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Home My WebLink AboutPJD_Pack_R5828 final 2.pdf5CmTmn °`"s"" ' °"4`O q�' � 2 u � c� .9�� .�,�� STATE OF NORTH CAROLINA DEPARTMENT OF TRANSPORTATION ROY COOPER GOVERNOR September 27, 2017 Mr. James Lastinger USACE 3331 Heritage Trade Drive, Suite 105 Wake Forest, North Carolina 27587 James. C.Lastinger@usace. army.mil SUBJECT: Dear Mr. Lastinger, JAMES H. TROGDON, III SECRETARY STIP Project Number R-5828 Roundabout construction at US 311 (N. Main Street) and SR 1918 (First Street) in Stokes County, WBS #47100.1.1 Enclosed is a draft Preliminary Jurisdictional Determination (PJD) package for your review, which includes the following attachments: ■ Figure 1 — Vicinity Map ■ Figure 2— USGS Quad Map ■ Figure 3 — Water Resources ■ Jurisdictional Determination Request Form NCDWR Wetland Rating Worksheets USACE Wetland Determination Data Forms ■ Preliminary JD Form Landowner property access notification letters have been mailed and include reference to the USACE site visit. In reference to page 11 of the JD Request Form, the GPS equipment utilized to locate features on this project was the Trimble� R1TM sub-meter accurate GPS receiver. The following table provides a summary of wetland characteristics for features within the project study area. No jurisdictional stream channels were located. Mailing Address.• NC DEPARTMENT OF TRANSPORTATION DIVISION 9 375 SILAS CREEK PARKWAY WINSTON-SALEM, NC 27127 Telephone.• (336) 747-7800 Fax: (336) 703-6693 Customer Service.• 1-877-368-4968 Website: www.ncdot.gov Location: 375 SILAS CREEK PARKWAY WINSTON-SALEM, NC 27127 Table 1. J Map ID WA WB urisdictional char: NCWAM Classification Bottomland Hardwood Forest Bottomland Hardwood Forest �cteristics of wetla� Hydrologic Classification Riverine Riverine ids in the study area NCDWR Wetland Rating 46 30 Total Area (ac.) 0.14 0.11 0.25 Please contact me at 336.747.7800 (aeuliss@ncdot.gov) or our consultant, Pete Stafford at 919.878.9560 (pstafford@rkk.com) if you have any questions or would like additional information. Sincerely, Amy Euliss, Division Environmental Officer NCDOT-Division 9 cc Davc Wanucha, DWR Amy Chapman, DWR Mark Pierce, RI{K . � + .� l/�� '�/�.�', ^'+''" + • + � _ _ �, ` ,1 � ,� a . N � �--_ J.,""`yr �,;;,_:� •�.'`�ac - .. r � • ._�. .t�l �`� .,, - �- '�,ti'I` ' � �' , . ' !� _ �`1t' �- -. 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'�J� , � �t�'� 31 1 � � ��i- l a � i � ,.;� '�:. � �v : � �' jifi `� , ' �'f/ � �� u�i� � :;., _ � ��_ . �c/.:F � -�� y w Q v .� /"�; ��-A •r -- �� ,M � �� i' �X, �� y t -q �� ,•` � ti'e.�-.' � _ , ` �',y'� s • ��T �f � '� y . ar :^..Jj 'k . yi�`� �i`- v � '1.7�� • +'�� .'. � � ��=%(� .: '� j - a�^ � �u - i �i � �- `s�- �. / �/ � af� . y�� ( . � � !� 3�-' " - .a�','�,` i _ �. _ �` _ � �� •7�r �i R � �f.� �' �,' , °�r�,��e �• ��a -�.x �!� ��y�'� �''� j,�` �' o ,' 1ooY 200 400 600 voorriic:�aoutvn�>er,�xrnii:vr��r �'�''� �,-' � ��- �' . Y� �• ''T. . 'r�� ' YT' Feet .�. Ta.4V5Pou7'nTTON ��d.:'Ll._� .� . .. L�.�.�r�f� '.� 6��.3,'� ♦ . �- � ,,� ,r� �� _..�. , , DIVISION 9 � ; , .;3`<� / . � -�1,�r '� A . T ��,`°` _ ` , , , _ ,3`, � ° . . '' � � f�' � ,. � '�! r�,}� � ,,. � �� ' � ST1P PROJECT: R-5828 f � :� � �� r �, '�" �� y� �; � +,w.,,� ��.Y , ADDITION OFAROUNDABOUT � :yr Legend IVTCRSECTION OF US 311 AND FIRST STRCET . �� .� �' ��, , � , �� ,� � i. _ � f� ,�' . .�' ��` ,.�` •�" � �,�;� 3 y �,� � � '' � StudyArea WaLNUT COVE - STOKCS COUVTY .� i �� ,e { "�f•.r � : �:� '� . r n�� ,� �� . � �' f.�r ��,�1 ; '� � ` � , j� f ' � _��yy`J� p,; *.�� Delineated Wetlands JURISDICTIONAL FEATURES FIGURE 3 WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region ProjecUSite: R"582$ City/County: Stokes County Sampling Date: 6/14/2017 ApplicanUOwner: NCDOT State: NC Sampling Point: WA Investigator(s): Pete Stafford Section, Township, Range: N/A Landform (hillslope, terrace, etc.): Floodplain Local relief (concave, convex, none): Concave Slope (%): Flat Subregion (LRR or MLRA): LRR-N Lat: 36.292543 Long: "$0.142588 Datum: NAD 83 Soil Map Unit Name: Clover fine sandy loam, 8 to 15 percent slopes NWI classification: PSS1 Are climatic / hydrologic conditions on the site typical for this time of year? Yes � No �(If no, explain in Remarks.) Are Vegetation �, Soil �, or Hydrology � significantly disturbed? No Are "Normal Circumstances" present? Yes �✓ No Q Are Vegetation D Soil �, or Hydrology � 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? Hydric Soil Present? Wetland Hydrology Present? Yes � No� Yes � No� Yes � No� Is the Sampled Area within a Wetland? Yes � No � Wetland hydrology, hydrophytic vegetation, and hydric soil are present at this location. HYDROLOGY Wetland Hydrology Indicators: Secondarv Indicators (minimum of two reauired) Primarv Indicators (minimum of one is reauired; check all that applv) � Surface Soil Cracks (B6) ❑✓ Surface Water (A1) ❑ True Aquatic Plants (614) ❑ Sparsely Vegetated Concave Surface (68) ❑✓ High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1) ❑✓ Drainage Patterns (B10) ❑✓ Saturation (A3) ❑✓ Oxidized Rhizospheres on Living Roots (C3) 0 Moss Trim Lines (B16) ❑ Water Marks (61) � Presence of Reduced Iron (C4) ❑ Dry-Season Water Table (C2) ❑ Sediment Deposits (B2) � Recent Iron Reduction in Tilled Soils (C6) ❑ Crayfish Burrows (C8) ❑ Drift Deposits (B3) � Thin Muck SurFace (C7) ❑ Saturation Visible on Aerial Imagery (C9) ❑ Algal Mat or Crust (B4) � Other (Explain in Remarks) ❑ Stunted or Stressed Plants (D1) ❑ Iron Deposits (65) ❑✓ Geomorphic Position (D2) ❑ Inundation Visible on Aerial Imagery (B7) � Shallow Aquitard (D3) ❑✓ Water-Stained Leaves (B9) � Microtopographic Relief (D4) ❑ Aquatic Fauna (B13) � FAC-Neutral Test (D5) Field Observations: Surface Water Present? Yes �✓ No Depth (inches): 2 Water Table Present? Yes ✓ No Depth (inches): � Saturation Present? Yes ✓ No Depth (inches): � Wetland Hydrology Present? Yes � No� includes ca illa frin e Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available: Remarks: Wetland hydrology present at this location. US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 VEGETATION (Four Strata) — Use scientific names of plants. Sampling Point: WA Absolute Dominant Indicator pominance Test worksheet: Tree Stratum (Plot size: � 000 sq. ft. � °/a Cover Species? Status Number of Dominant Species � Salix nigra 5 n1� �B� That Are OBL, FACW, or FAC: 6 (A) 2 Acer rubrum 25 YgS FAC Total Number of Dominant 3• Species Across All Strata: 6 (B) 4. Percent of Dominant Species 5• That Are OBL, FACW, or FAC: � OO.00% �,q�g� �l 50% of total cover: 15 Saplina/Shrub Stratum (Plot size: 1000 sq. ft. � � Acer rubrum 2 Carpinus caroliniana 4. 5. 6. 7. 9. 50% of total cover: 15 Herb Stratum (Plot size: 1000 sq. ft. � � Peltandra virginica 2 Carex sp. 3 Polygonum pensylvanicum 4 Impatiens capensis 5 Cinna arundinacea 6 Microstegium vimineum 7. 8. 9. 10. 11. 50% of total cover: so Woodv Vine Stratum (Plot size: 1000 sq. ft. � � Smilax rotundifolia 2. 3. 50% of total cover: 7•5 30 = Total Cover 20% of total cover: 6 20 Yes FAc � o Yes Fac 30 = Total Cover 20°/a of total cover: 6 15 15 10 5 25 50 No No No No Yes Yes �zo - Total Cover 20% of total cover: 24 OBL N/A FACW FACW FACW FAC 15 Yes FAc 15 = Total Cover 20% of total cover: 3 Remarks: (Include photo numbers here or on a separate sheet.) Hydrophytic vegetation present at this location. Prevalence Index worksheet: Total % Cover of: Multiplv bv: OBL species x 1 = � FACW species x 2 = ° FAC species x 3 = � FACU species x 4 = � UPL species x 5 = ° Column Totals: � (A) � (B) Prevalence Index = B/A = ❑ 1- Rapid Test for Hydrophytic Vegetation ❑✓ 2 - Dominance Test is >50°/a ❑ 3- Prevalence Index is 53.0' ❑ 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. Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or more in diameter at breast height (DBH), regardless of height. SaplinglShrub — Woody plants, excluding vines, less than 3 in. DBH and greater than or equal to 3.28 ft(1 m) tall. Herb — All herbaceous (non-woody) plants, regardless of size, and woody plants less than 3.28 ft tall. Woody vine — All woody vines greater than 3.28 ft in Hydrophytic Vegetation Present? Yes No � US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 SOIL Sampling Point: WA Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.) Depth Matrix Redox Features (inchesl Color (moistl % Color (moistl % Tvpe, Loc Texture Remarks 0-5 10YR 5/1 70 7.5YR 5/6 30 C PL Silt Loam 5-16+ 10YR 4/1 90 7.5YR 5/6 'Type: C=Concentration, D=Depletion, Hydric Soil Indicators: [] Histosol (A1) 0 Histic Epipedon (A2) 0 Black Histic (A3) 0 Hydrogen Sulfide (A4) �I Stratified Layers (A5) L] 2 cm Muck (A10) (LRR N) [] Depleted Below Dark Surface (A11; [] Thick Dark Surface (Al2) L] Sandy Mucky Mineral (S1) (LRR N, MLRA 147, 148) ❑ Sandy Gleyed Matrix (S4) � Sandy Redox (S5) � Stripped Matrix (S6) Restrictive Layer (if observed): Type: Depth (inches): Remarks: RM=Reduced 1 � C PL Sandy Clay Loam MS=Masked Sand Grains. ZLocation: PL=Pore Lining, M=Matrix. Indicators for Problematic Hydric Sc Q Dark Surface (S7) � 2 cm Muck (A10) (MLRA 147) 0 Polyvalue Below Surface (S8) (MLRA 147, 148) 0 Coast Prairie Redox (A16) � Thin Dark Surface (S9) (MLRA 147, 148) (MLRA 147, 148) � Loamy Gleyed Matrix (F2) 0 Piedmont Floodplain Soils (F19) p Depleted Matrix (F3) (MLRA 136, 147) � Redox Dark Surface (F6) 0 Very Shallow Dark Surface (TF12) � Depleted Dark Surface (F7) � Other (Explain in Remarks) � Redox Depressions (F8) 0 Iron-Manganese Masses (F12) (LRR N, MLRA 136) 0 Umbric Surface (F13) (MLRA 136, 122) 0 Piedmont Floodplain Soils (F19) (MLRA 148) D Red Parent Material (F21) (MLRA 127, 147) Hydric soils present at this location. 3lndicators of hydrophytic vegetation and wetland hydrology must be present, 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 ProjecUSite: R"582$ City/County: Stokes County Sampling Date: 6/14/2017 ApplicanUOwner: NCDOT State: NC Sampling Point: WB Investigator(s): Pete Stafford Section, Township, Range: N/A Landform (hillslope, terrace, etc.): Floodplain Local relief (concave, convex, none): Concave Slope (%): Flat Subregion (LRR or MLRA): LRR-N Lat: 36.2927132 Long: "$0.1403789 Datum: NAD 83 Soil Map Unit Name: Dan River and Comus soils, 0 to 4 percent slopes, occasionally flooded NWI classification: N/A Are climatic / hydrologic conditions on the site typical for this time of year? Yes ✓� No �(If no, explain in Remarks.) Are Vegetation �, Soil �, or Hydrology � significantly disturbed? No Are "Normal Circumstances" present? Yes �✓ No Q Are Vegetation D Soil Q, or Hydrology � 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? Hydric Soil Present? Wetland Hydrology Present? Yes � No� Yes � No� Yes � No� Is the Sampled Area within a Wetland? Yes � No � Wetland hydrology, hydrophytic vegetation, and hydric soil are present at this location. HYDROLOGY Wetland Hydrology Indicators: Secondarv Indicators (minimum of two reauired) Primarv Indicators (minimum of one is reauired; check all that applv) � Surface Soil Cracks (B6) ❑ Surface Water (A1) ❑ True Aquatic Plants (614) ❑ Sparsely Vegetated Concave Surface (68) ❑ High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1) ❑✓ Drainage Patterns (B10) ❑ Saturation (A3) ❑✓ Oxidized Rhizospheres on Living Roots (C3) 0 Moss Trim Lines (B16) ❑ Water Marks (61) � Presence of Reduced Iron (C4) ❑ Dry-Season Water Table (C2) ❑ Sediment Deposits (B2) � Recent Iron Reduction in Tilled Soils (C6) ❑ Crayfish Burrows (C8) ❑ Drift Deposits (B3) � Thin Muck SurFace (C7) ❑ Saturation Visible on Aerial Imagery (C9) ❑ Algal Mat or Crust (B4) � Other (Explain in Remarks) ❑ Stunted or Stressed Plants (D1) ❑ Iron Deposits (65) ❑✓ Geomorphic Position (D2) ❑ Inundation Visible on Aerial Imagery (B7) � Shallow Aquitard (D3) ❑✓ Water-Stained Leaves (B9) � Microtopographic Relief (D4) ❑ Aquatic Fauna (B13) � FAC-Neutral Test (D5) Field Observations: Surface Water Present? Yes � No ✓ Depth (inches): NiA Water Table Present? Yes No ✓ Depth (inches): N�A Saturation Present? Yes No ✓ Depth (inches): N�A Wetland Hydrology Present? Yes � No� includes ca illa frin e Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available: Remarks: Wetland hydrology present at this location. US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 VEGETATION (Four Strata) — Use scientific names of plants. Sampling Point: WB Absolute Dominant Indicator pominance Test worksheet: Tree Stratum (Plot size: N/A ) °/a Cover Species? Status Number of Dominant Species 1. That Are OBL, FACW, or FAC: 5 (A) 3. 4. �l 50% of total cover: ° Saplina/Shrub Stratum (Plot size: 1000 sq. ft. � � Acer rubrum 2 Acer negundo 3 Fraxinus pennsylvanica 4. 5. 6. 7. 9. 50% of total cover: 30 Herb Stratum (Plot size: 1000 sq. ft. � � Juncus effusus 2 Carex sp. 3 Bidens frondosa 4 Rubus argutus 5 T�erbesina alternifolia 6 Microstegium vimineum 7. 8. 9. 10. 11. 50% of total cover: ss Woodv Vine Stratum (Plot size: 1000 sq. ft. � � Smilax rotundifolia 2. 3. 50% of total cover: 7•5 ° = Total Cover 20% of total cover: ° 20 Yes FAc zo Yes FAc zo Yes Facw so = Total Cover 20°/a of total cover:12 35 25 5 25 10 10 Yes Yes No Yes No No ��o = Total Cover 20% of total cover: 22 FACW N/A FACW FACU FAC FAC 15 Yes FAc 15 = Total Cover 20% of total cover: 3 Remarks: (Include photo numbers here or on a separate sheet.) Hydrophytic vegetation present at this location. Total Number of Dominant Species Across All Strata: 7 (B) Percent of Dominant Species 71.43% That Are OBL, FACW, or FAC: (A/B) Prevalence Index worksheet: Total % Cover of: Multiplv bv: OBL species x 1 = � FACW species x 2 = ° FAC species x 3 = � FACU species x 4 = � UPL species x 5 = ° Column Totals: � (A) � (B) Prevalence Index = B/A = ❑ 1- Rapid Test for Hydrophytic Vegetation ❑✓ 2 - Dominance Test is >50°/a ❑ 3- Prevalence Index is 53.0' ❑ 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. Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or more in diameter at breast height (DBH), regardless of height. SaplinglShrub — Woody plants, excluding vines, less than 3 in. DBH and greater than or equal to 3.28 ft(1 m) tall. Herb — All herbaceous (non-woody) plants, regardless of size, and woody plants less than 3.28 ft tall. Woody vine — All woody vines greater than 3.28 ft in Hydrophytic Vegetation Present? Yes No � US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 SOIL Sampling Point: WB Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.) Depth Matrix Redox Features (inchesl Color (moistl % Color (moistl % Tvpe, Loc Texture Remarks 0-5 10YR 5/2 90 7.5YR 6/6 10 C PL Clay Loam 5-16+ 10YR 4/2 70 10YR 4/4 'Type: C=Concentration, D=Depletion, Hydric Soil Indicators: [] Histosol (A1) 0 Histic Epipedon (A2) 0 Black Histic (A3) 0 Hydrogen Sulfide (A4) �I Stratified Layers (A5) L] 2 cm Muck (A10) (LRR N) [] Depleted Below Dark Surface (A11; [] Thick Dark Surface (Al2) L] Sandy Mucky Mineral (S1) (LRR N, MLRA 147, 148) ❑ Sandy Gleyed Matrix (S4) � Sandy Redox (S5) � Stripped Matrix (S6) Restrictive Layer (if observed): Type: Depth (inches): Remarks: RM=Reduced 30 C M MS=Masked Sand Grains. Sandy Clay Loam ZLocation: PL=Pore Lining, M=Matrix. Indicators for Problematic Hydric Soils3: Q Dark Surface (S7) � 2 cm Muck (A10) (MLRA 147) 0 Polyvalue Below Surface (S8) (MLRA 147, 148) 0 Coast Prairie Redox (A16) � Thin Dark Surface (S9) (MLRA 147, 148) (MLRA 147, 148) � Loamy Gleyed Matrix (F2) � Piedmont Floodplain Soils (F19) p Depleted Matrix (F3) (MLRA 136, 147) � Redox Dark Surface (F6) 0 Very Shallow Dark Surface (TF12) � Depleted Dark Surface (F7) � Other (Explain in Remarks) � Redox Depressions (F8) 0 Iron-Manganese Masses (F12) (LRR N, MLRA 136) 0 Umbric Surface (F13) (MLRA 136, 122) 0 Piedmont Floodplain Soils (F19) (MLRA 148) D Red Parent Material (F21) (MLRA 127, 147) Hydric soils present at this location. 3lndicators of hydrophytic vegetation and wetland hydrology must be present, 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 ProjecUSite: R"582$ City/County: Stokes County Sampling Date: 6/14/2017 ApplicanUOwner: NCDOT State: NC Sampling Point: WA, WB-Upland Investigator(s): Pete Stafford Section, Township, Range: N/A Landform (hillslope, terrace, etc.): Upland Local relief (concave, convex, none): N�'4 Slope (%): 2-5 Subregion (LRR or MLRA): LRR-N Lat: 36.292673 Long: "$0.140816 Datum: NAD 83 Soil Map Unit Name: Dan River and Comus soils, 0 to 4 percent slopes, occasionally flooded NWI classification: Are climatic / hydrologic conditions on the site typical for this time of year? Yes ✓� No �(If no, explain in Remarks.) Are Vegetation �, Soil �, or Hydrology � significantly disturbed? No Are "Normal Circumstances" present? Yes �✓ No Q Are Vegetation D Soil Q, or Hydrology � 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? Hydric Soil Present? Wetland Hydrology Present? Yes � No� Yes � No� Yes � No� Is the Sampled Area within a Wetland? Yes � No � Wetland hydrology, hydrophytic vegetation, and hydric soil are not present at this location. HYDROLOGY Wetland Hydrology Indicators: Secondarv Indicators (minimum of two reauired) Primarv Indicators (minimum of one is reauired; check all that applv) � Surface Soil Cracks (B6) ❑ Surface Water (A1) ❑ True Aquatic Plants (614) ❑ Sparsely Vegetated Concave Surface (68) ❑ High Water Table (A2) ❑ Hydrogen Sulfide Odor (C1) ❑ Drainage Patterns (B10) ❑ Saturation (A3) ❑ Oxidized Rhizospheres on Living Roots (C3) 0 Moss Trim Lines (B16) ❑ Water Marks (61) � Presence of Reduced Iron (C4) ❑ Dry-Season Water Table (C2) ❑ Sediment Deposits (B2) � Recent Iron Reduction in Tilled Soils (C6) ❑ Crayfish Burrows (C8) ❑ Drift Deposits (B3) � Thin Muck SurFace (C7) ❑ Saturation Visible on Aerial Imagery (C9) ❑ Algal Mat or Crust (B4) � Other (Explain in Remarks) ❑ Stunted or Stressed Plants (D1) ❑ Iron Deposits (65) ❑ Geomorphic Position (D2) ❑ Inundation Visible on Aerial Imagery (B7) � Shallow Aquitard (D3) ❑ Water-Stained Leaves (B9) � Microtopographic Relief (D4) ❑ Aquatic Fauna (B13) � FAC-Neutral Test (D5) Field Observations: Surface Water Present? Yes � No Depth (inches): NiA Water Table Present? Yes No Depth (inches): N�A Saturation Present? Yes No Depth (inches): N�A Wetland Hydrology Present? Yes � No� includes ca illa frin e Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available: Remarks: Wetland hydrology not present at this location. US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 WA, WB - Upland VEGETATION (Four Strata) — Use scientific names of plants. Sampling Point: Absolute Dominant Indicator pominance Test worksheet: Tree Stratum (Plot size: N/A ) °/a Cover Species? Status Number of Dominant Species 1. That Are OBL, FACW, or FAC: � (A) 3. 4. �l 50% of total cover: ° Saplina/Shrub Stratum (Plot size: N/A � 1. 2. 4. 5. 6. 7. 9. 50% of total cover: ° Herb Stratum (Plot size: 3000 sq. ft. � � Festuca paradoxa 2 Trifolium repens 4. 5. 6. 7. 8. 9. 10. 11. 50% of total cover: so Woodv Vine Stratum (Plot size: 3000 sq. ft. � � Lonicera japonica 2. 3. 50% of total cover: 2.5 ° = Total Cover 20% of total cover: ° � = Total Cover 20°/a of total cover: ° eo Yes Fac eo Yes Facu �oo - Total Cover 20% of total cover: 20 s Yes FACU 5 = Total Cover 20% of total cover:' Remarks: (Include photo numbers here or on a separate sheet.) Hydrophytic vegetation not present at this location. Total Number of Dominant Species Across All Strata: 3 (B) Percent of Dominant Species 33.33% That Are OBL, FACW, or FAC: (A/B) Prevalence Index worksheet: Total % Cover of: Multiplv bv: OBL species x 1 = � FACW species x 2 = ° FAC species x 3 = � FACU species x 4 = � UPL species x 5 = ° Column Totals: � (A) � (B) Prevalence Index = B/A = ❑ 1- Rapid Test for Hydrophytic Vegetation ❑ 2 - Dominance Test is >50°/a ❑ 3- Prevalence Index is 53.0' ❑ 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. Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or more in diameter at breast height (DBH), regardless of height. SaplinglShrub — Woody plants, excluding vines, less than 3 in. DBH and greater than or equal to 3.28 ft(1 m) tall. Herb — All herbaceous (non-woody) plants, regardless of size, and woody plants less than 3.28 ft tall. Woody vine — All woody vines greater than 3.28 ft in Hydrophytic Vegetation Present? Yes No � US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 SOIL Sampling Point: WA, WB - Upland Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators. Depth Matrix Redox Features (inchesl Color (moistl % Color (moistl % Tvpe, Loc Texture Remarks 0-16+ 10YR 4/6 100 Clay Loam 'Type: C=Concentration, D=Depletion, Hydric Soil Indicators: [] Histosol (A1) 0 Histic Epipedon (A2) 0 Black Histic (A3) 0 Hydrogen Sulfide (A4) �I Stratified Layers (A5) L] 2 cm Muck (A10) (LRR N) [] Depleted Below Dark Surface (A11; [] Thick Dark Surface (Al2) L] Sandy Mucky Mineral (S1) (LRR N, MLRA 147, 148) ❑ Sandy Gleyed Matrix (S4) � Sandy Redox (S5) � Stripped Matrix (S6) Restrictive Layer (if observed): Type: Depth (inches): Remarks: RM=Reduced Matrix, MS=Masked Sand Grains. ZLocation: PL=Pore Lining, M=Matrix. Indicators for Problematic Hydric Soils3: Q Dark Surface (S7) 0 Polyvalue Below Surface (S8) (MLRA 147, 148) � Thin Dark Surface (S9) (MLRA 147, 148) � Loamy Gleyed Matrix (F2) p Depleted Matrix (F3) � Redox Dark Surface (F6) � Depleted Dark Surface (F7) � Redox Depressions (F8) 0 Iron-Manganese Masses (F12) (LRR N, MLRA 136) 0 Umbric Surface (F13) (MLRA 136, 122) 0 Piedmont Floodplain Soils (F19) (MLRA 148) D Red Parent Material (F21) (MLRA 127, 147) Hydric soils not present at this location. � 2 cm Muck (A10) (MLRA 147) 0 Coast Prairie Redox (A16) (MLRA 147, 148) � Piedmont Floodplain Soils (F19) (MLRA 136, 147) 0 Very Shallow Dark Surface (TF12) � Other (Explain in Remarks) 3lndicators of hydrophytic vegetation and wetland hydrology must be present, unless disturbed or problematic. Hydric Soil Present? Yes a No � US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0 WA WETLAND RATING WORKSHEET Fourth Version Project Name R-ss2s County Stokes Name of evaluator Pete Stafford Wetland location on pond or lake ✓ on perennial stream on intermittent stream within interstream divide other: Nearest Road us s„ Wetland area ��14 acres Wetland width 3s Date 6/14/2017 Adjacent land use within 1/2 mile upstream, upslope, or radius) ✓ forested/natural vegetation 20 % ✓ agriculture, urban/suburban 60 % ✓ impervious surface 20 % Clover fine sandy loam, 8 to 15 percent Soil series: slopes Dominant vegetation Qpredominantly organic - humus, muck, or (1) Microstegiumvimineum peat �✓ predominantly mineral - non-sandy _ predominantly sandy �H draulic factors steep topography ditched or channelized total wetland width > 100 feet Wetland t pe (select one)� ✓ Bottomland hardwood forest Headwater forest Swamp forest Wet flat Pocosin Bog forest (21 Acer rubrum .. �3� Cinna arundinacea feet Flooding and wetness Q semipermanently to permanently flooded or inundated ✓ seasonally flooded or inundated intermittently flooded or temporary surface water no evidence of flooding or surface water Pine savanna Freshwater marsh Bog/fen Ephemeral wetland Carolina bay Other: ` The rating system cannat be applied to salt or brackish marshes or stream channels -------------------------------------- = R Water storage s x 4. QO =� 2 � A Bank/Shoreline stabilizativn , X 4 Qq =� Wetland j rating � T Pollutant removal 3 i* K S.O� _ � 5 I Wildlife habitat s K 2,p0 — 0 �� N A q u ati c lif e � a l u e � x 4. U Q = 0 G Recreatian/Education , x 1.UQ = 0 =** Add i paint if in sensiti�e watershed and �10% nonpaint source disturbance within'/z mile npstream, upslape, or radius WETLAND RATING WORKSHEET Fourth Version Project Name R-ss2s County Stokes Wetland area �_� � Name of evaluator Pete Stafford Wetland location on pond or lake ✓ on perennial stream on intermittent stream within interstream divide other: Dan River and Comus soils, 0 to 4 percent Soil series' slopes, occasionally flooded Q predominantly organic - humus, muck, or peat �✓ predominantly mineral - non-sandy _ predominantly sandy �H draulic factors steep topography ditched or channelized total wetland width > 100 feet Wetland t pe (select one)� ✓ Bottomland hardwood forest Headwater forest Swamp forest Wet flat Pocosin Bog forest Nearest Road SR 1918 acres Wetland width 30 Date 6/14/2017 Adjacent land use within 1/2 mile upstream, upslope, or radius) ✓ forested/natural vegetation 20 % ✓ agriculture, urban/suburban 50 % ✓ impervious surface 30 % Dominant vegetation (1) Juncus effusus (21 Rubus argustus .� �3) Carexsp. � feet Flooding and wetness Q semipermanently to permanently flooded or inundated seasonally flooded or inundated intermittently flooded or temporary surface water ✓ no evidence of flooding or surface water Pine savanna Freshwater marsh Bog/fen Ephemeral wetland Carolina bay Other: ` The rating system cannat be applied to salt or brackish marshes or stream channels -------------------------------------- = R Water storage 2 x 4.Q0 = s� � A Bank/Shoreline stabilizativn o X 4.Qp =� Wetland j rating � T Pollutant removal 3 i* K S.O� _ � 5 I Wildlifehabitat 2 K 2'pq _� �� N Aquatic life �alue 1 x 4.UQ = 0 G Recreatian/Education , x 1.UQ = 0 =** Add i paint if in sensiti�e watershed and �10% nonpaint source disturbance within'/z mile npstream, npslape, or radius J�ri�diet�or�a� D�termination �tequest 0 US A�vny Corps ot �ngineers �A�dir. n�in�� Gisvn'� This fa� is intenc�ed f�r eise; by anyo2l� rec�ucstin� a jurisdictional d��crr�ination (JD) fr�rn the U.S. Army C'orps oi� Engir��er�, Wulrnuax��n Disqc-iet (Coc�s}. PAease rnc�ude a➢l su��+�+rtin� inf�rm�tion, as d�s�:ribed wittiin eai:h categoa-y, witlti your request. You may submit yQup r�auesx to th� appro�riate Corps Field C�ffic�. (�r praject rt�an�ger, if knowrr) via �nail, �llectronoc ma'tl, op facsin-►ile_ A c�nrrer�t l�st of cc�ui�ty assigr�ments 6y Fie1d �ffice a�ld �pr�aject manager can be found o�-lir�� al: �l��rp•'''�w��tiv ,a�� us�r� �nr�v r��i�lIlrii�sions�Rc:��ulat�orvPe__rn�itPrc��'�m.as�x , by t�:lephoninb: 91U-45 �-��i33, or by c�rn¢accdn� any of the tiel� ofiices listed belaw: as��:v��.i.f. �Fc��i..��zv nr�.n c��r•tcr LS Army t_'orPS c�f Esa�rncca-s 1� I Pattan A��enuc, Rr�om 2�18 Aslievall�e, '�urili Carulana 2ii$Q l -aClUci Ger��;ral �lumbcr: (K2�3) ?71-74:�f1 Fflx :�IuRrb�r: f 828} 2� I-�t 1 ZI} ltt�►(.k.l[;H 1'tEGl�LA1"OFtY` �I��,D OFFlCt: �1S :Amiy Cor}�, of �ngineers 33 + 1 I[erita�e Trac�c Drive. Suite 1 Il? l'�'akc �aresc. North C'aroliraa Z7557 rcnei��l V��tnbcr: {4lH) i�.�-•�8R4 Fax'�usnber: IQ19� �62-04r1 u'n�s�ii�c'ro� [��:cui..��rott�� Ft�:�.� or�icF- Uti Artny Cc�rps uf Lt��ir�eer� _'��17 V1r�.til Fltth Sl�z�t Vw'ashin�;tun. 1Vorth Ca�roli�ta �7Q8y C'ieneral Numher: f410)2�1-�blfl F:�s IVu�i�ber� (?i?) �)7�_i3�9 LVIi.MI�IGTOti REGULATORY �'IELD OFFICE [�S Arn�y C�rps ui� Gu�in�:�rs b4 17arli�gtc�n A��nue Wilmiiigtan. lvnnh �'ara9iz�a 2K403 C'rcneral Nurnb�r: 91 �f-2� 1-4�i33 �zx Numbcr: l� L 01 251-�1f??S Versi�n: December 2013 P�g� 1 J�r��dactional I�etermin�tiot� Reques� INSTRUCTIa�S: All requestors rr�ust cor�tipl�te F�rts A, B, C, D, E a�d �. N�JT� T'C) C+[��I5LJLTANTTS .�1NQ AG�N�C�ES: Ifi yc,t� �re rec��esting a.iD �on bet�al�� of a paying clier�� or your agency, p�ease rt�tc t�e specific st��rriittal rLquiremer�ts irs Part G. N�TE QN PAItT D— PR{)P�RT�' �W�IE� Ai�Td-T�QRIZAT��N: POease be aw�ar� ��t all .�D� r�quests rnust include che cu�ent �r�pe�ty �aw¢�er �utfll�rization f�r the +C'orps t� praceed with tt�e det�rmina�tic�n, which may imcl��cie inspeeti�n o� the �ropert� wher� toecessa�ry. Th�s fa� must be si ,ned by tlie c�uTent pro�serty c�um�r to be corasideret� a complete request. N�TC �;�] PA�RT Q- NCI��T �EQUESTS: Property owner autl�orization/r�otifie�tion fc�r JD reque�ts asso�i�ted with l�c�rth CarcaDina D�p�rtrr�ent o�Traa�sportation �NCD[)T) projects will' be conduct�d accardi�� to t31e. curr�� NCDt}TI[15A+CE �r�tocol�. N4T� T� USi�f� PROGI�M FAEtT1CIP"�"4NT�: l� Coi-�s approv�ed Qr prelirninary 7D may na2 be val�d for the wet3an� consei`�•a¢ion provisior�s �f xl�e F�c�c�r� Security Act af ��?85. Z� yau or yous ten�nt �� LIS�A Pr��ram �articipants. ��r antici�ate participatiort in �[1SDA prc��ra�s, y�o� shou�d also eequest a c�:rti�ied wetland dzt�rrni��atian from the local otfce c�f R�e Nat�ral R�sour�es Conserr�ation Serugce, �ruar to startin� work. Versiors: i�ecem4�er 2�13 Page 2 I:� � 1ur�sc�ictio��l Det�r�inatian �tequ��st 'PARC�L I`�'(��MAT1�3N Sit'ee.t Add�ess: � +� �+ �+a�^ s�Tcer �C'ity, S�ate: w�i�,�� co�e. r�c z�osz � o ur�ty: s��s Dirzctions: s�� }�"�Q Pa�cel Index �1umb�r(s) (FII'�f ]: �Ef�iJESTOR [I�iFQRN�A"FiO�i NrA N21ITie: Amy Euliss �S11111� ,r�'1(�C�1"CSS: NCC10T Di+nsuon 9• 375 Silas Creek Parkway Winsio�i Sa4em. 27527 Telephane Alunlbec_ c��sa ��a� �soo ��e�l7di11� ��! � .�.ddi'�55 � ; aeul�ss@ncdot.g�v S�deCt 011�: � ! a�i the currea�t praper�y o�vn�r. � 1 am a�r� Author�zed A��.nt or Eo�vironmen�al Cc�nsulta►7c` ❑ [�cerzsted Buyer �or Und�r �ontra�t t� Purchase �, C7ther, ple�se exp�ain. NQrth �arolina �epartment at Transportat9on r��,arding �Proyecz RVo. R-5828 PR�PERTY OWN�I� INFQRMA'I'1QN � a��: 5�re Attachment �vfasling Adrlress� Tc:�ephonc Numl�er: Ele�:trar�ic Mail Addu�essi: � Proof of �Qwnership At�ached {e.g. a copy oi Deed, Cc�unty �ISIParcel/Tax Rccord tla�a) 1 Vf available z Must attach completed Agenfi Authvrizatia�o Farm � If auailable �Version: []�eem�er 2U13 -- Page 3 Juri�dictio�a� De�era��na�i�n Re�q�i��t D. PROPERTY �OW�� t �ER�IFICATI(lN� �, th� �ndea'yi�;-�ted, a duly autlt�7razed' own�r ot recor� �t tlie pra�aertylp��rerties id�n2itied herein, d� autl��r�x� rtpresentaEives c�f the W�lra�in�ton �istr�ct, �J.S. Aert�y C'orps of Ensineers (C"arps) ko e�tcs- �po� tkYe pr�per�y hc:rcirs de�crib�u� fe�r tlz� p�r�ose af c�ncYuct�n,� �t�-sit�, tinvesti�ations and assu�n� a deterr�tii�atyon assocaateci warth Wciter� at �he LJ.S. su@�j�ct �o'Federal jurisdiction under 5c:ction 4�4 �f th� Clean'+�►�ater Act an�ilor Se�:tioc� 1(l af' lhe Rivers and �-iarbors A�t ot V $99. �'roperty Owne� (�l��se pri�►t) Date Pr�perty Owner Signature E. ,�URISDtCTIONAL iD�TE�P►�1N�T1�N TYPE S�➢ect �On�: � 1 am requestin� that ch� C��rps provicYe a pr•elirminarv -9� fi�r ti�e pr+�pert� ia�ntifi�d herein T�ris request d��s include. a delin�;ati��n. � I am rcquest'sn� tl�at tt�e �Ce�rps pr�vide- ��reiim�narv JD for d�e �aroperty identi�ied hereitt_ Tl�is req�e�t daes N{�'(' incl�u�ie a de�ii�eafu�yn. � I am rec�uestin� i�at �th� Co�ps investi�ac�. rhe proJ�erty/prc3�e�t area for th� p�esett�� ar absence of WoUS� anci �rc�vicf� an �nr�v�ti_J77� f�rr tlle praperty �de�tilicd'herein_ This request dc�es NQT ir�clude � req�uc,st for a verifi�.d d�liraeatian. � I am req�estir�g that the Corps d�lin�ate the buun�aries af aIM WoUS on a property/pro,ject area and provide an ��•�ved �!D (this may �r ralay r�ok include � survey plai), i� I am req;uesting th�t th� C'�zps eva3uate and a�prove a delic�eation of WaU� {eonducted b}r othersl on a}�rc�pea�4ylpro�ect area and provide an an�ro^ved JU �.may c+r �ay �ot incl�de a survey plat). �` For NCG+S3T requests followirtg the current N[DOTJIJ�ACE protoco�s, skip to Part �, ; Vhlaters a# the United States Versio�r: Decerr�ber 2b�3 i'a�e 4 Jurisdictionai �eterr�ina�ian �equest F. �LL REf�UC'�TS � �4iap of E'roperty or Praject Area �att�ched}. Th�s 1��Ia�+ m�ist cl�arly cl��aie;t thc bc�utac�aries ��t'th� area of ev�iva�i�n. � Size of Pr�per�y or Proje�t Ar�,a �� acr�s III verify Chat t�he prc��cr�y l�c }�roject) E��wnda�'eLs have �ec��rtily �eer� survey�d and rraarked by a li�ensed lared s�rveyor� QfZ are utherw�is� cleariy markzd c�r disticYguishabl�. �. JD �E¢UESTS F°�i0':V[ CONSLTL'1'AN'�'S Cl�R AGENCTES � I ) Preliminary ,�D Req�ests: a�Can�pBeted and si�aed Prel�mi�arv .Furisclict�o�Yal Detem�indtian Foran"'. 3�6.292649 Lalitu�f� -�0.1403�� Lonabtu�d� �✓ Pr�y�ct �u�rdes�ates: � Maps Qnc� lar�ir than o➢xf 7} wi�h Progect ��ndary �verlay; � Lar�e and small scale rnaps that depiet, aa. minir�um: st�eets, intersec�i�ns, �owns �✓ Aeria➢ Ph�to�raphy of c��e prajeet area �✓ �JSGs TnpograPlli�: Map �! S�il Surve.y Ma�� ' �ther MaFs, as appropriate (e.g. Nat��a1 Wetland lnventory Map, Pro�osed Site Plan. �pre��iaus del��eation tna��, L�AR ma�s. FE�'lA floodpla�n r�taps� � 5ee A�pendix A af this C-arrn. From Regulatory Guidar�ce �Letter Na. 08-0�, datett lune 26, �008 Versian: Decernber 2013 �a�� J�risdie�ior�a� Deterrnination Request [�elineation [nfor�roats�n (�vhe�� app1ical��e)7: ��t1��5: � 'JJetland Data Sheets�' � Upla�d I]ata Sheets � Lanc�scape Phatas, �f taken �`rabutarges. � 4JSAC� Assessmet�t Form� ❑ 4�t}�er Asse�smc:nt Fc�rn�s (wh�n a�pp�opriate) � Field Sketch or�erlain on legi�ile Map 4hat in�fluc�ey: • A11 aquatic resourc�s (fc�r :�it�s with multiple resc�urczs, la'b�l anci identify) ■ Locati�ns af w�.tland data points ancil�r treh�u2ary ass�ssmznt reach�s ■ Locati�n5 of pl�otc� statiatx:� � Apprc�xin�ate a�crea��llinear footage of a��uatie resaurces �(�J A�proved.�Ds incl�udirrg Ver�tication of a Del�neation: aPraject. C+�ardanates: Lati�ude Ma�s (no larger than i 1 x� 7} with Pro�jc�t Bounci��-�r Overlay: ❑� ❑� � � i,ongicudc Lar�e ar�d sma11 sc�l� map�s tha� de�i�t, at ai�inir�a�m: sCreets. sntersectic�ns, lowns Aeria� P�otogra��y c�f tfze projec2 area USGS Ta�pog�aphic Map Soil Survey Nlap � �t'her Maps, as appropriate (e.g. Nationat Wetfand Inventory Map, Prop�s�:d Site Plan, previ�us del9neation maps� � 1987 �/lanual Regioraal 5uppler�nents and pata fflra�ns can be �oe�rrd at: htrp //www usace arrnv mil/�vlissians/Ci�ItWorkslResu�lat�irVPro�ramandi�ermits/re� suoo.�sox We�land and 5tream Assessment Methodolc��ies can be found a2: htco•//��ta� ncr�enr ar�['c/docum�ret iibrarv/�et fi6e7��uid=76f3r586-dabS-�960-ba43-45b7fa#06P4c&erou�Fd=3S_364 and, htlo //Nuww saw usace armV ml'I(Porl�+ls/5qldocslre�,ulatprVf�vhls�nr7ti�es(2p13/NCSAM DrafC User 41iEanuaE 13a318,pdf e Delineation information mtast inelude, at mir�dmurm, ane wetland data sheet for each wetVa�dJcounmunity type. Versian: Decer�lt�er 20�3 ��e � J�risdictional Det�rny�natic�r� Req��st Delia�eatior� Intnrm�tion (when a��dicablel: Wetlands: � Wella�d I]ata Sheet�`� � L�J �i Up�ar��d I��ata Slie�ts [.�ndscape Phc�tc�s, ifta�:�n Tributat�ies: � LISAC� AsseSsrrient Foc�ras � Otlter Assess��nk F��nns (wh�n ap�ro�rQate} �'ieid S�ctch overlaii� �n 1c�ible Ma� khat inc�uc��s: • All aquatic Pesout'ces (�'or si2�s w�i�h inulaipl�: resources, labt7 and identifyy � Laea�ions �t �Jet�and daca points andlar tributary assessment reaches • L�tiati�rus ��d'�hcato stat�ons • Appraxirna�e acrea�el�ir►ear �oota�e �f ac�uat�c reso�ces S�pp��ting Jur-osdict�onal Inforn�atiar� (ioT Appravec� JDs orily) � ❑� Approved Juris�iictic�t�al I��:termi�ati�n Form{s) Qals� known as "Rapanos Fonn( s j")� M�p(s) d�pictin� the p�te�tiai (ar lack �f potential) t�ydrolo�ic connectRa�{s), adja�en�y, �tc. to navigabl� watees, 9 Del�neation infarmatian rnusc incl�de, at m�rsirnum, one wv�tland data sheet for e�ch wetland/"comsnun�ty type. Vers4on: December 2(}13 Page 7 Jurisc��tional aete�tn�natian R��uest �REQU�S'I'S FOR C�Rf'S �I,PPR4VAl� ��' SISRV�Y PLAT Prior to Cu�al producti�n c�f a Plat, t3�e Wilrnin�tot� I�i�trict r�van�m4z�ds �hat the Lan� S�rveyor el�ctronical�y su�bmit a ciraft at a S�9rv�y Plat. ta tl�� Cor�s pr�ject manager for review. I)u� to storage lirnitali�ns af' our a�mini�trative recor�s, tt�e Curps requires thac all h�rd- cvpy �ubi�ittals in�l�r�e �t least one ari i�al Pm�t (ta scal�) ihac is no lar�er t�an I I"xl7" (the �se ot mat�h lincs for l�rgea° �cacts ac�ce�tabl�:�. A�drti�n�9 cc��ies of a p�at, �ncCuciirtg t�ose �arger tlhan E I"x 1�i ", i�nay a�so be submitted tor Corps si�atu�r�e as nee�d�d. Th� �C�arps al�o ��c��ats el�ct�anic subpnitta�s crf plats, suc1� as th��s�. t��ar��rn�t��l as a Portable Doeiimcrat Forma4 {PDF) tiV�. L�pon ��erif�,ati�n, tl�e C'e�rps �:an �.l�,ctranica60y si�,� thuse p�ats ar�d return t�l��m via e=m,ai1 to th�e req�a�st�or. (l) P'LA�'S SUBM['I`TEa F4fZ APPRi)YAL n ❑ � ❑� � � ❑ C 1V�u�t t�e s�aled a►�ei sig�ed by a licensed pc+�fessiarsal lanci surveyor Must b� ta scal� (all rnaps must amclud� �both � gra�ahic �ca�e and a v�rbal scale) Must be le�il�➢�; Mus� inclt�de a�c��lt Arrow, Sca1e(sj, TiNc, Property lnformation 1�1ust i��cpude a ��gible W'�Jc�U5 Delir�eation Tabf� of distar�ces anci bearingsf�netes and bU�rtds/GPS co�rdinates t�f all surv�,yeci deliQle�tian poinks Must cleariy ciepict surveyzd p�rcapcity or prc�j�ct bounc�aries Must c��arVy ic�e�ntify th� krsown surweyed �aint�s� us�d as ret�erence (e.,�. prap�rty coa-ncr. USGS �nonumer�tj Where wetCands aee c�cpict,�d: � I��st �uc�ucie acrea�e {or squxre Co��tage) �f wetlamd po1ygons + Must identify eacl7 ��etlar�� aly�ua� usrng at� alphan�ame�c system Versinn: Decemt�er 2f�9.3 f'age $ Jurisciictic�nal Determir��tion �equ�st � Wl1�n tr�bu�aa-ies are depicted: � IVYust �nclude eit��cr �� st�n�eyed, a�pr�rxin7at� c�nterline �i �-ib�tary wi�h appruximat� width ��f�tributary C�� s�r,rveyed i�rdiriary Hi�l� �Jater Marks SOH'JVM} ol'tribukary . i��ust identi�y each uihutary using ar� alp�anumeric. syst�m + 11�lusc include tiine�r fooca�e oitrml�utaries and ca9culst�r� ar�a (t�sin� apprax�mate w�i�ichs �c sur��eyei� O�IVvT�1j • h�lcist incl�ide n�r�� f tribu2a�y (bas+:�l on ti1�e mc�st recent US�S tu�ographd� ma�) o�, w1��n no 4JSGS nartii� �.x��ts, i�lentify as "u�c�auned cributary" � a19 d��i�ted V4'��S (vv�tl�fl�d pulyg�ns a��l trib�tary lines) rnust �ntersect or tie4Yo surveyed �a�aa�cVpra�e�cy b�unda�ies � Must incl�rde tk►e focatian oi'wetlan� data poi�ts �ndlor triY�utary assessrrsent r�ac��s � iv�ust incl►�de, Vab�l ace�rd�ngly, a��d depict acre��e of �tll waters nc�t �urre�tly s�l�jeck to t9�e req�uircr�ents of the C'Wi� (e.g. "isolaQed w�tlan�is", "nun- jurisdictional watees"J. Nf�TE: An aJ�prov�d JD cr�ust be conduct�ci i� c�rder to r�ake an ot�iciaV C'orps t�etermirsatio� that a,particular waterb�dy oi- wetlar�d is noC �trrisdicti�nal. � �us� ir�clud� �nc� suruey all exis�ing conveyances �pipts, cutv�rts, exc.) t��tat transport WoIJS V��-sic��: i�ecert�ber 2�}13 Page 9 Ju�isdicti�naY �leter�nination F�equest (2} �ERTIFICAT�CD� LANG�IA+GE �i WFrcn thc cntire aet�ai 1t�risdic;�ioroal B�.tiun�a ss de ictcd: irlclud� th�e fall�owin� C�r�s �ert�fca�ion lai��aagc: "7�hrs cert�fies that this capy �of this plat occurately� deprrts the bourrd�ry of the jUriscfictaon of Seciian 404 af the CleQr� �!/a�ter Act as determirred by the �unc�ersrgned on this d�afe. ilr�less th�re is r� ehange rn the lovv or aur published regulatiQns, the derer�rrina�ror� of Secfir'on 404 jurisa��ction moy be re�recf upan far a period nac �to exceed frve (Sj years frarrr chis �late. T,he �rn��rsigned compJeted t,his deterrrpina�ron u'�til►`zi�rg the Qppre�prr"ate R�gi��raJ Supplernent c� fhe 1987 U.,S.,4rmy �'arps �f �ngine�rs Wetfonds D��ir�eatran rManucrl'.•• Regu�arory OjFficraf: Trtle: D�rre: �ISACF Actr`�n r� No.: � When up[ands ma,v be pre��l[ �within a depict�ec� durisdicta�nal Boundarv: include rh� fallowit�� Car�s Certific.�tion language: "This certr"fres thafi this copy af this plo� rdentrfres alf areQs of waters vf the �lnited States regulated ,��rrsuont [o Sectiar� 404 of rhe Cdean Water Act as determrrred by ihe undersigr�ed an this date. iJr+less there rs change rn the law ar aur pubfished regulations, thrs deterrnirr�tiQn oj5�c[ian 404 �urisdictiorr r�a�ry be refred e�porr for a period not to exceed five years frsarn this a'a�e. T�he undersJgned completed tiris derermina�ron crtilizrng rire appropriate RegiQrra! Sr�pp�ement io ihe 1987 U.S. Arrv�y �Corps of Engineers INetlarrds l7elr�reatian Manual.,, ReguPatary pfficral: Trtle: ,�aXe: USACE Artian 1�D No.; Version: Decerr�ber Z013 P�g'� �'� ��r�sa�T�tianal Det�rrr�inativn Reqe�es� (3y GPS SURVEY4 Far Surv�ys pr�;par�ci usin� a Gl�b�l Pflsa�iar�ing �ystean (C�E'S�, the Suru�ey nr�usl inc�ude a1l r�f t�ie abc�v�., as �v�.l l as: I� be at sub-rreeter a4c�aracy at each s�urvey p+�int. � incl�d� an ��curacy v�rifcation: C)ne or mor� knawn points (prc�pe�ty eot-�er, m4r�u�n�nt} sh�ll be loeated with che GP5 ancC cross�reFcret�ced vvith ahe �xistin� traditiarlaE pr�pe��y s�rvey {metes an+� bo unds ). � include a brief ��scripuaa�s of the �PS �c��rx�rment utilized. Versian: Decem�er 2(�13 �'a,�e 11 Appendix 2- PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM BACKGROUND INFORMATION A. REPORT COMPLETION DATE FOR PJD: B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Amy Eu�iss, NCDOT Division 9, 375 Silas Creek Parkway Winston Salem, 2��2� 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: StOkeS c�ty: Walnut Cove Center coordinates of site (lat/long in degree decimal format): �at.: 36.292756 �ong.: -80.141532 Universal Transverse Mercator: N/A Name of nearest waterbody: Town Fork Creek E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY): ❑ Office (Desk) Determination. Date: ❑ Field Determination. Date(s): TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY JURISDICTION. Site Latitude Longitude Estimated amount Type of aquatic Geographic authority number (decimal (decimal of aquatic resource resource (i.e., wetland to which the aquatic degrees) degrees) in review area vs. non-wetland resource "may be" (acreage and linear waters) subject (i.e., Section feet, if applicable) 404 or Section 10/404) �/A 36.292514 -80.142453 �.14 Wetland Section 404 �/B 36.292649 -80.140347 0.11 Wetland 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:Potential Jurisdictional Features 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: Walnut Cove, NC 1:24000 � Natural Resources Conservation Service Soil Survey. Citation: � National wetlands inventory map(s). Cite name: � � State/local wetland inventory map(s): FEMA/FIRM maps: ❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929) � Photographs: ❑ Aerial (Name & Date): or � Other (Name & Date): � Previous determination(s). File no. and date of response letter: 0 Other information (please specify): Lidar used for fieldwork IMPORTANT NOTE: The information recorded on this form has not necessarily been verified bv the Corps and should not be relied upon for later iurisdictional determinations. Signature and date of Regulatory staff member completing PJD 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. Waters_Name State Cowardin_Code HGM Code Meas_Type Amount Units Waters Type Latitude Longitude Local Watenvay WA North Carolina PF01 RIVERINE Area 0.14 ACRE DELINEATE 36292543 -80.142588 Town Fork Creek WB North Carolina PSS1 RIVERINE Area 0.11 ACRE DE�INEATE 36.2927132 -80.1403789 Town Fork Creek