20180482 Ver 1_StreamlinedConsultationForm_20180405

Northern Long-Eared Bat 4(d) Rule Streamlined Consultation Form
Federal agencies should use this form for the optional streamlined consultation framework for the northern long-
eared bat (NLEB). This frainework allows federal agencies to rely upon the U.S. Fish and Wildlife Service's
(USFWS) Januaiy 5, 2016, intra-Service Programmatic Biological Opinion (BO) on the final 4(d) rule for the
NLEB for section 7(a)(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined
framework; (2) describing the project with sufficient detail to support the required determination; and (3) enabling
the USFWS to tracic effects and determine if reinitiation of consultation is renuired per 50 CFR 402.16.
Thrs form is not necessary if an agency determines that a proposed action will have no effect to the NLEB or if
the USFWS has concurred in writing with an agency's determination that a proposed action may affect, but is not
likely to adversely affect the NLEB (i.e., the standard informal consultation process). Actions that may cause
prohibited iilcidental take require separate formal consultation. Providing this information does not address
section 7(a)(2) compliance for any other listed species.
Information to Determine 4(d) Rule Com liance: YES NO
1. Does the project occur wholly outside of the WNS Zone�? � �
2. Have you contacted the appropriate agency� to determine if your project is near � ❑
known hibernacula or �naterility roost trees?
3. Could the project disturb hibernating NLEBs in a known hibernaculum? ❑ �X
4. Could the �roject alter the entrance or interior environment of a known ❑ �
hibernaculum?
5. Does the project remove any trees within 0.25 iniles of a known hibernaculuin at ❑ ❑X
any time of year?
6. Would the project cut or destroy known occupied maternity roost trees, or any ❑ �
other trees within a 150-foot radius from the materiliry roost tree froin June 1
through July 31.
You are eligible to use this form if you have answered yes to question # 1 or yes to question #2 and no to
questions 3, 4, 5 and 6. The remainder of the form will be used by the USFWS to track our assumptions in the
BO.
Agency and Applicant3 (Name, Email, Phone No.): NCDOT, Division 12, Trish Beam,
�dbeam cr,ncdot.gov, 980-522-4218
Project Name: 12.204911
Project Location (include coordinates if known): -80.857474 35.556257
Basic Project Description (provide nan-ative below or attach additional information): replacement of a
failing concrete ditch carrying an unnamed tributary to Catawba River (Lake Nonnan) on I-77 north
bound lane at exit 33 in Iredell County
1 http://www.fws.gov/midwest/endangered/mammalshlleb/pdf/WNSZone.pdf
2 See http://www.fws.gov/midwest/endangered/mammals/nleb/nhisites.hmzl
3 If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are parry to the consultation.

General Project Information YES NO
Does the project occur within 0.25 miles of a known hibernaculum? ❑ �X
Does the project occur within 150 feet of a known maternity roost tree? ❑ �X
Does the project include forest conversion4? (if yes, report acreage below) ❑ �
Estimated total acres of forest conversion
If known, estiinated acres' of forest conversion from April 1 to October 31
If k�1ow��, estimated acres of forest conversion from June 1 to July 3] �
Does the project include timber harvest? (if yes, report acreage below) ❑ �X
Estimated total acres of timber harvest
If ]cnown, estimated acres of timber harvest from April 1 to October 31
If lcnown, estimated acres of timber harvest from June 1 to July 31
Does the project include prescribed fire? (if yes, report acreage below) ❑ ❑X
Estimated total acres of prescribed fire
If lrnown, estiinated acres of prescribed fire from April 1 to October 31
If lrnown, estimated acres of prescribed fire from June 1 to July 31
Does the project install new wind turbines? (if yes, report capacity in MW below) ❑ �X
Estimated wiild capacity (MW)
encv Determination:
By signing this form, the action agency deterinines that this project may affect the NLEB, but that any
resulting incidental take of the NLEB is not prohibited by the fina14(d) rule.
If the USFWS does not respond within 30 days from submittal of this form, the action agency may
presuine that its determination is infornzed by the best available information and that its project
responsibilities under 7(a)(2) with respect to the NLEB are fulfilled through the USFWS January 5,
2016, Programmatic BO. The action agency will update this detei-mination annually for multi-year
activities.
The action agency understands that the USFWS presumes that all activities are implemented as
described herein. The action agency will promptly report any departures from the described activities to
the appropriate USFWS Field Office. The action agency will provide the appropriate USFWS Field
Office with the results of any surveys conducted for the NLEB. Involved parties will promptly notify the
appropriate USFWS Field Of�ce upon finding a dead, injured, or sick NLEB.
Signature:
Date Submitted:
4 Any activity that temporarily or permanently removes suitable farested habitat, including, Uut not limited to, tree removal
from development, energy production and transmission, mining, agriculture, etc. (see page 48 of the BO).
5 If the project removes less than ] 0 trees and the acreage is tmknown, report the acreage as less than 0.1 acre.
� if the activity includes tree clearing in June and July, also include those acreage in April to October.