20191196 Ver 1_PCN Form Submission (3)_20190910

DWR
MOM— of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Oange only if needed.
BIMS # Assigned * Version#*
20191196 1
Is a payment required for this project?*
r No payment required
r Fee received
Reviewing Office*
r Fee needed - send electronic notification
Central Office - [phone]
Select Project Reviewer*
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Ditch and outfall repair at 1-40 and Millstream Road
1a. Who is the Primary Contact?*
NCDOT Division 7 Division Engineer, Mr. Mike Mills, PE
1b. Primary Contact Email:*
1c. Primary Contact Phone:*
[e-mail]
[phone]
Date Submitted
9/10/2019
Nearest Body of Water
UT to Little Alamance Creek
Basin
Cape Fear
Water Classification
16-19-3-(0.5); WS-IV; NSW
Site Coordinates
Latitude: Longitude:
36.058076-79.642336
AProcessing Information U
County (or Counties) where the project is located:
Guilford
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
WBS # (?)
50455.3.1
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - Express
W Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
C Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
r- Owner rJ Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NC Department of Transportation
2b. Deed book and page no.:
N/A
2c. Responsible party:
2d.Address
Street Address
PO Box14996
Address Line 2
City
State / Frovinre / R�gion
Greensboro
NC
Fbstal / Zip Code
Q�untry
27415
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
*
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NCDOT Division 7 Division Engineer, Mr. Mike Mills, PE
3b. Business Name:
3c.Address
Street Address
PO Box14996
Address Line 2
CKY
Greensboro
Postal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
If appropriate)
1c. Nearest municipality/town:
Greensboro
2. Project Identification
2a. Property Identification Number:
N/A
2c. Project Address
Street Address
Address Line 2
cfty
Postal / Zip Cede
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Little Alamance Creek
3b. Water Resources Classification of nearest receiving water:*
16-19-3-(0.5); WS-IV; NSW
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300020303
4. Project Description and History
State / Frwince / Pagion
NC
Country
USA
3e. Fax Number:
[phone]
2b. Property size:
N/A
State / R'winee / RPogion
Country
4a. 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 existing site conditions include industrial property (i.e. LabCorps, General Dynamics) and their associated parking lots, Interstate 40 to the north and Millstream Road to the south
(Millstream parallels 1-40 eastbound lanes; the project area is in between these two roads) and AT&T Drive (Mich runs north -south) to the east. There is a small amount of undisturbed
forested area within the project boundaries that currently contains a failing/broken concrete flume. The rest of the project is within the maintained right-of-way between Millstream Road
and 1-40.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r^ Yes r No r^ Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Millstream_AT&T_Guilford_USGS.pdf 205.66KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)

Millstream _AT&T _Guilford_Soil.pdf 313.29KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.00
49. List the total estimated linear feet of all existing streams on the property:
-40
4h. Explain the purpose of the proposed project:*
Collapsed pipes under 1-40 resulting in 2 sinkholes have necessitated the need to collect and redirect stormwater into a drainage system that parallels 1-40 and Millstream Road. The
existing drainage systems - which include a grassed swale paralleling 1-40 at grades steeper than 4 % up to 15 % and a concrete flume paralleling Millstream Road (each system drained
their respective roadway drainage) - are failing, unstable and cannot handle any additional stormwater and therefore must be reinstalled.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The Department will flowable fill the failing 24-inch pipe under 1-40 and collect the stormwater in a 30-inch RCP which will run parallel to 1-40 and Millstream Road. This pipe will extend to
the Millstream Road and AT&T Drive crossing. The pipe size and type wt11 then transition to a 36-inch HDPE which will also pick up the existing drainage from an existing 18-inch pipe
under AT&T drive. This will then drop down to a junction box (see attached schematic) which will have a 42-inch HDPE outlet to a rip rap pad at the stream. Please note there is an
existing "cut out" in the stream bank (visible in one of the attached pictures) where all the stormwater has and is currently flowing; the Deparment's goal is to tie into that with as little
disturbance to the stream bottom as is possible. Additionally, a new grassed ditch between 1-40 east bound lanes and Millstream Road Will collect stormwater for approximately 1.3 acres
of pavement, however, the slope will be steeper than 4 % and the Department intends to install rock checks prior to the inlets to slow the water down and provide some treatment.
Equipment to be used includes a track hoe, dump truck, paving equipment and various hand tools, possibly a crane to move construction material such as reinforced bars of steel and
concrete buckets to place concrete
4j. Please upload project drawings for the proposed project.
MillstreamRd_140_plans.pdf 27.14MB
MillstreamRd_140_buffer.pdf 2.65MB
MillstreamRd_140_buffer_con.pdf 2.71 MB
Picture Log.pdf 432.92KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No f Unknown
Comments
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries W Buffers
r Open Waters r Pond Construction
3. Stream Impacts
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name* 3e. Stream Type* �[3f. Typeofh* 3h. Impact
(?) urisdiction* length*
g� Rip rap pad outlet Permanent Rip Rap Fill U`T to Little Alamance Creek Perennial Both 1Ave aqe (feet) 2Qinea feet)

3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
25 0
3i. Total stream and ditch impacts:
25
3j. Comments:
There is an existing "outlet" through the stream bank where stormwater has traditionally (and continues) to flow, the department will add rip rap
stabilization from the outlet of the junction box to tie in with the stream channel. It is the intent to only add enough to insure long term stability and will
not fill the entire channel.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Clh ck all that apply.
r Neuse r Tar -Pamlico
r Catawba r Randleman
r Goose Creek W Jordan Lake
r Other
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
Grading/Fill P UT to Little Alamance Creek No 2,650 2,180
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 2,650.00 2,180.00
Zone 1 Zone 2
Total combined buffer impacts: 2,650.00 2,180.00
61. Comments:
The area was previously impacted when the original stormwater flume was installed. It is currently just outside the "existing transportation facility"
(ETF) as defined. The department will limit tree removal to what is strictly necessary and will revegetate the area post construction (native grasses).
Currently, the area is severely eroded and the bedrock is exposed (i.e. no mature vegetation in that immediate vicinity).
Supporting Documentation
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Collapsed pipes under 1-40 resulting in 2 sinkholes have necessitated the need to collect and redirect stormwater into a drainage system that parallels
1-40 and Millstream Road. The existing drainage systems - which include a grassed swale paralleling 1-40 at grades steeper than 4 % up to 15 % and a
concrete flume paralleling Millstream Road (each system drained their respective roadway drainage) - are failing, unstable and cannot handle any
additional stormwater and therefore must be reinstalled. The Department will flowable fill the failing 24-inch pipe under 1-40 and collect the stormwater
in a 30-inch RCP which will run parallel to 1-40 and Millstream Road. This pipe will extend to the Millstream Road and AT&T Drive crossing. The pipe
size and type will then transition to a 36-inch HDPE which will also pick up the existing drainage from an existing 18-inch pipe under AT&T drive. This
will then drop down to a junction box (see attached schematic) which will have a 42-inch HDPE outlet to a rip rap pad at the stream. Please note there
is an existing "cut out" in the stream bank (visible in one of the attached pictures) where all the stormwater has and is currently flowing; the
Department's goal is to tie into that with as little disturbance to the stream bottom as is possible. Additionally, a new grassed ditch between 1-40 east
bound lanes and Millstream Road will collect stormwater for approximately 1.3 acres of pavement, however, the slope will be steeper than 4 % and the
Department intends to install rock checks prior to the inlets to slowthe water down and provide some treatment.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation BMPs will be installed prior to construction. The outside wetland, stream and riparian areas will be noted with highly visible
fencing. Impacts will be minimized by strict enforcement of Best Management Practices for the protection of surface waters, restrictions against staging
of equipment in or adjacent to waters of the US and coordination (including a pre -construction meeting) with the Division Environmental Office
Supervisor.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
f Yes r No

2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The impacts are below mitigation requirement thresholds.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
• Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments
G. Supplementary Information v
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes
r No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)? *
r Yes
r No
Comments:*
The project falls belowthe SEPA notification thresholds.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes
r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes
r No
3b. If you answered "no," provide a short narrative description.
Per the NC DWQ April 2004 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such as widening projects, bridge
replacements and intersection improvements — have a "low potential for cumulative impact since little (if any) new impervious surface is added and the
projects are usually already in developed locales." This proposed project is within a somewhat developed landscape (i.e. existing residences in the
vicinity), this is not a road on a new location (i.e. there is an existing road and bridge structure and thus the area already contains impervious
surfaces) and the project drains to Little Alamance Creek, which is Class WS-IV; Nutrient Sensitive Waters (NSW), (i.e. not HOW or ORW). We
anticipate the NCDWR will advise us if a qualitative or quantitative analysis is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes
r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*

r Yes (- No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No r Unknown
Se. Is this a DOT project located within Division's 1-8?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPAC and field investigation.
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
This project takes place in Guilford County which not near any coastal habitat that would support EFH (i.e. salt marshes, oyster reefs, etc.)
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
SHPO web map viewer.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
NCDOT MCA
8c. What source(s) did you use to make the floodplain determination?*
NC FRIS Maps
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
W By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
James Michael Mills
Signature
6—#L�A44,4"
Date
9/10/2019