pool complexes Explain SA good riffle pool, SB and SH poor structure
Tributary geometry ely
Relativ straight
Tributary gradient (approximate average slope) 5 %
(c) Flow
Tributary provides for SeaSea"so
_Ikow
Estimate average number of flow events in review area/year ?0 ur greuteC
Describe flow regime SA perennial, SB ephemeral, SH perennial
Other information on duration and volume
Surface flow is bisci" Characteristics
Subsurface flow PickList Explain findings
[I Dye (or other) test performed
Tributary has (check all that apply)
® Bed and banks
? OHWM6 (check all indicators that apply)
? clear, natural line impressed on the bank
? changes in the character of soil ?
? shelving
? vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
® sediment deposition ?
? water staining ?
? other (list)
? Discontinuous OHWM 7 Explain
if factors other than the OHWM were used to determ
? High Tide Line indicated by Q
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/charactenstics
? tidal gauges
? other (list)
(iii) Chemical Characteristics
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
ine lateral extent of CWA junsdiction (check all that apply)
Mean High Water Mark indicated by
? survey to available datum,
? physical markings,
? vegetation lines/changes in vegetation types
5 Flow route can be described by identifying, e g , tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW
6A natural or man-made discontinuity in the OHWM does not necessarily severj unsdiction (e g, where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e g , flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break
'ibid
Charactenze tnbutary (e g , water color is clear, discolored, oily film, water quality, general watershed charactenshcs, etc )
Explain SA and SH moderate clarity, SB no flow
Identify specific pollutants, if known
(w) Biological Characteristics Channel supports (check all that apply)
® Riparian corridor Characteristics (type, average width) vegetated and urban
® Wetland fringe Characteristics wetland A, 13,C, and D
? Habitat for
? Federally Listed species Explain findings
® Fish/spawn areas Explain findings supports Centrarchidae spawning habitat
? Other environmentally-sensitive species Explain findings
® Aquatic/wildlife diversity Explain findings macro invertebrates, crayfish, and fish
2 Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size 0 09 acres
Wetland type Explain Bottomland Hardwood Forest
Wetland quality Explain WA 40, WB 37, WC 36, WD 29 (NC Wetland Rating Worksheet 4th Version)
Project wetlands cross or serve as state boundaries Explain no
(b) General Flow Relah_ onshin with Non-TNW
Flow is P.,,erennial tlum
Y Explain WA and WB have a direct hydrologic connect WC is connected via ehemeral
channel, WD is connected via under ground drainage pipe
Surface flow is 3isere
Characteristics
Subsurface flow pick List Explain findings
? Dye (or other) test performed
(c) Wetland Adjacency Determination with Non-TNW
® Directly abutting
? Not directly abutting
® Discrete wetland hydrologic connection Explain water from all of the above mentioned wetlands will end up in
Hig Point Lake
® Ecological connection Explain Above wetlands can impact biological integrity of High Point Lake
? Separated by berm/bamer Explain
(d) Proximity (Relationship) to TNW
Project wetlands are 2-5 river miles from TNW
Project waters are 1 ?(or less) aerial (straight) miles from TNW
Flow is from Wetland to navigable waters
Estimate approximate location of wetland as within the (IOx=> ?reay floodplam
(n) Chemical Characteristics
Characterize wetland system (e g , water color is clear, brown, oil film on surface, water quality, general watershed
characteristics, etc ) Explain urbanized area with minimal wooded buffer All wetlands receive significant stormwater
Identify specific pollutants, if known
(w) Biological Characteristics Wetland supports (check all that apply)
® Ripanan buffer Characteristics (type, average width) 50-100 feet
® Vegetation type/percent cover Explain 40-80% vegetative cover
? Habitat for
? Federally Listed species Explain findings
? Fish/spawn areas Explain findings
? Other environmentally-sensitive species Explain findings
? Aquatic/wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis 4
Approximately ( 0 09 ) acres in total are being considered in the cumulative analysis
For each wetland, specify the following
Directly abuts? (Y/N) Size (in acres) Directly abuts? (YIN) Size (in acres)
Wetland A Yes 0 01
Wetland B Yes 0 05
Wetland C No 0 02
Wetland D No <0 01
Summarize overall biological, chemical and physical functions being performed Wetland B serves as a pollutant removal
and minor floodplam water storage
C SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands It ?s not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly, the fact an adjacent wetland lies within or
outside of a floodplam is not solely determinative of significant nexus
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook Factors to consider include, for example
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below
1 Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III D
2 Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III D
3 Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III D Wetland C has the capacity to carry flood waters, pollutants, organic carbon, and nutrients to High Point Lake
Wetland C could have a minimal impact on the biological integrity of High Point Lake Wetland D serves as a small stormwater
impoundment that was not originally intended to funaction as a wetland, substrate below 6 inches is entirely rip rap It does not
support aquatic life functions but could carry sediment, nutrients, and organic carbon to High point Lake
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY)
1 TNWs and Adjacent Wetlands Check all that apply and provide size estimates in review area
TNWs linear feet width (ft), Or, acres
Wetlands adjacent to TNWs acres
2 RPWs that flow directly or indirectly into TNWs
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional Provide data and rationale indicating that
tributary is perennial Pond provides year round flow
? Tnbutanes of TNW where tnbutanes have continuous flow "seasonally" (e g, typically three months each year) are
junsdlctlonal Data supporting this conclusion is provided at Section III B Provide rationale indicating that tnbutary flows
seasonally
Provide estimates forjunsdictlonal waters in the review area (check all that apply)
[Q Tnbutary waters linear feet width (ft)
E Other non-wetland waters acres
Identify type(s) of waters
3 Non-RPWss that flow directly or indirectly into TNWs
? Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW isjunsdictional Data supporting this conclusion is provided at Section III C
Provide estimates forjunsdlctlonal waters within the review area (check all that apply)
? Tnbutary waters linear feet width (ft)
? Other non-wetland waters acres
Identify type(s) of waters
4 Wetlands directly abutting an RPW that flow directly or indirectly into TNWs
Wetlands directly abut RPW and thus are junsdictional as adjacent wetlands
Wetlands directly abutting an RPW where tnbutanes typically flow year-round Provide data and rationale
indicating that tnbutary is perennial in Section III D 2, above Provide rationale indicating that wetland is
directly abutting an RPW Pond maintains water even at extreme drought
? Wetlands directly abutting an RPW where tnbutanes typically flow "seasonally " Provide data indicating that tnbutary is
seasonal in Section Iii B and rationale in Section III D 2, above Provide rationale indicating that wetland is directly
abutting an RPW
Provide acreage estimates forjunsdictional wetlands in the review area <0 01 acres
5 Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
Q Wetlands that do not directly abut an RPW, but when considered in combination with the tnbutary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW arejunsidictional Data supporting this
conclusion Is provided at Section III C
Provide acreage estimates for junsdlctlonal wetlands in the review area acres
6 Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW arejunsdlctlonal Data supporting this
conclusion is provided at Section III C
Provide estimates forjunsdichonal wetlands in the review area acres
7 Impoundments of jurisdictional waters 9
As a general rule, the impoundment of ajunsdictional tnbutary remains junsdictional
Demonstrate that impoundment was created from "waters of the US," or
? Demonstrate that water meets the cntena for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below)
E ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) 10
? which are or could be used by interstate or foreign travelers for recreational or other purposes
'See Footnote # 3
9 To complete the analysis refer to the key in Section III D 6 of the Instructional Guidebook
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos
[] from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
d which are or could be used for industrial purposes by industries in interstate commerce
[] Interstate isolated waters Explain
1# Other factors Explain
Identify water body and summarize rationale supporting determination
Provide estimates for Junsdictional waters in the review area (check all that apply)
? Tributary waters linear feet width (ft)
? Other non-wetland waters acres
Identify type(s) of waters
M Wetlands acres
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)
Q If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
? Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR)
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction Explain
? Other (explain, if not covered above)
Provide acreage estimates for non -lunsdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i e , presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply)
Q Non-wetland waters (i e, rivers, streams) linear feet width (ft)
M Lakes/ponds acres
Other non-wetland waters acres List type of aquatic resource
Q Wetlands acres
Provide acreage estimates for non-lunsdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for Junsdiction (check all that apply)
Non-wetland waters (i e, rivers, streams) linear feet, width (ft)
Lakes/ponds acres
? Other non-wetland waters acres List type of aquatic resource
? Wetlands acres
SECTION IV DATA SOURCES
A SUPPORTING DATA Data reviewed for JD (check all that apply -checked items shall 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
Data sheets prepared/submitted by or on behalf of the applicant/consultant
? Office concurs with data sheets/delineation report
? Office does not concur with data sheets/delineation report
Data sheets prepared by the Corps
Corps navigable waters' study
U S Geological Survey Hydrologic Atlas
? USGS NHD data
? USGS 8 and 12 digit HUC maps
? U S Geological Survey map(s) Cite scale & quad name
® USDA Natural Resources Conservation Service Soil Survey Citation Guilford County 1977
E-3 National wetlands inventory map(s) Cite name
[] State/Local wetland inventory map(s)
? FEMA/FIRM maps
Q 100-year Floodplam Elevation is (National Geodectic Vertical Datum of 1929)
Photographs ? Aerial (Name & Date)
or ? Other (Name & Date)
? Previous determination(s) File no and date of response letter
? Applicable/supporting case law
[] Applicable/supporting scientific literature
Other information (please specify)

B ADDITIONAL COMMENTS TO SUPPORT JD Wetland A is a fringe wetland with the PTAA pond PTAA pond flows through SA,
East Fork of the Deep River, and then into High Point Lake (TN W) Wetland B receives water from SA, Wetland C receives storwater and
minimal groundwater then drains via SB into SA SH drains primarily groundwater (during drought) into SA

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USACE AID# DWQ # Site # (indicate on attached map)
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment.
1 Applicant's name 0 Ird IY" 2 Evaluator's name
i?
8. Stream order
3 Date of evaluation ZZ C, Y 4 Time of evaluation _
5. Name of stream S14 6. River basin )24ti
7. Approximate drainage area
9. Length of reach evaluated 30
11 Site coordinates (if known) prefer in decimal degrees

) O: OG c v,
d fl G t." Yv?
A/A
10 County G tii I Foy---j?
12 Subdivision name (if any)
Latitude (ex 34 872312) Longitude (ex -77 556611)
Method location determined (circle) GPS Topo Shy Ortho (Aerial) Photo/GIS Other GIS Other Sof I t- L' - /Y
13. Location of reach under evaluation (no a nTc earby roads and landmarks and attach map identifying stream(s) location)
14. Proposed channel work (if any)
15. Recent weather conditions
16 Site conditions at time of visit
17. Identify any special waterway classifications known
-Trout Waters -Outstanding Resource Waters
18 Is there a pond or lake located upstream of the evaluati
19. Does channel appear on USGS quad map9 YES NO
21. Estimated watershed land use S% Residential
S % Forested
22. Bankfull width
23 Bank height (from bed to top of bank)
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity Straight -Occasional bends V Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2)• Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse). 6 Comments
Evaluator's Signature
Date
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change -version 06/03 To Comment, please call 919-876-8441 x26
-Section 10 -Tidal Waters -Essential Fisheries Habitat
_ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
on pomt9 YES NO If yes, estimate the water surface area
20 Does channel appear on USDA Soil Surveys EY NO
?b % Commercial _% Industrial _% Agricultural
_% Cleared / Logged _% Other (
STREAM QUALITY ASSESSMENT WORKSHEET
P 57+1-e-
O j
r
CHR?iCTERISTICS f ECORGiON IOIN T P'(iGE - M
- SCORF,
Coastal Piedmont Mountain

1 - Presence of flov? persistent pools in stream

'(no flow-or saturation = 0. stroiiL, flow = max points)
.0-5
0-41
0-5
Evidence of past human alteration
0-6
0-5
0
5
(extensive alteration =0: no alteration - max point--,)
-
J Riparian zone
0 - 6
0-4
0- 5
(no buffer 0. contiguous: wide:buffer = niax Points)
4 Evidence of nutrient or chemical discharges
(extensive discharges = 0; no dischar,,aes _rnax pointsl 0 - 0 4 0 4
Groundwater-discharar
0 ?
E c (n6 discharge= 0? springs: seeps, wetlands. etc = max points) 0-4 0 4 t

~ Presence of adjacent floodplain

??
a 6
-(no floodplain - 0,,extensive floodplain = max points)
- 4
0 - 4
0 2 Z
'Entrenchment /floodplain access
. (deepl} entrenched = 0: frequent flooding = max points) ".0 - 0 - 4",'
0?=2
8 Presence of adjacent wetlands
(no wetlands - 0. laree,adjaccnt ?ietlatids = max points) 0-6 0-4 0-? 12
9 - Channel sinuosity
(exterlsn°e channelization = 0, natural meander = max points') 0 4 0
10 Sediment input
_ _
(eartensivc'lde osition-'0,-tittle Dino sediment= max points) 0-4

- 0-4

i.l Size'& diversity of channel'bed substrate
NA
0
0
(fine, homoeenous = 0. laree, diverse sizes _max point-,;)
-
- 5
Evidence of channel incision or widening
h' ?;(deeph`riicised 0 :-stable bedR.banks-,maxpoints)
w?-?
0-`4..
0--5
P
c
..
l' resen
e of major bank failures
0-5
0-5
5
0
(severe erosion = 0. no erosion. stable banks = max pointsl -

l Root depth and densityon bank
(no visible roots O: dense roots throughout = max points) _ O 0 -
f Impact by agriculture livestock, or timber production

,(suhstantial impact -0, no evidence = max points) 0- 5 (1-4 0- 5
?T6 Presence ofriftle=pool/ripple- pool complexes
)
=0-
5
0

v'
(nWnffles'npplesorpbols - 0, well-developed =may pomU) - t-
6
C 17 Habitat complexit-, 0 - 6 0 6 ) - 6
(little or no habitat - 0, frequent, varied habitats = ma_v points)

is Canopy coverage' over streambed

0-5

0
5

0

(no shading vegetation 0, continuous canopy = max points) - -5

10 Substrate embeddedness
NA*
0=4
0-

(dec hembedded = 0, loose 'structure =maxi 4
It Presence-of stream invertebrates (see pale 4)

-

(no evidence = 0. c_mmon,,nurnerous types = may points)
0-4
0-5
-0-5 _

5
Presence of amphibians

?.
(no evidence 0. common, numerous,tvpes = max points) 0_4 0-4 0_4
Presence offish
(no evidence = 0. common, numerous rv es - inax points) 0-4 0-4 (1- 4 i
t Evidence of wildlife use

(no evidence = 0, abundant c?idence = mar points)

0-6

t)-5

ii-; r

J
Total Points Possible 100 100 100
rTOTAL SCORE i also 'tsnter'cii? first pa??j
3;£..
PC.d
-1 Z
i uwc cuaractCnstres are not assessed in coastal streams
USACE AID# DWQ # Site # (indicate on attached map)
Pro g der assessment.
i Applicant's name _ J A owns IP Ak M 2. Evaluator's name
3 Date of evaluation ??2 2 16 4. Tune of evaluation
!/4n?
5 Name of stream S A 6 River basin L4Pe. ?eQ,-/ Rand- ?YY1 A V1
7. Approximate drainage area 57 O aL t f. S 8. Stream order
9. Length of reach evaluated Sb -??1' 10. County r.-'-* 1 ?erC4
11 Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
12 Subdivision name (if any)
Longitude (ex -77 556611)
Method location determined (circle) GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13 Location of reach under evalu (note nearby roads and landmarks and attach map identifying stream(s) location)
r tiC 4 4q g! Lip Marks 4 Sf .?
14. Proposed channel work (if any)
15. Recent weather conditions r? ;'Y\ w f i n l'! Q r $
16. Site conditions at time of visit S 4,
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18 Is there a pond or lake located upstream of the evaluation point9 YE NO If yes, estimate the water surface area R c e - S
19. Does channel appear on USGS quad map? I'E NO 20. Does channel appear on USDA Soil Survey? YE NO
21 Estimated watershed land use _% Residvential 1-0-% Commercial ?% Industrial _% Agricultural
2-0 d % Forested _% Cleared / Logged % Other ( )
22. Bankfull width Z - 3 40?Z -i 23 Bank height (from bed to top of bank)
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse) Comments
Evaluator's Signature ZJL Date /2 Z /GS
This channel evaluation/form 1s intended to be used only as a guide to assist landowners na environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET
vide the followln information for the stream reach under

STREAM QUALITY ASSESSMENT WORKSHEET
ECOREGION, POI TT kANGE
CH
?ACTERISTICS .
_
.
.
J Coastaln`:
k :SCORE
Piedmont -'A untain i -1 ,
1 h? Presence offloK persistent pools in strewn ?•? w 0-4 0 ?
`(no:floNv or satur 16011 0. stronL flow -- max points) ;
Evidence of past human alteration 0 _ t? 0 - 5 0 - 5
extensive alteration = 0, no alteration = max- points,)
Riparian zone
3 (no buffer - 0, contiguous. tivide buffer = max points) 0-6 0-4 0-5
3
4 Evidence of nutrient or chemical discharges- -

(extensive dtschare`es'= no discharges = tndx-pomts) i0-?
- 0-4 0-4
, Groundwater discharge - '

(no discharge = 0;`springs?seeps, wetlands,,etc- m
-ax otntS, 0'
3

?-

-4

-4

6 Presence of adjacent floodplain
0-4
0 - 4
0
2
'r
(no floodplain - 0, extensive floodplain = max points)
-
2
Z Entrenchment / floodplain access
0
5
p (deeply entrenched = 0, frequent floodim-, = max pmts) - 0-4 0-2
_ Presence,of adjacent wetlands
,(no wetlands = 0, lar,e'adlacent wetlands - rnax owls) 0 6 , 0 - 4 0 -.2
Channel sinuosm
texte'nswe channelizatton?-'O, 'naturad meander max.pomts)

10 Sediment input
?
0-5
0-4
0-4
(extensive deposition- O: little or no sediment -max points)

11 Size & diversity of channel bed substrate
\A
0 -4
0-5
fine. homo,,,,enous = 0 laree, diverse sizes = max points)
Evidence of channelincisionor -widening
S

(dee l1 inei5ed',=`0_ stable bed R hanks =-max; ? mts) 0=- 0-4 - 0-5
1E
1, Presence of major bank failures - - ice,
0
5
0
0-
_
(sevcre erosion `O,,no erosion. stable banks - nias points) -? - 5.
Root depth and density on banks
14 (no visible roots = 0. dense roots throw hout = mar points) 0 -3 0 - 4 0 5

1? lmpactby agriculture, livestock, or timber production
0-5
0-4
CI-5
( suhstantial_impact =0, no evidence = mar points)

16 Presence-of riffle-pool/ripple-pool completes
0

_
=' .lnor?frles npples or ools =0.-well-developed -max point) - 6

1 7 Habitat complexity
0-6
0
6
0

E-
rlittle 'ornohabitat "`O;?trequent, varied habitats = max points)
- -
-6
- L

?

1? Canopy coverage over streambed
E
(no shading vegetation - 0, continuous canopy - max points) 0-5 0-5 0-5 C.?

IC Substrate embeddedness
N A*
0-4
04
(deepl% embedded == O; loose structure _ max)
?O Presence of stream invertebrates (see page 4)
U- 4
0
5
0
5
r ( no evidence = 0. common. numeroustypes = max points) - -
Presence of amphibians

(no evidence 0. common, numerous types",=max. omts) 0- 4 0-4' 0-4

.. Presence of fish
0-4
0-4
0-4 3
1 no evidence - 0, common: numerous t\ pes = max points)
Evidence of wildlife use
2_ (no evidence - O; abundant evidence = max points) 0-6 5
s Total Points Possible 1.00 . 100 1100

SC(RE latl5aenteronfrstpaeej,? -
* These characteristics are not assessed to coastal streams
USACE AID# DWQ # Site # (indicate on attached map)
M STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment
1 Applicant's name 3 a me 5 /pp -Fl q v, ?'1'1 2. Evaluator's name
3 Date of evaluation 5?2 /CFr 4 Time of evaluation ?., n JJ ''
5. Name of stream 5 6 6 River basin Cgpe lea- ! /2,? ?c_-1 M,1 n
7. Approximate drainage area 9e- -5 8. Stream order /
9 Length of reach evaluated '-to -h 10. County 6, " 1 4r
Crd
11. Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
12. Subdivision name (if any)
Longitude (ex -77 556611)
Method location determined (circle) tTIA Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
ECS f of te?secr r?' /VC 6o- Y- I.? . M arK0-t
14 Proposed channel work (if any)
15. Recent weather conditions f A IVX i , / "o, 1'((z A!'-5
16. Site conditions at time of visit 5 u n n
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation pointy YES CO If yes, estimate the water surface area
19. Does channel appear on USGS quad map9 YES 6 }20 Does channel appear on USDA Soil Survey? YES Q
21 Estimated watershed land use _% Residential 4"% Commercial 1'r 0 % Industrial _% Agricultural
z o % Forested
22 Bankfull width -Pe?,-t
_% Cleared / Logged _% Other ( )
23 Bank height (from bed to top of bank)
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity _.V Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2). Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse) 2- ! Comm
?/ 2 Z/og
Evaluator's Signature ? Date
This channel evaluatiofii for i mtended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
?S
STREAM QUALITY ASSESSMENT WORKSHEET ?-2 6 l
- ( , u'-d- Ce- my-
ECOREGION POINT RANGE
m CHARACTERISTICS
SCORF,
Coastal'' Piedmont Mountain
Presenceof flow I persistent-pools in stream
I no`flow'orsaturatiun = 0. stronc flow = inax points) ;.0 - . 0 - 4 0
Ei, idenceW past human. alteration
'
'
0 -
6
0--5

0 5
i extensive alteration -.0, no alteration
niaz points)
= _

1 Riparian ,zone
- 3 ?
(no butler- _0', continuous, wide _buffer max poi ? iits)
9-6
0-4
0-5 I

? Evidence of nutrient or chemical discharges
0
5
?
(extensive discharges = 0; no discharges = mar points) - 0-4 0-4
Groundwater discharge
0'

04

0-4
(no discharge =_O,-spring-s. seeps, wetlands. etc = max points)
:Presence of adjacent floodplain

(notlobdplam '0,extensivefloodplain matpoints) 0-4 0-a o - ? 0
Entrenchment / floodplam access
?0-4
0 +
(deepl' eiitrencNed 0. frequent flooding =:riiax points)
t f
4 Presence of adjacent wetlands
0-6

(no wetlands = 0. large adjacent v,,etlvtds = max points) 0-4 0-_?
9 Channelstnuosity _
04
0-
fextensnve channel ization 0: natural meander = max points)
10 Sediment input 0- 5 0-4 0-4
(extensivcdeposition- 0; little or no sediment =coax points)
Size-& diversity of channel,bedsubstrate
'

0-4

0-5
(fine: homoeenous = 0; larue, diverse sizes =:mavpomts)-
' Evidence.of- channelincisionor widening
='
?
U-
0-4
0-;

dee h anci5ed
0; stable bed & ba -s = inar?points ) o?

1 ? 'Presence of majorbank -failures
0
0
- (seNere erosion = 0. no erosion, stable banks = max points) 5 0
14 Root depth and density on banks

0 -3

0-4
5
0
? (no visible roots = 0, dense roots throunhout = max points) -
f
l5 Impact by agriculture, livestock, or timber production
0 5
?

(substaiinal impact -0: no evidence ,max., omts) 0-4 0-5 f
77
.; Presence ofriffle-pooUt-ipple-pool complexes

if W.F 16

(no nfTlrs" ?pplc s or pools- «elI-devcloped -max poinLS)
;H
l
x
h

- 0-5 _6
a
itat conip
e
it} --
(little orno,habitat 0_ trCgii(:nt, vaned!habitats =max'pomts)

is Canopy co-, erage over strearnbed
n
5
0
5
0
5

?Z
(no shadu)g "rerctanon 0, continuous canopy = mar points) - - - ?
o
L Substrate embeddedness
NA*
0-4
0-4
[deerkr embedded 0: loose structure=maxi

?0 'Presence of stream invertebrates (see page 41
0
4
0
5
0

(no evidence o_ common, numerous ripen=max points) - - -5
.r I Presence of amphibians "
0- 4
0_4
no evidence l,eommon, numerous ri es-max points)

22 Presence of fish
-
0-4_
0-4
U-4 -
(/
M MO evidence U. common. numerous t? es - max Dints)
Lvidence of wildlife use - 0_6
0
5
0
(no evidence - 0. abundant evidence = max points) - -
Total Points Possible 100 100 100
TOTAL SCORE .(also enter on first:pae) Z
* These characteristics are not assessed in coastal streams
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date S/Z Z/f-f Project 2 6 ?? Latitude
Evaluator A k-V'\ Site Longitude
Total Points 1 Other
Stream is at least intermittent L, County I G/d
if z 19 or perennial if z 30 • e g Quad Name

A Geomorphology (Subtotal = --7- ) Absent Weak Moderate Strong
la Continuous bed and bank 0 1 2 3
2 Sinuosity ® 1 2 3
3 in-channel structure nffle-pool sequence 0 1 2 3
4 Sod texture or stream substrate sorting 0 1 2 /3
5 Active/relic floodplain 0 1 2 3
6 Depositional bars or benches `C) 2 3
7 Braided channel 0 1 2 3
8 Recent alluvial deposits (Job 1 2 3
9 a Natural levees 0 1 2 3
10 Headcuts ( 0) 1 2 3
11 Grade controls 0 0 1 1 5
12 Natural valley or drainageway 0 1 15
13 Second or greater order channel on existmo
USGS or NRCS map or other documented
evidence
No ='0
Yes = 3
rvian-moue uncnes are not rates, see ais°cussions in manual
R Hvrirnlnnv lCiihtntal = 1, 1
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 1 2 3
16 Leaflitter 1 5 1 05 0
17 Sediment on plants or debris _ 05 1 1 5
18 Organic debris lines or piles (Wrack lines) 0 05 1 15
19 Hydnc soils (redoximorphic features) presents No = 0 Yes =1 5
C Bioloov (Subtotal = R 1
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 2 1 0
22 Crayfish 0 05 1 15
23 Bivalves 0 1 2 3
24 Fish 05 1 1 5
25 Amphibians MO) 05 5 1 15
26 Macrobenthos (note diversity and abundance) 0 0 1 1 5
27 Filamentous algae, penphyton 0 1 2 3
28 Iron oxidizing bacteriatfungus
_ co: 05 1 1 5

T9 Wetland plants in streambed -
FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Othe = 0
R6111D - GI,U L 1 1-U-1 I U[c picacinr= VI upianu pornts, nern ca focuses on the presence or aquatic or wetiana plants
Notes (use back side of this form for additional notes) Sketch
-- -- ----- {-; e 1 t ,
roS? dj__ /d'14Z_L
iY\e' hA,1 C(a vi,'
1
,l

0
APPENDIX - Comparison Between Version 2 0 and 3 1 Scoring Forms.
VERSION 2 0 FORM Versions 3 x Forms
Prima Field Indicators

I Geomorphology
1 Is there a nffle ool sequence? 3 In-channel structure nffle- ool sequence
2) Is the USDA texture in streambed different from
surroundin terrain? 4 Sod texture - Substrate sorting
Renamed attribute
3 Are natural levees resent? 9 Natural Levees
4 Is the channel sinuous? 2 Sinuosity
5 Is there an active or relic flood lain resent? 5 Active/relic flood lam
6 Is the channel braided? 7 Braided channel
7 Are recent alluvial deposits resent? 8 Recent alluvial deposits
8 Is there a bankfull bench resent? 6 Depositional bars or benches
9 Is a continuous bed & bank resent? 1 Continuous bed and bank
10) Is a 2 order or greater channel (as indicated on topo
ma and/or in field resent? 13 Second or greater order channel on existing
USGS or NRCS ma

II Hydrology
1 Is there a groundwater flow/discharge resent? 14 Groundwater flow/discharge

III Biology
1 Are fibrous roots resent in streambed? 20 Fibrous roots in channel
2 Are rooted plants resent in streambed? 21 Rooted plants in channel
3) Is penphyton present? *27 Filamentous algae, penphyton
Version 2 0 items combined
4 Are bivalves resent? 23 Bivalves

Secondary Field Indicators

I Geomorphology
1 Is there a head cut resent in channel 10 Headcuts
2 Is there a grade control point in channel 11 Grade Control
3 Does topography indicate a natural drainage way? 12 Natural Valle and drama ewa

II Hydrology
1 Is this ear's or last's leaf litter resent in streambed? 16 Leaflitter
2 Is sediment on plants or debris resent 17 Sediment on plants
3 Are wrack lines resent? 18 Organic debris lines or des Wrack lines
4 Is water in channel and >48 hrs since last known rain? 15 Water in channel and > 48 hrs since rain or
5) Is there water in channel during dry conditions or in
rovon season? Water in channel - dry or growing season
(Version 2 0 items combined)
6) Are hydnc sods present in sides of channel (or in
headcut 19 Hydnc sods (redoximorphic features)
resent?

III Biology
1 Are fish resent? 24 Fish
2 Are amphibians resent? 25 Amphibians
3 Areaquatic turtles resent? DELETED No aquatic turtles ever scored
4 Are crayfish resent? 22 Crayfish
--5 Are_rnacrobenthos resent? p -26 -Macrobenthos
6 Are iron oxidizing bactenaffun us resent? 28 Iron oxidizinbacteria/fun us
7 Is filamentous algae resent? *27 Filamentous algae, en h on
8 Are Wetland Plants in Streambed? 29 Wetland plants in streambed
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date 5 0 Project b ! / Latitude
Evaluator C V r^ Site s? Longitude
Total Points 1 (' 1
t^ / f CrC? Other
Stream is at least intermittent a ( County
if 2:19 or perennial if z 30 e g Quad Name . 01 A Geomor holo (Subtotal = lJ ) Absent Weak Mod rate Strong

la Continuous bed and bank 0 1 2 3
2 Sinuosity 0 1 3
3 In-channel structure nffle-pool sequence 3
4 Soil texture or stream substrate sorting 1 3
5 Active/relic floodplain 1 2 3
6 Depositional bars or benches 1 2 3
7 Braided channel 0 1 2 3
8 Recent alluvial deposits 0 1 2 3
9 a Natural levees 0 1 2 3
10 Headcuts 0 2 3
11 Grade controls 0 1 15
12 Natural valley or drainageway 0 1 15
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
No = 0
Yes = 3
swan-maae aitcnes are not rated, see discussions in manual
i
B Hvdroloov (Subtotal= Ie.11, S ) 14 Groundwater flow/discharge 0 1 2 3

15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 X11
l.? 2 3
16 Leaflitter 1 1 05 0
17 Sediment on plants or debris 0 05 1 15
18 Organic debris lines or piles (Wrack lines) 0 05 15
19 Hydnc soils (redoximorphic features) presents o = Yes =1 5
C Bioloav (Subtotal= fit , ' )
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 2 1 0
22 Crayfish 05 1 15
23 Bivalves 0 1 2 3
24 Fish 0 05 1 1 5
25 Amphibians CV 0 1 15
26 Macrobenthos (note diversity and abundance) 0 0 5 1 1 5
27 Filamentous algae, penphyton QL? 2 3
28 Iron oxidizing bacteria/fungus 0 05 1 1 5
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other 0
- Items 20 and 21 focus on the presence of upland plants, item 29 focuses on the presence of aquatic or wetland plants
Sketch
Notes (use back side of this form for additional notes )
PC - -1 1
is s -F
? r? ? c, ? c, ver t,, - nch
G,o.l
5-? S G
?A
??? rw?
YYICA h9a
APPENDIX - Comparison Between Version 2.0 and 3 1 Scoring Forms.
VERSION 2 0 FORM Versions 3 x Forms
Prima Field Indicators

I Geomorphology
1 Is there a nffle ool se uence9 3 In-channel structure nffle-pool sequence
2) Is the USDA texture in streambed different from
surrounding terrains 4 Sod texture - Substrate sorting
Renamed attribute
3 Are natural levees resent? 9 Natural Levees
4 Is the channel sinuous? 2 Sinuosity
5 Is there an active or relic flood lam resent? 5 Active/relic flood lam
6 Is the channel braided? 7 Braided channel
7 Are recent alluvial deposits resent? 8 Recent alluvial deposits
8 Is there a bankfull bench resents 6 Depositional bars or benches
9 Is a continuous bed & bank resent47 1 Continuous bed and bank
10) Is a 2 order or greater channel (as indicated on topo
ma and/or in field resent? 13 Second or greater order channel on existing
USGS or NRCS ma

II Hydrology
1 Is there a groundwater flow/discharge resent? 14 Groundwater flow/discharge

III Biology
1 Are fibrous roots resent in streambed? 20 Fibrous roots in channel
2 Are rooted plants resent in streambed? 21 Rooted plants in channel
3) Is penphyton present? "27 Filamentous algae, penphyton
Version 2 0 items combined
4 Are bivalves resent? 23 Bivalves

Secondary Field Indicators

I Geomorphology
1 is there a head cut resent in channel 10 Headcuts
2 Is there a grade control point in channel 11 Grade Control
3 Does topography indicate a natural drainage way? 12 Natural Valle and drama ewa

II Hydrology
1 Is this ear's or last's leaf litter resent in streambed'? 16 Leaflitter
2 Is sediment on plants or debris resent 17 Sediment on plants
3 Are wrack lines resent? 18 Organic debris lines or des Wrack lines
4 is water in channel and >48 hrs since last known rain? 15 Water in channel and > 48 hrs since rain or
5) Is there water in channel during dry conditions or in
growing season? Water in channel - dry or growing season
(Version 2 0 items combined)
6) Are hydnc soils present in sides of channel (or in
headcut 19 Hydnc sods (redoximorphic features)
resent?

111 Biology
1 Are fish resent? 24 Fish
2 Are amphibians resent? 25 Amphibians
3 Areaquatic turtles resent? DELETED No aquatic turtles ever scored
4 Are crayfish resent? 22 Crayfish
---5 -Are_macrobenthos resent? __26 -Macrobenthos
6 Are iron oxidizing bactena/fun us resent? 28 Iron oxidizing bacteria/fun us
7 Is filamentous algae resent? *27 Filamentous algae, en h on
8 Are Wetland Plants in Streambed? 29 Wetland plants in streambed
STREAM QUALITY ASSESSMENT WORKSHEET
Sc
CH:
RACTERISTICS ECOk ON i?0_ I?Y
EGI TC;fL

t
Coastal
Piedmont '
'f• i
'Iountain SCORE
Presence of-flow '.persistent pools instream
1
(no flow or saturation = 0, stronL flow - max points) 0-5 0-4 0_ 5

- Evidence of past human alteration
U-6
0-?
0-5

0
(extensive alteration =0, no alteration = max points)
Riparian zone
3
l no buffer = 0. contiguous. »ide buffer = max points) 0- - 6 0 - 0 -

4 Evidence?of nutrient or chemical discharges
..
(extensive dischar?es = 0 nodischar,es = maa":points) 0-? 0-4 0-4
Groundwater discharge _ -. ?-

o-; 1
0-4

0 4
- .(no-discharge = U,Isprm??s; sus. ?tietlands.'etc matt- oints)'=
.?.. Presence of adjacent floodplainy * r ?'
?
U4
4
0-
o
?
.- nb:floodplaifi 10.,extensive floodpldin °`max.poi?isl - t
Entrenchment / floodplain access
=-
Y 0-5 -
0-4
0-i2 G
(deeph entrenched= 0, frequentfloodin,, max omts)
Presence of adjacent wetlands
0-6
0-4
0- 2
(no ??etlands = 0. lane adjacent wetlands = max points)

o Channel smuosih

(extensnechannehzation -0;<natural meander=max points) 0-? 0-4 0-3
0

10 Sediment input
r)-5
0-4
0-4
(extensive deposition- 0; little or no sediment = max Dims)
Size S diversity of channel bed substrate
1l
( finc?homo>,enuus = 0: large, diverse sizes = max points l \?* 0-4 0- 5
Evidence of.channel incision or widemog- -
r t(,dec V! nei?ed - 0, stable bed &;-banks .anax: `Dints )

1 Presence of major bank failures
51
0
(se%erc,crosion O"no erosion, stable banks = max oints
] 4 'Root depth and densit- on banks 0
,
U 4
U
(no visible roots= 0, dense roots throuuhout = max points) - 5

15 Impact by agriculture, Livestock, or timber production
-

(sUhS'taitial impact 0, no evidence max points) 0 -5 (1-4 U-?

16 Presence of riffle-pooUripple-pool complexes

(no riftles./npples or pools = 0; well-developed - max points) 0 3 U o C,
Habitat complexit}
17
i tittle or no habiwt = 0. frequent, varied habitats = max points) 0-5 0 -6 0-6

i
18 Canopy coverage over streambed
5

(no`shadinL? %cgciation = 0, continuous cano v- max'points) 0 - n -? 0 5

lU -Substrate emheddedness
-
NA*
0"- 4
-4 2
- (deepk embedded 0, loose structure= max) ,
Presence of streammvertebrates (see pa,,e 4)
i _0
?(no evidence U Fcommon, numerous-type.,, = max points) -0-4 0-5 0-'5

21' Presence°Qf aT6WI iain9
-
-

.,
(no e\ l(ience, ,_ 0;fcommotnnumerous t? pes = may -points) G 4 U -4 Q
4 G
:.
..?
22 ? Presence of fish
0-4
0- 4
0-4
(no evidence 0, common, -numerous D pes = max points)
EN idence of wildlife use
0 - n
0
0
- (no evidence = 0. abundant evidence - max points) - -
Total Points Possible 100 100 100
TOTAL SCORE (also enter on first pale) 2 ?
* These characteristics are not assessed in coastal streams
L USACE AID# DWQ # Site # (indicate on attached map
M STREAM QUALITY ASSESSMENT WORKSHEET _
Provide the following information for the stream reach under assessment
1. Applicant's name _ ?? ?re5 p r?Q ti Vn 2. Evaluator's name
3 Date of evaluation 5 2 Z /0,? 4. Time of evaluation q V?1
5 Name of stream S G 6 River basin C&- at r 12- 4n CA-- 1 Y? R I V
7. Approximate drainage area
5-0 - f e- rt 5
9. Length of reach evaluated _
11. Site coordinates (if known)
Latitude (ex 34 872312)
c -Pde-t
prefer in decimal degrees
8. Stream order
10. County &-. ` /;or-c{
12. Subdivision name (if any)
Longitude (ex -77 556611)
Method location determined (circle) GI Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
e-4s-f ,4- 6 6 1:?- L.,, MC-If AZ-? of erSeL-f ,' 0,.,
14. Proposed channel work (if any)
15. Recent weather conditions
16 Site conditions at time of visit
r41iA-
in Y1 "
K `-112 h r.s
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation pointy YES NO If yes, estimate the water surface area Z 0 c- r"o- S
19 Does channel appear on USGS quad map? YES NO, 20 Does channel appear on USDA Soil Survey9 YES 0
21. Estimated watershed land use _% Residential 5<D% Commercial Ho % Industrial _% Agricultural
P0 % Forested _% Cleared / Logged _% Other (
22. Bankfull width 1"ce,-f 23 Bank height (from bed to top of bank) 2
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2) Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse)- 2 3 Comments
Evaluator's Signature `-? , Date ?'Z2 Z,??Q a
This channel evaluatio orm is riiite ed to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26

North Carolina Division of Water Quality - Stream Identification Form, Version 3.1
Date 5 2 %_ a S Project f / Latitude
Evaluator P f /°t L'. Yv, Site S Longitude
Total Points Other
Stream is at least intermittent County
if a 19 or perennial if a 30 GY e g Quad Name
A Geomorphology (Subtotal= I ) Absent Weak Moderate Strong
1a Continuous bed and bank 0 1 2 3
2 Sinuosity 0 1 2 3
3 In-channel structure nffle-pool sequence 1 2 3
4 Soil texture or stream substrate sorting 1 2 3
5 Active/relic floodplain 0 1 2 3
6 Depositional bars or benches 0 1 2 3
7 Braided channel 1 2 3
8 Recent alluvial deposits Uby 1 2 3
9 a Natural levees 1 2 3
10 Headcuts 1 2 3
11 Grade controls 0 0 1 1 5
12 Natural valley or dramageway 0 0 1 1 5
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
No = 0
Yes = 3
ivimi-niaue uiwnes are not Tama, see discussions in manual
R Hvclrnlnnv Mi ihtntal c ) _ 4, 1
14 Groundwater flow/discharge \ 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 1 2 3
16 Leaflitter 15 1 05 0
17 Sediment on plants or debris 0 05 1 1 5
18 Organic debris lines or piles (Wrack lines) 05 1 1 5
19 Hydnc soils (redoximorphic features) present? No = 0 'Llrees = 1
C Biology (Subtotal = , )
20° Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 2 1 0
22 Crayfish \,,- 0) 05 1 1 5
23 Bivalves CO` 1 2 3
24 Fish (1) 05 1 1 5
25 Amphibians 0` 05 1 1 5
26 Macrobenthos (note diversity and abundance) LIP 05 1 1 5
27 Filamentous algae, periphyton U91) 1 2 3
28 Iron oxidizing bacteria/fungus ,0) 05 1 1 5
29 Wetland plants in streambed FAC 0 5 FACW = 0 75, OBL = 1 5 SAV = 2 0, Other = 0
items zu ana zi rocus on the presence of upland plants, Item 29 focuses on the presence of aquatic or wetland plants
Sketch
Notes (use back side of this form for additional notes )
USACE AID# DWQ # f Site # (indicate on attached map)
M STREAM QUALITY ASSESSMENT WORKSHEET r< < a
Provide the following information for the stream reach u nder assessment
1 Applicant's name J rnQ 5 u e*pv 2. Evaluator's name
3 Date of evaluation g 2 2 4. Time of evaluation 3a " "
5 Name of stream 5 G 6. River basin 0n d-9-1 m a
7. Approximate drainage area 9L re S 8. Stream order
9. Length of reach evaluated SO 10 County C- I-'
11. Site coordinates (if known) prefer in decimal degrees 12 Subdivision name (if any)
Latitude (ex 34 872312) Longitude (ex -77 556611)
Method location determined (circle) GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)

14 Proposed channel work (if any)
15. Recent weather conditions 44.q- Ars
16. Site conditions at time of visit 51- n n V
17. Identify any special waterway classifications known _Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point9 YES 6--01 If yes, estimate the water surface area
19 Does channel appear on USGS quad map9 YES CO 20 Does channel appear on USDA Soil Survey? YES C
21. Estimated watershed land use _% Residential -VO % Commercial % Industrial _% Agricultural
O % Forested _% Cleared / Logged _% Other ( )
22. Bankfull width 23 Bank height (from bed to top of bank) ir, i n C- ..e. S
24. Channel slope down center of stream -Flat (0 to 2%) ,Gentle (2 to 4%) -Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g, the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse). i ?;' Comments
Evaluator's Signature Date
f'Z 2-10c>
This channel evaluation form Vint ed to be used only as a guide to assist landowners and environm ntal professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
S 6-
-
STREAM QUALITY ASSESSMENT WORKSHEET (jam,; ?erd Cov4y

., ROT SI KS
,
? f. , z?,CH,kR NCTERISTICS
c? _?

' j
aC'C?RE
`-r- •ti: k . Piedmont -"_Mountain
,?.
' Presence of flow ',persistent -pools in stream
- l
(no flow or saturation= 0: strong flow = max omts) 0-5 0-4 0-5
Evidence of past human alteration
i extensive alteration - 0 no alteration = max points) 0- 6 0 5 0 -
Riparian-zone
jnci•buf e? . 0; contt-uous..* i?tde buffer= max points)
0-6
0-4
0-?

4
- EJidenee+of nutrient or chesmical discharges -
-
(extc,nsive'dischargzs = Q do discharges = max points) 0-5 0-4 0-4 Q
.? Groundwater discharge
(no
discharge - 0: springs. seeps. wetlands. etc = max points) 0-

; 0-4 f-4
-
71
6 Presence of adjacent floodplain
- P
•
"
p-°-i ?
0-4
0-2
(riofloodpl?tn
:='0, ezten
sire-floiidplam =mat points) ?
; ?•± t
Entrenchment / floodplain access -
` - ,
(dee ply entrenched = 0. frequent flooding = max points) ;0. 0 - 4, 0--2 G
g Presence of adjacent wetlands
(no wetlands - 0. Jar,,-,e adjacent wetlands = mat points)
0-6
0-4
0-2

9 Channel sinuosity
.
(extensive chwinelization = 0,,natural meander = max points) 0-S 0-4 0->
Sedimentinput -

-
e?
e?
-
0 4

0 - 4
ten st
l ex
d
nsikon- 0: httleur no sediment rnaz points)
Size &diversity of channel'bed substrate x y %
1"1
(fine, homogenous = 0: lame, diverse sizes- max pointsl NA 0- 4 0- 5
Evidence of channel incision or widening
l
(deeply incised =0: stable-bed& banks-max points) 0-5 0-4 0?
Presence of major bank failures
=
- (severe erosion
O, no erosion; stable batiks = max points)
1:4 Root depth and density on banks
0
3
0
4
( no visible Foots = 0. dense roots throu<__*hout = max points)
-
-
0-5
7
2
l? impact by agriculture, -livestock, or timber production
a--s
0-4
5
0
L
(substantial impact -0; no evidence = max points) -
16 Presence of riffle-pooliripple-pool complexes

r?'
Inn riffluS'nppleS or pooh 0,'%tiell-developed -m;ix points) 0-3 0 -
? 0-6
-

'1 7,, Habitat coinplexit,
x
_
'01-6
0-6
0-6
tittle or no:habitat - 0, frequent,
aiied hahitats max ,-)intsl

1 Canopy coverage of er"stream bed -
(no shading v?cgetation = 0_ continuous canopy - mti\ points) 0 5 0 - 5 0 5

Ia Substrate embeddedness
?
(dcepl} embedded= 0, loose structure =matt) 1yA*_
. 0-4 0-4
Presence df`s6eam?nsyertebcates (see'pa,,c 4)
d 2c _ -
I no cvtdence a m0,-Common;tnumerous types = ma points) 0-4 0-5 0-5 6
?- _Presence of ainphttiians

Ct l
no evidence = 0, oamnion nunwous pes = may points) 0- 4 0- 4 p- 4

C I Presence of fish
0-4
O-4
0-4

O
(no evidence = 0, common, numerous types = mar points )
Evidence of wildlife use
(no evidence - U. abundant evidence = max points)
JotalIPoints -Pos-ib.e sr __ ;°
- A 1j00 y 100 IO() a
TOT.A_L; SCORE talso'enter on first page}
* These characteristics are not assesses in coastal streams
North Carolina Division of Water Quality - Stream Identification Form, Version 3 1
Date '5 Z s le, $ Project Latitude
Evaluator Site Longitude
Total Points Other
Stream is at least intermittent County
if z 19 or perennial if z 30 e g Quad Name

A Geomorphology (Subtotal = 7? ?_)
1a Continuous bed and bank Absent
0 Weak
1 M ate
2 Strong
3
2 Sinuosity 1 2 3
3 In-channel structure nffle-pool sequence 1 2 3
4 Soil texture or stream substrate sorting 1 2 3
5 Active/relic floodplain 0 1 2 3
6 Depositional bars or benches 2 3
7 Braided channel 1 2 3
8 Recent alluvial deposits 110 1 2 3
9a Natural levees L09 1 2 3
10 Headcuts l0 1 2 3
11 Grade controls 05 1 1 5
12 Natural valley or drainageway 0 1 1 5
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
No
Yes = 3
man-niauo UuU110* the IIUI IdLUU, see aiscussions in manual
B Hvdroloav tSuhtntal = I . S I
14 Groundwater flow/discharge 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 1 2 3
16 Leaflltter (1 5 1 05 0
17 Sediment on plants or debris 05 1 1 5
18 Organic debris lines or piles (Wrack lines) 0 05 1 1 5
19 Hydnc soils (redoximorphic features) presents No = 01 Yes= 1 5
C Biology (Subtotal = )
20° Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 3 2 1 0
22 Crayfish 0') 05 5 1 1 5
23 Bivalves 1 2 3
24 Fish v 05 1 1 5
25 Amphibians 0 05 1 1 5
26 Macrobenthos (note diversity and abundance) ) 05 1 1 5
27 Filamentous algae, periphyton 1 2 3
28 Iron oxidizing bacteria/fungus Ldp 05 1 1 5
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other 4T )
nems.du ano zi tocus on the presence of upland plants, Item 29 focuses on the presence of aquatic or wetland plants
Notes (use back side of this form for additional notes) Sketch
?) V o-t J'?-? ? 5 L/ I vi ? cry 0..1 --

STREAM QUALITY ASSESSMENT WORKSHEET

CHARACTERISTICS - R I? POF
- T. R IDE

J Coastal - Piedmont
Mountain SCORE.
I Presence of flow /persistent pools in stream 0 _ 5 0-4 0-5
(no flow or saturation = 0. strong flow - max points)
Evidence of past human alteration

9.
-
1 extensive alteration - 0, no alteration- max`.pomts) _-0 6 0 -5 0 -?5

-
'Riparian zone
.

'

(no?huffer =0. contiguous:,ride huffer max points) '
0-6 04 0-?
Z
4 Evidence of nutrient or chemical discharges ?) 5 0-4 0-4
G
(extensive discharges = 0, no discharges - max points)
Groundwater discharge
'
- ?
0 - 4
0 4
(no discharge- 0: spnii?s?'see s, wctlands.,etc
; rriax aunts);,
Presence ofadjacent flo( dplain
s
(no floudplam - Orextensii°e floodplain ="maa points )
Entrenchment / floodplain access
0 5 _
0_4
0 - 2
(deeply entrenched - 0. frc uent flooding - max points)
° Presence of adjacent wetlands 0-6 0-4 0
(no wetlands = 0. lar?pe°ad(acent wetlands = max points
Q_
Channel srnuosit} 0-4
(cxtensne channelization = 0. natural meander max outs''
.

10 Sediment input
?0-5

0-4

0-4
(extensive de osition= 0, little or no sediment -max points
?

11 Size & diversity of channel bed substrate
\A*
NT
? 0-4
0-5
z (fine homogenous = 0 large. diverse sizes = max points) - ?E
_
' Uidence of channel'incision oi widening
?
0, stable bed & banks ':'inas, points)
t' 0-:4 0-5

1 Presence of major bank failures
0 - 5
0 - 5
0
5 n
?= (se%crc erosion - 0_ no erosion. stable banks - max points) - l?

C`
14 Root depth and density on banks
0 3
0 - 4
0 - 5 ?, 1
(no visihle roots = 0. dense roots throughout = max points) V
.;t
1? lmpactlb}agriculture, livestock, or timber- production
0-5
0
4
I<, substi iitral impact -(i.,no evjdcuce = maa ;dints) -
? -
-
Pres'e'nce of riffl6- pool, ripple-pool complexes
16
(no riffles,ripples or pools - 0, well-developed = max points) 0-5 '0-6

17 Habitat complexitN
06
06
0-6
r- (little or no habitat - 0. frequent. varied habitats = max pointal
* Canopy covera2c over streambed
?
au (no shadmc, vcc uatton 0; continuous :cauno v' max points)
Substrate enibeddedness
-0-4
4
deeplti embedded= 0, loose structure - max i
Presence of stream invertebrates (see page 4)
?0
(no evidence - 0; common, numerous types - mar points) 0-4 0-5 0-5

1 Presence of
amphibians

0- }

0-4

0
4
(no e? idence 0, common, numerous types = may pouts) -
Al
xv= Presence of fish
0-4
0-4
'0-4
(J
MO cv idence - 0, common. numerous tNpes = max pouts)
Evidence of wildlife use
0 6
0 5
(no eN idence = 0: abundant eti idence =mar points)
r : Total Points,Possiblc -100 100

'h.. " TOTAL SCORE (aIso enter or?`f rst pale)
* These characteristics are not assessed in coastal streams
USACE AID# DWQ # Site #~ (indicate on attached map)
Prov -g information sent
1 Applicant's name J S ru 5 ??'?n " ''^ 2. Evaluator's name
3 Date of evaluation 5 ?2 y ?4 g 4. Time of evaluation // a ? ?.,
5 Name of stream 5 6 River basin ice- w P-ct. /m-i n
7 Approximate drainage area 8. Stream order j
9. Length of reach evaluated 2 5-1 -T-/ 10 County C "' / ra,
11. Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
12 Subdivision name (if any)
Longitude (ex -77 556611)
Method location determined (circle) GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
C° --4 2T AL) L f L? ??'L2_ F i rl N-r - GY?
14. Proposed channel work (if any)
15. Recent weather conditions r'? , ti / '? 5+ 4<;;- h' S
16. Site conditions at time of visit S" n n y , S ?.y ??a G? k P /fin cr S o S
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point9 YES ? If yes, estimate the water surface area
19. Does channel appear on USGS quad map9 YES (i5 20 Does channel appear on USDA Soil Survey? YES
21. Estimated watershed land use
22. Bankfull width G `?
_% Residential
t % Forested
S O % Commercial H c)% Industrial _% Agricultural
_% Cleared / Logged _% Other (
23 Bank height (from bed to top of bank) / 3 ?ee-+
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) X Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity --V Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2)• Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g, the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse) Comments-
Evaluator's Signature 4 X41 Zf/' Date 3?2Z/oe
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET is Abb,
ide the followin for the stream reach under asses m
-tw
10
North Carolina Division of Water Quality - Stream Identification Form, Version 3 1
Date 5 - a a - 0 Protect R - -l co (I
of Latitude
Evaluator
ER PFIC'Jov)
r1 c LAY 111 Site Longitude
Total Points
Stream is at least intermittent //
S
County
?T Other
e
Quad Name
if z 19 or perennial if Z 30 I g
n
A Geomorphology (Subtotal = (? ) Absent Weak Moderate Strong
1 a Continuous bed and bank 0 1 2 3
2 Sinuosity 0 2 3
3 In-channel structure nffle-pool sequence 0 2 3
4 Soil texture or stream substrate sorting 0 1 3
5 Active/relic floodplain 0 1 2 3
6 Depositional bars or benches 1 2 3
7 Braided channel 1 2 3
8 Recent alluvial deposits 0 1 2 3
9 a Natural levees 1 2 3
10 Headcuts 0 2 3
11 Grade controls 0 1 1 5
12 Natural valley or drainageway 0 09 1 1 5
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
No = 0
Yes = 3
man-maae ancnes are not ratea, see discussions in manual
B Hvdroloov (Subtotal= 3 1
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 1 2 3
16 Leaflitter 1.._5 1 05 0
17 Sediment on plants or debris 0 1 1 5
18 Organic debris lines or piles (Wrack lines) 0 0 5 1 1 5
19 Hydnc soils (redoximorphic features) present? No = 0 Yes= 1 5
C Bloloav (Subtotal = 1
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 3 2 1 0
22 Crayfish _ 05 1 1 5
23 Bivalves 1 2 3
24 Fish 0 05 1 1 5
25 Amphibians 05 1 1 5
26 Macrobenthos (note diversity and abundance) 0 0 1 1 5
27 Filamentous algae, periphyton 1 2 3
28 Iron oxidizing bacteria/fungus 0 5 1
29 Wetland plants in streambed FAC = 0 5, FACW = 5, OBL = 1 5 SAV = 2Y, Other --
items zu ana zl Tocus on me presence OT upiana piants, item 29 tocuses on the presence of aquatic or wetland plaits`
Sketch
Notes (use back side of this form for additional notes )
a`M ?, PnAs L :?
,h

North Carolina Division of Water Quality - Stream Identification Form, Version 3 1
Date ;-/ 'L 74o'y Protect Latitude
Evaluator Plf I4 k W` Site 5 r_ Longitude
Total Points Q S ?? Other
Stream is at least intermittent ? County
rf >_ 19 or erennial if z 30 ' 6- 1" t Gr e g Quad Name

A Geomorphology (Subtotal = > >) Absent Weak Moderate Strong
1a Continuous bed and bank 0 2 3
2 Sinuosity 2 3
3 In-channel structure nf8e-pool sequence 0 1 2 3
4 Sod texture or stream substrate sorting 0 1 2 3
5 Active/relic floodplain QOL) 1 2 3
6 Depositional bars or benches 0 1 2 3
7 Braided channel 0 1 2 3
8 Recent alluvial deposits 0 1 2 3
9 a Natural levees 0 1 2 3
10 Headcuts 0 1 2 3
11 Grade controls 0 05 1 1 5
12 Natural valley or drainageway 0 (05) 1 1 5
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
2N-
Yes = 3
rvwmrmaae ancnes are not rates, see aiscussions in manual
B Hvdroloov (Subtotal = 9 1
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season / \
v 1 2 3
16 Leaflitter 1 5 1 05 0
17 Sediment on plants or debris 0 05 1 1 5
18 Organic debris lines or piles (Wrack lines) 0 0 1 1 5
19 Hydnc soils (redoximorphic features) presents o = 0 Yes= 1 5
v
C Bioloov (Subtotal = 1
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 2 0
22 Crayfish 0 05 1 1 5
23 Bivalves 0 1 2 3
24 Fish - 05 1 1 5
25 Amphibians 0 05 1 1 5
26 Macrobenthos (note diversity and abundance) G 05 1 1 5
27 Filamentous algae, periphyton 0 1 2 3
28 Iron oxidizing bacteria/fungus Cg,} 05 1 1 5
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other = 0
11.011 IQ Gu Gllu 41 Iuwb ull um presence m uplano p1ams, item za tocuses on the presence of aquatic or wetland plants
Sketch
Notes (use back side of this form for additional notes )
5)Z
STREAM QUALITY ASSESSMENT WORKSHEET
P-2-4 /[
CGw/ro-d C o"J reJ
a, t r r ?t
:CH4RaiCTERISTIC S E, l-W6 16N NO `T NAi?TGE
- j: SC
URE
Piedmont l<9ountain ' .
-

- Presence of flog / persistent pools in stream
1
(no now or saturation = 0, strong flow = rnax points) 0-ti i 0-4 0-5
Evidence of past human alteration

?.
(extensive alteration - 0, no alteration -= max point) 0-6 0-S 0-? /?ti
0

s Ripnrian,zone
contiguous: wide
(no•hut4cr ` 0
huffer - ni2x`601111s
0 - 6.
0 -4
0
,
,
E?idence-of nutrient or chemical discharges
4
(extensive discharges = 0, no discharges - max points) 0-? < 0-4 0-4
a
" s Groundwater discharge 0 1) 0-4 0_4

,4
no discharge=0, springs, seeps, wetlands. etc =may points) 3
u,
f 'Presence of adjacent _floodplain
'
-
k
,• (rio tloodplam = O,,eatensii
e
floodplain - m rxipQihs i - r ~? -
-
a
?h
F1, `Entrenchment / floodplain access

0_s

0-4 '

-0-'

(deeph entrenched - 0. fiequent'floodm< max points) /

8 Presence of adjacent wetlands
0-6
0- 4
0- 2

Q
(no wetlands =0: large ad(acent wetlands = max points)

9 Channel sinuosity
0=5
0-4
0 -
(extensivechwinelization `O,Fnaturalmeander=maz?pomts)
Sedtmenttiriput

(extensiJefdepbsttn'on- 0, little or no`sediment - rhax"points)
?
0-4
0-4

d
Size,& diN°ersity?of channel-bed substrate
\`.
0-4
0_5
(fine. homogenous = 0; large, diverse sizes = max points)

12 Evidence of channel incision or widening
0
0
4
U
?. (deepk incised - 0, stable bed &_ bank, = max points), -
'+ Presence

of major bankTailures

'
-
0

- 5

o _
(sedere erosion =0_ no erosion. stable
banks
max pontes i

14 'Root'depth and density on banks
0-;
0-4
0-?
Q
( no visible roots = 0. dense roots throu,hout = max points)

I? Impact by agriculture, livestock, or timber production
0
5
0
4
0 s
(substantial irnpaet=0; no evidence - max points) - --

l 6 Presence of riffle-poolfripple-pool complexes
:
s

-(no riffles'/rip .les,or pools - 0, well-developed max points) 0
- j 0- ?) 6 1?
s E' , e Habitat complexiri -
'
'
0
-6
0-6
(little,or no'habrtat -0- fre
q
uent, varied-habitats inax'pomtsl 1

18 Canopy coverage over streambed
,
0
n-
0

no shading vc<ctauon = 0, continuous canopy= max points) - -

Io Substrate embeddedness
\_A*
0-4
0-4
deeply embedded = 0, loose structure = max
) Presence`ofstream mvertebmles (see pace 41
r!
(no evidence - 0, common; numerous types - may points)
`(? `4
('
0 -'
, Presence of amphibians
0-4
0-4
0-4
/
,. (no evidence - 0, common, numerous t_? PCs - ma.r poi nt,, )

22 Presence of fish
0-4
0-4
(1-4
(no evidence 0. common numerous types = rnax ointsl
Evidenceof-wildlife use
0
-6 0 -
0 -5
(no evidence = 0. abundant evidence = max points) -
nr s' .i G-; ,
To talPoints Possible__ t,.t r t
?TOU 100,
10O
TOTAL SCORE (also enter on first page) Z
* These characteristics are not assessed in coastal streams l
2 PC ivL J01, V) Y
USACE AID# DWQ # Site # (indicate on attached map) I
Provide the following information for the stream reach under
1. Applicant's name
3 Date of evaluation ? Z 2 O q
5. Name of stream 5
7. Approximate drainage area re S
9. Length of reach evaluated L q 0 -Fe-, t
11. Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
2. Evaluator's name
4. Time of evaluation Jr' AV,
River basin
C°,f?e Fear / ??• ?l rnQ n
8. Stream order
10 County -?0(-d
12. Subdivision name (if any) _
Longitude (ex -77 556611)
Method location determined (circle) GPS Topo Sheet Ortho (Aenal) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
C cg-f- d N C 6,'u' Nl GrfLe ?' , d f e? se G-t ;cry
14 Proposed channel work (if any)
15. Recent weather conditions `s^d='-?/ r-4 'K t-( g A e S
16. Site conditions at time of visit Sk n rv
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18 Is there a pond or lake located upstream of the evaluation point? YES e If yes, estimate the water surface area
19 Does channel appear on USGS quad map? YES COD 20. Does channel appear on USDA Soil Survey? YES
21 Estimated watershed land use _% Residential S 0% Commercial '3 a% Industrial _% Agricultural
ZL % Forested _% Cleared / Logged _% Other
22. Bankfull width/- 2 -? f 23 Bank height (from bed to top of bank) '25 - 1 4'a"'t
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity -,,Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g, the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
1.17
Total Score (from reverse) 1z Comments
Evaluator's SignaturiL/`i Date 57 /'Z
This channel evaluation orm is ded to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET mftft-!=JW
assessment
I USACE AID# DWQ # Site # (indicate on attached map)
Pro g o mation for the stream reach under assessment
1 Applicant's name 3 4 rr`25, IfT AI- r- 2. Evaluator's name
3. Date of evaluation S Z-2- Z /C ? 4 Time of evaluation
:/ ,-? M
5 Name of stream 5 T 6. River basin C.A,pL / elm ?Z n Yrl q ?1
7. Approximate drainage area !p° + q?re S 8. Stream order 2-
9. Length of reach evaluated 10 County Gam, / -rote-d
11. Site coordinates (if known) prefer in decimal degrees 12 Subdivision name (if any)
Latitude (ex 34 872312) Longitude (ex -77 556611)
Method location determined (circle) GPS o She t Ortho (Aenal) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
wes-;,' C--F W M1?,-k1.t R,.d /yC 6 Ss
14. Proposed channel work (if any)
15. Recent weather conditions Ta. ?`^ y? h r S
16. Site conditions at time of visit 5 4-:r `-f'9:t7rte c? /and 5 a V ! S
17. Identify any special waterway classifications known Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18 Is there a pond or lake located upstream of the evaluation pomt9 YES C-0) If yes, estimate the water surface area
19 Does channel appear on USGS quad map9 ? NO 20 Does channel appear on USDA Soil Survey9 ( NO
21. Estimated watershed land use 2 O % Residential 20 % Commercial ZO % Industrial ) % Agricultural
3 U % Forested _% Cleared / Logged _% Other
22. Bankfull width ti 5- 23 Bank height (from bed to top of bank)
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25 Channel sinuosity Straight Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse) -, U Comments
Evaluator's Signature- 4 Date 5 /2 Z /O ?'
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET A vide the followin mf r
4W
s5
A-2GI
STREAM QUALITY ASSESSMENT WORKSHEET ?(A 11-? rd
('-' C) L. q /
ECOREGIOVPOTNT RANGE
'
CHARACTERISTICS
SCORE
Coastal Piedmont Mountain
Presence of flow / persistent pools in stream
l
(no floNv or saturation = 0, strong flow = max points) 0 _ 0 - 4 0- 5

? Evidence of past human alteration
. -
extensive alteration = 0, no alteration -max points) 0-6 0
l 0- 5
Riparian zone 0-6 ;0 - 4 0 -
(no buffer 0 -rnntjguous' ?% tde,buffer = max.ponit )
?
^?
.rY
Evidence,of,nutrient,6r chemical discharges

Y 1 <
(extensive dischar,,eti = 0, no discharges = mat points) 0- 5 0-4 0-4
Groundwater discharge
.r
(no discharge =0, springs, seeps. uetlands. etc.=may points) 0-3 0 -4 0 -4 O
Presenceof adjacent floodplain
(no floodplain = 0.,extensive floodplain = mac points) 0 4 0-4 0 -?
:T a Entrenchment / floodplain access

(deepkr entrenched = 0, frequent flooding =max points)
- 0-5 .0_-4 0-'

S Presence of adjacent wetlands

?

0-6
=
?'0 4
_
0-2
no wetlands = 0, largc'adlacenr wetlands =max
points)
4
14
Channel sinuosity

?
,
-',1 ex"tensl?'e channehzatlon -'.0,'natnral meander max'pomts)
0 - 5
0-4
- 0- 3
'Sediment input
i ;10-_ - ;, _
(extensive deposition= 0; little or no sediment = max points) 0 5 0-4 0-4
Size & diversit
of channel bed substrate
j1 y
fine. homogenous = 0: large, diverse sizes -.max points) NA*
? 0-4 0-5
Evidence of channel incision or widening

?. 1
(deg k incised.= 0, stable bed & banks = max points) 0 s 0-4 0 s
???
• -
-c
1 - Presence of major bank failures
?•'
,
(sex ere erosion = 0.-no erosion, stable banks = max points) 0-5 :0=5 -0-5 2

P*k
l'4' Root deptb?and'densitN on banks
0 " 3
0-4 -
0 -5
"(no visible roots '0.-dense-roots'throurhout = max points )
l :' - Impact by agriculture,'livestock, or timber production 0 s 0
4

(substantial impact =0,?no evidence = max points) - 0 5
`
16 Presence of riffle-pool/ripple-pool complexes
0
?
0
S
-

(no riffles,rrpples or pools - 0, well-developed - max points) - - 0
6
Q 17 Habitat complexity
' 0_6 0-6 0-6
F (
little or no habitat - 0, frequent, varied habitats -- max points)
Canopy coverage over streambed
Ow shading vegetation = 0, continuous canopy - max points) ?

to Substrate-embeddedness
- NA*
0 4 , r
0-4
f deeph ennbedded = 0, loose structure = Max)

0 Presence,ofstream invertebrates (see page 4)
-
-
no evidence 0_ common. numerous types=max points) 0-4 0-5 0-?
Presence of amphibians

??. 21
i no evidence = 0. common, numerous types= max points) 0-4 0-4 0 7
Presence of fish

ino`evidence = 0: common, numerous types = max points) 0- 4 0- 4 - 4
Evidence of wddlifeuse
- (no evidence = 0. abundant evidence = max points) 0 - 6 0 - 5 0 -
Total•pomts:Possible fi_
f . - 100 10(1 100
-rT®
T4LSCORE (also.,eiAer n fir toga e) CJ
,
. These enaracterrstres are not assessed in coastal streams
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date 5, a _ (S)$ Project R_ awl 1 Latitude
Evaluatorjl)w\ s Vflc? Site Longitude
ftl? icIsle M6LA,--b IST
Total Points Other
Stream is at least intermittent I County J I
if z 19 or perennial if z 30 e g Quad Name
A Geomorphology (Subtotal = ) Absent Weak Moderate Strong
18 Continuous bed and bank 0 1 2 3
2 Sinuosity 0 1 2 3
3 In-channel structure riffle-pool sequence 1 2 3
4 Sod texture or stream substrate sorting 0 1 2 3
5 Active/relic floodplain 1 2 3
6 Depositional bars or benches 1 2 3
7 Braided channel 1 2 3
8 Recent alluvial deposits 1 2 3
9 a Natural levees 1 2 3
10 Headcuts 2 3
11 Grade controls 0 5 1 15
12 Natural valley or drainageway 0 0 1 15
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
Ce)
Yes = 3
Man-made ditches are not rated, see discussions in manual
R Hvdrolonv (Subtotal = 4 1
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel -- d or growing season 0 1 [2 3
16 Leaflitter 1 5 1 05 0
17 Sediment on plants or debris 0 0 1 1 5
18 Organic debris lines or piles (Wrack lines) 0
4
? Z 1 15
19 Hydnc soils (redoximorphic features) presents rNZ
-
- Yes =1 5
C Bioloav (Subtotal=
)
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel 3 2 1 0
22 Crayfish 05 1 15
23 Bivalves 1 2 3
24 Fish 05 1 15
25 Amphibians 0 05 1 15
26 Macrobenthos (note diversity and abundance) 0 5 1 15
27 Filamentous algae, periphyton CO 2 3
28 Iron oxidizing bacteriatfungus 0 05 1 15
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other =

VJes ?-
t'1GJILe?'
Items 20 and 21 focus on the presence of upland plants, item ze tocuses on the presence of aquatic or wetlano plants,.-,,---
Sketch
Aintoc fi ico hack cvio of this form fnr aririitinnal nntac 1 '
APPENDIX - Comparison Between Version 2.0 and 3.1 Scoring Forms.
VERSION 2 0 FORM Versions 3 x Forms
Prima Field Indicators

I Geomorphology
1 Is there a nffle- ool sequence'? 3 In-channel structure riffle-pool sequence
2) Is the USDA texture in streambed different from
surrounding terrains 4 Sod texture - Substrate sorting
Renamed attribute
3 Are natural levees resent? 9 Natural Levees
4 Is the channel sinuous? 2 Sinuosity
5 Is there an active or relic flood lam resent? 5 Active/relic flood lam
6 Is the channel braided? 7 Braided channel
7 Are recent alluvial deposits resent? 8 Recent alluvial deposits
8 Is there a bankfull bench resent? 6 Depositional bars or benches
9 Is a continuous bed & bank resent? 1 Continuous bed and bank
10) Is a 2 order or greater channel (as indicated on topo
ma and/or in field resent? 13 Second or greater order channel on existing
USGS or NRCS ma

II Hydrology
1 Is there a groundwater flow/discharge resent? 14 Groundwater flow/discharge

III Biology
1 Are fibrous roots resent in streambed? 20 Fibrous roots in channel
2 Are rooted plants resent in streambed? 21 Rooted plants in channel
3) Is periphyton present? `27 Filamentous algae, periphyton
Version 2 0 items combined
4 Are bivalves resent? 23 Bivalves

Secondary Field Indicators

I Geomorphology
1 Is there a head cut resent in channel 10 Headcuts
2 Is there a grade control point in channel 11 Grade Control
3 Does topography indicate a natural drainage way? 12 Natural Valle and drains ewa
_
II Hydrology
1 Is this ear's or last's leaf litter resent in streambed? 16 Leaflitter
2 Is sediment on plants or debris resent 17 Sediment on plants
3 Are wrack lines resent? 18 Organic debris lines or piles Wrack lines
4 Is water in channel and >48 hrs since last known rain? 15 Water in channel and > 48 hrs since rain or
5) Is there water in channel during dry conditions or in
growing season?
6) Are hydric soils present in sides of channel (or in
headcut

19 Water in channel - dry or growing season
(Version 2 0 items combined)
Hydnc soils (redoximorphic features)
resent?

III Biology
1 Are fish resent? 24 Fish
2 Are amphibians resent? 25 Amphibians
3 Areaquatic turtles resent? DELETED No aquatic turtles ever scored
4 Are crayfish resent? •22 Crayfish
-5 .Are-macrobenthos resent? -_ _ __26 -Macrobenthos
6 Are iron oxidizing bacteria/fun us resent? 28 Iron oxidizing bacteria/fun us
7 Is filamentous algae resent? '27 Filamentous algae, eri h on
8 Are Wetland Plants in Streambed? 29 Wetland plants in streambed

1 1

STREAM QUALITY ASSESSMENT WORKSHEET
5J
A-2? 11
G-t".` Peril
(ot4e4 y
E60REGION POIN T RANGE _
CHARACTERISTICS
SCORE
Coastal Piedmont Mountain
Presence of flow /persistent pools in stream
1
(no flow or saturation = 0. strong flow = max points) 0-5 0-4 0-5
Evidence of past human alteration
(extensive alteration = 0, no alteration = max points)
-o
0 5
0--5
Riparian zone
3
y (nobufter = 0; cohti(?uods.' widc;btiffer'=_niax points) -0-6 0-4 0-5
Evidence of nutrrent.or chemical discharges
(extchsrie discharges ='0, no discharges =?max,pomtsi
Groundwater :discharge 6-4
0-4
(no' discharge =0, sprines, seeps, wetlands: etc = max points)
Presence of adjacent floodplain
0 - _4
0 - 4
0 -
C)
r
( no tloodplain = 0; extensive floodplam - max pointsl
_

Entrenchment / floodplain access
(deeplti entrenched= 0,'tre uent flooding = max points) 0 - 5 0 - 4 0 - 2
8 Presence of adjacent wetlands

(no wetlands - 0, large adjacent wetlands = mar points) 0-6

, U

-4

U - 2 0
q Channel sinuosity

i extensive channehzation -0. natural m an'der- max points): 0--5 0 4 0-3
21 'Sedimenfiriput -
(exte nsire'deposuion= 0;-little or no sediment = max points)' - -
0-4
Q

1?1 Sve & drversio,of channel?bedisubstrate
to
,
`

E
_ , '(frnz:4homo enous = 0. 1,4Le, diverse sizes =.max points)
,7 4 0 -4 5
()-.
Evidence of channel'incision or widening -

y
Ace lv incised - 0; stable bed & banks = max points) 0
5 0-4 0 - 5 Q
Presence of major bank failures

(severe erosion - 0, no erosion, stable banks= max points) 0 5 0-5 0-5 0
14 Root depth and density on banks

(no visible roots = 0, dense roots throu(_zhout- max points)
0-;
0-4
0-5 1

5
1 Impact by agriculture, livestock, or timber production
5
0
0
4
.
(suhstanttalimpact=0, no etiidcuce max points) -_
- 0-S

16 Presence of riffle-
pool/ripple-pool complexes

?:

0
=

no?riffles'inpples or pools = 0,'well-de?eloped=max points). 3 0-5 U n
t Habitat compleritv
i httle or no'Habitat = 0, frequent,-, aried-habitats = max points)
Canopy coverage over` streambed
?. (no shading vc clatnon = 0, corrtmuous cano w = max points)
Substrate embeddedness
0-4
0 -4 '
(deeply embedded= 0, loose structure --max)
Presence of stream invertebrates (see page 4) _
(tic) evidence - 0, common; numerous iypes - mar points) 0-4 0 ? 0 - ?
O
Presence of amphibians 1
?1 no evidence 0, common, numerous types = max points) 04 0-4 04

.. Presence offish

(no evidence = 0. common: numerous types max points)
0-4
0-4
n-4 - O

-= Evidence of rtiildlife-use
- 0-6
0-,
n, 5
(no evidence - 0. abundant evidence - max points)
'
Total
Points Possible 3 l00 a 100 100 _
TOTAL SCORE (also enter on first page) f
* These characteristics are not assessed to coastal streams
USACE AID# DWQ # Site # (indicate on attached map)
Prov g for the stream reach under assessment
1 Applicant's name -- +-s IRA - i- 2 Evaluator's name
3 Date of evaluation 5- /2- Z /0 4 Time of evaluation 10
5 Name of stream S 6. River basin Qq n Z M"
n
7. Approximate drainage area
/0 4cr-es
9. Length of reach evaluated 4 O -F-e?-t
11. Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
8. Stream order
10. County G-z,; 1-?'c
12. Subdivision name (if any)
Longitude (ex -77 556611) _
Method location determined (circle) GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
C •oSsz d t,-t der (? . N1A'rk-2 f j Cc/ ?a.,t f /ervNe,-,, f ar / SC A0e
14. Proposed channel work (if any)
15. Recent weather conditions r' a k 4q 1 - S
16. Site conditions at time of visit 5 C>, 1 S 5-2, It-1 r o- t-e d ,h LI p ?4,d q ,-e A. S
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YE NO If yes, estimate the water surface area a r?s
19 Does channel appear on USGS quad maps YES NO 20 Does channel appear on USDA Soil Survey? YES CO)
21. Estimated watershed land use _% Residential 0% Commercial _% Industrial _% Agricultural
!o % Forested _% Cleared / Logged _% Other ( )
22. Bankfull width :7- --1 f-e-e-> 23 Bank height (from bed to top of bank) 6 - 4- f
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) -Moderate (4 to 10%) Steep (>10%)
25. Channel sinuosity _ Straight -Occasional bends -Frequent meander -Very sinuous -Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse) [b Comments:
Evaluator's SignatureO - fzz?`, Date -T-/2, a
This channel evaluatio form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET -F
W
ide the followin information
1
North Carolina Division of Water Quality - Stream Identification Form, Version 3 1
Date Z--/o g Project Latitude
Evaluator K10%In ?v` Site 5 2- Longitude
Total Points Other
Stream is at least intermittent
if >_ 19 or perennial if ;a 30 57-County G-(^ t (? d e g Quad Name

A Geomorphology (Subtotal = , 5) Absent Weak Moderate Strong
1a Continuous bed and bank 0 1 3
2 Sinuosity 0 1 3
3 In-channel structure riffle-pool sequence 0 2 3
4 Sod texture or stream substrate sorting 0 1 2 3
5 Active/relic floodplam 0 1 2 3
6 Depositional bars or benches 0 1 2 3
7 Braided channel 0 1 2 3
8 Recent alluvial deposits 1 2 3
9 a Natural levees 2 3
10 Headcuts 0 2 3
11 Grade controls 05 1 1 5
12 Natural valley or dramageway 0 0 5 1 1 5
13 Second or greater order channel on existing
USGS or NRCS map or other documented
evidence
No =
Yes = 3
nian-mane ancnes are not ratea, see aiscussions in manual
B Hvdroloov (Subtotal = G , ti 1
14 Groundwater flow/discharge 0 1 2 3
15 Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 ?+1
C, ) 2 3
16 Leaflitter 1 5 05 0
17 Sediment on plants or debris 11K QL? 1 1 5
18 Organic debris lines or piles (Wrack lines) 0 (01) 1 1 5 '
19 Hydnc soils (redoximorphic features) present? No = 0 Yes= 1 5 '
C Bioloav (Subtotal = . C 1
20 Fibrous roots in channel 3 2 1 0
21 Rooted plants in channel b 2 1 0
22 Crayfish 05 1 1 5
23 Bivalves 0 1 2 3
24 Fish 0 05 1 1 5
25 Amphibians 0 05 1 1 5
26 Macrobenthos (note diversity and abundance) '' 0 5 1 15
27 Filamentous algae, penphyton 2 3
28 Iron oxidizing bacteria/fungus 05 1 1 5
29 Wetland plants in streambed FAC = 0 5, FACW = 0 75, OBL = 1 5 SAV = 2 0, Other 0
1-11- cV enU 41 wcua on LIM presence or upiana piams, nem za rocuses on the presence of aquatic or wetland plants -
Sketch
Notes (use back side of this form for additional notes )
Yt a l?L 5 v41 r! . / K
JV a)
I P ese_ }

STREAM QUALITY ASSESSMENT WORKSHEET
sL
-z6//
?c,-d
?,
?' ;f •.? ,?? . ,.? ., , . . • >'
C"
f- ` 'CHARACTERISTICS, ? SEC'`OREG_?(?N...,I'?,"T?4?1?GE
:. Cn

+*
?
Coastal
Piedmont ?
Mountain S
RE
'Presence of flow /persistent pools instream

(no floe saturatifm = 0, stron';flo?w =-max points)
0 - ti
0 -
4
. 0 -5
-
4 `F
Evidence of past huinan alteration
-
(extensive alteration - 0, no alteration = max points)
0- 6 0-5 0-5
Riparian zone

jno buffer - 0: conh?4uous. wide huffermaz points)
0_6
0-4 0-?

4 ? aEvidenee of nutrient or chemical discharges. .
0=5_
0
4
0
4
.? (extensive`dischtue'i.s 0; no discharges -max points) - -
.? s Groundwater discharge
',(no discharge:-,0; sptm"es. seeps.'-wetlands. etc =max points)'
'Presence of adjacent floodplain'
E> (no-floodplain = 0,,extensiVe floodplain = max points) 0-4 0 - 0 -'
....;
Entrenchment / noodplam access

0

?`0 4
( deeply enGenched = 0_ fre uent floodmt, = max points)

e

8 Presence of adjacent
wetlands
?.
'
'

0-6_

0-4,

-0-2
r (no «etlands
0. lar?c
adjdcent wetlands = max points) ,
Channel sinuosity
0
04
0-3
., „ i extensive channelization = 0, natural meander - max points) _ -
'
-'
l0 _. -fSediment.input
Cl- i
0-4 _
0-4
(extensive de osition -- 0; little or no sediment - max points)
= Size-S diversity of channel bed substrate 'z
k?
-

F? _
tmc,ibomo6enious'= 0, la,,cAiverse sizes =4nax points) A? 0-4 0-5 U

I Evidence of channel incision or widening
U
?
0
4
0
?
r-: i deck)} ancised = 0..stable.:bed R banks = inay points) -; - -
tE=
1 Presence of major haiikfailures
0-
0-5
0-5
(see ere erosion = 0, no erosion, stable banks - max points)
?t
14 °Root depth and densitN on banks
0-3
0-4.,
0-.

F ;
(no visible roots = 0. dense roots throa<,*_hout = max points) 3

l, impact by agriculture, livestock, or timber production

S ._
(sirbsttuitial impact =0:rio'evidence = max points) .0 0-4 0- y

16 Presence of riffle-pool/ripple-pool complexes

(no riffles-apples or pools = 0, well-developed = max points) 0-3 0-? 0-6
l Q? , `, ?Habrtat complexit}'
1

(little 'or no habitat - 0_ frequent. Varied habitats = max points) 0-6 0-6
0 - 6

3

18 Canopy coverage over streambed
_0-5
0-;
0 5
'(no shadut, ?e,,7ctatuon 0, continuous canopy -max points) ' .

10 Substrate embeddedness NA* 0 - 0-4
'.A -:, (dceph embedded - 0, loose structure - max) ...

10 `Presence'of stream invertebrates (see pace 4)
0-4
0-s
0-?

r? ( no eN idence - 0. conimon,;nti'nnerous 1% pes = max points)
-
Presence of amphibians
0-4
0 -4
0
4
(no•evidence 0- common, numerous n pes = max points ) -
.,
.? Presence of fish
0 -4
0 -4
f) - 4 0
(no?evidence = 0. common. numerous t\ pes = max points)
Evidence of v ildhfe use
0 - 6
0 -
0
(no evidence = 0. abundant evidence = max points) -
i ` Total Points Possible t;,,`?`. 100 100 -'_ - 100
TOT.-kL SCORE (Aso enterein rs a ;e)
3 _ t`p
Ct

* These characteristics are not assessed in coastal streams
USACE AID# DWQ # Site # (indicate on attached map)
Pro g on for the stream reach under assessment
1 Applicant's name -i »t2S 00-rt' In" V?', 2 Evaluator's name
3. Date of evaluation ? 2 Z /0 <' 4 Time of evaluation
5 Name of stream S L-
7. Approximate drainage area
9. Length of reach evaluated tz 0
11. Site coordinates (if known) prefer in decimal degrees
Latitude (ex 34 872312)
) 0 A rv-
6 River basin C f C P/ 451 (1, d 2l m R?^
8 Stream order
10. County G l -?2rci'
12. Subdivision name (if any)
Longitude (ex -77 556611)
Method location determined (circle) GPS Topo Sheet Ortho (Aenal) Photo/GIS Other GIS Other
13 Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location)
14. Proposed channel work (if any)
15. Recent weather conditions NSA V,/ r A '-> L/`F- A r S
16. Site conditions at time of visit S '-%A n y , s ; 9 h.5 J re
17. Identify any special waterway classifications known -Section 10 -Tidal Waters -Essential Fisheries Habitat
-Trout Waters -Outstanding Resource Waters _ Nutrient Sensitive Waters -Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? 0 NO If yes, estimate the water surface area 2 q L i`t- S
19 Does channel appear on USGS quad map? YES
21 Estimated watershed land use _% Residential
2- T % Forested
22. Bankfull width J 2-
20 Does channel appear on USDA Soil Survey? YES e
`l% Commercial _% Industrial _% Agricultural
_% Cleared / Logged _% Other
23 Bank height (from bed to top of bank) O - 1 40a t
24. Channel slope down center of stream -Flat (0 to 2%) -Gentle (2 to 4%) Moderate (4 to 10%) -Steep (>10%)
25. Channel sinuosity Straight kOccasional bends -Frequent meander -Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc Every characteristic must be scored using the same ecoregion Assign points
to each characteristic within the range shown for the ecoregion Page 3 provides a brief description of how to review the
characteristics identified in the worksheet Scores should reflect an overall assessment of the stream reach under evaluation If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream under review (e g , the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality
Total Score (from reverse)- L Comments- 7tZe c-e. v-es /-, c, w
r" r\ r4-r 10-a" el ay I?"- -1-4a -+1 e d g ?L.
Evaluator's Signature (2- Date S Z v btu
This channel evaluation for is irate ed to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03 To Comment, please call 919-876-8441 x 26
STREAM QUALITY ASSESSMENT WORKSHEET -A
vide the followin informati