20171506 Ver 1_Jurdistictional Determination_20171127 (2)

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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
November 6, 2017
Crystal Amschler
US Army Corps of Engineers
Asheville Regulatory Field Ofiice
151 Patton Avenue, Room 208
Asheville, North Carolina 28403
7AMES H. TROGDON, III
SECRETARY
Reference: Preliminary Jurisdictional Determination for Proposed Improvements to Brookshire
Boulevard (NC 16) (TIP No. U-6084)
Dear Ms. Amschler,
Please iind the attached Preliminary Jurisdictional Determination Packet for NCDOT STIP Project
U-6084 in Mecklenburg County, NC. The North Carolina Department of Transportation (NCDOT)
proposes to perform improvements to Brookshire Boulevard (NC 16) from I-485 to approximately
0.4 miles beyond Mt. Holly-Huntersville Road.
Stantec has been retained by the NCDOT to provide environmental services related to Waters of
the US. The 29.6-acre project site was delineated on August 8 and September 20, 2017 using the
Routine Determination Method as outlined in the 1987 Corps of Engineers Wetland Delineation
Method, and methods described in the 2012 Regional Supplement to the Corps of Engineers
Wetland Delineation Manual: Eastern Mountains and Piedmont (Version 2.0). Approximately 447
linear feet of perennial and intermittent stream was delineated in the project area. One (0.03 acres)
wetland and one beaver pond (0.07 acres) were also delineated in the project area.
The project area is located in northwest Charlotte in Mecklenburg County, and lies within the
Piedmont ecoregion. The project area is characterized by rolling topography, good drainage, and
grassy stream margins. Land use in the vicinity of the project area consists primarily of residential
and commercial development with forested remnants remaining between the developed areas.
An overview of the streams delineated within the project area, their classiiication, and length are
presented in Table 1. An overview of the wetland delineated, its acreage, NCWAM classiiication,
hydrologic classifications is presented in Table 2. The location of all streams, wetlands and open
waters is presented in the attached potential jurisdictional features map. The stream locations were
ground-truthed and stream origins and wetland flags were surveyed using a sub-meter GPS unit.
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
HIGHWAY DNISION 10
716 W. MAIN STREET
ALBEMARLE, NC 28001
Contact:
Telephone: [phone]
Fax: [phone]
Website: www.ncdot.gov

Perennial Stream C was delineated during a previous delineation (SAW-2015-01564) and was
surveyed using traditional land surveying. Internuttent Stream E downstream of the current project
area was also included in that delineation. A NWP 39 was approved and completed for impacts to
Stream C in 2015. This 2017 delineation includes Stream C beginning at the location of the
previous fill as well as upstream extents of Stream E.
The attachments include photos, a Jurisdictional Determination Request form, Preliminary
Jurisdictional Deternunation form, a project area and vicinity map, a USGS topographic map,
National Wetland Inventory map, soils map, potential jurisdictional features map, and NCSAM
Worksheets. Please feel free to contact me if you have any questions.
Thank you for your assistance.
Sincerely,
Larry Thompson, PWS, LSS
Division 10
NCDOT
Cc: Donna Hood, DWR
Attachments: Summary Tables
Photos
Jurisdictional Determination Request
Preliminary Jurisdictional Determination Form
Vicinity & Project Area Map
USGS Topography Map
National Wetland Inventory & Soils Map
Potential Jurisdictional Features Map
NCSAM Forms

Table 1. Jlirisdictional characteristics of streams in the
Map ID
SA
SC
SE
Total
Length
(ft.)
178
179
90
447
Classificatio
Perennial
Perennial
Intermittent
ect area
Compensatory
Mitigation
n Re uired
Yes
Yes
Yes
Table 2. Jurisdictional characteristics of wetlands in ihe ro�ect area
Map ID Acres NCWAM Classi�cation Hydrologic
Classification
WA 0.03 Riverine Swamp Forest Riparian
River Basin
Buffer
Not Subject
Not Subject
Not Subiect

Representative Photos
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Photo 1— Stream A and Wetland A iooking upsh-eam (8/8/17 post rain)
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Photo 2. Beaverdain at Wetland A/Po�1d 1(8/8/17 post rain)

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Photo 3— Stream C— previous fi 11 (gravel/pipe) (9/20/ 17)
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Photo 4— Stream C(8/8/17 post rain)
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Photo 5— Stream E west of Brool<shire Blvd (8/8/17 post rain)
Photo 6. Stream E east of Brookshire Blvd (looki�ig downstream) (8/8/17 post rain)

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Photo 7. Stream E through transmissioi� ROW (just downstream of project area) (9/20/17)

urisdictional Determination ReQuest
US Army Carps
of EngEneers
Wilmington Diskrict
This fornl is intended for use by anyone requesting a jurisdictional determination (JD) froin the
U.S. Army Coips of Engineers, Willnington District (Corps). Please include all supportiilg
information, as described within each category, with your request. Yoii may subinit your request
via mail, electronic mail, or facsimile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be found on-line at:
http://www.s�w.usace.arniy.mil/Missions/RegulatoryPermitPrograin/Contact/CountyLocator.aspx,
by calling 9l 0-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CITARI.OTTE REGULATORY
FIELD OFFICES
US Army Corps of Engineers
151 Patton Avenue, Room 208
Ashcvillc, North Carolina 28801-5006
Ge�leralNumber: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps oF Engineers
3331 Heritage Trade D�ive, Suite 105
Wake Forest, North Carolina 27587
General Ntiimber: [phone]
Fax Number: [phone]
INSTRUCTIONS:
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Cngineers
2407 West Fifth Street
Washington, Noi�th Carolina 27889
General Number: (910) 25 ] -4610
Fax Nunlber. [phone]
WILMINGTON REGULATORY FIELD OTFICE
US Army Coips of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client ar your agency, please note the specific submittal requirements in Part H.
NOTE ON PART D— PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests must include the current property owner authorization for the Coips to
proceed with the detennination, which inay include inspection of the property when
necessary. This form must be signed by the current property owner(s) or the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D- NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with Narth Carolina Department of Transpoi�tation (NCDOT)
projects will be conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD
inay not be valid for the wetland conservation provisions of the Food SecLirity Act of
1985. If you or your tenant are USDA Program participants, or anticipate participation in
USDA programs, yoli should also request a certified wetland determination from the local
office of the Natural Resources Conservation Seivice, prior to starting work.
Version: May 2017 Page 1

►:�
B
C.
Jurisdictional Determination Request
PARCEL INFORMATION
StreetAddress: Brookshire Blvd & Mt. Holly-Huntersville Rd
City, State:
County:
Charlotte, NC
Mecklenburg
Parcel Index Number(s) (PIN): Cl/a
REQUESTOR INFORMATION
Name: Larry Thompson, LSS, PWS
Mailing Address
Telephone Number:
Highway Division 10, 716 Main St
Albemarle, NC 28001
704-983-4400
Electronic Mail Address: IthOfl'[e-mail]
Select one:
� I am the current property owner.
� I am an Authorized Agent or Environmental Consultantl
� Interested Buyer or Under Contract to Purchase
� Other, please eXplain. NCDOT Division Environmental Officer
PROPERTY OWNER INFORMATIONZ
Name: Il/a
Mailing Address:
Telephone Number:
Electronic Mail Address:
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,a
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Print Name
Capacity: ❑ Owner ❑ Authorized Agents
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
� I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
� I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
QI intend to construct/develop a proj ect or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
� I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section lO list and/or is subject to the ebb and flow of
the tide.
� A Corps JD is required in order obtain my local/state authorization.
� I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
� I believe that the site may be comprised entirely of dry land.
� Other:
For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

F.
❑✓
�❑
❑
G.
0
Jurisdictional Determination Request
JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
I am requesting that the Corps provide a preliminarX JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter OS-
02).
I am unclear as to which JD I would like to request and require additional infortnation
to inform my decision.
ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 29•6 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
� Project Coordinates (Decimal Degrees): Latitude: 35.325675
Longitude: -80.94522
� A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than l 1x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For Approved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non-wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non-Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non-
jurisdictional upland features should be identified as Non-Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminary Jurisdictional Determinations:
Wetland and non-wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non-wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
� Completed Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.mil/Missions/Re,gulatorv-Permit-
Pro,gram/Jurisdiction/
Version: May 2017 Page 5

✓❑
�
�
✓❑
�
Jurisdictional Determination Request
Completed appropriate Jurisdictional Determination form
PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
AJDS, please complete an Approved Jurisdictional Determination Formg
Vicinity Map
Aerial Photograph
USGS Topographic Map
Soil Survey Map
� Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
� Landscape Photos (if taken)
� NCSAM and/or NCWAM Assessment Forms and Rating Sheets
� NC Division of Water Resources Stream Identification Forms
� Other Assessment Forms
� www.saw.usace.army.mil/Portals/59/docs/repulator.�,gdocs/JD/RGL 08-02_A�p_A_Prelim JD_Form fillable.pdf
g Please see http://www.saw.usace.army.mil/Missions/Re ug latory-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the proj ect area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made a�ailable as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approvedjurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2- PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: � �/6/� 7
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Larry Thompson
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: U-6084 BfOOkShll"2 BOUIeVard ICYIpI'OV2CT1eC1tS
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: nJC County/parish/borough: MeCkIe11bU1'g c�ty: Charlotte
Center coordinates of site (lat/long in degree decimal format):
�at.: 35.325675 �ong.: -80.94522
Universal Transverse Mercator: NAD 1983 UTM Zone 17N
Name of nearest waterbody: UT to Long Creek, UT Mountain Island Lake
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)
SA 35.327997 -80.948928 177.7 If non-wetland waters 404
SC 35.324813 -80.942390 179.2 If non-wetland waters 404
SE 35.324040 -80.942598 89.7 If non-wetland waters 404
WA 35.327939 -80.948827 0.03 ac wetland 404
P1 35.327852 -80.948684 0.07 ac non-wetland waters (pond) 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:stream and wetland 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: 1:24K Mountain Island Lake
� Natural Resources Conservation Service Soil Survey. Citation: Mecklenburg Co
�■ 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: saw-2o�5-o�5sa si�oi�5 �pa�t�ai o�eriap>
� Other information (please specify): NCSAM forms for SE and SC
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.

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IMPROVEMENTS
MECKLENBURG COUNTY
TIP PROJECT U-6084
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Legend Project Location 1 7 1 001 778
; Hunfersville " NORTH CAROLINA DEPARTMENT OF TRANSPORTATION wo�e cou�ry, Nc P�epa�ed ov a.�c o� zon-�o-�9
; — � ;� � U6084 Project Area recnr,icai ae��ew nY rnMe on zoi�-io-2o
, ;Y'�o DIVISION OF HIGHWAY$ o-,aepe�denree��ewby�so�zon-�o-zo
'' _ DIVISION 10 USDA-NRCS Soil Map Units C�ient/Project
16 �--- NCDOT - Division of Hi hwa s- Division 10
Hydric Soils (Primarily Non-Hydric with Hydric Inclusions) 9 Y
GASTON NWI Wetlands Brookshire Blvd (NC16) Improvements
(� 0 300 600 TIP U-6084
Feet Freshwater Forested/Shrub Wetland Figure No.
� � Freshwater Pond 3
�' MECKLENBUR 1:3.600 (At original document size of l 1x17) Title
- ` Na�eS Soil Survey and NWI Map
Mf. Holly
Charlotfe 1 Coordinafe Sysfem: NAD 19835tqfePlane North Carolino FIPS 3200 Feet
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2 Mecklenburg County. NC SoIlSurvey: Web SoIlSurvey 2016
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J DIVISION OF HIGHWAYS
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1:2,800 (At original document size of l 1x17)
Notes
1. Coordinafe Sysfem_ NAD 19835tqfePlane North Carolino FIPS 3200 Feet
2. Streams and wetlands delineated by Huysman & Bandy (2015) and Stantec (2017)
3. Mic�osofi protlutl screen shot�sJ reprinfed wlth permission from Microsoft Corporoiion
Riverbend
Site Development
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Legend
� U6084 Project Area
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ProjectLocation 171001778
Wake County, NC Prepared by ALC on 2017-10-19
TeChniCal Review by MMR on 2017-10-20
Intlependenf Review by DS on 2017-10-20
Client/Project
NCDOT - Division of Highways - Division 10
Brookshire Blvd (NC16) Improvements
TIP U-6084
Figure No.
rti4
Potential Jurisdictional Waters Map

ies User Manual Version 2.1
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): U-6084 Brookshire Blvd 2. Date of evaluation: 9/20/17
3. Applicant/owner name: NCDOT 4. Assessor name/organization: A Coleman / Stantec
5. County: Mecklenburg 6. Nearest named water body
7. River Basin: Catawba on USGS 7.5-minute quad: Long Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.324888, -80.942119
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): Stream C 10. Length of assessment reach evaluated (feet): 100
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 8-10' f Unable to assess channel depth.
12. Channel width at top of bank (feet): 10-15' 13 ls ,; �ne �ach a<��;amp sire;in,? �'c:, � No
14. Feature type: ��«�' Perennial flow � Intermittent flow � Ti��d P�,tar,h S�r<<ui,
STREAM RATING INFORMATION:
15. NC SAM Zone: � Mountains (M) � Piedmont (P) � Inner Coastal Plain (I) � Outer Coastal Plain (0)
16. Estimated geomorphic \ /
valley shape (skip for � a ��-
Tidal Marsh Stream): (more sinuous stream, flatter valley slope)
17. Watershed size: (skip .�"'� Size 1(< 0.1 mi`) � Size 2(0.1 to < 0.5 mi`)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
�•'� b
(less sinuous stream, steeper valley slope)
�� Size 3(0.5 to < 5 mi`) � Size 4(>_ 5 miZ)
18. Were regulatory considerations evaluated? � Yes � No If Yes, check all that appy to the assessment area.
� Section 10 water I Classified Trout Waters I� Water Supply Watershed ([� I �� II �� III � IV � V)
� Essential Fish Habitat � Primary Nursery Area � High Quality WaterslOutstanding Resource Waters
f Publicly owned property I- NCDWR riparian buffer rule in effect f Nutrient Sensitive Waters
f Anadromous fsh I 303(d) List i- CAMA Area of Environmental Concem (AEC)
r pocumented presence of a federal and/or state listed protected species within the assessment area.
List species:
f Designated Critical Habitat Qist species):
19. Are additional stream information/suoolementarv measurements included in "Notes/Sketch" section or attached? �: Yes �"' No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
� A Water throughout assessment reach.
� B No flow, water in pools only.
� C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
� A At least 10 % of assessment reach in-stream habitat or riffle-pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
� B Not A
3. Feature Pattern - assessment reach metric
� A A majority of the assessment reach has altered pattern (examples: straightening, modifcation above or below culvert).
� B Not A.
4. Feature Longitudinal Profile - assessment reach metric
� A Majority of assessment reach has a substantially altered stream profile (examples: channel down-cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profle has not reformed from any of
these disturbances).
� B Not A
5. Signs of Active Instability- assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down-cutting (head-cut), active widening, and artificial hardening (such as concrete, gabion, rip-rap).
� A < 10% of channel unstable
� B 10 to 25 % of channel unstable
� C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
�A �A
�B �'�'B
�.'�C �C
Little or no evidence of conditions that adversely affect reference interaction
Moderate evidence of conditions (examples: berms, levees, down-cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors - assessment reachlintertidal zone metric
Check all that apply.
� A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
� B Excessive sedimentation (burying of stream features or intertidal zone)

C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
D Odor (not including natural sulfide odors)
E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
F Livestock with access to stream or intertidal zone
G Excessive algae in stream or intertidal zone
H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
I Other: (explain in "Notes/Sketch" section)
J Little to no stressors
Recent Weather—watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
� A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
� B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
� C No drought conditions
9 Large or Dangerous Stream — assessment reach metric
� Yes �.�' No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In-stream Habitat Types — assessment reach metric
10a. � Yes � No Degraded in-stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in-stream hardening [for example, rip-rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if > 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
� A Multiple aquatic macrophytes and aquatic mosses � N u F 5% oysters or other natural hard bottoms
(include livenvorts, lichens, and algal mats) � m � G Submerged aquatic vegetation
� B Multiple sticks and/or leaf packs and/or emergent o� �� H Low-tide refugia (pools)
vegetation � r o� I Sand bottom
I C Multiple snags and logs (including lap trees) L� � J 5% vertical bank along the marsh
� D 5% undercut banks andlor root mats and/or roots v� � K Little or no habitat
in banks extend to the normal wetted perimeter
( E Little or no habitat
********'***************'********REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****'***************'*******
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11 a. � Yes �.�' No Is assessment reach in a natural sand-bed stream? (skip for Coastal Plain streams)
11b. Bedform evaluated. Check the appropriate box(es).
� A Riffle-run section (evaluate 11 c)
f B Pool-glide section (evaluate 11 d)
� C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) _
absent, Rare (R) = present but s 10 % , Common (C) _ > 10-40 % , Abundant (A) _ > 40-70 % , Predominant (P) _ > 70 % . Cumulative
percentages should not exceed 100 % for each assessment reach.
NP R C A P
��.`�' � � � � Bedrock/saprolite
��:, �; �; �; �; Boulder (256 — 4096 mm)
� � � � � Cobble (64 — 256 mm)
� � � � � Gravel (2 — 64 mm)
� � � � � Sand (.062 — 2 mm)
� �«'� � � � SilUclay (< 0.062 mm)
� � � � � Detritus
� � � � � Artificial (rip-rap, concrete, etc.)
11d. � Yes � rJo i�� � po���s fiil� I ihi srcfnn�nr? fskip for Size 4�oastal Ptain streams and Tid�l Nlarsh Strea��e�sj
12. Aquatic Life — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. � Yes � No Was an in-stream aquatic life assessment pertormed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. � No Water � Other:
12b. � Yes '[�'� No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
(c I� Adult frogs
� � Aquatic reptiles
r � Aquatic macrophytes and aquatic mosses (include livenvorts, lichens, and algal mats)
I� � Beetles (including water pennies)
� f Caddisfly larvae (Trichoptera [T])
j� j` Asian clam (Corbicula )
� f Crustacean (isopod/amphipod/cra�sh/shrimp)
� � Damselfly and dragonfly larvae
� � Dipterans (true flies)
� f Mayily larvae (Ephemeroptera [E])
� � Megaloptera (aldertly, fshfly, dobsonfly larvae)
� f Midges/mosquito larvae
� f- Mosquito fish (Gambusia ) or mud minnows (Umbra pygmaea)
� � Mussels/Clams (not Corbicula )
� 1 Other fish
� Salamanders/tadpoles
f- Snails
f Stonefly larvae (Plecoptera [P])
f Tipulid larvae

f— � Worms/leeches
13. Streamside Area Ground Surtace Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
'�"� A � A Little or no alteration to water storage capacity over a majority of the streamside area
� B � B Moderate alteration to water storage capacity over a majority of the streamside area
� C � C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
� A � A Majority of streamside area with depressions able to pond water >_ 6 inches deep
� B � B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
� C � C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
� Y � Y Are wetlands present in the streamside area?
�N �N
16. Baseflow Contributors — assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
(— A Streams and/or springs Qurisdictional discharges)
� B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
� C Obstruction that passes some flow during low-flow periods within assessment area (beaver dam, bottom-release dam)
I� D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
� E Stream bed or bank soil reduced (dig through deposited sediment if present)
� F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
� A Eviden_r,F of sub�t� niial waler withtira�vals from the ass�ssmeni reach (includes areas excavated for pump ino<<,Il.j:icn )
f B Ohistruction not passing flow during low fiow periods affecting the assessment reach (ex: wateriight dam, sedimen? drpnsit)
� C Url�an sVeam (- 24% impervious surface for watershed)
� D Eviderce tnat ihe sfrearn-side area ha_ :�� n ���'iFi�= I i _.d�h�g u� ri�. .i;a �_ +raina� u int�; the �ssm� � i.,s'r�
� E Assessmen[ re.arh r.�lc�cat2d to valle/ �dei�,
f� F None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf-on" condition.
'� A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
� B Degraded (example: scattered trees)
� C Stream shading is gone or largely absent
19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
� A '�".� A � A � � A >_ 100-feet wide or extends to the edge of the watershed
� B � B � B � B From 50 to < 100-feet wide
� C � C � C � � C From 30 to < 50-feet wide
� D P� � D � D '�'� D From 10 to < 30-feet wide
� E � � E � � E � � E < 10-feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
� A � A Mature forest
� B � B Non-mature woody vegetation or modified vegetation structure
� C � C Herbaceous vegetation with or without a strip of trees < 10 feet wide
� D � D Maintained shrubs
� E � E Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: I�
�k)u[E �Ui�cct 30-5(ilc;,Yi
L� RE L[' RF3 LF3 Rt3
�`a�'A �A �A �A �A �A i:cr:; c:rap-
� 6 � B � B � B � B � B Mainlainc-d 'r, r(
� C � C � C � G �'� C � C Pastur2 i��o ;toi-k �' �', Li� I lu ticuliu�2
� D � D � D � D � D � D Pasture (acti �n �,o� r. ,i>�a I
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
� A � A Medium to high stem density
� B � B Low stem density
� C � C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer— streamside area metric (skip for Tidal Marsh Streams)

Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide.
LB RB
� A � A The total length of buffer breaks is < 25 percent.
� B � B The total length of buffer breaks is between 25 and 50 percent.
� C � C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition - First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
'�"� A � A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
.�''"� B � B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear-cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
� C � C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large poRion of expected strata or communities composed of planted
stands of non-characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity - assessment reach metric (skip for all Coastal P�ain streams)
25a. � Yes �.�' No Was a conductivity measurement recorded?
If No, select one of the following reasons. � No Water � Other:
�1:. Gn�J, I� �ox i r-5pr.,r �a i.�lhe , �t�ailyi, i,.9siii i;nl rurit.',:t mi��,rrsi�.i �. �t>,r,�r .,n.�m�ieri.
�A <!o �@ .c1o�67 �C G7to<I6 �D 7"tn-_230 �c � �,.,
Stream empties from -6" corrugated plastic pipe w/gravel from previous impact. LB is cleared for site development; RB is part of the Duke ROW

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name U-6084 Brookshire Blvd
Stream Category Pb1
Notes of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Function Class Ratin
(1) Hydrology
(2) Baseflow
(2) Flood Flow
(3) Streamside Area Attenuation
(4) Floodplain Access
(4) Wooded Riparian Buffer
(4) Microtopography
(3) Stream Stability
(4) Channel Stability
(4) Sediment Transport
(4) Stream Geomorphology
(2) Stream/intertidal Zone Interaction
(2) Longitudinal Tidal Flow
(2) Tidal Marsh Stream Stability
(3) Tidal Marsh Channei Stability
(3) Tidal Marsh Stream Geomorphology
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
Date of Evaluation 9/20/17
Assessor Name/Organization A Coleman / Stantec
(1) Habitat
(2) In-stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In-stream Habitat
(2) Stream-side Habitat
(3) Stream-side Habitat
(3) Thermoregulation
(2) Tidal Marsh In-stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In-stream Habitat
(2) Intertidal Zone Habitat
USACE/
All Streams
LOW
HIGH
LOW
LOW
LOW
MEDIUM
NA
LOW
LOW
LOW
MEDIUM
NA
NA
NA
NA
NA
LOW
HIGH
HIGH
HIGH
HIGH
YE5
LOW
NA
MEDIUM
LOW
HIGH
LOW
LOW
LOW
HIGH
MEDIUM
HIGH
NA
NA
NA
NA
NA
NA
NA
Overall LOW
YES
YES
YES
Perennial
NCDWR
Intermittent

User Manual Version 2.1
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT I SITE INFORMATION:
1. Project name (if any): U-6084 Brookshire Blvd 2. Date of evaluation: 9/20/2017
3. ApplicanUowner name: NCDOT 4. Assessor name/organization: A Coleman / Stantec
5. County: Mecklenburg 6. Nearest named water body
7. River Basin: Catawba on USGS 7.5-minute quad: Long Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.324144, -80.942543
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): Stream E 10. Length of assessment reach evaluated (feet): 30
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 1' � Unable to assess channel depth.
12. Channel width at top of bank (feet): 2.5' 13. Is assessment reacr� �a ti��np �ic , n� % � v<;:, � PJo
14. Featuretype: ;Perennialflow �;Intermittentflow � ficl,�l P•Aarsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: � Mountains (M) � Piedmont (P) � Inner Coastal Plain (I) ��"','Outer Coastal Plain (0)
16. Estimated geomorphic \ /
valley shape (skip for �a ��-
Tidal Marsh Stream): (more sinuous stream, Flatter valley slope)
17. Watershed size: (skip �Size 1(< 0.1 mi`) �Size 2(0.1 to < 0.5 mi`)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
�b
(less sinuous stream, steeper valley slope)
'("�Size 3(0.5 to < 5 mi`) �Size 4(>_ 5 miZ)
18. Were regulatory considerations evaluated? �Yes � No If Yes, check all that appy to the assessment area.
�Section10water (�ClassifiedTroutWaters f�WaterSupplyWatershed( ��I �;II �III ��.,'IV �V)
f Essential Fish Habitat I- Primary Nursery Area f- High Quality Waters/Outstanding Resource Waters
r Publicly owned property 6- NCDWR riparian buffer rule in effect f Nutrient Sensitive Waters
I Anadromous fish � 303(d) List � CAMA Area of Environmental Concem (AEC)
� Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
� Designated Critical Habitat (list species):
19. Are additional stream information/suoolementarv measurements included in "Notes/Sketch" section or attached? �+ Yes �": No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
� �A Water throughout assessment reach.
�� B No flow, water in pools only.
�'C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
�A At least 10 % of assessment reach in-stream habitat or riffle-pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
'�B NotA
3. Feature Pattern - assessment reach metric
��A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
�'B NotA.
4. Feature Longitudinal Profile - assessment reach metric
�A Majority of assessment reach has a substantially altered stream profile (examples: channel down-cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
�B NotA
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down-cutting (head-cut), active widening, and artificial hardening (such as concrete, gabion, rip-rap).
� �A < 10% of channel unstable
� B 10 to 25% of channel unstable
1�'� C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB�.
LB RB
�A �;A Little or no evidence of conditions that adversely affect reference interaction
,,�"�' B �; B Moderate evidence of conditions (examples: berms, levees, down-cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
�C �i ;C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplainlintertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
Water Quality Stressors - assessment reach/intertidal zone metric
Check all that apply.
� A 1�i� � i� ud ,�r in sh �im or int�iti,lal �_r�n i� iry w!� u. LIu=�. � i nat�.irel �,�� n�. a s�olr iru_�n_ c�.l, ���n_ d.r � ni ;;am;l
� B -a sive :, �n nenfe�tion (buryin� 01 stream iea[ures i utteiiidal tone)

� C Noliceable evldence of pollu[ant dlschary�s enteiinq the assessmenl reach and cau'sinq a water quaGty problem
� D Odor (not including natural sulfide odors)
� E Current published or coliected data indicating degradecJ water quality in ihe assessment reach. Cite source in the "Notes/Sketch"
section.
� F Livestock with access to stream or intertidal zone
f G Excessive algae in stream or intertidal zone
� H Degracied marsh vegeiekion in the intertidal zone (removal. burning. regular mowing. des;ruction. eic.)
� I ��I���er: lex�lein n Notcs;5b t�n'seciion)
� J Little to no stressors
8. Recent Weather — watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
M1�'�A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
�' B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
�'C No drought conditions
9 Large or Dangerous Stream — assessment reach metric
�, �Yes � No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In-stream Habitat Types — assessment reach metric
10a. �Yes �' No Degraded in-stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in-stream hardening [for example, rip-rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if> 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
(— A Muitipie aquatic m�crophytes and aqu<��Ic mossa� m" f— F 5% oysters or other naturel hard bottoms
(Include liver�vorts. Gci�ens, and algal mats'1 � m r G Submerged aquatic vegetation
� B AAultiple sticks anuior leaf packs and;or emcrg��nt o� � � H Low-tide refugia (pools)
vegetation � L o � I Sand bottom
f C h4ultiple snags and logs (including lap trees) t� � J 5% vertical bank along the marsh
i D 5�, under:ut b�nks ancl/or root mats and/or roois v� � K Little or no habitat
in uanks exi�rd to fie nomial wetted perimeb�r
i� E Little or no habitat
***********'***************'***'*REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS*******'***************'****
11. Bedform and Substrate — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11a. �Yes �No Is assessment reach in a natural sand-bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
I� A Riffle-run section (evaluate 11c)
� B Pool-glide section (evaluate 11d)
� C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach — whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) _
absent, Rare (R) = present but <_ 10 % , Common (C) _ > 10-40%, Abundant (A) _ > 40-70 % , Predominant (P) _ > 70 % . Cumulative
percentages should not exceed 100 % for each assessment reach.
NP R C A P
� �; � �; '� Bedrock/saprolite
��+�' �; � � �; � Boulder (256 — 4096 mm)
� � � �P; � Cobble (64 — 256 mm)
� �; � � �; � Gravel (2 — 64 mm)
� �; � �; '� Sand (.062-2 mm)
� �; � � [G; � SilUclay (< 0.062 mm)
� � � �P; � Detritus
� �; � �; � Artificial (rip-rap, concrete, etc.)
? 1 d- �l'es �'No Ar �ocls fille i � lr _,edir>>�it7 �ski� for Si.ze 4 Coastal Plain streams and Tida9 VVlarsi� Str�ar��rs)
12. Aquatic Life — assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. ��Yes '�No Was an in-stream aquatic life assessment pertormed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. � No Water �Other:
12b. �'Yes � No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
� � Adult frogs
� � Aquatic reptiles
� � Aquatic macrophytes and aquatic mosses (include liverworts, lichens, and algal mats)
I� � Beetles (including water pennies)
� � Caddisfly larvae (Trichoptera [f])
� � Asian clam (Corbicula )
� � Crustacean (isopod/amphipod/cre�sh/shrimp)
I f Damselfly and dragonfly larvae
� � Dipterens (true flies)
� � Mayfly larvae (Ephemeroptera [E])
� f Megaloptera (alderfly, fishfly, dobsonfly larvae)
f i Midges/mosquito larvae
� � Mosquito fish (Gambusia ) or mud minnows (Umbra pygmaea)
� � MusselslClams (not Corbicula )
f i Other fish
� � Salamanders/tadpoles
� � Snails
f � Stonefly larvae (Plecoptera [P])
� � Tipulid larvae

� � Worms/leeches
13. Streamside Area Ground SurFace Condition — streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
�'A �'A Little or no alteration to water storage capacity over a majority of the streamside area
�� B � B Moderate alteration to water storage capacity over a majority of the streamside area
� C �� C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage — streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
�A �;A Majority of streamside area with depressions able to pond water>_ 6 inches deep
� B �; B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
�� C �; C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence — streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB�. Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
�'Y �'Y Are wetlands present in the streamside area?
�N ��N
16. Baseflow Contributors — assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
f A Streams and/or springs (jurisdictional discharges)
f B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
� C Obstruction that passes some flow during low-flow periods within assessment area (beaver dam, bottom-release dam)
f D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
� E Stream bed or bank soil reduced (dig through deposited sediment if present)
� F None of the above
17. Baseflow Detractors — assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
I A Fviclence oi �ubsianii�d �Nater wiii�dr�nvals from ihe assessment raach jincludes areas excavated for pump insfallalion)
� B Ohstruction not passing flow during low flow periods affecting [he assessment reach (ex: watertight dam, sediment deposit)
� C Urban s,rea��i (= 24'% impervious surface for watershed)
� D cviJ�-nce lhat ihe stream-side area has been modified resulting in accelerated drainage into the assessment reach
I E Ass� ssment reach relocated to valley edge
�� F None of the above
18. Shading — assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf-on" condition.
�+�A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
'�B Degraded (example: scattered trees)
�C Stream shading is gone or largely absent
19. Buffer Width — streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
�i+p�'A �'A �'A �'A ? 100-feet wide or extends to the edge of the watershed
�' B �' B � B �' B From 50 to < 100-feet wide
� C �� C � C �' C From 30 to < 50-feet wide
�� D �' D �� D � D From 10 to < 3D-feet wide
� E � E �' E �' E < 10-feet wide or no trees
20. Buffer Structure — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
� �A �'�A Mature forest
�6 �B Non-mature woody vegetation or modified vegetation structure
�� C � C Herbaceous vegetation with or without a strip of trees < 10 feet wide
�D �D Maintainedshrubs
�� E �'� E Little or no vegetation
21. Buffer Stressors — streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: f�
:i'DUiS _ `;l ;,sci �.; iCY.i
LB RC� LCi R3 LB Rg
�'A �'A �'A �'A �'A �'A �tr,w:;,�;�>s
�;'B �;'e �;'6 �;'B �;'B �;'B Malntair,�dturi
�'C �'C �'C: �'C �C �'C Pasture (no livestock)/commercial horticulture
�'� �'D i�`��'� �'D �D [�'D Pasturel�ciivelivestocl:u,el
22. Stem Density — streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
'�A �A Medium to high stem density
� B � B Low stem density
,,�"�'C �C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer — streamside area metric (skip for Tidal Marsh Streams)

Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide.
LB RB
�A '+�'�A The total length of buffer breaks is < 25 percent.
��B �B The total length of buffer breaks is between 25 and 50 percent.
� C � C The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
�'A �'A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
�'B �B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear-cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
�'C �C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large poRion of expected strata or communities composed of planted
stands of non-characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal P�ain streams)
25a. �Yes �No Was a conductivity measurement recorded?
If No, select one of the following reasons. �No Water �Other:
<�1:. Gn�J P� i;�ox ��.i-r.��.��or i�a i.�lhe „ �t��.ilyi, i�.Jsiii i�;i�l r�icit. :i mi��rrsiEr �.n; p�r .�,n.�m'�i:ri.
�'A <qo '[�'�'8 4Gto=67 �C G7Lo<75 �'D 79[o<a30 �"�E � ��.,
Stream comes from —36" culvert under Brookshire. 30' wooded then into Duke ROW where it is more degraded. This form is for wooded area.

NC SAM Stream Rating Sheet
Accompanies User Manual Version 2.1
Stream Site Name U-6084 Brookshire Blvd
Stream Category Pa1
Nates of Field Assessment Form (Y/N)
Presence of regulatory considerations (Y/N)
Additional stream information/supplementary measurements included (Y/N)
NC SAM feature type (perennial, intermittent, Tidal Marsh Stream)
Function Class Ratin
(1) Hydrology
(2) Baseflow
(2) Flood Flow
(3) Streamside Area Attenuation
(4) Floodplain Access
(4) Wooded Riparian Buffer
(4) Microtopography
(3) Stream Stability
(4) Channel Stability
(4) Sediment Transport
(4) Stream Geomorphology
(2) Stream/Intertidai Zone Interaction
(2) Longitudinal Tidal Flow
(2) Tidal Marsh Stream Stability
(3) Tidal Marsh Channel Stability
(3) Tidal Marsh Stream Geomorphology
(1) Water Quality
(2) Baseflow
(2) Streamside Area Vegetation
(3) Upland Pollutant Filtration
(3) Thermoregulation
(2) Indicators of Stressors
(2) Aquatic Life Tolerance
(2) Intertidal Zone Filtration
Date of Evaluation 9/20/2017
Assessor Name/Organization A Coleman / Stantec
(1) Habitat
(2) In-stream Habitat
(3) Baseflow
(3) Substrate
(3) Stream Stability
(3) In-stream Habitat
(2) Stream-side Habitat
(3) Stream-side Habitat
(3) Thermoregulation
(2) Tidal Marsh In-stream Habitat
(3) Flow Restriction
(3) Tidal Marsh Stream Stability
(4) Tidal Marsh Channel Stability
(4) Tidal Marsh Stream Geomorphology
(3) Tidal Marsh In-stream Habitat
(2) Intertidal Zone Habitat
USACE/
All Streams
MEDIUM
HIGH
MEDIUM
HIGH
HIGH
HIGH
MEDIUM
LOW
HIGH
LOW
LOW
NA
NA
NA
NA
NA
MEDIUM
HIGH
HIGH
HIGH
HIGH
NO
LOW
NA
LOW
LOW
HIGH
LOW
MEDIUM
LOW
HIGH
HIGH
HIGH
NA
NA
NA
NA
NA
NA
NA
Overall MEDIUM
YES
YES
YES
Intermittent
NCDWR
Intermittent
MEDIUM
HIGH
MEDIUM
HIGH
HIGH
HIGH
MEDIUM
LOW
HIGH
LOW
LOW
NA
NA
NA
NA
NA
MEDIUM
HIGH
HIGH
HIGH
HIGH
NO
NA
NA
LOW
LOW
HIGH
LOW
MEDIUM
LOW
HIGH
HIGH
HIGH
NA
NA
NA
NA
NA
NA
NA
MEDIUM