Bridge 790155 PJD Request_110518

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STATE OF NORTH CAROLINA
DEPART'MENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
November 5, 2018
Mr. Bryan Roden-Reynolds
Asheville Regulatory Field Office
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801
RE: Request for Preliminary Jurisdictional Determination
Bridge Number 790155
Rowan County, NC
Dear Mr. Roden-Reynolds;
JAMES H. TROGDON, III
SECRETARY
Carolina Ecosystems, Inc. (CEI) has completed a delineation of streams and wetlands for Bridge
155 in Rowan County, NC. The attached information, including required forms, tables, and
figures, is submitted for your review and determination of jurisdiction under the Clean Water Act
(CWA).
Project Description & Methodology
As shown in Figure 1, Bridge 790155 is located in Salisbury, NC within the Yadkin Pee-Dee
River Basin (USGS HUC 03040103). This delineation was performed in compliance with
methodology set forth in the U.S. Army Corps of Engineers (USACE) Wetland Delineation
Manual (USACE 1987) and subsequent guidance including the Eastern Mountains and Piedmont
Regional Supplement. Streams were assessed for jurisdiction under the Clean Water Act using
field indications of ordinary high-water mark and the NC Division of Water Quality (NCDWQ)
Stream Identification Form Version 4.11.
Delineation Results
Figure 2 is presented using the Gold Hill (2013) US Geological Survey 1:24,000 Quadrangle
Map. Figure 3 presents the results of the delineation, including four wetlands and one stream.
The table in Appendix 2, Section E presents detailed information on each aquatic resource within
the study area, including latitude/longitude, estimated amount and type of aquatic resource in the
review area, and geographic authority to which the resource may be subject. Based on field data,
Mailing Address: Telephone: [phone] Location:
NC Department of Transportation Fax: [phone] Silas Creek Pazkway
Highway Division 9 Website: www.ncdot.gov Winston Salem, 27127
375 Silas Creek Pazkway
Winston Salem, 27127

Bridge Number 790155
November 5, 2018
Page 2
there is approximately 0.67 acre of wetland, and 249 linear feet of perennial stream in the study
area.
We respectfully request your review of this information so that a preliminary jurisdictional
determination under the CWA may be obtained. 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,
Amy DiqitallysignedbyAmyEuliss
DN: rn=Amy Euliss, o,
ou=NCDOT Division 9,
mai I=aeuliss@ncdotgov,
E u I I S S Date: 2018.11.0814:40:19
-OS'00'
Amy Euliss
NCDOT Division 9 Environmental Officer
Attachments:
- Jurisdictional Determination (JD) Request Form
- Preliminary Jurisdictional Determination Form
- Figure 1: Vicinity map
- Figure 2: USGS map
- Figure 3: Jurisdictional Features map
- Wetland Data Forms
CC: Phil May, Carolina Ecosystems, Inc.
CC: Dave Wanucha, NCDWR
CC: Richard Bollinger, RS&H

urisdictional Determination ReQuest
US Army Corps
of Engineers
Wllhninr�, ton O�iStnCd
This form is intended for use by anyone rec�uesting a jurisdictional detei-mination (JD) from the
U.S. Anny Corps of Engineers, Wihnington District (Coi-ps). Please include all supporting
information, as described within each category, with your request. You may submit your request
via mail, elech-onic �nail, or facsi�nile. Requests should be sent to the appropriate project
manager of the county in which the property is located. A current list of project managers by
assigned counties can be fouild on-line at:
littp://www.saw.usace.ai�ny.mil/Missions/ReaulatoiyPei�nitPrograin/Contact/CotultyLocator.aspx,
by calling 9l 0-251-4633, or by contacting any of the field offices listed below. Once your
request is received you will be contacted by a Corps project manager.
ASHEVILLE & CI�ARI.OT"I`E REGULATORY
FIELD OFFICES
US Ai�i�y Corps of Enginccrs
I 51 Patton Avenue, Room 208
Ashcvillc, Nortl� Carolina28801-5006
GeueralN�imber: [phone]
I'ax Nui��ber: [phone]
RALEIGH REGULATORY 1�'IELD OFFICE
US Anuy Co�ps aF Engineers
3331 Hcritagc Tradc Drive, Suitc 105
Wake Forest, Nortli Carolina 27587
Gcncral Numbcr: (919 ) 554-4884
Fax Number: [phone]
1NSTRUCTIONS:
WASHINGTON REGULATORY P'IELD OFFICE
US /�rmy Corps of Enginccrs
2407 West Fifth Street
Washington, North Carolina 27889
General Nurnber: [phone]
Fax Numbcr: [phone]
WILNIINGTON R�GULATORY FIELD OFFICE
US Arnry Corps of Engineers
69 Darlinaton Avei�ue
WilmingYon, Noril� Carolina 28403
Gcneral Number: 910-25 I -4633
Fax Number: [phone]
All requestors must complete Parts A, B, C, D, E, F and G.
NOTE TO CONSULTANTS AND AGENCIES: If you are requesting a JD on behalf of a
paying client or your agency, please note the specific subinittal requirements in Part H.
NOTE ON PART D— PROPERTY OWNER AUTHORIZATION: Please be aware that
all JD requests �nust i��clLide tlle current propet-ty ovv��er authorization for the Coips to
proceed with the detei-mination, which may iilclude inspection of the propei-ty when
necessary. This fonn ��nust be signed by the curt-ent pl-operty owner(s) oi�- the owner(s)
authorized agent to be considered a complete request.
NOTE ON PART D- NCDOT REQUESTS: Property owner authorization/notification for
JD requests associated with North Carolina Departme��t of Transportation (NCDOT)
projects will be conducted according to the clu-�ent NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICiPANTS: A Corps approved oi- preliminary JD
inay not be valid for the wetland conservation p�-ovisions of the Food SecLirity Act of
1985. If you or your tenant are USDA Program pai-ticipants, or anticipate participation in
USDA programs, you should also request a certitied wetland determination from the local
office of the Natural Resources Consei-vation Service, prior to starting work.
Version: May 2017 Page 1

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address: MUltlple pal"CeIS; See vicinity ma
City, State: Salisbu�-y, NC
County: ROWaII
Parcel Index Number(s) (PIN): C39OOZ,5060050000003,639036
B. REQUESTOR INFORMATION
Name: Amy Euliss, NCDOT
Mailing address: 375 Silas Creek Parkway
Winston-Salem, NC 27127
Telephone Number: (336� 747-7800
Electronic Mail Address: [e-mail]
Select one:
� I am the current property owner.
� I am an Authorized Agent or Environmental Consultantl
� Interested Buyer or Under Contract to Purchase
� Other, please explain. NCDOT PYOjeCt
C. PROPERTY OWNER INFORMATIONZ
Name: N/A
Mailing Address: N/A
N/A
Telephone Number: N/A
Electronic Mail Address: N/A
1 Must provide completed Agent Authorization Form/Letter.
2 Documentation of ownership also needs to be provided with request (copy of Deed, County GIS/Parcel/Tax Record).
Version: May 2017 Page 2

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION3,a
By signing below, I 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, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Print Name
Capacity: ❑ Owner ❑ Authorized AgentS
Date
Signature
E. REASON FOR JD REQUEST: (Check as many as applicable)
� I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
� I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
� I intend to construct/develop a project or perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
� I intend to construct/develop a project or perform activities in a navigable water of the
U.S. which is included on the district Section lO list and/or is subject to the ebb and flow of
the tide.
� A Corps JD is required in order obtain my local/state authorization.
� I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
� I believe that the site may be comprised entirely of dry land.
Q Other: NCDOT Prolect
For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

F.
�
�❑
�
G.
�
Jurisdictional Determination Request
JURISDICTIONAL DETERMINATION (JD) TYPE (Select One)
I am requesting that the Corps provide a preliminarX JD for the property identified herein.
A Preliminary Jurisdictional Determination (PJD) provides an indication that there may
be "waters of the United States" or "navigable waters of the United States"on a property.
PJDs are sufficient as the basis for permit decisions. For the purposes of permitting, all
waters and wetlands on the property will be treated as if they are jurisdictional "waters of
the United States". PJDs cannot be appealed (33 C.F.R. 331.2); however, a PJD is
"preliminary" in the sense that an approved JD can be requested at any time. PJDs do
not expire.
I am requesting that the Corps provide an approved JD for the property identified herein.
An Approved Jurisdictional Determination (AJD) is a determination that
jurisdictional "waters of the United States" or "navigable waters of the United
States" are either present or absent on a site. An approved JD identifies the limits of
waters on a site determined to be jurisdictional under the Clean Water Act and/or
Rivers and Harbors Act. Approved JDs are sufficient as the basis for permit
decisions. AJDs are appealable (33 C.F.R. 331.2). The results of the AJD will be
posted on the Corps website. A landowner, permit applicant, or other "affected
party" (33 C.F.R. 331.2) who receives an AJD may rely upon the AJD for five years
(subject to certain limited exceptions explained in Regulatory Guidance Letter OS-
02).
I am unclear as to which JD I would like to request and require additional infortnation
to inform my decision.
ALL REQUESTS
Map of Property or Project Area. This Map must clearly depict the boundaries of the
review area.
✓❑ Size of Property or Review Area 5• 3 acres.
❑ The property boundary (or review area boundary) is clearly physically marked on the site.
Version: May 2017 Page 4

Jurisdictional Determination Request
H. REQUESTS FROM CONSULTANTS
� Project Coordinates (Decimal Degrees): Latitude: 35.5949
Longitude: -80.3527
� A legible delineation map depicting the aquatic resources and the property/review area.
Delineation maps must be no larger than l 1x17 and should contain the following: (Corps
signature of submitted survey plats will occur after the submitted delineation map has been
reviewed and approved).6
■ North Arrow
■ Graphical Scale
■ Boundary of Review Area
■ Date
■ Location of data points for each Wetland Determination Data Form or tributary
assessment reach.
For A�roved Jurisdictional Determinations:
■ Jurisdictional wetland features should be labeled as Wetland Waters of the US, 404
wetlands, etc. Please include the acreage of these features.
■ Jurisdictional non-wetland features (i.e. tidal/navigable waters, tributaries,
impoundments) should be labeled as Non-Wetland Waters of the US, stream, tributary,
open water, relatively permanent water, pond, etc. Please include the acreage or linear
length of each of these features as appropriate.
■ Isolated waters, waters that lack a significant nexus to navigable waters, or non-
jurisdictional upland features should be identified as Non-Jurisdictional. Please
include a justification in the label regarding why the feature is non jurisdictional (i.e.
"Isolated", "No Significant Nexus", or "Upland Feature"). Please include the acreage
or linear length of these features as appropriate.
For Preliminarv Jurisdictional Determinations:
Wetland and non-wetland features should not be identified as Jurisdictional, 404,
Waters of the United States, or anything that implies jurisdiction. These features can be
identified as Potential Waters of the United States, Potential Non-wetland Waters of
the United States, wetland, stream, open water, etc. Please include the acreage and
linear length of these features as appropriate.
aCompleted Wetland Determination Data Forms for appropriate region
(at least one wetland and one upland form needs to be completed for each wetland type)
6 Please refer to the guidance document titled "Survey Standards for Jurisdictional Determinations" to ensure that the
supplied map meets the necessary mapping standards. http://www.saw.usace.army.miUMissions/Re u,g latory-Permit-
Pro,gram/Juri sdiction/
Version: May 2017 Page 5

a
✓❑
✓❑
�
❑
Jurisdictional Determination Request
Completed appropriate Jurisdictional Determination form
PJDs, please complete a Preliminary Jurisdictional Determination Form' and include the
Aquatic Resource Table
AJDS, please complete an Auuroved Jurisdictional Determination Formg
Vicinity Map
Aerial Photograph
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)
� Landscape Photos (if taken)
� NCSAM and/or NCWAM Assessment Forms and Rating Sheets
� NC Division of Water Resources Stream Identification Forms
� Other Assessment Forms
� www.saw.usace.army.mil/Portals/59/docs/re u,g lato .r�gdocs/JD/RGL 08-02_A�_A_Prelim JD_Form fillable.pdf
g Please see http://www.saw.usace.army.mil/Missions/Re u� latorv-Permit-Program/Jurisdiction/
Principal Purpose: The information that you provide will be used in evaluating your request to determine
whether there are any aquatic resources within the project area subject to federal jurisdiction under the regulatory
authorities referenced above.
Routine Uses: This information may be shared with the Department of Justice and other federal, state, and local
government agencies, and the public, and may be made a�ailable as part of a public notice as required by federal
law. Your name and property location where federal jurisdiction is to be determined will be included in the
approved jurisdictional determination (AJD), which will be made available to the public on the District's website
and on the Headquarters USAGE website.
Disclosure: Submission of requested information is voluntary; however, if information is not provided, the
request for an AJD cannot be evaluated nor can an AJD be issued.
Version: May 2017 Page 6

Appendix 2- PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD:
B. NAME AND ADDRESS OF PERSON REQUESTING PJD. AmyEuliss,EnvironmentalSupervisor,NCDOTDiv9,9357SilasCreekPkwy,Winston-Salem,27127
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: nJ.0 County/parish/borough: ROWaCI c�ty: Salisbury
Center coordinates of site (lat/long in degree decimal format):
�at.: 35.5949 �ong.: -80.3527
Universal Transverse Mercator:
Name of nearest waterbody: High Rock Lake
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site Latitude Longitude Estimated amount Type of aquatic Geographic authority
number (decimal (decimal of aquatic resource resource (i.e., wetland to which the aquatic
degrees) degrees) in review area vs. non-wetland resource "may be"
(acreage and linear waters) subject (i.e., Section
feet, if applicable) 404 or Section 10/404)
WA 35.5950 -80.3530 0.15 acre Wetland SeCtion 404
WB 35.5952 -80.3526 0.11 acre Wetland Section 404
WC 35.5948 -80.3523 0.20 aCre Wetland Section 404
WD 35.5947 -80.3530 0.21 acre Wetland Section 404
SA 35.5948 -80.3528 249 linear feet Non-wetland water Section 404

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
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 AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) 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) 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) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicanYs acceptance
of the use of the PJD; (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 PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives 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 AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, 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. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be"waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
�■ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:Vicinity Map
� Data sheets prepared/submitted by or on behalf of the PJD requestor.
� Office concurs with data sheets/delineation report.
� Office does not concur with data sheets/delineation report. Rationale:
❑ 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: Gold Hill (2013) 1:24K
� 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 Geodetic Vertical Datum of 1929)
�■ Photographs: �■ Aerial (Name & Date): 2014 NC Statewide Aerial Photography
or � Other (Name & Date):
� Previous determination(s). File no. and date of response letter:
� Other information (please specify):
IMPORTANT NOTE: The information recorded on this form has not necessarilv
been verified bv the Corps and should not be relied upon for later iurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Digitally signed by Amy Euliss
A m y E u I i s s DN: cn=Amy Euliss, o, ou=NCDOT
Division 9,
email=[e-mail], c=US
Date: 2018.11.08 14:41:00 -OS'00'
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
' Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

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Lat: 35.5948 / Long: -80.3524
Project Location:
Rowan County
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Q Study Area
USGS Named Streams
Replace Bridge 155 over
UT to High Rock Lake
Rowan County, NC
Figure 1: Vicinity Map

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Map Date: November 2018
Revised:
Revised:
Revised:
�
Replace Bridge 155 Over UT
to High Rock Lake
Rowan Countv, NC
Figure 2: U5GS Map

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, aoRTH � Re lace Brid e155 Over UT
��oe cqqo N Map Date: November 2018 P g
Q Study Area
/ 2� to High Rock Lake
�y ��� Feet �i Perennial Stream Revised: Rowan County, NC
�\�� Q�P� 0 75 150 Wetlands Revised: Figure 3: Jurisdictional
FtiroFTapNye�� FQatUiOS Map
— = 2014 NC Statewide Aerial Photography Revised:

1����
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
ProjecUSite: � \ City/County: ,�'� Sampling Date:��
ApplicanUOwner: C State: �� Sampling Point: 1N O
Investigator(s): •� �C � Section, Township, Range:
Landform (hiilslope, terrace, etc.): ``(� C� Local relief (concave, convex, none): N����✓ Slope (%). �
Subregion (LRR or MLRA): ���(1 Lat: ,��. S°l�{� Long: '� U.�`> L��" �p Datum.��j� �l
Soil Map Unit Name: �' �OGt z NWI classificaGon: �r C%
Are climatic / hydrologic conditions on the site typical for this time of year? Yes No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed?NO Are "Normal Circumstances" present? Yes V No
Are Vegetation . Soil , or Hydrology naturally problematic? �� (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS - Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present?
Hydric Soil Present?
Wetland Hydrology Present?
Fu�,� c,�;o rr�;�P;rr,}S
HYDROLOGY
Yes� No
Yes No
Yes � No
�n/A , � r$, �r L �C tN c-�
Is the Sampled Area
within a Wetland? Yes No
Wetland Hydrology Indicators: Secondarv Indicators (minimum of two required)
Prima Indicators minimum of one is re uired• check all that a I _ Surtace Soil Cracks (66)
Surtace Water (A1) True Aquatic Plants (614) _ Sparsely Vegetated Concave Surtace (B8)
�High Water Table (A2) _ Hydrogen Sulfide Odor (C1) Drainage Patterns (B10)
� Saturation (A3) _ Oxidized Rhizospheres on Living Roots (C3) �Moss Trim Lines (B16)
_ Water Marks (61) _ Presence of Reduced Iron (C4) _ Dry-Season Water Table (C2)
_ Sediment Deposits (62) _ Recent Iron Reduction in Tilled Soils (C6) _ Cra�sh Burrows (C8)
_ Drift Deposits (B3) _ Thin Muck Surtace (C7) _ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (B4) _ Other (Explain in Remarks) —�Stunted or SVessed Plants (D1)
_ Iron Deposits (65) ✓ Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (67) _ Shallow Aquitard (D3)
✓ Water-Stained Leaves (69) Microtopographic Relief (D4)
_ Aquatic Fauna (B13) � FAC-NeuVal Test (D5)
Field Observations: � /
Surtace Water Present? Yes No v Depth (inches):
Water Table Present? Yes � No Depth (inches):�_ /
Saturation Present? Yes �� No Depth (inches): � Wetland Hydrology Present? Yes v No
includes ca illa frin e
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks: SI � e � � '
vc..�
US Army Corps of Engineers Easiern Mountains and Piedmont – Version 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
Absolute Dominant
Tree Stratum (Plot size: � Z �) % Cover S eci s?
1. N ^ � �
2. _�D
�
5.
6.
7.
�= Total Cover /
50% of total cov r: �� 20% of total cover: �\Q
Sa lin /Shrub Stratum (Plot size: � �� /
,. -�,,20�����. c r,,te.�l2� �� ✓ �
7
�� = Total Cover �
50% of �tq{tal cover: � 20% of total cover:
Herb Stratum (Plot size: \ �C.-1 )
1.
11
= Total Cover
50% of total cov r: 20% of total cover:
Woodv Vine Stratum (Plot size: � �1 � . )
1.
2.
3.
4.
5.
= Total Cover
50% of total cover: 20% of total cover:
Remarks: (InGude photo numbers here or on a separate sheet.)
Sampling Point:
(,Jb w2.-!c-
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: �- (A)
Total Number of Dominant 3
Species Across All Strata: (B)
Percent of Dominant Species
That Are OBL, FACW, or FAC: I��/0 (q/g�
Prevalence Index worksheet:
Total % Cover of: Multi�lv bv:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
UPL species x 5 =
Column Totals: (A) (B)
Prevalencelndex = B/A =
Hydrophytic VegeWtion Indicators:
Rapid Test for Hydrophytic Vegetation
_ 2 - Dominance Test is >50%
3- Prevalence Index is 53.0'
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Tree - Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub - Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft(1
m) tall.
Herb - All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine - All woody vines greater than 3.28 ft in
Hydrophytic
Vegetation
Present? Yes No
US Army Corps of Engineers Eastem Mountains and Piedmont - Version 2.0

SOIL
���
Samplinq Point:
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.)
Depth Matrix Redox Features
(inchesl Color (moist) % Color (moist) % Tvoe Loc Texture Remarks
5_ IZ-�� 2- � Z�� \ � C��-
� � ��
'T e: C=Concentration, D=De letion, RM=Reduced Matrix, MS=Masked Sand Grains. ZLocation: PL=Pore Linin , M=Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
_ Histosol (A1) _ Dark Surface (S7) _ 2 cm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2) _ Polyvalue Below Surface (S8) (MLRA 147, 148) _ Coast Prairie Redox (A16)
_ Black Histic (A3) _ Thin Dark SutFace (S9) �(MLRA 147, 148) (MLRA 147, 148)
_ Hydrogen Sulfide (A4) Loamy Gleyed Matrix (F2) Piedmont Floodplain Soils (F19)
_ Stratified Layers (A5) � Depleted Matrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N) _ Redox Dark Surface (F6) _ Very Shallow Dark Surface (TF12)
_ Depleted Below Dark Surtace (A11) _ Depleted Dark Surface (F7) _ Other (Explain in Remarks)
_ Thick Dark Surtace (Al2) _ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N, _ Iron-Manganese Masses (F12) (LRR N,
MLRA 147, 148) MLRA 136)
_ Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122) 3lndicators of hydrophytic vegetation and
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
_ Stripped Matrix (S6) Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic.
Restrictive Layer (if observed�:
Type:
Depth (inches): Hydric Soil Present? Yes V No
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

ProjecUSite: �^,
ApplicanUOwner:
WETLAND DETERMINATION DATA FORM - Eastern Mountains and Piedmont Region
Sampling Date:_\ \` 2 � � �-
_ Sampling Point:_�/ ".�s`�L
Investigator(s): "1 • l' . L� �' Section, Township, Range:
Landform (hillslope, terrace, etcJ: I � Local relief (concave, convex, none): ��1� Slope (%):�S
Subregion (LRR or MLRA): �� 3� �at: 35 . Sy�!D Long: � c��D. 352 % Datum:—�,�\��y
Soil Map UnitName: CI� /"�' CI,r�_�._t �� ��Yit NWI classification:
Are climatic / hydrologic conditions on the site typical for this time of year? Yes ✓ No (If no, explain in Remarks.)
Are Vegetation , Soil , or Hydrology significantly disturbed?�� Are "Normal Circumstances" present? Yes V No
Are Vegetation . Soil , or Hydrology naturally problematic?N� (If needed, explain any answers in Remarks.)
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vegetation Present? Yes d No—y— Is the Sampled Area �
Hydric Soil Present? Yes No ✓ Within a Wetland? Yes No
Wetland Hydrology Present? Yes No�
Foi,.,.., a,;,� .rr�,���.£�:F� wA� �f��'�'��^/C WC�-
HYDROLOGY
Wetland Hydrology Indicators: Secondarv Indicators (minimum of two requiredl
Primarv Indicators (minimum of one is required: check all that apply) _ SurFace Soil Cracks (B6)
_ Surface Water (A1) _ True Aquatic Plants (B14) _ Sparsely Vegetated Concave Surtace (68)
_ High Water Table (A2) _ Hydrogen Sulfide Odor (C1) _ Drainage Patterns (B10)
_ Saturation (A3) _ Oxidized Rhizospheres on Living Roots (C3) _ Moss Trim Lines (B16)
_ Water Marks (61) _ Presence of Reduced Iron (C4) _ Dry-Season Water Table (C2)
_ Sediment Deposits (62) _ Recent Iron Reduction in Tilled Soils (C6) _ Cra�sh Burrows (C8)
_ Drift Deposits (B3) _ Thin Muck Surface (C7) _ Saturation Visible on Aerial Imagery (C9)
_ Algal Mat or Crust (B4) _ Other (Explain in Remarks) _ Stunted or SVessed Plants (D1)
_ Iron Deposits (B5) _ Geomorphic Position (D2)
_ Inundation Visible on Aerial Imagery (B7) _ Shallow Aquitard (D3)
_ Water-Stained Leaves (B9) _ Microtopographic Relief (D4)
_ Aquatic Fauna (B13) _ FAC-Neutral Test (D5)
Field Observations:
Surface Water Present? Yes No � Depth (inches):
Water Table Present? Yes No Depth (inches):
Saturation Present? Yes No Depth (inches): Wetland Hydrology Present? Yes No�
(includes ca illa frin e)
Describe Recorded Data (stream gauge, monitoring well, aerial photos, previous inspections), if available:
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

VEGETATION (Four Strata) — Use scientific names of plants.
�O�
(Plot size:
,
2
°/a Cover S eci s? S�tatus
J �
� �
� ��
� � rr'�-
7.
�� = Total Cover
50% of total cover: � 20% of total cover:��
�
Sa in /Shrub Stratum (Plot size:
,. ��p�\�.ra r'4��� 2O _� �'(-�C
7
�� = Total Cover
� 50% of total cover: _�� 20% of total cover: 1'�' _
Her Stratum (Plot size: S R �. � 1 / 'l
1. t�� ) \� V ��IC.V
2. � � -' c�
3.
4.
7
11.
�= Total Cover �
50% of total cover: �� 20% of total cover:
Wood Vi e Stratum (Plot size: )
1.
2.
3.
4.
5. — .
= Total Cover
50% of total cover: 20% of total cover:
or on a separate sheet.)
Sampling
Dominance Test worksheet:
Number of Dominant Species
That Are OBL, FACW, or FAC: (A)
Total Number of Dominant �
Species Across AII Strata: (B)
Percent of Dominant Species '� � AJ
That Are OBL, FACW, or FAC: �(A/B)
Prevalence Index worksheet:
Total % Cover of: Multi�lv bv:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
UPL species x 5 =
Column Totals: (A) (B)
Prevalence Index = B/A =
Hydrophytic Vegetation Indicators:
�/1 - Rapid Test for Hydrophytic Vegetation
J 2- Dominance Test is >50%
3- Prevalence Index is 53.0'
_ 4 - Morphological Adaptations' (Provide supporting
data in Remarks or on a separate sheet)
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed or problematic.
Definitions of Four Vegetation StraW:
Tree — Woody plants, excluding vines, 3 in. (7.6 cm) or
more in diameter at breast height (DBH), regardless of
height.
Sapling/Shrub — Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3.28 ft(1
m) tall.
Herb — All herbaceous (non-woody) plants, regardless
of size, and woody plants less than 3.28 ft tall.
Woody vine — All woody vines greater than 3.28 ft in
Hydrophytic
Vegetation
Present� Yes No
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

SOIL
Sampling Point: L/�� \ y�)
Profile Description: (Describe to the depth needed to document the indicator or confrm the absence of indicators.)
Depth Matrix Redox Features
(inches) Color (moisU % Color (moistl % Tv�e Loc Texture Remarks
� � 3 � -- - ` ��
I_ 1� ,_.�
'T e: C=Concentration, D=De letion, RM=Reduced Matrix, MS=Masked Sand Grains. ZLocation: PL=Pore Linin , M=Matrix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils':
_ Histosol (A1) _ Dark Surtace (S7) _ 2 cm Muck (A10) (MLRA 147)
_ Histic Epipedon (A2) _ Polyvalue Below Surtace (S8) (MLRA 147, 148) _ Coast Prairie Redox (A16)
_ Black Histic (A3) _ Thin Dark Surtace (S9) (MLRA 747, 748) (MLRA 147, 148)
_ Hydrogen Sulfide (A4) _ Loamy Gleyed Matrix (F2) _ Piedmont Floodplain Soils (F19)
Stratified Layers (A5) _ Depleted Matrix (F3) (MLRA 136, 147)
_ 2 cm Muck (A10) (LRR N) _ Redox Dark Surtace (F6) _ Very Shallow Dark SurFace (TF12)
_ Depleted Below Dark Surtace (A11) _ Depleted Dark Surface (F7) _ Other (Explain in Remarks)
_ Thick Dark Surface (Al2) _ Redox Depressions (F8)
_ Sandy Mucky Mineral (S1) (LRR N, _ Iron-Manganese Masses (F12) (LRR N,
MLRA 147, 148) MLRA 136)
_ Sandy Gleyed Matrix (S4) _ Umbric Surface (F13) (MLRA 136, 122) 3lndicators of hydrophytic vegetation and
_ Sandy Redox (S5) _ Piedmont Floodplain Soils (F19) (MLRA 148) wetland hydrology must be present,
Stripped Matrix (S6) Red Parent Material (F21) (MLRA 127, 147) unless disturbed or problematic.
Restrictive Layer (if observed):
Type:
Depth (inches): Hydric Soil Present? Yes No �
Remarks:
US Army Corps of Engineers Eastern Mountains and Piedmont — Version 2.0

i�� � �, �� , ��
WETLAND RATING WORKSHEET Fourth Version
Project Name �►' ����P, � SS Nearest Road �i �, n� l� o c, �
County �o �i��'3 Wetland area �. L 1 acres Wetland width �% feet
Name of evaluator 3� 1�� -�!� ;
We land location
on pond or lake
_ on perennial stream
_ on intermittent stream
_ within interstream divide
other:
Soil series•
_ predominantly organic - humus, muck, or
/peat
✓ predominantly mineral - non-sandy
_ predominantly sandy
Hydraulic factors
_ steep topography
_ ditched or channelized
_ total wetland width > 100 feet
Date C)3/ZD��c?t
Adjacent land use
(within %2 mile upstream, upslope, or radius)
'� forested/natural vegetation �5 %
�;agriculture, urban/suburban �%
� impervious surface �%
Dominant vegetation
(1) �rG,�.�r,ut ��;,ns.�l u� .� � ��,
(2� �� *t„�.. �1; �, � �
�3) �G.n;n.u's fa�n6�/i i�.�1�.
Flooding and wetness
semipermanently to permanently flooded or
/inundated
✓ seasonally flooded or inundated
_ intermittently flooded or temporary surface water
_ no evidence of flooding or surface water
Wetland type (select one)*
� Bottomland hardwood forest Pine savanna
Headwater forest Freshwater marsh
Swamp forest Bog/fen
_ Wet flat _ Ephemeral wetland
_ Pocosin _ Carolina bay
_ Bog forest _ Other:
" The rating system cannot be applied to salt or brackish marshes or stream channels
R Water storage 3 x 4.00 = I Z
A Bank/Shoreline stabilization 1--� x 4.00 =� wetland
T Pollutant removal c. ** � rating
x 5.00 = Z
I Wildlife habitat Z x 2.00 = 0
�°�
N Aquatic life value �- x 4.00 = r 6
G Recreation/Education � x 1.00 = 0
** Add 1 point if in sensitive watershed and >10% nonpoint source disturbance within 'h mile upstream, upslope, or radius