20181302 Ver 1_U-5818 McDowell Signed PJD_9/25/2018 10:01 AM

STATE OF NORTH CAROLINA
DEPARTN�NT OF TRANSPORTATION
ROY COOPER
GOVERNOR
February 21, 2017
Ms. Lori Beckwith
Asheville Regulatory Field Office
U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
Dear Ms. Beckwith:
JAMES H. TROGDON, III
SECRETARY
Carolina Ecosystems, Inc. (CEI) has completed a jurisdictional stream and wetland delineation on the
above referenced project for the North Carolina Department of Transportation (NCDOT). The attached
information is submitted for your review and determination of jurisdiction under the Clean Water Act.
Enclosed please find the following information:
➢ Jurisdictional Determination (JD) Request Form
➢ Preliminary JD Form
➢ Preliminary JD Table
➢ Vicinity Map
➢ USGS Map
➢ Jurisdictional Features Map
➢ Stream and Wetland Data Forms
Project Description & Methodology
As shown in Figure 1, the U-5818 project is located in McDowell County, NC. The study area for this
project is located along Sugar Hill Road (SR 1001) from the I-40 W ramps to 0.3 mile west of the I-40 E
ramps. The study area lies within the Catawba River Basin (USGS Hydrologic Unit 03050101), and
comprises approximately 63.6 acres. The field work for the delineation was performed on December 14,
2016 in compliance with methodology set forth in the USACE Wetland Delineation Manual (USACE
1987) and subsequent guidance. This included the use of the four-strata Wetland Determination Form for
the Atlantic and Gulf Coastal Plain Regional Supplement (Version 2.0). Streams were assessed for
jurisdiction under the Clean Water Act using iield indications of ordinary high water mark and the NC
Division of Water Quality (NCDWQ) Stream Identification Form Version 4.11.
Delineation Results
Figures 2 and 3 present the results of the delineation, including North Muddy Creek, and seven unnamed
tributaries. Figure 2 is presented using the Marion West (2013) US Geological Survey 1:24,000
Quadrangle Map. Figure 3 is presented using 2014 NC statewide aerial photography.
MailingAddress: Telephone.• [phone] Location:
NC DEPARTMENT OF TRANSPORTATION FcTX: ($2H� ZS 1-6394 SS ORANGE STREET
HIGHWAY DIVISION 13 Ct[St07ri¢Y S¢7'ViCC.' 1-$%%-36g-496g E�SHEVILLE, NC 2gg�1
55 01taNGE Sr1tFEr Website: www.ncdot.gov
ASHEVILLE, NC ZHHO1

Ms. Lori Beckwith
February 21, 2017
U-5818
Page 2
Table 1 presents detailed information on the jurisdictional streams within the study area, including
latitude/longitude, Cowardin classification, estimated amount of aquatic resource in review area, and
class of aquatic resource. Based on field data, there are approximately 2,844 linear feet of perennial
stream and 71 linear feet of intermittent stream. Intermittent streams are documented on the attached
data forms. Perennial streams e�ibited distinct characteristics including biology, hydrology, and
geomorphology.
We request your review of the attached documentation and mapping, and issuance of a Preliminary
Jurisdictional Determination for this project.
If you have any questions, need additional information, or would like to schedule a site visit, please
contact me at your earliest convenience at [phone] or [e-mail].
Sincerely,
DocuSigned by:
�� �. ��.
33212C738E68411...
Roger Bryan
Division Environmental Supervisor
cc: Kevin Barnett, NCDWR

A.
B.
C.
Jurisdictional Determination Request
PARCEL INFORMATION
Street Address: 2975 Sugar Hill Road (SR 1001)
City, State: Marion, NC
County: McDowel I
D1P0Ct10riS: From Asheville, take I-40 E to exit 81 for Sugar Hill Road in Marion. Project
occurs along Sugar Hill Road extending east and west of I-40.
Parcel Index Number(s) (PIN): Various
REQUESTOR INFORMATION
Name: Roger Bryan
Mailing Address: 55 Orange Street, Asheville, NC 28801
Telephone Number: [phone]
Electronic Mail Addressl: [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 Project. Right-of-way to be acquired where needed.
PROPERTY OWNER INFORMATION
Name:
Mailing Address
Telephone Number:
Electronic Mail Address3:
N/A
N/A
N/A
N/A
N/A
❑ Proof of Ownership Attached (e.g. a copy of Deed, County GIS/Parcel/Tax Record data)
1 If available
z 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 preliminary JD for the property identified herein.
This request does include a delineation.
� I am requesting that the Corps provide a preliminary 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 a�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 a�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 approved JD (may or may not
include a survey plat).
4 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.
0
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 63.6
�
G.
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 Preliminary Jurisdictional Determination Form6.
35.6465 -82.0355
✓ Project Coordinates: Latitude Longitude
Maps (no larger than l 1x17) with Project 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 Sheets8
❑�
�
❑�
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 l 1x17) with Project Boundary Overlay:
�
❑�
�
�
�
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.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits/reg supp.aspx
Wetland and Stream Assessment Methodologies can be found at:
http://portal.ncdenr.org/c/document librarv/�et file?uuid=76f3c58b-dab8-4960-ba43-45b7faf06f4c&sroupld=38364 and,
http://www.saw.usace.army.mil/Portals/59/docs/resulatory/publicnotices/2013/NCSAM Draft User Manual 130318.pdf
$ 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 original Plat (to scale) that is no larger than 11"x17"
(the use of match lines for larger tracts acceptable). Additional copies of a plat, including
those larger than 11"x17", 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
n
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 linear 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 proj ect/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 Boundar, i�picted:
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 ID No.:
� When uplands may 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:
Roger Bryan, NCDOT
55 Orange Street, Asheville, NC 28801
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
2975 Sugar Hill Road (SR 1001) over I-40.
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/parish/borough: McDowell City: Marion
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.6465 °N; Long. -82.0355 °W.
Universal Transverse Mercator:
Name of nearest waterbody: North Muddy Creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
2,915 linear feet: 2-15 width (ft) and/or acres.
Cowardin Class: R3 and R4
Stream Flow: Perennial and Intermittent
Wetlands: acres.
Cowardin Class:
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal:
Non-Tidal:
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
applicant/consultant: Vicinity Map
❑✓ Data sheets prepared/submitted by or on behalf of the
appl�nt/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: Mar�onwest�2o,3>,:2aK
❑ 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: ❑`� Ael"IaI �Nallle & Date�: 2014 NC Statewide Aerial PhotographyOr
� Other (Name & Date):
� Previous determination(s). File no. and date of response letter:
� Other information (please specify):
�

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.

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
necessarilv been verified bv the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
�
DocuSigned by:
���r �, �q,�, 9/25/2018
"0"'
33212C738E68411...
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

TIP No. U-5818 Aquatic Resources in Review Area February 2017
Table 1. Preliminary Jurisdictional Determination Table
Cowardin
Estimated Amount of Geographic authority to which
Site Name Latitude Longitude Classification Aquatic Resource in Review the aquatic resource "may be"
Area sub'ect
Streams (linear feet�)
North Muddy 35.6458 -82.0367 R3 1,816 Section 404
Creek
SA 35.6466 -82.0324 R3 203 Section 404
SB 35.6482 -82.0345 R3 171 Section 404
SC 35.6456 -82.0396 R3 97 Section 404
SD 35.6444 -82.0388 R3 415 Section 404
SE 35.6459 -82.0366 R3 21 Section 404
SF 35.6461 -82.0354 R3 121 Section 404
SG 35.6462 -82.0337 R4 71 Section 404

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TIP U-5818
SR 1001 (Sugar Hill Rd)
McDowell County, NC
Figure 1: Vicinity Map

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Map Date: February 2017 TIP U-5818
� Study Area •� Intermittent Stream SR 1001 (Sugar Hill Rd)
� Feet Revised: McDowell Count , NC
I50 300 � Sheet Limits �i Perennial Stream Revised:
Figure 2: USGS Map
Marion West (20] 3) USGS 1:24,000 Quadrangle Map Revised: (Sheet 1 of 2)

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��� °.� � �e SR 1001 (Sugar Hill Rd)
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��' '\' Feet y Revised: McDowell Count , NC
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,�oF �JO�'��� �Rq N Map Date: February 2017 TIP U-5818
�Q �ti` � Stud Area �"�. �,,� Intermittent Stream SR 1001 (Sugar Hill Rd)
��' '\' Feet y Revised: McDowell Count , NC
�� �� 0 I50 300 0 S1�eetLimits �i Perennial Stream
1q O�
Revised: Figure 3: Jurisdictional
���FN;oF�,pNs?%� Features Ma Sheet 2 of 2
2014 NC Statewide Aerial Photographs Revised: P� �

NC DWQ Stream Identification Forrn Version 4.11
Date: �a��/�� ProjecUSite: �_Sg�g Latitude:3�
Evaluator: �� �o���� County: M`DO Longitude:,�
Total Points: Stream Deterjninat' (circle one) Other
Stream is at least intermittent ��-� Ephemeral, lntermitt��erennial e.g. Quad Name:
if >_ 19 or erennial if z 30*
A. Geomorphology (Subtotal =_ ) Absent Weak Moderate
1a� Continuity of channel bed and bank 0 1 2
2. Sinuosity of cnannei along thalweg U � 1 2
3. In-channel structure: ex. riffle-pool, step-pool, p 1 2
ripple-pool sequence
4. Particle size of stream substrate 0 1
5. Active/relict floodplain 0 1
6. Depositional bars or benches
7. Recent alluvial deposits 0
8. Headcuts l 0 1
9. Grade control 0.5
10. Natural valley ( 0 0.5
11. Second or greater order channel o= 0
a artificial ditches are not rated; see di cussions in manual
B. H drolo (Subtotai = r
12. Presence of Baseflow 0 1
13. Iron oxidizing bacteria � �
14. Leaf litter 1.5 1�
"5. S..'dimer:t en � !ants or �e�ri� 0
•�
16. Organic debris lines or piles 0
17. Soil-based evidence of high water table? No = 0
C. Biolo Subtotal =
18. Fibrous roots in streambed 3
19. Rooted upland plants in streambed 3 2
20. MaCroben4hos (note diversity and abundance) �
21. Aquatic Mollusks 0 1
22. Fish 0 0.5
23. Crayfish 0.5
24. Amphibians 0.5
25. Algae 0 0.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Sk�tc":
5G
2-�tl�
SC�
3
3
3
3
3
3
1.5
1.5
1
1
2
2
1
1
1
1,
e
0
0
3
3
1.5
1.5
1.5
1.5
� N o�-�h l��y
_ ��

USACE AID#
DWQ # Site # (indicate on attached map)
;,,,; STREAM QUALITY ASSESSMENT WORKSHEET SG
Provide the following information for the stream reach uader assessment:
1. Applicant's name: N��j�jT
3. Date of evaluation:� rcL� `I,I �
5. Name of stream:�_� j���.� �� �,/' f� k
7. Approximate drainage area:_ � � Ot[JP
9. Length of reach evaluated: �� �¢�}
2. Evaluator's name: K.(� �a ►�� �t g r
4. Time of evaluation: a; S('j �,,,n
6. River basin: � ��A �,�� p�
8. Stream order: I �'
10. County: /���p ��
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
Latitude (ex. 34.872312): _ � J�, �,4(� d, Longitude (ex. —77.556611):_ �gd , ���g
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):
-1ln�i- c r.,.� �.. i..12- � i _ U �l 1, I � . � . 1 . � .. n. n ,
14. Proposed channel work (if any): � �
15. Recent weather conditions: /�„ f�, � ;,� �� � UR 1,�
v!
16. Site conditions at time ofvisit: ('a�r.d���
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 � If yes, estimate the water surface area•
19. Does channel appear on USGS quad map? YE� N(;�
21. Estimated watershed land use: _% Resident�a�
20. Does channel appear on USDA Soil Survey7 YE NO
% Commercial _% Industrial _% Agricultural
�S' % Forested �% Cleared / Logged S�% Other (�1 �k /p� )
I
22. Bankfull width:� 23. Bank height (from bed to top of bank): n.S '�
24. Channel slope down center of stream: ✓� Flat (0 to 2%) _Gentle (2 to 4°/a) 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
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 Signature 1 �"1 // A _� ,c� � Date ��( % 1( � �O
This channel evaluation m�s m�tended to be used only as a guide to assist landowners and environmental professiooals 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
partiwlar mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET '��
! � C'T�,�l�'���;`�'�����"���':� i',._ ��'��I��:�����d ��°����� ���:��a�' ; �._
� C' �'€��a��;a � ;�a�drr��r�rt ���s��e�t:��e� ° ��:��$ �':
- � . --..� _--- -----� --�-�---.1,
_ —�-_.
� �� i'reseiice of flo« / persistent pcsols 'sn str�eam � � � o�
( no Il<>�v nr satucatian - 0; stron� fIow = max points) 0 5 ! �`� 0-- 5
� � Ei�idence {�f gast hur��an a�ie�°a�ioza � �
(extensive alt�eraiion = Q; i10 alteration = ma� poitits) - �' - � � - � �
� Iti�arian �o�ae
(r�o bu�Ffez• = 0; conti�uous, «-ide buffer = tt�a� � aints}� �' _ � ' � 0 - � 'l
� Evi�lence of riutrient ar che�r�ieal disciaaa°ges �
fexte�isivedisch�€r:,��es=0•nadischar�es=r��axpeints) ��� -5�� �'-'� �-`� �
�
� � � ' � � �raandwater disc�iarge ,
(no discfiar6e = 0; sprita;;s, seeps, vvetlands; e.lc, - niax points} k 4 3 � -4 Q� 4
�� �
� � Presence oiaci.j�cent floocg�lai►a
('iio t7ood lai�i - �; exTensive flood �lain = n�ax � oints) � � �- `� p _ � �'�`
i � (
� 7 �ntrenclame►yt I flaod�lain accesc {
{dEep(y e��trenahed = (}: fi�eqaent'floodin� - a��� � � - 4 � q- 7 9
�, - rtlax points} , l
g Presence of ad;pacent evetl�gyds
�(i3o tivetlar�ds - �; iarge adiacei�t �vetiands = n�ax �points} � Q 6 �1 ` 4 � - � ,`�
c� Ch�ea�n�I sia�uositer ;' r
{estensive chanuelizatio�� = fl;�ttatu�•�I ineander =maY �ints) �� � �� � `� 0�= 3 ' �
` Ip � � �� � Seditt3e�finput �� �
(extensiue de�position- 4; little or no sediment - tna� points} � �� ���- 4 0- 4
i i Sizc & di�e�sity of ehannel bed �ubsirate ,., �
� (fin�, homo�e��o�!5 - C7: �la��ge, diverse size.s = inaa �ioi�7ts) � � '- 4 � �" 5 � � ;
� � I�;vidence €�f channef incisaon ��• wBdening � `�
� h;
� (dee [ incised ={?; stable beci c,�, banks = max aints) � 5 U��- 4 p- 5 �
t;
,� 1� Fa•esence of �a�ajor bank faitu�a-es �� �
�� � � (seves•e erosion - �: na erosioti, stal�Ie. banks = i��ax points) d � �� Q � � � 0 - � �
i� , t� Ttook de}�th and density c�c� 6anl:s � s .
� (�io r isible roots = 0; dense roots tl�rou�r
-
�
� ' ;,hout = inaY points) � �' � - � 0- 5 �
� ti im�sact by agric�alture, fivestock, cai� tizntzer pyadtaction �� � � ' ��
� � (sttbstantia( iir�pact -p; no evidence = max painYs) � � � � �� r, � � - � �
IE' Presence o9'riffle-poo9trip�le-}�ool cs�m�l�xes -
�;
(no rif'fleslei��p}es �r pools = f}; well-�e�velopec3 = ���ax pc�intsj - � � �--� 0 - 6'� � '
�C �7 H;�E�itaf can�plexito� �
� (little ar z�o habitat = 0; freque�lt, v�ried habitats = max poirits) -�' �-` 0-�
� � $ � Cano�ry cover•a�e �r���r sta�eambeti � � � � �
(no shac�in�> ve«etation =_� 0; continuoiis cano �
-� Q 0 5 �
� —. � =� � py = max points) � ' �
— ---- -----
���14 ���� 5�t�ste•ate ena6eddeciness � �;
� (dee (y e�rzibedded = 0; loose stz�ucture = n3ar) t� � ' 0 -- �
7d ���� Piesence ofsire�pa� iiave�-tel�r�tes (�s�,e pag� 4) �'� �
{i�o evidence�-�p; cQi�ln�on, 13�merous t4 es -�iiaa � ��ints �'- `� � 0 � 0 - �
:��
� � i 6'resence of am�3i�ibians � �' 4 fl- 4 -
� (no evidence = Q; com�non, numet•�us� � ,pes - tnaa points) � � `�
� �� �'reserYcc ot' fish ( -- �
�'�� � { no evidence = 0; conimoai, �i�i�n}erous i�.ypes �- max �painis� � � - 4 � - 4 � � i "�
� �...: r
,! -,� Evidene� of tt�iliflife use - 6 - 5 0- i' 1
_�� -� ( no eviderlce = Cl; abu��dac�t�evicence �= max poi�its�� � � �=i �
t -� _
� �'ot�� ��+�aae� �'€�ss€b�� 1 �JE7��_t GCi �_ � i ti4 -
�___ __ _��
. .. ___J_�_.�
�'��'���L ��:��� t;�i�c� �:�attur c��: �rst ;���rti ��
* These characteristics are not assassed in coastal streams.
2