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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
May 30, 2018
David Bailey
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
JAMES H. TROGDON, [lI
SECRETARY
Re: Reyuest for Preliminary Jurisdictional Determination
TIP No. B-5728; Replace Bridge 112 on NC 87 (North Carolina Highway 87) over
Reedy Fork Creek in Alamance County, North Carolina
Dear Mr. Bailey,
Dewberry Engineers [nc. has been contracted by the North Carolina Department of
Transportation (NCDOT) to execute a jurisdictional waters delineation in Guilford County as a
part of the Group 8 Bridge Replacement projects. NCDOT proposes to replace bridge number
112 on NC 87 (North Carolina Highway 87) over Reedy Fork Creek in Alamance County, North
Carolina (T[P B-5728). Dewberry has determined the limits of jurisdictional waters of the U.S.
(including wetlands) within the boundaries of the site, and is requesting a Preliminary
Jurisdictional Determination (PJD) to confirm those boundaries. Surveys were conducted by
Dewberry scientists using methods outlined in the 1987 Corps of Engineers Wetlands
Delineation Manual and the 2012 Eastern Mountains and Piedmont Regonal Su�plement. Data
to support these decisions are included with this reyuest.
Please contact William A. Barrett with any questions or comments at wabarrett�ncdot.�ov or
[phone].
Thank you,
�(/l�,�i'�-�f . `-L---�'y
William A. Barrett
Environmental Specialist
enc: Jurisdictional Determination Request Form and Preliminary Jurisdictional Determination
Form
Stream [D Forms
Stream Quality Form
Figures I-3
cc: April Norton, DWR
Mail ing Ad�lress:
NC DEPARTMENT O� TRANSPORTATION
ENVIRONMENTAL ANALYSIS UN1T
1548 MAIL SERVICE CENTER
RALEIGH, NC 27699-1598
7elep/roi:e: [phone]
!•i�s: [phone]
Cuslowmr Service: 1-877-368-4968
fvebsi�e: www.ncdot.gov
I.oc[Uio�7:
1000 BIRCH RIDGE DR1VE
RALEIGH, NC, 27610

jurisdictional Determination Request
� ,�
� ,. ,
US Army Corps
of Engineers..
Wilmington Distric[
This form is intended far use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
to the appropriate Corps Field Office (or project manager, if known) via mail, electronic mail, or
facsimile. A current list of counry assignments by Field Office and project manager can be
found on-line at: http://www.saw.usace.arm_y.mil/Missions/Re ug latoryPermitPro_ am.aspx , by
telephoning: 910-251-4633, or by contacting any of the field offices listed below:
ASHEVILLE REGULATORY FIELD OFFICE
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
Version: December 2013 Page 1

jurisdictional Determination Request
1NSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E and F.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part G.
NOTE ON PART D— PROPERTY OWNER AUTHORIZATION: Please be aware that all JD
requests must include the current property owner authorization for the Corps to proceed with the
determination, which may include inspection of the property when necessary. This form must be
signed by the current property owner to be considered a complete request.
NOTE ON PART D- NCDOT REQUESTS: Property owner authorization/notification for JD
requests associated with North Carolina Department of Transportation (NCDOT) projects will be
conducted according to the current NCDOT/LJSACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD may not
be valid for the wetland conservation provisions of the Food Security Act of 1985. If you or
your tenant are USDA Program participants, or anticipate participation in USDA programs, you
should also request a certified wetland determination from the local office of the Natural
Resources Conservation Service, prior to starting work.
Version: December 2013 Page 2

jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: TIP-B5728, NC Hwy 87
City, State:
CoUTlty: Alamance
D]TeCt10riS: From Burlington NC: head North on NC 87 approximately 5 miles until hwy
intersects Reedy Fork Creek
Parcel Index Number(s) (PIN): 8848933219, 8858022192, 8858004885
B. REQUESTOR INFORMATION
Nappe: wi��iam A. Barrett, NCDOT-NES
Mailing Address: 1598 Mail Service Center, Raleigh, NC 27699-1598
Telephone Number: 919-�o�-sios
Electronic Mail Address 1: [e-mail]
Select one:
� I am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant2
❑ Interested Buyer or Under Contract to Purchase
❑✓ Other, please explain.
NCDOT TIP No. B-5728
C. PROPERTY OWNER INFORMATION
Name:
Mailing Address:
Telephone Number:
Electronic Mail Address3:
❑ Proof of Ownership Attached (e.g. a copy of Deed, Counry GIS/Parcel/Tax Record data)
1 If available
2 Must attach completed Agent Authorization Form
3 If available
Version: December 2013 Page 3

jurisdictional Determination Request
D. PROPERTY OWNER CERTIFICATION4
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on-site investigations
and issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction
under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899.
Property Owner (please print)
Property Owner Signature
E. JURISDICTIONAL DETERMINATION TYPE
Select One:
Date
� I am requesting that the Corps provide a preliminarX JD for the property identified herein.
This request does include a delineation.
� I am requesting that the Corps provide a preliminarX JD for the property identified herein.
This request does NOT include a delineation.
� I am requesting that the Corps investigate the property/project area for the presence or
absence of WoUSS and provide an �proved JD for the property identified herein. This
request does NOT include a request for a verified delineation.
� I am requesting that the Corps delineate the boundaries of all WoUS on a property/project
area and provide an �proved JD (this may or may not include a survey plat).
� I am requesting that the Corps evaluate and approve a delineation of WoUS (conducted
by others) on a property/project area and provide an �proved JD (may or may not
include a survey plat).
° For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
5 Waters of the United States
Version: December 2013 Page 4

F.
❑✓
jurisdictional Determination Request
ALL REQUESTS
Map of Property or Project Area (attached). This Map must clearly depict the boundaries
of the area of evaluation.
❑� Size of Property or Project Area � 6•2
I� I
Ce�
acres
I verify that the property (or project) boundaries have recently been surveyed and marked
by a licensed land surveyor OR are otherwise clearly marked or distinguishable.
JD REQUESTS FROM CONSULTANTS OR AGENCIES
(1) Preliminary JD Requests:
❑✓ Completed and signed Preliminarv Jurisdictional Determination Form6.
�✓ Project Coordinates: 36.173074 Latitude -79�510306 Longitude
Maps (no larger than 11 x 17) with Proj ect Boundary Overlay:
❑✓
❑✓
❑✓
�
�
Large and small scale maps that depict, at minimum: streets, intersections, towns
Aerial Photography of the project area
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
6 See Appendix A of this Form. From Regulatory Guidance Letter No. 08-02, dated June 26, 2008
Version: December 2013 Page 5

jurisdictional Determination Request
Delineation Information (when applicable)�:
Wetlands:
� Wetland Data Sheets$
❑�
�
❑✓
Upland Data Sheets
Landscape Photos, if taken
Tributaries:
� USACE Assessment Forms
� Other Assessment Forms
(when appropriate)
Field Sketch overlain on legible Map that includes:
■ All aquatic resources (for sites with multiple resources, label and identify)
■ Locations of wetland data points and/or tributary assessment reaches
■ Locations of photo stations
■ Approximate acreage/linear footage of aquatic resources
(2) Approved JDs including Verification of a Delineation:
� Project Coordinates:
Latitude
Maps (no larger than 11 x 17) with Proj ect Boundary Overlay:
�
❑�
u
�
�
Longitude
Large and small scale maps that depict, at minimum: streets, intersections, towns
Aerial Photography of the project area
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site Plan,
previous delineation maps)
� 1987 Manual Regional Supplements and Data forms can be found at:
http://www.usace.armv.mil/Missions/CivilWorks/Re�ulatorvPro�ramandPermits/re� supp.aspx
Wetland and Stream Assessment Methodologies can be found at:
http://portal.ncdenr.or�/c/document librarv/�et file?uuid=76f3c58b-dab8-4960-ba43-45b7faf06f4c&�roupld=38364 and,
http://www.saw.usace.armv.mil/Portals/59/docs/re�ulatorv/publicnotices/2013/NCSAM Draft User Manual 130318.pdf
a Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 6

jurisdictional Determination Request
Delineation Information (when applicable):
Wetlands:
� Wetland Data Sheets9
❑�
❑�
❑�
Upland Data Sheets
Landscape Photos, if taken
Tributaries:
� USACE Assessment Forms
� Other Assessment Forms
(when appropriate)
Field Sketch overlain on legible Map that includes:
• All aquatic resources (for sites with multiple resources, label and identify)
• Locations of wetland data points and/or tributary assessment reaches
• Locations of photo stations
• Approximate acreage/linear footage of aquatic resources
Supporting Jurisdictional Information (for Approved JDs only)
u
❑�
Approved Jurisdictional Determination Form(s) (also known as "Rapanos
Form(s)")
Map(s) depicting the potential (or lack of potential) hydrologic connection(s),
adjacency, etc. to navigable waters.
9 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 7

jurisdictional Determination Request
I. REQUESTS FOR CORPS APPROVAL OF SURVEY PLAT
Prior to final production of a Plat, the Wilmington District recommends that the Land
Surveyor electronically submit a draft of a Survey Plat to the Corps project manager for
review.
Due to storage limitations of our administrative records, the Corps requires that all hard-
copy submittals include at least one ori�inal Plat (to scale) that is no lar�er than 11 "x 17"
(the use of match lines for larger tracts acceptable). Additional copies of a plat, including
those larger than 11 "x 17", may also be submitted for Corps signature as needed. The
Corps also accepts electronic submittals of plats, such as those transmitted as a Portable
Document Format (PDF) file. Upon verification, the Corps can electronically sign these
plats and return them via e-mail to the requestor.
(1) PLATS SUBMITTED FOR APPROVAL
I-
u
�
I-
❑�
u
�
❑�
Must be sealed and signed by a licensed professional land surveyor
Must be to scale (all maps must include both a graphic scale and a verbal scale)
Must be legible
Must include a North Arrow, Scale(s), Title, Property Information
Must include a legible WoUS Delineation Table of distances and bearings/metes
and bounds/GPS coordinates of all surveyed delineation points
Must clearly depict surveyed property or project boundaries
Must clearly identify the known surveyed point(s) used as reference (e.g. property
corner, USGS monument)
When wetlands are depicted:
• Must include acreage (or square footage) of wetland polygons
• Must identify each wetland polygon using an alphanumeric system
Version: December 2013 Page 8

jurisdictional Determination Request
� When tributaries are depicted:
• Must include either a surveyed, approximate centerline of tributary with
approximate width of tributary OR surveyed Ordinary High Water Marks
(OHWM) of tributary
• Must identify each tributary using an alphanumeric system
• Must include 1inear footage of tributaries and calculated area (using approximate
widths or surveyed OHWM)
• Must include name of tributary (based on the most recent USGS topographic
map) or, when no USGS name exists, identify as "unnamed tributary"
� all depicted WoUS (wetland polygons and tributary lines) must intersect or tie-to
surveyed project/property boundaries
� Must include the location of wetland data points and/or tributary assessment
reaches
� Must include, label accordingly, and depict acreage of all waters not currently
subject to the requirements of the CWA (e.g. "isolated wetlands", "non-
jurisdictional waters"). NOTE: An approved JD must be conducted in order to
make an official Corps determination that a particular waterbody or wetland is not
jurisdictional.
� Must include and survey all existing conveyances (pipes, culverts, etc.) that
transport WoUS
Version: December 2013 Page 9

jurisdictional Determination Request
(2) CERTIFICATION LANGUAGE
� When the entire actual Jurisdictional Bounda .r tv 's depicted:
include the following Corps Certification language:
"This certifies that this copy of this plat accurately depicts the boundary of the jurisdiction
of Section 404 of the Clean WaterAct as determined by the undersigned on this date.
Unless there is a change in the law or our published regulations, the determination of
Section 404 jurisdiction may be relied upon for a period not to exceed five (5) years from
this date. The undersigned completed this determination utilizing the appropriate Regional
Supplement to the 1987 U.S. Army Corps of Engineers Wetlands Delineation Manual."
Regulatory Official:
Title:
Date:
USACE Action lD No.:
� When uplands mav be present within a depicted Jurisdictional Boundar�
include the following Corps Certification language:
"This certifies that this copy of this plat identifies all areas of waters of the United States
regulated pursuant to Section 404 of the Clean WaterAct as determined by the
undersigned on this date. Unless there is change in the law or our published regulations,
this determination of Section 404 jurisdiction may be relied upon for a period not to exceed
five years from this date. The undersigned completed this determination utilizing the
appropriate Regional Supplement to the 1987 U.S. Army Corps of Engineers Wetlands
Delineation Manual."
Regulatory Official:
Title:
Date:
USACE Action ID No.:
Version: December 2013
Page 10

jurisdictional Determination Request
(3) GPS SURVEYS
For Surveys prepared using a Global Positioning System (GPS), the Survey must include
all of the above, as well as:
� be at sub-meter accuracy at each survey point.
� include an accuracy verification:
One or more known points (property corner, monument) shall be located with the
GPS and cross-referenced with the existing traditional property survey (metes and
bounds).
� include a brief description of the GPS equipment utilized.
Version: December 2013 Page 11

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
William A. Barrett, NCDOT-NES, 1598 Mail Service Center, Raleigh, NC 27699-1598
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
Raleigh Regulatory Field Office
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Replace Bridge 112 on NC 87 (NC Hwy 87) over Reedy Fork Creek
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/parish/borough: A�arna�ce Clty: Ossippee
Center coordinates of site (lat/long in degree decimal format):
Lat. 36.173074 °�J; LOng. -79•510306 °�/,
UC11V@I"SaI TI"a1lSV@I"S@ M@I"Cat01": 17S 633973mE, 4004173mN
Nalll@ Of Cl@al"@St Wat@I"bOC�y: Reedy Fork Creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
633 (total) linear feet: 1�5' (R3), s' (R4) width (ft) and/or acres.
Cowardin Class: R3, R4
Stl"@al'71 FIOW: Perennial (R3), Intermittent (R4)
W@tIaC1CIS: NA acres.
COWaI"C�ICI CIaSS: NA
Name of any water bodies on the site that have been identified as Section 10
waters:
Tlda�: None
NOn-Tldal: None
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
❑ Office (Desk) Determination. Date:
� Field Determination. Date(s):
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should 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
app�ICaC1t�COC1SU�tallt: Dewberry Engineers Inc.
❑ Data sheets prepared/submitted by or on behalf of the
appl, i�nt/consultant.
u 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; Ossippee
❑ USDA Natural Resources Conservation Service Soil Survey.
Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/Local wetland inventory map(s):
❑ FEMA/FIRM maps:
� 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:
� Other information (please specify):
2

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre-construction notification" (PCN), or requests verification for a non-reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
3

This preliminary JD finds that there "may be"waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
necessarily been verified bv the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
�
������(. �- _� �=�� �`�l�
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
Amount of
Site Number Latitude Longitude Cowardin Aquatic Class of Aquatic
Class Resources
Resources in
Review Area
Reedy Fork 36.173171 -79.510051 R3 385 linear feet Non-Section 10 —
Creek non-wetland
SC 36.173143 -79.509766 R4 60 linear feet Non-Section 10 —
non-wetland
SD 36.175824 -79.510020 R4 188 linear feet Non-Section 10 —
non-wetland
Reetly Fork Creek was tlagged in the tield as SA
Stream 56 and wetland WA flagged in field and later determined to be beyond study area

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oF NORTH cq9 USGS MAP - HIGH POINT EAST
�� ,� o��� NORTH CAROLINA DEPARTMENT Div: TIP #
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9��� �P ENVIRONMENTALANALYSIS UNIT in Alamance County Feet
���TOFTRPN�'Q�Q TIP Project 6-5728 JULY 2016

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oF NORTry Cq9 JURISDICTIONAL FEATURES MAP Div: TIP #
,�� ,� o�� NORTH CAROLINA DEPARTMENT
� � OF TRANSPORTATION Replace Bridge No.112 on NC 87 � 40� 7 g-572$
o� '�Z DIVISION OF HIGHWAYS over Reedy Fork Creek
m � o PROJECT DEVELOPMENT AND Date:
9��� �P ENVIRONMENTALANALYSIS UNIT in Alamance County Feet
���TOFTRPN�'eoQ TIP Project B-5728 JULY 2016

NC DW Stream Identification Form Version 4.11
Date: _ I) _ 1 ProjecUSite: �
Evaluator: � County:
Total Points: I� Stream Deter
Sfream is at /easf intermittent
if>_ 19 ornerennial if>_ 30*
nterm
� $C Latitude: 3�.�-'3 ��,3
Longitude: ,9.c�97b(A
rcle one) Other OSSi�, 1J�►'
Perennial e.g. QuadName: ��
A. Geomor holo (Subtotal =�•'rJ ) Absent Weak Moderate Strong
18 Continuity of channel bed and bank 0 1 2 3
2. Sinuosity of channel along thalweg 0 2 3
3. In-channel structure: ex. riffle-pool, step-pool, 0 1 2Q 3
ri le- ool se uence
4. Particle size of stream substrate 0 2 3
5. Active/relict floodplain 1 2 3
6. Depositional bars or benches 1 2 3
7. Recent alluvial deposits 1 2 3
8. Headcuts 1 2 3
9. Grade control 0 0.5 1 1.5
10. Natural valley 0 0. 1 1.5
11. Second or greater order channe� No = 0 Yes = 3
............. ............ ..... ..... ......... ...... .................... ... ............
B. Hydrology {Subtotal = �i. s }
12. Presence of Baseflow
13. Iron oxidizing bacteria
14. Leaf litter
15. Sediment on plants or debris
16. Organic debris lines or piles
17. Soil-based evidence of high water table?
C. Biology (Subtotal = '��
2
0.5
1
1
18. Fibrous roots in streambed 3 2 1
19. Rooted upland plants in streambed 3 2 1
20. Macrobenthos (note diversity and abundance) 0 1 2
21. Aquatic Mollusks 1 2
22. Fish 0 0.5 1
23. Crayfish 0 0.5 1
24. Amphibians 0 0.5 1
25. Algae 0 0.5 1
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5 (
*perennial streams may atso be identified using other methods. See p. 35 of manual.
Notes: S�r,ro�.,... -+�1,..�.��. a..�:vb_ �r._ •�» _
Sketch:
��,
�
�
��
�I
/�-- SC.
�
N
Yes = 3
e
3
3
0
1.5
1.5
0
0
3
3
1.5
1.5
1.5
1.5

NC DWQ Stream Tdentification Form Version 4.11
Date: . I�,�� Project/Site: $cJ72$ SD Latitude: �, f-�rJ82
Evaluator: � g -r County: � Longitude: 79 .�j�Oo2(�
Total Points: Stream Det circle one) Other � SS! �, iJC
Stream is at /east intermittent a a Ephemeral Intermitten Perennial e.g. Quad Name:
ifZ 19 ornerennial ifz 30' ���3
A. Geomo holo Subtotal = .'Jr ) Absent Weak Moderate Strong
1a� Continuity of channel bed and bank 0 1 2 3
2. Sinuosity of channel along thalweg 0 1 2 3
3. In-channel structure: ex. riffle-pool, step-pool, � 1 2 3
ri le- ool se uence
4. Particle size of stream substrate 0 1 2 3
5. Active/relict floodplain 0 1 2 3
6. Depositional bars or benches 0 1 2 3
7. Recent alluvial deposits 0 1 2 3
8. Headcuts 0 1 2
9. Grade control 0 0.5 1 5
10. Natural valley 0 0.5 1 1.5
11. Second or greater order channel No = 0 Yes = 3
artificial ditches are not rated; see discussions in manual
B. Hydrology (Subtotal = �
12. Presence of Baseflow
13. Iron oxidizing bacteria
14. Leaf litter
15. Sediment on plants or debris
16. Organic debris lines or piles
17. Soil-based evidence of hiqh water
C. Biolo Subtotal = . 5
18. Fibrous roots in streambed 3 2
19. Rooted upland plants in streambed 3 2
20. MaCrobenthos (note diversity and abundance) 0 1
21. Aquatic Mollusks 1
22. Fish 0 0.5
23. Crayfish 0 0.5
24. Amphibians 0 0.5
25. Algae 0 0.5
26. Wetland plants in streambed FACW = 0.
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sketch:
�
sD
NC 87
�
N
OBL = 1.�" Other =
0
0
3
3
1.5
1.5
1.5
1.5

USACE AID# DWQ # Site #$��indicate on attached map)
;,�„ STREAM QUALYTY ASSESSMENT WORKSHEET ; , . �
Provide the following information for the stream reach under assessment:
1. Applicant's name: �I� ,r7iDi~ 2. Evaluator's name: �•�i�� �� .�.�.`�}�� 1r,o,r.e.
3. Date of evaluation: — � ti— i h 4. Time of evaluation: ti�00
5. Name of stream: �r '�b tk �N��� 6. River basin: ��
7. Approximate drainage area: ZS� fw�,Z 8. Stream order: 3"�
9. Length of reach evaluated: �C-b� 10. County: Q� Aw.�! p_
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any): tJ� �e--
Latitude (ex. 34.872312): 3�1. I L 3 I� I _,� Longitude (ex. —77,55661 I): +! 1•� ���
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):
r^.�If�'��nn �+►t� 1�s['af't� v►�tr b„� _ F�S124 �11'tlZ1 6n�^'l0�` u,p �0�}�80�aY�
T'
14. Proposed channel work (if any): V►�++dt3��rw., ;.:e � ,,,,,,,
•
15. Recent weather conditions: �\A�� ►r�.v. _ �P�v�n . [ne` , ^' S� � �� �
16. Site conditions at time of
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters ,,,�Outstanding Resource Waters �1 Nutrient Sensitive Waters�� Water Supply Watershed v(I-IVl
J
18. 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? YE NO 20. Does channel appear on USDA Soil Survey? YE NO
21. Estimated watershed land use: 3 O% Residential S% Commercial S% Industrial �� % Agricultural
/O % Forested �% Cleared / Logged / O% Other (� Li7 j
Z2. Bankfull width: l�0� 23. Bank height (from bed to top of bank): — i� �
24. Channel slope down center of stream: _Flat (0 to 2%) _Gentle (2 to 4%) V Moderate (4 to 10%) _Steep (�10%)
25. Channel sinuosity: Straight �Occasional bends _Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
chazacteristics 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 chazacter of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of ] 00 representing a stream of the
highest quality.
Total Score (from reverse): Comments:
Evaluator's Signature ' Date �— � � � � �,D , ,_
This channel evaluation form is intended be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26.

STREAM QUAL�TY ASSESSMENT WORKSHEET
ECOREGION POINT RANGE
�# CFIARACTERISTICS Coastal Piedmont Mountain SCORE
1 Presence of flow / persistent pools in stream 0- 5 0� 4 0� 5 �
no flow or saturation = 0; stron flow = max oints)
2 Evidence of past human alteration 0- 6 0- 5 0- 5 Z
extensive alteration = 0• no alteration = m� oints
Riparian zone �
3 no buffer = 0; conti uaus, wide buffer = ma�c oints) 0- 6 0- 4 0- 5
� 4 Evidence of nutrient or chemical disch�rges 0- 5 0- 4 0- 4 3
extensive dischar es = 0• no dischar es = max oints
� 5 Groundwater discharge 0- 3 0- 4 0- 4 2,
U no dischar e= 0• s rin s, see s, wetlands, etc. = max oints}
�, Presence of adjacent floodplain
� 6 {no flood lain = 0• extensive flood lain = max oints) 0- 4 0- 4 0- 2 f�
,� , � Entrenc�roent / floodplain access 0- 5 0- 4 0- 2 2
� (dee 1 entrenched = 0; fre uent floodin. = max oints
Presence of adjacent wetlands
8 no wetlands = 0; lar e ad'acent wetlands = max oints) 0- 6 0- 4 0- 2 Cj
9 Channel sinuosity r 0- 5 I 0- 4 0- 3 3
ext�nsive �haan�li�tiQn n Q; n�t�r�l me�n��r m nnax o�nt�}
10 Sediment input 0- 5 0- 4 0- 4 3
(extensive de osition� 0• little or no sediment = max oints}
1� Size & diversity of channel bed substrate NA* 0-- 4 0- 5 I.}
fine, homo enous � 0; lar e diverse sizes = max oints)
12 Evidence of channel incision or widening 0� 5 0- 4 0�-- 5 2,
�, dee 1 incised = 0• stable bed & banks = max oints)
� �3 Preseace of major bank failures p� 5 0� 5 0 m 5 2,
a severe erosion = 0� no erosion, stable banks - max oints
� 14 Rdot depth and density on banks 0- 3 0- 4 0- 5 '2,
(no visible roats = 0: dense roots throu hout = max oints)
�/ Impact by agriculture, livestock, or timber production �
15 0-5 0-4 0-5
(substantial im act =0; no evidence = max oints}
� 16 , Presence of rift'le-pooUripple-pool complexes 0- 3 0- 5 0- 6 5
F (no riffleslri , les or ools = 0• well-develo ed = max oints}
� Habitat complexity /_
U 0-6 0-6 0-6
�F� {little or no habitat = 0; fre uent varied habitats = max oints `�
�Canopy coverage over streambed �
1 g no shadin ve etation = 0• continuous cano = max oints} 0- 5 0- 5 0- S
Sabstrate embeddedness *
� 9 dee 1� embedded = 0• loose structure = max NA 0- 4 0- 4
20 Presence of stream invertebrates (see page 4) 0- 4 0- 5 0- 5 L.�
� no evidence = 0• common numerous es = max oints)
� Z1 Presence of amphibiaos 0- 4 0- 4 0- 4 .�j
O no evidence = 0• common, numerous es = max � oints
a Presence of tis6 � 1
O 22 0-4 0-4 0-4
� no evidence = 0; common, numerous es = max oints `T
23 Evidence of wildlife use 0- 6 0- 5 0- 5 5
{no evidence = 0• abundant evidence u max oints}
Total Points Possible 100 100 100
TOTAL SCORE (also enter on first page) �a
* These characteristics are not assessed in coastal streams.

USACE AID# DWQ # Site #.X� (indicate on attached map)
; ,�, ; STREAM QUALITY ASSESSMENT WORKSHEET
,.
Provide the following information for the stream reach under assessment:
1. ApplicanYs name: �� �T 2. Evaluator's name:_ T - �Ca1.6! T�tS>
3. Date of evaluation: �-��-��D 4. Time of evaluation: 130p
5. Name of stream: K 6. River basin:�tr �r
7. Approximate drainage area: C �•��Z" 8. Stream order:
9. Length of reach evaluated: i Q�� 10. County: ��sti- � o-
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):�N ►s• , ,,, ,„
Latitude (ea. 34.872312): �J�v . tZ31 �k3 Longitude (ex. —77.556611): �1 �1 • ��9 ��elG ,. _
Method location determined (circle): � 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):
�ncx�Ir.Q.�t�e,�,c..�, o�'r �� �cA , c�# _o�' Ncg7
14. Proposed channel work (if any): llLhdt�-r,irY.�,vtiarl ,,,,,, „,
15. Recent weather
16. Site conditions �
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES NO If yes, estimate the water surface area: � i Gtt,
19. Does channel appear on USGS quad map? YE NO 20. Does channel appear on USDA Soil Survey? YES �
21. Estimated watershed land use: �J'_� % Residential _% Commercial _% Industrial %�% Agricultural
/O % Forested _% Cleared 1 Logged _% Other (
22. Bankfull width: 2•�� 23. Bank height (from bed to top of bank): i• 3�
24. Channel slope down center of stream: _Flat (0 to 2%) _Gentle (2 to 4%) �,.,,,Moderate (4 to 10%) _Steep (�10%)
25. Channel sinuosity:� Straight _Occasional bends _Frequent meander _Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, tenain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse): � Comments: ArC�V� GOvJ c�i.�u�P�
Evaluator's Signature Date �� � ��) �
This c6annel evaluation form is in nded to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version 06/03. To Comment, please call 919-876-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
ECOREGION POINT RANGE
# CHARACTERISTICS Coastal Piedmont Mountain SCORE
t Presence of flow / persistent pools in stream 0-� 5 0� 4 0- 5 �.
no flow or saturation = 0; stron flow = max oints)
2 Evidence of past human alteratian 0� 6 0� 5 0� 5 [
extensive alteration = 0• no alteration = max oints}
3 Riparian zone 0- 6 �0 � 4 0- 5 3
(no buffer = 0; conti uous wide bufFer = max oints)
Evidence of nutrient or chemical disc6arges ,
4 extensive dischar es - 0; no dischar es = max �ints Q- 5 0- 4 0- 4
�' S, Groundwater discharge 0- 3 0- 4 0- 4 l
{no dischar e= 0• s rin s, see s, wetlands, etc. = max oints}
� Presence of adjacent floodplain 2
��,, 6 no flood lain = 0• extensive flood lain = max oints} 0- 4 0- 4 0- 2
� Entrenchment / floodplain access
A'" � (dee I entrenched = 0• fre uent floodin = max oints) 0- 5 0- 4 0- 2 2.
g Presence of adjacent wetlands 0- 6 0- 4 0- 2 0
(no wetlands = 0; lar e ad'acent wetlands = max oints)
9 C6annel sinuosity 0- 5 0- 4 0- 3 Q
f extensive channelization = 0; natural meander = max oints
� 0 Sediment input 0- 5 0- 4 0- 4 �
extensive de osition= 0; little or no sediment � max oints
i l Size & diversity of channel bed substrate NA* 0� 4 0� 5 Q
fine homo enous = 0; lar e, diverse sizes = max oints)
� 2 Evidence of channel incision or widening 0-� 5 0- 4 0- 5 2,
y{ dee 1� incised = 0• stable bed & banks = max oints)
,,,F''„ � 3 Presence of major bank failures 0- 5 0-� 5 0�- 5 �
d (severe erosion = 0• no erosion, stable banks = max oints}
� � 4 � Root depth and density on banks 0- 3 0- 4 0- 5 �
E,,, no visible roots = 0• dense roots throu hout = max ointsl
� Impact by agriculture, livestock, or timber productioo Q
� 5 substantial im act =0; no evidence = max oints) 0- 5 0- 4 0- 5
� 6 Presence of riffle-pool/ripple-pool complexes 0- 3 0- 5 0- 6
� (no riffles/ri les or ools = 0; well-develo ed = max oints) 2
.� 17 Habitat complexity 0- 6 0- 6 0- 6 �
�„N,� little or no habitat = 0; fre uent varied habitats = max oints}
�Canopy coverage over streambed o
� g no shadin ve etation = 0� continuous cano °= max oints 0- 5 0- 5 0- 5
� 9 Substrate embeddedness NA* 0- 4 0- 4 �
[dee 1 embedded = 0• loose structure = max
20 Presence of stream invertebrates (see page 4) 0- 4 0- 5 0- 5
� no evidence = 0• common numerous es = ma�c oints) �
� 21 Presence of amphibians 0- 4 0- 4 0- 4 Q
O no evidence - 0; common numerous es = max oints
', Presence of fish
� 22 (no evidence � 0; common, numerous es � max oints 0- 4 0- 4 0- 4 Q
23 Evidence of wildlife use 0- 6 0� 5 0- 5 �
no evidence = 0• abundant evidence = max oints
Total Points Possible 100 J 00 100
TOTAL SCORE (also enter on first page) ap
* These characteristics are not assessed in coastal streams.

USACE AID# DWQ # Site #� (indicate on attached map)
;,�,; STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
2. Evaluator's name: �� ��kS - w��j�
. j5oo '
4. Time of evaluation•
6. River basin: ��� ��
8. Stream order: 1
10. County: C,�
1. Applicant's name: N�.S]OT_
3. Date of evaluation: �'_�\ �ip
5. Name of stream: j�T '�o �+2���'tl�rlG�Xt.Q�
7. Approximate drainage area: �-���L
9. Length of reach evaluated:_ _��
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):_ ___ EJAr
Latitude (ex. 34.872312): 3�D. ���$Z"1 Longitude (ex. -77.556611): �,�' S��2-�
Method location determined (circle): GP Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
vtorah. e�,�r�� �s'1�a��t�= �� w n� tJCS']
14. Proposed channel work (if any): ��de�kt,✓,nn��2�, _ �
15. Recent weather conditions:
16. Site. bonditions at time of visit:
17. Identify any special waterway classifications known: _Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters _ Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES �O f yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES NO 20. Does channel appear on USDA Soil Survey? YES�
21. Estimated watershed land use: Zi� % Residential =% Commercial =% Industrial �% Agricultural
30 % Forested �% Cleazed / Logged i�% Other ( iZ�7 ` r00� )
22. Bankfull width: l.$ � 23. Bank height (from bed to top of bank): ��
24. Channel slope down center of stream: _Flat (0 to 2%) _Gentle (2 to 4%) �Moderate (4 to 10%) _Steep (>10%)
25. Channel §inuosity: Straight� Occasional bends _Frequent meander _Very sinuous _Braided channel
lnstructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse):
' �-/l�b
Evaluator's Signature Date
This channel evaluation form is in nded to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change - version 06/03. To Comment, please ca11919-876-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
ECOREGION POINT RANGE '
# CHARACTERISTICS Coastal Piedmont Mouatain SCORE
1 Presence of flow / persistent pools in stream 0- 5 0� 4 0- 5
no flow or saturation � 0; stron flow = max oints) j �
Evidence of past human alteration 3
2 extensive alteration = 0• no atteration = max oints 0- 6 0- 5 0- 5
3 Riparian zone 0- 6 0- 4 0-- 5 3
no buffer = 0, conti uous, wide buffer = max oints}
Evidence of nutrient or chemical discharges �
4 extensive dischar es = 0; no dischar es = max oints 0- 5 0- 4 0- 4
�5 Groundwater discharge 0- 3 0- 4 0- 4 2
V (no dischar e= 0• s rings, seeps, wetlands, etc. - max oints}
� 6 Presence of adjacent floodplain 0- 4 0- 4 0- 2 `
{no flood lain = 0; extensive flood lain = max oints)
� � Entrenchment / floodplain access 0� 5 0� 4 0- 2 2
{dee 1 entrenched = 0; fre uent floodin = max oints)
8 Presence of adjacent wetlands 0- 6 0- 4 0- 2 �
no wetlands = 0; lar e ad'acent wetlands = rnax oints)
9 Channel sinuosity • 0-- 5 0- 4 0- 3 3
extensive channelization = 0• natural meander � max oints}
� � Sediment input 0- 5 0- 4 0- 4 3
(extensive de osition= 0• little or no sediment = max oints
�� Size & diversity of channel bed substrate NA* 0- 4 0- 5 �
fine homo enous � 0• lar e diverse sizes v max oints}
' � Z Evidence of c6annel incision or widening 0- 5 0- 4 0- 5 3
� dee 1 incised = 0• stable bed & banks = max oints)
,,E''� Presence of majar bank failures
a 13 0-5 0-5 0-5
(severe erosion = 0; no erosion, stable banks = max oints)
� � 4 Root depth and density on banks 0- 3 0- 4 0- 5 3
no visible roots = 0• dense roots throu hout � max oints)
� Impact by agriculture, livestock, or timber production ` 1
15 0-5 0-4 0-5 .,�
(substantial im act =0; no evidence = max oints)
� 6 Presence of riffle-pooUripple-pool complexes 0- 3 � 0- 5 0- 6 1
F no riffles�ri les or ools = 0• well-develo ed = max oints}
� Habitat complexity � 1
17 0-6 0-6 0-6 .-t
� little or no habitat = 0; fre uent varied habitats = max oints)
�' Canopy coverage over streambed �
� 8 no shadin ve etation = 0; continuous cano = max oints 0- 5 0- 5 0- 5
19 Substrate embeddedness NA* 0- 4 0- 4 3
dee 1 embedded � 0; loose structure = max)
20 Presence of stream invertebrates (see page 4) 0- 4 0- 5 0- 5 2•
�„i no evidence � 0; common numerous es = max oints
�, 21 Presence of amphibians 0- 4 0- 4 0- 4 2
Ono evidence = 0; common numerous es = max oints)
Presence of fish �c
O 22 0- 4 0--4 0-4
� (no evidence = 0; common, numerous _ es = max oints)
23 Evidence of wildlife use 0- 6 0-- 5 0- 5 �..
(no evidence � 0: abundant evidence = max oints)
Total Points Possible ] 00 100 100
T4�`AL SCORE (also enter on first page) ��
* These characteristics are not assessed in coastal streams.