20180252 Ver 1_401 Application_20180218

E -PCN Submittal
DWR
Division of water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are ansmred.
Also, if at any point you wish to print a copy of the E -PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https:lledoes.deq. nc.govfWaterResources101edoci624704iPCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County (or Counties) where the project is located:
Johnston
Is this project a public transportation project?
r Yes r No
1a. Type(s) of approval sought from the Corps:*
Pr Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
17 Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Number Other:
List all NN nunbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
W 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
....................................
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
O Yes G No
For the record only for Corps Permit: O Yes r No

le. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter fromnitigation bank or in -lieu fee program
r Yes r No
1f. Is the project located in anyof NC's twenty coastal counties?*
r Yes r No
1h. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://wwvv.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx

B. Applicant Information
B. Applicant Information
1a. Who is the Primary Contact?*
Wyatt Brown
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
PF Owner r- Applicant (other than owner) r- Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
County of Johnston
2b. Deed book and page no.:
01405, 0530
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
309 E. Market Street
Address Line 2
CRY
Smithfield
Fbstal / Zip Code
27577
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / Rovince / Fbgion
NC
Country
Johnston

C. Project Information and Prior Project History
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Drainage Improvement Plan
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Smithfield
1d. Driving directions*
If it is a new project and can not easily be found in a GPS napping system Rease provide directions.
site address: 600 B CLEARWATER DR, Smithfield
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
260600-07-7131
2b. Property size:
(in acres)
102.4
2c. Project Address
Street Address
600 B Clearwater Drive
Address Line 2
City
State / Province / Pegion
Smithfield
NC
Fbstal / Zip Code
Country
27577
Johnston
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as
appropriate, based on howthe location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.58038 -78.32708
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Neuse River
3b. Water Resources Classification of nearest receiving water:*
WS -N; NSW
Surface Water Lookup

3c. What river basin(s) is your project located in?*
Neuse
River Basin Lookup
4. Project Description
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
The site is the Johnston County public water supply treatment plant, the project is an eAsting sediment basin
constructed on a Neuse Buffer stream being constructed pre Neuse Buffer Law.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Click the upload button or drag and drop files here to attach docurrent
Quad sheet.pdf
File type rrust be pdt
M[.111:/3
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Click the upload button or drag and drop files here to attach docurrent
soil, streams, owner.pdf 380.46KB
File type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
— 10 acres
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
4835
4f. Explain the purpose of the proposed project:*
The eAsting pre Neuse Buffer BMP/sediment basin has a rusting, damaged riser, if the riser/barrel fails a possible
failure of the structure could occur putting sediment in the down stream.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:
Site is a pre -Neuse Buffer built sediment basin on a now buffered stream. The riser/barrel is rusty and failing, the
basin is full of sediment, the plan is to replace the damaged riser barrel with a new barrel, fill the eAsting
riser/barrel with concrete, if the eAsting riser/barrel fails it will cause tremendous sediment loss to the stream,
stream flow will be pumped around and work performed in the dry, sand bags installed upstream and down stream
of work area, track how will be used for work.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docurrent
WTP Drainage Sealed 2-7-18 (1).pdf 2.62MB
File type rrust be pdt
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas? *
r Yes r No F Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
r Preliminary r Approved r Unknown C WA
Corps AID Number:
Exarrple: SAW -2017-99999

5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
nick the upload button or drag and drop files here to attach docurnent
File type rrust be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the
proposed project or related activity? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre -construction notification.

D. Proposed Impacts Inventory
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r- Wetlands 17 Streams -tributaries V Buffers
F- Open Waters r- Pond Construction
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites
impacted.
3a. Site # - Reason for 3b.lmpact 3c. Type of impact* 3d. Stream name * 3e. Stream 3f. Type of 3g. Stream 3h. Impact
impact* type* Type* Jurisdiction* width* length*
repair culvert P Culvert UT to Neuse Intermittent DWR 4 92
fvbp label (e.g. Fbad Grossing 1) Permanent (P') or Perennial (PER) or Average (feet) (linear feet)
Tenporary (T) intermittent (INT)
"" All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
92
3i. Total temporary stream impacts:
0
31. Total stream and tributary impacts:
92
3j. Comments:
existing riser/barrel will be filled with concrete, new barrel will be installed to carry stream flow.
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Project is in which protect basin(s)?*
Check all that apply.
V Neuse
F Catawba
r- Goose Creek
r- Other
6b. Impact Type*
6c. Per or
Temp*
Exempt, allowable
P
Location and Exempt, Allowable, allowable w/
Ferrranent () or
rritigation
Temporary (T)
Exempt, allowable
T
Location and Exempt, Allowable, allowable w/
Pernanent (P) or
mitigation
Temporary (T)
r- Tar -Pamlico
F Randleman
r- Jordan Lake
6d. Stream name * 6e. Buffer mitigation
required?
UTto Neuse River No
UT to Neuse River No
6f. Zone 1 6g. Zone 2
impact* impact*
782 0
(square feet) (square feet)
2,075 0
(square feet) (square feet)

6h. Total buffer impacts:
Zone 1 Zone 2
Temporary impacts: 2,075.00 0.00
Zone 1 Zone 2
Permanent impacts: 782.00 0.00
Zone 1 Zone 2
Total buffer impacts: 2,857.00 0.00
6i. Comments:
Existing riser/barrel is rusting and badly damaged, bmp was installed before the Neuse Buffer Rule
Rick Trone of Raleigh Regional Office made inspected the site on 12/19/17.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
nick the upload button or drag and drop files hereto attach docurrent
F1 Impact Map 02-13-2018.pdf 269.8KB
File nest be FDF

E. Impact Justification and Mitigation
E. Impact Justification and Mitigation
......... ......... ......... ........ ......... ......... ......... ...................
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Construction work area will be confined by sand bags upstream and downstream of work area, work area will be
small as possible to perform the work, stream flow will be pumped around and construction performed in the dry.
Work will not be performed when precipitation is immanent. Planned culvert length is minimized as much as
possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Track how will be used for work, track how will be on high ground, silt fences will be used to protect down stream,
pump around of stream will be used to divert clean water around the construction.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
less than the threshold, basin instillation was performed before the Neuse Buffer Rule, the riser/barrel is badly rusted, repair is necessary to
prevent possible failure of the structure
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
F Yes r No
1b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?
rf Level Spreader
r- Vegetated Conveyance (lower SMWT)
r- Wetland Swale (higher SMWT)
r- Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diffus Flow Documentation
nick the upload button or drag and drop files here to attach docurnent
File type crust be FDF
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes F No

2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
t: Yes
r No
To lookup low density requirement click here 15A NCAC 02H .1003(2).

G. Supplementary Information
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental Policy Act (NEPA/SEPA)?*
r Yes r No
Comments:*
Not required per: 15A NCAC 01 C .0407 STANDARD MAINTENANCE OR REPAIR ACTIVITIES and 15A NCAC 01C
.0408 MINOR CONSTRUCTION ACTIVITIES
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B.0200)?
f Yes r No
2b. Is this an after -the -fact permit application?*
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
repair of existing culvert on County property, should not result in additional development, should help or improve
downstream water quality because replace eiasting rusting culvert.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
r Yes r Nor N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*

r Yes F No
5g. Does this project involve bridge maintenance or removal?*
f Yes r No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?**
r Yes G No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers,
mechanized pile drivers, etc.?*
r Yes G No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
Natural Heritage Program
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
http://wvvw.habitat.noaa.gov/protection/efh/habitatmapper.htmi
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural
preservation status (e.g., National Historic Trust designation or properties significant in North Carolina history and archaeology)?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Dept. Cultural Resources, Historic Preservation Office
7c. Historic or Prehistoric Information Upload
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File rrust be FDF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA -designated 100 -year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA map 3720260600J.
Miscellaneous
Miscellaneous attachments not previously requested.
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File rrust be FDF

Signature Page
Signature
m By checking the box and signing below, I certify that:
■ I have given true, accurate, and complete information on this form;
■ I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions Act');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions Act');
■ I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
■ I intend to electronically sign and submit the PCN form.
Full Name:*
Wyatt Brown
Signature

Initial Review
Is this project a public transportation project?*(?)
r Yes r No
Change only ff needed.
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
BIMS # Assigned *
20180252
Version#*
Reviewing Office*
Raleigh Regional Office - [phone]
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Is a payment required for this project?*
r No payment required
f Fee received
G Fee needed - send electronic notification
What amout is owed?
* $240.00
r $570.00