20090744 Ver 1_Application_20090706

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STATE OF NORTH CAROLINA 1?0
09
DEPARTMENT OF TRANSPORT
ATIONs'°cq„yy',? BEVERLY EAVES PERDUE EUGENE A. CJR.
GOVERNOR SECRETARY
July 1, 2009
O
Mr. David Baker, NCDOT Regulatory Project Manager
I U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
C Asheville, NC 28801-2714 0 90744
C Subject: Nationwide 3 Permit Application
SR 1 186 -. Frank Allen Road - Culvert Extension
Jackson County
Dear Mr. Baker:
L
The North Carolina Department of Transportation (NCDOT) is proposing to extend a culvert on SR
1186, Frank Allen Road, in Jackson County. NCDOT proposes to extend the culvert and widen the
existing shoulder.
I am enclosing a completed PCN application, pipe extension drawing, photographs, a marked
county map, and USGS topographic map for your review.
The North Carolina Natural Heritage Database was checked for records of federally threatened and
endangered species. There are no records listed for the unnamed tributary of the Chattooga River.
Additionally, there are no records listed for the Chattooga River upstream of Cashiers Lake or
within Cashiers Lake. The culvert extension will be in an area that has been disturbed previously.
This project is limited in scope and the impacts from a 10-foot culvert replacement will be minimal.
The stream is small and lacks sufficient flow to support mussels and fish habitat is limited. For
these reasons, we believe there will be "no effect" to threatened or endangered species.
The area to be effected has already been disturbed and the channel has been scoured. We do not
believe there will be adverse effects to cultural resources from this project.
The best management practices will be used to minimize and control sedimentation and erosion on
this project. The construction foreman will review all erosion control measures daily to ensure
sedimentation and erosion is being effectively controlled. If the planned devices are not functioning
as intended, they will be immediately replaced with better devices.
I
r
SR 1186, Frank Allen Road
Impacts to Waters of the United States
June 24, 2009
The unnamed tributary of Chattooga (DWQ Class B ORW) is not shown on the USGS topographic
map. The stream is small with a well-defined channel. The channel is primarily composed of sand
and silt and lacks vegetation. The unnamed tributary flows approximately 975 feet to Cashiers Lake
and the Chattooga River. Cashiers Lake meets the definition of a Traditional Navigable Water. For
these reasons, we believe the unnamed tributary of the Chattooga River meets the definition of a
Relatively Permanent Water and is under the jurisdiction of the U.S. Army Corps of Engineers.
NCDOT is requesting to extend one culvert in an unnamed tributary within the Savannah River
Basin. The impacts are listed below.
Site No.
Existing Condition
Proposed Condition Net
Im
acts
Station p
Site 1 50' x 18" CMP 60'x 24" CMP 10'
Site 1 A Free Flowing Stream Flow Diversion 85'
Total Temporary Impacts Impervious Dike and Flow Diversion tso'
ota iStreamin? acti
Permits Requested
NCDOT is hereby requesting authorization under Section 404, of the Clean Water to proceed with
the project outlined above. By copy of this letter, I am asking Mr. David McHenry, Mountain
Region Coordinator, of the North Carolina Wildlife Resources Commission (NCWRC) to comment
directly to you concerning the Nationwide 3 Pen-nit request.
Additionally, I am asking Mr. McHenry and Ed Ingle, Roadside Environmental Field Operations
Engineer (NCDOT), to comment directly to me concerning this permit request.
If you have any questions or need additional information, please contact Mr. Wesley Jamison or me
at [phone]. Your early review and consideration will be greatly appreciated.
SincereI ) A
Gtirot!`/%
onathan Woodard, P.E.
District Engineer
Enclosures
cc: Mr. Mike Parker, DWQ, DENR, Asheville (I Courtesy Copy)
Mr. Troy Wilson, Biologist, U.S. Fish and Wildlife Service, Asheville
Mr. David McHenry, Mountain Region Coordinator, NCWRC, Waynesville
Mr. Joel B. Selzer, P.E., Division Engineer, NCDOT
Mr. Jonathan Woodard, P.E., District Engineer, NCDOT
Mr. E. L. Ingle, Roadside Environmental Field Operations Engineer, NCDOT
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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
la. Type(s) of approval sought from the

Corps:
® Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NW 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. 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
le. 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
1g. 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: SR 1186 -Frank Allen Road -Pipe Extension
2b. County: Jackson County, North Carolina
2c. Nearest municipality / town: Cashiers
2d. Subdivision name: N/A'
2e. NCDOT only, T.I.P. or state
project no: 14.205011
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: N/A
3e. City, state, zip: - N/A
3f. Telephone no.: N/A
3g . Fax no.: N/A
3h . Email address: N/A
Page 1 of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ® Other, specify: District Engineer
4b. Name: Jonathan Woodard
4c. Business name
(if applicable): North Carolina Department of Transportation
4d. Street address: 345 Toot Hollow Road
4e. City, state, zip: Bryson City, NC 28713
4f. Telephone no.: [phone]
4g. Fax no.: [phone],
41h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: N/A
5b. Business name
(if applicable): N/A
5c. Street address: N/A
5d. City, state, zip: N/A
5e. Telephone no.: N/A
5f. Fax no.: N/A
5g. Email address: N/A
Page 2 of 10
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): N/A

.1112 Longitude: - 83.1002
Latitude: 35
1 b. Site coordinates (in decimal degrees): (DD. DD DDDD) (-DD. DDDDDD)
1 c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Unnamed Tributary of Cashiers Lake
proposed project:
2b. Water Quality Classification of nearest receiving water: DWQ Class: B Tr ORW
2c. River basin: Savannah
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: .
The area of the project is within the Town of Cashiers with some,residences and businesses.
3b. List the total estimated acreage of all existing wetlands on the property:
N/A
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
N/A
3d. Explain the purpose of the proposed project:
The purpose of the project is to extend a culvert and widen the shoulder of the road to make it safer for the traveling
public.
3e. Describe the overall project in detail, including the type of equipment to be used:
The work will require removing the existing pipe and replacing it with a new one. Dump trucks and track hoes will be
used for the repair. Sandbags, pumps and diversion pipe will be used as needed for dewatering.
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: N/A
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: N/A
Name (if known): N/A Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
N/A
5. Project History
5a. Have permits or certifications been requested or obtained for
El Yes ®No ? Unknown
this project (including all prior phases) in the past?
f 5b. If yes, explain in detail according to "help file" instructions.
N/A
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
i
N/A
Page 3 of 10
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 N/A N/A ? Yes
? No ? Corps
? DWQ N/A
? Yes ? Corps
W2 ? P ? T ? No ? DWQ
? Yes ? Corps
W3 ? P ? T ? No ? DWQ
? Yes ? Corps
W4 ? P ? T ? No ? DWQ
? Yes ? Corps
W 5 ? P ? T ? No ? DWQ
? Yes ? Corps
W6 ? P ? T ? No ? DWQ
2g. Total wetland impacts N/A

2h. Comments: N/A
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
t Impact
length
number - (PER) or (Corps - 404, 10 s
ream
idth (linear
Permanent (P) or intermittent DWQ - non-404, w feet)
Temporary (T) (INT)? other) (feet)
S1 ® P ? T Pipe extension UT to Cashiers
Lake ® PER
? INT ® Corps
? DWQ 1 10
S2 ? P ® T Flow Diversion UT to Cahsiers
Lake ® PER
? INT ® Corps
? DWQ 1 85
? PER ? Corps
S3 ? P ? T ? INT ?DWQ
? PER ? Corps
S4 ? P ? T ? INT ? DWQ
? PER ? Corps
S5 ? P F1 T ? INT ? DWQ
? PER ? Corps
S6 ? P ? T ? INT ? DWQ
3h. Total stream and tributary impacts I 10
q cnmm2nts' Tntal Imnacts for Imoervious Dike and Flow Diversion is 85 linear feet
Page 4 of 10
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 0 . 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 N/A N/A N/A N/A
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts N/A

4g. Comments: N/A

5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 51b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond 1D Proposed use or purpose (acres)
number of pond Flooded Filled Excavated Flooded Filled Excavated Flooded
P1 N/A N/A N/A N/A N/A N/A N/A N/A
P2
5f. Total N/A N/A N/A NA N/A NA N/A
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ®No If yes, permit ID no:
5i. Expected pond surface area (acres): N/A
5j. Size of pond watershed (acres): N/A
5k. Method of construction: N/A
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 u MUST fill out Section D of this form.

6a. 1
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
61b. 60. 6d. 6e. 6f. 6g. 4
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 re uired?
131 E-1 P F1 T N/A N/A ?Yes
? No N/A N/A
?Yes
B2 ?P?T ? No
Yes
?
B3 ?P?T ? No
6h. Total buffer impacts N/A
Ai cnmmentc' N/A
Page 5 of 10
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Culvert will be extended the minimum length necessary to meet current NCDOT standards.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Appropriate erosion and sedimentation control devices will be installed prior to work being done. The pipe extension will be
placed below the existing stream bed so natural substrate can be re-established. The culvert installation site will be de-
watered to minimize impacts from sedimentation.
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 Stale? ? 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
® Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
3b. Credits Purchased (attach receipt and letter) Type N/A Quantity N/A
3c. Comments: N/A -
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): N/A square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: N/A acres
4h. Comments: N/A
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.
N/A
Page 6 of 10
PCN Form - Version 1.3 December 10, 2008 Version
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 ? Yes ®No
buffer mitigation?
61b. 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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 N/A N/A 3 (2 for Catawba) N/A
Zone 2 1.5
6f. Total buffer mitigation required: N/A
69. 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).
N/A
6h. Comments: N/A
Page 7 of 10
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan

la. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? ? Yes ® No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments: N/A
2. Stormwater Management Plan

2a. What is the overall percent imperviousness of this project? N/A %
21b. Does this project require a Stormwater Management Plan? ? Yes ®No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Proje ct is Covered by Individual NPDES
Permit NCS000250
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
N/A
? 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? N/A
? Phase II
3b. Which of the following locally-implemented stormwater management programs

apply (check all that apply): ? NSW
? USMP
? Water Supply Watershed
? Other:
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
(check all that apply): ? ORW
? Session Law 2006-246
? Other:
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
51b . Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 8 of 10
PCN Form - Version 1.3 December 10, 2008 Version

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Erigin'ers
This form should be completed by following the instructions provided in Section IV of the 1D 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: SR 1186 Frank Allen Road Culvert Replacement/Extension
Statc:NC County/parish borough: Jackson City: Cashiers
Center coordinates of site (]at/long in degree decimal format): Lat. 36.1112° R, Long. -83.10020 Universal Transverse Mercator:
Name of nearest waterbody: Unnamed Tributary to Chattooga River (Cashiers Lake)
Name of nearest Traditional Navigable Water (TN W) into which the aquatic resource flows: Cashiers Lake
Name of watershed or Hydrologic Unit Code (HUC): 03060102010010
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., otfsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different 1D form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date: June 24, 2009
F1 Field Determination. Date(s):
SECTION 11: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There AAr no "no viguble ureters 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.
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 Aie `waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): t
F] TNWs, including territorial seas
0 Wetlands adjacent to TNWs
Relatively permanent waters' (RPWs) that flow directly or indirectly into TNWs
Q Non-RPWs that flow directly or indirectly into TNWs
Q 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
Q Impoundments of jurisdictional waters
Q 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: 100 linear feet: I width (ft) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on: EstebLshed_by'Q_g_?6!!
Elevation of established OH WNI (if known):
2. Non-regulated seaters/wetlands (check if applicable):
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 fornr, 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 IILD.I.; otherwise, see Section HUB 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 TNNw) 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 forjurisdiction 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 IILBA for
the tributary, Section 111.6.2 for any onsite wetlands, and Section IILB.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-TNR's that flow directly or indirectly into TNW
(i) General Area Conditions:_
Watershed size: P1c6L''ist
Drainage area: !Ptck.I;ist
Avera-e annual rainfall: inches
Average annual snowfall: inches
(ii)- Physical Characteristics:
(a) Relationshio with TNW:
? Tributary floes directly into TNW.
? Tributary flogs through PickvDist tributaries before entering TNW.
Project waters are Piekl:ist river miles from TNW.
Project waters are Pick %t river miles from RPW.
Project waters are Pi&Xist aerial (stmight) miles from TNW.
Project waters are Pickliist 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 identif ing, 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 aoolv):
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: Pic- k?.
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: Pic7UR
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: ick Lie
Estimate average number of flow events in review area/year: ckL'is
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pi -1 71st. Characteristics:
Subsurface flow: Pick 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):
? Discontinuous OHWM.' Explain:
If factors other than the OHWM were used to determ
Q High Tide Line indicated by: Q
? oil or scum line along shore objects
? tine 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 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 OH W NI does not necessarily severjunsdiction (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 OH WM that is unrelawd 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 typo. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: P c? List. Explain:
Surface flow is: Pek+Lis
Characteristics:
Subsurface flow: Pick_Lis . Explain findings:
? Dye (or other) test performed:
(c) Wetland Adiacencv 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 JJt river miles from TNW.
Project waters are Pick?L'ist aerial (straight) miles from TNW.
Flow is from: Pct Batt -
Estimate approximate location of wetland as within the P ca Cis floodplain.
(ff) 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 typelpercent 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: PiekjLStst
Approximately ( ) acres in total arc 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 TNVI'.
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 W s, 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 rindings 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 IILD:
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 IILD:
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:
3'i TNWs: linear feet width (ft), Or, acres.
Q Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNW's.
Tributaries of TNWs where tributaries typically flow year-round arejurisdictional. Provide data and rationale indicating that
tributary is perennial: The stream is small but typically has water flowing during our site visits..
El 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:
i
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 100 linear feet 1 width (ft).
Q Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-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 isjurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
R] Tributary waters: linear feet width (ft).
F1 Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
El Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
El 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:
13 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 forjurisdictional 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 arejurisidictional. 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.
El. 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.
As a general rule, the impoundment of ajurisdictional tributary remains jurisdictional.
F-1 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
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):to
0 which are or could be used by interstate or foreign travelers for recreational or other purposes.
Q 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.
R 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 C WA 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 Memorandom Regarding CIVA Act Jurisdiction Following Rapanot

Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
to Other non-wetland waters: acres.
Identify type(s) of waters:
Q 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.
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).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
0 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):
0 Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
r; 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):
a 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.
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):
Q 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.
i ? Office does not concur with data sheets/delineation report.
R Data sheets prepared by the Corps:
Corps navigable waters' study:
Q U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
? USGS 8 and 12 digit HUC maps.
Q U.S. Geological Survey map(s). Cite scale & quad name:
Q USDA Natural Resources Conservation Service Soil Survey. Citation:
it National wetlands inventory map(s). Cite name:
Q State/Local wetland inventory map(s):
on, FFEMA/FIRM maps:
0 t00-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
® Photographs: ? Aerial (Name & Date):
or ® Other (Name & Date):Culvert Site Photographs, June 2009.
Q Previous determination(s). File no, and date of response letter:
Applicable/supporting case law:
Q Applicable/supporting scientific literature:
E] Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD:
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