20180028 Ver 1_MCDC Final_20180105

MINIMUM CRIT�RIA D�T�I2MINATION CH�CKLIST
The following questions provide direction in determining when the Dep�i4ment is
required to prepare eirvironmental documents For state-funded construclion and
ntaintenance �ctivities. Ans�ver questions for Parts A through C by checking either "Yes"
or "No". Complete Part
#12(i), or#IS are used.
TIP Project No.: n/a
D of the checklist �vhen Minimum Criteria Rule categories #8,
State Project No: 14.204911
Shvctw•e No.: n/n
Project Locatim�: SR 1344 (Dillard Ro�d), Jackson County
Project Descriptim�: This is a maintenance project to replace I deteriorated corrugated
met�l culveit pipe and extend the corrugated metal culvert pipe approximately 5 linear
feet iu UTs discl��rgiug iulo the Tuckasegee River (Class B;Tr) under SR 1344 (Dill�rd
Road) in Jackson County.
Anticipated Per�uit or Consultation Requiremeuts:
I. Outside river corridor = no (permit veritication required)
2. Belo�v impact thresl�old for applicable NWY = yes
3. Tree cle�ring = Yes, aud otheitivise have no effect ou T&E = No (Near
Tuckasegee)
4. Trout �vatershed = ycs (follow moratorium unless veritication NCWRC letter
states no)
5. NLEB HUC = clear
NWP 3 will requice written autl�m�ization. GC 4085 automatic, �io writteii 401 iieeded.
Special Pcoject Iuformatiou:
Tl�is project should I�ave no eflecl on wetlands, but due to lhe praximity to the
Tuckasegee River (critical habitatfor Appalachian elktoe mussels), die project `Snay
�ffect, no[ likely adverscly aftecP' Appal�chi�n elktoc mussels. Stringent erosion control
measure ��ill be required.
Tt�e culverts are being replaced in the footprints of the old cuh�erts w/in existiug r/w.
12/IS/17 I of4

PART A: MINIMUM CRIT�RIA
YES NO
Iteni 1 lo be couipleled Gy lhe Gngineer.
L Is the proposed project listed as a type and class oY activity allowed under � �
the Minimum Giteria Rulein which environmental documentation is not
required? —
If the answer to number I is `no", then the project does not qualiCy as a
mininwm criteria project. A state environmental assessment is required.
If yes, under which category?
If either category #8, #12(i) or #15 is used complete Part D of tliis checklist.
PART B: MININIUM CRIT�RIA �XC�YTIONS
Ilems 2— 4 lo Ge covrpleled bj� /Ite L�igiireer.
2. Could the proposed activiry cause signihcant changes in land use
concenUations that would be expected to create adverse air quality
impacts?
3. Will the proposed activity have secondary impacts or cumulative impacts
that may result in a signi�caut adverse impact to human healtli or the
environment?
q. Is the proposed activity of such an unusual nature or does the proposed
activity have such widespread implications, that an uncommon concern
for its environmental effects has been e�pressed to the Deparlment?
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71em 5-810 be conip(elerl by Division E�t��iroanre�rtnl Officer.
5. Does the proposed activity have a signiticant actverse ei'fect on wetlands; � �
surface waters sucli as ri��ers, streams, and estuaries; parklands; prime or
unique agricultural lands; or areas of recognized scenic, recreational,
archaeological, or historical value?
6. WiII the proposed activity endnnger ihe existence of a species on the
Department of Interior's threatened and endangered species list?
7. Could tlie proposed �ctivity cause significant changes in land use
concenhations that would be expected to cre�te adverse water quality or
ground water impacts?
12/I S/17 2 of d
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Y�S NO
8. Is the proposed activity espected to have a signiecant adverse efYect on � �
lonb term recreational benefits or shellfish, e„esn, wildlife, a their
natural habitats
If any questions 2 tlu�ougli 8 are aoswered `yes", the proposed project may not qualify as a
Minimum Criteria project. A state environmental assessment (EA) may be required. For
assistance, contact:
M�nager, Project Development and Environmental Analysis Br�nch
P. O. Bos 25201
Raleigli, NC 27611
(919) 733 —3 L41
Fax: [phone]
PART C: COMPLIANC� WITH STAT� AND P'�D�RAL R�GULATIONS
Ilen�s 9-1210 be cantpleterl bj� Division Environmentnl Offrcer. Y�S NO
9. Is a federally protected thre�tened or e�id�ugered species, or its � �
habit�k likely to be impacted by the proposed action? Ma� Affect
10. Does the action require the placemei�t of temporary or permanent � �
fill in �v�ters of the United States?
l L Does the project require the placement of � signiticant amount of
fill in high quality or relatively rare wetlaud ecosystems, such as
mountain bogs or pine savannahs?
12. ls the proposed action located in an Area of Enviroumeutal
Coucern, as defined in the coastal Area Managemeut Act?
I/ents !3 — I S lo fie ca�r�ple/ed b y!he E��gineer.
13. Does the project require stream relocation or channel changes?
Cultw•aI Resources
14. W ill the project have an "effecP' on a properq� or site listed on the
Nation�l Register of Historic Places?
15. Will the proposed action require acquisition of additioual right of
way from publicly o�vned parklaud or recre�tional areas?
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Questious iu Part "C" are desigued to assist Uie Engineer and the Divisiou Environmental
Ofticer in determining whether a permit or consultatiou �vith a state or federal resource
agency may be required. If any questions in Pait `C" are a��swered "yes", follow the
appropriate permitting procedw�es prior to beginning project construction.
12/IS/17 3 of4

PART D: (To be comnletecl wheu eitlier cateeorv #8, #12(i), m• #15 of the rules are
nsed.
Itenis 16- 22 to be canipleleJ hp Divisioir Euviroi���ieirfnl Officei�.
I6. Projectlength:
l7. Right of W�y �vidth:
18. Project completion date:
19. Total acres of newly disturbed
ground surface:
20. Tot�l acres of wetlnnd impacts:
21. Total linear feet of stream impacts:
22. Project piu•pose:
IFPart D of the checklist is completed, seud a copy of the entire checklist document to:
Don G. Lee
State Ro�dside Environmental Engineer
Mail Service Center 15�7
Raleigh, NC 27699-1557
[phone]
FTx [phone]
Email: dlee�dokstate.naus
ooc�sgnea ey:
Reviewed by:
Mv�a� (�iU, D�te: 12/18/20v
��i c��7 I'�` ivision Id
Assist�nt District 2 Engineer
%<�tiw� �-J-/�Y�-...---�L� Date: i2.2a.zo��
Patrick J. Breedlove
Division 14 Environmental Specialist
i zn sn � a of�

Jackson County
Replace and Extend Culvert in unnamed tributary discharging into the
Tuckasegee River under SR 1344 (Dillard Road) near Webster, N.C.
WBS No. 14.204911
• NWP 3 will require written authorization for this project. GC 4085
automatic, no written 401 needed.
• Project will comply with the standard 2017 NWP 3 and 2017 GC 4085
conditions.
• Project will adhere to NCDOT best management practices.