20090405 Ver 1_401 Application_20090409

HABITAT
ASSESSMENT AND
RESTORATION
tRVIOWIA I
APR 2 2 2009
DENR - WATER Ql1A,
WETLAM AND STORI/WAy
_ __
PROGRAM, INC. - ?-?--
Ms. Lia Myott Gilleski
Express Coordinator
DWQ 401 Oversight/Express Review Unit
2321 Crabtree Blvd., Suite 250
Raleigh, NC 27604
Re: Randleman Water Main - City of Greensboro
April 21, 2009
Dear Ms. Gilleski,
It was a pleasure meeting with you Monday. We truly appreciate your time, effort and advice. Enclosed
per your request is the updated Project Permitting Document for the Randleman Water Main for the City of
Greensboro along with 4 individual copies of the Finding of No Significant Impacts (FONSI) Preconstruction
Notification (PCN), 404 Permit, 401 Permit (1999 issued to Piedmont Triad Water Authority for Randleman
Reservoir). Under separate cover Mr. Vane of Hazen and Sawyer will forward the revised Engineering
Drawings and the CD containing all project documentation.
Regarding the items that seemed to concern you most; stream impacts lengths, stream crossing 7B and
stream crossing 10B the following is our findings:
Mr. Vane had his AutoCAD tech re-measure the length of stream impacts in AutoCAD and we have
discovered that some of the lengths were incorrect. Some where longer as you expected, and some were
shorter. The total length of impact is now calculated at 443 feet. This represents an overall increase of 23
feet of impact.
Stream crossing 7B - (a photo is now included with the Project Permitting Document Notebook) When the
field work was performed my wetland scientist John Soule considered this to be a stormwater conveyance.
When USACE personnel visited the site it was upgraded to an Intermittent Stream and we calculated it as
an impact. When Mr. Vane and I visited the site yesterday and studied the drainage we agree with my
wetland scientist that this is not a stream. The drainage was created by the road fill. The thing that I feel
USACE personnel are calling an intermittent stream is the drainage associated with two 90 degree turns of
ditches. However, for the sake of argument we have decided to leave the impact in place. Please see
email dated April 21, 2009 containing videos of 7B and 10B.
Stream crossing 10B - (a photo is now included with the Project Permitting Document Notebook) When the
field work was performed my wetland scientist John Soule did not consider this to be a stream. When
USACE personnel visited the site they too did not consider it to be a stream. The beginning of the drainage
is within 10 feet of the culvert at a 90 degree angle, it is a roadside ditch. The soils map reflects some type
301 McCullough Drive, 4"h Floor - Charlotte, NC 28262 Phone: [phone] Fax: [phone] Cell: 336.362.6776
of drainage. The location of the water line crossing is on the opposite side of the road from what we feel
USACE is considering an intermittent stream. Please see email dated April 21, 2009 containing videos of
713 and 10B.
With this information and updated documentation in hand along with the revised Engineering Drawings we
are hopeful that you have all that you need to render a decision in our favor. If you wish to visit the project
site we are happy to provide personnel to assist you with locating of each of the stream crossings. (As the
project is approximately 8.5 miles of twists and turns it is much more expedient if you have a tour guide, we
are happy to help!) Thank you again for your help. We appreciate your time.
Please do not hesitate to contact me if you have questions regarding the Permitting Documents and please
feel free to contact Mr. Vane at Hazen and Sawyer if you have questions about the Engineering Drawings.
We look forward to hearing from you.
Respectfully submitted,
&L%X?
Karri Cecil Blackmon
President
CC: Mr. Andrew Vane, PE Hazen and Sawyer
File

1h
S Hazen and Sa er P.C.
""
AWYER
ZEN AND 4944 Parkway Plaza Blvd.
Environmental Engineers & Scientists Suite 375
Charlotte, NC 28217
704 357-3150
Fax: [phone]
To: NCDENR 401/Wetlands Permitting Unit
Date: April 21, 2009
Address: 2321 Crabtree Blvd, Suite 250 Job: City of Greensboro
Raleigh, NC 27604 Randleman Water Line (30966)
Attention: Ms. Lia Gilleski (919-733-9502
We Are Sending You: &Herewith ? Under Separate Cover Sent By: ? Blue Printer ? Hold for Pickup
eports ? Tracings ? Prints ? Messenger ? Mail
? Shop Drawings ? Specifications f?UPS ? Federal Express
? Samples ? Contracts fi?Other
No.
2F +
3H Sheet No Date Description

Construction Drawings
1 Check in the Amount of $2,000 for Express Permitting Fee
1 CD with all updated documentation included (including pics & vids)

D ??
APR 2 2 2009
DENR - WATER QUALITY

Remarks:
Transmitted: Copies to:
? At Your Request M. King, COG
? For Your Information K. Blackmon, HARP
? For Your Comments
)(For Your Approval Very truly yours
? For Distribution Hazen and Sawyer, P.C.
? For Correction
? Furnish as Submitted
? Furnish as Corrected File: 30966 By: Z94d?q4ulll
? Revise and Resubmit Andrew S. Vane, PE
New York, NY • Armonk, NY • Upper Saddle River, NJ • Raleigh, NC • Charlotte, NC • Vienna, VA • Hollywood, FL • Boca Raton, FL • Fort Pierce, FL • Jupiter, FL • Miami, FL • Bogota, D.E. Colombia
Version 1.4
January 9, 2009
401 Oversight/Express Permitting PCN Submittal Checklist
® The application fee (Checks may be made out to "N.C. Division of Water Quality"
- $240.00 for 401 Water Quality Certification with minor impacts
- $570.00 for 401 Water Quality Certification with major impacts
- Express Review Fee (Amount requested on Acceptance Letter)
® Five (5) complete and collated copies of the PCN Application and supporting
documentation (instead of providing 5 copies of the full size plans you may provide two
copies of full size plans along with three copies of 11 X 17 plans)
? Stormwater Management Plan (if applicable - see PCN Form Help File Section E)
1) Please provide three (3) copies of the stormwater management plans along with all
supporting information pertaining to this project including the following:
a. Entire site development/layout plans delineating all drainage areas;
b. Design calculation sheets for all proposed BMP(s) sized for both on-site and
off-site drainage;
c. BMP supplements for each proposed BMP and Required Items Check List
(http://h2o.enr.state.nc.us/su/bmp forms.htm) along with all required
items;
d. A Notarized Operation & Maintenance Agreement for each stormwater
management facility;
e. Detailed construction drawing sheets shall include
(i) Erosion and sediment control plans;
(ii) Installation and planting schedules for the proposed BMPs;
(iii) Appropriately scaled plan views and cross sectional details of all
BMPs and associated components - inlet and outlet structures,
forebay, respective zones and pertinent elevations.
? If your project is located within a State implemented Riparian Buffer Rule Area, submit the
following along with site plans and PCN form:
1) Three (3) copies of the details for on-site diffuse flow provisions, (refer to
http://h2o.enr.state.nc.us/su/bmp_forms.htm).
® DWQ Stream Determination Forms for streams on property and DWQ determination
letter for wetlands or streams (if applicable).
The following is the most critical of all the information that you must provide. The quality and
detail of the information will often determine the expeditiousness of the review. The following is
a checklist of the types of pertinent information required at a minimum:
Maps and Plans:
® The most recent version of the 1:24,000 USGS Topographic Map - Please cleanly draw or
delineate the site boundaries on the topographic map.
® The most recent version of the bound and published County NRCS Soil Survey Map -
(required for projects within the Neuse River Basin, Tar-Pamlico River Basin, Randleman
Lake Watershed and the Catawba River Basin, also recommended for all projects) -
Please clearly delineate the site boundaries, etc. on the map. If the delineation obscures
any of the features, it is recommended that a clean copy be provided. Copies of the
Version 1.4
January 9, 2009
current soil survey and/or soil survey map sheets can be obtained from the local NRCS
County Office (http://www.nc.nres.usda.gov/). GIS soil layers are not acceptable.
® Vicinity map - Please clearly mark the location and approximate boundaries of the property
and project on the map. Please indicate north arrow and scale. Please include applicable
road names or State Road numbers.
® The Site Plan - The most critical map to be provided is the site plan. You must provide full
sized plans. The following is the minimum list of plans that are typically needed.
® Pre-construction/Pre-existing conditions - This sheet (or sheets) must include:
• All jurisdictional and non-jurisdictional wetland, stream, water features, State regulated
buffers (delineated into Zones 1 and 2)
• Topographic contours with elevations
• Any existing structures and impervious areas
• Existing utility lines and easements
• Existing roads, culverts, and other pertinent features
• North arrow and the scale (1":50' scale is recommended).
® Proposed conditions - This sheet (or sheets) must include:
• All jurisdictional and non-jurisdictional wetland, stream, water features, State regulated
buffers (delineated into Zones 1 and 2)
• Lot layout (if a subdivision or commercial development is proposed) - lots must be
developable without further impacts to jurisdictional and non-jurisdictional wetlands,
streams, water features, and State regulated buffers. Building envelopes must be
provided when streams, wetlands, riparian buffers, or water features exist on a lot
• All built-out structures and impervious cover
• Final grading contours with elevations
• All utilities and easements (including septic fields on all lots within 100 feet of stream,
wetland, or water features - if applicable)
• Impacted areas - these should correspond with the Impact numbers listed on your PCN
form.
? Drainage Plans - Final drainage plans must include the following:
• Locations and pertinent elevations and sizes of the stormwater collection system and
drainage ways
• All inlets and outlets must also be shown with pertinent elevations (All outlets to
wetlands must be at a non-erosive velocity, generally less than 2 ft/sec during the peak
flow from the 10-yr storm)
• Scaled stormwater BMPs must also be indicated as required by DWQ rules and policies
• In certain cases (see Section E of PCN form), final stormwater management plans must
also be provided (see Stormwater Management Plan Checklist)
® Proposed Impacts - All impacts to jurisdictional and non-jurisdictional wetland, stream,
water features, and State regulated buffers must be shown and labeled on the site plans at
a scale no smaller than 1" = 50'. All excavation, fill, flooding, stabilization, and other impacts
that will be conducted in or near jurisdictional and non-jurisdictional wetland, stream, water
features, and State regulated buffers must be indicated. Please provide cross sectional
details showing the provisions for aquatic life passage (burial of culvert 20% for culverts <_ 48
inches, and 1-foot for culverts > 48 inches).
Version 1.4
January 9, 2009
Wetland Impacts:
® Precise grading and final elevation contours must be provided. Existing
vegetation and any clearing must be specified.
® All subsurface utility lines must indicate the location of anti-seep collars.
Construction detail for anti-seep collars must be provided.
® Roadway or other crossings of riparian wetlands may require floodway culverts to
maintain existing hydrological conditions.
® Plans should show that the hydrology of remaining wetlands on the site will be
maintained.
Stream Impacts:
® Stream impacts must be clearly shown on the plans. The centerline as well as
the banks of the stream must be surveyed or located by GPS for the portion of
the stream to be impacted.
? The inlet and the outlet of all culverts should be aligned with the stream as
much as possible. Inlet and outlet elevations and streambed elevations should
be indicated. Any inlet or outlet protection must be shown and enumerated on
the impact map(s).
? For bottomless culverts or other spans, a vertical cross section should be
provided that shows the minimum distance from each span to each stream bank,
the stream cross section, the height of the span above the stream and the
minimum distance from the edge of each footer to each stream bank.
Additionally, please provide a signed and sealed geotechnical report of
subsurface soils at the proposed bottomless culvert location. The report must
comply with the Division of Highways - Guidelines for Drainage Studies and
Hydraulic Design, prepared by A.L. Hankins, Jr., State Hydraulics Engineer -
1999.
? Multiple culverts or sectioned box culverts typically require the use of sills, off-
setting or other means to match the cross section of the existing stream (in order
to maintain stream stability and provide aquatic life passage). A vertical cross
section of the culverts should be shown overlain with the up and downstream
stream cross section including the stream flood-prone area.
® Impacts associated with dam construction must indicate and enumerate all fill
associated with the dam footprint, spillway and any bank stream bank
stabilization. The length of stream impounded must also be indicated and
enumerated.
Table of Contents
Section 1 - Copy of Finding of No Significant Impact (FONSI)
Section 2 - Preconstruction Notification (PCN); Copy of 404 Permit; Old Format PCN from
which 404 permit was obtained; 401 Permit issued to Piedmont Triad Water
Authority March 11, 1999.
Section 3 - Site Map; Location (Vicinity) Map; Topographic Maps; Soils Maps.
Section 4 - Stream Crossing Coordinates Table; Stream Identification Forms; Approved
Jurisdictional Determination Forms (USACE); Stream Quality Assessment
Worksheets; DFIRM Maps and Photographs for Stream Crossings 1 through 15
and Wetland Numbered 5.
Section 5 - Randleman Buffer Rules letter of Approval from Shea Bolick, Guilford County.
Section 6 - Comments from Division of Water Quality and Wildlife Resources Commission
to DRAFT PCN with Responses and Acceptance of Responses.
Section 7 - Biological Assessment with Natural Heritage Element of Occurrence Quads.
Section 8 - Archeological and Cultural Resources Communications.
Q?0F WATEgg G
Y
o ?
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
? 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
® 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 In
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: City of Greensboro, NC Randelman Feeder Main 30" and 24" Water Transmission Main
2b. County: Guilford
2c. Nearest municipality / town: Greensboro
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: See document following original PCN entitled"List of Property Owners"
3b. Deed Book and Page No. See document following original PCN entitled"List of Property Owners"
3c. Responsible Party (for LLC if
applicable): City of Greensboro, Director of Water Resources Mr. Allan Williams
3d. Street address: 2602 S. Elm-Eguene Street
3e. City, state, zip: Greensboro, NC 27406
3f. Telephone no.: 336-373-2489
3g. Fax no.: 336-412-6305
3h. Email address: [e-mail]
Page I of 14
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 14
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): See document following original PCN entitled"List of
"
Property Owners
Latitude: See "Stream Crossing Coordinates Table"
1 b. Site coordinates (in decimal degrees): Longitude: - for coordinates encompassing this linear
project
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 31.50 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Deep River via Unnamed Tributaries and Hickory Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: Perennial
2c. River basin: Cape Fear/DeepRiver HUC:03030003
Page 3 of 14
PCN Form - Version 1.3 December 10, 2008 Version
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Surburban/Urban
3b. List the total estimated acreage of all existing wetlands on the property:
0.120 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
There are 7 perennial and 7 intermittent stream crossings within this approximate 8.5 mile linear project. Within the 30'
wide corridor there exists 420 linear feet of stream.
3d. Explain the purpose of the proposed project:
With the construction and filling of Randleman Lake on the Deep River in Randolph and Guilford Counties, supplying
water from the lake to municipalities will require additional feeder mains to connect with the existing water supply lines.
The City of Greensboro is proposing to install a feeder main of 44,800 I.f. from the junction of Coltrane Mill Road and NC
62 in Guilford County to a terminus on McCuiston Road in the City of Greensboro (Exhibits 1 & 2 A-D). The main will
consist of 30 in. and 24 in. pipes. The ROW (hereafter used to refer to the water main right-of-way) will pass through
suburban/urban areas, along or in existing road rights-of-way, except for three lengths where the ROW will cross through
fields and forests, off paved road rights-of-way. The three lengths are: 2,650 I.f., + 4,000 I.f. + 800 I.f., for a total of 7,450
I.f. The width of the construction corridor is 30-50 ft. depending on location and obstructions. Acreage of impact given
below is taken from the engineering plans and reflects the exact width of the corridor. Where the corridor parallels existing
road rights-of-way, the main will usually be installed within the existing road right-of-way, in the ditch or just outside.
Where an existing power line right-of-way parallels the road, the water main ROW parallels the power line to take
advantage of an already cleared right-of-way. In areas, where fields are connected by unpaved farm roads, the ROW is
sited in the farm road whenever possible. Coupling climate changes (more droughts) with growth, the Greensboro Triad
area has sought an additional and more reliable water supply. The City of Greensboro obtains water from Lake Brandt
and Lake Townsend, in the Rocky River drainage system. The supply from Randleman Lake will provide the third source,
and from a different drainage (Deep River). The city also has the ability to pump water to/from the City of High Point, but
High Point also needs additional water. The City of Greensboro wants the ability to respond to future supply and drought
needs as soon as possible. Currently the water pressure in the southern part of the city is approaching a potential crisis
mode. The Groomtown Tank needs additional water for supply and to boost the fire flow pressures in that area. A future
looped line is planned for the Bishop Road area, allowing a better distribution of water. This increased service from Lake
Randleman, for instance, is very important for Sumner Elementary School at South Holden and Old Randleman Roads.
This school has two water tanks of 20,000 gallons each. A modern fire trucks pumps 2,000 gallons/minute, which would
empty both tanks in 20 minutes, likely insufficient time for fighting a fire. Southern Guilford High School and Elementary
School (and the proposed Southern Middle School) are just west of the proposed Randleman Road water line and have
even less storage capacity. Providing water for the southern part of Greensboro and fire protection for the public schools
will be extremely important. Hydrants located at high points along the ROW route can provide this protection and act as
air release valves. However, the primary purpose of the water line is transmission. Please also see attached
Environmental Assessment.
3e. Describe the overall project in detail, including the type of equipment to be used:
Raw water will be pumped from Randleman Lake, treated near the lake, then pumped up Coltrane Mill Road to a finished
water pumping station located in a field southeast of the junction of Coltrane Mill Road and NC 62. This feeder main will
be constructed as one phase from the booster pumping station. The water treatment plant and pipe to the finished water
pumping station are a separate phase. The City of Greensboro desires to have the feeder main in place when the
treated water becomes available. Acquiring the right-of-way at 2007 prices will reduce land costs as compared to the
future. Due to the ever present impact of droughts, installation of the feeder main will begin as soon as practicable.
Machines used will be track excavators, rubber tire loaders for off loading pipe and stone, rubber tire tractors for fine
grading and rubber tire dump trucks. Please see attached engineering drawings and attached Environmental
Assessment for complete details and construction notes.
Page 4 of 14
PCN Form - Version 1.3 December 10, 2008 Version
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ? No ? Unknown
project (including all prior phases) in the past?
Comments: Corp has issued 404 permit Ocotber 24th 2008
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ®Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Habitat Assessment and
Restoration Program, Inc.
Name (if known): John T Soule Other:
4d. If yes, list the dates of the Corps jurisdictional determinations o r State determinations and attach documentation.
October 24th, 2008 see attched 404 Action# : SAW-2008-02587
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
This project although related to the Randleman Dam Projedct i s in itself a separate project. The Randleman Dam project
consisted of dam, water treatment plant and the Town of Rand leman's distribution water line but not this distribution water
line for the City of Greensboro.
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 5 of 14
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ®T Excavation Hardwood ® Yes
? No ® Corps
? DWQ >0.04
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts >0.04
2h. Comments: The City of Greensboro and their design engineers, Hazen and Sawyer worked closely with Habitat
Assessment and Restoration Program, Inc. to ensure the water main alignment minimized impacts to natural resources.
Except as noted in 3d "Explain the purpose of the proposed project" the alignment follows the existing, cleared, and
maintained road rights-of -way and utility lines rights-of-way.
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. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ? P ®T Excavation Stormwater ? PER ? Corps NSA Not
Conveyance ?INT ? DWQ regulated
S2 ? P ® T Excavation Deep
i
ver Trib ® PER ® Corps 16' 48'
6
2 ? INT ? DWQ
S3 ? P ® T Excavation UT to Deep River ® PER ® Corps 6' 30'
Trib 26 ? INT ? DWQ
S4 ? P ® T Excavation UT to Deep River ? PER ® Corps 4.5 30'
Trib 26 ® INT ? DWQ
S5 ? P ® T Excavation UT to Polecat ? PER ® Corps 4.5' 40'
Creek ® INT ? DWQ
S6 ? P ® T Excavation UT to Polecat ® PER ® Corps 4' 30'
Creek ? INT ? DWQ
3h. Total stream and tributary impacts 443'
3i. Comments: See below for crosssings 7a through 15.
Page 6 of 14
PCN Form - Version 1.3 December 10, 2008 Version
Crossing #7A Hickory Creek Trib 2 Excavation Intermittent Corps 2' 26'
Crossing #7B Hickory Creek Trib 2 Excavation Intermittent Corps 2' 29'
Crossing #8 UT to Polecat Creek Excavation Stormwater Conveyance Not Regulated
Crossing #9 UT to Hickory Creek Excavation Perennial Corps 4' 30'
Crossing #10A UT to Hickory Creek Excavation Intermittent Corps 1.5' 25'
Crossing #10B UT to Hickory Creek Excavation Stromwater Conveyance Not Regulated
Crossing #11 UT to Hickory Creek Excavation Intermittent Corps 8' 32'
Crossing #12 UT to Hickory Creek Excavation Intermittent Corps 2' 32'
Crossing #13 UT to Hickory Creek Excavation Perennial Corps 3' 57'
Crossing #14 UT to Hickory Creek Excavation Perennial Corps 4' 34'
Crossing #15 Hickory Creek Deep Bore Perennial Corps No Impact
4. Open Water Impacts
If there are proposed impacts to lakes, po nds, estuaries, tri butaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary (T)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, the n complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Fill ed Excavated Flooded Filled Excavated Flooded
P1
P2
K Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes
? No
If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 7 of 14
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
? Neuse ? Tar-Pamlico ? Other: Please be
advised that Guilford County has jusridiction over the
6a. Randleman Rules at this time no formal regulation exists.

Project is in which protected basin? Shea Bolick, PE of Guilford County has reviewed the plans
and approved the temporaty impacts to the buffers. Please
see attched correspondance dated August 8, 2008.
? Catawba ® Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary (T) impact required?
B1 ?P?T ?Yes
? No
B2 ? P ? T ? Yes
? No
B3 ? P ? T ? Yes
? No
6h. Total buffer impacts
6i. Comments: See attached correspondance from Shea Bolick, PE of of Guilford County Planing and Development dated
August 08, 2008 for approval of the plan in compliance with Randleman Lake Riparian Areas giving buffer authorization.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The City of Greensboro and Hazen and Sawyer, the design engineers, have made all efforts to minimize detrimental impacts
to the environment. The water main alignment was revised a number of times to provide the best route for the water main
within the scope of the project. Alternative analyses approval of Randleman Lake and the decision to build and fill the lake
have now necessitated the need to develop the process of removing water from the lake to supply basic water requirements
for homes, businesses and public facilities. Not to build, following the construction of the lake, does not appear to be a
practical option since the reason for the construction of Randleman Lake was to supply water to the Piedmont Triad area.
The site for construction of the ROW was carefully considered to provide the most direct delivery, while reducing the
environmental impacts as much as possible by using existing road rights-of-way and crossing woodlands only when
necessary. Out of a total of 44,800 I.f. of line, only 7,450 I.f. impact woodlands, and the woodlands impacted are all urban
secondary growth. This equates to only 17% of the ROW being off the road rights-of-way. Although the city is purchasing a
30 ft. right-of-way (outside the existing highway right-of-way) for installation and construction, much of the ROW parallels
existing, maintained power line rights-of-way. This decision will usually reduce the need to disturb the construction right-of-
way because the water line is being installed in or just outside the ditch along the road in or at the edge of the existing road
right-of-way. The proposed site for the water line is the preferred alternative because it is the shortest route and impacts the
least amount of woodland (Exhibit 2 A-D). In addition, the roads chosen for the ROW are residential and are not main
thoroughfares, which will reduce the impact to businesses and traffic during construction. There will be no permanent
impacts to streams or wetlands. All impacts are temporary. Additionally a financial analysis was performed to determine if
boring under these streams was feasible. The cost for boring under the streams is approximately 1.4 million dollars above the
current plan to open cut the channels. Therefore it was determined that boring under the streams is not feasible.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The excavation will be performed in- the -dry, utilizing check dams and pump arounds. Upon installtaion of water line all
distrubed aeas will be returned to preconstruction topography and stream banks as wetlands will be stabilized and replanted
with native vegetation.
Page 8 of 14
PCN Form - Version 1.3 December 10, 2008 Version
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? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c.
If yes, which mitigation option will be used for this

project? ? Mitigation bank

El Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
Page 9 of 14
PCN Form - Version 1.3 December 10, 2008 Version
6h. Comments:
Page 10 of 14
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a . Does the project include or is it adjacent to protected riparian buffers identified ® Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1 b . If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ®No
Comments: Not required.
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? 0%
2b . Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Proposed alignment is off edge of
pavement; No additional permanent impervious area is expected. Check dams, silt fence with minimum use of rip rap will
be utilized for surface water protection.
2d . If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
? Certified Local Government
2e . Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Guilford County
? Phase II
3b . Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
® Other: None
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a . Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply):
? Session Law 2006-246
® Other: None
4b . Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a . Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5b . Have all of the 401 Unit submittal requirements been met? ® Yes ? No
Page 11 of 14
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
1 b. 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 ® Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ® Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation o f the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A
Page 12 of 14
PCN Form - Version 1.3 December 10, 2008 Version
i-- _ . i
t,. ,.„:£i> s aa.#ti P epFt? ._. _ +
_..... .._....._.._ ._._..._.._._. ... ._..._._____ _.__?.._...._..._. ......... ....
w5.. 041 this project occz,,r 41 P,€°s4i fir? earr,ta witt° 6,s> FF od o€` 7
habELc<
b?
,?na Have y 3€? r#f? ,il,? ,?d a.;,P'YY rSC'. ?:...r@,i Q
irnpa."AS`? a.
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5c, S
I ?, s
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1,1abita!
E
i.?r..ti f°. r :af86 w _ °,z?<:...o 2,"i ...;.E s f tie ,s°..cq',£
1.. ;'. n I
and Enna ages E,4 $ £ S.. £t ey C" ti 3 a r i a € E ar. tt3 i 43 '$+. t o ItL E s
data bs,s a?r. :d x., d.i ef4) aa4 a ai` s,>s ,tonn net
f...T tt ..
r?o.ti'a'::"y i
i
s:xetYtB<'31 F'?$"4 t"s b:tat; ("`a3 p`1
I ? I
j 6a, VON this project o£;cu +r, cr near ?:n area de. , ,_, ?d a,? r.a?as?,i,a3.a1 ,""sh ,?a3bi at? (I e:a ".:. =30
_._.._.___...........
Ot°. ?I?tat data 'ss.«+;:c? ca.*i y?°u o=?e to t 3a,Y ¢ ie'?i ??.aO
t ?3
c.
North Carolina Nat:'Kai Heritage Frog ei a a, data base ? , ,..aka .vith the to this ;t€;c r7e :?t; +
i s9.cG`=T?tc,,.3 to ?, £, '.a.,f -.:'.7. ,t, .n?xei..krT,$ , .+k".9 and ft'=si" E7 .fnPt bV; l eq ,'. the, ::? T he , v8v wrss" G--1=t. trµte;._ j
7. 6tr?todcorf?;naf?a?R Cullbwaf esour::.,?,,o (Corp fz&quirelnentt
,
Ta. "Ahil this project ocr..at iv, or an t,aW, f„ fem. c- n-11,
governments have designated as having historic or cultural preservation
status (e g., National Historic Trust designation or properties significant in ? Yes No
North Carolina history and archaeology)? .._._._._............ ............. ........................... ........... _...
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Contact ' .t., H' f ;k! t =l<.ta is U-) aE'+._ .; sf ,1.,'9 C,t.;eF of ?1wk.ArcEteO(€?gy
I?:, r, -rites vvit ? , ,...,,?, .e fi.wks"1 to bo Ct el.w tt, for la?.;r.a`zsU?'".
in the National Register of Historic Places and the other (31 Gf 423) has not been evaluated for its significance at the time k
of this submittal. See attached correspondence between Ms. Hall and Dr. James Mathews dated December 3, 2007,
8. Flood Zone Designation (Corps Requirement)
( 8a. Will this project occur in a FEfutA-designated 1 00-year floodplain?
Yes No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the fioodptain determination?
r
311710)
Director ofVI-a7ZT ?SO 'U
City of Greensboro North Carolina Apfeu4g+ti Date
(Agent's signature istaBTid only if an authorization let r rmrn the, apol+cant
A llcantIA ent`s Printed Name - s proliaed)
PP??,Qe of 14
1,3 .,ec', 71.,. ,- f CK'a ift,-'4,a8m
sr
{
Page 14 of 14
PCN Form - Version 1.3 December 10, 2008 Version
??? 1
j ?
NCQENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins Dee Freeman
Governor Director Secretary
April 15, 2009
EXPRESS REVIEW ACCEPTANCE LETTER
Mr. Allan Williams, Dir. of Water Resources
City of Greensboro
2602 S. Elm-Eugene Street
Greensboro, NC 27406
Guilford County
Project Name: City of Greensboro Randleman Feeder Main Project (30" & 24" Water
Transmission Main)
On April 14, 2009, the 401 Oversight/Express Permitting Unit of the Division of Water Quality received
a request from Ms. Karri Cecil Blackmon, of Habitat Assessment and Restoration Program Inc., regarding
a project known as "City of Greensboro Randleman Feeder Main Project" for acceptance into the Express
Review Program. This letter advises you that your project will be accepted into the Express Review
Program once the following items are received:
1) The application fee of $2,000.00 [for 401 Water Quality Certification with major impacts], made
payable to the North Carolina Division of Water Quality];
2) Five (5) complete and collated copies of the PCN Application (instead of providing five copies of
the full size plans you may provide two copies of the full size plans along with three copies of the
11X17);
3) One (1) copy of the completed PCN Submittal Checklist
(http://h2o.enr.state.nc.us/ncwetlands/doeumcnts/PCNClieckIist vi 4.doc);
4) One (1) data CD of full size plans in TIFF Group 4 format (black and white, not grayscale or color).
If the plans are too large to store in TIFF format, they can be stored in PDF.
A pre-application rnceting (to include applicant) is required prior to the submittal of your completed
application package. The clock for this project will not start until receipt of the completed application
package and required fee are received. If the impacts are greater than indicated on the Initial Interest
Form and/or the services are different, you may be required to remit an additional fee. If you have any
questions or wish to discuss these matters further please do not hesitate to call Lia Myatt Gilleski at 919-
733-9502.
Sincerely,
4- N 61. ?
Cyndi Karoly, Supervisor
401/Express Review Oversite Unit
CBK/hng
cc: File copy
Ms. Karri Cecil Blackmon, Habitat Assessment and Restoration Program, ]nc., 301
McCullough Dr., 4u' Floor, Charlotte, NC 28262
401 Oversighl)Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
Localion 2321 Crabtree Blvd., Raleigh, North Carolina 27604
Phone: [phone] FAX [phone]
Internet! httpalh2o.enr.state.nC.us/nckvet€ands/
One
NorthCafolina
,aturally
An Equal Opportunity'. Affirmative Action Employer
Randleman Feeder Main
City of Greensboro, North Carolina
Stream Crossing Coordinates
Stream
Crossing No. Drawing
Page # Latitude
(North) Longitude
(West)

1 P4 Down graded by USACE to Stormwater convenance
2 P5 35.9241 79.82849
3 P6 35.92622 79.82909
4 P9 35.9366 79.82776
5 P12 35.9432 79.82564
6 P16 35.9572 79.8276
7A P24 35.97152 79.83127
7B* P24 35.97152 79.83127
8 P26 Down graded by USACE to Stormwater convenance
9 P27 35.98764 79.83142
10A P29 35.99182 79.83057
10B* P29 Stormwater conveyance
11 P32 35.99644 79.83891
12 P33 35.99844 79.83934
13 P35 36.00292 79.84083
14 P36 36.00446 79.84166
15 P36 No impact due to decision to Deep Bore
Location determined from Guilford County GIS.
7B* Please see video and photos of this area. Our position was that this was a ditch.
USACE field personell labeled it an intermident channel, however it truly is not, but for the
sake of argument we will accept the impact.
10B* Please see video and photos of this area it is not a stream channel it is a
stormwater conveyance
Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # I
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID numbers): None
5. Site 6. Subdi ?sion Name: None 62 W. to a StOt?' ??tct
Dowr9ta?ea
7. City: Greensboro V?onva?,ce
8. County Guilford
9. Lat: 35.92292 Long. -79.83046 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Deep River Tributary 26
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder
Assign number in ORM
Begin Date
Authorization:
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date: Z3 Mb 200} Project: }VA P- 'PAW Latitude: 3S.:? Z29z-
Evaluator: ---J d NM `T. ut-r-- site: C ro sv'vv & Longitude:
l-FPcR P
'total Points: Other -Pr' 645PV&3F (7ARD6A
Stream is at least intermittent ?. 5 County: 601 L F 8 Rh, e.g, Quad Name:
if.! 19 or perennial if z 30
A. Geomorphology Subtotal = 8 .5 Absent Weak Moderate Strong
1a. Continuous bed and bank 0 1 3
2. Sinuosity 0 1 2 3
3. In-channel structure: riffle-pool sequence 0 1 2 3
4. Soil texture or stream substrate sorting 0 2 3
5. Activelrelic foodplain 0 1 2 3
6. Depositional bars or benches 1 2 3
7. Braided channel 0 1 2 3
8. Recent alluvial deposits 0 1 2 3
9 a Natural levees 0_ 1 3
10. Headcuts 0 1 2 3
11. Grade controls 0 0.5 1 1.5
12. Natural valley or drainageway 0 0.5 1 1.5
13. Second or greater order channel on. existing
USES or NRCS map or other documented

evidence.
o -o

Yes =`3
Man-made ditches are not rated; see discussions in manual
C] 4.lvr,t?nlnnv ICI IMMM1 = -7 _ 1
14. Groundwater flow/discharge 0 1 2 3
15. Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 1 2 3
16. Leaflitter 1.5 7 0.5 0
17. Sediment on plants or debris 0 0.5 1 1.5
18. Organic debris lines or piles (Wrack lines) 0 0.5 1 115
19. Hydric soils (redoximorphic features) present? No = 0 Yes = 1.5
r` nhnlnrn? 1C1lhfnfml = 4- %
2. Fibrous roots in channel 3 r 2-D 0
21b. Rooted plants in channel 3 1 0
22_ Crayfish 0 0.5 1 1.5
23. Bivalves 1 2 3
24. Fish 0,5 1 1.5
25. Amphibians 0.5 1 1.5
26. Macrobenthos (note diversity and abundance) 0 0.5 1 1.5
27. Filamentous algae; periphyton 1 2 3
28. Iron oxidizing bacteriarfungus. Q 0.5 1 1
29 . Katfa d plants in streambed FAC = 0.5; FACW = 0.75; 08L = 1.5 SAV = 2. , Other = 0
"Items 20 and 21 focus on the presence of uplana plants, Item Z9 focuses on ure presence of aquauc w vrauenru pow
Sketch:
Notes: (use back side of this form for additional notes.)
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the ID Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #I
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.92292° Long. -79.83046° W.
Universal Transverse Mercator: 17 0605493E, 3975815N (NAD 27)
Name of nearest waterbody: Deep River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep; HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different ID form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
E] Office (Desk) Determination. Date:
0 Field Determination. Date(s):
SECTION IL SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B- CWA SECTION 404 DETERMINATION OF JURISDICTION.
There writers of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part328) in the review area [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U-S. in review area (check all that apply):
[Q TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into T'NWs
Q Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RP W's that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
[3 Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non wetland waters: 600 linear feet: 1.5 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Establ?shed?y[Fi4i'
Elevation of established OHWM (if known): Unknown.
2. Non-regulated waters/wetlands (check if applicable):}
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section B[ below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months)-
3 Supporting documentation is presented in Section 111.17
SECTION III: CWA ANALYSIS
A- TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.I. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section I11.13 below.
1- TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OR TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i-e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody' is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section 11I.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section IILC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 44acres
Drainage area: 28 acres
Average annual rainfall: 50.24 inches
Average annual sno«fall. 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with T'NW:
? Tributary flows directly into TNW.
Tributary flows through i tributaries before entering TNW.
miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Project waters are Z-s river miles from `I-NW
Project waters RPW.
are 1?or lessriver miles from
Project waters are 1-2 aerial (straight) miles f
aerial (straight) miles f
.................
Project waters are 1 (or less) aerial (straight)
Identify flow route to TNW5: Non RPW a flows to RPW b (Deep River Trib 26) which flows to TNi W (Deep River),
Tributary stream order, if known: D.
' [dote that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the grid
West.
` Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW_
(b) General Tributary Characteristics (check all that apply):
Tributary is: 2 Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 2 feet
Average depth: 1 feet
Average side slopes: 2f.
Primary tributary substrate composition (check all that apply):
N silts 0 Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover: Mixed hardwoods, 90%
? Other. Explain:
Tributary condition/stability (e.g.. highly eroding, sloughing banks]. Explain: Stable banks.
Presence ofrun/riff3e/pool complexes. Explain: None.
Tributary geometry: Meandering
Tributary gradient (approximate average slope): 2 to 4 %
(c) Plow:
Tributary provides for: EphenteraC €lo w
`
Estimate average number of flow events in review area/year Z {ar grea#er
Describe flow regime: Storm event flow only.
Other information on duration and volume: Not observed.
Surface flow is: Discrete and confined. Characteristics:
Subsurface flow: Unknown. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
OHWM6 (check all indicators that apply):
clear, natural line impressed on the bank EJ
? changes in the character of soil ?
? shelving
0 vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.' Explain:
If factors other than the OH WM were used to determ
F1 High Tide Line indicated by: El
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ine lateral extent of CWA jurisdiction (check all that apply):
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Not observed.
Identify specific pollutants, if known: Highway runoff.
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'[bid.
(iv) Biological Characteristics. Channel supports (check all that apply):
N Riparian corridor. Characteristics (type, average width): Bottomland hardwood, 30' wide.
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wctland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow relationship with Non-TNW:
Flow is: pick List. Explain:
Surface flow is: OicJk Lisf
Characteristics:
Subsurface flow: ]Pick LisE. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to lNW
Project wetlands are pick ]List river miles from TNW.
Project waters are Fick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List 17oodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
ldentify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation typc/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysts flk>Lis
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directlv abuts? (YIN) Size (in acres) Directlv abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands- It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TN W?
:Vote: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: The tributary has
the capacity to carry pollutants or flood waters to TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW.
The tributary does not provide babitat and lifecycle support functions for fish and other species, such as feeding, nesting, spawning,
or rearing young for species that are present in the TNW. The tributary has the capacity to transfer nutrients and organic carbon
that support downstream foodwebs. The tributary may have additional physical, chemical, or biological relationships that could
affect the integrity of the TNW.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below. based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
F1 TN Ws: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Q Tributaries of TNWs. where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Q Tributaries of TNW where tributaries have continuous flow `seasonally' (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWse that flow directly or indirectly into TNWs.
to, Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
INW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: 600 linear feet 1.5 width (ft).
Q Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RAW that flow directly or indirectly into TNWs.
Q Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Q Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Q Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an R-PW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.'
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Q Demonstrate that impoundment was created from "waters of the U.S.,"or
Q Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
'See Footnote # 3.
'To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding Clf:4 Act Jurisdierion Following Rapanos.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
?' Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce,
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
?. Non-wetland waters (i.e., rivers, streams): linear feet width (#t).
?. Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Q Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consu[tant:
C] Data sheets prepared/submitted by or on behalf of the appiicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
? Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 45.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
StatelLocal wetland inventory map(s):
FEMA/FIR1bI maps: Map # 37107759001, June 18, 2007.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
App] icablelsupporting case law:
? Applicable/supporting scientific literature:
Other information (please specify):
?.; STREAM QUALITY ASSESSMENT WORKSHEET
Provide the followingf iinformation for the stream reach under assessment: erg 1 n " ?-
pplicant's name: Evaluator's name: --J 0 ,'+KA ? . S C? u. z. C
3. Date of evaluation. 4. Time of evaluation: + 1 ?•, A
5. Name of stream: U1I {a f? ?" 24? 6. River basin:. {? per' 't `? ?' - ? ,°r• s' 6
7. Approximate drainage area & Stream order.
9. Length of reach evaluated: 1 ?g 10. County:__
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): ?J D ?J
latitude (ex. 34-872312):-?> Z Longitude (ex 77-556611): f
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Phow/GIS GLS tither 6UI L F1?-- C-? c'; b°
13. Location of mach under evaluation (note nearby roads and landmarks and atta;? entif¦y?ing stream(s) location):
J 1.' ?ja( ? b s?4 l? I properly q,G4'!{? 'i -j©ca r?=nap id ,ivy ?? y77*rr' t-- z t!q
14. Proposed channel work (if any):
15. Recent weather conditions: -t) L- i 5hD GL! e r5 az _-
16. Site conditions at time of visit: G l " e-001
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters ZWater Supply Watershed a-IV)
I& Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area:
19. Does channel appear on USES quad map? YES NO 20. Does channel appear on USDA Soil Survey? YE NO
?stiunrnated Watershed land use: 3` ,8afa Residential ' % Commercial % Industrial 1?1?a/o Agricultural
10 % Forested - % Cleared. / Logged =°/v Other (
r
22. Bankfull width: 233.. Bank height (from bed to top of bank):
24. Channel slope down center of stream: Flat (0 to 2a/o) ? Gentle (2 t,a 4a/o) Moderate (4 to 10%) Steep (>10%)
25. Channel sinuosity: Straight w'0ccasional 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 chmecteristic must be scored using the same ecoregion. Assign points
to each characteristic withm 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 c amat 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 strearn of the
highest quality.
Total Score (ft m reverse): Comments:
Evaluator's Signature / r_ n Date
't`his channel evaluation form Wiintended to be used only as a guide to assist landowners and environmental professionals in
Bering 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 USAGE approval and does not imply a
particular mitigation ratio or requirement Form subject to change - version 06/03_ To Cogent, please call 919-876-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
EGOREG ION POINT RANGE SCORE
# C4A?iACTERfkks

syoastai
Piellmo??t
.,

Mountauz.

Presence of flow / persistent pools in stream o-5 0-4
p
0-5
1
no flow or saturation = 0; strop flow = max points)
Evidence of past human alteration 0-6 0-5
?j
0-5
2
extensive alteration = 0; no alteration = max points)
Riparian zone 0-6 0-4 0-5
3
no buffer = 0• contiguous, wide buffer = max rots
Evidence of nutrient or chemical discharges 0-5 0-4 0-4
4
extensive dischar es = 0• no discharges = max ints
Groundwater discharge 0-3 0-4 0-4 U
5
no discharge = 0; s s seeps, wetlands etc. = max points)
1-- 6 Presence of adjacent floodplain 0-4 0- 4 0-2
d
no flood lain = 0• extensive flood lain = max points)
Entrenchment / floodplain access o-5 0-4 0-2
R±. dee 1 entrenched = 0• frequent flooding = max rots
Presence of adjacent wetlands 0-6 0-4 0-2 0
8
no wetlands = 0• large adjacent wetlands = max points)
Channel sinuosity 0-5 0-4 o-3
9
extensive channelization = 0• natural meander = max rots

10 Sediment input 0_ 5 A? 4 o-.4
extensive d sition= 0• little or no sediment = max Dints
Size & diversity of channel bed substrate
*
NA.
0 _ 4
0-5
11
fine homo enous = 0; !are diverse sizes = max points)
Evidence of channel incision or widening 9-5 0-4 0 - 5 3
l2
(deeply incised = 0• stable bed & banks = max points)
Presence of major bank failures
13
0-5
0-5 j
0-5
L!-
severe erosion = 0; no erosion stable banks = max points)
Root depth and density on banks 0 _ 3 0 _ 4 0-5
14
no visible roots = 0• dense roots throughout = max rots
` Impact by agriculture, livestock, or timber production 0 _ 5 0-4 0-5
1 S
substantial ` act =0; no evidence = max rots
16 Presence of ride-pool/ripple-pool complexes o-3 0-5 0-6
no riffles/riles or pools = 0; well-developed = max ints
Habitat complexity
17
0-6
0-6
0-6
=±.' (little or no habitat = 0• fruen varied habitats = max in #s
sw:
Canopy coverage over streambed
0-5
0-5
0-5
18
no shading vegetation = 0; continuous canopy = max points)
19 Substrate embeddedness NA* 0-4 0-4 7-
(deeply embedded = 0• loose structure = max
Presence of stream invertebrates (see page 4) 0-4 0-5 0-5
20
no evidence = 0• comma numerous PLM = max farts
Presence of amphibians
21
0-4
0-4
0-4
d
no evidence = 0• common, numerous bTqs = max ints
a.. Presence of fish
0-4 0--4 0-4
22
no evidence = 0; common, numerous !ym = max points)
Evidence of wildlife use
0-6 0-5 0-5
23
no evidence = 0• abundant evidence max points)
00
Taal Points lPossilfIe 340 100 1
.:

also in ter on first 'a e
TOTAL SCORE
(
* These characteristics are not assessed in coastal streams.
-ytif -
;zi
C' h UPI., I
, F, Abutting r _
Wetland Unnamed Tributary
Seasonal Flow
RPW
1000", 2000
:J' 1f f CALE (FEES')
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t
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RANDLEMAN
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Perennial Flow
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Deep River Trib 2$
Perennial Flow
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1 f' f J r ?? . 7ti f !may'
w- t a Stormwater conveyance .
Ephemeral Flow ?, •
Non-Jurisdictional
RANDLEMAN FEEDER MAIN I J (i
Greensboro, NC
USGS TOPO MAP
PLEASANT GARDEN QUAD k t `r k
r +
R
HAS TAr • eece .,I <.m ,' HAZEN S
ASSFSSME?.-D ??
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AND FIG
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PROGRAMIM1= EnviVn ronmental Engineers & Scientists
9sas.3 uo,o. a.e cn{n°nt. _,:;,° -- June 27, 2008 - `+? + 4944 Pgrkwaf I'lon Blvd, Suite 375° Chade fe, North Carding 28217
01-
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RANDLEMAN FEEDER MAIN
Greensboro, NC E ?•' 3i
USGS TOPO MAP ,
r
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Hne?rn7 t ' 4?/ .i.il l E AND SOUR
AssE55MENT ?JJ? f ?y , , YI f'?
RE5FOR4TIQN V ? a
I?rocrxa,i c, _ + ? Environmental Engineers & Scientists ' ;+ G L
4944 Park. Plaza Blvd, SuRe 175, CherloNe, Norih Carolina 2E2H
d,ar1LIAt . \ `,
Hickory Creek ~' - _a ^.`` #. I' ;' e
t[M j RPW Perennial Flow RANDLEMAN FEEDER MAIN
.?
.'f Unnamed Tributary Greensboro, NC
USGS TO PO MAP
Perennial Flow
RPW 14 fix` GREENSBORO QUAD
'71
.
{ i
?} y Unnamed Tributary
Perennial Flow -?
RPW
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 2
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 7015 Faulkner Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.9241 Long: -79.82849
10. (quadrangle Name: PLEASANT GARDEN
11. Waterway: Deep River Tributary 26
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
(Decimal Degrees)
The following information will be completed by Corps office:
AID:
Prepare File Folder
Authorization:
Assign number in ORM
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Begin Date
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #2
State: North Carolina County/parish borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 33.9241° iii, Long. -79.82849°
Universal Transverse Mercator: 17 0605669E, 3975948W (NAD 27)
Name of nearest waterbody: Deep River Tributary 26
Name of nearest Traditional Navigable Water (TN W) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep; HUC: 03030003
M Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
G3 Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick L91 "navigable waters of the U.S."' within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. (Required]
Q Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters ofthe U.S" within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S- in review area (check all that apply):
TNWs, including territorial seas
L) Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
0 Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
n Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 1925 linear feet: 16 width (ft) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based or): titsbltsh 1
Elevation of established OHWM (if known): Unknown.
2. Non-regulated waters/wetlands (check if applicable):3
E] Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
' Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
'Supporting documentation is presented in Section 11I.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section IILD.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent"!
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbodya is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.I for
the tributary, Section III.B.2 for any onsite wetlands, and Section III-B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
L Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
...............
Watershed size: Pick List
Drainage area: Pick List
.:........................
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
......................
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pict: List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries, Explain:
Identify flow route to TNW':
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
West.
' Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which them flows into TNW.
(b) General Tributary Characteristics check all that a lv :
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick_)!_.ist.
Primary tributary substrate composition (check all that apply):
? silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for:
1'ck'i is#
Estimate average number of flow events in review arealycar_ Pick List
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow: 1F iek List. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM' (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: Q
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ine lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings:
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows undereround, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
z. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: I'cekU
Characteristics:
Subsurface flow: Pick Li . s . t. Explain findings:
...............
? Dye (or oth(-r) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to T_INW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List f oodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface, water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain Findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pic(( U ' A
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/NI Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TIVW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section II1.1):
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK. ALL
THAT APPLY):
L TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
[] TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS map, on USDA. SCS Soils map.
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g.. typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 1925 linear feet 16 width (ft).
[]' Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
El Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates forjurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width ($).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
[] Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
[? Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Q Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of ajurisdictionai tributary remains jurisdictional.
Q Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Q Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE[ WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):''
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
[l which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote 9 3.
To complete the analysis refer to the key in Section 111. D.6 of the Instntctional Guidebook.
Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
Q Tributary waters: linear feet width (ft).
? Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)-
Fl. If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or (oreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Q Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis ofjurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
?. Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
? Lakes/ponds: acres.
Q Other non-wetland waters: acres. List type of aquatic resource:
Q Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
Q Other non-wetland waters: acres. List type of aquatic resource:
Q Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Q Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
Office does not concur with data sheets/delineation report.
? Data sheets prepared by the Corps:
Q Corps navigable waters' study:
Q U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000. PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 45.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
Q State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710775900J, June 18, 2007.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Q Applicable/supporting case law:
Q Applicable/supporting scientific literature:
0 Other information (please specify):
B_ ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM QUALITY ASSESSMENT WORKSHEET AQP
Provide the following information for the stream reach under assessment:
-pplicant's,name:T awr an 64(J &-- ;n erJ'Y 2. Evaluator's name: _^f ? ?J -r ,5 o R;'
3. Date of evaluation: 2 3 C Time of evaluation: V
5. Name of stream: U T 6 P95-eP P I VC- R, TI-lb 474 G& River basin. CAPE 66ACS G: fj O3,D0 ?
7. Approximate drainage area: ] . a b,5 59 &.4 & Stream order: 2-
9. Length of reach evaluated:---a-00 10. County:_
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
latitude (em 34.872312): 35 "°.)2±1 A Longitude (ex -T1.556611): ! 7 S •B Z 8 4 <?O
Method location determirrod (circle): GPS Tapp Sbeet Oruro (Aerial) Ph)tolGlS (»r GI5 Other '-
13. Location of teach under evaluation (note nearby, rroads and landmarks and reap identifying stream(s) location):
fc u k vm' Rnn ?, Rroped -j ?i?cOtjess: 7015 iaulkger ,
14. Proposed channel work (if any): R o ndama i 'Raw Water rimer' C?Sj ru c&',,rr
15. Recent weather conditions: t7 rzy ! O 5hz?6oe,'s
16. Site conditions at time of visit: C L -e-
17. Identify any special waterway classificaidon5 known: Section 10 Vidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters ? water Supply Watershed ! (I V)
•g QG
18. Is there a pond or lake located upstream of the evaluation point? ?O If yes, estimate the water surface area
19. Does channel appear on USGS quad map? ED NO 20. Does channel appear on USDA Soil Survey? XES NO
stimated watershed land use: Zl % Residential - % Couunereial ? % Industrial Z Z % Agricultural
48 -7-% Forested Z • °? % Cleared / Logged Other ( O ZZO
(!
22. Bankfull wihth:_ 23. Bank height (from bed to tap of bank):
24 Channel slope down center of stream: Flat (0 to rA) ?Gentle (2 to 46%) Moderate (4 to 1Wa) __Steep (>10%)
25. Channel sinuosity: Straight ,10ccasional bends FrequEnt meander Very sinuous Braided channel
Instructions for completion of workskeet (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. Paw 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
eliameteristic 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 duanges in the character of a stream under review (e g, the stream flows from a pasture
ago 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 suvauu of the
highest quality.
Total Score (from reverse): Comments:
Evaluator's Signature Date 3 451 51 2044
'*is chmmel evaluation form Wended tD be used only as a gaide-to assist landowners and environmental professionals in
herag toe data required by the United States Army Carps of Engineers to nags a preliminary meat of stream
quality. The total score remd ioag from the completion of this ford is subject to USAGE approval and does not imply a
particular mitigation ratio or requirement Form subject to charge - version 06103. To Commeait, please tall 919-876~8441 x 26.
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 3
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers &. Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 7033 Faulkner Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.92622 Long: -79.82909 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Deep River Tributary 26
12. Watershed: Cape Fear/ Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM
Authorization: Section 10 Section 404
Begin Date
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION 1: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #3
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site ([at/long in degree decimal format): Lat. 35.92622° N, Long. -79.82909° .
Universal Transverse Mercator: 17 0605612E, 3976182W (NAD 27)
Name of nearest waterbody: Deep River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep; HUC: 03030003
0 Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
ZCheck if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RIIA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
Ej TNWs, including territorial seas
F1 Wetlands adjacent to TNWs
0. Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
0 Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
[Q Impoundments ofjurisdictional waters
0 Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-welland waters: 3,325 linear feet: 1 to 6 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: stRbliS
Elevation of established OHWM (if known): Unknown.
2. Non-regulated waters/wetlands (check ifapplicable):3
Q Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
'Boxes checked below shall be supported by completing the appropriate sections in Section III below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least `seasonally'
(e.g_, typically 3 months)-
' Supporting documentation is presented in Section HIT
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections IH.A.1 and 2
and Section III.D.I.; otherwise, see Section IILB below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e- tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section IILC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: I'ic.1k List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
0 Tributary flows directly into YNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW':
Tributary stream order, if known:
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
West.
' Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Pi.e L
Estimate average number of flow events in review area/year AC-_k,lU§f
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow: Piek List. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestriai vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.7 Explain:
If factors other than the OHWM were used to determ
? High Tide Line indicated by: 13
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ne lateral extent of CWAjurisdiction (check all that apply):
Mean High Water Mark indicated by:
? survey to available datum;
physical markings;
? vegetation lines/changes in vegetation types..
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check ail that apply):
Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain Findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow relationship with Mon-TNW:
Flow is: Pick List. Explain:
Surface flow is. PickList
Characteristics:LL
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Admacencv Determination with Non-TvW:
? Directly abutting
Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship to TiNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface. water quality; general watershed
characteristics. etc.), Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply)-
F-1 Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis. Fick Lit
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/N) Size (in acres]
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
* Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
+ Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TN-Ws. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section 111.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section 111.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
? Wetlands adjacent to TNWs: acres.
2. RPWs that now directly or indirectly into TNWs.
Tributaries of TN Ws where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS topographic map, on USDA, SCS Soils map.
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section 111.13. Provide rationale indicating that tributary flows
seasonally:
Provide estimates far jurisdictional waters in the review area (check all that apply):
Tributary waters: 3,325 linear feet 1 to 6 width (ft).
(] Other non-wetland waters: acres.
Identify type(s) of waters:
3. Nan-RPWs" that flow directly or indirectly into TNWs.
0 Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW. and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
D Tributary waters: linear feet width (ft).
0Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section IMB and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
0 Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictionai wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
0 Demonstrate that impoundment was created from "waters of the U.S.," or
0 Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
0 Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
0 which are or could be used by interstate or foreign travelers for recreational or other purposes.
0 from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
? Interstate isolated waters. Explain:
0 Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
'To complete the analysis refer to the key in Section 111.D.6 of the Instructional Guidebook.
j0 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ For
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Aer Jurisdiction FollowingRapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
? Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWAVCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis ofjurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
Judgment (check all that apply):
Q Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
[] Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
N Maps, plans. plots or plat submitted by or on behalf of the applicant/consultant:
L1 Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
? Data sheets prepared by the Corps:
? Corps navigable waters' study:
? U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 45.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710775900J, June 18, 2007.
? 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
Previous determination(s). File no. and date of response letter:
? Applicable/supporting case law:
Applicable/supporting scientific literature:
Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:

STREAM QUALITY ASSESSMENT WORKSHEET
ti r- the s6re:4m reach ender assessment-

--Svade tLe €oilowrng mforrma on r r45s@ ?? 3
,jplicanf s name, yozen Ar) d 54? r 67 2. Evaluator' S naive: -J [3 fF?l T. 3. Date of evaluation. 4. Time of evaluation: l . ?E
5. Name of stream: LI-r o 'Deejo Ri Ver, 7,--)'h 74P 6. River basin: f --? a3 n 3 0D6 ?
7. Approximate drainage area: & Stream order: t
9. Length of reach evaluated: 10. County-
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
Latitude (m 34.872312Y . `? Z Ca ZZ.' Longitude (m -77.556611): - 7 ? • ?3 `? 09°
Method location dcuxmimed (circle): GPS Topo Sheet Ordxi (Aerial) Photo/GIS GIS Other 21f? L{ C Q ! _._. ??;
13. Location of reach under evaluation (note nearby roads and landmarks and abg map Identifying stream(s) location):
ea5? -6j?de 1-mule,- Pone rro ee-i G4d t s5: X033 Oli1k er PJ,
14. Proposed channel work

15. Recent weather conditions:_! ??4
16. Site conditions at time of visit:
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanditkg Resource Waters Nutrient Sensitive Waters 1f Water Supply Watershed 0(i-)
1S Is there a pond or lake located upstream of the evaluation point? YES( NO)If yes, estimate the water surface aareew
19. Does channel appear on USES quad map? YES NO 20_ Does channel appear on USDA Soil Survey? ( YES PTO
;-., tad watershed land use: 'VP % Residential - % Commercial =% Industrial It % Agricultural
1 ?Lv, [ % Forested % Cleared / Logged 3,5 % other ( 4W Y rZZ O 7
22_ Banldull width: 6 23. Bank height (from bed to top of bank): L- , S
24. Channel slope down center of stream: Flat (0 to 2%) t/ Gentle (2 to 4%) Moderate (4 to 101/6) Steep (>100/,)
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 hove to review the
characumstics identified in the worksheet. Scores should reflect an. overall assessment of the stream reach under evaluation. If a
rhairacGeristic cannot be evaluated due to site or weather conditions, eater 0 in the scoring box and provide an explanation in the
cotnnneat section. Where tit= 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 4 and 104, with a score of 104 representing a stream of the
highest duality.
Total Score (from reverse): Comments:
Evaluator's =t , - Date_ Z N ZC3
``%is clrraooenation fo is intended to be and only as a guide to assist landowners and eavimamental prolesaionals in
lering the data required by tke United States Army Corps of Engineers to mauve it preen huwy assessment of stream
quality. The total score remIting from the completion of thb form is subject to USACE approval and does not imply a
particular mitigation ratio or regniremeot. Form subject to change -- version 46/43. To Comment, please call 919-875-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
coc roN rune GE : scRE
# . ?ccrEx?rs??zcs
_ . .. :. ', COaSt$? ?: P?edmOQt ,' „ , MAUp?ata ,
i Presence of flow / persistent pools in stream 0-5 0-4 0-5
no flow or saturation. = 0; strop flow = max Points)
Evidence of past human alteration 0-6 0-5 0 -5
2
extensive alteration = 0• no alteration = max rots
3 Riparian zone 0-6 0- 4 0- 5 Lf
no buffer = 0• contiguous, wide buffer = max points)
Evidence of nutrient or chemical discharges 0-5 0 _ ?} 0 - 4 A'
4
extensive discharges = 0; no discharges = max points)
5 Groundwater discharge 0-3 0-4 o-4
3
. no discharge = 0; springs, seeps, wetlands etc. = max points)
Presence of adjacent floodplain

6 0-4 0-4 0-2
Z
no fl lain = 0• extensive flood lain = max points)
' Entrenchment / floodplain access 0-5 0-4 o-2
(deeply entrenched = 0; firequent fl!? = max points)
8 Presence of adjacent wetlands
j 0-6 0_ 4 0- 2 Q
acent wetlands = max ints
no wetlands = 0; l e ad
Channel sinuosity 0-5 0-4 0-3
Z
extensive channelization = 0; natural meander = max points)
10 Sediment input. 0 -'$ 0-4 4 0-4
extensive deposition= 0• little or no sediment = max points) `
I Size & diversity of channel bed substrate TA
* 0 _ 4 0 - 5
1
fine homogenous = 0;large, diverse sizes = max points) ?
12 Evidence of channel incision or widening 0-5 0 - ¢ 0-5
de 1 incised = 0• stable bed & banks = max points
Presence of major bank failures
'•?' 13
0-5
0-5
0-5
Z.
severe erosion = 0• no erosion stable banks = max Dints
Root depth and density on banks
14 0-3 0 - 4 0 - 5
no visible roots = 0• dense roots throughout = max points)
Impact by agriculture, livestock, or timber production 0-5 0 - 4 0 - 5 Z
15
substantial impact =0; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 3

no riffles/ripples or pools = 0; well-developed = max rots .
Habitat complexity
17
0-6
0-6
0-6
Z
E=E'
(little or no habitat = 0• fruen varied habitats = max points)
r?+ Canopy coverage over streambed
l S
0 5
0-5
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no shading vegetation = 0• continuous canopy = max points)
19 Substrate embeddeduess NA* 0 -4 0 - 4 .3
(deeply embedded = 0• loose structure = n?ax
20 Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
no evidence = 0• common, numerous types = max oinnts
Presence of amphibians
21
0-4
0-4
0-4
D
no evidence = 0; common, numerous types = max points)
0
IW Presence offish
Q 22
0-4
0-4
0-4.
U
r=E: no evidence = 0• common, numerous types = max points)
Evidence of wildlife use
0-6 0 5 0-5
23
na evidence = 0; abundant evidence = max points)
77
'I'ota Po?ots PASSible ' 100 ` l00 100
,

T4?AL SCORE (also ester on .first paged _ 5 '?
* These characteristics are not assessed in coastal streams.
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: R.ANDLE1ViAN FEEDER MAIN, Stream Crossing # 4
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 6700 Thurber Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 359366 Long: -79.82776 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Deep River Tributary 26
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
.............................................................................................................................................
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
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APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #4
State: North Carolina County/parish borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 39366° , Long. -79.82776° .
Universal Transverse Mercator: 17 0605718E, 3977335W (NAD 27)
Name of nearest waterbody: Deep River
Name of nearest Traditional Navigable Water (TN W) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep. HUC: 03030003
.S Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
CR Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
0 Office (Desk) Determination. Date:
0 Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Are "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review
area. [Required]
[] Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S" within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): `
TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 1,829 linear feet: I to 4 width (R) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on;
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable)-3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
'Boxes checked below shall be supported by completing the appropriate sections in Section Ill below.
z For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
' Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and Z
and Section III.D.I.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TN--VV) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbodys is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section IILC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 50 acres
Drainage area: 36 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through Z tributaries before entering TNW.
Project waters are 2-5, river miles from TNW.
Project waters are 1(or.less) river miles from RPW.
Project waters are-9 aerial (straight) miles from TNW.
Project waters are 1(or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5: Tributary a flows to Seasonal RPW b, which flows to RPW c, which flows into TNW.
Tributary stream order, if known: 0.
'Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
' Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW,
(b) General Tributary Characteristics (check all that apply):
Tributary is: 0 Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Is flowing under HWY 220.
Tributary properties with respect to top of bank (estimate):
Average width: 4 feet
Average depth: 1.5 feet
Average side slopes: 2:f.
Primary tributary substrate composition (check all that apply):
® Silts ® Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover: Mixed hardwoods, 50% and open herbaceous 50%
0 Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Stable banks with ponding.
Presence of run/riffle/pool complexes. Explain: Channel partially clogged by vegetation.
Tributary geometry: Mean' Bering
.... .......... .
Tributary gradient (approximate average slope): 0 to 2 %
(c) Flow:
Tributary provides for: Cntermitten# bnntseasonal It©vv
Estimate average number of flow events in review area/year 2a,(ar greater)
Describe flow regime: Storm flow events.
Other information on duration and volume: Not observed.
Surface flow is: Discr'ete and confined. Characteristics:
Subsurface flow IJaknown(. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
E Bed and banks
Z OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil
? shelving
vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
® sediment deposition
? water staining
? other (list):
® the presence of litter and debris
? destruction of terrestrial vegetation
® the presence of wrack line
? sediment sorting
scour
? multiple observed or predicted flow events
? abrupt change in plant community
? DiscontinuousOHWM.7 Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ine lateral extent of CWAjurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Water clear at time of visit.
Identify specific pollutants, if known: Highway runoff.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OH WM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
7[bid.
(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Bottonland hardwoods, herbaceous vegetation.
? Wetland fringe. Characteristics:
® Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
® Aquatic/wildlife diversity. Explain findings: Frogs noted at time of visit.
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Welland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Nan-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pilefc:Iist
Characteristics:
Subsurface tlow PExplain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from; Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear. brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any) y
All wetland(s) being considered in the cumulative analysis: MIs_Lisf
Approximately ( } acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y!N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanps Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note- the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: Tributary has the
capacity to carry pollutants or flood waters to TNW, or to reduce the amount of pollutants or flood waters reaching a TNW. The
tributary provides habitat for species other than fish. The tributary has the capacity to transfer nutrients and organic carbon that
support downstream foodwebs. The tributary may have other relationships to the physical, chemical, or biological integrity of the
TNW.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section 1II.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands. then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
(? TNWs: linear feet width ($), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Q Tributaries of TN Ws where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: At time of visit flowing well. scored above 19 on NCDWQ Stream ID form.
Provide estimates €or jurisdictionai waters in the review area (check all that apply):
[l Tributary waters: 1,829 linear feet I to 4 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW. but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: 1,829 linear feet 1-4 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an IZPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section I1I.13 and rationale in Section III.D.2. above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
d Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section IILC.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Q Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE. OR INTRA-STATE[ WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
'See Footnote # T
'To complete the analysis refer to the key in Section III. D.6 of the Instructional Guidebook.
L' Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiedon Fallowing Rapanos.
?i from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
? which are or could be used for industrial purposes by industries in interstate commerce.
? Interstate isolated waters. Explain:
? Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
0 Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
? If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the NIBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Q Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
? Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Q Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
®', Lakes/ponds: acres.
[] Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
? Data sheets prepared by the Corps:
Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
0 USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 45.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
? State/Local wetland inventory map(s):
FEN1A/FiRrM maps: Map # 37107759001, June 18, 2007, Panel 7759J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or El Other (Name & Date):Photo 4, Crossing 4.
Previous determination(s). File no, and date of response letter:
? Applicable/supporting case law:
? Applicable/supporting scientific literature:
0 Other information (please specify):
STREAM QUALITY ASSESSMENT WORKSHEET
AQP
• CYo?Si? ??
Provide the following information for the stream reach under assessment:
.pplicant's name: A zevz Q0 d 'S4vq e t ??. ?`; r° 2. Evaluator's name:
3. Date of evaluation: 7-3 u a y 2 C;44 4. Time of evaluation: it', 4 S
5. Name of streani: UL t o UW 7 `-Ver 7r, ;& Z to 6. River basin: eaoe- fear 140: : b 03 Oc . )
7. Approximate drainage area: 3 5 .`b 0 Q 8. Stream order:
r
9. Length of reach evaluated: / Jo Iii. County: 6aw' l f
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
Latitrk (eX. 34. rM 12): Longiarae (ex -n-:5s6611): ?-, -7 Z -7 7 ?q °
Method location determined (circle): CPS Topo Shed Oruro (Aerial) PhoWGlS dither GLS r ?-x !-?, Dr a r? i,' ?
13. Location of reach under evaluation (note nearby roads and landmarks and attac'R-=-p identifying stream() ocation): ?-
I brfh? 7?44r- r Pt>ad,zg(si at (j5 z7-os, pKbpeo,4dress; (_Q780 7 lfrber- ,
14. Proposed channel work (if airy): Ra KV 1?111h?'t'? GC' ??r'r?I?-r D
15. Recent weather conditions:^ 5)7 0 ;x.3 ; dO L J ; of
16. Site conditions at time of visit~ C? f
17. Identify any special waterway classifications known: Section 10 Vidal Waters Essential Fisheries Habitat
Trott Waters Outstanding Resource Waters Nutrient Sensitive Waters Water Supply Watershed (i-IV)
M Is there a pond or lake located upstream of the evaluation point? YE ND f yes, estimate the water surface area:
19. Does chaimel. appear on USGS quad map? YES(]r j 20. Does channel appear on USDA Soil Survey? YE ND
Estimated watershed land use: 25'5 % Residential - % Commercial % industrial 4z' 8 % Agricultural
/ Pg 11-% Forested =% Cleared / Logged 14.Z% Other ( 4W j 7-7-13
22. Bankfull width: t"5 23. Bank freight (from bed to top of bank): 1 . S 1
24. Channel slope down center of stream: t/ Flat (0 to r/1) Gentle (2 to 4%) Moderate (4 to 100%) Steep (>10-/.)
75. Channel sinuosity: Straight ?Occasional bends Frequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located oa page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every charartstic must be scored using the saute 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
chiistic cannot be evaluated due to site or weather conditions, enter 0 in the scaring 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 Fran a pasture
into a forest), the stream may be divided into smaller reacims 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): ?P Z' Comments:
,
Evaluator's Signature - 164 Date 23 M 0 2007
'T'his channel evaluation form intended to be used only as a guide to assist landowners and environmental professionals in
Aering 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 Corrnent, please call 919-976-9441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
CORE?ION P©INT RACE . CORE
# CIIRACTELS ICS
r ?baatsl "? clnaont
.Pie
?ouattsin
s
1 Presence of flow 1 persistent pools in stream 0-5 0-4 0-5
Z-
(no flow or saturation = 0; strop flow = max points)
2 Evidence of past human alteration 0-6 0-5 0 - 5 ?j
extensive alteration = 0; no alteration = max points)
3 Riparian zone 0-6 0-4 0-5
no buffer = 0; contiguous, wide buffer = max points)
Evidence of nutrient or chemical discharges 0-5 0-4 0-4 7-
4 extensive discharges = 0; no dischar es = max points)
5
-' Groundwater discharge
no discharge = 0• springs, seeps, wetlands, etc. = max points) 0-3 0-4 0-4

I
6 Presence of adjacent floodplain 0-4 0-4 ?:0- 2
M
: no flood lain = 0• extensive flood lain = max points)
7 Entrenchment/ floodplain access 0-5 0-4 0- 2 3
d 1 entrenched = 0• fruent flooding = max points)
s 8 Presence of adjacent wetlands 0-6 0-4 0:-2
no wetlands = 0;large adjacent wetlands = max ints
9 Channel sinuosity 0_ 5 0- 4 0- 3 z
extensive channelization = 0; natural meander = max points)
10 Sediment input 0-5 0--4 0-4 4--
(extensive deposition:= 0; little or no sediment = max points)

11 " Size & diversity of channel bed substrate
,- ''
t&e homogenous = 0• large, diverse sizes = max points
-1 2 Evidence of channel incision or widening 0-5 0-4 0 - 5
(deeply incised = 0; stable bed & banks = max points)

13 Presence of major bank failures
J
0-5
0-5
0-5
severe crosion = 0; no erosion, stable banks = max points)

14 Root depth and density on banks
0-3 0-4 0-5
a no visible roots = 0• dense roots throughout = max points

15 Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
substantial impact =0; no evidence = max points)
16 Presence of riffle-pooVripple-pool complexes 0-3 0-5 0-6
3
no riilles/ri les or Is = 0; well-developed = max points)
1

~ lti
Habitat complexity
'

0-6

0-6

0 - 6

S
? ttle or no habitat = 0• frequent, varied habitats = max points)

18u Canopy coverage over streambed
0-5
0-5
0 - 5
no shading vegetation = 0• continuous canopy = max ints
19 Substrate embeddedness
NA*
0-4
0-4
-
(deeply embedded = 0• loose structure = max
{
20 Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
p
no evidence = 0; common, numerous es = max points)

21 Presence of amphibians
0-4
0-4
0-4
4
no evidence = 0; common, numerous es = max points)

22 Presence of fish
0 - 4
0 - 4
0 - 4
C7
no evidence = 0; common, numerous es = max points)

23 Evidence of wildlife use
0-6
0-5
0-5
--7-
(no evidence = 0; abundant evidence max points)
ot?l?n(a l'ess?ble 100 T00 100

{? 90 11 CF ?FXI f
T4T t S1 ?
o -
P 2-
m
,
* These characteristics are not assessed in coastal streams.

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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 5
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 5824-5826 Old Randleman Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.9432 Long: -79.82564 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Polecat Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
- ire-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords;
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #5
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (tat/long in degree decimal format): Lat. 35.9432' N, Long. -79,82564',W,
Universal Transverse Mercator: 17 0605900E, 397807ON (NAD 27)
Name of nearest waterbody: Polecat Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep: HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
E Field Determination. Date(s):
SECTION [I: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFA part 329) in the
review area. [Required]
[] Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. (Required]
1. Waters of the U.S.
a. Indicate presence ofwaters of U-S. in review area (check all that apply):'
n TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
[ Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 2,731 linear feet: I to 4 width (ft) and/or acres.
Wetlands: 1.5 acres.
c. Limits (boundaries) of jurisdiction based on: Pick L;is€
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable):3
El Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be notjurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section Ill below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least `seasonally'
(e g, typically 3 months).
'Supporting documentation is presented in Section If I.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section I11.13 below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent'":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 121 acres
Drainage area: 36 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through 2 tributaries before entering TNW.
Project waters are 15-20 river miles from TNW.
Project waters are l- river miles from RPW.
Project waters are 5.19 aerial (straight) miles from TNW.
Project waters are I- aerial (straight) miles from RPW,
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW': RPW a flows to RPW b which flows to TNW.
Tributary stream order, if known: 1.
a Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
3 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics check all that apply):
Tributary is: ® Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Flows under HWY 220.
Tributary properties with respect to top of bank (estimate):
Average width: 4 feet
Average depth: l feet
Average side slopes:
Primary tributary substrate composition (check all that apply):
® silts ® Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover: Bottomland hardwoods, 80%
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Low. realativel-y stable banks.
Presence of run/riffle/pool complexes. Explain: Low gradient, sand-silt bottom with poor riffle/pool development.
Tributary geometry: Meandering
Tributary gradient (approximate average slope): 2 to 4 %
(c) Flow:
Tributary provides for: Sensorial I[ov
Estimate average number of flow events in review area/year i() (pr greater)
Describe flow regime: Ground water and storm events.
Other information on duration and volume: Unknown.
Surface flow is:
Characteristics:
Subsurface flow: Unkrinwu`. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
? OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil
? shelving
® vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
sediment deposition
? water staining
? other (list):
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: 0
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (fist):
® the presence of litter and debris
? destruction of terrestrial vegetation
® the presence of wrack line
® sediment sorting
® scour
? multiple observed or predicted flow events
? abrupt change in plant community
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: No surface flow at time of visit only small pools, clear.
Identify specific pollutants, if known: Highway runoff.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices)- Where there is a break in the OHWM that is unrelated to the waterbody-s flow
regime (e. g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'lbid.
(iv) Biological Characteristics. Channel supports (check all that apply):
Riparian corridor. Characteristics (type, average width): Bottomland hardwoods, >SO ft.
® Wetland fringe. Characteristics: Bottomland hardwoods. Smilax, little herbaceous.
® Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
® Aquatic/wildlife diversity. Explain findings: Frogs and crayfish holes.
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain: .
Wetland quality. Explain: .
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is Prck I;ii(. Explain:
Surface flow is: '»sE
Characteristics:
Subsurface flow Pick ItS, Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain: Surface water not present.
Identify specific pollutants, if known: Unknown.
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain: .
? Habitat for
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick lisi
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and iifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary. in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself., then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section 111.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section 111.13: .
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
Q Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Tributaries of TNW where tributaries have continuous flow -`seasonally" typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: On USGS topo map.
Provide estimates for jurisdictional waters in the review area (check all that apply):
2) Tributary waters: 2,731 linear feet I to 4 width (ft).
E] Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWsa that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an VW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW isjurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Q Tributary waters: linear feet width (ft).
D Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
E] Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III. D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
91 Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section fll.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: 1.5 acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Q Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section IILC.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of ajurisdictional tributary remains jurisdictional.
[Q Demonstrate that impoundment was created from "waters of the U.S.," or
El Demonstrate that water meets the criteria for one of the categories presented above ( 1-6), or
d Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATEI WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
? which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Q Interstate isolated waters. Explain:
? Other factors. Explain:
Identify water body and summarize rationale supporting determination:
sSee Footnote # 3.
'To complete the analysis refer to the key in Section II I. D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates forjurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
0 Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in -STV,41VCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus- standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check ail that apply)-
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
[] Other non-wetland waters: acres. List type of aquatic resource:
?', Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
? Corps navigable waters' study:
? U.S. Geological Survey Elydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
Z USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County. NC, Dec. 1977, Sheet 45.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
Ell FEMA/FIRM maps: Map # 3710775900J, June 18, 2007, Panel 7759!.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
.Ell ?' Applicable/supporting scientific literature:
? Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM QUALITY ASSESSMENT WORKSHEET
°
n*nvide tke following information for tke stream reach ender xwessment--
.ppItcaat's name:" A Z???! ??1C?_ SQ?1 /t.f E- 1?+9t! r?r?t? 2.Evaiuatoes Maine: -J al- M / . 'So(,(le.
3. Date of evaluation: 4. Time ofevaluation 12:16
5. NameofstreamLr - o 'aIeeat (Qel? &Rivwb sin: Cape- : 'eor- / lDeep D3 03 000
7. Approximate drainage area: 3+,6 a? & Stream order: !
9. Length of reach evaluated: n.0 / 10. Ccnutty:u'
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (i€ any):
o
L zdtude (ex-34.8M12): 35 . °,? 2 Longidbde c? -rr_ss?t - 7 2
:5tt r' r fi Co u /f - 1,5
Method location determined (circa): Gus Togo sheer ottlm (Aerial) P>de/GIS Omer Cds
dwr
13 Location of reach under evaluation (note nearby roads and landmarks and identifying Aream?s) location):
+kWest of O!d a d?eman , SR 110 - , f rojoer'y addresS: 582f-58ZQ cold Randlew)ari P,4
14. Proposed channel work (if arty)- rya yid len o n Raw Wa to ,?- 7e eciIer ?- arc f n
15. Rooent weal her condition: 1?'? hf ra,'n d a,!? before-
16. Site dons at time ofvisitr L',1 fO 41eOl
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 (L-
I& Is theme a pond or lake located upstream ofthee evaluation point? OYFS NO Ifyes,, estimate cite water surface area: Q , ac.
19 Does channel appear an USGS quad map?NO 20. Does cal appear on USDA Soil Surveyl YES NO
Esdinated watershed land use. - % Residential - % Commercial - % Industrial I ?, ` % Ag icxtWnul
I Leb, 0 % Forested - % Cleared / Logged 13,±y.Othff [ GljURC ?6p7 ?7c-
22. Bankfull width: jp• 4 `Ja 14WY ZZD 23. Bank height (from bed to top of bank): !t
24 Chanird slope down cadw of stream: Flat (0 to 2%) ZGende (2 to 40A) Moderate (4 to 10%) Steep (>l0%0)
25. (`barrel sinuosity: Straight Occasidtasl bends -Fmp wt meander Very siutrsous Braided channel
I nstractions for completion of worksheet pocated em page 2)= Begin by determining the most appropriate ecoregion based on
kxmhon, terrain, vegetation, stream chnsif' tda don, etc. Every charachmstic must be scored using the same eeoregKxL Assign paints
to each chanuAmistic within the range shown for the ecoregion. Page 3 provides a brief descsptidm of hour to review the
identified in the worksheet. Scores should reflect an overall assessment of the stream mach under evaluation. If a
chards is cannot be evaluated due to site or weather conditions, enter 0 in the searing box and provide an won in the
comment boat. Where there ace obvious cbuqps in the characwr of a sft m under review (cg, the stream flaws f vin a pasture
into a forests the strum may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total scare assigned to a stream mach must range between 0 and 100, with a score of 100 resting a stream of the
highest quality.
Total Score (from reverse)cCol?snents:
Evahrator's 5igaata`?---- Date 2 3 h16?
nris chmnael revaluation fo b Intended to be used only as a gnfde to assht landowners and environmeatihl prefessonab in
tiering the data regwuv d by the United Stales Army Corp of Engineers to r inke, a preliuamaary t of stream
quality. The total more inuring from the completion of lids form is subject to USACK approval and does not imply a
purticalar mitigation ratio or requirement Form subject to change - version 06/03. To Commcait, pleaso Call 919-876-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
ECOREG IONPOINTRAIV?11t; scoltE
cgAx?cTEiusTICS
aasta? ` ..
ielmont 1Kount :. .

Presence of flow / persistent pools in stream 0-5 o-4 0-5
3
1 no flow or saturation = 0; strop flow = max points)
Evidence of past human alteration 0-6 o-5 0-5
2 extensive alteration = 0• no alteration = max rots
Riparian zone 0-6 0-4 0-5
3 no buffer = 0• contiguous, wide buffer = max oints
Evidence of nutrient or chemical discharges 0-5 0-4 0-4
4 extensive discharges = 0; no disc es = max oints
Groundwater discharge 0-3 0-4 0-4
5 no disehar e = 0 springs, sees wetlands etc. = max points)

.=c Presence of adjacent flood lain
] p
Q_.4
0-4
0-2
3
.
6 no flood lain = 0• extensive fl lain = max points)
..Entrenchment/ floodplain access 0 5 fl -4 0 -2
?j
? dee 1 entrenched = 0; frequent flooding = max points)
Presence of adjacent wetlands 0-6 0-4 0- 2
8 no wetlands = 0; lame adjacent wetlands = max points)
Channel sinuosity 0-5 0-4 0- 3 -
9 extensive channelization = 0; natural meander = max rots
Sediment input 0-5 0 -4 0-4
10 extensive deposition= 0; little or no sediment = max Dints
Size & diversity of channel bed substrate
A* _
0-4
0-5
11 fine homogenous = 0; large, diverse sizes = max rots
Evidence of channel incision or widening 0-5 0-4 0-5
j
12 dce incised 0• stable bed & banks = max points)
f
il
ures
a
Presence of major bank 0-5 0-5 0-5
L?
13 severe erosion = 0• no erosion, stable banks = max points)
? Root depth and density on banks 0-3 0-4 0-5
. 14 no visible roots = 0` dense roots throughout = max rots
rA. Impact by agriculture, livestock, or timber production 0 -5 0-4 0-5
15 substantial impact =0; no evidence = max Dints
Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6
16 no riffles/ripples or pools = 0; well-developed = max points)
1 Habitat complexity 0- 6 0-6 0-6
E-+
' little or no habitat = 0; frequent, varied habitats = max points
i Canopy coverage over streambed 0 5 0_ 5 0-5
18 no shadm ve etation - 0• continuous canopy max
points Substrate embeddedness Nt4* 0-4 0-4
d l embedded = 0; loose structure = max
Presence of stream invertebrates (see page 4) 0-4 0-5 0-5
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 6
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 5651 Old Randleman Road, (SR 1104)
6. Subdivision Name: None
7. City: Greensboro
8. County {Guilford
9. Lat: 35.9572 Long: -79.8276
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Polecat Creek
(Decimal Degrees)
12. Watershed: Cape Fear/ Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM
Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #6
State: North Carolins County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.9572°, Long. -79.8276° .
Universal Transverse Mercator: 17 0605705E, 3979620N (NAD 27)
Name of nearest waterbody: Polecat Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUG): Cape Fear 1 Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
F1 Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick Llu "navigable tivaters of the U.S." within Rivers and Harbors Act (PHA) jurisdiction (as defined by 33 CFR part329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Q Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce-
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick 1C. "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
TNWs, including territorial seas
Wetlands adjacent to TNWs
} Relatively permanent waters` (RPWs) that flow directly or indirectly into TNWs
Nan-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Q Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
}1 Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 2,485 linear feet: 4 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on Estalsl?slrjbQlt
Elevation of established OFIWM (if known): Unknown.
2. Non-regulated waters/wetlands (check if applicable):3
F1 Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least --seasonally"
(e.g., typically 3 months).
Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.I. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.I and 2
and Section IIi.D.I.; otherwise, see Section IILB below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.a.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section HLB.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
.. ........... .
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick Lisf river miles from RPW.
Project waters are Pick List, aerial (straight) miles from TNW.
Project waters are Pick List, aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
'Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b. which then flows into TNW.
(b) General Tributary Characteristics (check ail that apply):
"tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
`tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick Lis
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for Pick ES#
Estimate average number of flow events in review area/year PttO.rs
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List Characteristics:
Subsurface flow: Pick'bs€. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: ?
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ine lateral extent of CWAjurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics.
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
']bid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Picli:l;Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List tloodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality: general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any) T
All wetland(s) being considered in the cumulative analysis Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directlv abuts? (YIN) Size (in acres) Directly abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e-g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with ail of its
adjacent wetlands, then go to Section 111.1):
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section 11I.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
?TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS topo map, on USDA, SCS Soil map, has water flowing in extreme drought of 2007.
Tributaries of TNW where tributaries have continuous flow --seasonally" (e.g.. typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section 111.8. Provide rationale indicating that tributary flows
seasonally:
Provide estimates forjurisdictional waters in the review area (check all that apply):
Tributary waters: 2,285 linear feet 4 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
0 Waterbody that is not a TNW or an I2PW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
0 Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Q Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Cl Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section IILC.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates forjurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
Asa general rule, the impoundment of a jurisdictional tributary remamsjurisdictional.
[? Demonstrate that impoundment was created from "waters of the U.S.," or
? Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see 11 below).
E. ISOLATED ]INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
El. which are or could be used by interstate or foreign travelers for recreational or other purposes.
[] from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Q Interstate isolated waters. Explain:
Q Other factors. Explain:
Identify water body and summarize rationale supporting determination:
"See Footnote 9 1
"To complete the analysis refer to the key in Section 11I.D.6 of the Instructional Guidebook.
Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Aci Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
[] Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)-
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
Prior to the Jan 2001 Supreme Court decision in "STVANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the -`Significant Nexus' standard, where such a finding is required for jurisdiction. Explain:
Q Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis ofjurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
[? Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
0' Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
?' Data sheets prepared/ submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
? Corps navigable waters' study:
? U.S. Geological Survey Hydrologic Atlas:
? USGS NFID data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000. PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977. Sheet 39.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785000J, June 18, 2007, Panel 7850J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
? Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
? Applicable/supporting case law:
? Applicable/supporting scientific literature:
Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM QUALITY ASSESSMENT WORKSHEET
*'-vide the following information for the stream reach under assessment:
?
pplicant's mime: QZp-v\ a r-)? 6aw er 2. Evaluator's name: -J 0 ( A K
c
3. Date of evaluation: 2-4 M" 2201 4. Time of evaluation. l
5. Nate of stream: T a Pole Cd¢ e- e ek 6. River basin;, +" 1 ? e
7. Approxihnate drainage area: Q l3. Stream order. +
9. Length of reach evaluated: Z C30 10. County:
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
35.9 Z° ?-T "?. 827
l,atihhde (ex 3a.8'J23tz): ? Longitude (ex 77.SS66t I):
? LrA 1 d ?c? ?D x r ? ?y C-y?
Method location detemdned (circle): GPS Topo Sheet Ortho (Aerial) Phow/GIS Other Gl5 dff
13 Location of read under evaluation (note nearby roads and landmarks and map h Tying stream(s) location):
'- stde e f Old lRotndte-mj,3,n-RJ sK 1(04 ?r'a r? address : ?? 5a 01d Rctndlerrar) Fd ,
14. Proposed channel work (if
'Pa)dlei,all 'Pz2&q Water~ ?Feederr nsfrcrckf'orn
15 Recent weather conditions-,- ? n.`1 11A f ra `r) of A be o fe-
16. Site conditions at time of visit 0
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 (i-rv)
18. Is there a pond or lake located upstreawrof the evaluation poh&( YES )NO If yes, estimate the water surface area: f p C
y ,map? YES NO 20. Does- s channel appear on USDA Soil Survey? YIDS )Na
19. Does channel appear on USGS quad
3stinhated watershed land use: 'Zr g % Residential % Commercial % Industrial 7 ' ?% Agricultural
1 4 4,. 3 % Forested % Cleared / Logged °/n Other ( )
I
22. BarddWl width: 4 23. Bank height (from bed to top of bank):^
24. Channel slope down center of stream: Flax (0 to 21a) Gentle (2 to 4%) Moderate (4 to 10%) Steep (>i0%)
25. Channel sinuosity: Straight /Occasional bends Frequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located on page x): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, streahn classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregiion. - page 3 provides a brief description of how to review the
acs iderhtified ni the worksheet. Scores should reflect an overall assessment of the stream reach under "nation. U a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the soaring 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 tonal score assigned to a stream reach must range between 0 and 100, with a score of 100 resting a stream of the
higbest quality.
Total Score (from reverse): Comments:
Evaluator's Siguaturu ?%'`L 0- Date Z5 ti d Z ®,b,*
-%is channel evaluation torha "tended to be and only as a guide to assist landowners and environmental professionals in
,tiering the data required by the United States Army Corps of Engineers to make a preliminary assewinest of stream
quality. The total score resufflog from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Fortin subject to change - version 06/Q3. To Comment, please call 919-876-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
.E+COREG ION ?OYNT RANDS - SCORE
# CHARACTERISTICS

Co951ay

Pie;fmont'
.
l?+ligl![I?AiA ,'

1 Presence of flow / persistent pools in stream 0-5 0-4
0-5
3
no flow or saturation = 0• strop flow = max Points)
Evidence of past human alteration 0-6 0-5 0-5
Z
extensive alteration = 0• no alteration = max points)
3 Riparian zone 0-6 0-4 0-5
3
no buffer = 0• contiguous, wide buffer = max ints
Evidence of nutrient or chemical discharges 0-5 0-4
r{-
0-4
4
extensive disc es = 0; no discharges = max points)
Groundwater discharge 0-3 0-4 0-4
5
no discharge = 0• springs, seeps, wetlands etc. = max points)
w. Presence of adjacent floodplain p- 4 0- 4 0-2 0
6 no flood lain = 0• extensive flood lain = max points
Entrenchment/ floodplain access 0-5 0-4
(7
0-2
(deeply entrenched = 0 uent flooding = max points)
8 Presence of adjacent wetlands 0-6 0-4
p
0-2
no wetlands= 0; far a adjacent wetlands = max points)
Channel sinuosity
0-5
0-4
0-3
extensive channelization = 0; natural meander = max points)
10 Sediment input _ 5 p_ 4 0- 4 Z
extensive. deposition--- 0; little or no sediment = max points)
Size & diversity of channel bed substrate NA* 0-4 0-5
Z
11
fine homogenous =0; ]e, diverse sizes = max Points)
Evidence of channel incision or widening 0-5 0-4 0-5
12
de 1 incised = 0• stable bed & banks = max rots
Presence of major bank failures
13
0-5
0-5
0-5
severe erosion = 0• no erosion, stable banks = max points)
14 Root depth and density on banks 0-3 0-4 0-5
3
na visible roots = 0• dense mots throughout = max points)
Impact by agriculture, livestock, or timber production 0-5 0-4 0-5
15 (substantial i et =0; no evidence = max points)
Presence of riffle-pool/ripple-pool complexes 0-3 0-5
0-6
16
no riffles/ripples les or pools = 0 well-develo d = max points)

=a Habitat complexity
17
0-6
0-6
0-6 s?
H (little or no habitat = 0; frequent, varied habitats = max points
w-r
18 Canopy coverage over streambed
0-5
0_ 5
0_ 5
no shading vegetation = 0; continuous canopy = max points)
Substrate embeddedness
19
`* -
0 4 _
0 4 9
-
d 1 embedded = 0' loose structure = max
Presence of stream invertebrates (see page 4) 0 - 4 0 - 5 0 - 5 O
20
no evidence = 0• common, numerous es = max points)
?' Presence of amphibians
21
0-4
0-4
0-4 C)
no evidence = 0• common, numerous es = max points)
' Presence of fish
0 - 4
0 - 4
0 - 4
22 no evidence = 0; common, numerous !ITes; = max points

Evidence of wildlife use
0-6 0-5 0-5
` 23

U
no evidence = 0; abundant evidence = max points
:100 -100 100
'
`
'
Total Pvnzts k
tasvble
? -:
-? . - ¢ }yam
biio? I+r
* these characteristics are not assessed in coastal streams.
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 7A & 7B
2. Name of Properly Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 5307 Old Randleman Road, (SR 1104)
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.97152 Long: -79.83127
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Hickory Creek I Tributary 2 (No 37)
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
(Decimal Degrees)
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
............................................................................................................................................,
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing 97A & 713
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (latllong in degree decimal format): Lat. 35.97152°, Long. -79.83127°W.
Universal Transverse Mercator: 17 0605355E, 3981205N (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep; HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites. disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
EJ Office (Desk) Determination. Date:
[, Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There 8re? "navigable waters ofthe U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review
area. [Required]
Q Waters subject to the ebb and flow of the tide.
Q Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There y? "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): t
Q TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
0 Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 800 linear feet: 1-2 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on Este Wsbed hyA
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable)?
E] Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
'Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g... typically 3 months).
Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.I. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section 111.8 below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section 111-D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.I for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 63.5 acres
Drainage area: 41.7 acres.
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through tributaries before entering TNW.
Project waters are Z-5 aerial {straight) miles fr
Project waters are 1 (or less) aerial (straight)
Project waters cross or serve as state boundaries. Explain:
Project waters are 2-5. river miles from TNW.
Project waters are 1 (or less) RPW.
river miles from
P from TNW.
...............
P miles from RPW.
Identify flow route to TNW5: Non-RPW a flows to unnamed tributary b, which flows to RPW c (Pfickory Creek). which
flows to TNW (Deep River).
' Note that the lnstructionaS Guidebook contains additional information regarding swales, ditches, washes, and erosional features ,generally and in the arid
West.
'Flow route can be described by identifying, e.b., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
Tributary stream order, if known: 0.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ® Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Flows through culvert under Old Randleman Road.
Tributary properties with respect to top of bank (estimate):
Average widtb: 2 feet
Average depth: 3 feet
Average side slopes: Vertical (t':l ®r less).
Primary tributary substrate composition (check all that apply):
® silts Z Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ® Vegetation. Type/%cover: Mixed hardwoods, 100%
? Other. Explain:
Tributary condition/stability highly eroding, sloughing banks]. Explain: Entrenched with stable banks.
Presence of run/riffle/pool complexes. Explain: None.
Tributary geometry: Meaadering
Tributary gradient (approximate average slope): 2-4 %
(c) Flow:
Tributary provides for. ,,EA me ~al l?Io
Estimate average number of flow events in review area/yearl4 i#`s gr`e4ter
Describe flow regime: Ephemeral from storm events.
Other information on duration and volume: Not observered.
Surface flow is: Discrete and confined. Characteristics:
Subsurface flow: Ilnkna . Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
21 Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil ?
? shelving ?
® vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.7 Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: ?
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
other (list):
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings:
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film: water quality: general watershed characteristics, etc.).
Explain: Not Observed.
Identify specific pollutants, if known: Highway runoff.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's now
regime (e g,, flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
Z Riparian corridor. Characteristics (type, average width): Mixed hardwoods, »0 ft.
? Wetland fringe. Characteristics:
Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics.
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-WNW:
Flow is: Pick Lisi. Explain:
Surface flow is: Pack ES
Characteristics:
Subsurface flow: Pic- Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationshipj t_o_TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
................
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List lloodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics: etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any),
All wetland(s) being considered in the cumulative analysis Pick Lf0
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? {YIN) Size (in acres) Directly abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TN Ws, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TN-Ws. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section 111.1): The tributary does
have the capacity to carry pollutants or flood waters to TNWs. The tributary does not provide habitat and lifecycle support
functions for fish and other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW.
The tributary does have the capacity to transfer nutrients and organic carbon that support downstream foodwebs. The tributary may
have other relationships to the physical, chemical, or biological integrity of the TNW which were not observerd at the time of site
visit.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below. based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
[I TNWs: linear feet width (ft), Or, acres.
Q Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Q Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
10 Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 800 linear feet I to 2 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates For jurisdictional waters within the review area (check all that apply):
Tributary waters: 800 linear feet I-2 width (ft).
Q Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Q Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
0 Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary
seasonal in Section IILB and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Q Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
[] Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
Impoundments of jurisdictional waters.9
As a general rule, the impoundment of ajurisdictional tributary remains jurisdictional.
E3 Demonstrate that impoundment was created from "waters of the U.S.," or
E1 Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
E] Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
0 which are or could be used by interstate or foreign travelers for recreational or other purposes.
'See Footnote 9 3.
'To complete the analysis refer to the key in Section III. D.6 of the Instructional Guidebook.
m Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWAAct Jurisdiction Following Rapanos.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
?! Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
?' Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
?! Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the '`Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the NIBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non-wetland waters (i.e_, rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Nan-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
El Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
USGS NHD data.
® USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County. NC, Dec. 1977, Sheet 39.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
? State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785000J, June 18, 2007, Panel 78501.
100-year FIoodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ® Other (Name & Date): Photo 7, Crossing 7A.
Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature.
? Other information (please specify):
USAGE AID#
DWQ9
Site # (indicate on attached map)
M STREAM QUALITY ASSESSMENT WORKSHEET
_ - ? ??
Provide the following information for the stream reach under assessment: C °' "d
-? r??r? '- C?1 / E
- ,q Zen.. f-? %.4 f er 2. Evaluator's name:
1. Applicant's name
3. Date of evaluation: 4. Time of evaluation: 0
5. Name of strearrt- T l° A ,1 r 6. River basin:.
7. Approximate drainage area: 4- I ' & Stream order.
9. Length of reach evaluated: l 10. County:. '?' T t? r 11
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
Latitude (ex 34.872312): J-5 • Longitude (ex 77.556151 [}: - f °?. ? f -
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Pbotn/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attac trap identifying stream(s) location):
En Si FJ 5F ? ib 04;tf?55: 5307 00 P21`',
', --?-
, fir?
14. Proposed channel work (if any): i o Y&I e ?Y? i, F? ki W a iC-4:?e r r s 4 f ii'Y"
15. Recent weather conditions-.- L?,P-
16. Site conditions at time of visit:
17. Identify any special waterway classifications known: -Section 10 Tidal Waters -Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters Y /Water Supply Watershed-(I-iv)
1& Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES ONO 2(L Does channel appear an USDA Soil Survey? YE NO
21. Estimated watershed land use: 12, % Residential -% Commercial =% Industrial Z'f? 3 % Agricultural
6 7- • 8 % Forested -% Cleared / Logged - % Other
22. Bankfall width: 23. Bank height (from bed to top of bank): Z
24. Channel slope down center of stream: Flat (0 to 2%) 'Gentle (2 to 4%) -Moderate (4 to 10%) -Steep (>10%)
25. Charnel 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 eroregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic mast be scored using the same ecoregion. Assign points
to each clraracteristic 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
chmacterMc cannot be evaluated due to site or weather conditions, enter 0 in the scouring box and provide an explanation in the
comment section Where there are obvious changes in the character of a stream weeder 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 scone of 100 representing a streaun of the
highest quality.
Total Score (from reverse): -} Comments:
Date
Evaluator's Signature
This channel evaluation form isi'tended to be used only as a guide to assist landowners and eavironmental 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
ECOREG ION.PUllV'? IcAl?t?r, SC(URE
CHARACTERLSCS V :
Coastal main _
Piedmont 1?Io
: _
Presence of flow / persistent pools in stream o-5
0 - 5
0-4
1 no flow or saturation = 0; strop flow = max Points)
Evidence of past human alteration 0-6
l?-
0-5 0-5
2 (extensive alteration = 0; no alteration = max rots
Riparian zone 0- 6 0-4 0-5
3 no buffer = 0• contiguous, wide buffer = max Points)
Evidence of nutrient or chemical discharges 0-5
'
0-4 0-4
4 extensive discharges = 0; no discharges = max points)
5 Groundwater discharge
no discharge = 0• s rip s, sees wetlands etc. =coax points) 0-3 0-4 0-4
Presence of adjacent fioodplain 0-4 0-4 0-2
O
6 no flo lain = 0• extensive flood lain = max points)
Entrenchment/ floodplain access 0-5 0-4 0-2
d
7 dee l entrenched = 0; frequent flooding = max points)
Presence of adjacent wetlands 0-6 0-4 0-2
d
8 no wetlands = 0.large adjacent wetlands = max rots
Channel sinuosity 0-5
0- 3
0-4
9 extensive channelization = 0; natural meander = max ints
Sediment input 0-5 0-4 0-4
L-
10 extensive deposition:= 0; little or no sediment = max rots
Size & diversity of channel bed substrate Nor `' 0-4 0-5
11 diverse sizes = max point
fine homogenous 0; large
S)
,
-

` Evidence of channel incision or widening
0--5
0-4 0-5
., 12 dee 1 incised = 0; stable bed & banks = max oints
Presence of major bank failures 0-5
1
0-5 0-5 j
d 13 severe erosion = 0; no erosion, stable banks = max points)
' 14 Root depth and density on banks
no visible roots = 0; dense roots throu out = max 0-3 0-4 0-5
points Impact by agriculture, livestock, or timber production 0-5
!-
0-4 0-5
substantial impact =0• no evidence = max rots
Presence of riffle-pool/ripple-pool complexes
0-3
j
0-5 0-6

4! 16 no riffles/ri les or ols = 0• well-develo d = max rots
Habitat complexity `
0-6 0-6 j
.' 17 little or no habitat = 0• frequent, varied habitats = max points) 0-6
Canopy coverage over streambed 0-5 0-5 0-5
18 no shading vegetation = 0• continuous canopy = max points)
19 Substrate embeddedness TA* 0-4 0-4
d 1 embedded = 0; loose structure = max
Presence of stream invertebrates (see page 4) 0-4 0-5 0-5
c?
20 no evidence = 0; common, numerous types = max oints
Presence of amphibians 0- 4 0- 4 ©- 4
O
21
no evidence = 0• comma numerous tyWs = max points)

22 Presence of fish 0-4 0-4 0-4
O no evidence = 0; comma numerous types = max points)
Evidence of wildlife use
0-6 0-5 0 5
23
no evidence = 0; abundant evidence = naaac oints

100 i.OQ
:
f
"Total Points Possle t.

I
4
TOTtL SCORE -`(also eater as`trt page) 53
These characteristics are not assessed in coastal streams.
?_
USACE AID#
;.e.;
DWQ # Site # (indicate on attached map)
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment: ?a?asv, oil
1. Applicant's name: azen ah S,iwa &)q/'?e y?rn1 2. Evaluator's name: l
3. Date of evaluation: 1 4. Time of evaluation:
.31
5. Name of stream: 4 t4icko1'x Cre,_ _J? 6. River basin: d ye- -7peat / peP,4
7. Approximate drainage area: 3 ' 8. Stream order.
9. Length of reach evaluated: 10. County: t ? U, J` Y
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): N6
Latitude (ex 34.872312): 56- QJ-7 $ 15V Longitude (ex -77.556611): - -7 C). 8z i
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):
14. Proposed channel work (if
15. Recent weather conditions:
16. Site conditions at time of
on,dlernav? Ra,,1 WAter -7eed6t-
/1"q A? rain
fir'! ? va
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
19. Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
21. Estimated watershed land use: 10 % Residential % Commercial - % Industrial 50%A iral
ult% Forested % Cleared / Logged _::-20/6 Other ( )
22. Bankfull width: Z ' 23. Batik height (from bed to top of bank): Z r
24. Channel slope down center of stream: Flat (0 to 21/4) Gentle (2 to 40/6) Moderate (4 to 10%) -Steep (>100/a)
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 roust 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 Signafu Date 2 3 NOU ©C?'
This channel evaluation form is ntended to used only as a guide to assist landowners and environmental professionals in
gathering the data required 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 46/43. To Cornrnent, please call 919-876-SUI x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
* These characteristics are not assessed in coastal streams.
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Carps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 8
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program 1 John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 5129 Old Randleman Road, (SR 1104) to a Storm Watel
6. Subdivision Name: None GE DQ,,"gNsloed
7. City: Greensboro t}SA ce
8. County Guilford C()Meyan
9. Lat: 35.97822 Long: -79.83339 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Polecat Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder
Assign number in ORM
Begin Data
Authorization
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date: Z3 my 2oo-- Project: va bL M o R`?'? Latitude: 3,g? 8zz R FE
Evaluator: .J04N T SOULIG Site: CROSSIM67 * 8 Longitude: - "8 -5,5-613
H&PIP
Total Points: Other REASANT 6ARDE-M
Stream is at least intermittent County: 601 M) 2b e.g. Quad Name:
if ;? 19 or perennial if z 30
A. Geomo hol (Subtotal = Absent Weak Moderate Strong
1". Continuous bed and bank 0 1 2 3
2. Sinuosity 0 1 2 3
3. In-channel structure: riffle-pool sequence r0 I 2 3
4. Soil texture or stream substrate sorting 0 1 2 3
5. Activelrelic floodplain 0 1 2 3
6. Depositional bars or benches 0 1 2 3
7. Braided channel CO 1 2 3
8. Recent alluvial deposits 0 1 2 3
9 8 Natural levees 0 1 2 3
10. Headcuts 0 1 2 3
11. Grade controls 0 0-5 1 1.5
12. Natural valley or drainageway 0 'Q.5 . 1 1.5
13. Second or greater order channel on existing
USGS or NRCS map or other documented
evidence.
'No=0
Yes = 3
u Man-made ditches are not rated; see discussions in manual
R I-I?irErnlnnv !C? ihtnta! = ? 1
14. Groundwater flow/discharge 0 1 2 3
15. Water in channel and > 48 hrs since rain, or
Water in channel - d or growing season 0 (?^ 2 3
16. Leaflitter 1.5 le, 1 0.5 0
17. Sediment on plants or debris 0 , 6.6 1 1.5
18. Organic debris lines or piles (Wrack lines) 0 0-5
L 1 1.5
19. Hydric soils (redoximorphic features) present? -o Yes = 1,5
C_ Rinlnnv 1.qiih4n4al = 60 1
2. Fibrous roots in channel 3 2 1 0
21 . Rooted plants in channel 2 1 0
22. Crayfish 0 0.5 1 1.5
23. Bivalves 1 2 3
24. Fish (705 0.5 1 1.5
25. Amphibians 0 0.5 1 1-5
26. Macrobenthos (note diversity and abundance) 0 0.5 1 1.5
27. Filamentous algae; periphyton 0. 1 2 3
28- Iron oxidizing bacteria/fungus. 0 0.5 1 1.5
29 °.1IN?_lland Piar, "_? i ?7 st v?ra?bai SAC = 0.5; FACW = 0.75; OBL = 1.5 SAV = 2. Other = 0
`items 20 and 21 locus on the presence of upland plants, Item zu Focuses on me presence vi cyuaui: ul w-al iu F 1 ..
Sketch:
Notes: (use back side of this form for additional notes.)
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION 1: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #8
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (iat/long in degree decimal format): Lat. 35.97822° PF, Long. -79.83339° .
Universal Transverse Mercator: 17 0605155.487 E, 3981946.088 N, (NAD 27)
Name of nearest waterbody: Polecat Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (KUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)-
E] Office (Desk) Determination. Date:
El Field Determination. Date(s):
SECTION H: SUMMARY OF FINDINGS
A. RHA SEC'T'ION 10 DETERMINATION OF JURISDICTION.
There Are "navigable waters of the US." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review
area. [Required]
F1 Waters subject to the ebb and flow of the tide.
El Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There P'kkl!ij -waters of the U.S."within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
[[ - NWs, including territorial seas
F1 Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Nan-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
F1 Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments ofjurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 800 linear feet: 2 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on gstpltshedl>yQIIII
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable) :3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
' Boxes checked below shall be supported by completing the appropriate sections in Section III below.
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least --seasonally"
(e.g., typically 3 months).
' Supporting documentation is presented in Section 111.1',
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only, if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CIIAP kCTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section IILD.2- If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section IILC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 38acres
Drainage area: 7.24 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through tributaries before entering TNW.
Project waters (straight) om TNW.
Project waters are 1 (or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Project waters are 15-20 river miles from "INW.
Project waters P W.
are t (or less) river miles from R
are 10-Ifiaerial miles fr
Identify flow route to TNW5: Non-RPW a flows to RPW b, which flows to RPW b (Polecat Creek), which flows to
TNW c (Deep River).
'Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
West.
Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW_
Tributary stream order, if known: 0.
(b) General Tributary Characteristics (check all that apples
Tributary is: Z Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Ditched at highway.
Tributary properties with respect to top of bank (estimate):
Average width: 1-2 feet
Average depth: 1-1.5 feet
Average side slopes: Vertical (11-1 'or less).
Primary tributary substrate composition (check all that apply):
® Silts ® sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ® Vegetation. Type/% cover: Mix of scrub/shrub and trees, 100%
? Other. Explain:
Tributary condition/stability [a ., hiuhly eroding, sloughing banks]. Explain: Bare banks but real itively stable.
Presence of run/riffle/pool complexes. Explain: None.
Tributary geometry: Relatively straight
Tributary gradient (approximate average slope): 2-4 %
(c) Flow:
Tributary provides for: E?hamecxl flaw
-J
Estimate average number of flow events in review arealyear f6rr'
Describe flow regime: Ephemerial storm events.
Other information on duration and volume: Unknown.
Surface flow is:
Characteristics:
Subsurface flow: [Jnkaowg. Explain findings:
Dye (or other) test performed:
Tributary has (check all that apply):
Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil
? shelving
® vegetation matted down, bent. or absent
® leaf litter disturbed or washed away
® sediment deposition
? water staining
? other (list):
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: Q
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
® the presence of litter and debris
? destruction of terrestrial vegetation
? the presence of wrack line
® sediment sorting
® scour
? multiple observed or predicted flow events
? abrupt change in plant community
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings:
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Not observered.
Identify specific pollutants, if known: Highway runoff.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction where the stream temporarily flows underground, or where
the OH WM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'[bid.
(iv) Biological Characteristics. Channel supports (check all that apply)-
0 Riparian corridor. Characteristics (type, average width): Mixed hardwood, 30-50 ft.
? Wetland fringe. Characteristics:
Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick Lisiw
Characteristics:
e. Explain findings:
Subsurface flow: Pick ? List'
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Nan-TNW;
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain;
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick Lest.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants. if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)"
All wetland(s) being considered in the cumulative analysis: Pik.- isf
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN} Size (in acres) Directly abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: The tributary has
the capacity to carry pollumats or flood waters to TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW.
The tributary does not provide habitat and lifecycle support functions for fish and other species. such as feeding, nesting, spawning,
or rearing young for species tnat are present in the TNW. The tributary does have the capacity to tansfer nutrients and organic
carbon that support downstream foodwebs. The tributary may have other relatinships to the physical, chemical, or biological
integrity of the TNW although not observered at the time of the site visit.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III. D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section IfI.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
[] Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
[] Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Q Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
H Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs$ that flow directly or indirectly into TNWs.
Eg, Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates forjurisdictional waters within the review area (check all that apply):
Tributary waters: 800 linear feet 2 width M.
0, Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
d Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
El Wetlands directly abutting an RP W where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
d Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section I11.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
[? Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
EJ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TN W are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters!
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Q Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR (NTRA-STATE[ WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE CONINIERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):")
0 which are or could be used by interstate or foreign travelers for recreational or other purposes.
'See Footnote # 3.
To complete the analysis refer to the key in Section Ill. D.6 of the Instructional Guidebook.
° Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA IIQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding Cif'A Aet Jurisdiction Following Rapanos.
M from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Q Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
0 Other non-wetland waters: acres.
Identify type(s) of waters:
[Q Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC." the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required forjurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the 141BR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
0 Non-wetland waters (i.e., rivers, streams): linear feet width (ft),
Q Lakes/ponds: acres.
Other non-wetland waters: acres- List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Q Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
} Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
0 Data sheets prepared by the Corps:
Q Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24.000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 39,
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
} FEMA/FIRM maps: Map 9 371078 1 OOJ, June 18, 2007, Panel 785 LI.
? 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
El Photographs: E] Aerial (Name & Date):
or ? Other (Name & Date):
Previous determination(s). Fife no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature:
? Other information (please specify):
STREAM QUALITY ASSESSMENT WORKSHEET
n-nvide the following information for the stream reach under assessment: C r o s5 e n ? # ? o
? p 4
.pplicant's name: 2. Evaluator's na , -J o,; ?'! ¢ z c t,° . `
3. Date of evaluation: Z3 N& ? '+- 4. Time of evalnadtion 2- +5. Name of stream: UT (.O FOIOCa L r-ee, 5. River basin:- Cd ge- 761,-
7. Approximate drainage area: Qy 8. Streatn order:
r
9. Length of reach evaluated: j S M county: 11. Site coordinates (if known): prefer in decimaat degrees. 12. Subdivision name (if any): dA)
Latitude (ex. 34.872312): 35 , g7 8 Z ?-° Longitude (ex. -7,.55661 t ): - 7 e3. S 5334
Method location determined (circle): GPS Topo Sheet Order (Aerial) PWt WAS G1S O her 6U' f w??p "7 . 6!:::
13. Location of reach under evaluation (note nearby roads and landmarks and Tying s s) location):
? s1jd C bi A -;cone letm ap, R8 S5R 11Q 4 Prop --e-ty address; Sf Zg d panel lema.r -Rc?,
14. Proposed channel work (ifany): ROY14dri9V1VY'1 RCSyV Water Ifeder- n 'GC i'?3r's
15. Recent weather conditions:- ?T/ J4 V ' e 4iw?dr
16. Site conditions at time of visit
17. Identify any special waterway classifications known: Section 14 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters ZWater Supply Watershed?(I-N)
18` Is there a pond or lake located upstream of the evaluation point? YE DNO-
19. yes, estimate the water surface area:
20. Does channel appear on USDA Soil Survey? YES NO
Does channel appear on USOS quad map? YE(?NO
Minuted vau-slned land use: '524 % Residual " % Commercial % bulustrial 13.4 % Agricultural
3 +, Z % Forested - % Cleared / Logged =% Odner ( )
22. Bankfull width: 23. Bank height (from bed to top of bank): ,'-G
24. Channel slope down center of stream: Flat (4 to 21b) C,entle (2 to 40 Modkratc (4 to 10%) Steep (> 10 %)
25. Channel sinuosity: _ZStraight Occasional bends Fregtx:at meander Very sinuous Braided channel
bLvtructions 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 assesmsid of the stream reach ender 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 dlaracter 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 140 representing a stream of the
highest quality.
Total Score (from reverse): Comments:
Evaluator's Signature Date
Phis channel evaluation fvrslt is/6- tended to be rmed only as a guide to assist landowners and environmental prolessiosb in
tiering the data required by te United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total scare resulting from the colnpkUM of this form is subject to USAGE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change -- version 46/03_ To Comment, please call 919-876-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
CHA .ECOREGIQN P03NT' RANGE . SCORE
RACTERISTICS " Cnastgt ` 1'edmon# 11?Ioun
l Presence of flow / persistent pools in stream o-5 0-4 0-5 -z_
(no flow or saturation = 0• strong flow = max fiats
2 Evidence of past human alteration o-6 0-5 0-5
0
extensive alteration = 0• no alteration = max points)

3 Riparian zone
o-6
0-4
0-5 3
no buffer = 0• contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
extensive dischar es = 0 no disc es = max points),
5 Groundwater discharge 0-3 0-4 0-4 (a
no discharge = 0 nn s, see s, wetlands, etc. = max points)
f-r Presence of adjacent floodplain
6 0 - 4 0-4 o-2
no flood lain = 0• extensive flood lain = max points)

° Entrenchment/ floodplain access 0- 5 0- 4 0- 2 Z
a+ (deeply entrenched = 0• frequent floodin = max ints
8 Presence of adjacent wetlands 0-6 0-4 0-2 Q
no wetlands = 0.large adjacent wetlands = max points)
9 Channel sinuosity 0-5 0-4 0-3 a
extensive channelization = 0; natural meander = max points)
10 Sediment input 0-5- 0-4 0-4
extensive d osition= 0• little or no sediment = max points)
11 Size & diversity of channel bed substrate NA* o-4 0-5
fine homogenous = 0• large, diverse sizes = max points)
12 Evidence of channel incision or widening 0-5 0-4 0-5
7-
(deeply incised = 0• stable bed & banks = max points)

Presence of major bank failures
13
0-5
0-5
0-5
severe erosion = 0• no erosion stable banks = max points)
14 Root depth and density on banks 0-3 0-4 0-5
?
no visible roots = 0• dense roots throw out = max points) -
Impact by agriculture, livestock, or timber production
15
0-5
0-4
o-5
substantial impact =1• no evidence = max oints
16 Presence of riffle-pool/ripple-pool complexes 0_ 3 U_ 5 U- 6 Q
no riiileshi les or pools = 0; well-developed = max points)

Habitat complexity
I7
0-6
0-6
0-6
p
little or no habitat = 0• fre went, varied habitats = max points
Canopy coverage over streambed
18
0-5
0-5

0-5 4
no shading vegetation = 0; continuous canopy = max points)
19 Substrate embeddedness NA* 0-4 0-4
(deeply embedded = 0; loose structure = max
20 Presence of stream invertebrates (see page 4) 0-4 0-5 0-5
no evidence = 0• common, numerous types = max points)
Presence of amphibians
21
0-4
0-4
0-4
p
no evidence = 0; common, numerous types = max points)
!^ Presence of fish
22
0-4
0-4
0-4
d
no evidence = 0• common, numerous types = max inns
Evidence of wildlife use
23
0-6
0-5
0- 5
O
no evidence = 0; abundant evidence = max points)
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* These characteristics are not assessed in coastal streams.

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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 9
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 4650-R1 S Holden Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.98764 Long: -79.83142
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide. Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
(Decimal Degrees)
The following information will be completed by Corps office:
AID:
Prepare File Folder
Authorization:
Assign number in ORM
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Begin Date
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #9
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.98764° N, Long. -79.83142° W.
Universal Transverse Mercator: 17 0605320.570 E, 3982993.073 N (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick Lisi "navigable waters of the US." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
?I Waters subject to the ebb and flow of the tide.
Q Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the US." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): '
TNWs, including territorial seas
Wetlands adjacent to TNWs
0 Relatively permanent waters: (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
0.. Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Q'; Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Q Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 3,371 linear feet: 4-6 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Established by OIIWMs
Elevation of established OHWM (if known): Unknown.
2. Non-regulated waters/wetlands (check if applicable):3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
typically 3 months).
Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbodya is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TN W.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW':
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West,
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Fick List
Estimate average number of flow events in review area/year: PickList
Describe flow regime:
Other information on duration and volume:
_.._............_____......
Surface flow is: Pick List. Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
?High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick Gist
Characteristics:
Subsurface flow: Puck List:. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directlv abuts? (YIN) Size (in acres) Directlv abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
[] TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS topo map, on USDA, SCS, Soil Survey map, had flow during extreme drought of 2007.
[ Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 3,371 linear feet 4-6 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
? Tributary waters: linear feet width (ft).
? Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
? Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of ajurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):'0
? which are or could be used by interstate or foreign travelers for recreational or other purposes.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
?; Interstate isolated waters. Explain:
r1l Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
to Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
Q! Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
F1 If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Q Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Q Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
El Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Q Lakes/ponds: acres.
Q Other non-wetland waters: acres. List type of aquatic resource:
Q Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required forjurisdiction (check all that apply):
Q' Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Q Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Q Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
0! Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Q Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
Q Corps navigable waters' study:
Q U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
{ U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
® USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 39.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
Q State/Local wetland inventory map(s):
FEMA/FIRM maps:Map # 3710785 100J, June 18, 2007, Panel 785 I J.
Q 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Q Photographs: E] Aerial (Name & Date):
or E1 Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Q Applicable/supporting case law:
0 Applicable/supporting scientific literature:
Ell
Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:

STREAM QUALITY ASSESSMENT WORKSHEET
'Provide the following information for the stream reach under assessment:
(-4roSIZ n? T SOU
.,apiicant's name:*761'Rn? ^s? ?? ?? avj? 2. Evaluator's name: -J
3. Date of evaluation: Z 7' AJ® V ZOO 4. Time of evaluation:
5. Name of stream: tc, 6. River basin- a =redze°
7. Approximate drainage area: 5-+,5 & Stream order:
+d
9. Length of reach evaluated: ? 00r 11D. County: ?Va1
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): Q0 AJ 5-
1.atibude (ex. 34.M 12): 3 . longitude (ex -77.ss66> > : - 7 ?-?-'
Method location determined (circle): GPS Topo Sheet Ortho (Acriai) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attac map i Eying stream(s) location):
. -'side of S t r,4A-,n . + e 50 -RI S !roller cJ,
14. Proposed channel work (if any): Ra/ ,3dle P-r? -Pa ?,AfL
15. Recent weather conditions:
16. Site conditions at time of visit" ®r L1' I ?t?
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters eater Supply Watershed -a-IV)
I& 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? S NO 20. Does channel appear on USDA Soil Survey? YES O
estimated watershed land use. % Residential r % Commercial " % Industrial - -49 % Agricultural
t ? ® % Forested % Cleared / Logged l Z f7% Other (6e_h vJ Sro a .-d s )
22. Bankfull width: (e' ACI° A one Y ZZO 23. Bank height (from bed to top of bank): 4-,5"
24. Channel slope down center of stream: Fiat (0 to 2%) ZGG/entle (2 to 4%) -Moderate (4 to 101%) 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 ch °c 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 m the worlLsheeL 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): S ?-9 Comments:
Evaluator's Signature e--? Date d Za __42 'Nis channel.evaluation form ' tended to be used only as a guide to assist landowners and environmental professionals in
Aering the data required by the United. Stag 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 requirements Form subject to change - version 06/03. To Comment, please call 919-876-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
MOREG ION POINT RANGE SCORE
CHARACTERLSTICS Coasfal Piedmont ` Mountain" .:
1 Presence of flow / persistent pools in stream 0-5 0-4 0-5
Z
no flow or saturation = 0; strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5
extensive alteration = 0• no alteration = max points)
3 Riparian zone 0-6 0-4 0-5
?j
no buffer = 0; contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
s?
extensive discharges = 0; no discharges = max points)
5 Groundwater discharge 0-3 0-4 0-4
no discharge = 0• springs, sees wetlands etc. = max points)
N 6 Presence of adjacent floodplain 0-4 0-4 0-2
no flo lain = 0• extensive flood lain = max oints

7 Entrenchment / floodplain access 0-5 0-4 0-2
Q
(deeply entrenched = 0; frequent flooding = max points)
8 Presence of adjacent wetlands
j 0- 6 0- 4 0- 2 Q
acent wetlands = max points)
no wetlands = 0;large ad
9 Channel sinuosity 0-5 0-4 0-3
extensive channelization.= 0; natural meander = max points)
10 Sediment input 0_ 5 0- 4 0- 4
extensive deposition- 0• little or no sediment = max points)
11 Size & diversity of channel bed substrate NA* 0-4 0-5
fine homogenous = 0; large, diverse sizes = max points)
12 Evidence of channel incision or widening 0-5 0-4 0-5
3
(deeply incised = 0• stable bed & banks = max points) .
'
13 Presence of major bank failures
0-5
0-5
0-5
severe erosion = 0• no erosion stable banks = max points)
14 Root depth and density on banks 0-3 0-4 0-5
3
E, no visible roots = 0• dense roots throughout = max points)

15 Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
substantial impact =0; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5
0- 6
3
ffl
no n es/riles or pools = 0; well-developed = max points)

17 Habitat complexity

'
0-6
0-6
0-6
Z
f4 ttle or no habitat = 0• frequent, varied habitats = max points)
H
18
Canopy coverage over streambed
0-5
0-5
0-5
no shading vegetation = 0• continuous canopy = max points)
19 Substrate embeddedness NA* 0- 4 0-4
3
(deeply embedded = 0; loose structure = max
20 Presence of stream invertebrates (see page 4) 0-4 0-5 0-5
no evidence = 0 common numerous types = max points)

21 Presence of amphibians 0-4 0-4 0-4
Q
O no evidence = 0• common, numerous types = max points)

22 Presence of fish
0-4
0-4
0-4
no evidence = 0• common, numerous types = max points)
23
Evidence of wildlife use

0 - 6

0 - 5

0 -

Z
no evidence = 0• abundant evidence = max points
t
P
s
bl
1'
l P
i 100 100 140 "
n
s
o
si
e
0 ta
o
TbTAL SCORE .(also enter ort first page) . 5
* These characteristics are not assessed in coastal streams.
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USGS TOPO MAP d : • \ .r_.
PLEASANT GARDEN QUAD \\?
H - - _ ` MZEN AND SNWYER FIG 3
R x `? Environmental Engineers & Scientists l
« `\ d9a n.wcy = a o E'.+1, wile 575 Chc; oN, North Ccroba,?,2:1
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f` Perennial Flow s RANDLEMAN FEEDER MAIN
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y' Unnamed Tributary USDA, SCS, SOIL SURVEY
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FIG 6
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 10
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 4612 S Holden Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.99182 Long: -79.83057 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X_ Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM
Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing # 10
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.99182° N, Long. -79.83057° W.
Universal Transverse Mercator: 17 0605391.631 E, 3983457.634 N (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
.._ ..............................
There Pick List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
E]j Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): '
[] TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
Q Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 2,572 linear feet: 1.5 to 4 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Established by OIIWM
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable):3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
3 Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.I and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbodya is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 70.8 acres
Drainage area: 13.9 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through 2 tributaries before entering TNW.
Project waters are 5-10 river miles from TNW.
Project waters are I (or less) river miles from RPW.
Project waters are 2-5 aerial (straight) miles from TNW.
Project waters are 1 (or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain
Identify flow route to TNW': Non-RPW a flows to RPW b, which flows to RPW c (Hickory Creek), which flows into
TNW (Deep River).
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
Tributary stream order, if known: 0.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ® Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Flows under Holden Road.
Tributary properties with respect to top of bank (estimate):
Average width: 1-5 to 4 feet
Average depth: 4 feet
Average side slopes: Vertical (11 or less).
Primary tributary substrate composition (check all that apply):
® Silts ® Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover: Mixed hardwoods, 80% cover
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Unstable banks in upper reach.
Presence of run/riffle/pool complexes. Explain: None observed.
Tributary geometry: Meandering
Tributary gradient (approximate average slope): 2-4 %
(c) Flow:
Tributary provides for: Ephemeral flow
Estimate average number of flow events in review area/year: 2(} (or greater)
Describe flow regime: Storm event dependant.
Other information on duration and volume: Not observed.
Surface flow is:
Characteristics:
....._ ....................
Subsurface flow: UA6. own. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil
? shelving
® vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
® sediment deposition
? water staining
? other (list):
El Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
® the presence of litter and debris
? destruction of terrestrial vegetation
® the presence of wrack line
® sediment sorting
® scour
? multiple observed or predicted flow events
? abrupt change in plant community
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Not observed.
Identify specific pollutants, if known: Highway runoff:
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type; average width): Woody, >50 ft.
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Pick
..................................:.
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick Dist floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: PiCk_List
........................
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (YIN) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: The tributary has
the capacity to carry pollutnats or flood waters to TNWs, or to reduce the amount of pollutnats or flood waters reaching a TNW.
The tributary does not provide habitat and lifecycle support functions for fish and other species, such as feeding, nesting,
spawining, or rearing young for species that are present in the TNW. The tributary does have the capacity to transfer nutrients and
organic carbon that support downstream foodwebs. The tributary may have other relationships to the physical, chemical, or
biological integrety of the TNW which were not observed.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS[WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
E] TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: Scored above 19 on NCDWQ Stream ID.
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 2,572 linear feet 1.5 to 4 width (ft).
Q Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: 2,572 linear feet 1.5 to 4 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that now directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
l Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):lo
(] which are or could be used by interstate or foreign travelers for recreational or other purposes.
8See Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
° Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA FIQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
?from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
?'; Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
?'', Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
?, Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required forjurisdiction (check all that apply):
?'', Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
13 Data sheets prepared by the Corps:
? Corps navigable waters' study:
{ U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
® USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 39.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
? State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785 I OOJ, June 18, 2007, Panel 785 1 J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ® Other (Name & Date): Photo 10, Crossing 10.
Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
? Applicable/supporting scientific literature:
Other information (please specify):
STREAM QUALITY ASSESSMENT WORKSHEET
M=1
Gra55?d1? `-_
vide the following information for the stream reach under assessment:
1. _.pplicant's name: i4azeRa 4y ? ?r? i i• ?91c3t i? 1 2. Evaluator's name: JO?W 7- ?50c4Aizp
3. Date of evaluation: 2 7 P164 '2/ 001 4. Time of evaluation:
S. Name of stream: 07 46 6. River basin:
7. Approximate drainage area: I B's aG S. Stream order. J
9. Length of reach evaluated. 3 00 10. County: (::"7UJ'I 4-
I1. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): 0?
Latitude (ex. 34.872312): a?°? fl 8Z' Longitude (ex. -77.556611): T5, 8 3 0
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS GIs other 6u "l-ro ? el
?,of reach under evaluation (note nearby roads and landmarks and attach map identifying streappnks)aa location):
13. Location
?Jt a of {?aA o `i c a r -/ ? F ° o (g 2 k? ! v
14. Proposed channel work
I Recent weather

W.A

16. Site conditions at time of visit Dal f b t??Fj'1 e'10 u d 5 v
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)
1S. Is there a pond or lake located upstream of the evaluation point`.' YES NO If yes, estimate the water surface area:
"k Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
Estimated watershed land use: (JP, 5 % Residential % Commercial % Industrial 21 . 8 % Agricultural
401, $ % Forested 3.8 % Cleared I Logged % Other ( )
BankM 22. width: 1.15 23. Bank height (from bed to top of bank): 4.5
24. Channel slob 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 (!orated 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 worlLsheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
charmAeaistic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
conmumt 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): 4?e Comments:
A. T
Evaluator's Signature' Date
his chsnnel evaluation form ' intended to be used only as a guide to assist landowners and environmental professionals in
.thering 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 06103. To Cormnent, please call 919-976-W] x 26.
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Photo 7b: Randleman Feeder Main, Stream Crossing #7b, Looking downstream from
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 11
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent; Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 2623-2631 Long acre Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.99644 Long: -79.83891 (Decimal Degrees)
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing #I I
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.99644'N, Long. -79.83891'W.
Universal Transverse Mercator: 17 0604633.749 E, 3983961.090 N (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
Pick .... _.___.
There List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): 1
rl. TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters: (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
0 Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 4,027 linear feet: 2-8 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on:
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable) :3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
3 Supporting documentation is presented in Section III. F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.I for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 213 ac3res,
Drainage area: 96.8 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through 2 tributaries before entering TNW.
Project waters are 5-10, river miles from TNW.
Project waters are I (ur_less) river miles from RPW.
Project waters are 2- aerial (straight) miles from TNW.
Project waters are 1(or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5: Seasonal RPW a flows to RPW b (Hickory Creek), which flows into TNW (Deep River).
Tributary stream order, if known: 1.
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ® Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 8 feet
Average depth: 2.5 feet
Average side slopes: 24
Primary tributary substrate composition (check all that apply):
? Silts ® Sands ? Concrete
® Cobbles ® Gravel ? Muck
® Bedrock ? Vegetation. Type/% cover: Mixed hardwoods, 100%
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Considerable bedrock, stable banks.
Presence of run/riffle/pool complexes. Explain: Well developed riffle/pool .
Tributary geometry: Meandering
Tributary gradient (approximate average slope): 2-4 %
(c) Flow:
Tributary provides for: Se a' l'flo'
Estimate average number of flow events in review area/year: 20 (or greater)
Describe flow regime: Storm events with ground water runoff between, pools semipermanent .
Other information on duration and volume: Not observed.
Surface flow is:
Characteristics:
Subsurface flow: Unknown. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil
? shelving
® vegetation matted down, bent, or absent
® leaf titter disturbed or washed away
® sediment deposition
® water staining
? other (list):
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
® the presence of litter and debris
? destruction of terrestrial vegetation
® the presence of wrack line
® sediment sorting
® scour
? multiple observed or predicted flow events
? abrupt change in plant community
ine lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum:
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Water clear, not films or odors.
Identify specific pollutants, if known: Agricultural and possible industrial.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Mixed hardwoods, >50 ft.
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
......................
Surface flow is: Pick gist
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick. List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the now
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
M TNWs: linear feet width (ft), Or, acres.
0 Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: Not on USGS topo map, is on USDA, SCS, Soil Survey map, had pools but no flow at time of visit.
Provide estimates forjurisdictional waters in the review area (check all that apply):
Tributary waters: 4,027 linear feet 2-8 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
[1 Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Q Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TN-Ws.
F1 Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
Asa general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Q Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
which are or could be used by interstate or foreign travelers for recreational or other purposes.
E from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
0 which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
n! Other factors. Explain:
Identify water body and summarize rationale supporting determination:
"See Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
0 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
?, Tributary waters: linear feet width (ft).
? Other non-wetland waters: acres.
Identify type(s) of waters:
?', Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
Q If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
?Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
?Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
?Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
01 Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
? Data sheets prepared by the Corps:
Corps navigable waters' study:
?U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
{ U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
{ USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 33.
® National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785 100.1, June 18, 2007, Panel 785 1J.
? 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
?', Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature:
? Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
'i STREAM QUALITY ASSESSMENT WO BEET - r 4 -
, Me
4 --ovide the following information for the stream reach under assessment: ro Ss; V-? &7
QT{ "?
applicant's name: nq Zer aA2 -1-54yi lf er EY' ; 0 CerD r
? 2. Evaluator's name:
4
3. Date of evaluation: 27 N 4. Time of evaluation:
5. Name of stream: 6. River basin: t,_^0
7. Approximate drainage area: & Stream order.
9. Length of reach evaluated: 10. County: 6 /.1 + / For d
11. Site coordinates (if known):: prefer in decimal degrees. 12. Subdivision name (if any):
LatiftKb (ex 34.872312): Longitude (ex 77.556611): - 7 1:5 -3 811 9
blethod lotion determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Ot?h?er GISS Other G0,40 rol C'U -
13. Location of reach under evaluation (note nearby roads and landmarks and attachidentifying stream s) location):
Im VA t k^: -'T Wu-&Pe --tv 0J eess: Z ?p 2 3 - 2 49 3 I L o» q X94; A .
4f
5 r v'?
14. Proposed c tl work (if any): 'Rl)r + 1c®M !') 4 '1° F-e -eClt°f` or)
15. Recent weather conditions: ?? ?-k rG J ?e?? y ;= li

16. Site conditions at time of
17. Identify any special waterway classifications known:
Trout Waters Outstanding Resource Waters _
I& Is there a pond or lake low upstream of thee--evaluati,
19. Dais channel appear on USGS quad map? (YESJ NO
Estimated watershed land use: +18 % Residential
33.5 % Forested
r
Section 10 Tidal Waters Essential Fisheries Habitat
_ Nutrient Sensitive Waters ? Water Supply Watershed t (I-IV)
3n point? ?No If yes, estimate the water surface arm: 3 . - Q C-
20. Does channel appear on USDA Soil Survey? YES NO
- % Commercial J4--t9 % Industrial Zl -3 % Agricultural
5,+ % Cleared / Logged - % Other ( )
l
22. Bankfull width: 8> 23. Bank height (from bed to top of bank): 2,5/
24. Channel slope down center of stream: Flat (0 to 20%) 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 pourts
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
chmacteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring lox 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 fi-orn 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): Lo Comments:
Evaluator's Signature Date
-Nis channel evaluation form is ' ded to be used only as a guide to assist landowners and environmental professionals in
Jwrmg the data required by the United Sues 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 919-976-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
Jl !? MAn 1--VVb7QT7!1CC
1 Presence of flow / persistent pools in stream 0-5 0-4 0 - 5 3
no flow or saturation = 0• strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5
S
extensive alteration = 0• no alteration = max points)

3 Riparian zone
0-6
0-4
0-5
no buffer = 0; conti ous, wide buffer = max oints
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
L?-
(extensive discharges = 0; no discharges = max points)
5 Groundwater discharge 0-3 0-4 0-4
Q
no discharge = 0• springs, sees wetlands, etc. = max points)
.. Presence of adjacent floodplain
0-4
0-4
0-2
Z
no flood lain = 0• extensive flood lain = max points)

7 Entrenchment / floodplain access
0-5
0-4
0-2
3
(deeply entrenched = 0 frequent flooding = max points)

8 Presence of adjacent wetlands
j
0-6
0-4
0-2
no wetlands = 0• large ad
acent wetlands = max points)
9 Channel sinuosity 0- 5 0-4 0-3
4-
extensive channelization = 0; natural meander = max ints
10 Sediment input 0-5 0 - 4: 0-4
?
-
extensive
deposition= 0• little or no sediment = max points)

11 Size & diversity of channel bed substrate
NA
0-4?
0-5
fine homogenous = 0• large, diverse sizes = max is ,

12 Evidence of channel incision or widening
0 - 5
0 - 4
0 - 5
(deeply incised = 0• stable bed & banks = may " mts _

13 Presence of major bank failures
0-5
0-5
0-5
severe erosion = 0; no erosion, stable banks = max points)

14 Root depth and density on banks
0-3
0-4
0-5 3
no visible roots = 0 dense roots throughout = max points)

15 Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
>.. substantial impact ?; no evidence = max points)

16 Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6

rj
no riffles/ripples or pools = 0• well-developed = max points)

l Habitat complexity 0- 6 0-6 0-6
little or no habitat = 0; frequent, varied habitats = max points)
18 Canopy coverage over streambed 0-5 0-5 0-5
rj
no shading vegetation = 0• continuous canopy = max points)
19 Substrate embeddedness +? 0 - 4 0-4
Lt
(deeply embedded = 0• loose structure = max

ti
20 Presence of stream invertebrates (see page 4)
0-4
0-5
0-5 I
no evidence = 0• common numerous types = max omts

21 -Presence of amphibians
0-4
0-4
0-4
b
?j ; no evidence = 0; common, numerous types = max points)
?.•:
22 Presence of fish
0-4
0-4
0-4
D
t* no evidence = 0; common ,numerous types = max points)

23 Evidence of wildlife use
0-6
0-5
0 5
no evidence #;0; abundant evidence = max points)
i'otal omts fosse j 00
100
100
:q

TOTAU SCURE f also enter an gage) ? ? (p?
* These characteristics are not assessed in coastal streams.
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RANDLEMA N
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\ Environmental Engineers & Scientists
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 12
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 2617 Long acre Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 35.99844 Long: -79.83934
10. Quadrangle Name: PLEASANT GARDEN
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
(Decimal Degrees)
The following information will be completed by Corps office:
AID:
Prepare File Folder
Assign number in ORM
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Begin Date
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing # 12
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 35.99844° 1 , Long. -79.83934° W.
Universal Transverse Mercator: 17 0604592.348 E, 3984182.467 N, (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
?'! Office (Desk) Determination. Date:
?', Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
.._.._.__..___....._..__.
There Pick List "navigable waters of the U .S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Q Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): t
Q TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters'` (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Q Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 850 linear feet: 2-6 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Established by 0ftwm
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable) :3
Q Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
z For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
3 Supporting documentation is presented in Section III. F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.I and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.I.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 28.7 acres
Drainage area: 22.4 acres
Average annual rainfall: 50.24 inches
Average annual snowfall: 3.8 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
® Tributary flows through 2 tributaries before entering TNW.
Project waters are 5-10 river miles from TNW.
Project waters are 1(or less) river miles from RPW.
Project waters are 2-5. aerial (straight) miles from TNW.
Project waters are 1 (or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5: RPW a flows to RPW b, which flows to RPW c (Hickory Creek), which flows into TNW
(Deep River).
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West-
5 Plow route can be described by identifying, e. g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
Tributary stream order, if known: 1
(b) General Tributary Characteristics (check all that apply):
Tributary is: ® Natural
? Artificial (man-made). Explain:
® Manipulated (man-altered). Explain: Upper reach has old, breached dam.
Tributary properties with respect to top of bank (estimate):
Average width: 2-6 feet
Average depth: 4 feet
Average side slopes: 2J.
Primary tributary substrate composition (check all that apply):
? Silts ® Sands ? Concrete
® Cobbles ® Gravel ? Muck
® Bedrock ? Vegetation. Type/% cover: Mixed hardwoods, 100%
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Upper reach eroding with headcut, lower
reach relatively stable with cobble and bedrock .
Presence of run/riffle/pool complexes. Explain: Riffle and pool physical features present but not running water at visit.
Tributary geometry: Meandering'
Tributary gradient (approximate average slope): 2-4 %
(c) Flow:
Tributary provides for: Intermittent but not seasonal flow
Estimate average number of flow events in review area/year: 20 (or greater)
Describe flow regime: Storm events.
Other information on duration and volume: Not observed.
Surface flow is: Discrete and confined. Characteristics
Subsurface flow: Unknown. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
? changes in the character of soil ?
? shelving
® vegetation matted down, bent, or absent
® leaf litter disturbed or washed away
® sediment deposition ?
® water staining ?
? other (list):
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
? High Tide Line indicated by: ?
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: Not observed.
Identify specific pollutants, if known: Not known.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWNI that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Mixed hardwood, >50 ft.
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick list aerial (straight) miles from TNW.
Flow is from: PickList.
Estimate approximate location of wetland as within the Pick list floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus. .
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: The tributary has
the capacity to carry pollutants or flood waters to TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW.
The tributary does not provide habitat and lifecycle support functions for fish and other species, such as feeding, nesting, spawning,
or rearing young for species that are present in the TNW. The tributary does have the cajpacity to transfer nutrients and organic
carbon that support downstream foodwebs. The tributary may have other relationships to the physical, chemical, or biological
integrity of the TNW which were not observed.
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
F1 TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Q Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: Listed on NRCS Soils map.
Provide estimates for jurisdictional waters in the review area (check all that apply):
0 Tributary waters: 850 linear feet 2 - 6 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
El, Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
M' Tributary waters: 850 linear feet 2-6 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
C] which are or could be used by interstate or foreign travelers for recreational or other purposes.
8See Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
?from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
?Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
? Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
?', Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
?', Lakes/ponds: acres.
?'; Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
?j Lakes/ponds: acres.
?', Other non-wetland waters: acres. List type of aquatic resource:
?', Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
® USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, PLEASANT GARDEN.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 33.
National wetlands inventory map(s). Cite name: PLEASANT GARDEN.
State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785100J, June 18, 2007, Panel 7851J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature:
? Other information (please specify):
STREAM QQUAU[TY ASSESSMENT WORKSHEET P--vide the following information for the stream reach under assessment:
_t,plicant's name: 2et!? q E17 X11'7t'e_r_ i 12. Evaluator's name. _ l 0NA] o 5 o yt, '
__rr r
3. Date of evaluation: 'ZJ P? o q ?"0 0 -? 4. Time of evaluation: ? Z
5. Name of stream: UT -tic, WICA"ORl'? drE6VI 6. River basin: 4??Pe, r 04
7. Approximate drainage area: & Stream order:
9. Length of reach evaluated: Z5 ® 10. County: 6ai F-0 reli
-
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):-7
Latitude (ex 34.872312): 3S-f)28,+40 Longitude (ex 77.556611): 5
Method location determined (circle): Cd'S Topo Sheet Ortho (Aerial)Photo/GIS Other GIS
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
Aea ejf^- Laa,t LDriq acre ,
r
14. Proposed channel work (if any): Ra-. 41,--mvy vi n yy W gees wee dew
15. Recent weather conditions: -L) W ;4k yecat i , e G9in +he- do befye.
16. Site conditions at time of visit; COC 4 , ;l
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)
I& Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey . YES O
watershed land use: 51t% Residential -- % Commercial -' % Industrial -- % Agricultural
,stimated ' Z , rz % Forested - % Cleared / Logger - % Other ( )
22. Bankfidl width: Z + 23. Bank height (from bed to top of bank): t
24. Channel slope down center of stream: Flat (0 to 21/6) ? Gentle (2 to 41/6) Moderate (4 to 100/6) Steep (>1(N)
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 ecoregiom 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 workshy. 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 Date 2T tid goo +
"''riis channel evaluation form is ' ded to be used only as a guide to assist landowners and environmental professionals in
,tiering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
gualW. 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 919-576-8441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
SCORE ON POINT
CE
RAl:_

CHARACTERISTICS

l P
n

ii
?t
M SCORE
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# .
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onn
s
_;

1 Presence of flow / persistent pools in stream
0-5
0-4
0-5

p
no flow or saturation = 0; strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5
3
extensive alteration = 0; no alteration = max points)

3 Riparian zone
0-6
0-4
0-5 L ?
no buffer = 0• contiguous, wide buffer = max points) l
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
extensive discharges = 0• no discharges = max points)
5 Groundwater discharge 0-3 0-4 0-4
no discharge = 0; springs, seeps, wetlands, etc. = max points)

6 Presence of adjacent floodplain
0-4
0-4
0-2
? no #1 lain = 0• extensive flood lain = max points)
' Entrenchment / floodplain access 0-5 0-4 0-2
_ (deeply entrenched = 0• frequent flooding = max points)
8 Presence of adjacent wetlands o-6 0-4 0-2
Q
no wetlands = 0; large adjacent wetlands = max points)
9 Channel sinuosity 0- 5 0-4 0-3
extensive channelization = 0• natural meander = max points) .
10 Sediment input 0-5 0-4 0-4
extensive deposition--- 0• little or no sediment = max points)
11 Size & diversity of channel bed substrate
A* ?
0-4
0-5

-Z 7 fine homogenous = 0• large, diverse sizes = max oints
a s' Evidence of channel incision or widening
0
5
0-4
0-5
3
12 (deeply incised = 0• stable bed & banks = max points) -

13 Presence of major bank failures
0-5
0-5
0-5
severe erosion = 0; no erosion, stable banks = max points)
14 Root depth and density on banks 0-3 0-4 0 - 5
no visible roots = 0; dense roots throughout = max points)

15 Impact by agriculture, livestock, or timber production 0-5 0-4 0-5
substantial impact =0; no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 7

(no riffles/ripples or pools = 0• well-developed = max points) -

17 Habitat complexity 0-6 0-6 0-6
S
(little or no habitat = 0; frequent
varied habitats = max points)

18 ,
Canopy coverage over streambed
0 5
0 - 5
0 - 5
C?
no shading vegetation = 0• continuous canopy = max points)
19 Substrate embeddedness ? ' p _ 4 0-4
(deeply embedded = 0; loose structure = max

20 Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
Q

r no evidence = 0• common, numerous types = max points)
5
21 Presence of amphibians
o- 4
0-4
0 - 4
D
no evidence = 0; common, numerous types = max points)

-1 1,
0.
22 Presence of fish
0-4
0-4
0-4

D
v-r no evidence = 0• commo numerous types = max points)
Evidence of wildlife use
23
0-6
0-5
0-5

3
no evidence = 0; abundant evidence = max points)
le E
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* These characteristics are not assessed in coastal streams.
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 13
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 2620 Long acre Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 36.00292 Long: -79.84083 (Decimal Degrees)
10. Quadrangle Name: GREENSBORO
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing # 13
State: North Carolina C ounty/parish/b o rough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 36.00292°N, Long. -79.84083°W.
Universal Transverse Mercator: 17 0604452.141 E, 3984677.786 N, (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear/ Deep, HUC: 03030003
0 Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
E]', Office (Desk) Determination. Date:
0 Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RUA SECTION 10 DETERMINATION OF JURISDICTION.
..........._....._._._
There Pi List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
El, Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick List "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):
TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters'` (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
0 Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 2,416 linear feet: 3 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Rsti#bllisl?ed by ORW1VI
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable):3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section QLC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW':
Tributary stream order, if known:
Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to tlow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that applv):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick Mist.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
_ ..............
Tributary provides for: Pick Lust
Estimate average number of flow events in review area/year: Pick List
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
F-1 Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
Q High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
me lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known,:
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick ListCharacteristics:
Subsurface flow Pick List Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
Q Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS topo map, on USDA, SCS, Soil Survey map, flowing during extreame drought of 2007.
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 2,416 linear feet 3 width (ft).
0 Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
El Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
S. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
0 Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of ajurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Q Demonstrate that water meets the criteria for one of the categories presented above (1-6). or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
Q which are or could be used by interstate or foreign travelers for recreational or other purposes.
n from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
[] which are or could be used for industrial purposes by industries in interstate commerce.
[]. Interstate isolated waters. Explain:
©. Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
' To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
Q'. Tributary waters: linear feet width (ft).
0 Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
?! Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
[ Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Q Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Q Lakes/ponds: acres.
Q Other non-wetland waters: acres. List type of aquatic resource:
[] Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Q Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
[3 Lakes/ponds: acres.
0, Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Q Data sheets prepared by the Corps:
Corps navigable waters' study:
?' U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, GREENSNORO.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 33.
National wetlands inventory map(s). Cite name: GREENSBORO.
Q State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785200J, June 18, 2007, Panel 7852J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: E] Aerial (Name & Date):
or ? Other (Name & Date):
? Previous determination(s). File no. and date of response letter:
?, Applicable/supporting case law:
0 Applicable/supporting scientific literature:
Q Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM QUALrrY ASSESSMENT WORKSHEET
P-vide the following information for the stream reach under assessment:
_J 0 4 P1 -T:
.pplicant s name: 0 a Z >^ OVId ?30 asp I e r q10L,Cre Yn? 2. Evaluators name: s • r?`;" `'?
3. Date of evaluation: 4. Time of evaluation: G
5. Name of stream: 6. River basin: ipa J Deed'
7. Approximate drainage area: . ' & Stream order: d
9. Length of reach evaluated: Z-> 10. County: G? u,'`?a r'
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision mane (if any):
Latitude (ex_ 34.872312): ?? • cs longitude (ex 77.556611): -745, 06 70Method for ion determi ai (circle): GI'S Tops Sheet Ortho (Aerial) 1'hotolGlS r GIS Other 64-' ar J CDO dA c
13. Location of reach under evaluation (note nearby roads and landmarks and attar map identifying stream(s) location):
r s ???? ?l5 2Z? SY?? P ZcP2® LoY??Yr
14. Proposed channel work (if any): R0 r)d 1eYY1G9 * Raw c t 3 / eed er° Cop sT f y c`- ° b it ,
15. Recent weather conditions: L r y f?) f e ,-4 f a iri !) t Gt aK be_t`c_
16. Site conditions at time of visit: G 0' o h r q <-- dZ)% d s
17. Identify any special waWrway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters t'Water Supply Watershed (I-IV)
M Is there a pond or lake located upstream of the evaluation point? YES ONO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
Estimated watershed land use: % Residential 0-40- % Commercial 10 .'? % Industrial - % Agricultural
1 4S A % Forested 4-6 % Cleared / Logged *Z53% Other ( Tr SS
22. BankfW1 width: 7J 23. Bank height (from bed to top of bank): 2
24. Channel slope down center of stream: Flat (0 to 2%) t? Gentle (2 to 4%) Moderate (4 to 100/.) Steep (>1(M)
sinuous Braided channel
25. Cltaaaaael sinuosity: ----Straight Occasional bends ? Frequent meander Very
instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, strrom classification, etc_ Every characteristic must be scored using the saute ecoregion. Assign paints
to each characteristic within the range shown fbr 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:
s Bate Z bq z7oomV
Evaluator's Signature
'' channel evaluation form intended to be and only as a guide to assist landowners and environmental professionals in
therinrg the data req ed ffie 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 06103. To Comment, please call 919-876-9441 x 26.
STREAM QUALITY ASSESSMENT WORKSHEET
I%COREG ION P03NT RANGE
#

;
CHARACTERISTICS
.

oastal '

edmod?

om'
SCRE
O
1 11, 1 Presence of flow / persistent pools in stream 0-5 0-4 0-5 2
.1 no flow or saturation = 0; strop flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5
?-
extensive alteration = 0; no alteration = max points)
3 Riparian zone 0-6 0-4 0-5
no buffer = 0; contiguous, wide buffer = max points)
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
extensive discharges = 0; no discharges = max points)
Y S Groundwater discharge 0-3 0-4 0-4
no discharge = 0; springs, seeps, wetlands, etc. = max points)

` 6 Presence of adjacent floodplain
0 - 4
0 - 4
0 - 2
Z
no fllain = 0• extensive flood lain = max points
Entrenchment / flood
lain access
7 p 0-5 0-4 0-2 Z
(deeply entrenched = 0; frequent flooding = max points)
8 Presence of adjacent wetlands 0-6 0-4 0-2
no wetlands = 0; large adjacent wetlands = max points)
9 Channel sinuosity 0-5 0-4 0-3
L?-
(extensive channelization = 0; natural meander = max points)
10 Sediment input 0-5 0-4 0- 4 7 -
(extensive deposition= 0; little or no sediment = max points)
11 Size & diversity of channel bed substrate NA* 0-4 0-5
Li-
fine homogenous = 0• large, diverse sizes = max points)

12 Evidence of channel incision or widening
0-5
0-4
0-5
(deeply incised = 0• stable bed & banks = max points)
Presence of major bank failures 0-5 0-5 0-5

41 severe erosion = 0• no erosion, stable banks = max points)
14 Root depth and density on banks

no visible roots = 0• dense roots throughout = max points) 0-3 0-4 0-5
L!-

15 Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
substantial impact ?• no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0- 6 5
no riffleshi les or pools = 0; well-developed = max points)
i
w
1 Habitat complexity
(little or no habitat = 0; frequent, varied habitats = max points)
0-6
0-6
0-6

S
_

18
Canopy coverage over streambed

no shading vegetation = 0; continuous canopy = max points)

0
5

-5

-5
19 Substrate embeddedness NA* 0-4 0-4
(deeply embedded = 0; loose structure = max

20 Presence of stream invertebrates (see page 4)
0-4
0-5
0-5 Z
no evidence = 0• common, numerous types = max points)
Presence ofam
hibians
21 p 0-4 0-4 0-4 Q
no evidence = 0; common, numerous types = max points)

22 Presence of fish
0-4
0-4
0-4
O
?-r= no evidence = 0; common, numerous types = max points)

23 Evidence of wildlife use
0-6
0-5
0 5
no evidence = 0; abundant evidence = max points)
Total Pont(s Posble 100 00 Otl

TOTAL SCURF, ??tl3o eFIt?I' on; fi rst ?ag?) • C X ?
* These characteristics are not assessed in coastal streams.
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 14
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: 3910 S Holden Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 36.00446 Long: -79.84166
10. Quadrangle Name: GREENSBORO
11. Waterway: Unnamed Tributary to Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
(Decimal Degrees)
The following information will be completed by Corps office:
AID:
Prepare File Folder
Authorization:
Assign number in ORM
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Begin Date
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing # 14
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 36.00446° N, Long. -79.84166° W.
Universal Transverse Mercator: 17 0604375.306 E, 3984847.771 N, (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
[] Office (Desk) Determination. Date:
0 Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
_........_...___.__...__..
There Pick List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
[] Waters subject to the ebb and flow of the tide.
F1 Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Pick Last "waters of the US." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): '
Q TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
F1 Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 450 linear feet: 2-5 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: Established; by C>71Tt?'M
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable):3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least -'seasonally"
(e.g., typically 3 months).
3 Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.I and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) now, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that applv):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: I?tck Ltst
Estimate average number of flow events in review area/year: Pick List
Describe flow regime:
Other information on duration and volume:
................................
Surface flow is: Pick List. Characteristics:
.................... _._..........
Subsurface flow: Pick List. Explain Findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
Q High Tide Line indicated by: 0
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ne lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film: water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
.... _.__ .................
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis. Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
Q TNWs: linear feet width (ft), Or, acres.
Q Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: Flowing during extreame drought of 2007, fish present.
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section 111.13. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 450 linear feet 2-5 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
?' Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
[ Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
which are or could be used by interstate or foreign travelers for recreational or other purposes.
[] from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
Q which are or could be used for industrial purposes by industries in interstate commerce.
Q Interstate isolated waters. Explain:
Q Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
?', Wetlands: acres.
NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
?'; Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
?Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
?' Other non-wetland waters: acres. List type of aquatic resource:
?Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
?Data sheets prepared by the Corps:
Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
® USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24.000, GREENSBORO.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 33.
National wetlands inventory map(s). Cite name: GREENSBORO.
? State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785200J, June 18, 2007, Panel 7852J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ® Other (Name & Date):Photo 14, Randleman Feeder Main, Stream Crossing # 14, looking upstream, 4/16/08.
Previous determination(s). File no. and date of response letter:
?I Applicable/supporting case law:
Applicable/supporting scientific literature:
? Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM LW.791 QUALITY ASSESSNT WORKSHEET
-,
a
Provide the following information for the stream reach under assessment: Cro 55in 9 g
.
Applicant's name: q:: ? 5..1tAl- xps- 2. Evaluator's name: -J-04M T '50 U . "R?
ri
3. Date of evaluation: /?" ij?jr l ZoD3 4. Time of evaluation: 7 t? s d A
5. Name of stream: 01 40 i?ka ?fi° h-- 6. River basin: C?PPe- . Fe--,,r 0'563 ®®os
7. Approximate drainage area: 8. Stream order:
9. Length of reach evaluated: 10. County: 614 0'40 rJ
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): MGN\ S
Latitude (ex. 34.872312): 3 C-0• ®e)4 Longitude (ex. --77.556611): - q S • 6 4149 LQ
Method location determined (circle): GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIs Otlter ??/a?l?d??I5
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
n, P-
14. Proposed channel work (if any): a nJitrylo; r) Feeder Mai 'n
.4 _1'4 ?D3A,-
a" f1'?vre
15. Recent weather conditions: t i'
166 Site conditions at time of visit aj -U /7 no Or
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-I?
1& Is there a pond or lake located of the evaluation point? YES NO If yes, estimate the water surface area: CC,
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES NO
Estimated watershed land use: ®/o Residential 4-75-1 % Commercial % Industrial % Agricultural -46 8 B5 % Forested % Cleared / Logged Z L 1 % Other ( 14WY_ $- )
22. Bankfiill width: .4 23. Bank height (from bed to top of bank): e
24. Channel slope down center of stream: -Flat (0 to 2%) Gentle (2 to 4%) ? Moderate (4 to 100%) 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 ecor5egion. 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 worksheeL 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.
3 -f
Total Score, (from reverse):
a 'Ue, 14.
r 2
Ir`€'?P! A.?a I ems: ? ???_ tllid ?'Y6QttffDdf 5 f t?e?°l ????? ????ta?a?_ _T sdTfi? ? @?1??. "J?L&e','«!0
Evaluator's Signature Rate t
assist landowners and e>avironmental professionals is
This channel evaluation fo a intended to be used only as a guide to
'Athering 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
NNW ?Yi4

L; 4. 1 a `fi'L ?i. ?.1-tS`4 `FP's • 17 55 } .-_i b L ?1 i. 1_
1 Presence of flow / persistent pools in stream 0-5 0-4 0-5
no flow or saturation = 0• strong flow = max points)
2 Evidence of past human alteration 0-6 0-5 0-5
extensive alteration = 0• no alteration = max points)

3 Riparian zone
0-6
0-4
0-5
no buffer = 0• contiguous, wide buffer = max points)
Evidence of nutrient or chemical discharges
4 0- 5 0- 4 0- 4 3
extensive discharges = 0• no discharges = max points)
Groundwater discharge
5 0-3 0-4 0-4
no discharge = 0• springs, seeps, wetlands etc. = max oints
FVi Presence of adjacent floodplain
6 0 - 4 0 - 4 0 - 2
G no flo lain = 0• extensive flood lain = max points
. 7 Entrenchment/ floodplain access 0- 5 0- 4 0-2
` : dee 1 entrenched = 0• frequent flooding = max points)
Presence of adjacent wetlands
8
j 0-6 0-4 0-2
no wetlands = 0; large ad
acent wetlands = max points)
Channel sinuosity
9 0-5 0-4 0-3
extensive channelization = 0• natural meander = max points)
10 Sediment input 0-5 0-4 0-4
extensive deposition= 0• little or no sediment = max points)
z
Size & diversity of channel bed substrate
11 fi
= 0• l
h
di
i
=
i sNA 0 - 4 0 - 5
ne
omogenous
arge,
verse s
zes
max po
nts

12 Evidence of channel incision or widening
5
0
4
0
0-5 Q
(deeply incised = 0• stable bed & banks = max points) - -

13 Presence of major bank failures
0-5
0-5
0 - 5 O
severe erosion = 0• no erosion stable banks = max points)
Root depth and density on banks
14 0-3 0-4
0-5
no visible roots = 0• dense roots throughout = max points)
'
1 Impact by agriculture, livestock, or timber production
0
5
5 0-5 0-4 -
substantial impact -0• no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0-3 0-5 0-6 3
no riffleshi les or pools = 0• well-developed = max points)

17 Habitat complexity

0-6

0-6

0-6
` the or no habitat = 0• fruent varied habitats = max points)

18 Canopy coverage over streambed 0
5 0
5 0-5
?
=
i
h
•
di
i - - J
no s
0
cont
a
ng vegetat
on
nuous canopy = max points)
19 Substrate embeddedness 0-4 0-4
d eeply embedded = 0• loose structure = max
Presence of stream invertebrates (see page 4)
20 0 - 4 0 - 5 0 -5
no evidence = 0• common, numerous types = max points)

21 Presence of amphibians
0-4
0-4
0-4
no evidence = 0• common, numerous types = max points)
Presence offish
22 0-4 0-4 0-4
Z
-? no evidence = 0• common, numerous types = max points)
Evidence of wildlife use
23 0-6 0-5 0-5 Z
no evidence = 0• abundant evidence = max points)
W
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Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: RANDLEMAN FEEDER MAIN, Stream Crossing # 15
2. Name of Property Owner/Applicant: City of Greensboro / Hazen and Sawyer Environmental
Engineers & Scientists
3. Name of Consultant/Agent: Habitat Assessment and Restoration Program / John T. Soule
4. Related/Previous Action ID number(s): None
5. Site Address: Adjacent to 2361 Campground Road
6. Subdivision Name: None
7. City: Greensboro
8. County Guilford
9. Lat: 36.00445 Long: -79.84273
10. Quadrangle Name: GREENSBORO
11. Waterway: Hickory Creek
12. Watershed: Cape Fear / Deep, HUC: 03030003
13. Requested Action:
Nationwide Permit #
General Permit #
X Jurisdictional Determination Request
Pre-Application Request
(Decimal Degrees)
The following information will be completed by Corps office:
AID:
Prepare File Folder
Authorization:
Assign number in ORM
Section 10 Section 404
Project Description/ Nature of Activity/ Purpose:
Begin Date
Site/ Waters Name:
Keywords:
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: Randleman Feeder Main, Stream Crossing # 15
State: North Carolina County/parish/borough: Guilford City: Greensboro
Center coordinates of site (lat/long in degree decimal format): Lat. 36.00445° N, Long. -79.84273° .
Universal Transverse Mercator: 17 0604278.884 E, 3984845.456 N, (NAD 27)
Name of nearest waterbody: Hickory Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Deep River
Name of watershed or Hydrologic Unit Code (HUC): Cape Fear / Deep, HUC: 03030003
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Plek List "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
Waters subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): r
TNWs, including territorial seas
Q Wetlands adjacent to TNWs
Relatively permanent waters: (RPWs) that flow directly or indirectly into TNWs
[, Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
0 Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 2,750 linear feet: 3-9 width (ft) and/or acres.
Wetlands: 0 acres.
c. Limits (boundaries) of jurisdiction based on: E+"'st#b1toedby QI?
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable) :3
Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
'' For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.&, typically 3 months).
3 Supporting documentation is presented in Section III.F.
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody' is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick Last
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: 1'ckLis>
Estimate average number of flow events in review area/year: Pick Ligt
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow: Pick tisi. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
F-1 Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by:
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
ine lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Dick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: PkList
Approximately ( ) acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSIWETLANDS ARE (CHECK ALL
THAT APPLY):
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: On USGS topo map, on USDA, SCS, Soil Survey map, flowing during extreame drought of 2007, fish
present.
Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 2,750 linear feet 3-9 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section 111.13 and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Q Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
[? Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
0 Interstate isolated waters. Explain:
El Other factors. Explain:
RSee Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook-
'" Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
?' Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required forjurisdiction (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? Office concurs with data sheets/delineation report.
? Office does not concur with data sheets/delineation report.
Data sheets prepared by the Corps:
? Corps navigable waters' study:
U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
® USGS 8 and 12 digit HUC maps.
U.S. Geological Survey map(s). Cite scale & quad name: 1:24,000, GREENSBORO.
USDA Natural Resources Conservation Service Soil Survey. Citation: Soil Survey of Guilford County, NC, Dec. 1977, Sheet 33.
National wetlands inventory map(s). Cite name: GREENSBORO.
State/Local wetland inventory map(s):
FEMA/FIRM maps: Map # 3710785200J, June 18, 2007, Panel 7852J.
100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ? Aerial (Name & Date):
or ® Other (Name & Date):Photo 15, Randleman Feeder Main, Stream Crossing # 15, Looking upstream, 4/16/08.
? Previous determination(s). File no. and date of response letter:
Applicable/supporting case law:
Applicable/supporting scientific literature:
Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
STREAM QUALITY ASSESS NT WORKSHEET Provide the following information for the stream reach under assessment: Cr®5 1 y,
Applicant's name: t to ZeA if
2. Evaluator9s name: ? ?Q,
®®
3. Date of evaluation: ? t-P P a? 1 ?-? 4. Time of evaluation: 2 -P ".
5. Name of stream: ? 9 c k0v (eak 6. River basin: _ _egjaa FOP r z?ee ?/Ild: 4)3050601;
7. Approximate drainage area: 4 g. Stream orders
9. Length of reach evaluated: 3 10. County: c.=-u%l ford
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
Latitude(ex.34.$72312): J?®a??"+s Longitude(ex_-77,SW11): -°+4=,° E5 7--4 E
Method location determined (circle): GPS Tops Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13.?gLocation /of reach ;ugnder aluation (note nearby (roa pds and landmarks and attach map identifying
?jsttream(s) location):
p? ?y
r `o 3. ?? @ b?C ralJor6ir b i?bt?k? ?,Letan ®?''.{ Y a ro6° Ad'
n. 46 zJ n
t
14. Proposed channel work (if any):
15. Recent weather
16. Site conditions at time of
'es- Map'n

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)
1& Is there a pond or lake located upstream of the evaluation point? YES,. O If yes, estimate the water surface are :
19. Does channel appear on USGS quad map? (S >,O 20. Does channel appear on USDA Soil Survey? YES O watershed aC? b Agri
Estimated land use: %Residential 33, a%Commercial to % Industrial % cultural
% Forested V7,8 % Cleared / Logged % Other ( )
22. Banldull width: a 23. Bank height (from bed to top of bank):
24. Channel slope down center of stream: lat (0 to 21/6) Gentle (2 to 4%) Moderate (4 to 101%) Steep (>10%)
25. Channel sinuosity: Straight Occasional bands 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 eooregion. 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.
Score (from reverse): Commence
71g- n -,°z° h C> 5 ?'??'_?s rnn f .. DUG Apo i s d4 L! a2aa1 TYa'1°?1r Ps?E•P?rk i ?? ?P`a x
Evaluator's Signatn " APP Bate l ? 1L? F-48
_
-rho channel evaluation fo is Intend to be used only as a guide to assist landowners and environmental professionals in
Altering 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 USAGE approval and does not imply a
particular mitigation ratio or requirement. Fora subject to change - version 06/03. To Comment, please call 91 M76-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET

# '
CHARA
C`!`ERl[STICS ECOREG ZON JOINT MANGE,
CO
.
,.
v o edgno llon?

1 Presence of flow / persistent pools in stream
0 - 5
0 - 4
0 3
no flow or saturation = 0• strop flow = max points
2 Evidence of past human alteration 0-6 0-5 0-5
Lf -
extensive alteration = 0• no alteration = max points)

3 Riparian zone
0 - 6
0 - 4
0 - 5
no buffer = 0• contiguous, wide buffer = max points
4 Evidence of nutrient or chemical discharges 0-5 0-4 0-4
extensive discharges = 0• no discharges = max points)
S Groundwater discharge
no discharge = 0• springs
sees wetlands etc
= max points) 0-3 0-4 0-4
6 ,
.
Presence of adjacent floodplain 0-4 0-4
0-2

3
no flood lain = 0• extensive flood lam = max points) r
s '
Entrenchment / floodplain acce
s ` 0 - 5 0-4 0-2
(deeply entrenched = 0• frequent floodm = max points) ?`' -

8 Presence of adjacent woAands
lli
0
0-4
0-2
O
no wetlands = 0• large adjacent weii
= max rots
9 Channel sinuosity 0-5 0-4 0-3
extensive iftelization = 0• natural meander = max points)
'10 Sediment input 0-5 0-4 0-4
extensive deposition-- 0• little or no sediment = max points)
11 Size & diversity of channel bed substrate 0-4
0-5
fine homogenous = 0• large, diverse sizes = max points)
12 Evidence of channel incision or widening 0 - 5 0-4 0-5
Z
(deeply incised = 0• stable bed & banks = max points)

13 Presence of major bank failures
:
0-5
0-5
0-5
severe erosion = 0 no erosion stable banks = max points)
' 14 Root depth and density on banks
no visible roots = 0• dense roots throughout = max points) 0-3 0-4 0 -5

15 Impact by agriculture, livestock, or timber production
0-5
0-4
0-5

Z
substantial impact ?• no evidence = max points)
16 Presence of riffle-pool/ripple-pool complexes 0- 3 0- 5 0- 6 5
no riffles/ripples les or pools = 0• well-developed = max points)

1 Habitat complexity
0 - 6
0 - 6
0 - 6
(little or no habitat = 0; frequent, varied habitats = max rots

t 1 S Canopy coverage over streambed

no shading vegetation = 0• continuous canopy = max points) 0-5 0-5 0-5
C?
19 Substrate embeddedness vNA 0-4 0-4
3
(deeply embedded = 0• loose structure = max

20 Presence of stream invertebrates (see page 4) '
0-4
0-5
0-5
no evidence = 0• common, numerous types = max points)
5

-

21
Presence of amphibians

(no evidence = 0• common, numerous types = max points)

0-4

0-4

0-4

-Z-
'

l-r
22 Presence of fish

no evidence = 0• commo numerous types = max ints
0-4
0-4
0-4
'Z.
E
id
f
ildlif
v
ence o
w
e use
23
0 - 6 0 - 5 0 - 5
no evidence = 0• abundant evidence = max points

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Perennial Flow. RANDLEMAN FEEDER MAIN
' RPW 15 "*
A r Greensboro, NC
Unnamed Tributary
Perennial Flow # E I'r USGS TOPO MAP
E
GR D
RPW is?lK ENSBORO QUA
st ?? f,
Unnamed Tributary
V
t Perennial Flout y -C, { tit
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Unnamed Tributary '
I: Intermittent Flow w
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S - I Unnamed Tributary
( Seasonal Flow q j
i .? RPWr' 1000 2000 r
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'A >*
Unnamed Tributary
Intermittent Flow j '• `?
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i - Unnamed Tributary
Perennial Flow
RPW
p RANDLEMAN
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i A 4a
t i
.a 3 p ffi , l .. rcr
`.. Stormwater Conveyance
j Ephemeral Flow
1 Non-Jurisdictional C
RANDLEMAN FEEDER MAIN
Greensboro, NC
USGS TOPO MAP
PLEASANT GARDEN QUAD
t a
KAZEN AND SAWYER
R T ?? Environmental Engineers & Scientists FIG 3
Y ` ?44 Pcuwoy'+'ota @ivd, Sule P" Chcdo'le, North Ccroho ',U! 7
3
Hickory Creek
Perennial Flow } i # RANDLEMAN FEEDER MAIN
RPW 1s Greensboro, NC
USDA, SCS, SOIL SURVEY
Unnamed Tributary
3 4 " SHEET # 33
Perennial Flow
RPW
_•,y „
}
85?R _
#I i
Ile
%
r bpi
Unnamed Tributary
`' + A f Perennial Flow
sX <' ~RPW
`
a {? I Unnamed Tributary r
1 ,
f I, ' Intermittent Flow = F ? `
s
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>r ?? ;?? Unnamed Tributary..,I ; at 6:
t`- Jr Seasonal Flow i
11
ao RPW fags t µ.
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I v1/`1 Intermittent Flow L t_' }t 4
.'j { ?':1 r,?`,w. ,1r,•^,•'?`',°?"?? '?.y'...,' • ?,^j 1-?j- RPW
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'? •,? RANDLEMANPerennial Flowf ,Rw
k r,t' 77 RPW
' FEEDER MAIN
1,7
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Stormwater Conveyance
4-rt Ephemeral Flow
r
Non-Jurisdictional ® a i t
dog
t 4
RANDLEMAN FEEDER MAIN
Greensboro, NC
USDA, SCS, SOIL SURVEY ?W _'" `s^ # y..w
SHEET # 39
H - \\ _ ZEN AND SAMER
FIG 6
Environmental Engineers & Scientists
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APR-08-2009 11:26 NC DENR PUBLIC WATER SUPP
919 715 4374 P.08
NIFAA
D E N R
North Carolina Department of Environment and Natural Resources
Division of Environmental Health
Beverly Eaves Perdue Terry L. Pierce
Govemor Director
FUNDING OF NO SIGNIFICANT IMPACT (FONSI)
City of Greensboro Randleman Feeder Main Project
Guilford County, North Carolina.
Dee Freeman
Secretary
The State Environmental Policy Act (G.S. 113A) requires that the Division of Environmental Health determine whether a
proposed major agency action will significantly affect the environment. The City of Greensboro Randleman Feeder Main
Project is such a major action '
In order to determine whether the construction of approximately 44,800 linear feet of 30 and 24 inch pipe placed from the
junction of Coltrane Mill Road and NC 62 in Guilford County to a terminus on McCuiston Road in the City of
Greensboro will cause significant environmental impacts, an environment assessment has been prepared. This
environmental assessment is attached. It contains detailed information on the key issues, including a brief description of
the proposed project and a summary of probable environmental impacts with proposed mitigations. None of the impacts
were found to be significant.
On the basis of the analysis of the impacts as shown in the environmental assessment, no environmental impact statement
(EIS) will be prepared. This FONSI completes the environmental review record. The FONSI and Environmental
Assessment shall be available for inspection and comment for 30 days at the State Clearinghouse.
Summary of FQN51 for publication in the Environmental Bulletin: After completion of an environmental assessment
under G.S. 113A, a FONSI has been made in the case of the City of Greensboro Randleman Feeder Main Project.
Information supporting the need for the proposed project was reviewed, along with relative impacts, other alternative
approaches and mitigating measures. A /-)
?ierce (Date)
Environmental Health
Public Water Supply Section - Jessica G. Miles, Chief
1634 Mail Ssrvice Center, Raleigh, North Carolina 27699-1634
Phone; 918-733-23211 FAX; 919-71543741 Lab Form FAX; 919.716.66371 Internet: nedrinkingwater state ric,us
iii EVA Opportunity %Amrmauve ACUoo Empbyer
One
N hCara ina
turall
J
TOTAL P.08
APR-08-2009 11:24 NC DENR PUBLIC WATER SUPP 919 715 4374 P.02
North Carolina
Department of Administration
Beverly Eaves Perdue, Governor Britt Cobb, Secretary
March 30, 2009
Mr. Jim McRight
N.C. Department of Env. & Nat. Resources
Public Water Supply Section
1634 Mail Service Center
Raleigh, NC 27699
Re: SCH File # 09-1F-4300-0213; EA/FONSI; City of Greensboro Randleman Feeder Maia -
44,800 linear ft of 30 and 24 inch pipe, from junction of Coltrane Mill Rd and NC 62 to
McCuiston Rd in Guilford County
Dear Mr. McRight:
The above referenced environmental impact ini`ormation has been reviewed through the State
Clearinghouse under the provisions of the North Carolina Environmental Policy Act.
Attached to this letter are comments made in the review of this document. Because of the nature.of the
comments, it has been determined that no further State Clearinghouse review action on your part is
needed for compliance with the North Carolina Environmental Policy Act, The attached comments
should be taken into consideration in project development.
Best regards.
Sincerely,
?-7( )
Valerie W. McMillan, Director
State Environmemal Review Clearinghouse
Attachments
cc: Region G
MAR 31700
Mailing Address. Telephone: (919)$07-2423 Loeadan Address:
1301 Mall Service Center Fax [phone] Wes; Jones Stredt
Raleigh, NC 27699-1301 State Courier #51-01-00 Raleigh, North Carolina
e-mail raJa1,ie v.me+nlllan idoa.nc.gov
An Equal Oppurrunilvlrf jfirmarlve Acrion Employer
APR-08-2009 11:25 NC DENR PUBLIC WATER SUPP
4,.swe.
STATE QP NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVEPWOR
February 18, 2009
919 715 4374 P.03
EUCESIE A. C4M' JR
SECRP.TARY
MEMORANDUM TO: Chrys Baggett
NC State Clearinghouse pf?
AdministrativeBuilding, 51h Floor, Room #5
Ff
FROM- John A. (Andy) Bailey
Transportation Engineer
Triad Group, Transportation Planning Branch
SUBJECT:
09-E-4300-0213

These are comments from the NCDOT - Transportation Planning Branch regarding North
Carolina State Clearinghouse of Administration Intergovernmental Review 409-E-4300-0213.
The NCDOT - Transportation Planning Branch would like to make the North Carolina
Department of Environmental and Natural Resources aware that the Greensboro Long Range
Transportation Plan (years 2026-2035) has recommended widening S Holden Rd from I-85
Business to Randleman Drive from two to four lanes. Part of this project is on a new location
and will connect S Holden Rd with Drake Rd.
Please see the attached graphic for a better view of this proposal. If you have any further
questions, please do not hesitate to contact me at 733-4705 or email at [e-mail].
Attachments:
A portion of the 2035 Greensboro Long Range Transportation Plan (See F7)

MAILING AODRBS3: LOCATION:
NIC PEPARTv" OF UAN5F?oRTATJON too TJ P 1 B TRANSPORTATION BU[LOING
TRANSPORTATIQNPLANNING BRANGi TwAhYPOMrar,Ru rLAMN.nO wwsn??y 1SOLITMWILMINGTONSTREET
1554 MAIL SEWA 7= CENTER RALEIGH, NC 27801
RALEIGH NC 27699.1664 h(oYlitc&f.org1bWVprocon91Fuc0#tV phone: [phone]
Fax; 999-733-2417
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APR-08-2009 11:26 NC DENR PUBLIC WATER SUPP 919 715 4374 P.06
NORTIS CAROLINA, STATE CLEARINGHOUSE
DEPARTMT OP ,AM41HISTRATIONN
INTERGOWRIQMWAL REVIEW
STATE t V-1 Qq-E-4390-0213 Rol
DATZ RXC3G1VXD:02/13/2009
A=CSC AXOPO OB; 03/23/2009
PlvaW CLOAND., 03/27/2009
NS KELBA MCGEE
CLEARINGHOUSE COORD
DENR },F(43I5AATIVE AFFAIRS
ARCHDALE FLOG - MSC # 1401
RAIFIGH NC
REVIEW DISTRIBUTION
CM PS - DEM, FMP
DENR LEGISLATIVE AFFAIRS
DEPT or OUL R£SQURCES
DEPT OF TRANSPORTATION
Fiznmw TRM COG
Post it Fax Nate 7671 05' '
From
Co1DOpt Co,
Phone 4 Phone e
Faw a Fie ii
PROJECT INFO MATTON
APPLICANT: N.C. 0$pertment of Env. & Net. Resources
TYPE: stata Etlvironmenta l Policy Act
ERU: Environmental ?QSessmentJ??rtdat+q of No Significant 7mpdct
DESC: City of Greensboro Randlemon Feeder Mair - 44,900 linear ft of ?Q and 24 inch
pipe, from junction of Coltrane Mill Rd and NC €2 to McCuiston Rd in Guilford
County
The attaohad projnot hat been oubmitted to the N. C. 5tace Clearingbause for
intargavernmentol review. 8leaae review and subMit your response by the above
ind{cated data to 1301 HaXj Service Center, Aaleagh HC 27€99-1301.
It additional review time is needed, please conract this offie$ at (919f 807-2425.
F THIZ REVTZW THE FOLLOWING 13 5UBMITTED:
AS A RSy7-1
O COMMENT
OMM
E.NT6 ATTACHED
SIGNED BY:
[7ATF :
APR-08-2009 11:26 NC DENR PUBLIC WATER SUPP 919 715 4374 P.07T
??;YAK'1M?ivt yr Y„riiav1Q-Lx% 11-L--
INTE+RGOVERNMENTAL REVIEW
FCC ?-",
STATE NUMBER: ??- ?9 - 15I ?` 0l
]GATE RECEYVED: 02/13/2009
AGENCY RESPONSE: 03/23/2009
REVIEW CLOSED: 03/27/2009
MS RENEE GLEDHILL-EARLEY
CLEARINGHOUSE COORD
DEPT OF CUL RESOURCES
?D f 0#4 -X4%
ARC91VES-HISTORY BLDG - MSC 4617 ?7
8 9
RALEIGH NC p? If Z'111161
REVIEW DISTRIBUTION ''009 ?rCC&PS - DEM, FMP
DENR LEGISLATIVE AFFAIRS -+o*a?'?`A j,.((,)er1p?
DEPT OF CUL RESOURCES ri LPL;%/ yj
DEPT OF TRANSPORTATION
PIEDMONT TRIAD COG
?3,.a z, ai t'I
PROJECT INFORMATION
APPLICANT, N.C. Department of Env. & Nat. Resources 7??YZ
TYPE: State Environmental Policy Act 1
ERD: Environmental Assessment /Finding of No Significant Impact
DESC: City of Greensboro Randleman Feeder Main - 44,800 linear ft of 30 and 24 inch
pipe, from junction of Coltrane Mill Rd and NC 62 to McCuiston Rd in Guilford
County
The attached project has been submitted to the N. C. State Clearinghouse for
intergovernmental review. Please review and submit your response by the above
indicated date to 1301 Mail Service Center, Raleigh NC 27699--1301.
If additional review time is needed, please contact this office at [phone].
AS A RESULT OF THIS REVIEW THE FOLLOWING IS SUBMITTED:
9 NO COMMENT
F1 COM TS ATTACHED
SIGNED BY:
DATE:' 7 ?'?
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