20170827 Ver 1_401 Application_20170703

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO.
I � W--1�J
STREET ADDRESS: 12322 Old Camden Road
Midland, NC 28107
Please print: I&A Properties
Property Owner: p _
Property Owner; Tim Liescheidt
55340823660000
PARCEL ID: 55249832520000
I D
2 0 1 7 0 8 2 7
The undersigned, registered property owners of the above noted property, do hereby authorize
Larry Thompson, PWS, LSS , of Thompson Environmental Consulting, Inc.
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
152 American Dr, Oakboro, NC 28129
Telephone: 7G4-485-2234
RECEIVED
JUL 03 2017
DENR-LAND QUALITY
We hereby certify the above information submitted in this application is trudS&9tllit*gg@ F&SITTING
best of our knowledge.
Authorized Signature Authorized Signature
Date: 6 - 1 s - 1 -1
Date:

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
❑ No
2. Project Information
2a. Name of project:
CF Steel Facility
2b. County:
Cabarrus
2c. Nearest municipality / town:
Midland
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
N/A
3. Owner Information
go
3a. Name(s) on Recorded Deed:
I & A Properties, LLC
3b. Deed Book and Page No.
Book 11917, Page 0034
3c. Responsible Parry (for LLC if
applicable):
Tim Liescheidt, PE
3d. Street address:
P.O. Box 148
3e. City, state, zip:
Oaksboro, NC 28129
3f. Telephone no.:
704-516-1750
3g. Fax no.:
3h. Email address:
[e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
® Agent ❑ Other, specify:
4b. Name:
Larry Thompson
4c. Business name
(if applicable):
Thompson Environmental Consulting, Inc.
4d. Street address:
P.O. Box 541
4e. City, state, zip:
Midland, NC 28107
4f. Telephone no.:
[phone]
4g. Fax no.:
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
55340823660000, 55249832520000
1 b. Site coordinates (in decimal degrees):
Latitude 35.247014 Longitude: -80.572795
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
25.5 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT to Far Branch
proposed project:
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Yadkin River Basin (HUC 03040105)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project study area is comprised of a previously developed commercial area, hardwood forest, maintained roadway
along Old Camden Road and NC 24, and nearby residences. An unnamed tributary to Far Branch begins as an
ephemeral channel and runs south out of the subject property.
3b. List the total estimated acreage of all existing wetlands on the property:
0.19 acre
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1000 feet
3d. Explain the purpose of the proposed project:
To construct a permanent driveway by crossing the wetland.
3e. Describe the overall project in detail, including the type of equipment to be used:
The proposed project is the construction of a commercial building by crossing the onsite wetland with the construction of a
permanent driveway. Erosion and sedimentation control measures will be installed. Water will be diverted around the crossing
construction. A culvert pipe will be placed in the wetland at the crossing to allow natural flow of water within the wetland. The
wetland at the crossing will be excavated and realigned for low flow shaping. Water will be pumped around the work area during
construction by installed impervious dikes upstream of the proposed crossing. Equipment to be used includes a track hoe, dump
truck, paving equipment, pumps, and various hand tools.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑Yes ® No ❑ Unknown
project (including all prior phases) in the past?
Comments: N/A
4b. If the Corps made the jurisdictional determination, what type
El Preliminary [I Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: Three Oaks Engineering
Name (if known): Chris Sheats
Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
N/A
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number -
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ - non -404, other)
(acres)
Temporary T
W1 ®P ❑ T
Fill
Headwater Forest
® Yes
❑ No
® Corps
❑ DWQ
0.08
2g. Total wetland impacts
0.08
2h. Comments: There will be 0.08 acre impact due to the construction of a permanent driveway, providing access to the
subject property.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ - non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total Permanent Stream and Tributary Impacts
3i. Comments:
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P)
or Temr)orary T
01 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

53.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose of
(acres)
number
pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments: There are no ponds created for this project
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar -Pamlico ❑ Other: Jordan Lake
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P)
for
Stream name
mitigation
(square feet)
(square feet)
or Temporary T
impact
required?
131 ❑P❑T
El Yes
❑ No
B2 ❑P❑T
❑Yes
❑ No
6h. Total buffer impacts
6i. Comments: N/A
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project is to install a driveway and associated culvert crossing a wetland. As the wetland is the length of the
property, the only way to access the buildable area is to cross the wetland. Impacts are expected to be minimal, as the
crossing will be done perpendicular to the wetland. The proposed driveway has been narrowed as much as practical to avoid
any unnecessary impacts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMPs will be installed prior to construction. Water will be diverted around the work area to prevent
sedimentation of downstream aquatic resources. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of surface waters, restrictions against the staging of equipment in or adjacent to waters of the US.
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this project?
❑ Mitigation bank
❑ Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8of11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Yes ❑
❑ No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
23.5%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: The proposed project is not subject to a
Non -404 Jurisdictional General Permit, 3704, or 3705 General Certifications
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a. Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after -the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The construction of a commercial building will not result in future impacts. The property is located near roadways, other
commercial buildings, and some residential buildings. Therefore, this building will not further impact the area.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Wastewater generated from the proposed project will be directed into a septic drain field on the property.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
® Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCNHP Database
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
This building construction project takes place in Cabarrus County which is not near any coastal or tidal habitat that would
support EFH (i.e. salt marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
A review of the NC SHPO HPOWEB GIS service on June 16, 2017 found several historic buildings within 1.0 mile of the
subject project, but these properties would not likely be affected by this project. There are no buildings currently located
on the property.
B. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements: N/A
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Larry Thompson, PWS, LSS
_
6/19/2017
Applicant/Agent's Printed Name
_
4ppp@
Date
gent's Signature
(A,01s signature is valid only if an authorization letter from the
applicant isprovided.)
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

CF Steel
Preliminary Jurisdictional Determination
Package
Cabarrus County, North Carolina
Prepared for:
" chambers
_ engineering, pa
129 North First StreetI 704.984.6427 ph
Albemarle, NC 28001 www.ce-pa.com
Prepared by:
Thompson
Environments
$lll%
Consulting
PO Box 541
Midland, NC 28107
April, 2017

1.0 INTRODUCTION
Thompson Environmental Consulting, Inc. (TEC) was retained by Chambers Engineering, PA to
conduct an assessment of jurisdictional waters in Cabarrus County near Midland, NC. The study
area is approximately 5.93 acres and encompasses one entire parcel (PIN #'s 5534082366 [4.43
acres]) and 1.5 acres of the adjacent parcel to the north (PIN# 5524983252). The study area is
located on the west side of Old Camden Road, about 700 feet SW of the Highway 24 intersection.
The purpose of this investigation was to identify and map jurisdictional waters located within the
study area (Figure 1).
2.0 RESULTS
A jurisdictional waters delineation was conducted by TEC staff on April 05, 2017. One wetland
was identified (Wetland WA; Table 1; Figure 1). In addition, a small, non jurisdictional feature
was identified and mapped along the southern boundary of the study area (Figure 1). This feature
is not depicted on USGS topographic mapping (Figure 2), or the Cabarrus County Soil Survey.
Table 1. Jurisdictional Wetlands in the Study Area
Ma ID
p
NCWAM Wetland
Hydrologic
Acreage
g
Type
Classification
WA
Headwater Forest
Riparian
0.19
CF Steel April 2017
JD Package Page 2

Appendix A.
Figures
CF Steel April 2017
JD Package Page 3

Thompson
Environmental
Consulting
CF Steel
Jurisdictional Waters Assesment
Jurisdictional Features Map
Cabarrus County, North Carolina
Date: April 2017
Scale: 0100 200 Feet
I t t
Job N0. 17-605
Drawn By:
LSC
Checked By:
CMS
Figure

Thompson
Environmental
Consulting
CF Steel
Jurisdictional Waters Assesment
USGS 7.5 Minute
Topographic Quadrangle Map
Cabarrus County, North Carolina
Date: April 2017
Scale: 0 130 260 Feet
l I �
Job N° 17-605
Wetland WA = 0. 19 acres
if 11 k *
N
.�� ��•+'
0
N
'
#
Grey Com mevcial of NC -24827
Q& �60
Ci'2 2 v� • tT �t,TYr
4221
J'
.Ephemeral
Channel
lip
1
4
�r
J•4.a,� tiro— yr _rf
y
3
r4
F
r-16{,
k a
N
'
1
l
Legend
P
Roads
--�•-�— Ephemeral Channel
Study Area (5.9 acres)
Parcel Boundary
_ Wetlands
r` I r
Thompson
Environmental
Consulting
CF Steel
Jurisdictional Waters Assesment
USGS 7.5 Minute
Topographic Quadrangle Map
Cabarrus County, North Carolina
Date: April 2017
Scale: 0 130 260 Feet
l I �
Job N° 17-605
Drawn By:
LSC
Checked By:
CMS
Figure

Thompson
Environments
Consulting
CF Steel
Jurisdictional Waters Assesment
NRCS Soils Map
Cabarrus County, North Carolina
Date: April 2017
Scale. 0100 200 Feet
t � t
Job No.: 17-605
Drawn By.Checked
LSC
By.
CMS
Figure

Appendix B
Army Corps of Engineers Wetland Determination Data Forms
CF Steel April 2017
JD Package Page 4

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: CF Steel City/County: Cabarrus Sampling Date: 04/05/2017
ApplicanUOwner: **TBD** State: NC Sampling Point: WA -6 (WET)
Investigator(s): Chris Sheats & Lizzy Stokes -Cawley Section, Township, Range: Midland
Landform (hillslope, terrace, etc.): Headwater forest/TOS Local relief (concave, convex, none): Convex
Subregion (LRR or MLRA): LRR-P Lat: 35.247097 Long: -80.572825
Slope (%): 0
Datum: NAD -83
Soil Map unit Name: Tarrus Silt Loam, 8-15% Slopes NWI classification: None
Are climatic/ hM
s conditions on the site typical for this time of year? Yes = No (If no, explain in Remarks.)
Are VegetationSoil �, or Hydrology significantly disturbed? NO Are "Normal Circumstances" present?
Yes 0 No ❑
Are Vegetation ✓ Soil 0✓ , or Hydrology L_y J naturally problematic? No (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes �� No Is the Sampled Area
Hydric Soil Present. Yes ✓ Not:i within a Wetland? Yes 0 No
Wetland Hydrology Present? Yes J r L No=
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two required)
Primary Indicators (minimum of one is required: check all that aooly)
❑ Surface Soil Cracks (136)
M Surface Water (Al)
❑ True Aquatic Plants (614)
❑ Sparsely Vegetated Concave Surface (68)
❑� High Water Table (A2)
❑ Hydrogen Sulfide Odor (Cl)
❑✓ Drainage Patterns (B10)
❑� Saturation (A3)
❑✓ Oxidized Rhizospheres on Living Roots (C3)
❑ Moss Trim Lines (1316)
❑ Water Marks (131)
❑ Presence of Reduced Iron (C4)
❑ Dry -Season Water Table (C2)
❑ Sediment Deposits (132)
❑ Recent Iron Reduction in Tilled Soils (C6)
❑ Crayfish Burrows (C8)
❑ Drift Deposits (133)
❑ Thin Muck Surface (C7)
❑ Saturation Visible on Aerial Imagery (C9)
❑ Algal Mat or Crust (134)
❑ Other (Explain in Remarks)
❑ Stunted or Stressed Plants (131)
❑ Iron Deposits (135)
❑ Geomorphic Position (D2)
❑ Inundation Visible on Aerial Imagery (137)
❑ Shallow Aquitard (D3)
Water -Stained Leaves (139)
❑ Microtopographic Relief (D4)
j❑Aquatic Fauna (1313)
❑✓ FAC -Neutral Test (D5)
Field Observations:
Surface Water Present? Yes Q
No Q Depth (inches): 4-6
Water Table Present? Yes =
Q
No Q Depth (inches): surface
❑ @ Surface
n
Saturation Present? Yes
No Depth (inches):
Wetland Hydrology
Present? Yes No
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Five Strata) - Use scientific names of plants.
30'Rad.
Apsolute
uommant Inaicator
Tree Stratum (Plot size: )
% Cover
Species?
Status
1, Acer rubrum
25
Yes
FAC
2. Carpinus caroliniana
25
Yes
FAC
3. Ulmus americana
25
Yes
FACW
6.
50% of total cover: 37.5
Sapling Stratum (Plot size: 30'Rad.
1.
2.
3.
4.
6.
75 = Total Cover
20% of total cover: 15
0 = Total Cover
50% of total cover: 0 20% of total cover: 0
Shrub Stratum (Plot size: 30'Rad.
1 Carpinus caroliniana 10
2 Viburnum sp. 5
3 Alnus serrulata 5
A Arundinaria tecta 5
5.
6.
50% of total cover: 12.5
Herb Stratum (Plot size: 30'Rad. )
1.
2.
3.
4.
6.
7.
9.
10.
11.
Yes FAC
Yes NI
Yes OBL
Yes FACW
25 = Total Cover
20% of total cover: 5
0 = Total Cover
50% of total cover: 0 20% of total cover: 0
Woody Vine Stratum (Plot size: 30'Rad. )
1. Wisteria sinensis 5
4.
Yes NI
CF -Steele
Sampling Point: WA -6 (WET)
Number of Dominant Species
That Are OBL, FACW, or FAC:
6
(A)
Total Number of Dominant
Species Across All Strata:
6
(B)
Percent of Dominant Species
That Are OBL, FACW, or FAC:
100
(A/B)
Prevalence Index worksheet:
Total % Cover of:
Multiply by:
OBL species
x 1 =
FACW species
x2=
FAC species
x 3 =
FACU species
x4=
UPL species
x 5 =
Column Totals:
(A)
(B)
Prevalence Index = B/A =
❑ 1 - Rapid Test for Hydrophytic Vegetation
Q✓ 2 - Dominance Test is >50%
❑ 3 - Prevalence Index is :53.01
❑ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Five Vegetation Strata:
Tree - Woody plants, excluding woody vines,
approximately 20 ft (6 m) or more in height and 3 in.
(7.6 cm) or larger in diameter at breast height (DBH).
Sapling - Woody plants, excluding woody vines,
approximately 20 ft (6 m) or more in height and less
than 3 in. (7.6 cm) DBH.
Shrub - Woody plants, excluding woody vines,
approximately 3 to 20 It (1 to 6 m) in height.
Herb -All herbaceous (non -woody) plants, including
herbaceous vines, regardless of size, and woody
plants, except woody vines, less than approximately 3
It (1 m) in height.
Woody vine -All woody vines, regardless of height.
Hydrophytic
5
= Total Cover Vegetation
50% of total cover: 2.5 20% of total cover: 1
Present? Yes II No=
yrs here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0

SOIL
CF -Steele
Sampling Point: WA -6 (WET)
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth
Matrix
❑ Coast Prairie Redox (A16)
❑ Thin Dark Surface (S9) (MLRA 147, 148)
Redox Features
❑ Loamy Gleyed Matrix (F2)
❑ Piedmont Floodplain Soils (F19)
Depleted Matrix (F3)
(inches)
_ _ Color (moist)
%
Color (moist)
%
Type'
Loc
Texture Remarks
0-2
10 YR 4/2
75
10 YR 5/6
25
C
M
CL Clay Loam
2-10
10YR 4/6
60
10 YR 4/2
10
D
M
CL
10YR 5/6
30
CL
10-17
10 YR 5/2
60
10 YR 5/6
40
C
M
CL
RM=Reduced Matrix. MS=Masked Sand Grains.
Hydric Soil Indicators:
Histosol (Al)
❑ Histic Epipedon (A2)
❑ Black Histic (A3)
❑ Hydrogen Sulfide (A4)
❑ Stratified Layers (A5)
❑ 2 cm Muck (A10) (LRR N)
❑ Depleted Below Dark Surface (A11)
❑ Thick Dark Surface (Al2)
❑ Sandy Mucky Mineral (S1) (LRR N,
MLRA 147, 148)
❑ Sandy Gleyed Matrix (S4)
❑ Sandy Redox (S5)
❑ Stripped Matrix (S6)
Type:
Depth (inches):
Remarks:
2Location: PL=Pore Lining, M=Matrix.
Indicators for Problematic Hydric Sc
❑ Dark Surface (S7)
❑ 2 cm Muck (A10) (MLRA 147)
❑ Polyvaiue Below Surface (S8) (MLRA 147, 148)
❑ Coast Prairie Redox (A16)
❑ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
❑ Loamy Gleyed Matrix (F2)
❑ Piedmont Floodplain Soils (F19)
Depleted Matrix (F3)
(MLRA 136, 147)
❑ Redox Dark Surface (F6)
❑ Very Shallow Dark Surface (TF 12)
D Depleted Dark Surface (F7)
❑ Other (Explain in Remarks)
Redox Depressions (F8)
❑ Iron -Manganese Masses (F12) (LRR N,
MLRA 136)
❑ Umbric Surface (F13) (MLRA 136, 122) 'Indicators of hydrophytic vegetation and
❑ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
❑ Red Parent Material (F21) (MLRA 127,147) unless disturbed or problematic.
Hydric Soil Present? Yes ❑✓ No ❑
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
Project/Site: CF Steel City/County: Cabarrus Sampling Date: 04/05/2017
Applicant/Owner: **TBD"* State: NC Sampling Point: WA -6 (UPL)
Investigator(s): Chris Sheats & Lizzy Stokes -Cawley Section, Township, Range: Midland
Landform (hillslope, terrace, etc.): Hlllslope Local relief (concave, convex, noney Convex
Subregion (LRR or MLRA): LRR-P Lat: 35.247097 Long: -80.572825
- Slope (%): 10
Datum: NAD -83
Soil Map Unit Name: Herndon Silt Loam, 2-8% Slopes NWI classification: None
Are climatic / hMV
s conditions on the site typical for this time of year? Yes � v i No (If no, explain in Remarks.)
Are VegetationSoil l v i, or Hydrology significantly disturbed? NO Are "Normal Circumstances" present? Yes No ❑
Are VegetationSoil 0✓ , or Hydrology D naturally problematic? No (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes No Is
Is the Sampled Area ✓
Hydric Soil Present. Yes No ✓ within a Wetland? Yes 0 No 0
Wetland Hydrology Present? Yes = No=
Remarks:
HYDROLOGY
Wetland Hydrology Indicators:
Secondary Indicators (minimum of two reauired)
Primary Indicators (minimum of one is required: check all that apply)
❑ Surface Soil Cracks (136)
❑ Surface Water (Al) ❑ True Aquatic Plants (614)
❑ Sparsely Vegetated Concave Surface (138)
❑ High Water Table (A2) ❑ Hydrogen Sulfide Odor (Cl)
❑ Drainage Patterns (610)
❑ Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3)
[] Moss Trim Lines (1316)
❑ Water Marks (131) ❑ Presence of Reduced Iron (C4)
❑ Dry -Season Water Table (C2)
❑ Sediment Deposits (132) ❑ Recent Iron Reduction in Tilled Soils (C6)
❑ Crayfish Burrows (C8)
❑ Drift Deposits (133) ❑ Thin Muck Surface (C7)
❑ Saturation Visible on Aerial Imagery (C9)
❑ Algal Mat or Crust (134) ❑ Other (Explain in Remarks)
❑ Stunted or Stressed Plants (D1)
❑ Iron Deposits (135)
❑ Geomorphic Position (D2)
❑ Inundation Visible on Aerial Imagery (137)
❑ Shallow Aquitard (D3)
❑ Water -Stained Leaves (139)
❑ Microtopographic Relief (134)
❑Aquatic Fauna (1313)
❑ FAC -Neutral Test (D5)
Field Observations:
Surface Water Present? Yes Q No 0 Depth (inches): 0
Water Table Present? Yes ❑ No Q Depth (inches): 0
❑ ❑✓ 0
n
Saturation Present? Yes No Depth (inches):
Wetland Hydrology
Present? Yes No JZ1
includes capillary fringe)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Five Strata) - Use scientific names of plants.
CF -Steele
Sampling Point: WA -6 (UPL)
30'Rad.
Absolute Dominant Indicator
Dominance Test worksheet:
Tree Stratum (Plot size: )
% Cover Species? Status
Number of Dominant Species
1. Phyllostachys aurea
100 Yes NI
That Are OBL, FACW, or FAC: 0 (A)
2.
Total Number of Dominant
3.
Species Across AII Strata: 0 (B)
4.
Percent of Dominant Species
5.
That Are 013L, FACW, or FAC: 0 (A/B)
6.
100 = Total Cover
Prevalence Index worksheet:
50% of total cover: 50
20% of total cover: 20
Total % Cover of: Multiply by:
Sapling Stratum (Plot size: 30'Rad.
OBL species x 1 =
FACW species x 2 =
1.
FAC species x3=
2.
FACU species x4=
3.
UPL species x 5 =
4.
Column Totals: (A) (B)
5.
6•
Prevalence Index = B/A =
0 = Total Cover
Hydrophytic Vegetation Indicators:
50% of total cover: 0
20% of total cover: 0
❑ 1 - Rapid Test for Hydrophytic Vegetation
Shrub Stratum (Plot size: 30'Rad.
F-12 - Dominance Test is >50%
1.
❑ 3 - Prevalence Index is <_3.0'
2.
❑ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
3.
❑ Problematic Hydrophytic Vegetation' (Explain)
4.
5.
'Indicators of hydric soil and wetland hydrology must
6
be present, unless disturbed or problematic.
0 = Total Cover
Definitions of Five Vegetation Strata:
50% of total cover: 0
20% of total cover: 0
Herb Stratum (Plot size: 30'Rad. )
Tree - Woody plants, excluding woody vines,
approximately 20 ft (6 m) or more in height and 3 in.
1 •
(7.6 cm) or larger in diameter at breast height (DBH).
2.
Sapling - Woody plants, excluding woody vines,
3.
approximately 20 ft (6 m) or more in height and less
4.
than 3 in. (7.6 cm) DBH.
5.
Shrub - Woody plants, excluding woody vines,
6
approximately 3 to 20 It (1 to 6 m) in height.
7•
Herb -All herbaceous (non -woody) plants, including
g.
herbaceous vines, regardless of size, and woody
plants, except woody vines, less than approximately 3
9
it (1 m) in height.
10.
11.
Woody vine - All woody vines, regardless of height.
0 = Total Cover
50% of total cover: 0
20% of total cover: 0
Woody Vine Stratum (Plot size: 30'Rad. )
1. Wisteria sinensis
15 Yes NI
Hydrophytic
15
= Total Cover Vegetation
50% of total cover: 7.5 20% of total cover: 3
Present? Yes n Non
(Include photo numbers here or on a separate sheet.)
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0

SOIL
to the depth needed to document the indicator or confirm the absence of
CF -Steele
Sampling Point: WA -6 (UPL)
Depth Matrix Redox Features
(inches) Color (moist) % Color (moist) % Tvne Loc Texture Remarks
0-8 10 YR 4/4 100 CL Clay Loam
8-14 10YR 4/6 70
10 YR 5/3 30
RM=Reduced Matrix. MS=Masked Sand Grains.
CL
CL
Hydric Soil Indicators:
❑ Histosol (Al)
❑ Dark Surface (S7)
Indicators for Problematic Hydric Soils3:
❑ 2 cm Muck (At 0) (MLRA 147)
❑ Histic Epipedon (A2)
D Polyvalue Below Surface (S8) (MLRA 147, 148)
❑ Coast Prairie Redox (A16)
❑ Black Histic (A3)
❑ Thin Dark Surface (S9) (MLRA 147, 148)
(MLRA 147, 148)
❑ Hydrogen Sulfide (A4)
❑ Loamy Gleyed Matrix (F2)
�j Piedmont Floodplain Soils (F19)
❑ Stratified Layers (A5)
❑ Depleted Matrix (F3)
(MLRA 136, 147)
❑ 2 cm Muck (A10) (LRR N)
❑ Redox Dark Surface (F6)
❑ Very Shallow Dark Surface (TF12)
❑ Depleted Below Dark Surface (A11)
❑ Depleted Dark Surface (F7)
❑ Other (Explain in Remarks)
❑ Thick Dark Surface (Al2)
D Redox Depressions (F8)
❑ Sandy Mucky Mineral (S1) (LRR N,
❑ Iron -Manganese Masses (F12) (LRR N,
MLRA 147, 148)
MLRA 136)
❑ Sandy Gleyed Matrix (S4)
❑ Umbric Surface (F13) (MLRA 136, 122)
'Indicators of hydrophytic vegetation and
❑ Sandy Redox (S5)
[] Piedmont Floodplain Soils (F19) (MLRA 148)
wetland hydrology must be present,
❑ Stripped Matrix (S6)
❑ Red Parent Material (F21) (MLRA 127, 147)
unless disturbed or problematic.
Type:
Depth (inches):
Remarks:
Hydric Soil Present? Yes ❑ No ❑✓
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

Appendix C.
JD Request Form
Preliminary JD Form
CF Steel April 2017
JD Package Page 5

Jurisdictional Determination Request
US Army Corps
of Engineers
Wilmington District
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www. saw.usace.anny.mil/Missions/Rep-ulatorvPermitProgram/Contact/CountyLocator.aspx,
by calling 910-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CHARLOTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number. [phone]
Fax Number. [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number. [phone]
Fax Number. [phone]
WILMINGTON REGULATORY FIELD OFFICE
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
US Army Corps of Engineers
69 Darlington Avenue
3331 Heritage Trade Drive, Suite 105
Wilmington, North Carolina 28403
Wake Forest, North Carolina 27587
General Number: 910-2514633
General Number. [phone]
Fax Number. [phone]
Fax Number: [phone]
INSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Corps to
proceed with the determination, which may include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Department of Transportation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
may not be valid for the wetland conservation provisions of the Food Security Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, you should also request a certified wetland determination from the local
office of the Natural Resources Conservation Service, prior to starting work.
Version: May 2017 Page i

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: 12322 Old Camden Road
City, State:
Midland, NC 28107
County: Cabarrus
Parcel Index Number(s) (PIN): 55340823660000/5524983252001
B. REQUESTOR INFORMATION
Name: Larry Thompson
Mailing Address: PO Box 541
Telephone Number:
Midland, NC 28107
704-301-4881
Electronic Mail Address: [e-mail]
Select one:
nI am the current property owner.
✓❑ I am an Authorized Agent or Environmental Consultant'
Interested Buyer or Under Contract to Purchase
Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: Tim Liescheidt, PE
Mailing Address: P.O. Box 148
Oaksboro, NC 28129
Telephone Number: 704-516-1750
Electronic Mail Address: [e-mail]
' Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
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Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION',4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Larry Thompson
Print Name
Capacity: ❑ Owner ✓❑ Authorized Agents
June 23, 2017
Date
Digitally signed by Larry
Larry Thompson Thompson
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
rocess.
v I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
8 A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑ Other:
3 For NCDOT requests following the current NCDOTABACE protocols, skip to Part E.
a If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
s Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

Jurisdictional Determination Request
F. JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
17 I am requesting that the Corps provide a preliminary JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
F] I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter 05-
02).
F] I am unclear as to which JD I would like to request and require additional information
to inform my decision.
G. ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 25.5 acres.
❑✓ The property boundary (or review area boundary) is clearly physically marked on the site.
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Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
Project Coordinates (Decimal Degrees): Latitude: 35.247014
Longitude: -80.572795
0 A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than 11x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).'
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non -wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non -Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non -
jurisdictional upland features should be identified as Non -Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
■ Wetland and non -wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non -wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Re ug lato -Pry ermit-
Program/Jurisdiction/
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Jurisdictional Determination Request
Completed appropriate Jurisdictional Determination form
• PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
• AJDs• please complete an Approved Jurisdictional Determination Form'
✓❑ Vicinity Map
✓z Aerial Photograph
✓❑ USGS Topographic Map
r✓ Soil Survey Map
❑ Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
❑ Landscape Photos (if taken)
NCSAM and/or NCWAM Assessment Forms and Rating Sheets
NC Division of Water Resources Stream Identification Forms
❑✓ Other Assessment Forms
' www.saw.usace.army.mil/Portals/59/docs/re ug latory/reizdocs/JD/RGL 08-02 App A Prelim JD Form Tillable pdf
' Please see http://www.saw.usace.army.mil/Missions/Re ulatory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made available as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
A. REPORT COMPLETION DATE FOR PJD: June 23, 2017
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Larry Thompson, PO Box 541, Midland, NC 28107
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: CabarruS City: Concord
Center coordinates of site (fat/long in degree decimal format):
Lat.: 35.247014 Long.: -80.572795
Universal Transverse Mercator: 17S 538866,3900610
Name of nearest waterbody: UT t0 Far Branch
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date: June 23, 2017
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
W 1
35.247014
-80.572795
0. 19 acre
Wetland (Headwater Forest)
Section 404

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a
Nationwide General Permit (NWP) or other general permit verification requiring "pre -
construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) the
applicant has the right to request an individual permit rather than accepting the terms
and conditions of the NWP or other general permit authorization; (4) the applicant can
accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has
determined to be necessary; (5) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps permit
authorization based on a PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives any challenge to such jurisdiction in any administrative or judicial compliance
or enforcement action, or in any administrative appeal or in any Federal court; and (7)
whether the applicant elects to use either an AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, a proffered individual permit (and all terms
and conditions contained therein), or individual permit denial can be administratively
appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be" waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
❑■ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:
Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ 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: Midland, NC
❑ Natural Resources Conservation Service Soil Survey. Citation: Cabarrus County
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929)
❑ Photographs: ❑ Aerial (Name & Date):
or ❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Larry Thompson Digitally$19^�DyLerryThomP�"
Date: 2017.06.28 22:51:54 -04'00'
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
' Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.