Please review and answer as many of the questions below as possible to the best of your ability.  If you are not 
sure of how to answer a question, contact division staff for assistance. Please complete this document and request funds in your Strategic Plan by June 1, 2022. 
If you have questions regarding this survey or need more time to complete, please contact Ken Parks at ken.parks@ncagr.gov or (919) 707-3788.
Completing this survey will allow your district to request Impaired/Impacted Funds from the Agriculture Cost Share Program in your annual strategic plan.  Surveys are active for 5 years.
** Completing this survey is voluntary.  Submitted information will help guide resource agency staff to conduct 
further investigation, assessments, identify funding resources, and/or implement remedial actions.***  
Stream Segment Information
Refer to the 303(d) list in the most recent finalized Integrated Water Quality Report. Open the
2020 Integrated Water Quality Report Map in a new tab or window.
If the stream is not on the 303(d) list as Impaired, then select Impacted for Question 12.
12. Is this stream listed as: *
Noted sampling violations:
Refer to the 'Parameter' column in the 303(d) list. *
14. Is there a current active monitoring program on this stream segment? *
15. Does the watershed encompass a Public Water Supply?
Open this map in a new tab or window to see a map of Public Water Supply watersheds. *
16. Is the identified stream a natural stream or a stream modified by human activity? (e.g. channelized) *
Water Quality Concerns
17. Is there an apparent sediment problem in the stream itself or from connected tributaries? *
If yes, is the excessive sedimentation coming from: *
19. Select applicable sources of pollution delivery into the identified stream segment from the upland watershed area: (check all that apply) *
20. Check the items listed below if they appear in this stream: *
What is the typical buffer vegetation (grass, shrubs, trees, etc.): *
22. Select the options below that best describe land use changes in the watershed over the past 5 - 10 years: *

Resource Needs and District Activity

Please give us a sense of the kinds of projects and/or programs which would be most effective at addressing the
most pressing water quality problems.  
This section will be used for basinwide planning and in efforts to secure
grant funding outside of our regular Cost Share Programs, so please be specific.
23.  Describe the extent of the top five existing BMPs implemented in the watershed area within the past 10 years. Include the following information: Name of the BMP (e.g. livestock exclusion, stormwater retention, streamside buffers, etc.), Units/Amount (e.g. 28 acres), Cost ($), and Funding Source (e.g. Farmer-only, ACSP, EQIP, 319, EEG). *
 Name of BMP (e.g. livestock exclusion etc)Units (linear feet etc.)AmountCost ($)Funding Source (e.g. ACSP or EQIP or 319 etc)
24.  Identify up to four recommended actions to address identified problems in the watershed:

If your district does not have four separate recommendations select "Not Applicable" to move forward.
E.g. "Pastureland BMP Implementation" is selected as the first and only recommendation; select "N
ot applicable" for recommendations two through four.
25. For the five BMP categories within the Agriculture Cost Share Program, prioritize the different BMP categories most needed in the watershed to address impairments or impactions and fulfill recommended actions:

If your district does not have five separate BMP category priorities in this watershed, select "Not Applicable" to move forward. E.g. Agrichemical pollution prevention measures is selected as the first and only priority; Not Applicable is selected for priorities 2 - 5.

For a refresher, you can open the list below of ACSP BMPs and their categories in a new tab or window:
https://www.ncagr.gov/SWC/costshareprograms/ACSP/BMPs.html *
 First PrioritySecond PriorityThird PriorityFourth PriorityFifth Priority
Agrichemical Pollution Prevention Measures
Erosion and Nutrient Management Measures
Sediment and Nutrient Management Measures
Stream Protection Management Measures
Waste Management Measures
Not Applicable
26. Identify up to five priority BMPs needed on the impaired or impacted stream segment or within the watershed, identify expected funding sources, and estimate BMP extent and cost.

If outside grants are needed/expected to fund BMP implementation, please either specify the grant program name to be used or type in 'outside grant'.
 Name of BMP (e.g. livestock exclusion etc.)Unit (e.g. linear feet etc.)AmountEstimated Cost ($)Funding Source (e.g. ACSP or EQIP or outside grant etc)
27. Please select the three most significant potential barriers or limiting factors for implementing BMPs and mitigating identified problems in the watershed: *
28.  List up to five resources (other than cost share) needed by your district to address the identified water quality problems. Include the Item (Staff, Equipment, Supplies/Materials, Outside Technical Assistance, etc.), Units/Amount Needed, and Estimated Cost ($).

Item #1       Part-Time Staff                       Hours                                   100                                  $2,000

 Item NameUnitsAmountEstimated Cost ($)
29. To your knowledge, has this watershed received grant funding in the past for agriculture nonpoint source pollution prevention planning or BMP implementation projects? *
30. Is there local interest in working with neighboring districts/counties in pursuing grant funding for cross-county nonpoint source pollution prevention projects in this HUC 12 watershed or at the HUC 10 watershed scale? *
31. Does your district have shovel-ready projects in this watershed in need of additional funding? *
32. Does your district have outstanding ACSP application requests in this watershed? *

Special Watershed Issues

33.  Is there a pipe or drainage ditch that empties into the impaired or impacted stream segment? *
Please specify if a pipe, drainage ditch, or both empties into the stream segment: *
Describe the discharge flow from the pipe (if any):
Rate of flow *
Describe the appearance of pipe flow*
Describe the discharge flow from the ditch (if any):
Rate of flow *
Describe the appearance of ditch flow*
34. Is this watershed covered by an active local watershed management or action plan?

The NC Division of Water Resources keeps limited records of existing local watershed action plans (WAPs) and plans under progress statewide through the WAP mapping application. Records of existing 9-element watershed plans can be found on the DWR supported 9-element plans mapping application. Open links in a new tab or window to review. *
35.  To your knowledge, is this watershed covered by an approved 9-element plan?

This mapping application shows all currently eligible 9-element plans in NC. Open in a new tab or window to review.
9-element plans must be reviewed and approved by the Division of Water Resources or EPA Staff.
Is there local interest in developing an approved 9-element watershed plan for this watershed? *
36. Is this watershed prioritized on your district ACSP ranking form? *

Please send any relevant documentation you are not able to upload to Ken Parks.
Thank you for completing this survey!  
These recommendations will be used to help develop proposals for additional funding through Commission Cost Share Programs, Section 319 grants, Clean Water Management Trust Fund, and other grant sources.  Survey
results will also help the DWR's Basinwide Planning Program in developing basinwide plans and to assist you in
developing watershed plans for your watershed of interest.
Please contact Ken Parks at (919) 707-3788 for assistance as needed or email Ken at ken.parks@ncagr.gov.