20171454 Ver 1_Sampson 148 PJD Package_signed_20170215

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATI�N
A. REPORT COMPLET{�N DATE FOR PRELIMiNARY .lURISDICTIONAL
DETERMINATION (JDj:
B. NAME AND ADDRESS OF PERSON REQl1ESTlNG PRELlMINARY J�:
NCDOT Mighway Di�isian 3
55D1 Barbadas Blvd., CasUe Hayne, NC 28429
C. DISTRICT OFFICE, FfLE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
5ampson Bddge 148 on llunRey 5chool Road (5R 1434} over Mill Swamp
(IJSE THE ATZACHED TABLE TO �OCUMENf MUE.TIPI.� WAT�RBODIES AT DIFFERENT
sir�s�
State: NC Countylparishlborough: 5ampsan Ci�y:
Center coordinates of site (latllong in degree decimal format):
Lat. 35.0808fi °N; Long. 78•50897 °W,
Univ�rsal Transverse Mercator: »s �z»6s saezs3o
Name of nearest waterbody: M��� swama
tdenti#y {�stimate) amount of waters in the review area:
Nan-wetland waters:
soo linear feet: 15 width {ft} andlor �0�25 acres.
Cowardin Class: Riv��n�r�aGus��+n�
St�garp F�OW: Perennlal
Wetlands: �o�� acres.
Cowardin Class: Fores�@d
Name of any water bodies on the site that have been identified as 5ection 1�
waters:
Tidaf:
Non-Tidal:

E. REVIEW PERFORMED �OR SITE EVALUA710N (CH�CK ALL THAT
APPLYj:
� Office {Desk} Determinatian. Date:
� Field Determinaiion. Date(s): �z�rzfl�s
SUPPORTlNG DATA. Data reviewed for preliminary JD
(check all that apply - checked items should be included in case file and,
wher� checked and requested, appropriately reference sources below?:
aMaps, plans, plots or plat submitted by or on behalf of the
$�rJiIC3f1tIC0115UIt811t: Environme�tal Servlces, Inc.
✓❑ Data she�ts preparedlsubmitted by or on behalf of the
app ' nticonsultant.
Office cancurs with data sheetsldelineaiion repart.
Office does not cancur with data sheetsldelineation report.
❑ Data she�ts pr�par�d by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological 5urvey Hydrolagic Atlas:
� USGS NHD data
� USGS 8 and '�2 digit HUC maps
❑✓ U.S. Gefllogical Survey map{s). Cite sca[e & quad name: Sai@mbur�. NG �:za.oaa
❑✓ USDA Natural Resources Conservation Ser�ice Sail 5urvey.
GtatI0I1: �RCS Digital 5oil 5urvay oi 5ampson County, 2009
❑ National wetfands inventory map(s). Cite name:
❑ StatelLocal wetland inventory map(s):
❑ FEMAIFIRM maps:
� 1 a0-year Floadplain Elsvation is:
{Naiional Geodectic Vertical Datum of 'f929}
❑ Photographs: ❑ Aerial (Name & �ate}: or
� Other (Name & Date):
� Pre�ious determination(s). File no. and date o# response ietter:
� Other information (please specify): 2oa7 ��a e�eYa�on Qa�, NCDOT Lidar, Sampson Caunty

1. The Corps of Engineers beiieves that ther� may be jurisdictional waters of the
United States on t�e subject site, and the permit applicant or ather affected parly
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an appraved jurisdict+onal determination (JD) for that site.
Nevertheless, the permit apPlicant or other person who requested this
preliminary JD has declined to exercise the option to abta�n an approv�d JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Natianwide G�neral Permit (NWP) or other generaf permit verification reguiring
"pre-construction notification" (PCN), or requests verification for a non-reparting
NWP or other g�neral permit, and the permit applicant has not re�uested an
approved JD for the aciiviky, the pemnit applicant is hereby made awara of the
following: (1) the permit applicank has electe� to seek a permit aukhorization
based on a preliminary JD, which daes not make an official determination of
jurisdic�ional waters; (2) that the applicant has the option to request an appraved
JD befare accepting the terms and con�itions of the permit autharization, and
that basing a permit authorization or� an approved JD could passibly result in less
compensatory mit+gatian being req�ired or different special canditions; (3) that
the applicant has the right to request an individual permit rather than accepting
tF�e terms and conditians af khe NWP or other general permit authorization; {4)
thai the applicant can accept a permit authorization and thereby agree to comply
with all the terms and canditions af that permit, including whatever mi#igation
reauirements khe Corps has determined to be r�ecessary; {5} that undertaking
any activity in reliance upan the subject permit authorization without requesting
an appraved JD constiiutes the applicank's acceptance of the use of the
prefiminary JD, b�t that e�t�er form of JD will be processed as soon as is
practicable; (6) accepting a permit au#h�rizatian (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form af Corps
permit authorization based on a preliminary JD conskitutes agreement that all
wetlands and ather water bodies on the site affected in any way by #�at aciivity
are jurisdickional waters af the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative aPpeal o� in any Federal court; and (7} whether
the ap�licant elects to �se either an appraved JD or a preliminary JD, that JD
will ba processed as soon as is practicable. Further, an approved JD, a proffered
individual permit {and all terms and conditions contained kherein), or individuai
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any adminiskrative aPpeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a}{2)). If, during that administrativ� appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
ta pravid� an official deii�eation of jurisdictional waters on the site, th� Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
��

This preliminary JD finds that there amay be" waters of the United States on the
subject project site, and identifies afl aquatic features an the site that cauEd be
affected by the proposed activity, based an the following �nformatior�:
IMPORTANT NOTE: T�e information recorded on this form has not
necessarilv been verified bv the Corps and should not be relied upon for
later 'urisdict�onal determinations.
Signature and da#e of
Regulatory Praject Manager
(REQUIRED}
�
Digitally signed by Mason Herndon
�DN: cn=Mason Herndon, o=NCDOT,
�,.�_ �%��,,,�— ou=Division 3,
email=[e-mail], r–US
Date: 2017.02.15 17:16:34 -OS'00'
Signature and date af
person requesting preliminary .fD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated amount
Site Cowardin of aquatic resource Class of
number Latitude Langitude Class in r�vicw area aquatic
Linear Acres �'�source
ft.
Non-Section
10 non-
SA 35.05083� -7$.50855 Riverine 600 ft wetland
Non-Section
10 non-
SB 35A60816 -78.50916 Riverine 50 ft wetland
Non-Section
10 non-
SC 35.06153 -78.50898 Riverine 100 ft weland
Non-Sectian
Wp 10 — Wetland
35.06071 -78.54892 Forested <4.1 acre
Non-Section
SWA 10 — non- tida!
35.06144 -78.50924 Lacustrine <.25 acre

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Project: ER16053.07
Date: Mar 2016
Drwn/Chkd: KT/RT
Figure: 1

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Project: ER16053.07
Date: Nov 2016
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O Project Study Area �L �N��) � � ` - • �„_
O ll
' Potential Wetland Waters of the US (Wetlands) f�"�',a;� ';�.'�'`
_ � `� / � _
0 Potential Non-Wetland Waters of the US (Pond) _; '�,,� 'l.�' ,�+'� j�
Potential Non-Wetland Waters of the US (Intermittent Stream) . �� ' �'��r ��� ->,`';
r _ {� 1 ^ r
— Potential Non-Wetland Waters of the US (Perennial Stream) � '` �'� ' pa �k
� �J
Potential Non-Wetland Waters of the US (Tributary) .' ,,.�"� ` : � �~ ,' ;r_ y
� ., � � :
0 50 100 _ �`'� ,�i.... '. �_,��. .
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4 ,�e.��.� ;y6 .M�' � _
Feet �` r� � � *� �•�
! � p ry `
k! ,. - ��� i � .� ; ...,
Source: High Resolution NC Statewide Orthoimagery, CGIA. 2012; NRCS Digital Soil Suroey of �-.. �
Sampson Counry 2009; Project Boundary approximated by ESI. � � . ': �.�
�' � 5
Disclaimer The infortnation depicted on this figure is for informational purposes only and was not prepared for, and is not l ,,,,,�
suitahleforlegalorengineering purposes. M2�7, NC Center for�Geo ��pfiic I�i�orr�i�ation ai�d An�al,��,sf�',5�.'NG '�
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Path:P:\GeoGra\Pmjects\2016\053\00_OS\GIS\figJuris_5148_ACOEmxd Date:12/2/20161028:O6AM
Project: ER16053.07
Date: Dec 2016
Drwn/Chkd: LJ/KT
Figure: 2

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OProject Study Area
Elevation
- High
�
- Low
0 500 1000
Feet
Source:High Resolution NC Statewide
Orthoimagery, CGIA, 2012;
Project Boundary approximated by ESI.
i5•.
�isclaimer The information depicted on this figure is for � �
informational purposes only and was no[ prepared for. —
and is not suitable for legal or engineering purposes.
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LIDAR
Sampson 148
Sampson County, North Carolina
Path: P:\GeoGra\Projects\20161053\00_08\GIS\fig_lidar_V2.mxd Date- 3/8/2016 9:46:05 AM
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nr�°ti`,����y ���ici Analy� i�:��NC'
`°`i "i -'�'9grf�'t, _ _
Project: ER16053.07
Date: Mar 2016
Drwn/Chkd: KT/RT
Figure: 3

s�
NC D�'V Strc�m Identification Fort�� �'ersion 4.11
Date: 3_ Z_ r 6 ProjecU5ite: s�.k�o� t`-� �
Evaluator: Tu����� � �� County: �k Sp_
Totaf PointS: Stream Determinatian (circie
Stream !s at least fnfermittent 3 ir Ephemera! lntermittent erenr
if t i 9 or perennie! if 2 30'
Latitude: 3 j, v6 () 8 3�4
Long�tude: -7�, Sv�,S+{
Other �
e.g. Quad Name: ���'"
f4. Geoma hola Subtokal *!� S Absent Weak Moderate Strong
'I a� Ca�linu9ty ai channel bed and bank 0 1 2 3
2. 5inuosity of channel alnng thalweg 0 2 3
3. In-channel structure: ex. riE�e-pool, step-paol, � � 2 3
rR le- oal se uence
4. ParGcle size of stream substrate 0 1 2 3
5. Aciivelrelici fEoodplain 0 1 2
6. Depositiona) bars or benches U 1 3
7. Receni alluvial deposits l 2 3
8. Headculs S 2 3
9. Grade contral 0.5 1 1.5
10. Natural valley 0 0.5 1 'i.5
11. 5econd or greater order channel No = 0 Yes = 3
��tC.�i�l J•_I�L�� ..... ....� w.l...l. w.....1;�.+..e.r]n..w �.. .wan���sl
B. H drol Subtotal = �
12. Presence oF Baseflow 0 1 2
13. Iron oxidizing bacieria 1 2 3
i 4. Leaf lirier 1.5 1 0.5 0
� 5. 5ediment on plants or debris a 4.5 'i 1.5
� 6. Organic debris linas or piles 0 0•5 �•5
'17. SoiE-based evidence of hlgh water table? No = 0 s� 3
C. Biolo Su6total = �
18. Fif�rous root5 in streambed 2 1 D
19. Rooted upland plants in streambed 2 '1 0
20. Macrnbenthos (nota dtverstty and abundancej 0 2 3
21. Aqual9c Mollusks 1 2 3
22. Fish 4 Q. 1 1.5
23. Cra�sh fl•5 '� �•�
24. Amphibians Q.5 1 1.5
25. Algae 0 0.5 �•5
2B. Wetland plants in streambed FACW = 0.75; OBL =1.5 �ther = D
•perennEal slreams may alsa he identifed using olher melhods. 5ee p. 35 af manual.
Notes:
Sketch:

t��.�C E.11D= D11 C1= Si�e = � inilic:�s� nn ;�ttacl�ed ��ta�>>
0
STR�AA� QU�LITY ,-�SSESSI1�IEl�T �'�'�R.KSHEET 5TlT
Pro� ide t�c fo�lo�i ing inforns�tion i'or fl�e stre��s� rc:�cls uncici• �ssessnlenl:
i. App�scant's nai»e: i�lG T
3. �i;�l � ��{� er ;Ilu�ll�s1: J� Z� y G
�. ��a�3ie of siresm: 1�'t i-a I►'�;�\ ��..�....o
7. .�ppro�imate drainage area: � 8�,0 ac.rc,s
9. Le��e�h of re�ch e�alu;�ted: Zd �F�'
I 1. Site coordinates (if3,nn��n): �?refer in dccima! decrces.
2. E� aluator's name: rr.
a. iit�ie of e� alnatinn: �- �
G. R i� er l�asin: Gz� �
A. Stres�m order: �.
10. Counn : ��,
4�. Subdi�ision name fi!'�r�v): ILoru.
I.a�i�udc 1cx_ �4_Si233_1: ��0 i{ 1 on ilude [ca. •i7,556b] I): '%_ $ ��Ssy
Aletl�od loration dc�er�nincd {circlel: GPS T'opo Shcci nho {,�erial) Phaio.Gl, O�her G15 Other
i3. L��catinn of reaclz un�ier e��aluation fz�ote nearb� m�ds ai3 I�i} mar •s and atlach map ide�3iifj�ing sireaiii(s) location):
� �n J'1 �- SA-�+�. � i n �� �
1�. �roposed chan»el ��•ork ( if am•1:�� r�r�= �-� „�.
I S. Iteceni ��'easher conditiaisc: ,�.c.,, _ �.��.�� �� �+��.— .
iG. Site conditions at ti�}�e of�isit: r:� ..� crc..-4l S •►�
17. Identifi� �m� specia! �+�at�n� a�• classifications kna„m: _5ection 10 �Tida11'�'ater� ��scential Fisherizs t�abitat
_Trc��t 1��alers _Outsi�ndine Resource 11`aters �Nutrient Sensiii��e 11'aiers _1�,'a�er Su�pl�� 1�lfaterslied (1-1V)
13. Is tf�2r� a pond or lake lacated up�tream o�the eraluaiion poi�3i? � I�0 !f �•es, estimaze the �saier surface area:_'L� *�ru
19. Dors channel a�+pear un USGS qu:�d map? �E NO ?0. Does cl�annel appear on USDA Soil Sun e�•? � 3�0
21. ��timated ��•ate��chrd land use: (�° o Recidemial °o Commercial °o Induhrial ra �°o ��ricultural
�° o Forested ° o Cleared J Lo�ged ° o Oiher f )
� �Trp c f �An�� — —
3?. a»kful ���id �: ��f ?3. Bank IZei��ltit (from bed to tap of l�ank): ���'
2�f. Channel clope do���n center of �tream: _Flat �0 to ?°ol � G2m�e e� to �°`o) �!1]oderaie (� �o l0° o) _Sieep {� 10° o)
25. Cl�ann�l �inuain: 5trai=ht ��ccaciona] bends _frequent meander �Ven� �i�3uous _Brai�ed cl�annel
Znctr�scti�ins ior c�n;�l��it��s ;,f «�i'i:SisEr# {iut�atrd o�y pr��.e Z}: Dtk1l� U\ t�E�CI7i111i1i1L 11�e nw�t appru�,riatz ecurr��inn i�ased �n
locatiai�. terrain. �e_et��1i013. streant elassiticalion. cte. E�t'n ci�ar�etcrissic n�ust be senred usins tii�e �aine ect�r��ion. asci��� points
tu zaclt characirr�stic �;ithin ihe ran__e sho��i� for ii�e ecaregion. Page 3 prolidec a brief descrip�ion of ho�t� to re�3e��' i3�z
cl»racieri�tic; i�rntife� in ihe ���orksl�e�t. Scores sl3oul3 rei�ec� an o��erali as52s�ment of ti�e �lream reach un��r �� �luation. 1!' a
eharacteristic ca�}noi bz e�aluai�d due to �ite or �+•eailszr cos�d'stions. enter 0 in th� �coring bo� and �ro�ide sn ��pia�iatic+it in th2
��il]Illc]ll S�Cik611. l�,'I�er� sliEre are �h���iaus chan�_es iii th2 cl��rarter c�f a stream urder r��ie��• �e,�.. ih� sar�ani �la��c 4'roni a�+assure
into a f�rest �. th2 �trcai�t ma� be di� ided imo 5mallcr r�scl�cs thai �iispiay raorr continuin•. and a separate �'nnn us�� in �� sluate each
resclti. Thz irnal �c��r� ac�i��iie� to a 4irram rracll muct ra�3:� bet�ieLn p and 100. ��ith a scor2 af 14+1 re�resEr,tii��� a stream of the
i�i��l�esi yus�in.
Taial Seai•e tfi•nii� rE��er�cl: � C�niments: �►���� ,
�� a[ua�or`s Si�nsture Date �'�-�� —
Tltis cE�annel e�-aluat9c+n foriiy is it�tend lQ �C ElSE{� Gllit �� 3=t11fIE t0 flS�lSt Ial1{�Gli'llEl'S 3flE� EIit!!'OI111iEI1Y�� ]il'G��SSIOIl��S II1
h�ti1H1'1l1� 1�1C C��f3 1'CC�llII'Ed �i�' l�iC L`ttlSEd ClfltC5 �1'lllt �UI'ji� of En�inEEr� l0 illa�iE 3�}I'E�1R3iEi�!'1 ASSE5511]Eilt 4� �tre�ns
qualitt-. TI3C lGiB� �CGI't' PCSl3�lliiQ fi'GI13 lllf CGIli�IClIGiI Gf 1�1i5 �OTifl TS Sil�}�ECl iA t'SAC� a��ro��ai aF�d docs 11GC Illln��` �
�]�rSICUI�I' i11111rdiiG�3 M�ilO GP l'CqlIi!'EAiElli. ��4'iii �l��;cil 1�� ��1c91�� —`.cr5i��t1 �iC i�� . T� t=i!i's��ict;t. ��l��`� i'c�� "�u.��h-w� �'+ -�,

STREAI�'i QUALITY ASSESS]1�ENT W�RKSHEET
;ti�- �'���#. ��y4+�� ';d���' ti�,:�j' r�'`��.;4Z;s.Fy�,�� _ w x. ���'��:fl8�'d ' w'�l�P.[ilil 3�.'F't�,�lUU[1 A1TI „ _'•
-t .S�t:' ... �" � -
��x� 1� Presenre of 110�� 1 persistent pools sn sireani �_ � 6—� 0— 5
? (no 110�� or saturat3on = 0: stron flo�v = m� ointsl
ti �'
x E�-idencc af �ast Luraan ulterniio� 0_ G a_� 0—$
�-�� � �extensi��e alferalion = U• no altera#ion = max oinis
.s 3 -' It��arian zone � 0_ 6 0-4 Q-5
{no b�1'er.= 0• ronii uous. w�de buffer = max oints -
� 4� �. �. �� ���idence u!' nvtrfept or c�ieniieal disc7iarges 0— S 0-4 ' O�- 4
�. eaieiisive discbar' e�.= 0• no disciiar es =�i �ax � ints
� ` - -_. ,� ,. ' Gronrd�ater discl�arge = ;:�: , : � . .
.�s � 5 no,disci�ar e= 4- ian se s�;;eilands etc, � ma�: ints
0-3 fl-4 0��4
` 6 :`• c; � I'reseace af adjacen� IIaodpls�n � 0— 4 0-4 0— 2
.A ���na {lbod �a� = 0• e�►�Ser�sive fiood lain = ma�c oints
;�"�= 7 � �nt"renchzuent 1lloodplain access 0— 5 D— 4 Q— 2
dee l entrenched = 0• fze nent floodin = rnax oints
'� �' ' - PrescaCe af ad,�acent ssetEands
��¢; $ no ���etlands = 0• lar e ad'acerit we#Zands =�sax oFnfs �—� 0— 4 0— 2
` �'" Channel sinuosity
.'��, 9 0-5 0-4 4-3
{extensive channelization = 0' natural meander= m� oints
'��' 10 .: .Y Sediment inpUi ` � - p _ 5 0 — � 0 — 4
ea-tensive d osition= 0• little or no sediment � max aints : -
�� . . . �:�a�:•c•,�,,,...
�$iie 8c dir�ersity of chattnei bec� su�strate ,•a :�jA��;��:� 0— 4 0— 5
'�`�� � � fine haiuo enous = 0` lar e, diverse s�zes �= max oints � * � �-_ �.:_.�' � :�
.� _
''=�' j 2 E��idence of chanael incisian or �►'Ydeniag 0_ 5 4— 4 4— 5
_ ,:. �
(dee 1 inc�sed = 0• stable bed � banks = raax oints
�i 13 PreseQce of majar Uank faitures 0—� 0— S 0— 5
�'� sa�rere erasian = 0• no erosian stabie banks = max oin t s
p; �� Root depth and density on banlcs p_ 3 0— 4 0— 5
�� {�o visible roots = 0� dense roois ihrou out = maa oints
�� �� Im act b a ricutlture, li�•cs#ocic, or timiser production
�..;�, [� y g 0--5 0-�4 4-5
t:?; 1$ substar,tial im act =0• na evidence = max oints
�;',::;' Presence oF riffle-�ooilripnle-goal campleaes 4—� p—� 0— b
�=''t �6 no rif#leslri Zes or ools = 4• uell-develo ed= mex ints
�� - Habitat compleaity
0-6 4—b Q-6
�' � 7 lit�le ar no habitat = 0• fr uen varied habitats = max oints
,� l 8 Cauapy co��erage o��er streambed 0— 5 0— 5 U-- 5
(no shadin r•e etation = 0• continuous cano v= rnax oint�
-� � �9 • Se��strateembeddedness ,-� �A� . 0-4 0--4
: �a= .
,.;r ,. {dee 1 embedded = 4• loose struci�ue = max
'`.�� ' Presence oistream inrertebrates {see page 4)
�.�. -y4 0—� 0-5 0-5
(�o evidence = 0: comman. nutnerous es = maX aints)
� `�`. Presence af am�f►ibiaas
:V'' �� Q—� 0—� 0—�
: Q� (no evidence = 0: cArnman. numerous es = max o�nls
`�'-`�- i'resence of fis� � _,� p _ ,� p _ �
�a �� (no eridente = 0: co�unon numerous t� es = max �nts)
-`�� �3 � E�idence aitirildlife u5e 0— b 0— 5 0— 5
� ��c- {na e�'icience = �: abundant e��idencs = max oints
. . ....
� _.r: . .. � ._- . � � � - � � -
`_ ' - . ' . " . Total P.oints Po�si6le � _ . - - : I00 ' 10� 1�1Q�- °
w . - .. , . . :. _ � ` -
; :� : _ � Y� ,. .�, � � � � ' ' ' �also �erit - - - i �.
I, .. : �'s •_'-- � _ _, � � - ��� '�OTAI� SCORE �r oi� fir'st paee� � > _ .
:1��: •3 _ :: -�� . - _ - - - � - _ f
„z - _ ' -
''" Th�se characteristics are not asses�ed in coanal streams.
,
3
3
�
3
Z
y
�

S�
NC D�V Stream Identification Far�n Version �.11
Date: ��Z _ l(� ProjectlSite: �w�c,. �''�$ Latftude: 3 j, Q(',��jrp
Evaluator:T��n��� Va j,�w Gounty: � SU,� Longitude: --�� �Uy�s�
TotaE Pofnts: Stream aete circle onej Other i �
Stream is at least fntermittent 2 S_ � Ephemera Intermittent Perenniai e.g. 4uad Name: �I�"` `"�
i{ z 19 or verertrtia! if z 30' ___
A. Geomarphology �S�btotal= r.3
18' Continuity oi channel bed and bank
2. Sinuosity of channel along thalweg
3. In-channel slruclure: ex. riffie-poal, siep-pool,
ripple-ponl sequence
4. Parlicle size oi stream s�bstrete
5. Activelrelict iloodplain
6. Depositional bars or benches
7. Recent alluvial deposits
e. Headcuts
9. Grade cvntrol
1 Q. Natural valley
11. 5econd or greater order channel
artificial ditches are not rated; see disaissions in ma
3
3
3
3
3
3
3
B. Fi drola Subtotal= '7. �
12. Presence of Base(Iaw 0 � 2 3
13. Iron oxidizin bacteria a � 2 3
14. �eaf lit#er � l 0.5 0
15. Sedimenf on p�ants or debris 0.5 1 1.5
16. O anic debris lines or piles 0 0.5 1.5
17. Soil-based evidence of high water table? No = 0 Yes = 3
C. Biolo Subtotal =
i B. Fibrous roots in slreambed 3 Z a
19. Roated upland plants In streamhed 2 '1 �
2D. Macrobenthas {note dtversity and abundance) 0 2 3
2'1. A uatic Mol�usks 1 2 3
22. Fish 0.� 1 1.5
23. Cra�sh o•� � '�•�
24. Amphibtans 0.5 9 1.5
25. Algae 0.5 1 1.5
26. Wetfand planls In streambed FACW = 0.75; OBL =1. Olher =
'perenniaE strearns may also be identified using other methods. See p. 35 of manual,
i�iote5:
Sketch:

l{S,�Cf •I1D= U1� f� _
�i�e = � in�li�aSe �,iti anached m:t�� 1
� STRrAA7 QU�LITl' ,�►SSLSS]12�NT «'4R.KSHELT
Pra� ide tl�e f4[lo�� i�g infarmaiion for 1he strcam �•e�ch u�zdcr �s<csstneni:
?.E�a9uator'sname: r�,�..1 „�
�. ii�ne af e� s�ltiaii�n: � �
G. R i� er ba�in: G F�
R. Stream order: �
l. A���icai�t's nai��e: L
3.1�,�ie��fe�altiatinn: ���-�� __ _
�. ��:�iii� of 4irean�: LLT �ka 1►�: ti 5�.,���
7. ,-�ppraximate drain2Le ar�°a: �'.�i �trc.s
9. Lans:th o!'renef� e� alu�tecl: 2a �
I I. Site coordinates lif�.��o�cnl: prefer in �iccinral degrce�.
�
t �i,� 7 � �
10. Counn�: 5av-� o'►
12. 5ubdivision name f if any): no'��
I.:i1ilU�3e ie�. : 4.K;231 _�: �5 d(e �� f G _ l onnitudc {ca. -77.5566i 1): " 70_ SO �l � S%
Ale�h�d loca�inn dcsentilined (circte}: GPS ['opo Sl�ect rtho IAerial) I'hota�Gl Oth�r G!S Odur
13. Locaiirn of reac�s under e� aluation lzlote nearb�• macls an an �nar •s and �ttach mn� identifj ittg stream(s) loc:�tionl:
�r.c.�a�- o•. F{�...-Llc�. SG�aI �1 . So�-��- o� i-tal�c.,,�i'S Clns�i _
I �4. Proposed cham�ei �rork f if am�}: � t .c�a�c. ���»�..'� - - - —
15. IZereno �reatherconditians: a•� 4+•�-:- 8 ho��
1G. Siiz cnnditions �t time �!'�isit;_ S�«-� �rk.,s, .�- ►'��a a ���'1���
17. Ide�i�ifif ai�� specia! �+�aten��a�• classifications kno�j�n: �Secti�n 10 �Tidal l'�'aters _Escentia! Fisheries HaUitat
_Traut 1�'asers �Outst�ndin� Recource lt'at2�5 �Nutrient Sensiti�e 1'1'�iers _1'�'ater Suppl�� 1'1'alershed (1-1V1
13. Is tl�zre a pond or lake larsted upclreatn oithe e� alnsiian point? 1'�S �0 If ��es, estimase tl�e ��•ater surface area: C� �{
34. Dozs cl�a�me� appear on USG5 guad map? 1� !0 20. Daes channel a�pear on USDA Soil Sun�e��:' �'Ea 1�4
?l. E�tiit�atzd �satershed land use: �� °b Re�idential °o Cominercial °o Ind�stria] �a0 �o ��r�reiltural
�� ° o Forested ° o Cleared 1 Log�e� ° o Other { )
��Tcp o f �prt�� � �
. ankful «��d i: 33. Bank height (frair, bed so i�p of bank); 3�+
?�. Cl�annel slnre drn��n centzr ofstrenm: ^Fiat �0 to 3°0) �Gemle i? to -�°'o} *�i�4odera�e (a to 10°0) _St�ep {> 1[►°'0l
3ti. Cltannel sinuosin : 5trai�i�i ��ccasiona! bends �Frequen4 meander _�jen sir�uous �k3raided cha�mel
�I15iY[1Cif0115 i�Gk' CG3ii�iiffi0ii GT R'vCI:SiSh"ri (�G�a4E� uu ��a�r 2j: Ec�iu by deteri��i�iin� t13� �ziust ap�ru��ria[e ecure�ion based �n
iQC3li01Y. 12TI'3111. �e�El11i011. 5t]'e3113 C�3551TIC3110Il. 21C. ���F} CI131'�Ct�T1511C Ilill�l b@ SCDT2� USllla ihe samz �cc�re�inn. .assi�n pnints
ia zscl� cf�aract�ristic �� ithin thz ran�-e s13u»n for the ecor�s!inn. Pase s�ro� idzc a rrief descrip�ion of lio��• to re� ie�ti- tl�z
ct7�racteri�tics identifie� i�� t!}e ���orksl�ezt. �cnres slSc�uld reflect an o�erall as�ess»ient of the nre�m reach undzr ��aivation. l!' a
chai-a�t2ristic �a��not b� e�aluated due to siie or �i�eatl�er canditi�ns. znler 4 in tl�� �coring ba� and �+ro��ide an ��pla3�ati��n i� ihz
���mm�nt s��tion. 1��I�ert the�•e are ob�ious chan��es in �he cl��rac�er �f a stre;�m �Ei�der r��ie«� (e.��.. the Sli'c:illl 1�0��5 fl't'�fll 3 pA51UiZ
into a fiorestl. t13e stresm Enn} be di�ided into sr��aller rEachrs th:�t displa�� n�orz coniinuin�. and a separaie %nn us�d io e�alu5se each
I'c3CIl. TI12 101:il <r��re as�i4n�d to a sura��1 reach mus� ��an�� berneen 4 and IUD, ��itl� a�care of lOq re�r<<tr,�i��� a stre�nl nf i]�e
lti<<�iest �uaiin.
Totai Scare Ifron3 rEr ersrl: Can��nents: � � ��� __ _
E��aluaiar's �i��a�ure - �ate ��3-�G __
Tliis rl�anntl E`�aluatiaci fari�f is itttFnded o �e vsed onl� ss � z!lif�F f0 �SSISS ��t1C�0`iI]E!'S 3I1(� C•IriIF'QIlE]iE111AI �)i•afEs�iouais in
r�i�1[1'II]� i�1C E�3C3 C({�illl'Ed I31' 1�1L' L'llli@CI C1�1E•5 �I'I11t Cnr�ss c►f Eii=i�EErc to tn�kE a�[•cliniinar� assEtsmEitit af 5ll'F3Ii7
qu��it��. Tlic totsi ccore re�ulti��¢ rl'G111 lIlE COI3}�'j�C110l1 Gf iI115 farui ic sub3Ec1 to GSACL ap�ro«I aud dae� ttoi inipl�- a
j)afilCUjar llilll=�if301] i�TiO GI' 1'C�U11'EIItEI1t. Ei�i'ii� Sl��iril 1�� ��7e1i=� -� cl�lQll II� ilj. �L, c_; i;;,y;��,�. f�1,#gfC �Gl� �?�i�.� h-S �� ]\�b,

STREAR�. QUALTTY �SSESSn'fENT �'VQRKSHEET
'u`�A F � r�i�.. .r f . .rt.Fj �•�?�� t��':� i a�� �' �.� � �. . . .
�•. } k �S ,�a.x ^� • ^ r�4� + '�ir�+� 1;�Nif�f Y:� r:.; � - t �k ��,� ��
�. ;'� t....��� � �fr �':13., ti7kll � e � �+,
�;:L :r� +• r 5�t $'r�.� ��7a`�ttv ..5� ,'� *t"?-1�'-z ai.� 1 4k�"*r r� ��'.��R���$ 5�r Sq,� L'A �I�R�� �� Y1 A1� C
:'-�$ Presence a1'i�a��� ! persistent �aols in stream -
; � 0-5 0—� 0-5
�4 ,
(na iia�v c�r saturasio» = 4: stron flo�v = inaY b113t5
�� � Eridencc of past Luman alieraSion 0— G U— S 0— S
�; (eatensive alieratian = 0• no alteration =�ax oints
�`'" _ Itinarit�n zone �
' ' 0-6 0-4 0-5
�� •,; 3 � (�no b�er. = 0• �oNi uou ��=ide buffer = max oints � �-
�� � 4 •;i E��idence oF riUtrie�t or c��ieiuicai disctiarges p— 5 - 0—� �' 0— 4
'. �eafensive discha � es.= U• no dischar es = rn�.�c oin�s
�` . - . Groui�d�vater t�isc�iarge :. ; � : � - . -
�: � 0-3 0-4 0=4
� 5 no'discl�ax e= 0• -rin s s «�etlapds eic, = rnax oi�ts
�� � 6 , . ' . Prese�te af adjacent �Iaod�lain � _ � d � � q _ 2
�i '']30 �QQa �S1Il = O• e7�fensive fiood lai.n = max oints
�` { Entrencltrucn# 1 iloodplain uccess p_� p— 4 0—?
a� � dee 1 entrenched = 0• fr uent f�oodin = max oints
�� �s �- Fresence of ad,jacent �►'etlands
��-�� 8 0-6 0—h 0-2
;,��• . no wetlands = 0' ]a e ad'acenl wetlands.-= max oints
;� 9 Channel sinuosity 0— 5 0— 4 0— 3
• k� {exter�sive channelization = 0• natural meander = max oFnts
.��.„: -:,- Sedi�nent inpc�t ' p_� Q— 4 0— 4
�� �� extensive d osition 0• litlle or na sediment = max inls
� I 1 ' Size & di��ersity af �i�annef bed substrafe :• �'-� "�sti. ��
.�.� ` fine hamo enous = 0' lar e, diverse sizes = max aints ".; r NA:". ��:r, y- 0— 4 0 � 5
��, -
'�a,' � 2 E��idence of channel incision or widexting 0— 5 0—�4 0— 5
`,;:, .
.(dc 1 incised = 0• stable bed R banks = max nints
��� � 3 Presence of ma jos �iattk fasiures p �� 4_� 0— 5
� a, sevete erosion = 0• no erosion stable banks = maa� oints
.�: j� Roat depth and density oa banl;s q_ 3 �_ 4 0— 5
,� (no visii�le roots = 0• dense rooLs i}u�ou out a max oir�ts
'�,v1. � 5 Impact by agricniture, lir•estacEc, or timber productian 4_� 0— 4 0— S
�� substaniial im act =D• no e�idence - max oints
�'.�.' 1� Presence of rifi3e-�oa�lrip�[e-ponl compleaes 0— 3 6— 5 4— 6
=� no rif#]es/ ' les or oals = 0• r�°el�-develo ed= rnax ints
.� Habitat camplea'sty fl_ 6 0— b 0— 6
E-�� �� linte ar no habitat = �• fr uen varied habitats � max aints
��~ �� Canapy co��erage arer strearabed �_ 5 0— S 0— 5
(no sl3adin ve etation = 0• continuous cano v� ma� oints
;,- �.
}g Substrafeemheddedness =' NA* � 0-4 0-4
dee � embedded = 4• ]oose structure ? �nax -
Presence of sfream i�rertebrates (see page 4}
. K� �Q 0-4 4-5 0-5
� (no e�ridence = 0; common. �iumerous es � ma.�t ints
� � Presence of arnphibians
C� �� 0-4 0—� 0—�
_ D (no e�idence = 0; cormnon nu�nerous es - max oints
� �- Presence of fis�
�?? 0—� 0—� U—�
: (no evidence= 0: cominan nuinerous es =�uaz ints
.�_ �3 Evzde�ce af r��ildlife use Q_ 6 0— 5 0—�
- {no evidence = 0• abund�nt e��idenca = max i�ts
. � . . . . ., ..
� � F • ` ` � Tata! Pa`s�fs Po�sibie ' . ,- : i40 " ` �00 � I�O� -
� � '�.•' = - . ` � � �_� } TOTAL SCORE {also �enter ou first page� : _ � : ` . • u
s, > ' -.� � - - - - �r -
_,
* Tl�e�e characteristics are not a�sessed in coana] streams.
G

,5G
NC DW Stream Identifcation Form Version 4.11
Date: 3 Z �� ProjectlSite: 5a..�rfn., I�f� Lat�tude: 3 s, d� 153
Evaluatow ESI� -� "r�.r�b•. f j County: Sa,.uprw, Longitude: �75� Sa S�S
Total Paints: � d
Stream is at lesst rntermittent p
if z i 9 or perennra! if z 30"
A. Geomorphology (Subtotal = S. S )
1°� Ca�tinuity of channel hed and bank
2. 5inuosity of channel along thalweg
3. In-channel strudure: ex. ri�ie-paol, siep-pool,
ripple-pool sequence
4. Parlicle size of stream suhsirate
5. Activelrelict floodplain
6. Depositional bars or benches
7. Recent alluvial deposiis
e. Headcuts
9. Grade oonirol
10. Natural va�ley
11. Seoond or greater order channel
artifiGal dilches are nol raled; see dlscusslans In manual
0
Q
0
�
Q
0
�
9
0
(circle one} Other SalcrL�f, 1�G
it Perennial e g. 4uad Nema:
3
�
■
0
�
E
0
0
Yes=3
3
3
3
3
3
3
3
1_5
'f.S
B. H drala Subtotal= `7 • S
�2. Presenoe of Baseflow D 1 Q 3
13. Irun oxirlizing bacleria 1 2 3
14. Leaf litter 1.5 0.5 0
15. Sediment on plants or debris 0 1 1,5
1fi. Organic debris lines or piles D 0.5 i.5
17. Sail-based evidence of high water table7 No = 0 es = 3
C. Biolfl Subtotal = S
18. Fibrous roats in streambed 3 z 1 0
19. Rovted upland plants in streambed 3 2 1 0
20. Macrobenthos (note diversity and abundance) 'k 2 3
21. Aquatic Mollusks 1 2 3
22. Fish 0,5 � 1,5
23. Cra}r5sh Q.5 1 1,5
24. Amphibians D.5 1 1,S
25. Algae 0.5 1 1,5
26. Wetland pla�ts in streambed FACW = 4.75; OBL = 1.5 Other
'perennia! streams may also 6e Identified using other methads, 5ee p_ 35 of manual.
Notes:
Sketch:

l��,aC� 1iD}
p11 �� � Site = i indic;�te �n at+aci�ed mapl
��
� STREA�� QU�L1Tl' �►SS�SSA'iEhT «'QRf�SHEET
Pro� idc tl�c follor�is3g i[�forn�alian far tE�c strcans reacli under �ssessinrnl:
2. E� alu�lor's name: i1� '�'4� �1�41 �
a. �'ime nf e� al�»ti�n: �� � �O �,�,
G.Ri�e�l�a�itl: C� %c�
$. Stream order: �
l0. lout�t� :. ��pSa�.
I. Applicant's naFi�e:
3. D�i�e ceE�e�alua�i��t�: -2-
�.'�:�in� of stream: A'�� ll S
7. �ppro�iinate draina�e are�: �l0 Lr�S
9. 1_en��li of reach e� aluated: ��'�
I i. Site caordi�t3lcs {if kito��n): prcfer in,i.cimal deerces.
��. SU�]dil'iS1013 1�3Slle {lfail\'�: �R�
,�.
', r ;
1.�^�i� � !
�F
.y
k.a�iiudciex.?a.Si?31�1: 3S G1.13 LoneiluJe�c�.-77.55G611): �%c�.s��y8 _
A1etl�od In�uiinn dct�rn�ined Icirclel: Gi;S 1"�pu Sh ei Onlin IAcri�i) �'fy��o;Gl. iher G15 Qiher
13. I_oraiic�n o!'re�cl� under e�alitation (�io�e nearb�� r�ads mtid landmarks and at�ach m�p identifi�in� ttream(s) loca�ianl:
�r��� Oti �ik..�l 5E1�.e�1 1�Ci , So.�� o� —�ia�l��.�.'S C�•�c� _
I-�. Prapas�d chan�tel �� ork ( if an.�): 1 � � �4��w �
I S. 12ecen� ��-eather conditioilc: RQ.,�. v;�}�.:.• � g �.owl
ifs. Site coi�ditinns a� �ime nr�isi�: ����- �� ��1ou �.G�ril
17. ldenti�i� am• special ���ater�va�� classifications kno���n: _Section 10 _Tidal 1'�'aters ,�Essen�ia3 Fislte�ies Habitat
_Trc+�t 11'aters �Outs�andinL Re�ourre 11'aters �,Nutrient Se�isiti�e 1'l'�ters _l�'aterSu�ply 1�'aterslieci {i-1V}
I 3. Is t1�er� a pond nr lake locs�ed up�tream of the e� aluation poir3�? 1'ES t� If }�es. ec3»ilate t�e ���at�r surface area:
19. D��s clia�tinel a}�pear on USGS quad m��? YES �
31. Esti�n:�ted «atei�hed lai3d use: �� °o Residemial
?0. Does ch3nne] a�pe�r nn U5DA Soil Sun-e�? 1'ES �
°o Comntzrcia] °o Indu5lria! Co0°o r��_ricultural
Z5 � o�orested ° o Cleared l Log�ed ° o Otfier f )
� �TcpcF �An�� � - -
. a�ll;ful ����d r 2��' 23. Bank IZei4_ht (from bed so top of bank): ��
2-!. Cl�annei clnre do�r3i cznter afstr�gn�: �Fiat tU to ?°o) _Genile (? to -�°�) �A'Eaderale (a io lU°�o) _Steep 1> IO°o)
3�. Ch;�nnel sinu�,sin : ✓Strai��ht ���ccasion3l i�ends _�"re�uen� meander _Ven sinuous _Br�ided cl�annel
�nst��uctioiis for cem�IEti�,n i,f ��ar�:siiE�t (It�.at�� vi� p��c 3}: DCLIIl �\ �irt�nn�nin�: tiie nwst aNpru��ri�le ecurr_=iun l�as�d on
l��ca�ion, terrain. �e�etatio». stream cEa�sitication, ete. E�t�n cltis���eteristic must be 5cnred u�in� the ss�n� rc��r�ginn. .�ssi�n ��oints
�u each characteil5sic �� i�hin the ran�,� sho�� n for tl�e ecaregion. Pace 3 pro� idzs a brief descri�tion o!' lio��- io rz� ie�►' t13e
charactzri�tics i�en�ifie� in th� �ti�orkshezi. Scores sl�u«Id rellaci an o�erail ascess�nent ni the sireai3i re:�eit un+��r �� 3luati��n. !f a
C�l3I'aC121'ISSIC C31111uT h2 Z\:iEllAlZd i.jUZ l0 si�e 01' �iZalil2P COI1CIIt1P115. enser 4 in ihz seoring k�c�� and pro�ide �i� e��la��ati��t� in the
Ci�ll7kilt'lil SZt11011. ��'hzr� Q�crz arz o���ious chan��es in the characi�r of a �u•e�m under �2� ie�;• (e.��.. l�lZ 51fC3Ii1 �70�� � fro�n a pasture
into a f��resil. lil� �il'23l11 111i1\' L�� l�i\iC�2d 13310 51�1�IIl'I' I'E3CIleS II13S CllSpl3) 1110T� C011liflUll�'. �ilC� 3 52j?:iC�tt �01'l13 USe� l0 z13�116iZ Z�C�I
1'r3C�3. TI12 1013I SC01'2 a5cj��nzd to a sir�aE�ti rzach niuc� ra�i`� het�~een 0 and l0(1. „isl� a SCGI'2 C�f 1Q� repr�sentin� a�iP��ll7 {►�1�i2
�31_?�1�S1 l�ll3�iT� .
Ta��l Scare Efrom re��ei•se): �� Coninte�its: ��5a� l�� . __
E�aluatar'sSi=natui•H � r� U�te ��`�-�L ^,
`�13is cl»nncl ���aluatio�� tornti is inte�ided Ise usHd onl� as a�uide ta �Ssist ia[tida�r�net�s ���d en�ir�onf�tfnl�!'�31'Qf@SS101i3�5 Ili
=atEie�•in� lj1C (�ai9 1'FCl011'Ed b�' t�1i L'�llif•(� CtBICS �I•m� Cnrns af Eu�iEiEErc (0 I11�i:F 3�r�limin�i'� �SS@55li3EEll 4f �ll'EaIll
qllS�ll�'. ��1C SOla� SCdI'E' 1'C�ll�illiq il'Glll i�iE COl71�]I(110i1 Or 1t1i5 r0I'tll 1< <_II�JjfCl i0 �'S.a�� 3jij7I'0\3I flIIC� (IO[S 1SOt lRljl��' :l
]3aiiFCli�3C i111116aElOR I':1T16 GI' !'Cf�UlI'EEl7EIll. �f�]'1i7 Sl]�jC�l l�� ��lwll_c � �ct'S1t�f1 �JC �<<. �0 LE�li's{licliL �:�IC�S`C CG�� `��y-C�h-CT� �,\ �t+.

STREAI�1 QUALjTY �SSESSn'IENT `'�rQRKSHEET
� r . � , , . , .. � , ,. .�. }- , , '�+ �CC�� ��. -_•� _`- ;� '� { ` �' ' '
t �i�,y�*a�i'. .�r^� ���e�TC� xn l,iV��� �iz.'F . 1if+.+. . - -_, n t -_� ��'1)7;'l.'�
� � tt T�"�S �x� �, �� � �-�.+� �� i�.r�
f � � ��'' f �! <rU i �y�, Y�+,e�y �:.._-�,yA` ' ► • (``LOi3$t$� ����Il�ll��`„'� ''L n�ain - ;Y�'.'
�� a�`�,.'.� �' »�<^ ��� � •�1rF` i � ��a., 3��+.i'.,'Y. �7�� s.�.s�ti u - -
-� �:, 1A Presence a�'#iotii� 1 persistept pools in stream `4 _ j p_�} p_$ ,
•�-
� (no llo�v or saiuralfon = D: stron flow = max oints
i; � E��idcnce af pasi Laman ttltcrntian p_� 0– 5 0– 5 �
�',�� (exte��sive alteraiion = 0• no alteration = max oints
=�"�- . Riparian zone .
:�
3 {no buffer. = 0• ronii uous �vide �uffer � max oinis 0– 6 0– 4 Q– 5 �
`` � ��t°idence of nu#ricnt or c�iemical disc3iarges
� � � extensive dischar e� - 0• na dischar es = riiax ints Q– 5 0– 4 0– 4 Z
{ 5 . � Gro�ndw�terdiscl�arge _ �'� � p_3 0--4 0=4 �
�� i no discltai' e= 0• 'r�n s se s �vetlands eic� = max oints
� H � Presence of adjatent tloodplaia 0– 4 0– 4 0-- 2 (�
'� (no iload lain = 0• eatensive #lood �ain � max oints
��' � EnfrencLnjeni I floodp��in Aecess 0– 5 0– 4 0– 2 �
dee i entrenched = 0• �e uent floodin � max oints
'� ��'- � Presence of adj�cent ��•etlands Z
`� 8 (no �vetiands = 0• lar e ad'acent wetlands � max oints) 0– 6 0– 4 0– 2
, �'�
;:;�;� � 9 Channel sinuosity 0– 5 0– 4 0– 3 d
'' exiensive channeiization = a• natural meander � max oints
�'n: � Sediment in�ut �
�� �� eatensive de osition= 0' li#t!e or no sed'unent � maa: ints 0– 5 0– 4 0– 4
�y,.. : ::.:; ,,. ;� w .
�r Size & di��ersity of chaanel bed substrate _� NA"` ��f�; ; p– 4 0– S —
�,� II
.� � (fule homo enous = 0' lar e, diverse sizes � max oints • � , : �±'� �._.
_ j 2 E`�ideace of channel incision or �►�idening �_ 5 g_ 4 Q_� s
�� {dee 1 incised = 0• stable bed c� banl:s = max oints
"� 13 Presence of �najur �ank failures 0– 5 0– 5 fl– 5 ,�
�; se�ere erosion = D• no erosion stable banks = max aints
Raot depth and density on banl:s 0– 3 0– 4 0– 5 Z
,�. 1� no visible root� = 0; dense raots ihrou out = max oints
�� 15 �� Pact by agricuEture, li��estock, or tisnber �roduction 6– 5 0– 4 0– S (�
subsfantial im aci =0• no evidence = max oints
•":: � 6 Presence af riftIe-paa[Iripple-pool complexes 4– 3 0– 5 0– 6 [7
no rifflesl�i les or ools = 0• �;°ei!-de�elo ed = rnax ainu
�: � � Habitat rompleaity 0_ 6 0– 5 0– 6 Z
� (little or na habitat = 0• fr uen varied habitats = max oints
.� 18 Cauopy ca�•erage a��er streambec� 0– 5 0– 5 0– 5 �
(no shadin ve etation = 0• continuous cano v= max oints
f.�+, � 9 � Sabstrafe embeddedness , ., �A'� . . 4 _ 4 d _ 4 �
(dee 3 ernbedded = 4• ]oose structure = max
';: �' �� Presence of stresm in`•erte�rates (see page h) 0–� p–� 0– 5 Q
'' (no evidence = 0; commo�. numerous es = ma� oi�tsl
� �, Presence af am �tihians
G� �� � 0–� 4–� 4–� �
O ino e��idence = 0: com�n4n numerous es = rnax ints
`p Presence of fuh O
�� 0-4 0-4 4-4
�� (no e�ridence = 0: comman, nttmeraus es = n�a�: ints
t. �3 E��icience af «�ildli% use 0– G �– S 0– � �
-�� {na evidence = 4: abundant e��idence = max aints
r" � � ' � ` Tatal Points Po�sihEe . ' � - - ` � .iUO " � 106 � ib0� �
� : - ' ..: .. , . . -� �
_ . TOTA.L SCORE �also enter on first page) . .� �- 3 Z
.._ - � - - -
* These charactensti�5 are not assessea m coa��ai ssreams.

W�7LAN� DE`�ERMINA'iION �A7A FORM —Atlantic and Gulf Coastal Plain Reglon
ProjecUSkte: SampsOn 148 CItylCounty; Sampson County Sampling Dale: 3I21�8
AppEicantlOwner. NCDOT 5ta�e: NC 5ampling Point: WA4 Wet
Investigator(sp Vaughan Section, Township, Range: �A
Landform (hiltslope, terrace, elc.): Depression Local relief (concave, canvex, nonej: Concave Slope (96): z
Subregian (LRR or MLRA); LRRP Lat: 35.OB069 �flng: -78.5089Q Oatum: WGS$4
Soil Map Unit I�ame: Si�� and Jahnston soils, freq�ently flaoded NWi classification: �FO
Are climalic 1 hyclrotagic condttians on the site typica! for this time of year? Yes X No (If no, explain in Remarks.)
Are Vegelallon , Sail , or Hydrolagy signiScantly dEsturbed? Are "Normal Circumslances" present? Yes x Na
Are Vegetalion , Soil , or Mydrology nalurally problematic7 (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map shawing sampling point focations, transects, imporEant features, etc.
Hydrophytic Vegetation Present?
Hydric Soll Present7
Wetland Hydrology Presenl7
h1YDRO�OGY
Yes X �o �s the Sampled Area
Yes x No within a Wetland7 Yes X No
Yes x No
Wetland Hydrology Indiaators: 5econdarv Indicators (minimum oi two,�g�quiredl
Primarv Indicalors {mfnimum of ane is reauired: ciieck ap Ihat aflalvl ❑ 5ufface Soll Cracks (BB)
�5urtace Waler (A1) 1❑--f Aqualic Fauna (B13) 5parse�y Vegetated Concave SurCace (88)
� High Water Table {A2j tu-7 Marl Deposits (B15) (LRR L} +� Drainage Pattems (81U)
� Saturatian (A3) l..J Hyslrogen S�Ifide Odor (Ci ) Mflss 7rim Lines (B16)
I f () P 9 9 () sY- ()
�� Weter Marks 61 1--� Oxidized Rhfzas heres alon Livin Roots C3 ❑ D 5eason Waler Tabfe C2
✓� Sedimant Deposits (B2) I--[ Presence of Reduced Iran (C4) � Crayfish Burraws (C8)
Drkfl Oeposils (B3) Q Recenl Iron Reduction [n Tilled Soils (Cfi) � Saturakion Visible on Aeriallmagery (C9)
Q, Algal Mat or Crust (B4j � Thin Muck Sur(ace (C7} ❑ Geomorphlc PosltEan (D2)
a Iron �eposils (85) Other (�cplain in Remarks} ❑ Shallaw Aquitard (D3)
a Inundation Visible on Aerial Imagery (B� II FAGNeutral Test (D5)
[], Waler-5iained leaves (�9) �] Sphagn�m mass (D8j (LRR T, U}
Flald 4bservatlans:
Surface Water Presenl7 Yes No x �eplh (inches): Np'
Waler Tab[e PresenlT Yes X Na Deplh (Inches): ��
Saturat�an Present7 Yes x Na Deplh (inches): 4 Wetland Hydrology Present7 Yes X No
includes ca illa frin e
describe Recorded Data (stream gauge, monitori�g we1i, aerial photos, previaus inspectEons), if available;
Remarks:
US Army Corps of Engineers Atlantic and Gulf Coastal Plain Region — Version 2.0

VEGETATION (Four Strata} - Use scientifc names of plants.
Tree Stratum (Plot size: 30i1 X 30f1 � 96 Cover ecies? Status
�. Acerrubrum 20 yss FAC
� Liquldam6ar styracif�ua 40 yes FAC
3.
4.
5.
6.
7.
$. -
60 = Total Caver
50�6 of tota! cover: 30 2096 of lotal cover. 12
SeolinalShru6 5tratum {Plot slze: 30ft X 30ft }
�, Lfguslrumsinense 60 yes FAC
2.
3.
4.
5.
B.
7.
8.
60 = Total Caver
5096 of total cover: 30 2095 of iatal cover: 12
Herb Stratum (Plot size: 30i1 X 30ft �
� Nvne
2.
3.
4.
5.
B.
7.
$.
9.
10.
11.
t2.
� = i'atal Caver
5496 of total cover. 2096 of total cover:
Wooclv Vine 5tratum (Plot size: 34R X 34R �
�. Smilax rolundifalla 24 yes FAC
2.
3.
4.
5.
20 = Total Cover
5036 of total cover: 1 a 2496 of total cover: `�
5ampling Paint: �A4 Wet
Number of Domfnanl Species
Thal Are OBL, FACW, or FAC: a (A)
Total Numher af Dominant
Spectes Acrass All Strata: 4 (B)
Percent of Daminant Species
That Are OBL, FACW, ar FAC: 1D0 �q�g�
To�al 9b Cove� 4t: Multinlv bv:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x b =
UPI. species x 5 =
Column iolals: (A) {Bj
Prevalence Index = B1A =
Hydrophytic Vagatation Indicators:
❑ 1- Rapid Test 4or Hydrophytic Vegelation
�✓ 2 - Dominance Test is �5096
❑ 3- Pre�alence Index is 53.U°
II Problematic hlydraphytic Vegelalicn' (Facplain}
'Indicators ot hyddc soil end wetland hydrology must
be present, unless dis�urbed or pro6lematic.
Tree - 4Voody plants, exGuding vines, 3 in. (7.6 cm) tir
mare in diameter at breast height (pBHj, regardless of
heighl.
SaplinglShru6 - Waady plants, exGud]ng �ines, less
than 3 in. DBhI and greater than 3.28 ft i� m) tall.
Harb-All herbaceous (non-woody) ptanls, regardfess
of size, and woady plants less ihan 3.28 ft tafl.
Waody vine - All woody vines greater than 3.28 ft in
hefght.
Hydrophytic
Vsgetatian
Present? Yas x No
US Army Corps of Engineers Atlantic and Gulf Coastal P1ain Region - Version 2.0

SDIL Samp�ing Point: WA4 Wet
Profile Description: (Oescribe to the depth needed to document the indicatar or conflrm the absence of indicators.)
De�th Matrfx
(ir�chesl Color (moistl � Color (moistl � Tvne Texlure Remarks
0-14 10 yr 212 100 ML high organics
'10-20 10 yr 211 1 DO L
�T e: C=Concentralion, D=De letfon RM=Reduced Malrix MS=Masked Sand Grafns. =Location: PL=Pore Linin M=Matrix.
Hydric Soil Indfcators: {AppllcabFe to all LRRs, unless otherwfse notsd.} Indicators for Problematic HydHc SvfIs':
� Histosol (A1) n Polyvalue Below Suriace (58) (LRR S, T, U} 1 cm Muck (A9) {LRR aj
�HistEc Eplpedon (A2j � Thin dark Surface (59) (LRR 3, T, U) 2 cm Muck (A10) (LRR 5�
Black Histic (A3} Loamy MnGry Mineral {F1) (LRR O� Reduced VeAic (F1 B) (outsida MLRA 150A,B)
� Mydrogen Sulfide (A4) � Loamy Gleyed hlfatrix (F2) � Pledmont Floodplain 5oils (F19) (LRR P, S, T�
�5tralified Layers (A5) DepleEed Matrix (F3) �,4nomalous Brighl Loamy 5ails (F20}
arganic Bodies (ABj (LRR P, T, U) � Redax Dark Surface (FS) {MLRA 153Bj
�5 cm M�chy Mlneral (A7j (LRR P, T, Uj � DepleEed aark Surtace (F7j ❑ Red Parent Material (TF2)
Muck Presence (A8} [LRR Uj Redox Depresslons (Fe) � Very Shallow Dark Surface (TF42)
� 1 cm Muck (A9) (LRR P, T} n Marl (F10) (LRR Uj � Oiher {Facplain in Remarks}
II �epleted Below dark Surface (A11) � Depleted Ochric (F11) (MLRA 151 j
� Thick Dark Surface (Ai2) L] Iran-Manganese Masses (F12} {LRR O, P, T) 'Indicato�s of hydrophytic vegelation and
$Coast Preirie Redox (A16) (MLRA 184Aj Umbric Surfsce {F13) (LRR P, T, Uj wetland hydroloqy musl be present,
5ancly Mucky Mineral (S1) {LRR O, S) Delta Ochric (F1� (MLRA 151j unfess disiurbed or problemalic.
D Sandy Gleyed Matrix {S4) ,[] Recfuced Vertic (F18) {MLRA 150A,15DBj
D 5andy Redox (55) � Piedmonl Floodplain Sails (F19) {MLi2A 149A)
II 5tripped Matrix (SB) Anomalaus Srlght Loamy Sotls (F20� (MLRA 149A,153C,153a)
n Dark 5urtace (S7} (LRR P, 5, 7, U)
Restrictive l.ayer {If observed):
Type:
Deplh (inches): Hydric 5oil Present? Yas x No
Remarks:
US Army Corps of Engineers Aqantic and Gulf Coastal Plain Region — Version 2.fl

WETLAND DE'T'�RMINATION DATA FORM — Atfaniic and Gulf Coastal Plain Region
Project/Site: 5ampson 148 CitylCnunty: Sampson County Sampling Uaie: 3-2-1$
Applicant/Owner. NCbOT State: NC SampEing Paint: WA4 Up
Investigator(s}: Vaughan Section, Township, Range: none
l.a�dform (hfl�slope, terraca, etc.): Depression Local re[ief (wncave, convex, none): ConCave Slope (%): �
Suhregian (LRR or MLFtA): LRRP �at: 35.06074 La�g: -78.50903 Datum; WGS84
Soil Map llnit Name: �Ibb and Johnston soils, frequently flooded N1M classifcation; NA
Are climalic ! hydrolagic condilions on the site typical for khis time of yea� Yes X No (If no, explain in Remarks.)
Are Vegetatian , Soil , ar Hydralogy sEgnificantly disturbed7 Are "Normal Circumstanoes' present? Yes X No
Are Vegetation , 5oil , or Fiydrology naturally problematic? {If needed, explain any answers in Remarics,)
SUMMARY OF FINDINGS — Attach site map showing sampling paint locations, transects, important features, etc.
Hydraphytic Vegetation �resent?
Hydric 5oil Present?
Wetland Hydralogy Present?
HYDR�LOGY
Yes X No
Yes No X
Yes No X
Is the Samplsd Area
within a Wetland? Yes No X
Wetland Hydro�ogy Indicators: Sewndarv_Indicators {minimum of two reqN[redl
Primery Indicalors frreinimum of one is reauired: check all that aoolvl ,^ n Sur�ace Soil Cracks {86)
Q Surface Water {Ai) ❑ Aquatic Fauna (813) Sparsely Vegetated Conca�e SurFace {68)
II High WaterTable (A2j II Marl Deposits {6i5} �LRR ll) Drainage Pattems (Bi0)
II Satureticn (A3) II Hydrogen Sulfide Qdor (C1) Moss Trim �[nes (Bi6)
g Water Marks (81) II Oxidized Rhizos�heres along Livi�g Roots {C3} ❑ Dry-5eason Water Table (C2�
�Sediment Deposits (B2� � Presence of Reduced Iron (C4} II Cra�sh Burrows (CB}
�rift Deposits (B3} Q Recent Iron Reduclian in Tilled 5ails (C6) II 5aturation Vsible on Aerial Imagery (C9j
II Algal Mat or Crust (B4) Thin Muck 5urfaoe (C7} II Geomorphic PositEon (D2j
II Iron Deposits (B5) Other (Explain in Remarks) II Shallow Aquitard (D3}
a In�ndalian VisibEe on Aerial Imagery (67) II FAC-Neutre[ Test (D5}
a Water-Stained Leaves (B9y II Sphagnum moss (DB� (LRR T, U}
Field Observations:
Surface Water Present? Yes No x Depth (inchesj: NA
Water Table Present7 Yes No x Depth (inchesj: '2fl inches
5aturalion Presenl7 Yes No x �epth (inches): '20 inches Wetland Hydrolagy Present? Yes I�o x
includes ca illa frin e
Uescribe Recorded �ata (stream gauge, monitoring well, aerial photas, prev�ous inspections), if available;
Remarks:
U5 Army Corps of Engineers Atlantic and Guli Coastal Plain Region — Versian 2_0

VEGETATION (Four Strata) — Llse sci�ntific names af plants. samAiin9 Potnt: w,aa �1p
Absolute Qaml�ant Indicatar porriinance 7'est worksheet:
Tree Stralum (Plot size: ��ft x�� ) °1sS4��L. �3 �i�1L� Number of Dominant Species
�. None That Are 08L, FACW, or FAC: ti3 (A)
Z' 7otal Number of Daminant
3• Species Across All 5trata: 4 (B)
4.
Pertent of �ominant Species
5• Thal Are bBL, FACW, or FAC: 5fl�� (PJB)
fi.
7 Prevalence Index workshest:
e 'fotal % Cover of: Muftiolv hY:
� = 7otal Co�er OB! speraes ��' x 1=��$
50°� of total cover: 20°� oi tatal wver. FACW species � x 2= �
�q� x r�pg FAC specie5 11Q x 3= 3��
5aulinal5hrub Stratum (Plot size: )
� Ligustr�m sinensa BO Yes FAC FACU species 2a�� 5 x 4= 80160
Z, Phytolacca amedcana 5 IVo FACU UPL species 4 x 5= 0
3.
Column Tolals: �30 �q� 41Q1395 {g�
4• Prevalence Index = BIA = 3.1513.03
5• Hydrophytic Vegetation �ndicators:
6.
7- Rapid Test for Hydrophylic Vegetation
7.
2 - Domfnance Test is �50°�
8.
3- Prevalence Index is 53.01
85 = ToSal Cover a prablemalic Hydrophylic Vegetalion' (�acplain)
50°� af latal cover: 42�� 20°� of total wver. ��
Herb Stratum (Plat sEze: � On x��� ) 'Indicators of hydric soil and wetland hydrology must
1. Dlchanthelium sp. 5 Yes �ncuroe� be present, unless disturbed or problematic,
2, DefinitIons af Four Vegetation Strata:
3.
Tree — Woody plants, exGuding vines, 3 in. (7.8 cm} or
4. mare in diameter at breast heighl (DBH), regardless of
5 height.
fi• 5aplinglShruh — Woody plartts, excluding vines, less
7, lhan 3 in. DBN and greater than 3.2B R(1 m) tall.
8• Herb — All herbaceous (non-woody) planls, regardless
g, of size, and woody plants less than 3.28 fl IaIL
10. Woody vine —All woody �ines greater than 3.28 R In
11. height
12.
5 = Tolal Cover
5U°� of tolal cover. Z•� 20°� aF total cover: 1
�Voody Vfne Stralum (Plot sEze: 10H x 50ft �
�. Lonicara japonica 9U Yes FACU
z. 5milax rotundifalia 34 Yss FAC
3.
A.
�• Hydrophytic
Aa = Tatal Cover Vegehation
54% at tatal cover: 20 20°� of latal co�er: B Present7 Yes No X
Remarks: {1f observed, list marphological adaptations below).
Pre�alence test was performed witF� Dichanthefi�m as FACU and OBL. Prevalence indexes were
both >3.0
U5 Army Corps af Engineers Atlantic and Gulf Coasial Plain Region — Verslon 2.0

SOII.
or
Sampling Point: WA4 Up
Qeplh Matrix Redox Featu�es
linchesl Calor fmaistl °�a Color lmaistl % Tvoa Loc� 7exiure Remarks
0-5 'i Oyr 312 100 5
5-20 2.5y 414 10Q
S
�iype: C=Cancentratian, D=Deplstian, RM=Reduced Mat�ix, MS=Masked Sand Grains. �Lacation: PL=Pore Lininq, M=Matrix.
Hydric Soil Indicators: (Applicahla to all LRRs, unless otherwfsa noted.j Int3icators for Problematic Hyd�ic Solls':
r Histasol (A�) �'
Hislic Epipedon (AZ)
Black Histic (A3)
Mydrogen Sulfide (A4}
Stratified Layers (A5)
Organfc Bodies (A5} {I.RR P, T, U}
5 cm Mucky Mineral {A7) (LRR P, T, U}
Muck Presenca (AS) (LRR U}
1 cm Muck {A9) {LRR P, Tj
Depleled Below Dark Surface (A1 i}
Thick Dark Surface (Al2)
Coast Prairie Redox (A16) (MLRA 150A}
Sandy Mucky Mineral (51} (LRR O, 5j
Sandy Gleyed MaUix (S4)
5andy Redox (55)
5tripped Matrix (56)
Dark Surface (S7) {LRR P, S, T, Uj
Type:
Depti� (inches}:
Polyvalue 8elow 5urface (S6} {LRR S, T, U) 1 cm Muck (A9) (LRR Oj
Thin Uark 5urface (59} (LRR S, T, U) 2 cm Muck (A1fl) (I.RR S)
Loamy Mucky Mineral (F1) (LRR O) Reduced Vertic (F�8) (outside MLRA 154A,Bj
Loamy Gleyed Matrix (F2) � Piedmont Fioodplain 5oils (Ft9� (I.RR P, S, T}
Depleted Matrix (F3} � Anomalous 9right Loamy 5oils (F2U)
Redox dark Surtace (Ffi} (MLRA 1538)
Depletec! Dark Surtace (F7} ❑ Red Parent Material {TF2}
Redox pepress[ons (FB} � Very Shallow Da�k Sufface (TF�2j
Marl (F10} {LRR Uj D Other (Facplain in Remarks}
Depleted Ochric (F11) (MLRA 151)
Iron-Manganese Masses (F12) (LRR O, P, �') 'Indicators of hydraphylic vegetaSion and
Umbric Surfaoe (F13� (LRR P, T, Uj wetland hydrology musk be present,
Delta Ochric (F17) (MI.RA 151 j unless disturhed or problsmalic.
Reduced Vertic (F1B) (MLRA 15UA,15aBj
Piedmont Flaodplain Saiis {F19) (MLRA 149A)
Anomalous Bright Laamy Svils (F20) (MLlZ4 '149A, 953C, 153D}
Hydric Soil Present7 Yes No X
US Army Corps of Engirieers Atlantic and Gulf Coastal Plain Region — Version 2.0