20180344 Ver 1_401 Application_20180318

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 mark ed with a red asterisk * below are required. You will not be able to submit the form until all mandatory questions are answered.
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://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Countie s) whe re the proje ct is locate d:*
Is this proje ct a public transportation proje ct?*(?)
1a. Type (s) of approv al sought from the Corps:*
1b. What type (s) of pe rmit(s) do you wish to se e k authorization?*
Nationwide Pe rmit (NWP) Numbe r:
NWP Numbe r Othe r:
1c. Type (s) of approv al sought from the DWR:*
1d. Is this notification sole ly for the re cord be cause writte n approv al is not re quire d?*
For the re cord only for DWR 401 Ce rtification:
For the re cord only for Corps Pe r mit:
1e . Is payme nt into a mitigation bank or in-lie u fe e program propose d for mitigation of impacts?
Ne w Hanov e r
Yes No
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Nationwide Permit (NWP)
Regional General Permit (RGP)
List all NW numbers you are applying f or not on the drop dow n list.
check all that apply
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Yes No
Yes No
If so, attach the acceptance letter f rom mitigation bank or in-lieu fee program.
Yes No
1f. Is the proje ct locate d in any of NC's twe nty coastal countie s?*
1g. Is the proje ct locate d within a NC DCM Are a of Env ironme ntal Conce rn (AEC)?*
1h. Is the proje ct locate d in a de signate d trout wate rshe d?*
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
1a. Who is the Primary Contact?*
1b. Primary Contact Email:*
1c. Primary Contact Phone :*
1d. Who is applying for the pe rmit?
2. Owner Information
1a. Name of proje ct:*
Yes No
Yes No Unknown
Yes No
B. Applicant Information
Michael Cramer, Town Manager
[e-mail]
(xxx)xxx-xxxx
[phone]
Owner Applicant (other than owner)Agent/Consultant
(Check all that apply)
2a. Name (s) on re corde d de e d:
2b. De e d book and page no.:
2c. Re sponsible party:
2d. Addre ss
2e . Te le phone Numbe r:
2f. Fax Numbe r :
2g. Email Addre ss:*
(for Corporations)
City State / Province / Region
Postal / Zip Code Country
Street Address
Address Line 2
(xxx)xxx-xxxx
(xxx)xxx-xxxx
[e-mail]
C. Project I nformati on and Pri or Project History
1. Proj ect Information
1b. Subdiv ision name :
1c. Ne ar e st municipality / town:*
1d. Dr iv ing dire ctions *
2a. Prope rty Ide ntification Numbe r:
2b. Prope r ty size :
2c. Proje ct Addre ss
2d. Site coordinate s in de cimal de gre e s
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 how the 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 :*
3. Surf ace Waters
3a. Name of the ne are st body of wate r to propose d proje ct:*
3b. Wate r Re sour ce s Classification of ne are st re ce iv ing wate r:*
Surface Water Lookup
3c. What r iv e r basin(s) is your proje ct locate d in?*
R iver Ba s in Lookup
4. Project Descriptio n
Carolina Beach WWTP Outfall Pipe
(if appropriate)
Carolina Beach
If it is a new project and can not easily be f ound in a GPS mapping system. Please provide directions.
Address located at 404 South Dow Road, Town of Carolina Beach WWTP front entrance and drive west to the rear of the plant site towards
Cape Fear River, where the discharge is located.
2. Proj ect Identi fication
(tax PIN or parcel ID)
(in acres)
City
Carolina Beach
State / Province / Region
NC
Postal / Zip Code
28428
Country
US
Street Address
404 South Dow Road
Address Line 2
34.03008611
ex: 34.208504
-77.91805556
-77.796371
Cape Fear River
Cape Fear River SC
Cape Fe ar
4a. De scribe the e xisting conditions on the site and the ge ne ral land use in the v icinity of the proje ct at the time of this application:*
4b. Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the USGS topographic map indicating the location of the proje ct site . (for
DWR)
4c. Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the publishe d County NRCS Soil Surv e y map de picting the proje ct site .
(for DWR)
4d. List the total e stimate d acre age of all e xisting we tlands on the prope rty:
4e . List the total e stimate d line ar fe e t of all e xisting stre ams on the prope rty:
4f. Explain the purpose of the propose d proje ct:*
4g. De scribe the ov e rall proje ct in de tail, including indire ct imapacts and the type of e quipme nt to be use d:*
4h. Ple ase upload proje ct drawings for the propose d proje ct.
5. Jurisdictio nal Determinations
5a. Hav e the we tlands or stre ams be e n de line ate d on the prope rty or propose d impact are as?*
Comme nts:
5b. If the Corps made a jurisdictional de te rmination, what type of de te rmination was made ?*
Cor ps AID Numbe r:
5c. If 5a is ye s, who de line ate d the jurisdictional are as?
Name (if known):
Age ncy/Consultant Company:
Othe r:
5d. If ye s, list the date s of the Corps jurisdictional de te rminations or State de te rminations and attach docume ntation.
The existing WWTP outfall pipe consisted of two corrugated metal and iron discharge pipes on wood piles. These
pipes were replaced with two HDPE pipes with concrete anchors.
The property is in the MOTSU Sunny Point blast zone. The current use in the vicinity of the project is the WWTP
plant,and the State Park north of the site.
Click the upload button or drag and drop files here to attach document
File type must be pdf
Click the upload button or drag and drop files here to attach document
File type must be pdf
(intermittent and perennial)
The purpose of the project is to replace the two existing failing WWTP outfall pipes with two new outfall pipes.
The project will replace the two existing WWTP outfall pipes with two new outfall pipes and concrete anchors. In
doing this, the project requires the addition of 112 wood piles to the both stabilize and protect the WWTP outfall
pipes from impacts from floating debris (trees). Installation equipment will include the use of a 30x40 spud barge,
with a 120 excavator, thompson jet pump, jet rod and vibratory tamp plate with turbidity curtain around work area.
Click the upload button or drag and drop files here to attach document
14002 CBeach Outfall Pipe Plan & Profile (02-28-18)-Permitting Review.pdf 533.42KB
File type must be pdf
Yes No Unknown
By Tyler Crumbley
Preliminary Approved Unknown N/A
Example: SAW-2017-99999
5d1. Jurisdictional de te rmination upload
6. Project History
6a. Hav e pe rmits or ce rtifications be e n re que ste d or obtaine d for this proje ct (including all prior phase s) in the past?*
7. Future Project Plans
7a. Is this a phase d pr oje ct?*
Are any othe r NWP(s), re gional ge ne ral pe rmit(s), or indiv idual pe rmits(s) use d, or inte nde d to be use d, to authorize any part of the
propose d proje ct or re late d activ ity? This include s othe r se par ate and distant crossing for line ar pr oje cts that re quire De par tme nt of the
Army authorization but don’t re quire pre -construction notification.
1. Impacts Summary
1a. Whe re are the impacts associate d with your proje ct? (che ck all that apply):
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. then individually list
all open water impacts below.
4a. Site # - Re ason for
impact *
4b. Impact type *4c. Name of wate rbody *4d. Activ ity type *4e . Wate rbody type *4f. Impact
are a *
4g. Total te mporary ope n wate r Impacts:
4g. Total pe rmane nt ope n wate r impacts:
4g. Total ope n wate r impacts:
4h. Comme nts:
1. Avoidance and Minimization
1a. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts in de signing the proje ct:*
1b. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts through constr uction te chnique s:*
Click the upload button or drag and drop files here to attach document
File type must be PDF
Yes No Unknown
Yes No
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
Site #1 WWTP
Map label (e.g. Road Crossing 1)
P
Permanent (P) or
Temporary (T)
Cape Fe ar Riv e r
(if applicable)
Othe r Tributar y 0.21
(acres)
0.00
0.21
0.21
E. Impact Justifi cati on and M itigation
The project will replace the existing two pipes with two pipes at the same length and will reduced number of piles,
from, 111 piles from approximately 180 piles, and re-vegetated any disturbed areas
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Doe s the proje ct re quire Compe nsatory M itigation for impacts to Wate r s of the U.S. or Wate rs of the State ?
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
*** Recent changes to the stormwater rules have required updates to this section .***
1. Dif f use Flow Plan
1a. Doe s the proje ct include or is it adjace nt to prote cte d riparian buffe r s ide ntifie d within one of the NC Riparian Buffe r Prote ction
Rule s?
For a list of options to meet the diffuse flow requirements, click here.
2. Sto rmwater Management Plan
2a. Is this a NCDOT proje ct subje ct to compliance with NCDOT’s Indiv idual NPDES pe rmit NCS000250?*
2b. Doe s this proje ct me e t the re quire me nts for low de nsity proje cts as de fine d in 15A NCAC 02H .1003(2)?*
To look up low density requirement click here 15A NCAC 02H .1003(2).
2c. Doe s this proje ct hav e a stormwate r manage me nt plan (SM P) re v ie we d and approv e d unde r a state stormwate r program or state -
approv e d local gov e rnme nt stormwate r pr ogram?*
3. Sto rmwater Requirements
3a. Se le ct whe the r a comple te d stormwate r manage me nt plan (SM P) is include d for re v ie w and approv al or if calculations are prov ide d
to docume nt the proje ct will not cause de gradation of downstre am surface wate rs.*
3b. Stormwate r M anage me nt Plan: If submitting a SM P for re v ie w and approv al, it shall comply with the high-de nsity de v e lopme nt
re quire me nts se t forth in 15A NCAC 02H .1003. Include all appropriate stormwate r control me asure supple me ntal for ms and associate d
ite ms.
3c. Antide gradation Calculations: If submitting calculations to docume nt the proje ct will not cause de gradation of downstre am surface
wate rs, the docume ntation shall include a de taile d analysis of the hydrological impacts from stormwate r runoff whe n conside ring the
v olume and v e locity of stormwate r runoff from the proje ct built upon are a and the size and e xisting condition of the re ce iv ing
wate rbody(ie s).
The town is working with DCM Fisheries to minimize the impacts from installation of the piles. Jetting is the
preferred method.
Yes No
F. Stormwater Management and Diffuse Fl ow Plan (requi red by DWR)
Yes No
Yes No
Yes
No
Yes
No
Hint: projects that have vested rights, exemptions, or grandfathering from state or locally implemented stormw ater programs or projects that satisfy state or locally-implemented stormw ater programs
through use of community in-lieu programs should answ er no to this question.
Stormwater Management Plan Antidegradation Calculations
Click the upload button or drag and drop files here to attach document
FILE TYPE MUST BE PDF
Click the upload button or drag and drop files here to attach document
FILE TYPE MUST BE PDF
G. Supplementary Information
1. Enviro nmental Do cumentation
1a. Doe s the proje ct inv olv e an e xpe nditure of public (fe de ral/state /local) funds or the use of public (fe de ral/state ) land?*
1b. If you answe re d “ye s” to the abov e , doe s the proje ct re quire pre paration of an e nv ir onme ntal docume nt pursuant to the
re quire me nts of the National or State (North Carolina) Env ironme ntal Policy Act (NEPA/SEPA)?*
Comme nts:*
2. Vio lations (DWR Requirement)
2a. Is the site in v iolation of DWR Wate r Quality Ce rtification Rule s (15A NCAC 2H .0500), Isolate d We tland Rule s (15A NCAC 2H .1300), or
DWR Surface Wate r or We tland Standards or Riparian Buffe r Rule s (15A NCAC 2B .0200)?*
2b. Is this an afte r-the -fact pe rmit application?*
2c. If you answe re d “ye s” to one or both of the abov e que stions, prov ide an e xplanation of the v iolation(s):
3. Cumulative Impacts (DWR Requirement)
3a. Will this proje ct (base d on past and r e asonably anticipate d future impacts) re sult in additional de v e lopme nt, which could impact
ne arby downstre am wate r quality?*
3b. If you answe re d “no,” prov ide a short narrativ e de scription.
4. Sewage Disposal (DWR Requirement)
4a. Is se wage disposal re quire d by DWR for this proje ct?*
4b. De scribe , in de tail, the tre atme nt me thods and dispositions (non-discharge or discharge ) of waste wate r ge ne rate d from the
propose d proje ct. If the waste wate r will be tre ate d at a tre atme nt plant, list the capacity av ailable at that plant.
5. Endangered Species and Designated Critical Habitat (Co rps Requirement)
5a. Will this proje ct occur in or ne ar an are a with fe de rally prote cte d spe cie s or habitat?*
5b. Hav e you che cke d with the USFWS conce rning Endange re d Spe cie s Act impacts?*
5d. Is anothe r Fe de ral age ncy inv olv e d?*
5e . Is this a DOT proje ct locate d within Div ision's 1-8?*
5f. Will you cut any tre e s in orde r to conduct the work in wate rs of the U.S.?*
Yes No
Yes No
The outfall pipes have an existing NPDES permit #NC0023256 for the WWTP.
Yes No
Yes No
The Town of Carolina Beach was issued a notice of violation by CAMA #08-09D for the maintenance construction
of the replacement pipes for the WWTP outfall without first obtaining a permit from the NCDEQ.
Yes No
All impacts are temporary and no loss of waters and the number of piles will be reduced.
Yes No N/A
The project is the Town of Carolina Beach WWTP outfall pipe. The plant permitted capacity is 3.0 MGD.
Yes No
Yes No
Yes No Unknown
Yes No
5g. Doe s this proje ct inv olv e bridge mainte nance or re mov al?*
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Doe s this proje ct inv olv e the construction/installation of a wind turbine (s)?**
5i. Doe s this pr oje ct inv olv e (1) blasting, and/or (2) othe r pe rcussiv e activ itie s that will be conducte d by machine s, such as jackhamme rs,
me chanize d pile driv e rs, e tc.?*
5j. What data source s did you use to de te rmine whe the r your site would impact Endange re d Spe cie s or De signate d Cr itical Habitat?*
6. Essential Fish Habitat (Corps Requirement)
6a. Will this proje ct occur in or ne ar an are a de signate d as an Esse ntial Fish Habitat?*
6b. What data source s did you use to de te rmine whe the r your site would impact an Esse ntial Fish Habitat?*
7. Historic or Prehistoric Cultural Reso urces (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 proje ct occur in or ne ar an are a that the state , fe de ral or tribal gov e rnme nts hav e de signate d as hav ing historic or cultural
pre se rv ation status (e .g., National Historic Trust de signation or prope rtie s significant in North Carolina history and archae ology)?*
7b. What data source s did you use to de te rmine whe the r your site would impact historic or arche ological re source s?*
7c. Historic or Pre historic Information Upload
8. Flo o d Zone Designatio n (Corps Requirement)
Link to the FEM A Floodplain M aps: https://msc.fema.gov/portal/search
8a. Will this proje ct occur in a FEM A-de signate d 100-ye ar floodplain?*
8b. If ye s, e xplain how proje ct me e ts FEM A re quire me nts:
8c. What source (s) did you use to make the floodplain de te rmination?*
M isce llane ous attachme nts not pre v iously re que ste d.
Yes No
Yes No
Yes No
Yes No
Talked with Corps agency representative
Yes No
Verified through Curt Weychert with DCM Fisheries
Yes No
NCDCR link provided
Click the upload button or drag and drop files here to attach document
File must be PDF
Yes No
The project consist of two outfall pipes into the Cape Fear River
FEMA floodplain map
M iscell aneous
Click the upload button or drag and drop files here to attach document
File must be PDF or KMZ
*
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 :*
Signature
Date
Si gnature
By checking the box and signing below, I certify that:
Brian Gilbert Cox
3/7/2018