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Home My WebLink AboutU5737_PJD_AgencyPacket_10262017Appendix 2- PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM BACKGROUND INFORMATION A. REPORT COMPLETION DATE FOR PJD: B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Adam Efird, Moffatt & Nichol, 4700 Falls of Neuse Road, Suite 300, Raleigh, NC 27609 C. DISTRICT OFFICE, FILE NAME, AND NUMBER: D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: (USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR AQUATIC RESOURCES AT DIFFERENT SITES) State: NC County/parish/borough: ChathafYl city: Siler City Center coordinates of site (lat/long in degree decimal format): �at.: 35.732947 �ong.: -79.452975 Universal Transverse Mercator: 17S 3955432.23 N 639903.71 E Name of nearest waterbody: ROCky RIVeI' 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) 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: See attached � 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: ❑ ❑ ❑■ U.S USGS NHD data. USGS 8 and 12 digit HUC maps. . Geological Survey map(s). Cite scale & quad name: Sllef Clty 24k 0 Natural Resources Conservation Service Soil Survey. Citation: 2006 Chatham COUnty � National wetlands inventory map(s). Cite name: � State/local wetland inventory map(s): ❑ FEMA/FIRM maps: ❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum of 1929) ❑■ Photographs: ❑■ Aerial (Name & Date): ESRI Built-in basemapping or � Other (Name & Date): � Previous determination(s). File no. and date of response letter: � Other information (please specify): IMPORTANT NOTE: The information recorded on this form has not necessarily been verified bv the Corps and should not be relied upon for later iurisdictional determinations. Signature and date of Regulatory staff inember completing PJD �� 10/12/17 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. Site Number Latitude Longitude Estimated Type of Geographic (decimal (decimal amount of aquatic authority to degrees) degrees) aquatic resource (i.e., which the resource in wetland vs aquatic review area non-wetland resource "may (acrage and waters) be" subject linear feet, if (i.e., Section applicable) 404 or Section 10/404) WA 35.733821 -79.488126 0.04 acres wetland Section 404 WB 35.729948 -79.438633 0.04 acres wetland Section 404 SA 35.733911 -79.467167 616 linear feet non-wetland Section 404/401 SB 35.733437 -79.473283 220 linear feet non-wetland Section 404/401 SC 35.733290 -79.473018 126 linear feet non-wetland Section 404/401 SD 35.734096 -79.457496 280 linear feet non-wetland Section 404/401 SE 35.732734 -79.458310 789 linear feet non-wetland Section 404/401 SF 35.732970 -79.460100 162 linear feet non-wetland Section 404/401 SG 35.732668 -79.461917 975 linear feet non-wetland Section 404/401 SH 35.733374 -79.460016 481 linear feet non-wetland Section 404/401 SI 35.732684 -79.437818 499 linear feet non-wetland Section 404/401 SJ 35.733132 -79.433390 211 linear feet non-wetland Section 404/401 ,, N r � � �� ` � �� t00G �� p `��y�l�iwe _ , ., � � / � Chatham County, North Car�l-i�a ,,�� - ,_, ��'- ;,f , `''� � � oaa ,,� �y;Y4Zrkorth � U5411 � ,1 A � � J . w �.. , j � '!_.. `� � b ` 3 �� . �- �! 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No. 54027.1.FR1 � . � . �- I T � `,, . •� �� - l � �� 0 187.5 375 750 � �, ,'� � `� Federal Aid No: NHP-0064(181) Feet ,� � `{ � " - ` F i u r e 3- P o t e n t i a l J u r i s d i c t i o n a l F e a t u r e s - P a e 2 � � , ' * . �_ � �- • � �� Source: Esri, Di�iialGfobe, GeoEye, Earthstar Geographi g g h i i • l � � �• i i `�. i � � r �L I ,� � • _ � � � � , • +i , -�,k � � � � - • � � �� _ . _ r'- � .�� . .— .., - �T� _ � � 1 ��r} .. , ` � ;y � tl � �4"` � � �► _ �j*�— . 64 :� � . r�►«., -, � �� f # � • r � it� i � . y r i ! !' }Y f . �T _- �� ' '� � `•� � I �! �� y� , � ••� . . , � ;.�.� - - OWA �• -_ + s � �: - , • -- . - r �� ti .. - .. { YYB yti• �- o �e�9r * �7 I ��ya •�r' •r , � �M • ' � , ._- � . '_ t �ti � � � � � � � �' ,. 'w '�".�� r. ' a. " , •- , • L .� • C � - ..r .� � , . �W B ' �- - � , �" ` � � � �_ ,� .��: �,�;-r � .- , .� ,� � � � . i- f � - S i Y f '+} ' , � � � — 0 187.5 375 750 Feet t .��—. � , I �� ir ' 'r. . . � . . ' � sour�e; Esr�, oig�ta��obe, �eoEye. ��rtr,sc�r ��ogrann�a Figure 3- Potential Jurisdictional Features - Page 3 Legend o Data Form Location Potential Wetland Waters of the US Potential Open Waters of the US Potential Non-Wetland Waters of the US (Stream) � U-5737 NRTR Study Area 64 F ' _ � fi (<��'�_ � - �, � R' SJ � �� `. �. ' � � . � � ' '� � - 421 7 � � ,�""� _ f'� � � �r��A��+�;o. NORTH CAROLINA DEPARTMENT ` OF TRANSPORTATION DIVISION OF HIGHWAYS PROJECT DEVELOPMENTAND ENVIRONMENTALANALYSIS UNIT U-5737 US 64 (11TN STREET) IMPROVEMENTS CHATHAM COUNTY WBS. No. 54027.1.FR1 Federal Aid No: NHP-0064(181) U � WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region J ��'�� 'JS� 3� S`�e"' C`� Y Y 4�+i C`' 7 I`-"�o1�,4L''l Sam�ling aate: S� 3- � 7 Pro ecUSite: Cit /Count : � �—�— ApplicantlOwner. �- �� State: 1V �. Samplirsg Point: LV� Investigator(s): ►��'fd ! � �u fV' Section, Township, Range: LandForm (hillslope, terrace, etc.): � Local relief canCB�e, convex, rspne}; ✓ Slope (�o): Subregion (LRR or MLRA): La • ��]3 � o� Long: � Q� � Z D8t �� j Soil Map Unit Name: ��'�`�'�✓� � Iv4N ��' 4� �'n NWI dassification: 1~ Are climatic / h rol ic conditions on the si[e Eypical for this time of year? Yes �No Q(If no, explain in Remarks.) Are Vegeta[ion Soil �, or Hydrology significan[ly dis[urbed? Are "Normal Circumstances" present? Yes� No � Are Vegetation Soil �, or Hydrology � naturally problematic? (IF needed, explain any answers in Remarks.) SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc. Hydrophytic Vegetation Present? Yes � NG, Hydric Soil Presen[? Yes� No, We[land Hydrology Present? Yes �, No Remarks: HYDROLOGY Is the Sampled Area within a Wetland? Yes No 0 Wetland Hydrology Indicators: Secondary Indicators (minimum of two required) Prima Indicators minirnum oF one i r uired• ch ck all EhaE a( D Surface Soil Cracks (B6) Surface Water (A1) ❑ True Aquatic Plants (B14) ❑ S arsely Vegetated Concave Surface (BS) � High Water Table (A2) � rogen Sulfide Odor (C1) �ainage Patterns (B10) ❑ Saturation (A3) Oxidized Rhizospheres on Living Roots (C3) � Moss Trim Lines (B16) �Water Marks (61) � Presence of Reduced Iron (C4) ❑ Dry-Season Water Table (C2) ❑ Sediment Deposi[s (62) ❑ Recent Iron Reduc[ion in Tilled Soils (C6) ❑ Crayfish Burrows (C8) ❑ Drift Deposi[s (B3) ❑ Thin Muck Surface (C7) ❑ Saturation Visible on Aerial Imagery (C9) ❑ Algal Mat or Crust (64) ❑ Other (Explain in Remarks) ❑ Stunted or Stressed Plants (D1) ❑ Iron Deposi[s (B5) � Geomorphic Position (D2) ❑ fpundation Visible on Aerial Imagery (B7) ❑ Shallow Aquitard (D3) Lj Water-S[ained Leaves (B9) ❑ iCrolapographlC Relief (D4) �Aquatic Fauna (B13) �AC-Neutral Test (D5) Field Observations: Surface Water Presen[? Yes �No Q Depth (inches): ��'S Water Table Present? Yes Q No Q Depth (inches): Saturation Present? YesQ No� Depth (inches): Wetland Hydrology Present? Yes,� No� (includes ca illar frin e) Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), iF available: Remarks: SJ r��e �,cr i�v (��e4e�-� ��n So��^ 2�14 ce S, f US Army Corps of Engineers Eastern Moun[ains and Piedmont— Version 2.0 VEGETATION (Five Strata) — Use scientific names of plants. � � ��,4 Hosoiute uominan� maica�or Tree Stratum (Plot size: ) % Cover Saecies? Status �. �k, ��, �0 �� -F�_ 2.��, e �kr �� - �- C 5. 6. �= Total Cover r�50� af lotal cover: t`V 2095 0€ [otal cover:� S�pl�ri(j S!{"BtUm {Plot size: �7U'F' �U �'�C S 7. �a iX vi►L�Jc, �� S �_ 2. iFteJ {�� F S � 3._ �L`�'�l�S Q�NItIS`j�Jq,r1� LC 4, 5. � = Total Cover 50% of total cover: � 20% oF [otal cover: `�, Shrub Stra[um (Plot size: � `i-� l�I�:SC ) ,. 1 r► � �(� �� 'l., 2._ �,aaJ ,j �fJw� �� `i'CS � 3. t v��K✓S D��ny�w-�i, �� 4. 5. 6. �= Total Cover 50% oF total cover: � 2096 Of total cover:� Herb SUatum (Plo[ size: �f' �� j 1. Jlt� J � �� 2. 1 �� iv� _ �. 3. R�I f �f �i �f) 6. 7. 1 Q. 11. �_ = Total Cover 50% oF total cover: �� 20% of to[al cover; � C Woody Vine Stra[um (Plot size: 2. 3. = Total Cover 50% oF [otal cover: 20% oF total cover: Remarks: (Include photo numbers here or on a separate sheet.) Sampling Poir�t: �✓� Dominance Test worksheet: � fVumber of Dominant Species Tha[ Are OBL, FACW, or FAC: (A) Total Number of Dominant Species Across All SVata: (B) Percen[ oF Dominant Species Tha[ Are OBL, FACW, or FAC: (A/B) Prevalence Total % Cover of: Multiolv bv: OBL species x 1 = FACW species x 2 = FAC species x 3 = FACU species x 4 = UPL species x 5 = Column Totals: (A) (B) Prevalence Index = B/A = Hydrophytic Vegetation Indicators: ❑ 1, = Rapid Test for Hydrophytic Vegetation �2 - Dominance Test is >50% ❑ 3- Prevalence Index is 53.0' ❑ 4 - Morphological Adaptations' (Provide supporting data in Remarks or on a separate sheet) � Problematic Hydrophytic Vegetation' (Explain) 'Indicators of hydric soil and wetland hydrology must be present, unless disturbed or problematic. Definitions of Five Vegetation Strata: Tree - Woody plants, excluding woody vines, approximately 20 ft (6 m) or more in heigh[ and 3 in. (7.6 cm) or larger in diame[er at breast height (DBH). Sapling - Woody plants, excluding woody vines, approximately 20 ft(6 m) or more in height and less than 3 in. (7.6 cm) DBH. Shrub - Waody plants, excluding woody vines, approximately 3 to 20 ft(1 to 6 m) in height. Herb - All herbaceous (non-woody) plants, including herbaceous vines, regardless of size, and woody plants, except woody vines, less than approximately 3 ft (1 m) in height. Woody vine - A!I woody vines, regardless of height. Hydrophytic Vegetation Present? Yes Pdo,� US Army Corps of Engineers Eastern Mountains and Piedmon[ - Version 2.0 `�V�O SOIL Sampling Point: _„� Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.) Depth MaVkx Reclwc Features (inches) Co1ar (moisd °/o 1 o35t X Ty� ,�r , Textare Remarks 0- � tL5 � .� .� G i� �� G �� T e: C=GanCenU'atiDn, D=De IeGon, RM=Reduced MaVix MS=Masked Sand Grains. ZLocalion: PL=Pore Linin , M=Ma[rix Hydric Soil Indicators: Indicators for Problematic Hydric Soils': � Histosol (A1) � Dark Surface (S7) 0 2 cm Muck (A10) (MLRA 147) ❑ Histic Epipedon (A2) D Polyvalue Below Surface (S8) (MLRA 147, 148) ❑ Coast Prairie Redox (A16) ❑ Black Histic (A3) ❑ Thi Dark Surface (S9) (MLRA 147, 148) (MLRA 147, 748) ❑ Hydrogen Sulfide (A4) ❑ amy Gleyed Ma[rix (F2) � Piedmont Floodplain Soils (F19) ❑ Stratified Layers (A5) Depleted Ma[rix (F3) (MLRA 136, 147) ❑ 2 cm Muck (A10) (LRR N) D Redox Dark Surface (F6) Q Very Shallow Dark Surface (TF12) � Depleted Below Dark Surface (A11) D Depleted Dark Surface (F7) � Other (Explain in Remarks) ❑ Thick Dark Surface (Al2) � Redox Depressions (F8) � Sandy Mucky Mineral (S1) (LRR N, � Iron-Manganese Masses (F12) (LRR N, MLRA 147, 148) MLRA 136) � Sandy Gleyed Matrix (S4) ❑ Umbric Surtace (F13) (MLRA 136, 122) 3lndicators of hydrophy[ic vegetation and ❑ Sandy Redox (S5) L] Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology mus[ be present, � Stripped Matrix (S6) � Red Parent Material (F21) (MLRA 127, 147) unless dis[urbed or problema[ic. Restrictive Layer (if observed): Type: Depth (inches): Hydric Soil Present? Yes � No ❑ Remarks: US Army Corps of Engineers Eastern Moun[ains and Piedmon[ — Version 2.0 � WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region ProjecUSite: �OW � l,l -- �1 �� City/Counry: S��'�✓ �� ( b � �� "� � « Sampling C]ate: � � i r � � ApplicanUOwner: Ld� State: iU C Sampling Pa3nG�Ai'� t0 Investigator(s): � � �� Section, Township, Range: Landform (hillslope, terrace, e[c.): Lo(��al relief conCBve, convex, none): Slope (% • Subregion (LRR or MLRA): Lat: � • 7� 7 �� Long: � �% 1 � � � � v � Datum: �� Soil Map Unit Name: � �ocf�vL��'Q NWI classification: �4-� Are climatic / h dral ic conditions on the site typical for this time oF year? Yes ��No Q(If no, explain in Remarks.) Are Vegetation Soil �, or Hydrology � significantly disturbed? Are "Normal Circumstances" present? Yes� No � Are Vegetation Soil �, or Hydrology � naturally problematic? (If needed, explain any answers in Remarks.) SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc. Hydrophytic Vegetation Present? Yes Hydric Soil Present? Yes We[land Hydrology Present? Yes Remarks: HYDROLOGY No Is the Sampled Area �—J�-fj within a Wetland? Yes I�J No 0 Wetland Hydrology Indicators: Secondary ir�dicators iminimum of two required� Primary Indicators (minimum of one is required; check all that apply) ❑ Surface Soil Cracks (B6) ❑ Surface Water (A1) ❑ True Aqua[ic Plants (B14) ❑ arsely Vegetated Concave Surface (B8) [✓�High Water Table (A2) � ydrogen Sulfide Odor (C1) - Drainage Pa[terns (B10) �aturation (A3) Q Oxidized Rhizospheres on Living Roo[s (C3) [] Moss Trim Lines (B16) Water Marks (B1) � Presence oF Reduced Iron (C4) ❑ Dry-Season Water Table (C2) � Sediment Deposits (B2) ❑ Recen[ Iron Reduction in Tilled Soils (C6) � Cra�sh Burrows (C8) ❑ Drif[ Deposits (63) ❑ Thin Muck Surface (C7) ❑ atU�atiotl Visible on Aerial Imagery (C9) ❑ Algal Mat or Crus[ (B4) � O[her (Explain in Remarks) �Stunted or Stressed Plants (D1) ❑ Iron Deposi[s (65) � Geomorphic Position (D2) ❑ unda[ion Visible on Aerial Imagery (B7) � Shallow Aquitard (D3) Water-Stained Leaves (69) ❑ y�liCrotopc�graph€C Relief (D4) Aquatic Fauna (B13) Lvj FAC-Neutral Test (D5) Field Observations: Surface Water Present? Yes No � Depth (inches): Wa[er Table Present? Yes No Q Depth (inches): �_ Sa[uration Presen[? Yes No � Depth (inches): �_ Wetland Hydrology Present? Yes,� No� {includes ca illa fri ey Oescri6e Recorded Data (sVeam gauge, monitoring well, aerial photos, previous inspeetions), if available: Remarks: US Army Corps of Engineers Eastern Mountains and Piedmont— Version 2.0 VEGETATION (Five Strata) - Use scientific names of plants. !O� ' Sampling Point: '�/ �� j� Absolute Dominant Indicator pominance Test worksheet: Tree Stra[um (Plot size: 7il t� i(��'� ) °% ove� 5 f� t t Number of Dominant Species 1, riJ� aJ 1� ❑V�t1 �� That Are OBL, FACW, or FAC: � (A) 2. c� �! d �d� �" � �� FFtt • ,� • �t� ��r[[[ Total Number of Dominant 3. IJ41�•�1'�, G�vt1p�l��vQ�tO ___y�___�� SpeciesAcrossAllSVata: (B) A., �,�tJG.� i1�+14 Percent of Dominant Species 5• That Are OBL, FACW, or FAC: �(� (A/B) 6. �= Total Cover prevalence Index worksheet: To[al % Cover of: Multinlv bv: 50% of total cover: c_?��--� 20% of total cover:�� OBL i s 1- 5a 31n tratum (Plot size: 3�X�Q � ) 1. C�V l�il�'�'� �� F�� 2. ��`� P?��nS�(1�r►�i•CG �_ �_ �(i .�.1 3. 6. �= Total Cover 50% oF total cover: � 20% of total cover:� ShrubrStra[um (Plotsize: ��t ) 1. 1-i �luc 'i`�'`^^ S MCN GP �� r '� 3. '�U = Total cover 50% of total cover: `Q 20% of total cover: 1� _ Herb Stra[um (Plot size: �O � � } , . M � c.vo s�k�,,..�.� �iM.�--; � � � �� 2. � . " .! C-�. � � � S � 3. 4. 5. 9. 16. 11 �,� = Total Cover 50% of [otal cover: � 20% of total cover.�_ Woody Vine Stratum (Plot size: ) 1. 4. 5. 50% of total cover: Remarks: (Include photo numbers here or on a separate = Total Cover 20% of total cover: spec e x - FACW species x 2 =, FAC species x 3 =, FACU species x 4 = UPL species x 5 = Column Totals: (A) (B) Prevalence Index = B/A = Hydrophytic Vegetation Indicators: ❑ 1- Rapid Test for Hydrophytic Vegetation �2 - Dominance Test is >50% Q3• Prevalence Index is <_3.0' ❑ A • Morphological Adaptations' (Provide supporting data in Remarks or on a separate sheet) � Problematic Hydrophytic Vegetation' (Explain) 'Indicators of hydric soil and wetland hydrology must be present, unless disturbed or problema[ic. Definitions of Five Vegetation Strata: Tree - Woody plants, excluding woody vines, approximately 20 f[ (6 m) or more in height and 3 in. (7.6 cm) or larger in diameter at breast height (DBH). Sapling - Woody plants, excluding woody vines, approximately 20 ft(6 m) or more in height and less than 3 in. (7.6 cm) DBH. Shrub - Woody plants, excluding woody vines, approximately 3 to 20 ft(1 to 6 m) in height. Herb - All herbaceous (non-woody) plan[s, including herbaceous vines, regardless of size, and woody plants, except woody vines, less than approximately 3 Ft (1 m) in height. Woody vine - All woody vines, regardless oF height. Hydrophytic Vegetation Present? Yes No� US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2.0 SOIL Sampling Point: ��o Profile 17esCription: (UescHhe to the depth n6eded to doCument the indiCBtvr or cQnfirt't1 the absence of Indicators.) Depth Matrix fiedax Features (inches) Color {maistl � Col r mofst % TvdQ L� exture Remarks n c� � � �� 'T e: C=CanCBniraiivrl, D=[3e ledoil, RM=Reduced Matrix, MS=Masked Sand Grains. �Locat�qn: PL=Pore Linin . M=MaVix. Hydric Soil Indicators: Indicators for Problematic Hydric Soils': � Histosol (Al ) L] Dark Surtace (S7) 0 2 cm Muck (A10) (MLRA 747) ❑ Histic Epipedon (A2) D Polyvalue Below Surface (S8) (MLRA 147, 748) ❑ Coast Prairie Redox (A16) ❑ Black Histic (A3) ❑ Thin Dark Surtace (S9) (MLRA 147, 148) (MLRA 147, 148) ❑ Hydrogen Sulfide (A4) ❑ my Gleyed Matrix (F2) 0 Piedmon[ Floodplain Soils (F19) ❑ Stratified Layers (A5) Depleted Matrix (F3) (MLRA 136, 147) ❑ 2 cm Muck (A10) (LRR N) Redox Dark Surtace (F6) � Very Shallow Dark SurFace (TF12) [] Deple[ed Below Dark Surface (A11) � Deple[ed Dark Surface (F7) � Other (Explain in Remarks) ❑ Thick Dark Surface (Al2) � Redox Depressions (F8) � Sandy Mucky Mineral (S1) (LRR N, � Iron-Manganese Masses (F12) (LRR N, MLRA 147, 148) MLRA 136) ❑ Sandy Gleyed Ma[rix (S4) ❑ Umbric Surface (F13) (MLRA 136, 122) 3lndicators of hydrophytic vege[ation and Q Sandy Redox (S5) ❑ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present, � Stripped Matrix (S6) � Red Paren[ Material (F21) (MLRA 127, 147} unless dis[urbed or problematic. Restrictive Layer (if observed): Type: Depth (inches): Hydric Soil Present? Yes No ❑ Remarks: US Army Corps of Engineers Eas[ern Mountains and Piedmont— Version 2.0 WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region Project/Site: �� v O� V�� /�.}��f L�( City/County: ��F�f l.l e Sampling Date:� �� `� ` ��/ ApplicanUOwner: d State: _� Sampling Point: rWA ' -- V�(,/►I��% Investigator(s): .�1 � d✓�1<- Section, Township, Range: T�� Landform (hillslope, terrace, etc.): Local r�li f(concave, convex, none): Slope (%): Subregion (LRR or MLRA); t; + 3 1 �ong: _' �7� .�E �� S 7� Datum: � Soil Map Uni[ Name: �ONG�f � iQ. —�W1�qu� ( NWI classification: — Are climatic / h drol �C conditions on the site typiC I For [h'ss time of year? Yes No (IF no, explain in Remarks.) �-�j Are Vegetation Soil , or Hydrology� signiFicantly disturbed? Are "Normal Circumstances" present? Yesl '� I No � Are Vegetation Soil {._._l� or Hydrolo9Y � naturally problematic? (If needed. explain any answers in Remarks.) SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc. Hydrophytic Vegeta[ion Presen[? Hydric Soil Present? Wetland Hydrology Present? Remarks: HYDROLOGY Yes No Yes PJa Yes1 I No �cb�� ..�f� ..�� s�� a�� - Is the Sampled Area within a Wetland? Yes � No c� f� � w� . i` �, ��-�- �� ..��5 �,�,�,,ti �� • Wetland Hydrology Indicators: Secondarv Indicators (minimum of two required) Primary Indicators (minimum of one is required; check all tha[ a�plv) ,❑ Surtace Soil Cracks (B6) � Surface Water (A1) ❑ True Aqua[ic Plants (614) ❑ Sparsely Vegetated Concave Surtace (B8) � High Water Table (A2) � Hydrogen Sulfide Odor (C1) ❑ Drainage Patterns (B10) ❑ Saturation (A3) � Oxidized Rhizospheres on Living Roo[s (C3) ❑ Moss Trim Lines (B16) ❑ Water Marks (61) � Presence of Reduced Iron (C4) ❑ Dry-Season WaterTable (C2) ❑ Sedimen[ Deposits (62) ❑ Recent Iron Reduction in Tilled Soils (C6) ❑ Crayfish Burrows (C8) ❑ Drif[ Deposits (B3) � Thin Muck Surface (C7) ❑ Saturation Visible on Aerial Imagery (C9) ❑ Algal Mat or Crust (B4) ❑ Other (Explain in Remarks) ❑ Stunted or Stressed Plants (D1) � Iron Deposits (B5) � Geomorphic Positlon (D2) ❑ Inundation Visible on Aerial Imagery (B7) ❑ Shallow Aquitard (D3) ❑ Water-Stained Leaves (B9) ❑ Microtopographic Relief (D4) �Aquatic Fauna (B13) D FAC-Neutral Test (D5) Field Observations: Surface Water Present? Yes � No � Depth (inches): Water Table Present? Yes Q No � Qepth (inches): Saturation Presen[? Yes Q No ��Dep[h (inches): Wetland Hydrology Present? Yes n No (includes ca illar frin e Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available: Remarks: US Army Corps of Engineers Eastern Mountains and Piedmont— Version 2.0 VEGETATION (Five Strata) - Use scientific names of plants. Sampling P�int:�� Absolute Dominant Indicato Tree Stratum (Plot size: Z� �i- 2� �O� �) % Cover Species? S[atus 1, 2. 6. = Total Cover 50% of total cover: 20% oF total cover: Sapling Stratum (Plot size: %�� 2a-ei� ) 1. 5. = Total Cover 50% of total cover: 20% oF total cover: Shrub Stratum (Plot size: � � i� ��'1 ) 1. 3. 5. s. = Total Cover Number of Dominant Species That Are QBL, FACW, or FAC: (A) Total Number of Dominant Species Across All SVata: �^ (B) Percen[ of Dominant Species That Are OBL, FACW, or FAC: �— (A/B) Prevalence Index worksheet: Total % Cover oF: iNvl[iolv bv: OBL species x 1 = FACW species x 2 = FAC species x 3 = FACU species x 4 = UPL species x 5 = Column Totals: (A) Prevalence Index = B/A = �B) ❑ 1- Rapid Test for Hydrophytic Vegetation ❑ 2 - Dominance Test is >50�0 ❑ 3 - Prevalence Index is <_3.0' ❑ 4 - Morphological Adaptations' (Provide supporting data in Remarks or on a separate sheet) � Problematic Hydrophytic Vege[a[ion' (Explain) 'Indicators of hydric soil and weUand hydrology must be present, unless disturbed or problematic. 50% of total cover: 20% of total cover: Tree – Woody plants, excluding woody vines, Herb 5tratum (Plot size: �� )t approximately 20 ft (6 m) or more in height and 3 in. ��q,�'�pJ� Qie,/I�t� g,�pSSp�ry � wp�ca � ��.� (7.6 cm) or larger in diameter at breast height (DBH). 2• Sapling – Woody plants, excluding woody vines, 3, approximately 20 ft(6 m) or more in height and less � than 3 in. (7.6 cm) DBH. 5. Shrub – Woody plan[s, excluding woody vines, & approximately 3 to 20 ft(1 to 6 m) in height. �• Herb – All herbaceous (non-woody) plants, including g herbaceous vines, regardless of size, and woody plan[s, except woody vines, less than approximately 3 9� ft(1 m) in height. 10, 11. � = Total Cover 50% oF [o[al cover: � 20% of total cover � Woody Vine Stratum (Plot size: %� 2c 4 ) 1, 2. 3. = Total Cover 50% oF total cover: 20% of total cover: I Remarks: (Include photo numbers here or on a separate sheet.) �� V�i�� i � �ti v��H�4��c� �4 �.1,� q'�q - Woody vine – All woody vines, regardless oF height. Hydrophytic Vegetation Present? Yes �, Odo US Army Corps of Engineers Eastern Mountains and Piedmont – Version 2.0 SOIL Sampling Point: �� (� Prafile �esCripttun: [Describs to the depth needed to documerit the indicator or confirm the absence of indicators.) Depth Nfauix Redox Features On�hesl Colar m i t % Color (moisU % Type Loc Texture R�m�rk5_ .� !OQ a+� TT e: C=Concentrdtion, D=De letlon, RM=Reduced Matrix, MS�Masked Sand Grains. ZLocation: PL=Pore lin's , M=MaVix Hydric Soil Indicators: Indicators for Problematic Hydric Soils': 0 Histosol (A1) L] Dark Surface (S7) 0 2 cm Muck (A10) (MLRA 747) ❑ Histic Epipedon (A2) D Polyvalue Below Surface (SS) (MLRA 147, 148) ❑ Coast Prairie Redox (A"16) ❑ Black Histic (A3) ❑ Thin Dark Surtace (S9) (MLRA 147, 148) (MLRA 747, 148) ❑ Hydrogen Sulfide (A4) ❑ Loamy Gleyed Matrix (F2) 0 Piedmont Floodplain Soils (F19) ❑ Stratified Layers (A5) � Depleted Matrix (F3) (MLRA 736, 147) ❑ 2 cm Muck (A10) (LRR N) D Redox Dark SurFace (F6) D Very Shallow Dark Surface (TF12) [] Depleted Below Dark Surface (A11) � Deple[ed Dark Surface (F7) � Other (Explain in Remarks) ❑ Thick Dark Surface (Al2) � Redox Depressions (F8) � Sandy Mucky Mineral (S1) (LRR N, � Iron-Manganese Masses (F12) (LRR N, MLRA 147, 148) MLRA 136) ❑ Sandy Gleyed MaVix (S4) ❑ Umbric Surface (F13) (MLRA 136, 122) 'Indicators of hydrophytic vegetation and ❑ Sandy Redox (S5) � Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be presen[, � Stripped Ma[rix (S6) � Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic. Restrictive Layer (if observed): Type: Depth (inches): Hydric Soil Present? Yes ❑ No � Remarks: US Army Corps of Engineers Eastern Mountains and Piedmon[ — Version 2.0 WETLAND RATING WORKSHEET Fourth Version W .� Project Name ��- S �� 7 S, �e✓ r�y Nearest Road li S� Y County �`�A�-�„nw� Wetland area Q� � acres Wetland width z-� feet Name of evaluator A• E�°� � 7(�o�� Date S^�� ? Wetland location _ on pond or lake _ on perennial stream �o . intermittent stream � within interstream divide � other: Soil series• 1�4��af� �c��n co�„(l"� _ predominantly organic - humus,� r ,� eat \/predominantly mineral - non-sandy predominantly sandy Hy,draulic factors J steep topography ditched or channelized total wetland width > 100 feet Wetland type (select one)* Bottomland hardwood forest ✓ Headwater forest Swamp forest _ Wet flat Pocosin _ Bog forest Adjacent land use (within '/z mile upstream, upslope, or radius) "� forested/natural vegetation �o % agriculture, urban/suburban �d % impervious surface �o % Dom'rnan� vegetation � (1) +rnx,�-S I�e�wC��v�.cc� (2) �< < �c�r0�� , ti,,,, u ,iv�� 3> SQr��, h�� Flooding and wetness semipermanently to permanently flooded or inundated seasonally flooded or inundated 7 intermittently flooded or temporary surface water _ no evidence of flooding or surface water Pine savanna ~ Freshwater marsh Bog/fen _ Ephemeral wetland _ Carolina bay � Other: R The rating system cannot be applied to salt or brackish marshes or stream channels : R Water storage �_ x 4.00 =� � A Bank/Shoreline stabilization � x 4.00 =� wetland T Pollutant removal r�� ____W�___� *� x 5.00 = IS I Wildlife habitat � x 2.00 =� � G 'V N Aquatic life value � x 4.00 =� G Recreation/Education f x 1.00 = �� ** Add 1 point if in sensitive watershed and >10% nonpoint source disturbance within'/z mile upstream, upslope, or radius WETLAND RATING WORKSHEET Fourth Version � Project Name � � �' i� � 7 � � ✓ (� l� Nearest Road �/� [ �% _ County �Ir��,[iw1 Wetland area �� 0 acres We land width �ZZ feet Name of evaluator 1�t.��L� �• U�'-' W�tland location �� on pond or lake ✓on perennial stream on intermittent stream � within interstream divide other: Date �-y-�� Adjacent land use (within'/z mile upstream, upslope, or adius) forested/natural vegetation � °/v _ agriculture, urban/suburban % impervious surface °!o Soilseries: �C�o.�i,,r�� S1�4r] �-(�q�y r G��-�'��Domi antvegetation � predominantly organic - humus, muck�, �r°""` (1) �cef l�� peat �°°�P predominantly mineral - non-sandy �2� L��Js�✓� 5�� _ predominantly sandy (3) 1`��,,,,,., �,,,,;�� Hydraulic factors steep topography ditched or channelized total wetland width > 100 feet Wetland type (select one)* Bottomland hardwood forest � Headwater forest _ Swamp forest Wet flat Pocosin � Bog forest Flooding and wetness semipermanentZy to permanently flooded or inundated seasonally flooded or inundated �_! intermittently flooded or temporary surface water _ no evidence of flooding or surface water Pine savanna Freshwater marsh _ Bog/fen _ Ephemeral wetland _ Carolina bay ` Other: � The rating system cannot be applied to salt or brackish marshes or stream channels R Water storage � x 4.00 =� A Bank/Shoreline stabilization 3 x 4.00 =� wetland rating T Pollutant removal �� * x 5.00 = (�ci I Wildlife habitat �, x 2.00 = N Aquatic life value 1-- x 4.00 = G Recreation/Education � x 1.00 = � ** Add 1 point if in sensitive watershed and >10% nonpoint source disturbance within %z mile upstream, upslope, or radius NC DW Stream Identification Form Version 4.11 �� Date: � I �� ProjecUSite: Evaluator: � County: Total Points: � o Stream Determination (circ Stream is at /east intermittent � Ephemeral Intermittent �f if >_ 19 or perennial if >_ 30' ' _ Latitude: ''� � , � � C{ � � Longitude:�� (�� )� � Other e.g. Quad Name: A. GeomOr holD 5uhtotai = 1�' / Absent Weak Moderate 1a Continuity of channel bed and bank 0 1 2 2. Sinuosity of channel along thalweg 0 2 3. In-channel structure: ex. riffle-pool, step-pool, p 1 2 ri le- ool se uence 4. Particle size of stream substrate 0 1 2 5. Active/relict floodplain 0 1 2 6. Depositional bars or benches 0 2 7. Recent alluvial deposits 0 2 8. Headcuts 0 1 2 9. Grade control 0 1 10. Natural valley 0 .5 1 T 11. Second or greater order channel No = 0 Y = 3 artificial ditches are not rated; see discussions in manual B. H drolo Subtatal = 12. Presence of Baseflow 0 1 13. Iron oxidizing bacteria 0 1 2 14. Leaf litter .5 1 0.5 15. Sediment on plants or debris 0 .5 1 16. Organic debris lines or piles 0 1 17. Soil-based evidence of high water table? No = 0 Yes 3 C. Bi�lo 5ubtatal= 18. Fibrous roots in streambed Z � 19. Rooted upland plants in streambed 2 � 20. Macrobenthos (note diversity and abundance) 0 Z 21. Aquatic Mollusks � 2 22. Fish 0.5 1 23. Crayfish 0 0.5 1 24. Amphibians � 25. Algae 0 .5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other �� "perennial streams may also be identified using other methods. See p. 35 of manual. Notes: � _ r Sketch: �� } � � �� h ,� � 1 � � �`�` �` �,,, �, � � r c�f � 3 3 3 3 3 3 3 1.5 1.5 J 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 0 NC DW Stream Identification Form Version 4.11 Date: �'7 Project/Site: Evaluator: � County: � Total Points: Stream Deter Stream is af least intermittent Ephemeral I� if � 19 or ne►ennial if 2 30" .� � � � LatitudQ: S ( �_ Longitude: -� , �� n Other �e erennial )e.9. Quad Name: A. Geomo hDlo Subtotal = Absent Weak Moderate 18� Continuit of channel bed and bank 0 1 2. Sinuosit of channel along thalweg 1 2 3. In-channel structure: ex. riffle-pool, step-pool, /�^� � 2 ri le- ool se uence CL% 4. Particle size of stream substrate 0 1` 2� 5. Active/relict floodplain 1 2 6. Depositional bars or benches 0 2 7. Recent alluvial deposits 0 2 8. Headcuts � 1 2 9. Grade control 0.5 1 10. Natural valley 0.5 •. 1 11. Second or greater order channel N� • Yes = 3 artificial ditches are not rated; see discussions in manual ' B. H drolo 5ubtotal = . 12. Presence of Baseflow 0 1 2 13. Iron oxidizing bacteria 1 2 14. Leaf litter 1:5 1 0.5 15. Sediment on plants or debris 0 0.5 16. Organic debris lines or piles 0 1 17. Soil-based evidence of high water table? No = 0 Yes 3 C. Bioin Subtotal = 18. Fibrous roots in streambed 3 2 1 19. Rooted upland plants in streambed � 2 1 20. Macrobenthos {note diversity and abundance) 0 1^-� 2 21. Aquatic Mollusks 0' 1 2 22. Fish 0.5 1 23. Crayfish 0.5 1 24. Amphibians 0 b. 1 25. Algae 0' .5' 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other 0 "perennial streams may also be identified using other methods. See p. 35 of manual. Notes: � ' Sketch: ( ► �� yv�.U`�5 � '� � � �� d�5 ! � ` �`P� w�� -� � % � 3 3 3 3 3 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 , .; NC DW Stream Identification Form Version 4.11 • Date: • � � ProjecUSite: � LatitudQ: �S_ � �� Evaluator: r County: ,�Qr� Longitude: --��. �7�� Total Points: � Stream Dete (circle one) Other Stream is at least intermittent �� Ephemeral � termi t Perennial e.g. Quad Name: if z f 9 or erennial if Z 30 A. Geomo holo Suhtota) = Absent Weak Moderate Strong 1a� Continuity of channel bed and bank 0� 1 2 3 2. Sinuosity of channel along thalweg 2 3 3. In-channel structure: ex. riffle-pool, step-pool, 0 2 3 ri le- ool se uence 4. Particle size of stream substrate 0 2 3 5. Active/relict floodplain 0 2 6. Depositional bars or benches 0 1 7. Recent alluvial deposits 0 Z 8. Headcuts • 1 2 9. Grade control 0.5 1 10. Natural valley 0. • 1 11. Second or greater order channel N= 0 . Yes = 3 artificial ditches are not rated; see dis sai� in manual B. H drolfl Subtotal = • . 12. Presence of Baseflow 0 1� 2" 13. Iron oxidizing bacteria 0 ` 2 14. Leaf litter .5 1 0.5 15. Sediment on plants or debris 0 1 16. Organic debris lines or piles 0 , 1 17. Soil-based evidence of high water tabie7 No = 0 Ys 3 C. Biola Subtotal = � 18. Fibrous roots in streambed 2 19. Rooted upland plants in streambed 1 20. Macrobenthos (note diversity and abundance) 0 .1 2 21. Aquatic Mollusks 1 2 22. Fish 0.5 1 23. Crayfish 0.5 1 24. Amphibians 0.5 1 25. Algae 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other *perennial streams may also be identified using other methods. See p. 35 of manual. Notes: � " u Sketch: � � � +f. ,f -,I .., t �i�`:�. !.. ■ . � . �� 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 NC DW Stream Identification Form Version 4.11 Date: � Project/Site: � . Evaluator: � County: � Total Points: � Stream Determination (ci Stream is at /east intermittent !Z Ephemeral Intermittent ( if z 19 orperennial if Z 30* t A. Geamorphoiogy (5ubtotal= � `� 18� Continuity of channel bed and bank 2. Sinuosity of channel along thalweg 3. In-channel structure: ex. riffle-pool, step-pool, ripple-pool sequence 4. Particle size of stream substrate 5. Active/relict floodplain 6. Depositional bars or benches 7. Recent alluvial deposits 8. Headcuts 9. Grade control 10. Natural valley 11. Second or greater order channel artificial ditches are not rated; see dj,y,Fussions in manual Weak 1 � Latitud�: � �7��,� Longitude: "�.�?� Other e.g. Quad Name: Moderate 2 2 � �� 1 Yes 3 3 3 3 3 3 3 1.5 1.5 B. H dr010 Subtotal = '� � 12. Presence of Baseflow 0 1 3 13. Iron oxidizing bacteria 0 2 3 14. Leaf litter 1.5 0.5 0 15. Sediment on plants or debris 0 .5 1 1.5 16. Organic debris lines or piles 0 0.5 1 1.5 17. Soil-based evidence of high water table? No = 0 Ye C. Biolo Subtotal = 18. Fibrous roots in streambed 2 1 0 19. Rooted upland plants in streambed � 1 0 20. Macrobenthos {note diversity and abundance) 0 3 21. Aquatic Mollusks 0 3 22. Fish 0 1 1.5 23. Crayfish 0 0.5 1 24. Amphibians 0.5 1 1.5 25. Algae 0 .5 1 1.5 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 �ther 0 `perennial streams may also be identified using other methods. See p: 35 of manual. Notes: ' Sketch: o\ y'�('� M 7 ( C.� �� '�,�� . �� 1 � � c � �� e f� NC DW Stream Identification Form Version 4.11 � Date: (J1� �� Project/Site: � Latitud�: � Evaluator: County: Longitude: , 7 � ��$ Total Points: �� Stream Determinat.v� (circle one) Other Stream is at /east intermittent Ephemeral Iritermitterit�• Perennial e.g. Quad Name: if >_ 19 or peiennial if >_ 30"' • � A. GeomO holo 5ubtatal = Absent Weak Mod te 1a� Continuity of channel bed and bank 0 1 2 2. Sinuosity of channel along thalweg 0 2 3. In-channel structure: ex. riffle-pool, step-pool, � Z ri le- ool se uence 4. Particle size of stream substrate 0 1 2 5. Active/relict floodplain � 2 6. Depositional bars or benches 0 '1 2 7. Recent alluvial deposits 0 2 8. Headcuts 0 � 1 2 9. Grade control Q_5 1 10. Natural valley 0 � 11. Second or greater order channel No . 0 . Yes = 3 artificial ditches are not rated; see discuSSions in manual , B. H drala subtota� _ 12. Presence of Baseflow 0 1 � 13. Iron oxidixing bacteria � Z 14. Leaf litter 1.5 0.5 15. Sediment on piants or debris 0 0.5 16. 4rganic debris lines or piles 0 0.5 'I 17. Soil-based evidence of high ter table? No = 0 YQ = C. Biolo 5ubtotal = 18. Fibrous roots in streambed 3 � 19. Rooted �pland plant5 in streambed � 20. Macrobenthos {note diversity and ahundancej 0 2 21. Ac{uatic Mollusks � 2 22. Fish 0 0.5 1 23. Crayfish 0.5 � 24. Amphit�ians 0.5 T 25. Aigae 0 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other `perennial streams may also be identified using other methods. See p. 35 of manual. Notes: '� Sketch: a �l�� W�� 1 �1 3 3 3 3 3 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 /` . NC DW Stream Identification Form Version 4.11 � Date: � � � Project/Site: LatitudQ: �� Evaluator: 1 County: Longitude: •�, y�a �� Total Points: �� Stream Dete circle one) Other Streamisat/eastintermittent � E hemer ntermitt t Perennial e.g. QuadName: if >_ 19 or erennial if >_ 30" P / A. Geomo holo Subtotal= d� Absent Weak Moderate Stro 1a� Continuity of channel bed and bank +" 1 2 2. Sinuosit of channel along thalweg 1 2 3 3. In-channel structure: ex. riffle-pool, step-pool, � 2 3 ri le- ool se uence 4. Particle size of stream substrate 0 1 �" 3 5. Active/relict floodplain 0 1 2.. 6. Depositional bars or benches 0 1 7. Recent alluvial deposits 0 2 8. Headcuts 1 2 9. Grade control 1 10. Natural valley 0 1 11. Second or greater order channel No � �• Yes = 3 artificial ditches are not rated; see discussions in manual B. H droio Subtotal = . 12. Presence of Baseflow 0 1 2 13. Iron oxidizing bacteria 0 2 14. Leaf litter 1.5 0.5 15. Sediment on plants or debris 0 1 16. Organic debris lines or piles 0 .5 1 17. Soil-based evidence of high water table? No = 0 C. Biolo Subtotal = 18. Fibrous roots in streambed 3 1 19. Rooted upland plants in streambed 2 1 20. Macrobenthos (note diversity and abundance) 1 2 21. Aquatic Mollusks 1 2 22. Fish 0.5 1 23. Crayfish 0.5 1 24. Amphibians 0 0.5 1 25. Algae 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 C "perenn€al streams may also be identified using other methods. See p. 35 of manual. Notes: � Sketch: n � � � h ��..- � �� 3 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 0 1,�� NC DW Stream Identification Form Version 4.11 � Date: `� Project/Site: � Evaluator: � � County: � Total Points: • , l Stream Determination (ci n Stream is at /east intemrittenf V� E hemeral Intermittent renn if >- 19 or erennial if >_ 30" ' P A. Geomor ilolo Subtotal = �1" Absent Weak 1 a� Continuity of channel bed and bank 0 2. Sinuosity of channel along thalweg 0 3. In-channel structure: ex. rifFle-pool, step-pool, p �.� ri le- ool se uence 4. Particle size of stream substrate 0 1 5. Active/relict floodpiain 0 1 6. Depositional bars or benches 0 1 7. Recent alluvial deposits 0 8. Headcuts � 1 9. Grade control Q 10. Natural valley 0 11. Second or greater order channel N 0 '. artificial ditches are not rated; see d[sCu�ons in manual B. H drolo Subtotal = �� . 12. Presence of Baseflow 0 1 13. Iron oxidizing bacteria 0 14. Leaf litter 1.5 1 15. Sediment on plants or debris 0 16. Organic debris lines or piles 0 17. Soil-based e�idence of high w er table? No = 0 C. Biol� 5ubtotal = 18. Fibrous roots in streambed 2 19. Rooted upland plants in streambed 3 2 20. Macrobenthos (note diversity and abundance) 0 21. Aquatic Mollusks 1 22. Fish 0.� 23. Crayfish 24. Amphibians 0 .5 Latitud�: � Longitude: ,_'�� Other e.q. Quad Name: Moderate 2 2 2 2 � 2 2 1 1 Yes=3 2 0.5 1 1 1 1 2 2 1 Yes 25. Algae 0 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other 'parennial streams may also be identified using other methods. See p. 35 of manual. Notes: � " 3 3 3 3 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 Sketch: � `\, / � 1 � V � ( ` ,,�.,/ � �� \\�r/AI �� ! U �/ -`� L � ' „ .� r � �� ,� � NC DW Stream Identification Form Version 4.11 Date: � ProjecUSite: S Evaluator:� _ ,� J� � County: � ��,-�-�� Total Points: � % Stream Determination (c Stream is at /east intermittent 1 Ephemeral Intermitten�/ if >_ 19 or ne�nnial if >_ 30' A. Geomor holo Subtotal = Absent Weak 1a� Continuity of channel bed and ba k 0 2. Sinuosity of channel along thalweg 0 3. In-channel structure: ex. riffle-pool, step-pool, p ri le- ool se uence 4, Particle size of stream substrate 0 5. Active/relict floodplain 0 1 6. Depositional bars or benches 0 7. Recent alluvial deposits 0 •1 8. Headcuts 0 9. Grade control 0 10. Natural valley 0 . ) 11. Second or greater order channel No = 0 artificial ditches are not rated; see ' nS in manual B. H drQlo Subtotal = 12. Presence of Baseflow 0 1 13. Iron oxidizing bacteria 0 14. Leaf litter 1.5 - 15. Sediment on plants or debris 0 16. Organic debris lines or piles 0 0.5 17, Soil-based evidence of high water table? No = 0 C. Biolo Subtotal = 18. Fibrous roots in streambed 3 ' 19. Rooted upland plants in streambed 3 20. Macrobenthos (note diversity and abundance) f 1 21. Aquatic Mollusks 22. Fish 0 0.5 23. Crayfish 24. Amphibians � .5 25. Algae 0 I 26. Wetland plants in streambed FACW = 0.7 'perennial streams may also be identified using other methods. See p. 35 of manual. Notes: Sketch: ,��p� ��`��'� � � Latitude: "5 �- Longitude: _�Cr` Other e.g. Quad Name: 2• 1 2 2 2 2 2 1 1 1 1 1 1 2 2 1 1 1 1 =3 Stron 3 3 3 3 3 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 �� NC DW Stream Identification Form Version 4.11 Date: �C �� Project/Site: J Evaluator: � County: Total Points: j Stream Determination (circ Stream is af /east intermittent l� Ephemeral Intermittent erenni if t 19 or erennial if � 30* ' Latitudg: SS � 3 � Y Longitude: _��.�3�� Other e.g. Quad Name: A. GeOmo holo Subtotal = Absent Weak Moderate Strong 18 Continuit of channel bed and bank 0 1 2 2. Sinuosit of channel along thalweg 0 1� 2 3 3. In-channel structure: ex. riffle-pool, step-pool, 0 1� 2 3 ri le- ool se uence 4. Particle size of stream substrate 0 1 2 3 5. Active/relict floodplain 1 2 3 6. Depositional bars or benches 0 1 3 7. Recent alluvial deposits 0 � 2 3 8. Headcuts 1 2 3 9. Grade control 0 1 1.5 10. Natural valley 0 0.5 •: 1 1.5 11. Second or greater order channel N 0 • Yes = 3 artificial ditches are not rated; see dt cu55fons in manual ' B. H drolo Subtotal = . 12. Presence of Baseflow 0 1 2 13. Iron oxidizing bacteria 0 1 2 14. Leaf litter .5 1 0.5 15. Sediment on plants or debris 1 16. Organic debris lines or piles 0 1 17. Soil-based evidence of high ter table? No = 0 Yes C. Biolo Subtotal = 18. Fibrous roots in streambed 2 1 19. Rooted upland plants in streambed � 2 1 20. Macrobenthos (note diversity and abundance) 0 2 21. Aquatic Mollusks 2 22. Fish 0.5 1 23. Crayfish 0.5 1 24. Amphibians 0.5 1 25. Algae 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other *perennial streams may also be identified usfng other methods. See p. 35 of manual. Notes: r Sketch; � 1 �.� ,�� (� r �,1 .Q.�c��..Q- ��- �. �� 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 �� 3 - - • f 0 NC DW Stream Identification Form Version 4.11 �� Date: Project/Site: S' J LatitudQ: 3S , 7�� Evaluator: County: Longitude:�-7� _�g3�� Total Points: Stream Dete ' circle one) Other Stream is at /east intermittent �� Ephemer Ihtermitt Perennial e.g. Quad Name: if >_ 19 or e►ennial if Z 30" y�, A. Geomor holo Subtatal = �� J Absent Weak Moderate Strong 1 a Continuity of channel bed and bank 0 1 3 2. Sinuosity of channel along thalweg 0 1 �' 3 3. In-channel structure: ex. riffle-pool, step-pool, 0 1 i� 3 ri le- ool se uence 4. Particle size of stream substrate 0 1 3 5. Active/relict floodplain 0 1 3 6. Depositional bars or benches 0 1 7. Recent alluvial deposits 0 2 8. Headcuts 1 2 9. Grade control 0 0.5 10. Naturai valley 0 .� 1 11. Second or greater order channel No - Yes = 3 artificial ditches are not rated; see dlScus ans in manual � B. H drolo Subtotal = • 12. Presence of Baseflow 0 2 13. Iron oxidizin bacteria 0 2 14. Leaf litter 1.5 1 .5 15. Sediment on plants or debris 0 1 16. Organic debris lines or piles 0 0.5 17. Soil-based evidence of high water table? No = 0 Yes C. Biolo Subtotal = 18. Fibrous roots in streambed 3 1 19. Rooted upland plants in streambed 1 20. Macrobenthos {note diversity and abundance) 2 21. Aquatic Mollusks 1 2 22. Fish C!D 0.5 1 23. Crayfish 0.5 1 24. Amphibians 0.5 1 25. Algae 0.5 1 26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 Other = "perennial streams may also be identified using other methods. See p. 35 of manual. Notes: ' Sketch: � �`�� s�� V.� 3 3 3 1.5 1.5 3 3 0 1.5 1.5 0 0 3 3 1.5 1.5 1.5 1.5 r- Sr� USACE AID# DWQ # Site # (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET � .;�; . Provide the following information for the stream reach under assessment: 1. Applicant's name: I� � � 11 � 2. Evaluator's name: C: ��'f � J• DJ �`�� 3. Date of evaluation: �1�� 4. Time of evaluation:_ � ��. � ��("M 5. Name of stream: 1� 1��S �� 6. River basin: 4�'� �"�h'� � �c�t✓ 7. Approximate drainage area: 8. Stream arder: �.'� 0� 9. Length of reach evaluated: �� 10. County: ��'�'^� 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex, 34.872312): 3 / . �� 1 � 1 Longitude (ex —77.55661 ij: � 7 � ' � V � �� Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under evalu ' (note nearby roads and landmarks and attach map identifying stream(s) location): �.Lw«,a,d �I-°� � � .Ar+eS-� o � j� � �nd ,�►e h,r.-� 14. Proposed channel work (if any): 15. Recent weather conditions: S��lv1� , w� ��✓►, 16. Site conditions at time of rrisit:�1(iA�/1� �f'a�✓►S , WIoO�fii� 'f1o� 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters ,_,Outstanding Resource Waters _ Nutrient Sen5it' aters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the luation point? YE NO f yes, estimate the water surface a 19. Does channel appear on USGS quad map? YE NO 20. Does channel appear on USDA Soil Surve YES NO 21. Estimated watershed land use: �% Residential °� % Commercial �% Industrial � % Agricultural �% Forested �% Cleared / Logged _% Other (. 22. Bankfull width: � 24. Channel slope down center of stream: lat (0 to 2%) 25. Channel sinuosity: Straight i/ Occasional bends 23. Bank height (from bed to top of bank): 3. �i _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): � � Evaluator's Signatnre (1��` �' � I Date �S� I 1 T�� This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26. �� STREAM QUALITY ASSESSNI�NT WORKSHEET ECOREGION POINT RANGE �# CHARACTERISTICS _ Cu�stal Piedmont Mount�in PrQs�n�_e �f #lo�i / pe!•sisLen± �o�ls �n stre�m 1 0-> 0-4 0-5 (no tlow or saturation = 0; stron� �law = max points 1 �' 2 Evidence of past human alteration �_� p_ 5 p- � (extensive alteration = U; no alteration = max oints) dtipnrian zonc ' ( no buffer = 0; contiQuous, wide buffer = max points 1 u- o v-�+ u- � �;vidence of nutrient or chemical discharges � 4 (extensive discharQes = 0: no dischar�es - max points) 0- 5 0- 4 0-� � G�'ou��Jw:�ie� �iiscifar�e Q 5 0-3 0--4 0-4 U (no discharge = 0; springs, seeps, wetlands, etc. - max points) � � Presence of adjacent floodplain ��,', (no floodplain = 0; extensive flood lain - max pouits) � � � � � � ,'7� � �ntrenchment / tloodplain access �_ 5 �- d n- � I �"y I�aa�j�S' P��rPCICI�PJ - IJ ±I�:�L:P��L 17OOL�I�T - :T:�."�.�. �?4:::�-S� ' ' ' ' „ _ PrncPnrP nf a�j��rQnf syPfl�nr�c � i)-6 u-� o-z , . „ � . , • .. , � -.. - --F rc�° •• cn: :::_: - -- - --� i,.v ::a..u� — v, �c:�., �u., .,u�.0 : - u�t.;. �;:fu��,,� � ('h�nnei sinuosity �i - ; iI - 4 i} - 3 (eYtensive channelization = 0; natural meander = max points) Sedi►nent inpiit � �o u-s � u-4 � u-a (extensive deposition= 0; little or no sedimeni = max_points) _ Size & diversily uf cha��nel be�l substr�te �* ,. �� (fine. homo�enous = 0: larae. diverse sizes = max nointsl �'� Evodence af chane�el i7cisian �r ivider„�� I� .^i�� lZ i(�Fnili'v iiii 7�?i� = n. �in�ii? iir� n•" iiniiiCC — iiiAa iii�iiiiC i O-� 5 IFF n.-..�.,....,. „r..,,.;,..- ►,.,.,i. �.,:�..,.,.� a13 . ....,...... .,. .....,,. .. ........ ........ __. � _ 5 � ('severe erosioil= 0; no ei•osion, stable banks = max poi�itsl � � 4 Root depth and deusity on banks � } E,; (no visible roots =(1; dense roots tl3r��ei�hoy�1- max }>�.�1nts) _ ` � l5 impact by agriculture. livestock, or timber production �_ 5 tsuhstanfii�i impa�:t =G: no evicience = max points) i� Presence of riffle-pooliripple-pool comnlexes �_� � (no riffles/ripples or pools - 0; well-developed = max poi�rts) Q 1 � Habitat complexity 0- 6 E"'' (little or no habitat = 0; frequent, varied habitats = max points) ,.., _ I� � 8 Cnnopy coverage over strQambed Q S I x (no shadin� vegetation - 0; continuous canopy = mas points) �� Substrateembeddedness � NA* (deeply embedded = 0: loose structure = max) 20 Prescnce of stream invertebratcs jsee p�ge 4j �� (no evidence = 0; common, numerous types = max points) (� Z� PresenceoFamphibians 0-4 Oa (no evidence - 0; co►nmon, numerous typcs - max point9) 0 22 Presence of fish 0- 4 � (no evidence = 0; commoi�, i�timerous tv es = max oints) � 23 Evidence of wildlife use �� 6 (no evidence = 0; abundant evidence - max points) Total Points Possible l00 T�TAL SCORE (also enter on first page} �r 'l,lie5e characteristics are not a5sess�d in eo��stal strearfi�s. � (1 - '! Q-4 n-5 f� _ � 0-4 U-i 0-6 0-5 0-4 n_c 0-5 n-s �-` 0-5 U-(i 0-6 0-5 0-4 0-5 0-5 0-4 0-4 0-4 0-4 0-5 0-� lOQ l00 SCORE � � USACE AID# DWQ # Site # (indicate on attached map) � STREAM QUALITY ASSESSMENT WORKSHEET �� Provide the following information for the stream reach under assessment: 1. Applicant's name: N� �� 2. Evaluator's name: • C��►a 3. Date of evaluation: �� Zil�� 4. Time of e�aluation: � S Ivl 5. Name of stream: �� [^o �'� S�y-�C��— 6. River basin: C'i(� I'�'� 7. Approximate drainage area: 8. Stream order: �� 9. Length of reach evaluated: aUi'�` 10. Gounty: �i�►�� 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex. 34.872312): � ` � �� Longitude (ex. —77.55661 l ): � � ��,� �� p � Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under e�aluat (note nearby roads and landmarks and attach map identifying stream(s) location): Ad�a�s�-t+ �-�o J'a�1J� �viD��r-'S, c.tlt.3-� c9•� �.i• (l�o-f-�qoUn Atl� 14. Proposed channel work (if any): 15. Recent weather oonditions: S �'��!`. ��n-�"'� 16. Site conditions at time of e�� (�c�t O "✓ 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nuhtient Sens' '�e Waters ____Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? YES �(f yes, estimate the water surf'ace area: 19. Does channel appear on USGS quad map? YES �NO� 2�. Does channel appear on USDA Soi! Survey? (YE�/ N� 21. Estimated watershed land use: �'� % Residentia� 2� °/a Commercial �% Industrial �° Agricultura] �% Forested �% Cleared / Logged _% Other ( ' 22. Bankfull width: •�" �— 24. Channel slope down center of stream: ' Flat (0 to 2°/a) 25. Channel sinuosity: Straight �Occasional bends 23. Bank height (from bed to top of bank): �`� Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of l00 representing a stream of the highest quality. Total Score (from te�erse): � Comments: Evaluator's Signature �� // - � Date � ! ��' � This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please ca11919-876-8441 x 26. ��f � STREAM QUALITY ASSESSMENT WORKSHEET ``��'� ECOREGION POINT RANGE # CHARACTERISTICS Coastal Piedmont hlountaiu SCORE Presence of flow / persistent �ools in stream � I u-5 0-4 u-� �no flow or saturation = 0: strong flow = max points) Evidence of past human alteration ,-, 2 0-6 0-i 0-5 y, extensive alteration = 0; no alteration = max oints j � R.1�1:11'Ir�117.O11e n c n � n - � �' (no buffer = 0: contiQuous, wide buffer = max points) �' -" " - �` " - ✓� � �.vicience oi nutrient or chemicxi discrtarges �� 4 0-5 0-4 0-4 ; (extensive dischar�es = 0; no discharges = max points) � 5 Cr�u��dwater dischaE•ge 0- 3 ' 0- 4 0- 4 ,,' u (no dischar,�e = 0: sprinQs. seeps. wetlands. etc. = max �oints) ,..� Yresence of adjacent floociplain rr, 6 0-4 0-4 0-? 1 � (no floodplain = 0; extensive tloodplain=max poiiitsl_ ► �"2," Entrenchment / floodpl;�io access , � 7 , 0-5 0-4 0-2 � icieenly entrencheci = 0� freguent fionciin� = max n�intsj I 8 ` Presence ot' adiacent wetlands a- G Q-�4 a- r� i -- i_,_ . ._.i__a_ = n. i�..�� .__�:�,.,.._. ...i�...a_ — _ _ ,.� �,� — � _, i'� _"'»'"..� ... ._ _ , �j�__eat ..�,"":,v.. '"__.' r "'"' � o Ch�nnel sinuosity { lextensive ehannelization - 0; natural meander = max pointsl �� Q � 10 Sediment input p' p_� Q� I (extensive deposition= 0; little or na sediment = mas points) 4 Size & diversity of channel bed substrate � , 11 NA 0-4 0-5 i _ (tine, homogenous = 0; larne, diverse sizes = max points) _ _ _ � � � �.YefE�Pea4'� €ef elaaeare�i er.C.eci�er cer y�i(It�nin� _ � � I � �` 1�ee;;lv i..c:se� _ �: stuble bed �� ,�.::s = max �oi;:ts) 0 U- 4 0-� E"� PrncNnrP ni mninr honl: faih�rPc � � 13 ----- -- ------.,- .. :,_ . __ U-5 U-5 U-5 � � (severe erosion =�; no e�•osion, siaole oanics = max oints j �4 �� Root depth and densit,y on banks z � �_ 5 C�-_. Q- . J F,; (no visinie roois = V; tiense roots inrou,Kiiout = max pointsl �/�' I�»�:�ec l►y a�,°iculture, livcstaci�, ui- 4iii,ber p,�oductiu�� 15 0-5 0-4 Q-5 : f subs�a;�tiai ilii�i7Ci —Q; Rv 2ViCiEiiGc — li�a'ri �viiliS i T Yresence of riftle-pool/ripple-pool complexes � �° (no rifflesiripples or pools = 0: well-developed = max points) �-' �-' G-�' QHai�iiar compiexiiy � �� (little or no habitat = 0: frequent, varied habitats - max pointsl 0- 6 0- 6 0- 6 a� 8 C:►nopy coverage over streambed p_ 5 0-� 0- 5 ,� x _ (no sl�adin� veQetatiou = 0; continuous canop�� = max points) Substrate embeddedness �, 19 NA* 0-4 0-4 �71 (deeply enibedded = 0: loose structure = niax) � 2� Pwesence tif streani inti-ertebrates {see pagc 4) �� _� 0- 5 0- 5 ' � no evidence = 0• common, nuinerous tv es = max oints b Presence of am hibians , V 21 P 0-4 0-4 0-4 � O (no e��idence - 0: coinmon, numerous h�pes = max points) 0 22 Presence of �sh 0- 4 0- 4 0- 4 � (no evicieoce = 0; common, numerous tv es = max points) � Evidence of wildlife use -�, :,3 0-6 0-5 0-5 v (no evidence= 0; abundant evidencz = max points) �x" �� Tot:tl Points Possible 100 100 100 i TOTAL SCORE (atso enter on first page) �� ';�� ,� * Tl�ese characteristics are i�ot assessed in coastal sU-ea�us. USACE AID# DWQ # Site #� (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET : M Provide the following information for the stream reach under assessment: 1. Applicant's name: �� Q� 2. Evaluator's name: �• �� 3. Date of evaluation: S13� I 7 4. Time ofeva[usiion:_ ��"iS {� 5. Name ofstream: ��to l.ove� GK�� 6. River basin: Lne[ f'P4�% 7. Approximate drainage area: 8. Stream order: rs� 9. Length of reach evaluated:�� 10. County: �Vlce �aw� , 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex, 34.872312): 35 . 1 �� Longitude (ex. —77.55661 l ): � / 7 � { � J Methad ioeation determined {cirele)• GA ' Topo Sheet Ortho (Aerial) Photo1G15 Uther C3IS Other 13. Locati.o� of reach under e�alu ' (note nearhy roads and landmarks anc! attach map identifying stream(s) Eacation): , �.� � � P�,� s`�� -4-e- �lt� �� -,�, � �S � .��--4�, O� � s G W 14. Proposed channel work (if any): 15. Recent weather 16. Site conditions at time of visit S�J1�1�� kv.�v✓� Y�i�V�.�O�J � ��`Qc�sC'� �11V� 17. Identify any special waterway classifications known: �Trout Waters _Outstanding Resource Waters Section 10 _Tidal Waters _Essential Fisheries Habitat _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? YES (IV� )If yes, estimate the water surface area: L/ 19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES � 21. Estimated watershed land use: �% Residentia �% Commercial �% Industrial �% Agricultural '�% Forested i� % Cleared / Logged _% Other ( ' 22. Bankfull width: 24. Channel slope down center of stream: �Flat (0 to 2%) 25. Channel sinuosity: Straight �Occasional bends 23. Bank height (from bed to top of _Gentle (2 to 4%) _Moderate (4 to 10%) _Frequent meander _Very sinuous Steep (> 10%) Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of ]00 representing a stream of the highest quality. Total Score (from reverse): � Comm Evaluator's SignaEqre (�� Date �� F� �• � � This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please ca11919-876-8441 x 26. � �. STREAM QUALITY ASSE55MENT WORKSHEET ECOREGI�N POINT RANG� # CHARACTERISTICS Coastal Piedmont Mountain SCORE � Pre�ence pF tlow / ie�•sistent nols in stream 1 ! d� 0-� U-3 U-� f no f7ow or saturation = 0; stron� flow = max pointsl ,; - - � �.vidence oi past numan aicera[ion , � (extensive alteration = 0; no alteration = max points) 0-6 0-5 �-S � ,� filFILIPI.IIA ZUII!' n � n ._� ' (no buffer = 0; conti�lious, wide buffer = max points) v- � �- rt v- 5 � � Evicience o1 nutrient or chemical clischarges 0- 5 0- 4 0- 4 (extensive discharges = 0; no d'ssclya�;�es = ma� u��ints} _ ��., a Grou�dw�ter dis�harg� j Q 5 �'- �- - . ,_ ,_ _ . 0-3 0-4 0-4 U jilu uisCiiarQc — �; spi'iiiKs, scc�is. weiiallu�. ctc. — 1[7dz p01[ti51 — � 6 Presence of adjacent floodplain 0- 4 0- 4 D-? ' ��+ (no floodplain = 0; extensive floodplain - max points) 1 �.'T"., Entrenchment / floodpl:�in access ^ 7 0-� �-4 0-2 /� {�1rPt��y �ntY�nrhPrl = IJ; tC�'qLlellt tlpn�iJil� — iT]?a �OlS]rS� � Presence nf adjacent wetlan�is _ t — : � .- ----�--�.. _,,. �- -- -�'---------�--�- - ---- __, .�_. G -o G-�+ �-: 4 -- - - - - - - �t:,:� ;�, .;�.;:�; . �� Ch�nnel sinuosity n� �_ 4 �, _ i (extensive channelizatioii = ll; natural meander = max points) � Sediment input � 1Q 0-S 0-�4 0-4 ; (extensive deposition= 0; little or no sediment = max oints) Size �c diversity of ch�nnel �►ec� substrate * � _ � 1 (fine. homogenotis - 0; large. diverse sizes = max points 1 NA 0- 4 0- 5 ; �vocicancc c�tr` ehanracl incisi�n or widc�eing _, 'p� lZ �a,.� i. a- n. wi �,.� n. � i_. . � �- 4 l) - 5 �� i �u�,<G�J iiii:lii;u — v. iia�nC �, u, airni — iila;� ii(lifiiii i �""� Drrcrnrn nFmoinr {inn4 f�ilurnc �. � 13 , - - ------- - • ----� --- ------- -_•_-- -� U - 5 0 - 5 0 - 5 y (severe erosion =�: no erosion. stabie banKs = max oints) a1 Ront denth and density on hanks � � ��t ��_? n� � n_c <; F,; � no visibie roots - u: ciense roots tnroueiiout = max poiuts I � � Impxct by agricuiture, Gvesiock, or timber produciion IS � ,. „_ . 0-5 0-4 0-5 �j (iuuSt3i7iia� iii7j3nci —v; Il0 EVi�EilcO = iliax j7QliiiSj L'o Presence of riffle-pool/ripple-pool comQlexes �� _ � � b � (no riffles/ripples or pools - 0; well-developed = max points) _�• Q �labitat compiexity 17 0-G 0-6 0-6 F (little or no habitat = 0: fi•equent, varied habitats = max points) �..� —. _ f� Canopy coverage over streambed � Q �s o—s o—s o—s ,�, (no shadiny ve�etation = 0; continuous canopy = max points)_ � � Substrate embeddedness NA* 0- 4 0- 4 (deeply embedded = 0; loose structure = max) � Pre�ence of �lrewu inverle�r:�les (see p��e 4) r. _O ()-4 0-5 O-5 � Ulo evidence - 0: common, numerous types = max points) ti (� 21 Presence of amphibiaris 0- 4 0- 4 Q- 4 � O (no evidence = 0; common, numerous types = max points) `� Presence of fish � `� O 22 0-4 0-4 0-� 'f. � (no evidence = 0; common. numerous tv es = max ointsl _ Evidence of wildlife use --� 23 0-6 0-5 0-5 (no evidence = Q: abundant evidence = max poinks) �- Total Points Possible I00 I ] 00 100 TOTAL SCORE (also enter on first page) 1.-'� � * The.e charac�lrrielir•c are nnl ac�i�ccerl in ��n:ielal alrrarii� USACE AID# DWQ # Site #� (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET Provide the following information for the stream reach under assessment: 1. ApplicanYs name: ��`�t Q aT 3. Date of enaluation: �! �1 ! ( � �,}�- n ['� 5. Name ofstream: V � �0 1�-�pC� i4�['�+� 7. Approximate drainage area: 9. Length of reach evaluated: �� ,' ., . � .r ,�. 2. Evaluator's name: J� V df� 4. Time of evaluation: ��. �� 11 � 6. River basin: �►Pf �� 8. Stream order: �..��Ac� �Jac�� -t 10. County: �j�1v✓� , 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex. 34.872312): ��• / � V Longitude (ex —77.556611): "� � � ��1b Method location determined (c'srcic): GP Topa Sheet Urthv (Aerial) Photo/GI5 Other GIS flthcr 13. Locatian of reach under e�aluaEion {note nearby raads and lausdmarlts and attach map identifying stream(s) location): "�'., ;�- �n� ��c., n� � W es� �� jJ �'Z�C„ �i,-�.�`�..�.��2�'— v� S � �..� 14. Proposed channel work (if any}: 15. Recent weather conditions: ��n�ny, `^'�f � 16. Site conditions at time of visit: V��Jt"� Y��hS �Oc��1� 17. Identify any special waterway classifications known: _Section 10 ^Tidal Waters `Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of t luation point? YES I� If yes, estimate the water surface area: 19. Does channel appear on USGS quad rrtap? YES NO 20. Does ch�el appear on USDA Soil Survey? YES NO 21. Estimated watershed land use: �� % it ' ential � 0% Commercial �% Industrial �% Agricultural � % Forested �(�/o Cleared / Logged _% Other [ ' 22. Bankfull width: 1��" , 23. Bank height (from bed to top of bank): 3 S� 24. Channel slope down center of stream: � Flat (0 to 2%) _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) 25. Channel sinuosity: Straight v Occasional bends _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appmpriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): � Comments: Evaluator'sSignature C7�" 4�C� Date Sr��l � This channel evaluation form is iotended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change - version 06/03. To Comment, please ca11919-876-8441 x 26. STI2EAM QUALITY ASSESSMENT W�12KSHEE�' ECOREGI�N P�JINT RANGE # i CHARACTERISTICS Coastal Piedmont Mouotain SCORE PresQ��ce of flnw /�,e��sistQnt pnols in stre�r_n_ ( U-5 U-4 U-ti / (no flow or satw•ation = 0: strong flo�v = max oints) � Evidence of past human alteration 2 �-� n-s r,-s -� (ea�tensive alteration = U; no alteration = inax oints) '�, Riparia�n zonc - .J V—(1 V —`i V—J -i (no buffer = 0; conti,�uous, wide buffer = maa poinYs) ^1 � Evidence of nutrient or chemicnl discharges 0- 5 0- 4 0- 4 � (extensive discharges = 0; no dischar�es = max points) � a Gr�i�udivnier discharge � � U 5 0-3 0-4 0-� � �no discl�ar�e = 0; s riri�s, see s. weUands, elc. - rria�c oinlsl '� �, 6 Pwesence of adjacent floodplain n- 4 0- 4 4-? � �' (no tloodplain = 0; extensive floodplain = max pointsJ �� ;�+ _ � � - �.,," N:ntrenchment / tloodplain access � �,� ; , 7 - - 0-5 0-4 0-_ (rlaPnlv P.IIYI'PI]rI]P!� — �J. TT��UPII} ?IOO�II�Q — TTl�Y �p�nTc f PrPcrnre nf arljarent weHan�s � 8 ii-6 0-4 U-= el'J - uili:' — - - - !j�u'vvi:i - �— --'ilti.ii ' � t:hannel sinuosity a-� C- 4 �-� -,-�., (extensive channelizatiou = 0; natural meaiider = max poiiits) 10 - Se�liment input - —_- i 0- i 0- 4 0- 4 .� (extensive depositian= 0; little or no sediment = max poiuts) ;� „ Sixe & divcrsity of channel bed substratc # -� � ll I4A 4-� Q-5 - (fine, homo.�enous = 0; large, diverse sizes = maa points) C��a�dence of channcl ieycisoor or �vidcnin� � b 1� . . U-5 0-4 U-5 ' . � a,.,...,.. : �_ ��. ui.. �.,.a n�. w� i... `--, .i: iccuiy iiiCijc_ i_, ii�uic ncu c� �iin� = iiiri'i in'iiiliSi � � Pro�o.,�o..F.,,�:�,r F.o.,L 4'o:l..roo '� j � _ ...._ ...... ... .....�.,. .,....._ ..._.�..... Q — $ � � — S � — S � a (severe erosion = U; no erosion. stable l�anKs = max points) � m Rnot d��th a�d den.city on h�nkc � q ,� n - ' l,' � '� -- � �� E„� (no visiblz roots = U; dense roots [hrou�hout = max poiuts) �^ ✓ Impact by agriculiure, livestock, or tirober production �\ l5 . 0-� 0-=� 0-5 {s�,H:r>��;,� imj��ct=�i; ttci evidence— in:ix [i��i+iisj 1 ib Presence of riffle-pool/ripple-pool complexes �_� �_ � u- 6 �� (no rifflesiripples ar pools = 0: well-developed = max points) Q Habitat compfexity 17 0-6 0-6 0-6 � � (little or no habitat = 0: frequent, varied habitats = max points) 1 ] Canopy coverage over streambed `� Q 18 0-5 0-5 Q-5 x Ino shading veQetation = 0; continuous canopy = max points) _ 19 Substrate embeddedness NA* 0- 4 0-� � ( deepl embedded - 0: loose structure = max) ��` 2Q Pre�ence oi strexm Invertebrxtes (see pa�e d) (1- 4 0- 5 0- 5 p �„� (iio evidence = 0: common, nwnerous types = max points) _ ` (,� 2� Presence of amphibians 0- 4 0- 4 0- 4 1� I O (no evidence = 0; common, numerous t�-pes = max points) _ _ Presence of tish � O 22 0-4 0-4 0-4 k, � (no evidence = 0; common, numerous tvpes = max points) � Z`� Evidence of wildlife use {� _� 0- 5 0- 5 Ino evidence = 0; abundant evidence = maz points) Total Points Possible 100 �, 100 IQO � �,,. ,�� TOTAL SCORE (also enter on first page) --, M, '� T�i�ie�e characteristics ar�e noi assessed in coastdl strearns. USACE AID# DWQ # Site #� (indicate on attached map) � STREAM QUALITY ASSESSMENT WORKSHEET ;r, , .;; Provide the following information for the stream reach under assessment: 1. ApplicanYs name: o� 2. Evaluator's name: � IJ�r��f 3. Date of evaluation: �' � I 4. Time of evaluetian: ��' 1�!�M 5. Name of stream: v 1_'�� i-v� 6. River basin:_ �� 7. Approximate drainage area: �i U"t' 8. Stream ord�r: �S"� ��'✓ 9. Length of reach evaluated: 10. County; �.til��flM't 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex. 34.872312): � � � 7�� Longitude (ex. —77.556611): ^ 7 1 . � �� ( � Method location determined (circle): GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location): � o �� 6� h�-� � n� ��„ � �,� J N1n�l,,, t,�rc-� �� B� �-a _ � f. 14. Proposed channel work (if any): 15. Recent weather conditions: ��y►{�1,� r wn ✓� R 1 � 16. Site conditions at time of�isit: W�rec�c.wl� '[lfl"`� / 1"eCS'`'��1 ��`� � . 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Watsrs _. Nutrient Sensit'�e Waters _Water Supply Watershed (I-IV) 18. fs there a pond or lake Iocatecf upstream of the evaluation point? YES NO If yes, estimate the water surface area: 19. Does channel appear on USGS quad map? YE NO 28. Daes c annei appear on USDA 5oi1 Survey? YES � r 21. Estimated watershed land use: �� % Resident�a Z.J % Commercial �% Industrial (�% Agricultural �% Forested '�'�l� % Cleared / Logged _% Other { ) 22. Bankfull width: "�`�" 23. Bank height (from bed to top of bank}: ��`�' 24. Channel slope down center of stream: Flat (0 to 2%) _Gentle (2 to 4%) _Moderate (4 to l0%) _Steep (>10%) 25. Channel sinuosity: Straight ✓Occasional bends _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from re�erse): � Comments: Evaluator's Signature 3'''� I l I yV'" ' , Date �r �( r�� This channel evaluation form is intended to be used only as a guide to assist laodowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval aod does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please ca11919-876-8441 x 26. S'I'1ZPAIVI l2UAI,I'TY ASSESS1i�IEl�i'I' W()1ZKSI-�EE� ; - — - � 4 - — � ECOREGION POINT RANGE � # CHARACTERISTICS Coastal Piedmont I�Iountain SCORE ['rQsenca nf �45t' / YC'!'SES�P�lIf �D�ED�� !:: Sd!'i'^S!: '-! 1 0-5 0-4 0-i Ino flow or saturation = 0; stron� flow - max points) � Z Evidence of past human alteration �_ 6 �_ j �_ 5 � (extensive alteration = 0; no alteration = max pointsl Riolrian aone � ' (no buffer = 0; conti�.uous, wide buffer = max points) u- o u- 4 u- � „� 4 �vidence of nutrient or chemical discharges 0- 5 0- 4 0- 4 (extensive discharges = 0: no dischar,�es = max points j �- „a Groundwater ciischarge c �� Q 5 0-3 0-� 0-4 V (no disch�rge = 0: springs, seeps, wetlands. etc. = max poi�l[sl `� ,�..� Presence of ad,jacent #l�odplain � � (no floodplain = U; catcnsivc tloodplain - max points) 0- 4 0-•l 0- 2 �� '�I,�" � Entrenchment / tloodpl�in access n- 5 n_ 4 n-� '"`" ;d�epl�� er.treiic!.e:� _ �: !i•��uea; tl�L;di;�r = ,nax p� ir.ts) - '� PrQsence of adjace�et wetl�en�ls i 8 0-6 ii-4 Q- % �; 7�ii(i �yi:Ciiiifii� — l/; i<`ii'r.-;C: u.Cijai;�iii '�ti:'i32iiiiiS i11'ri?. j.i�iiit:i7 ti c� Channel sinuosity �- i 0- 4 �- 3 �, (extensive channelization = 0; natural meander - max points)__ —�_ _{'#` � � Sediment input - 0- 5 0- 4 �- 4 �,� (extensive de osition= 0• little ar no sediment = ma� oiuts �� Size & diversity of channel bed substrate �;,�* r� n r� _ j (fine, homoaenous = 0: lar�e. diverse sizes = max oints) Evidci�c� of �.I�a�i�ic9 iii�isian or ii�id�niiag -� = �I12 „ , . . , _ , ,. ,_ . 0-5 0-=� 0-S y ��_.N �a,; iili_•��r��i = �i` c:�iUii_ i}�_�S � J3�jH� _ �ii�> F,i�J�iiiy� - � n .............. ..r. . �.....�, e,.:�...,,.� �"� � 13 . ...�....... .,. .:: .��: .,...... .........., 0 _ 5 0 - 5 0 - S ,' �, (severe erosio�i = 0; iio eros�on, stable banks = max points) 7 m' � � Rooi depth aad density an banks �, , �, _ � �� _ � -� F„ i (uo visiblc roots_ 0; dcnsc roots thro�hout - nfaxQofuts) �- - `' '�/� Impact by agriculture, livestock, or timber production � IS ' 0-5 0-4 0-5 j substantiai impact =0: no eviaence = max points I —i �6 _� Presg�ce pf riftle-p�nl/ri�ple-pnol c�m[►lexes U- 3 G-� U- 6 �� (no riff7es/ripples or pools = 0; �vell-developed = max pointsl -� d' Nabitat complexity '� 17 0-6 0-6 0-6 �„E"'„� � (little or no habitat = 0: freque�it, varied habitats = max pointsl _�-� G�1 Canopy coverage over streambed ¢, 18 O 5 O 5 O-5 ,� (no slladin� vegetation = 0; continuous canopy = max points! �� 19 ', Substrate embeddedness NA* 0- 4 0- 4 " (deeply embedded = 0: loose structure = max► -• Presence of stream invertebrates �see page 4) � V ' 20 ' 0-4 0--i 0-i J'� , (no evidence = �; cnmmnn, numemus tyres - max n�ints) � G7 , 21 Presence of amphibians 0- 4 0- 4 0- 4 �� O (no cvidcncc - 0: common, nwncrous typcs - ma� points) 0 22 Presence of fish �� Q� �� R��1� � (no evidence = 0; common, nwnerous rypes = max points) � 23 Evidence of wildlite use �_ 6 �� _� �_ 5 � (no evidence = 0; aLiwidant evidenee = ma� points) Total Points Possible 100 l00 100 TOTAL 5CORE (also enter on first page) �,. �,;%? * T'11e�se� ch<�rzcterisii�s �r•e n�t ass�ssed in coastal strea�t�s. USACE AID# DWQ # Site # -- (indicate on attached map) �;,�,; STREAM QUALITY ASSESSMENT WORKSHEET '��, <_ w Provide the following information for the stream reach under assessment: 1. A licant's name: Jn pp N�.0 � 2. Evaluator's name: �� ''� , 3. Date of evaluation: 4. Time of evaluation: I�. �I S P r''� 5. Name of stream: C 6. River basin: l,�,OC �2c�✓ 7. Approximate drainage area: S. Stream order: I 5'�' 9. Length of reach evaluated: � S.�i' 10. County: C�'�n �nn 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any]: Latitude (ex 34.872312): �g. �- 7 � Longitude (ex —77.556611): '�� .�bQ ��`u Method location determined (circle}: GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under e�ai (note nearby roads and landmarks and attach map identifying stream(s) location): 14. Proposed channel work (if any): 15. Recent weather conditions: �v �'�"i �� f�`^ 16. Site conditions at time of visit:, � y�� t�341�'�3�� `�+ n��'1 S, ��e�- �o�uL � 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat ,_,Trout Waters _,Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? YES �If yes, estimate the water surface area: 19. Does channel appear on USGS quad map? YES �O 20. Does c appear on USDA Soil Survey? YES� 21. Estimated watershed land use: �% Residential '�� % Commercial �% Industrial �% Agricultural �� % Forested 3� % Cleared / Logged _% Other ( } 22. Bankfull width: S. S~�- 23. Bank height (from bed to top of bank): a� 24. Channel slope down center of stream: �at (0 to 2%) _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) 25. Channel sinuosity: Straight ✓Occasional bends _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): Comments: Evaluator's Signature [-/w�� // � Date �5��%' � � This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please ca11919-876-8441 x 26. S 11Z�:AlYI Ql1A�,11 �' ASS�SSIVI�l�iT �OIZI�S�i��'1 � � �. ECOREGI�N POINT RANGE � # CHARACTERISTICS Coastal Piedmont Mountain SCORE 1 Pr��e:�.� cf flnes� / �ier;ist�:�: }�€�o!s ::� str�a:n 0- 5 0- 4 �-� ° (no flow or saturation = 0; stron� flow - max points) � Evidence of past hwnan alteration � (extensive alkerakion = 0: no alteration = max oints) G- 6 G- 5 0- 5 ;,�r lti�ariao� zono 3 ' V— b V— 4 V-� �� (no buffer = 0: contiQuous, wide bufter = max points) � _ � Evidence of nutrient or chemic�l discharges 0- 5 0- 4 0- 4 (extensive discharQes = 0: no discharges = max points) I � ,� Grounciwater ciisci�arge 5 0-3 0-4 0-� �� U(no ciischarge = U: springs, seeps, wetlands. etc. = max pointsl � 6 !'resc.^.cc of aclj.^.cc�+t t�o�:l; l�ir► 0- 4 0- 4 �-`' (no £lood}�lain = 0; extensive iloodplain = max points) �'� "�' Entrenchmcnt / floodplain �ccess - � � n_; n_,� n_� ;deeplv entreac�ied - �; .:,quen. flG:,uif�r = R3c�x pcin[s; �", Pres�r�ce m'_F �r�,a;�c�ot �vekl;►nds 8 0-6 0-4 0-� �� :_.....�.� _, _ -;. ;.._._ :• . , � ; _ . - . - li�u w'-.icti:�G` —'v, i.ni�E iiujAGcili Wciiaiiu� — EYIa;: �UiP3L�i '�-� � Channel sinuosity U_ i �_� � � (extensive channelization = Q: natural meander = max points) `� � � Sediment input 0- � 0- 4 0- 4 ,�,! (exlensive deposition= 0: litNe or no sedimen[ = max pointsl \ Size & diversitv� of channel bed substrate l 1 l�rA* � 4 J-� -? (tine_ h�moaen�us = 0: lar�e. diverse sizes - max nointsl � _ l� � E�'idc�tcc of cha��ic0 i��c.isin�� nr i�irlc:��ii�g 0- Q- 4 0- j .l , i�I F it.PP�,i..� Rt,�icari = ' S:�^�s �?eC; :%'� FJa;,vJ — n;�X ^^lP.TS� ' �, F v n____...___ ..r_._:.._�_.__� r_n___...' �y i iwcu�c �� un�v� vnu� .auu. w -� � 13 n-5 n-i n-5 r,,,,, Isevere erosion = 0; no erosion, stable banks = max oints) _ _ � �, Root ciepth and density on banks � , ,� � } �`' (no visible roots = 0; deiise roots throuQliout = max points) " ' � �� ` �� Fy — — — � Impact by agriculture, livestock, or timk�er production � IS 0-5 0-4 Q-5 (substantial impact =U; no evidence = max oints) � PrQsence of rif�le-pc�c�l/ripple-pool complexes � 16 �-� 0-5 0-6 � � (no riffles/ripples or pools = 0; well-developed = max points) � Q Habitat complexity ? � 17 0-6 Q-6 0-G � (little or iio habitat = 0, frequent, varied habitats = max poiirts) �' ¢ � 8 Canopy covcrage ovcr strcambcd p 5 0- S 0 5 � II ,Z, (no 9h�clin� �e�?etiati�n = 0, evFytiriturt�s canopy = max points) ___ 19 Substrate embeddedness NA* 0- 4 0- 4 �''' '' (deeply embedded = 0; loose structure = max} �� i Presence ot stream invertebrntes (see page 4) 20 0-4 0-5 0--� !, � (no evidence = U; commou, numerous types = m�x points) _ __ • G7 21 Presence of amphibians 0_ 4 0- 4 0- 4 ' � f no zvidei�ce = 0; commun, numerous types = max points 1 ��? ''a Presence of fish �" O 22 0-4 0-�l 0-4 �,% h-+ �no evideuce = 0; common, munerous tvpes = max points) � Evidei�ce of wildlife use � 23 (no evidence = 0; abundant evidence = roax points) �- 6 0- 5 (� -� `� Total Points Possible ] 00 100 l OQ TOTAL SCORE (also enter on first page) ' ,- * These cllaracferistics are not assessc:d in coastal stre�i7ls. USACE AID# DWQ # Site # (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET , ` �,4 s, Provide the following information for the stream reach under assessment: 1. Applicant's name: IV �,� � 2. Evaluator's name: , oa�n 3. Date of evaluation: S� I/�� 4. Time of evaluation: �.� S PM 5. Name of stream: `'�C- ��-a-'_ 1 1`�� 6. River basin: ��y�r �-ea✓ 7. Approximate drainage area: 8. Stream ar[{er: �5� 9. Length of reach evaluated: ��'� 10. County: ��1 �'�'►nd'� 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any}: Latitude (ex. 34.872312): � 7 . �7�Z b 6 � Longitude (ex —77.55661 i): '� �� . r{ � ( � � Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under evaluation (note nesrb roads and landmarks and attach map identifying stream(s) location): Sd,�#-ti o� � S 6�iT a�n ��)� �!-�`tn t� �. l a t� C� �-1� 14. Proposed channel work (if any): 5 J,��n� �J� 15. Recent weather conditions: �� 16. Site conditions at time of visit: `� ��`�� "'� r f'P c P`'� •*� d`� .✓1 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nutrient Sen '� Waters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? YES N� f yes, estimate the water surface area 19. Does channel appear on USGS quad map? YES � O 20. Does channel appear on USDA Soil Survey? YES 21. Estimated watershed land use: �% Residentia �% Commercial �% Industrial ��% A' tural � % Forested �% Cleared / Logged % Other ( 22. Bankfull width: 24. Channel slope down center of stream: Flat (0 to 2%) 25. Channel sinuosity: Straight ' Occasional bends 23. Bank height (from bed to top of bank): S� _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) _Frequent meander ^Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range beriveen 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): �� Comments: Evaluator's Signature (/- "� � /� Date Ss� � ( � ( � This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26. �� STREAM QUALITY ASSESSMENT WORKSHEET � ECOREGION POINT RANGE # CHARACTERISTICS Coastal Piedmont Mountain SCORE � 7'res�ree of fiaw / peo•s9stcPit pools on stream �- 5 0- 4 0-� �n4 flow or saturation = 0: str�rt� flow = inalc p�Tir�tsj -�`� � Evidence �f past hi�mar� alterakian � 0 6 0 5 0� �.�- extensive alteration = p; ito alteration = max �iitt�) Riroari;�n 's.nne 3 -� u-� u-� u-s (no b»ffer = 0; �pnti�uour, v,-ide buffer = nt�x �c7l�tsb � Evidence of nutrient or chemical discharges 4 0-5 0-4 0-4 {extensive tlisch�tr�„cs = U�; no di�c&tar�es_max p��ints') � � C:roundwater discharge � � ; n-; n-� n-a � (no ciisch.iri�� = 0; s;�rin��s, se� s. �r�etlancis. etc. - max u'r�its} � � 6 Presence of adjacent floodplain 0-<1 0-�I 0- 2 y, (nis d1ui��lplain - 0: exlensive ll��crci��lain - max d�crinls) --,�, rF,C", � Entrenchment / tloodplain access v� V� V ` I� 0, � - ��ccjiij% Ellii2ilCiiEd = O; fl'Fyiici�t i�Gv(�iiiil?, = Ti73� �Gll7i5� � K i Prescns� o€ ��lj�err�t �ti-ctlaeeds ----0 - F t1- 4 n-? �� (riO w:.il•nnu3 = U: I.ti',t.*e; ttd�u�c�iY wctlniiiis = tii�ax puin[s; " � Ch�nnel sinuosity � - 5 � - � 0 - � � � iextensive channelization = 0; iiat�real meander = max u�intsl '%� 1� Scdimcnt input �_ 5 p_ 4 0- 4 (extensive deposition= Q: 1►ttle or no sediinent = max pautts3 � 1� �ize & diversit,y of channel bed substrate �� Q_� 0 j -, {el1C, h,0E11Q�£F1C�WS = �): ��11"R�. �iuPrcP ci�Pc = I!7�X 70t11xS� ''�, �vidence of channel incision or widening l'Z U-� 0-4 0-5 i r iciee Iy. , er - 0' �,,ubie �e� :.� �ur,'t,s -�:a� �u'sn,�a � �-.� ;� 1z fIC3C1ICtlVl�uuju� 4141181411WCJ �-5 �-s �-; "' �,a„� �severe erosion = 0: iio erosicrn, stable banks = max pointsl - � 1� � Root dcpth and dcnsity on bflnks v_ J V-•� " E, (iiu visible ruu�s - 0; �lense ruuls tl�ruu •huu� - wax �oiaitsl � J � � Im nct b, a riculture livestock, or timber roduction �q li P Y g + P Q-5 0-4 0-5 !•- ! f substantial imprict -U: no evidence - max oints) ?` I 16 �'resence nf riffle-pool/ripple-poel complexes 0- 3 0- 5 0- 6 �' F (no riffles/ripples or pools = 0: well-developed = max points) � FHabitat complezity �� 17 0-6 0-6 0-6 � (little_or_no habitat = 0; frequent, varied habitats = max pointsl W Canapy coverage over streambed d �8 �-1 �)-5 �-5 c� x (no shading ve�etation = 0; continuous canopy = maY points) 19 Substrate embeddedness NA* 0- 4 0- 4 (deeply embedded = 0; loose sh�uctum = max? � � Presence of stre�m invertebr�tes (see page 4) .� I 20 0-4 0-� 0-5 � (iio evidence = 0: common, numerous rypes = max ointsj (� ' 2� Presence of amphibians 0- 4 0- 4 0- 4 � (uu evitleuce - 0; cuuunuu. iiuiiietuu5 lvpes - �[�xx puuUS) � "� Presence of fish O 2Z 0-4 0-4 0-4 � {no evidence = 0; commoii, nuineroiis types = max points) � 23 Evidence of wildlife use �_ 6 �. � 5 ' Z� (no evidence = 0; abundant evidence - anax points) Total Points Possible 100 100 ! 00 TOTAL SCORE (also enter on first page) ��; h��lie:i{: C�17!'�iilt;i"iSCdCS i1.CC t10b cP5ScS5C� Itt ��OZtiI:£1� Si4'2sIltliS. USACE AID# DWQ # Site If (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET •�: .it Provide the following information for the stream reach under assessment: 1. Applicant's name: I"'�-� � 2. Evaluator's name: .S��l fT •��'�`�' 3. Date of evaluation:,��,' �-i �� 4. Time of evaluation: �. S Q 1P� 5. Name of stream:�r�L t�r �� 6. River baSin: CnO� �p4f 7. Approximate drainage area: 8. Stream order: Z� � n�� '�� 9. Length of reach evaluated: 2o{'F 10. County: L�na�^�w� 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex. 34.872312): �S r � � Longitude (ex —77.55661 l): `� ��, � � 1 � Method location determined (cit+cle : GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under evalu ' n(note nearby roads and landmarks and attach map identifying stream(s) location): 14. Proposed channel work (if any): 15. Recent weather conditions: ��,A�n�9 , v�U✓�✓` 16. Site conditions at time of visit: ��"� I�C ��i _ ti'V�o (� �n� TI�`^� 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nutrient Sea '' ters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? YES NO I es, estimate the water surface area: 19. Does channel appear on USGS quad map? YES �10 % 20. Does channel appear on USDA Soil Survey? YES� � 21. Estimated watershed land use: �% Residential ��% Commercial (�% Industrial �� % Agricultural �Z.� % Forested �3�% Cleared / Logged _% Other ( : 22. Bankfull width: � ��' 24. Channel slope down center of stream: Flat (0 to 2%) 25. Channel sinuosity: Straight ✓ Occasional bends 23. Bank height (from bed to top of bank): 3 S� _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): Com Evaluator's Sigaature (J"�"� ��% �/ Date �`1 1� I� This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26. STREAM QLIALITY ASSESSMENT WORKSHEET � �� ECOREGION POINT RANGE � # CHARACTERISTICS Coastal Piedmont Mountain SCORE � � �'rese�c� af t]aw / p�rsist�nt p�c;�s in strear� 0_ S 0- 4 0-� ^� (no flow or saturation = 0: strone flo�v = max pointsl EvidencQ �f past human alteratic�n ` f extensive alteration = 0; no alteration = max oints 1 � b � 5 �, Rlnarian z�iF 3 ---� ---- . U-6 0-4 0- 5 d (nc� hilffet' = 0' col�ti�iioiis_ wid� hi�ffet- = max_ nntntcl Evidence of nutrient or chemical discharges i 4 0-5 0-4 0-4 � (extensive discharges = 0; no dischar�es = max points) ; ,� 5 Groundwater discharge �� _` � n—a n_� (no �ischarge = 0; springs, seeps, wetlands, etc. _�nax points) � � Presence of adjacent tloodplain � _ � G - � � -- L � �' (nu fluudplain - 0; exlensive lloodplain = max pointsl Entrenchment / flood lain access � � V- C V- Y V�- � % � �CiEcjiiy Eiilici�Ciic�i = v; iiEQUciit �Gudiii;�, = iiid� piliiiiSj v' x Press;nsc of adj�eeenk =s�t9�n�ls �-� n- d n-� i 1 ji�u v�eiiarfus =- ii; izij`ne ati�aceni weiianc;s = ma;: pc�nisj � - �;' �� ChnnnGl sin��osity 0- 5 0- 1• U-� �,, � (extensive channelizatiou = 0: natural meander• = uiax nointsl Scdimcntinput 10 0-5 0-� 0-4 + (eYtensive deposition= 0; little or no sediment = max pointsl °. , Size �+k diversity of channel bed substr�te 1� N.a* � C�4 0-_ -) (fpP, hqmnac�r�qi�c = Q: IaraP i��VP7'CP C17PC = ltlal nni�ic) r-� 6. _ r� ' -- — Evideuce mf cl�aniiei incision or wideui��g � 12 . . 0-5 0-4 �-5 � %{aorl" � - VI. 4nhl:a l�a JVr N.�.��.n - V�, � � �Ca�i.Niy iiii;iSi.ti . :i�uuii, u�.� cx. �+u��na i�i8n }�viT:iSi P � ,. � 1.j IICJCI�I:C W IIli1�U1 U411N Ii111U1"CS n_. S (�1 — 5 !�1 — G .- _` � (severe erosion - 0: no erosio�l, stable banks = max oints) � t,� Root dcpth and dcnsity on bank9 ;, V T ✓ `� (tiu visible ruuls - 0; tlense ruuls lhruu�l�uul - rtiux pc�inlsl � ✓ � Impact by agriculture, livestock, or ti►nber production �� i5 n-5 n—a n—s (substailtinl impact -0; no cvidcncc - max poiiits) _ P�esence of riffle-pool!ripFle-po�l cnmplexes .-� 16 (no riffles/ripples or pools = 0; well-developed = max points) 0- 3 0-� 0- 6 � QHabitat complexity � �,,,� 17 0-6 0-6 0-6 � (little or no habitat = 0: freque►it, varied habitats = max points) � Canopy coverage over streambed -�� x 1� (no shading vegetation = 0; continuous canopy = max pointsl �- 5 0- S �-� l9 Substrate embeddedness NA* 0- 4 0- 4 (deeply etnbedded = 0; loose structure = max) � 2� Presence of stream invertebrates (see page =}) �_;� 0- 5 0- 5 ? � (no evidence - 0: common, numerous types = mar points) � 21 Preseoce of' amphibians 0- 4 0- 4 0- 4 ',`; 0 (nu evidence - 0; cumrrwn. nwrieruus Lypes = rriax poiuls) ""�' Presence of fish � O 22 0-4 0-4 0-4 � I� (no evideuce = 0: common, numerous t es = max oints) Evidence of wildlife use -� Z3 0-G 0-5 0-5 � (no e�vidence = 0; abunda��t evid�nce = max points) Total Points Possible 100 100 ] 00 �' TOTAL SCORE (afso enter on first page) �� " I�hese charac�erist�cs are not assesse�i ir2 c��stal str2ams. USACE AID# DWQ # Site #._ (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET Provide the following information for the stream reach under assessment: 1. Applicant's name: �Cd� 2. Evaluator's name: .f� 3. Date of evaluation: 1 f� I �� 4. Time of evaluation: 3-� S P 5. Name of stream: 1�'T' +� I�W�S �v�� 6. River basi�: � 0� �✓ 7. Approximate drainage area: 8. Stream order. Lst� 9. Length of reach evaluated: �k� 10. County: G`►a"�'�a'"" 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any}; 2 � u Latitude (ex, 34.872312): f� � SZ�� Longitude (ex -77.55661 l�: —�,-l�� , Method locatian determinecl (eirele): GP Topp Sheet Qrtho (Aeriat) Pho[o/GiS �ther GIS Uiher 13. L,ocation of reach under e�alu n(note nexrby roads and landmarks and attach map identifying stream(s) location : 5� .-4��c. aF v S 6�( , w� S� �►1� s m.,-r�, aG ��,,•q � k,� p4 �� a- f-. � 14. Proposed channel work (if any 15. Recent weather conditions: � dl �t-i ��"^'� , 16. Site conditions at time of r+isit: u�n9aL'°� � 1 v`C ��'�� N S 17. Identify any special waterway classifications known: _Section 10 �Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV) 18. Is there a pond or lake located upstream of the evaluation point? � NO If yes, estimate the water surface area: (, LS QCYYS 19. Does channel appear on USGS quad map? YES 'rN0 20. Does channel appear on USDA Soil Survey?� NO 21. Estimated watershed land use: �% Residential �% Commercial �% Industrial �(�°/n Agricultural �1 % Forested �% Cleared / Logged _% Other { ) 22. Bankfull width: i}�L={— � 24. Channel slope down center of stream: �Flat (0 to 2%) 25. Channel sinuosity: Straight �Occasional bends 23. Bank height (from bed to top of bank): 2� _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality. Total Score (from reverse): Comments: Evaluator's Signature_ � /� �� D�te �`l I_ l� This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please ca11919-876-8441 x 26. STREAM QUALITY ASSESSMENT WORKSHEET � ECOREGION POINT RANGE # CHARACTERISTICS Coastal � Piedmont Mountain SCORE I'r�sencc uf fiaw / pej-sistcnt poa.s �n strc;tni r 1 0-5 0-4 0-� 7 (no ilow or saturation = 0; strong flow = max points) Z Evi:lence of past human alteration 0- 6 0- 5 0-� � (extensive alteration = 0; no alteration = max oults) i Rir�aria�i •��nv -- - 3 ---r--• ••--• �..--_ 0- 6 0- 4 0-� ` (r�n hpffar = Q_ rpntiaiiniic� U✓iriP hii{�f�r = niaa, �nintcl > 4 Evidence of nutrient or chemic:►I discharges 0- 5 0- 4 0- 4 � � (extensive discharyes = 0: no discharges = max points) ,,a Groundwater discharge - d s n_; n_4 n_1 � (no discharge = Q; springs, seeps, �i�etiands, etc. = max points) --/ ,..� Presence of adjacent floodplain �y � 6 �-� 0-�l 0-Z .f � (no flood lain = 0; extensive tlood lain = inax poi�rtsl _ x ., Entrencl►ment / floodplain access „ � „ � „ ,, 'a I� �. / 1 I . C.. n _ _ • � v - J U - Y v - ._ ( ` iCieepiy etiirciiCileu = ii; irequeiii iwoCiiiiK =�riaa puinisl R Pa•es��ce Qf adjaeea�E wetlamds n_ � n_ a n_? - � Ir,o w�etiands = ii; far�e adjacent w�eiiands = max poirts i ' �� -- �� Channel sinuosity � 5 �-� �- 3 � (�xtensive �hannPlization = 0; t�atural -m�ander = max p�intsl `� 1 p Sediment input p-- S 0- 4 0- 4 '=i (Pxt�nsive riep�.�itinn= �; lirtle nr nn .,ecliment = max nmte) '` ��__ i 1 Size & diversity of channel bed substrate Tv.4* 0- 4 (� - � � =� - ��llle, hnTi:O�P!?Q!!S = n' ��rhC� �1b�T5P S:ZPS = :?3wX r^11??S�- - -- - - - — -- --- —. z E��idence uf cli:�uuei io�ci�ivii ur witlein�ag — - - — .--1 I � , �.. :.. ��,. � . �; ......�... - .._.,_. _,.:...,., � t) - 5 0 - 4 0 - 5 �_;� �I,l`ri �dcc4ny uiCiSc� = U; Siawc �c� u, ��ai�no - iva;. N�uiui � �. G..+ - - . _ _. . I� j^ �j 1"feSrllCe OI lil'd�Of UdOH lAllUfeS v-� V-� v- j � (severe erosion = 0; no erosion, stable banks = max oints) ��' � I 0.1 �T Root deoth and density on bauks ,; , � ., �_� --, ��' (no visible roots = 0; dense roots throu�hout = max ointsl V� "� I �` � E-� '� Imp�ct by agriculture, livestock, or timber production i 15 (substantial impact =0: no cvidcncc = max poiirts) n- 5 p_ a p_ 5 �, �_ �6 Presence of riffle=pool!ripple�pool complexes 0- 3 0- 5 0- 6 F (no rift7es/ripples or pools = 0; �vell-developed = max poiuts) � Q � � � Habitat complexity 0- 6 0- 6 0- 6 F'" (little or no habitat = 0; frequeirt, varied habitats = max pointsl �'�� r� aCanopy coverage ovew strean�bed � 18 0-5 0-5 0-5 '�-� x (no shadine vegetation = 0: co�rtinuous canopy = max points) i 19 Substrate embeddedness NA* I 0- 4 0- 4 �` i. _ ' (deeply embedded - 0; loose structure = max! � � �' .. 20 Presence of stream invertebrates (see pa2e 4) 0- 4 U- 5 0-� �� ' �no evidence = 0; common. ntimeroiis tvpes = max oints) - � 2t Presence of amphibians 0- 4 U- 4 0- 4 � Q (no evidence = 0: common, numerous tvpes = max points) �-- Presence of tish � } O 22 0-4 0-4 U-� I � (no evidence = 0; coinmon, numerous es = m�x oints) \1 23 Evidence of wildlife use 0- b 0- 5 0- 5 �`•� (no evidence = 0: �bundant evidence = max points) Total Points Possible 100 100 100 TOTAL SCORE (also enter on fiest page) ,�� ; * These eharacte�-isiics are not assessed i�a coastal streain�. USACE AID# DWQ # Site #� (indicate on attached map) ;,�,; STREAM QUALITY ASSESSMENT WORKSHEET ,r , ti� Provide the following information for the stream reach under assessment: 1. Applicant's name: �� 2. Evaluator's name: -� •� �`�^iO 3. Date of e►+alu�tion: 5,�, �,� �� 4. Time of evaluation: �1 `_ 5(� Q'n 5. Name of stream:��l �.t it�� +2 � 6. River basin: �n Qe- �1 ✓ 7. Approximate drainage area: 8. Stream order: �5-E' 9. Length of reach evaluated: �� 10. County: L�h`"� 11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Latitude (ex. 34.872312): "Z� .�� t� 2— Longitude (ex. —77.55661 I);�� 1 V �� Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other 13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location}: �0 �`�l1 �� V � �� n,nC� ��5�- vt,z � � � z � . 14. Proposed channel work (if 15. Recent weather conditi 16. Site conditions at time of J .1,�.� � WC` d ".�n �tv�-�8-�', wo�1� �.� �e.nS . 17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat _Trout Waters _Outstanding Resource Waters _ Nutrient Sensifva Waters _Water Supply Watershed (I-IV) r 18. Is there a pond or lake located upstream of the evaluatipn point? YE ;]VO If yes, estimate #he water surface area: 19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey Y NO 21. Estimated watershed land use: �% Residentia �% Commercial �% Industrial % Agricultural �� % Forested ,�% Cleared / Logged _% Other ( 22. Bankfull width: ��'� 23. Bank height (from bed to top of bank): �� 24. Channel slope down center of stream: ✓ Flat (0 to 2%) _Gentle (2 to 4%) _Moderate (4 to 10%) _Steep (>10%) 25. Channel sinuosity: Straight ✓ Occasional bends _Frequent meander _Very sinuous _Braided channel Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of ]00 representing a stream of the highest quality. Z Total Score (from reverse): Comments: Evaluator's Signature�/(� �� Date � � �� ` � This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26. S�'12EAlVi QUALI'I'Y ASSESSIi�IEl�'T WCII2KS�IE�T ECOREGION POINT RANGE # CHARACTERISTICS I� Co�stal Piedmont h1ountain - PrQse�ecP �f �lo�- / �ersestent po�ls �r. strearr: 1 0-5 0-4 0-5 (no flow or saturation = 0; stronQ flow = max points) � �;vidence ot" past human alteration 0- 0 4- 5 0-� (extensive alteration = 0; no alteration = max oiutsl Riaarian zone � f no buffer = 0; co�itiguotis, wide buffer - ma� points) u- o u- 4 �-� Evidence oFnutrient or chemical discharges 4 0 -5 0-� 0-4 (extensive dischar�es = 0; no dischar�es = max points) a �roundw:�ier discharge � 5 0-3 0-4 0-4 �no ciiscliarge = u; springs, seeps, wetiancis. etc. = max pointsl � � Presence of adjacent floodplain Q 4 �� , � (no floodplain - 0; cxtcnsivc floodplain - max points) �+ - 'i2', � Entrenchment / tloodpinin access n- 5 n- a n- � ''`" ;deeply e«treizcl�e�+ _ (?; freqae�.t 1�ood:�i� _ :r.ax poi:lts; � _ ., ., _ � Prese�►ce of adjacent wetlands �- 6 �- 4 �-� � t.1V YYLLI'.ILiGS 'J, isii�,C� ci:ljiiC:ilii 'rr�ii�ifiiis iiiil:� iiiillii5`j y Channel sinuosit_y �� _; ti _ 4 u-:i (estensive channelization = 0; natural meander= max points) 1 � - -- -- -- Sediment input _ 0-� I 0- 4 I 0- 4 extensive de osrtion= 0• little or no sednnent = max ouits 1� Size & diversity of channel bed substrate N.�� (fine, homo2enous = 0: larae, diverse sizes = m�x pointsl , E��idence af chAnnel incision ot° w•idcr►iteg IG �'_ __�- 1_�_ �___ �___ �_ . {�-S . :y ��nrrl�v ,i�irfi�_�� i` �!»�Llr n��i n ris��K� = iiis>_ �5ji�i[�i I� D.....,......,. ,.f .. .. i.....1. C..:1..,...., �� severe erosiony- 0: no erosion, stable banks�- max pourtsl I 0- 5 � ;� Root depth and density on banks �� F,;, (no visiblc roots - 0; deiisc roots throughout - max pointsl __ � � 5 , Imp.�ct by agriculture, livestock, or timber production 0- 5 i substantiai impact =�; no evidence = max poinis j Pr�sence of riffle-pool/ripple-pool camplexes F t� (no riffles/ripples or pools = 0: wel]-developed = maa pointsl �-' Q,+ 1� 1-Iabitat complexity U- 6 F"' (little or no habitat = 0: frec�uent, varied habitats = max points) � --- �� _� � Canopy coverage over streambed 5 �, (no shadinQ veQetation = 0: continuous canopy = max points) " Substrate embeddedness * 19 �dee ly embedded = 0; loose structure = max) NA �� Presence of stream invertebrntes �see page 4) 0- 4 � (no evidence = 0; crnlimon, nwnerous types = max points) (� 2 � Presence of amphibians �_� � (no cvidcncc - 0; common, numcrous typcs - ma� oints) Presence of fish � 22 (no evidence = 0: common. numerous t es = max oints) �� 23 Evidence of wildlife use �_� (no evidencz =O: abundant evidence = max points) Total Points Pos�ible 100 TOTAL SCORE (also enter on first page) '� Thesz ch<�racteristics are noi assesse<i in coast��il streams. 2 n_� Q - � n-5 L� - ^ 0-4 0-5 0-6 0-5 0-4 0- 5 0-5 p-5 f� - _`• 0-5 0-� 0-6 O-5 0-4 scoxE I ()-5 0-� al} v 0-4 0-4 (,\? 0-� 0-4 {,� , 0-S 0-5 J E00 100 �'' z �.